Treatment of the survivors from the Nagoya air crash

Sixteen multiparous nonpregnant lactating Holstein cows (each weighing 662 +/- 65 kg in 150.4 +/- 40 day of lactation) were confined to wooden metabolic cages with 12:12 h light:dark cycle during the experiment. The cows were divided into two sequences of eight cows each and exposed to electric and magnetic fields (EMF) in an exposure chamber. This chamber produced a vertical electric field of 10 kV/m and a uniform horizontal magnetic field of 30 microT at 60 Hz. One sequence was exposed for three estrous cycles of 24 to 27 days. During the first estrous cycle, the electric and magnetic fields were off; during the second estrous cycle, they were on; and during the third estrous cycle, they were off. The second sequence was also exposed for three 24 to 26 days estrous cycles, but the exposure to the fields was reversed (first estrous cycle, on; second estrous cycle, off; third estrous cycle, on). The length of each exposure period (21 to 27 days) varied according to the estrous cycle length. No differences were detected in plasma progesterone concentrations and area under the progesterone curve during estrous cycles between EMF nonexposed and exposed periods (2.28 +/- 0.17 and 2.25 +/- 0.17; and 24.5 +/- 1.9 vs. 26.4 +/- 1.9 ng/ml, respectively). However, estrous cycle length, determined by the presence of a functional corpus luteum detected by concentrations of progesterone equal to or more than 1 ng/ml plasma, was shorter in nonexposed cows than when they were exposed to EMF (22.0 +/- 0.9 vs. 25.3 +/- 1.4 days).     

Detection of 8-hydroxydeoxyguanosine, a marker of oxidative DNA damage, in white blood cells of workers occupationally exposed to styrene

Styrene-7,8-oxide (SO), the major in vivo metabolite of styrene, is a genotoxic compound and a potential carcinogenic hazard to occupationally exposed workers. The aim of the present work was to investigate the ability of styrene exposure to induce formation of 8-hydroxy-2'-deoxyguanosine (8-OHdG) in white blood cells (WBC) of boatbuilders occupationally exposed to styrene. The study of these adducts was conducted to see if styrene exposure can cause oxidative damage of DNA. The 8-OHdG/10(5) dG ratio from 17 styrene-exposed workers showed significant increases (mean +/- SD, 2.23 +/- 0.54, median 2.35, P < 0.001) in comparison to the controls (1.52 +/- 0.45, median 1.50). However, 11 out of 17 workers who were between the ages of 32 and 60 years and had been occupationally exposed to styrene for > 10 years showed higher 8-OHdG/10(5) dG ratios (2.31 +/- 0.62, median 2.37) in comparison to 6 workers with < 6 years of occupational styrene-exposure (2.11 +/- 0.36, median 2.05; P > 0.05, no significant difference between the two groups of workers). The studies presented here provide an indication that styrene exposure can result in oxidative DNA damage.     

Neurotic disturbances, depression and anxiety disorders in the population living in the vicinity of overhead high-voltage transmission line 400 kV. Epidemiological pilot study

Numerous reports suggest a relationship between the increased incidence of depressive and neurotic symptoms in humans and the exposure to extremely low frequency electromagnetic field (EMF) at the place of residence. Our study was conducted in one of the Cracow suburbs with low socio-economic status, adjacent to an easement containing two 400 kV high-voltage transmission lines (distance up to 50 m from the line). The population investigated comprised 70 persons (35 males and 35 females). This group was exposed to EMF from 1986. A control group (n = 37), non-exposed to EMF, was also tested. The EMF intensity was measured by special devices. The following assessments instruments were used: Anamnestic Data Questionnaire, Neurotic Symptoms Questionnaire "O" Spielberger Self-Rating Questionnaire, and Beck-Self-Rating Scale. The measurements of the electric field levels taken at the front walls of investigated buildings averaged much higher than normal values of safety exposure. Our investigation showed the increased psychopathological values in all clinical tests. The difference between the group exposed to EMF and the control population was statistically significant. The results of our study did not support a possible cause-and-effect relationship between EMF and psychopathology observed. Some other factors (noise) can be responsible for the data obtained. The hypothesis that EMF produced by external electric power lines may enhance the occurrence of neurotic symptoms and depression, requires further clinical and experimental investigations.     

