1. bookVolume 73 (2022): Edition 2 (June 2022)
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Occupational exposure to BTEX and styrene in West Asian countries: a brief review of current state and limits

Publié en ligne: 07 Jul 2022
Volume & Edition: Volume 73 (2022) - Edition 2 (June 2022)
Pages: 107 - 118
Reçu: 01 Feb 2022
Accepté: 01 Jun 2022
Détails du magazine
License
Format
Magazine
eISSN
1848-6312
Première parution
26 Mar 2007
Périodicité
4 fois par an
Langues
Anglais
Abstract

Svrha je uvođenja graničnih vrijednosti profesionalne izloženosti (engl. occupational exposure limits, krat. OELs) upravljanje rizikom ne bi li se zaštitilo zdravlje i dobrobit radnika od štetnih agensa kojima su izloženi na radnome mjestu. U ovom smo pregledu izdvojili granične koncentracije benzena, toluena, etilbenzena, ksilena (BTEX) i stirena u zraku i, analizirajući 49 članaka objavljenih u zemljama (jugo) zapadne Azije od 1980. do 2021., pronađenih sustavnom pretragom literature, ocijenili profesionalnu izloženost tim spojevima. Granične vrijednosti za BTEX i stiren uvedene su samo u Iranu i Turskoj, i na sličnim su razinama kao one koje vrijede u europskim zemljama i SAD-u. Analiziranih 49 članaka obuhvaćaju istraživanja izloženosti u šest zemalja, ali se većina (njih 40) odnosi na Iran. Prosječna profesionalna izloženost benzenu u radnika u industrijama povezanima s naftom viša je od preporučene granične vrijednosti, a profesionalna izloženost ostalim spojevima niža je od lokalnih graničnih vrijednosti (tamo gdje su uvedene). Trenutačno nema dovoljno podataka o razinama profesionalne izloženosti BTEX-u i stirenu u zemljama (jugo)zapadne Azije, stoga je u njima potrebno regulirati granične vrijednosti i primjenjivati ih. Osim toga, potrebno je provoditi sustavna istraživanja ne bi li se utvrdile stvarne razine profesionalne izloženosti, odgovori na koncentracije onečišćivala i gospodarske i tehničke mogućnosti industrija tih zemalja da riješe trenutačne probleme.

Key words

Ključne riječi

As far as national income is concerned, West Asian countries vary largely, spanning from low- to high-income. Over the last hundred years, some of them have made great strides in development thanks to oil resources. Oil and gas-related industries are the leading sources of uncontrolled hydrocarbon emissions, including volatile organic compounds (VOCs), aldehydes, alkenes, and phenols and present increased health risks for workers in oil-related industries (1, 2). Chronic occupational exposure to these compounds can lead to various adverse health effects and place considerable pressure on already high global burden of diseases (3).

This in particular concerns highly volatile, non-methane, and aromatic hydrocarbons benzene, toluene, ethylbenzene, xylene (BTEX), and styrene, which are extracted from petroleum and used in petroleum and chemical industries (4, 5). These compounds are released during various industrial processes and are quickly absorbed by workers through inhalation and skin (6, 7, 8, 9, 10, 11), which can, in turn, lead to neurological, psychological, developmental, liver, and respiratory adverse effects, lung cancer and leukaemia (11, 12, 13, 14).

Increased awareness of health hazards of exposure has led to the introduction of occupational exposure limits (OELs), first in Germany in 1877 and then in the USA in 1910 (15). In the 1940s, the American Conference of Governmental Industrial Hygienists (ACGIH) proposed the threshold limit values (TLVs) (16, 17) and other countries or organizations gradually followed suit with their own OELs to protect the health and well-being of workers and ensure effective risk management strategies (18).

This, however, resulted in uneven standards between countries, so that we now distinguish those “health-based” from those that are adjusted to technical and economic considerations (18, 19).

West Asian countries have used various methodologies to regulate their own OELs. In Iran, the legal authority for OELs is the Centre for Environmental and Occupational Hygiene at the Ministry of Health and it has relied on the ACGIH TLVs in setting the OELs.

The objectives of this review were threefold: 1) to identify available data about exposure to airborne BTEX and styrene at workplaces in West Asian countries, 2) to relate these data to applicable OELs, and 3) to identify research needs for the development of new regulations concerning OELs for chemical pollutants in West Asian countries.

