Since benzene is frequently used in industrial processes and is present in gasoline, workers employed in chemical plants and gas stations are most likely to be exposed to it; however, it is also present in the general environment, being released from paints, automobile exhausts, and cigarette smoke. Its concentration is higher indoors than outdoors, especially in homes where there are smokers.

Apart from workplace accidents, acute poisoning can follow unintentional consumption or inhalation of benzene or benzene-containing solutions at home, usually by children; exposure can also occur by intentional use of hydrocarbons, such as recreational abuse, or suicide attempts.

Acute ingestion or inhalation of benzene affects mainly the central nervous system (CNS) and is believed to be mediated by benzene itself, although there are claims [1] that benzene’s metabolites may also play a role. The signs are similar to alcohol intoxication and are the same irrespective of whether the chemical is inhaled or ingested, except for the irritation of the mucous membranes of the respiratory tract when the route is by inhalation. Also, according to some reports [2] the lethal dose (LD50) is higher by two orders of magnitude for hydrocarbons entering the body by ingestion than by inhalation. Therefore, aspiration of benzene-containing liquids, including vomitus is a major hazard. Mild exposure results in a headache, dizziness, euphoria, nausea, vomiting, tightness in the chest, and dyspnea. Higher concentrations may cause visual problems, ventricular fibrillation, paralysis, tremor, convulsions, or loss of consciousness [3]. Death can occur after large doses of benzene due to ventricular fibrillation.

In contrast to acute poisoning, the chronic effects of benzene on the cells of the hematopoietic system are mediated by its metabolic products [4]. All of these are oxidized derivatives (phenol, hydroquinone, catechol, benzenetriol, hydroquinone, and trans-Muconic acid). These are reactive chemical species and may contribute to benzene’s effects through different pathways, making the mechanism of toxicity a complex issue [5]. Patients suffering from chronic exposure present with general symptoms. These can include fatigue, weight loss, headaches, dizziness, weakness, pale skin, bleeding gums, nosebleeds, and bruising.

Chronic exposure to benzene may result in dysfunction of the hematopoietic system due to the chemical interfering with renewal and differentiation of stem cells; consequently, both anemic and leukemic diseases may develop [6].

Patients with chronic exposure may display signs of anemia and poor immunity. Sometimes, the condition of aplastic anemia caused by benzene exposure includes symptoms of hemolysis, such as mild bilirubinemia, shortened erythrocyte life-cycle and similar signs that are not present in idiopathic disease [7].

Leukemia may follow pancytopenia or aplastic anemia in about a quarter of the leukemia patients [7], often after a lag of several years [8]. Case reports and epidemiological studies demonstrate a variety of responses to chronic benzene exposure: both acute and chronic leukemias and other disorders are found. For example, among 74,828 people exposed to benzene, 82 were identified with hematopoietic diseases, with cases of acute leukemia, myelodysplastic syndrome, chronic granulocytic leukemia, malignant lymphoma and aplastic anemia [9]. In another study, among 28,460 people working in factories where they were exposed to benzene, 30 cases of leukemia were found, most of which were of the acute type [10]. The International Agency for Research on Cancer has determined that benzene is a carcinogen.

• Exposure to Benzene

  Albumin adducts of benzene derivatives can be used to measure longer term exposure. [symptoma.com]

  Because of its recognized link with benzene exposure, the association between a clinical diagnosis of benzene poisoning and benzene exposure was evaluated to validate the assessment method that we used in the cohort study. [ncbi.nlm.nih.gov]

  Common sources of benzene that lead to human exposure include emissions from burning oil and coal, motor vehicle exhaust, and smoke from cigarettes. Effects of Benzene Exposure Exposure to benzene can have several harmful effects on individuals. [seegerweiss.com]

  people who work with benzene in manufacturing plants are at the highest risk of benzene exposure Benzene Poisoning Long-term exposure to benzene can result in the development of several conditions and diseases including: Anemia - a condition in which [impactlaw.com]

