Non-malignant respiratory disease among workers in industries using styrene-A review of the evidence

Asthma and obliterative bronchiolitis (OB) cases have occurred among styrene-exposed workers. The aim of this study was to investigate styrene as a risk factor for non-malignant respiratory disease (NMRD). From a literature review, the authors identified case reports and assessed cross-sectional and mortality studies for strength of evidence of positive association (i.e., strong, intermediate, suggestive, none) between styrene exposure and NMRD-related morbidity and mortality. Fifty-five articles and two unpublished case reports were analysed. Ten OB cases and eight asthma cases were identified. Six (75%) asthma cases had abnormal styrene inhalation challenges. Thirteen (87%) of 15 cross-sectional studies and 12 (50%) of 24 mortality studies provided at least suggestive evidence that styrene was associated with NMRD-related morbidity or mortality. Six (66%) of nine mortality studies assessing chronic obstructive pulmonary disease-related mortality indicated excess mortality. The authors concluded that available evidence suggests styrene exposure is a potential risk factor for NMRD. Additional studies of styrene-exposed workers are warranted.

Authors: Nett RJ, Cox-Ganser JM, Hubbs AF, Ruder AM, Cummings KJ, Huang YT, Kreiss K. ;Full Source: American Journal of Industrial Medicine. 2017 Feb;60(2):163-180. doi: 10.1002/ajim.22655. ;