Methods
Compiling OELs for West Asian countries

To get as complete coverage of current OELs across the countries in West Asia, we compiled available information from the GESTIS database and online searches for OEL lists from West Asian countries. The European Chemicals Agency (ECHA) webpage was searched for recent EU level recommendations and derived no-effect levels (DNELs) based on the Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH) regulation (20). Scientific documentation about OELs from the US ACGIH, German maximum workplace concentrations (MAK), Scientific Committee on Occupational Exposure Limits (SCOEL) and ECHA Committee for Risk Assessment (RAC) were compiled and reviewed for information on critical effects, skin notation, carcinogen classifications, and biological monitoring guidance values.

Systematic literature searches for occupational exposure data

We systematically searched international datasets including PubMed, Scopus, Cochrane Library, CINAHL, ISI Web of Science, ScienceDirect, PROSPERO, and EMBASE to identify articles in English related to occupational exposure to BTEX and styrene in West Asian countries and published between 1980 and 2021. For this purpose, we used several combinations of the key words (benzene, toluene, ethylbenzene, xylene, styrene, occupational exposure, industrial exposure, threshold limit value, occupational exposure limit, recommended exposure level, permissible exposure limit, West Asia, and Middle East) and search criteria, including language and publication year (Table 1).

Search strategy for articles on occupational exposure to BTEX and styrene across major literature databases (slight differences in search strings are owed to different functionality of these systems)