• Anemia

  Patients with chronic exposure may display signs of anemia and poor immunity. [symptoma.com]

  CBP could give the appearance of different types of disorders such as leukopenia, agranulocytosis, anemia, pancytopenia, aplastic anemia (AA), myelodysplastic syndrome (MDS), and leukemia. [ncbi.nlm.nih.gov]

  Benzene has been identified as a carcinogen, and long-term exposure can lead to benzene poisoning, which can cause anemia, lymphoma, and leukemia, a form of cancer. [impactlaw.com]

  Year History of Benzene Toxicity: Aplastic Anemia and Leukemia 1897 Santeson - aplastic anemia; established benzene as powerful bone marrow poison 1903 LeNoir - leukemia in benzene workers 1911 Setting - benzene a bone marrow poison in rabbit bioassays [digitalsynergy.com]

  Benzene exposure mostly causes blood cancer or other blood related health conditions, like: anemia leukemia lymphoma aplastic anemia excessive bleeding irregular menstruation Benzene can also cause harmful effects to your immune system. [healthblurbs.com]

• Fatigue

  These can include fatigue, weight loss, headaches, dizziness, weakness, pale skin, bleeding gums, nosebleeds, and bruising. [symptoma.com]

  Exposure to benzene at work can cause immediate symptoms such as headache, fatigue, nausea and dizziness. [duncanlewis.co.uk]

  Acute Effects of Lead Poisoning • Fatigue • Headache • Irritability • Metallic taste in mouth • Poor appetite • Reproductive problems • Sleeplessness • Stomach upset 32. [slideshare.net]

  The patient over time begin to bother: fatigue; insomnia weakness; malaise; irritability; dizziness; insomnia; headache; noise in the head and ears; increased heart rate. Then joins nausea, vomiting, pain in the bones. [en.intoxication-stop.com]

  He expresses concern that he becomes easily fatigued at work, and 2 months ago he began noticing bruises on his arms and legs, although he does not recall the causes. [nap.edu]

• Gastric Lavage

  lavage ) Washing of the skin (irrigation) -- perhaps every few hours for several days You may be admitted to the hospital if the poisoning is severe. [indiatoday.in]

  Gastric lavage may be preferable to emesis if large amounts of benzene have been ingested or if the patient is seen more than 1 hour after ingestion. [nap.edu]

• Pathologist

  Author Information: Hutton, CJ Office of the Chief Forensic Pathologist, Province of Newfoundland and Labrador, Health Science Centre, St. [astm.org]

• Vomiting

  If someone has swallowed benzene, do not try to make them vomit or give them fluids to drink. Also, if you are sure the person has swallowed benzene, do not attempt CPR. Performing CPR on someone who has swallowed benzene may cause them to vomit. [rxwiki.com]

  Followed, may have nausea, vomiting, palpitations, instability of walking, trance, just like drunkenness 9. [slideshare.net]

  which can lead to breathing problems if the benzene-contaminated vomit enters the victim’s lungs Drowsiness Convulsions and Death Serious Health Problems Due to Long-Term Benzene Exposure If the victim has been exposed to benzene for one year or more [napolilaw.com]

  Typical signs of poisoning include rashes, vomiting, redness around the mouth and nose, chemical odors and burns. Empty pill bottles, unresponsiveness and difficulty breathing are also signs. [sharecare.com]

• Nausea

  Toxic effect caused by exposure to benzene through contact, inhalation, or ingestion, characterized by disorientation, dizziness, headache, and/or nausea. In severe cases it can cause death through respiratory failure . [businessdictionary.com]

  […] benzene poisoning a toxic condition caused by ingestion of benzene, inhalation of benzene fumes, or exposure to benzene-related products such as toluene or xylene, characterized by blurred vision, nausea, headache, dizziness, and incoordination. [medical-dictionary.thefreedictionary.com]

  Yet, some of the more common symptoms caused by benzene are: pallor tremors euphoria dizziness petechiae headache weakness staggering tachypnea drowsiness palpitations convulsions nervousness appetite loss blurred vision chest tightness nausea, vomiting [healthblurbs.com]