Improvement in word-fluency performance in patients with multiple sclerosis by electromagnetic fields

Impairment of cognitive functions is well recognized in patients diagnosed with multiple sclerosis (MS), especially those with a chronic progressive course. In fact, MS has been considered a type of "subcortical dementia" in which cognitive and behavioral abnormalities resemble those observed in patients with frontal lobe syndrome. Patients with frontal lobe syndrome are known to exhibit diverse cognitive and behavioral abnormalities which include, among others, diminished spontaneity of speech with difficulties producing appropriate words and phrases. It has been reported recently that extracranial application of extremely weak electromagnetic fields (EMF) in the picotesla range produced improvement in motor and cognitive functions in patients with MS. The present report concerns three women with MS (mean age: 44.3 +/- 8.5 yrs; mean duration of illness: 18.3 +/- 3.5 yrs), two with chronic progressive course and the third with a relapsing-remitting course in whom the Thurstone Word-Fluency Test, a reputed test of frontal lobe function, was administered prior to and following a series of 4 to 5 treatment sessions with EMF. Prior to the initiation of treatment with EMF all patients demonstrated word fluency performance which was well below age and sex-matched normal controls of similar level of education (mean output of MS patients was 42.6 +/- 1.1 words vs. 79.0 +/- 6.2 words of the controls). A series of treatments with EMF produced a 100% increase in word output within a short period of time (mean: 83.3 +/- 14.0 words). These findings suggest that this treatment modality improves frontal lobe functions in patients with MS and corroborate previous reports indicating beneficial effects of EMF on cognitive functions in these patients.     

Cancer mortality among electricity utility workers in a the state of Sao Paulo, Brazil

A number of epidemiologic studies have observed an association between exposure to 50-60 Hz electromagnetic fields and the development of specific types of cancer. In Brazil, a preliminary report from a study of electricity facility workers in Rio de Janeiro (RJ) has mentioned relatively similar results. An exploratory analysis of death certificates obtained from a sample of electricity workers in S. Paulo was made. Data was analysed by using the Proportional Mortality Ratio (PMR) and the Proportional Cancer Mortality Ratio (PCMR). A slightly elevated all-sites cancer mortality was observed among these workers (PMR 1.11; 95% CI 0.91-1.35). Site specific analysis has shown a statistically significant higher mortality of laryngeal cancer (PCMR 2.04; 95% CI 1.05-4.20). An excess of deaths was also seen for cancers of the buccal cavity/pharynx, prostate, bladder, brain and Hodgkin's disease, although the results lacked statistical significance. When analysed by categories of estimated exposure to magnetic fields, an excess of deaths from bladder cancer (PCMR 4.17; 95% CI 1.35-9.72), neoplasms of the brain (PCMR 7.7; 95% CI 1.02-9.65) and Hodgkin's disease (PCMR 5.55; 95% CI 1.14-16.21) was observed in the group with probably higher exposure to EMF. A comparison of cancer mortality between these workers and petrochemical employees has shown a higher PCMR for larynx tumours (PCMR 3.51; 95% CI 3.02-15.51) and bladder cancer (PCMR 7.53; 95% CI 3.02-15.51). For brain tumours, however, a PCMR of 0.74 (95% CI 0.27-1.61) was noted. Although restrictions related to sample size in the study and the lack of information about known confounders must be considered, the results of this study do not fully disagree with others previously mentioned in the literature.     