Web of Science (TS=(Benzene OR Toluene OR Ethylbenzene OR Xylenes OR Styrene OR Volatile Organic compound) AND TS=(Occupational exposure OR Industrial exposure OR Workplace exposure OR Chemical exposure) AND TS=(Threshold limit value OR Occupational exposure limit OR Recommended exposure level OR Permissible exposure limit) AND TS= (West Asia OR Middle east OR Iran OR Iraq OR Kuwait OR Syria OR Jordan OR Bahrain OR Lebanon OR Oman OR Qatar OR Saudi Arabia OR Afghanistan, Armenia OR Azerbaijan OR Yemen OR Israel OR Turkey OR Palestine) AND LANGUAGE: (English) Indexes=SCI-EXPANDED, SSCI, AND Time span=1980-2021
Scopus TITLE-ABS-KEY (Benzene OR Toluene OR Ethylbenzene OR Xylenes OR Styrene) AND TITLE-ABS-KEY (Occupational exposure OR Industrial exposure OR Workplace exposure OR Chemical exposure) AND TITLE-ABS-KEY (Threshold limit value OR Occupational exposure limit OR Recommended exposure level OR Permissible exposure limit) AND TITLE-ABS-KEY (West Asia OR Middle East OR Iran OR Afghanistan, Armenia OR Azerbaijan OR Yemen OR Israel OR Turkey OR Arab countries, Gulf Cooperation Council countries) AND PUBYEAR ≥ 1980
PubMed (Benzene [Title/Abstract] OR Toluene [Title/Abstract] OR Ethylbenzene [Title/Abstract] OR Xylenes [Title/Abstract] OR Styrene [Title/Abstract] OR Volatile Organic compound [Title/Abstract]) AND (Occupational exposure [Title/Abstract] OR Industrial exposure [Title/Abstract] OR Workplace exposure [Title/Abstract] OR Chemical exposure [Title/Abstract]) AND (Threshold limit value [Title/Abstract] OR Occupational exposure limit [Title/Abstract] OR Recommended exposure level [Title/Abstract] OR Permissible exposure limit [Title/Abstract]) AND (West Asia [All Fields] OR Middle East [All Fields] OR Iran [All Fields] OR Iraq [All Fields] OR Kuwait [All Fields] OR Syria [All Fields] OR Jordan [All Fields] OR Bahrain [All Fields] OR Lebanon [All Fields] OR Oman [All Fields] OR Qatar [All Fields] OR Saudi Arabia [All Fields] OR [All Fields] Afghanistan [All Fields], Armenia [All Fields] OR Azerbaijan [All Fields] OR Yemen [All Fields] OR Israel [All Fields] OR Turkey [All Fields] OR Palestine [All Fields]) Filters: from 1980/1/1 - 2020/6/30
Cochrane Library (Benzene [Title Abstract Keywords] OR Toluene [Title Abstract Keywords] OR Ethylbenzene [Title Abstract Keywords] OR Xylenes [Title Abstract Keywords] OR Styrene [Title Abstract Keywords] OR Volatile Organic compound [Title/Abstract]) AND (Occupational exposure [Title Abstract Keywords] OR Industrial exposure [Title Abstract Keywords] OR Workplace exposure [Title Abstract Keywords] OR Chemical exposure [Title Abstract Keywords]) AND (Threshold limit value [Title Abstract Keywords] OR Occupational exposure limit [Title Abstract Keywords] OR Recommended exposure level [Title Abstract Keywords] OR Permissible exposure limit [Title Abstract Keywords]) AND (West Asia [Title Abstract Keywords] OR Middle East [Title Abstract Keywords] OR Iran [Title Abstract Keywords] OR Afghanistan [Title Abstract Keywords], Armenia [Title Abstract Keywords] OR Azerbaijan [Title Abstract Keywords] OR Yemen [Title Abstract Keywords] OR Israel [Title Abstract Keywords] OR Turkey [Title Abstract Keywords] OR Arab countries [Title Abstract Keywords], Gulf Cooperation Council countries [Title Abstract Keywords]) Filters: from 1980/1/1 - 2020/6/30
CINAHL (EBSCO) (Benzene [Title/Abstract] OR Toluene [Title/Abstract] OR Ethylbenzene [Title/Abstract] OR Xylenes [Title/Abstract] OR Styrene [Title/Abstract] OR Volatile Organic compound [Title/Abstract]) AND (Occupational exposure [Title/Abstract] OR Industrial exposure [Title/Abstract] OR Workplace exposure [Title/Abstract] OR Chemical exposure [Title/Abstract]) AND (Threshold limit value [Title/Abstract] OR Occupational exposure limit [Title/Abstract] OR Recommended exposure level [Title/Abstract] OR Permissible exposure limit [Title/Abstract]) AND (West Asia [All Fields] OR Middle East [All Fields] OR Iran [All Fields] OR Iraq [All Fields] OR Kuwait [All Fields] OR Syria [All Fields] OR Jordan [All Fields] OR Bahrain [All Fields] OR Lebanon [All Fields] OR Oman [All Fields] OR Qatar [All Fields] OR Saudi Arabia [All Fields] OR [All Fields] Afghanistan [All Fields], Armenia [All Fields] OR Azerbaijan [All Fields] OR Yemen [All Fields] OR Israel [All Fields] OR Turkey [All Fields] OR Palestine [All Fields]) Filters: from 1980/1/1 - 2020/6/30
Embase TITLE-ABS-KEY (Benzene OR Toluene OR Ethylbenzene OR Xylenes OR Styrene OR Volatile Organic compound) AND TITLE-ABS-KEY (Occupational exposure OR Industrial exposure OR Workplace exposure OR Chemical exposure) AND TITLE-ABS-KEY (Threshold limit value OR TLV OR Occupational exposure limit OR OEL OR Recommended exposure level OR REL OR Permissible exposure limit OR PEL) AND TITLE-ABS-KEY (West Asia OR Middle East OR Iran OR Iraq OR Kuwait OR Syria OR Jordan OR Bahrain OR Lebanon OR Oman OR Qatar OR Saudi Arabia OR Afghanistan, Armenia OR AND Azerbaijan OR Yemen OR Israel OR Turkey OR Palestine) PUB YEAR ≥ 1980
Science direct from inception TITLE-ABS-KEY (Benzene OR Toluene OR Ethylbenzene OR Xylenes OR Styrene OR Volatile Organic compound) AND TITLE-ABS-KEY (Occupational exposure OR Industrial exposure OR Workplace exposure OR Chemical exposure) AND TITLE-ABS-KEY (Threshold limit value OR TLV OR Occupational exposure limit OR OEL OR Recommended exposure level OR REL OR Permissible exposure limit OR PEL) AND TITLE-ABS-KEY (West Asia OR Middle East OR Iran OR Iraq OR Kuwait OR Syria OR Jordan OR Bahrain OR Lebanon OR Oman OR Qatar OR Saudi Arabia OR Afghanistan, Armenia OR Azerbaijan OR Yemen OR Israel OR Turkey OR Palestine) AND PUB YEAR ≥ 1980

MESH terms in PubMed and Cochrane including: benzene, toluene, ethylbenzene, VOCs, occupational exposure, occupations, occupational groups, Asia western, oil and gas industry, threshold limit values

Study selection

First we identified 4199 references that matched our search key terms. Figure 1 shows how we proceeded until we got the final number of 49 full-text articles that met the inclusion criteria: they all had to be original articles in English reporting airborne workplace concentrations of the studied chemicals from 1980 to 2021. We excluded articles not containing original data, such as review articles, case series, and case reports. Each included article was individually assessed for completeness of reporting by two independent reviewers according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist (21).