  Mild exposure results in a headache, dizziness, euphoria, nausea, vomiting, tightness in the chest, and dyspnea. Higher concentrations may cause visual problems, ventricular fibrillation, paralysis, tremor, convulsions, or loss of consciousness. [symptoma.com]

  Followed, may have nausea, vomiting, palpitations, instability of walking, trance, just like drunkenness 9. [slideshare.net]

• Abdominal Pain

  Individuals that have ingested food or water contaminated with benzene may experience nausea, vomiting, stomach irritation, abdominal pain, convulsions, and death. [schmidtandclark.com]

  pain, occasionally bloody diarrhea, can cause serious liver and kidney damage 54. [slideshare.net]

• Hypotension

  If the patient is hypotensive and unresponsive to fluids, intravenous administration of a pure alpha-adrenergic agonist agent (eg, phenylephrine) is the therapy of choice. In cases of ingestion, do not induce emesis. [emedicine.medscape.com]

• Blurred Vision

  […] benzene poisoning a toxic condition caused by ingestion of benzene, inhalation of benzene fumes, or exposure to benzene-related products such as toluene or xylene, characterized by blurred vision, nausea, headache, dizziness, and incoordination. [medical-dictionary.thefreedictionary.com]

  Yet, some of the more common symptoms caused by benzene are: pallor tremors euphoria dizziness petechiae headache weakness staggering tachypnea drowsiness palpitations convulsions nervousness appetite loss blurred vision chest tightness nausea, vomiting [healthblurbs.com]

  One may experience blurred vision and inflammation of nose and throat. Among other symptoms are vomiting, loss of appetite and nausea. It may also cause irregular heartbeat and rapid, shallow breathing or even experience a tight chest. [ukaccidentatwork.co.uk]

  EYES, EARS, NOSE, AND THROAT Blurred vision Burning sensation in the nose and throat STOMACH AND INTESTINES Loss of appetite Nausea and vomiting HEART AND BLOOD Irregular heartbeat Rapid heartbeat Shock and collapse LUNGS AND CHEST Rapid, shallow breathing [stlukes-stl.com]

  Symptoms Eyes, ears, nose, and throat: Blurred vision Burning sensation in the nose and throat Gastrointestinal: Loss of appetite Nausea Vomiting Heart and blood: Irregular heartbeat Rapid heartbeat Lungs and chest: Rapid, shallow breathing Tight chest [indiatoday.in]

• Muscle Weakness

  Chronic Effects of Lead Poisoning • Kidney problems • Memory loss • Muscle & joint pains • Premature loss of teeth • Shortened life span • Stomach aches & pains, nausea • Weak wrists and ankles • Weight loss • Convulsions, coma or death 33. [slideshare.net]

• Euphoria

  There is dizziness, EUPHORIA, headache, weakness, trembling, clumsiness, tightness in the chest, coma and convulsions. Long-term, small-dose poisoning causes loss of appetite, irritability, severe ANAEMIA, LEUKAEMIA and LYMPHOMAS. [medical-dictionary.thefreedictionary.com]

  Yet, some of the more common symptoms caused by benzene are: pallor tremors euphoria dizziness petechiae headache weakness staggering tachypnea drowsiness palpitations convulsions nervousness appetite loss blurred vision chest tightness nausea, vomiting [healthblurbs.com]

  Mild exposure results in a headache, dizziness, euphoria, nausea, vomiting, tightness in the chest, and dyspnea. Higher concentrations may cause visual problems, ventricular fibrillation, paralysis, tremor, convulsions, or loss of consciousness. [symptoma.com]

  STOMACH AND INTESTINES Loss of appetite Nausea and vomiting HEART AND BLOOD Irregular heartbeat Rapid heartbeat Shock and collapse LUNGS AND CHEST Rapid, shallow breathing Tightness in the chest NERVOUS SYSTEM Dizziness Drowsiness Nervousness Convulsions Euphoria [stlukes-stl.com]