Regulation of c-fos is affected by electromagnetic fields

The goal of the present study was to determine if regulatory regions of the c-fos gene were responsive to electromagnetic field exposure. The research design used transfected cells to increase the sensitivity of assays designed to identify changes following exposure. HeLa cells were transiently transfected with plasmids containing upstream regulating regions of c-fos up to -700 base pairs, coupled with the prokaryotic reporter gene CAT. Cells were exposed to an environmentally relevant EMF of 60 Hz at 60 mGrms. CAT expression above control levels in transfected cells (region +42 to -700 bp) was observed following 5 min exposure to the electromagnetic field, with a peak at 20 min. The expression was at basal levels following 40 min exposure. Deletion analysis of upstream DNA narrowed the responsive region to 138 base pairs from -363 to -225, which contains the SRE/AP-1 sites.     

Effects of electromagnetic fields on the levels of biogenic amine metabolites, quinolinic acid, and beta-endorphin in the cerebrospinal fluid of dairy cows

Eight multiparous non-lactating pregnant Holstein cows at 198 +/- 35 d of gestation, weighing 608 +/- 24 kg, were confined to wooden metabolic cages in an electric and magnetic field chamber with a 12:12 h light:dark cycle. Subarachnoidal catheters were installed 5 d before the activation of the electric and magnetic fields. The cows were exposed to electric and magnetic fields (60 Hz, 10 kV/m and 30 microT) continuously except for the feeding and cleaning time for an average of 21.44 +/- 1.4 h per day for a period of 30 d. Cerebrospinal fluid samples were collected on three consecutive days before an exposure period of 30 d, on the last 3 d of the exposure period, and for 3 d starting 5 d after the exposure period. The concentrations of beta-endorphin, tryptophan, 5-hydroxyindoleacetic acid, homovanillic acid, 3-methoxy-4-hydroxyphenylethyleneglycol and quinolinic acid in cerebrospinal fluid were determined. There was a significant increase in quinolinic acid, and a trend towards an increase in tryptophan, findings consistent with a weakening of the blood-brain barrier due to exposure to the electric and magnetic fields.     

The effect of system restructuring on absenteeism due to sickness in the work place. I. Sickness absenteeism during the period 19989-1994

The current transformation of property relations and economic restructuring, along with many other factors, influence the health condition of workers. The objective of the study was to illustrate the size of the problem and to identify the major causes of work disability among persons employed in enterprises undergoing those processes during the years 1989-94 against the situation observed in the whole country during the same period. The study was carried out in one of the largest industrial plants undergoing the process of economic restructuring. The group investigated was composed of 8,588 workers (including 62.6% of males). In individual years the number of workers in this group was decreasing, and in 1994 the employment status in the group accounted for 37% in relation to the number of workers employed during the first year under observation. The analysis of work disability was based on the rate of sickness absenteeism calculated as a relationship between the number of days of work disability and the number of working days during that particular period. Due to the application of this method it was feasible to consider both workers employed and persons who left the plant, regardless of their employment duration during a year. The study showed a 20 per cent increase in sickness absenteeism during the period of 1989-94. The highest rate (8.60) was noted in 1994. It was higher by 16% in comparison to the rate for the whole country. The greatest difference between these rates was observed in 1990 (the rate in the group investigated was higher by 46%). As to the causes of work disability, the main differences concerned two categories of illnesses, diseases of the circulatory system, a major cause of sickness absenteeism in the group studied (21%), and diseases of the musculoskeletal system, a major cause of sickness absenteeism in Poland. The change in the relationship between sickness absenteeism and the age during the period of the plant restructuring resulted from the fact that a large number of workers left the job. It was observed that the rate of the sickness absenteeism was almost directly proportional to the percentage of persons leaving the plant in individual years. The study showed that changes in the size and the structure of employment resulting from the plant restructuring influence the level of sickness absenteeism, and the age-related diversification in causes of diseases, and in consequence alter the established regularities.     