  […] sensation in the nose and throat Gastrointestinal: Loss of appetite Nausea Vomiting Heart and blood: Irregular heartbeat Rapid heartbeat Lungs and chest: Rapid, shallow breathing Tight chest Nervous system: Dizziness Drowsiness Nervousness Convulsions Euphoria [indiatoday.in]

• Headache

  […] benzene poisoning a toxic condition caused by ingestion of benzene, inhalation of benzene fumes, or exposure to benzene-related products such as toluene or xylene, characterized by blurred vision, nausea, headache, dizziness, and incoordination. [medical-dictionary.thefreedictionary.com]

  These can include fatigue, weight loss, headaches, dizziness, weakness, pale skin, bleeding gums, nosebleeds, and bruising. [symptoma.com]

  Toxic effect caused by exposure to benzene through contact, inhalation, or ingestion, characterized by disorientation, dizziness, headache, and/or nausea. In severe cases it can cause death through respiratory failure . [businessdictionary.com]

  Acute Effects of Lead Poisoning • Fatigue • Headache • Irritability • Metallic taste in mouth • Poor appetite • Reproductive problems • Sleeplessness • Stomach upset 32. [slideshare.net]

  Headache. Sense of constriction about the head and chest. [jamanetwork.com]

• Dizziness

  […] benzene poisoning a toxic condition caused by ingestion of benzene, inhalation of benzene fumes, or exposure to benzene-related products such as toluene or xylene, characterized by blurred vision, nausea, headache, dizziness, and incoordination. [medical-dictionary.thefreedictionary.com]

  These can include fatigue, weight loss, headaches, dizziness, weakness, pale skin, bleeding gums, nosebleeds, and bruising. [symptoma.com]

  Toxic effect caused by exposure to benzene through contact, inhalation, or ingestion, characterized by disorientation, dizziness, headache, and/or nausea. In severe cases it can cause death through respiratory failure . [businessdictionary.com]

  These signs of benzene poisoning include: Confusion Irregular or rapid heartbeat Headache Unconsciousness Tremors Dizziness and Death Consuming benzene can also cause sudden health problems that develop in minutes or hours, which include the following [napolilaw.com]

  Some symptoms of inhalation may include: dizziness, increased/rapid heart rate, chronic headaches, muscle twitching or tremors, drowsiness, and unconsciousness. [legalinfo.com]

• Confusion

  How Benzene Poisoning Causes Damage to the Body When benzene is inhaled, it confuses the body’s cells into working improperly. [napolilaw.com]

  As pointed out in the preface to this report, conditions other than benzene poisoning simulate it so closely that the diagnosis is frequently confused. [jamanetwork.com]

  Toxic tort and injury laws are complex and confusing. The Metzger Law Group is here to help you. Call us today for a FREE evaluation to find out if you have a case or fill out our free evaluation forms to consult with a member of our caring staff. [digitalsynergy.com]

  Individuals who inhale or ingest high levels of benzene may go on to develop the following symptoms: confusion drowsiness dizziness irregular heartbeat irritation of the stomach headaches tremors unconsciousness vomiting Impact on long-term health Unfortunately [limepersonalinjury.co.uk]

  Lower levels (700–3,000 ppm) can cause drowsiness, dizziness, rapid heart rate, headaches, tremors, confusion, and unconsciousness. [aleretoxicology.co.uk]

• Seizure

  Seizures may begin without any prodromal signs or symptoms. If the patient is paralyzed after intubation, electroencephalographic monitoring is warranted. [emedicine.medscape.com]

  […] tightness Headache, lethargy Nausea, vomiting; appetite loss Vision abnormalities including blurry vision Increased or irregular heart-rate Feeling dizzy or drowsy Over-excitement, acting ‘drunk’ Lack of coordinated movements Low level of alertness Seizures [dovemed.com]

  Stupor, delirium, and drowsiness give way to seizures and coma. Fluid accumulates in the lungs compromising breathing; there is poor oxygen absorption from the air. Intensive treatment is necessary to prevent death. [livestrong.com]

• Excitement

  Clinical manifestationsClinical manifestations Acute poisoning manifestations can be expressed as a two-stage: The first phase is the eyes, nose and throat irritation symptoms, as well as headache, nausea, excitement, exciting, who will soon re-occurrence [slideshare.net]

  Respiratory difficulties, which may be severe if the chemical is inhaled Chest pain and tightness Headache, lethargy Nausea, vomiting; appetite loss Vision abnormalities including blurry vision Increased or irregular heart-rate Feeling dizzy or drowsy Over-excitement [dovemed.com]

In acute cases, people displaying neurological symptoms of benzene poisoning should be monitored for inadequate oxygenation. Even if only small amounts have been inhaled or ingested, patients should be transferred to a healthcare facility for evaluation. For severely affected patients, toxicologists, and poison centers should be consulted.

Exposure to benzene can be detected by measuring the concentration in blood, exhaled breath, and urine; this – or routine blood work - can also be used to monitor workers in hazardous occupations. There is a linear relationship between benzene levels in the patients’ environment and in their biological samples [11]. However, measuring benzene itself may not be completely reliable when there has been exposure to only a low level. Urinary benzene metabolites (trans-Muconic acid and S-phenyl mercapturic acid) are more suited for the measurements of low exposures [12], and thus, for monitoring general populations [13]. Albumin adducts of benzene derivatives can be used to measure longer term exposure [14].

Since benzene is a hematopoietic toxin, detection of hematologic abnormalities by a complete blood count with differential, erythrocyte indices, and thrombocyte counts is the most basic examination. Patient history may reveal current or past occupational or environmental exposure to benzene. Further tests may be needed to exclude other forms of anemia. Examination of bone marrow can produce highly variable results in that patients can have hypoplastic or hyperplastic bone marrow [7] [15].

• Neutropenia

  Symptoms of Chronic benzeneSymptoms of Chronic benzene poisoning--3poisoning--3 Major damage to the blood system: acute, chronic aplastic anemia, thrombocytopenia, neutropenia and leukemia 12. [slideshare.net]

  On the other hand, the immunophenotypic analysis confirmed neutropenia (33.00%), with a lower NK cell count (2.28%), with all NK CD56+/CD16− (Table 2 ; Fig. 1 ). CCRs found in case 1 and 2 and flow cytometric analyses of NK cell subsets. [ncbi.nlm.nih.gov]

  On the other hand, the immunophenotypic analysis confirmed neutropenia (33.00%), with a lower NK cell count (2.28%), with all NK CD56+/CD16− (Table 2 ; Fig. 1 ). Fig. 1 CCRs found in case 1 and 2 and flow cytometric analyses of NK cell subsets. [bmcresnotes.biomedcentral.com]

In general, prognosis of CBP cases is optimistic when appropriate treatment is given. [ncbi.nlm.nih.gov]

First aid and treatment for acute poisoning First aid in case of poisoning with benzene is reduced to the following actions. Fresh air Termination of contact with benzene. [en.intoxication-stop.com]

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. [arh.adam.com]

Though it is potentially curable with extensive chemotherapy, without any treatment, AML is generally fatal within weeks or months. I also lost two uncles to similar bone marrow cancers about the same time. [labovick.com]

With methods of logistic regression, a risk model was set up to predict the prognosis of CBP workers. [ncbi.nlm.nih.gov]

The results are discussed from the point of view of prognosis. [oem.bmj.com]

The prognosis of Benzene Poisoning is dependent on the amount of substance consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient If the individual can recover from the symptoms, with [dovemed.com]

The epidemiologic literature shows that benzene is the chemical most strongly associated with CML. [amlbenzene.net]

Author information 1 Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA. [email protected] Abstract We present a validation study of a quantitative retrospective exposure assessment method used in a follow-up [ncbi.nlm.nih.gov]