Reproductive and teratologic effects of electromagnetic fields

The reproductive risks of electromagnetic fields (EMF) were evaluated based on an extensive review of the scientific literature pertaining to human epidemiologic studies, secular trend data, in vivo animal studies and in vitro studies, and biologic plausibility. The epidemiologic studies involving the reproductive effects of EMF exposures to human populations have included populations exposed to: (1) video display terminals (VDTs), and (2) power lines and household appliances. The clinical use of diagnostic MRI (magnetic resonance imaging) has been increasing, but there are few reports or studies of pregnant women or individuals of reproductive age who have been exposed to MRI, and whose reproductive performance has been evaluated. The population that has been studied most frequently are women exposed to VDTs, but their EMF exposures are extremely low and frequently are at the level of the ambient EMF in a house or office. The results of epidemiologic studies involving VDTs are generally negative for the reproductive effects that have been studied. Based on the number of studies, the exposure levels, and the fairly consistent results, it can be argued that VDT epidemiologic studies should no longer be given priority. There have been fewer studies concerned with the reproductive risks of power lines, electric substations, and home appliances. In some publications, positive findings for reproductive risks were reported, but the more consistent findings indicate that EMF, even at these higher exposures, do not generate a measurable increase in reproductive failures in the human population. When compared to other fields of human epidemiology, it is obvious that these studies have many difficulties. Exposures are rarely determined. Studies frequently involve small sample sizes and the investigators rarely have a combined expertise in EMF physics, engineering, and reproductive biology. Because of the allegation that there may be particular windows of frequency, wave shape, and intensity that may be deleterious, it is impossible to disregard low frequency EMF exposures as having no deleterious reproductive effects. Yet the epidemiologic data that are available would point in that direction. Secular trend data analysis of birth defect incidence data indicate that increasing generation of electric power during this century is not associated with a concomitant rise in the incidence of birth defects. There are over 70 EMF research projects dealing with animal and in vitro studies that are concerned with some aspect of reproduction and growth. Unfortunately, a large proportion of the embryology studies utilized the chick embryo and evaluated the presence or absence of teratogenesis after 48 to 52 hours of development.(ABSTRACT TRUNCATED AT 400 WORDS)     

Cancer risk assessment of extremely low frequency electric and magnetic fields: a critical review of methodology

This review provides a discussion of cancer risk assessment methodology pertinent to developing a strategy for extremely low frequency electric and magnetic fields (EMF). Approaches taken for chemical agents or ionizing radiation in six key topic areas are briefly reviewed, and then those areas are examined from the perspective of EMF, identifying issues to be addressed in developing a risk assessment strategy. The following recommendations are offered: 1) risk assessment should be viewed as an iterative process that informs an overall judgment as to health risk and consists of a complex of related activities incorporating both positive and negative data, tumor and nontumor end points, and human and nonhuman sources of information; 2) a hazard identification resulting in a conclusion of weak or null effects, such as may be associated with EMF, will need to assign significant weight to animal cancer bioassays conducted under defined exposure conditions as well as to human epidemiologic studies; 3) a default factor to account for possible age differences in sensitivity to carcinogenesis should be included in an EMF risk assessment; 4) lack of evidence of dose response and the apparent lack of DNA reactivity of EMF suggest that a safety (or uncertainty) factor or margin of exposure type of risk characterization may be most appropriate; and 5) an EMF risk assessment should permit at least tentative conclusions to be reached as to the limits of carcinogenic risk from exposure to EMF, and should also define an efficient research agenda aimed at clarifying uncertainties appropriate to a more complete assessment.     

A case-control study of multiple myeloma and occupation

Lifetime job histories from a population-based, case-control study were analyzed to investigate the relationship between multiple myeloma and employment in various occupations and industries. Interviews were obtained from 89% (692) of eligible incident cases and 83% (1683) of eligible controls. An elevated risk was observed among persons ever employed as painters [odds ratio (OR) = 2.1, 95% confidence interval (CI) = 1.2-3.6], particularly for those employed for 10 or more years (OR = 4.1, 95% CI = 1.8-10.4). A small excess risk was observed among agricultural workers employed for 10 or more years (OR = 1.3, 95% CI = 1.0-2.2), with a higher relative risk observed among farm laborers (OR = 1.8, 95% CI = 1.0-4.0). Among agricultural workers who reported having been highly exposed to pesticides, the OR was 5.2 (95% CI = 1.6-21.1). Some evidence, based on smaller numbers, was also found to support an association with firefighting and employment in the petroleum- and coal-products manufacturing industries. Little evidence was found to support the previously noted association with wood exposure, and no evidence for an association with employment in the rubber or petroleum refining industries was found. This study lends further support to previously reported associations between multiple myeloma and employment among painters and agricultural workers.     

Independent and exclusive modulation of cardiac delayed rectifying K+ current by protein kinase C and protein kinase A

We have recently established that local exposure to a 929.2 MHz electromagnetic near-field, used for cellular phones, does not promote rat liver carcinogenesis in a medium-term bioassay system. In the present study, a 1.439 GHz electromagnetic near-field (EMF), another microwave band employed for cellular phones in Japan, was similarly investigated. Time division multiple access (TDMA) signals for the Personal Digital Cellular (PDC) Japanese cellular telephone standard system were directed to rats through a quarter-wavelength monopole antenna. Numerical dosimetry showed that the peak SARs within the liver were 1.91-0.937 W/kg, while the whole-body average specific absorption rates (SARs) were 0.680-0.453 W/kg, when the time-averaged antenna radiation power was 0.33 W. Exposure was for 90 min a day, 5 days a week, over 6 weeks, to male F344 rats given a single dose of diethylnitrosamine (200 mg/kg, i.p.) 2 weeks previously. At week 3, all rats were subjected to a two-thirds partial hepatectomy. At week 8, the experiment was terminated and the animals were killed. Carcinogenic potential was scored by comparing the numbers and areas of the induced glutathione S-transferase placental form (GST-P)-positive foci in the livers of exposed (48) and sham-exposed rats (48). Despite increased serum levels of corticosterone, adrenocorticotropic hormone (ACTH) and melatonin, the numbers and the areas of GST-P-positive foci were not significantly altered by the exposure. These findings clearly indicated that local body exposure to a 1.439 GHz EMF, as in the case of a 929.2 MHz field, has no promoting effect on rat liver carcinogenesis in the present model.     

Biological effects of continuous exposure of embryos and young chickens to electromagnetic fields emitted by video display units

The effects of continuous exposure of embryos and young chickens to electromagnetic fields (EMFs) emitted by video display units (VDUs) were investigated. Embryos and brood were continuously exposed during embryonic and postembryonic phases to EMFs emitted by two types of VDU (TV or computer). Embryonic mortality was evaluated in three independent experiments. Young chickens were immunized three times by porcine thyroglobulin (Tg). Blood samples were assayed after each immunization for specific anti-Tg antibodies (IgG), plasma corticosterone (CORT), and plasma melatonin (MLT). In the sham-exposed samples, embryonic death (10-33%) was restricted to the perinatal period and the IgG, CORT, and MLT responses of young chickens crested after the second immunization. Constant EMF exposure was accompanied by significantly increased fetal loss (47-68%) and markedly depressed levels of circulating anti-Tg IgG, CORT, and MLT. Collectively, these findings indicate that continuous exposure to EMFs, issuing from VDUs, adversely affects embryos and young chickens.     