Case reports and epidemiological studies demonstrate a variety of responses to chronic benzene exposure: both acute and chronic leukemias and other disorders are found. [symptoma.com]

It includes much new experimental evidence and is exceedingly practical in its recommendations for treatment and particularly for prevention. Finally, it is supplemented by an excellent bibliography covering the literature on the subject. [jamanetwork.com]

In cases of occupational exposure, alert public health authorities to assist in prevention of further exposures in a potentially unsafe work environment. [emedicine.medscape.com]

Technical Measures for the Prevention of Hazards; Occupational Hygiene 6. (1) Occupational hygiene and technical measures should be taken to ensure effective protection of workers exposed to benzene or to products containing benzene. (2) Notwithstanding [ilo.org]

In rabbits immunized by one to three intracutaneous injections with living culture of streptococci, an exposure to benzene with the following leucopenia did not consistently prevent the fixation of streptococci in an intracutaneous focus, as it is the [jimmunol.org]

1. Dempster AM, Evans HL, Snyder CA. The temporal relationship between behavioral and hematological effects of inhaled benzene. Toxicol Appl Pharmacol. 1984 Oct;76(1):195-203.
2. Gerarde HW. Toxicological studies on hydrocarbons. IX. The aspiration hazard and toxicity of hydrocarbons and hydrocarbon mixtures. Arch Environ Health. 1963 Mar;6:329-41.
3. Reese E, Kimbrough RD. Acute toxicity of gasoline and some additives. Environ Health Perspect. 1993 Dec;101 Suppl 6:115-31.
4. Snyder R. Xenobiotic metabolism and the mechanism(s) of benzene 
toxicity, Drug Metab. Rev. 2004; 36:531–547.
5. Yardley-Jones A, Anderson D, Parke DV. The toxicity of benzene and its metabolism and molecular pathology in human risk assessment. Br J Ind Med. 1991 Jul;48(7):437-444.
6. Dexter TM, Heyworth CM, and Whetton AD. The role of haemopoietic cell growth factor (interleukin3) in the development of haemopoietic cells. In: Evered D, Nugent J, Ivhelm J, Eds. Growth Factor in Biology and Medicine. Ciba Foundation Symposium, Vol. 116 London, England: Pitman. 1985;129-142.
7. Aksoy M. Hematotoxicity and carcinogenicity of benzene. Environ Health Perspect. 1989 Jul;82:193-197.
8. Vigliani EC, Forni A. Benzene and leukemia. Environ Res. 1976 Feb;11(1):122-127.
9. Travis LB, Li CY, Zhang ZN, et al. Hematopoietic malignancies and related disorders among benzene-exposed workers in China. Leuk Lymphoma. 1994 Jun;14(1-2):91-102.
10. Yin SN, Li GL, Tain FD, et al. Leukaemia in benzene workers: a retrospective cohort study. Br J Ind Med. 1987 Feb;44(2):124-128.
11. Brugnone F, Perbellini L, Faccini GB, et al. Breath and blood levels of benzene, toluene, cumene and styrene in non-occupational exposure. Int Arch Occup Environ Health. 1989;61:303–311.
12. Boogaard PJ, van Sittert N. Biological monitoring of exposure to benzene: a comparison between S-phenylmercapturic acid, trans, trans-muconic acid, and phenol. Occup Environ Med. 1995;52: 611–620.
13. Weaver VM, Davoli CT, Heller PJ, et al. Benzene exposure, assessed by urinary trans,trans-muconic acid, in urban children with elevated blood lead levels. Environ Health Perspect. 1996;104:318–323.
14. Rappaport SM, Waidyanatha S, Qu Q, et al. Albumin adducts of benzene oxide and 1,4-benzoquinone as measures of human benzene metabolism. Cancer Res 2002 Mar;62 (5):1330–1337.
15. Mallory TB, Gall EA, Bickley WJ. Chronic exposure 
to benzene. J. Ind. Hyg. Toxicol. 1939;21:355-393