Sleepiness as measured by modified multiple sleep latency testing varies as a function of preceding activity

Although female breast cancer rates are lower in China than in Western countries, rates have been rising rapidly in China. This increase may be due to changes in established breast cancer risk factors, but it is possible that exposure to occupational and environmental carcinogens in Shanghai also have contributed to the rise in incidence. We used data collected by the Shanghai Cancer Registry and the Chinese Third National Census to study the risk of breast cancer by occupation and by occupational exposures. Standardized incidence ratios (SIRs) were used to compare observed cases to expected numbers of cases, based on the incidence rates for Shanghai and the number of women in each occupation according to the 1982 census. Statistically elevated SIRs for breast cancer were seen for a number of professional occupational categories, with the greatest risk seen among scientific research workers (SIR = 3.3). Administrative clerks, political and security personnel, and makers of rubber and plastics products also had significant excesses. Significant deficits of risk were seen for the categories of production and related workers, construction workers, and transportation equipment operators. For specific occupations, the highest SIRs were observed among doctors of Chinese-Western medicine (SIR = 14.7, 95% CI = 5.9-30.3) and doctors of Chinese medicine (SIR = 7.2, 95% CI = 4.4-11.4). We also found excesses among teachers at each level of education, librarians, clerical workers, electrical and electronic engineers, nurses, lab technicians, accountants and bookkeepers, rubber manufacturing products makers, weavers, and knitters. SIRs were significantly elevated for high probability of exposure to organic solvents (SIR = 1.4). For benzene exposure, we found significant excesses for overall exposure (SIR = 1.1) and for medium level of exposure (SIR = 1.3). There was no evidence of an association between risk and electromagnetic fields (EMF) exposure. Based on a small number of exposed, SIRs were elevated for both medium probability and high level of exposure to pesticides. The elevations in occupations reported here support some previous reports. Our finding of an increased risk associated with benzene also has been reported previously; the finding for organic solvents is new. However, the literature on the risk of breast cancer related to occupational exposures is limited and there is no consistent body of literature for any of the exposures studied here. Further, many comparisons were made and the problem of multiple hypothesis testing cannot be ignored in a survey such as ours.     

Growth stage dependent effects of electromagnetic fields on DNA synthesis of Jurkat cells

A 1.8 mT, bone healing, electromagnetic field (EMF) and power frequency EMFs of 0.1 and 0.4 mT significantly inhibit DNA synthesis in otherwise unstimulated Jurkat (E 6.1) cells. Inhibition is generally most prominent in cells from mid log phase growth. In complete medium the bone healing EMF inhibits [3H] thymidine uptake of the latter cells by almost 50% vs. 20-25% inhibition by 60 Hz fields. Cells in conditioned medium are even more sensitive to EMFs with inhibition up to ca. 60%. The effects of the 0.1 and 0.4 mT power frequency EMFs were very similar suggesting saturation at 0.1 mT or lower.     

Recurrent aciclovir-resistant herpes simplex in a child with Wiskott-Aldrich syndrome

The possible cancer promotion potential of local exposure to a pulse modulated 929.2 MHz electromagnetic near-field on chemically-initiated rat liver carcinogenesis was investigated employing a medium-term bioassay. A 929.2-MHz electromagnetic near-field of time division multiple access (TDMA) signal for PDC (Personal Digital Cellular, Japanese cellular telephone standard) system was directed to rats through a quarter-wavelength monopole antenna. Maximum local specific absorption rates (SARs) on temporal average were 7.2-6.6 W/kg within the whole body and 2.0-1.7 W/kg within the liver, which was the target organ. The whole-body average SARs on temporal average were 0.80-0.58 W/kg. Temporal peak SARs had three times these values due to the duty ratio of the PDC signal. Exposure was for 90 min a day, 5 days a week, over 6 weeks. The exposure apparatus was specially designed for this experiment, to allow exposure of the lateral mid-section of the rat body to the electromagnetic near-field. Male F344 rats, 6 week-old, were initially (at week 0) given a single dose of diethylnitrosamine (DEN, 200 mg/kg body wt, i.p.). At 2 weeks later, exposure (48 rats) or sham-exposure (48 rats) was started. The exposure of electromagnetic near-fields was performed using the exposure apparatus mentioned above. At week 3, all rats were subjected to a 2/3 partial hepatectomy. At week 8 (i.e. after 6 weeks exposure or sham-exposure), the experiment was terminated and all rats were killed. Carcinogenic potential was scored by comparing the numbers and areas of the induced glutathione S-transferase placental form (GST-P) positive foci in the livers of the exposed and sham-exposed rats. A further group of 24 animals, given only DEN and partial hepatectomy, served as the controls. The numbers (no./cm2) of GST-P positive foci were 4.61 +/- 1.77, 5.21 +/- 1.92 (P < 0.05, versus control) and 4.09 +/- 1.47 and the areas (mm2/cm2) were 0.30 +/- 0.16, 0.36 +/- 0.21 and 0.28 +/- 0.15, for the exposed, sham-exposed and control groups, respectively. There were no significant differences between the exposed and sham-exposed groups. These findings clearly indicated that local body exposure to a 929.2-MHz field, modulated in a PDC waveform, has no significant effect on rat liver carcinogenesis under the experimental conditions employed.     

Neurophysiological findings among workers occupationally exposed to styrene

Ninety-six male workers occupationally exposured to styrene in 24 plants producing reinforced polyester plastic products were studied neurophysiologically. The mean age of the subjects was 29.6 +/- 7.4 years, and the duration of the exposure varied from 6 months to 14 years (mean 5.0 years). Mandelic acid concentration in the urine (mean of five values determined during five consecutive weeks) was used as the measure of exposure. The individual means of the mandelic acid concentrations varied from 7 to 4,715 mg/dm3 (median 808 mg/dm3). Neurotoxic effects of styrene exposure upon the central nervous system were revealed by abnormalities in the EEG. The overall prevalence of abnormal EEGs was 24% (23 out of 96), which is higher than that found among a normal population (p less than 0.05). Abnormal EEGs were found in one-third of the subjects with relevant styrene exposure (mandelic acid concentration over 700 mg/dm3), while low-level styrene exposure did not increase the prevalence of normal EEGs above that found in a normal population. Nerve conduction velocity measurements performed on 40 subjects did not reveal any definite relationship between neuropathy and styrene exposure. The EEG examination is useful in the investigation of the neurotoxic effects of styrene. Whenever a possibility exists of excessive styrene exposure or beginning poisoning, the workers should be submitted to an EEG examination.     

Distribution and role of aspartate in the nervous system of the chaetognath Sagitta

Forty-nine female workers in the shoemaking industry, exposed to a solvent mixture containing benzene and twenty-seven non-exposed controls, were investigated. Concentrations of benzene and toluene in the working atmosphere, as well as benzene and toluene in blood and phenols in pre- and post-shift urine as parameters of biological monitoring, were determined. In order to assess hematotoxic risk, a complete blood cell count with differential, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, reticulocytes, serum iron, alkaline phosphatase in neutrophils and red blood cell glycerol lysis time were determined in all subjects. Benzene concentrations in the workplace atmosphere at the shoemaking factory ranged from 1.9 to 14.8 ppm (median = 5.9). Significant difference in benzene in blood (p = 0.005) and phenol in post-shift urine (p = 0.003) between exposed workers and controls confirmed exposure to benzene. Hemoglobin level (p = 0.02) and mean corpuscular hemoglobin concentration (p = 0.0002) in the shoe workers were lower, and band neutrophils (p = 0.005) and mean corpuscular volume (p = 0.03) higher, than in controls. Red blood cell glycerol lysis time was significantly higher (p = 0.000001) in shoe workers (X +/- SD = 41.6 +/- 8.9) than in controls (X +/- SD = 31.1 +/- 6.5) and showed a significant correlation with exposure biomarkers. The results confirm that benzene exposure below 15 ppm may produce qualitative abnormalities, particularly macroerythrocytosis and increased red cell glycerol resistance, in the absence of an overt quantitative decrease in circulating blood cells. Increased resistance to the hemolytic action of glycerol is a potentially useful biological monitoring procedure in medical surveillance of benzene exposed workers. The results of this study suggest that potential threshold concentration for hematologic effects of benzene is lower than 15 ppm.