Figure 1

Search steps to identify full-text articles about occupational exposure in West Asian countries

Both static and personal monitoring studies were included. Quality of sampling was considered sufficient if sampling pump flow rate was between 0.1 and 0.3 L/min, and in case of static monitoring if samplers were placed at the height of 1.5 to 2 m.

Data extraction

After the screening, the data were extracted and cross-checked. Any inconsistencies were resolved by consultation with a third reviewer. The following information was extracted and tabulated: bibliographic information (reference ID, authors, year published, publication type), country where study was performed, industry sector, type of sampling (static or personal monitoring), type of sampler (active/pump or passive sampling), number of exposed workers and non-exposed workers (not applicable to static monitoring), number of area samples (not applicable to personal monitoring), number of individual samples (may be more than one per worker or area), duration of sampling, gender distribution (male/ female; not applicable to static monitoring), mean and standard deviation of age (of exposed and unexposed groups, not applicable to static monitoring), means and standard deviations of BTEX and styrene concentrations across all sections of investigated workplace, and, if applicable, range of means for subsections of investigated workplace and whether the reported concentrations were recalculated to represent the eight-hour (workday) exposure scenario (where the workday was shorter than 8 h).

All reported airborne concentrations were converted to ppm, using the following equation:

ppm = m g / m 3 × 24.45 m o l e c u l a r w e i g h t $$\text{ppm} =\frac{{mg} / {m}^{3} \times 24.45}{{ molecular weight }}$$

This assumes 25 °C and air pressure of 101.325 kPa (760 Torr).

Data analysis

Descriptive results of variables are given as means and standard deviations. For all analyses we used the Statistical Package for Social Sciences (SPSS), version 22 (IBM, Armonk, NY, USA).

Evaluating compliance with an OEL requires assessment of exposure variability for an exposed group. There is also a normative aspect, that is, how certain we wish to be that exposure is unlikely to be exceeded for a small part of the exposed group and how small that group should be. Industrial hygiene guidance documents refer to 70 % certainty that no more than 5 % of similarly exposed workers would experience exposures exceeding the OEL (22, 23). We, however, approached OEL compliance in a simpler fashion, by comparing reported average exposure to the applicable OEL, as the reviewed papers do not report their results in sufficient detail. As airborne exposures are generally log-normally distributed, the arithmetic mean will be a slightly more conservative than the true central estimates of the median or geometric mean. Where reported, we also compared the full range (min–max) of reported exposure to applicable OELs.

Results
Overview of OELs

Benzene is a well-known carcinogen, although conclusions as to whether its mechanism of action supports a threshold or not differs between OEL expert groups. However, more recent assessments tend to conclude that benzene can be viewed as a threshold carcinogen, and consequently that sufficiently low exposures would protect against cancer risk. Most eight-hour time-weighted averages (TWA) for OELs are 1.6 mg/m3 (0.5 ppm) while the most recent recommendation of ECHA RAC is that of 0.16 mg/ m3 (0.05 ppm) (Table 2).

Comparison of existing OELs and DNELs of BTEX and styrene by institutions and countries

Institution or country Benzene Toluene Ethylbenzene Xylene (isomers) Styrene
mg/m3 ppm mg/m3 ppm mg/m3 ppm mg/m3 ppm mg/m3 ppm
ACGIH, USA 1.6 0.5 75.37 20 86.84 20 434.19 100 85.19 20
OSHA, USA 3.19 1 376.85 100 434.22 100 434.19 100 212.99 50
NIOSH, USA 0.32 0.1 753.7 200 434.22 100 434.19 100 425.97 100
Australia 3.19 1 188.43 50 434.22 100 347.35 80 (monomer) 212.99 (monomer) 50
Brazil - - 293.94 78 338.69 78 338.67 78 - -
Canada 1.6 0.5 75.37 20 86.84 20 434.19 100 (monomer) 149.09 (monomer) 35
Japan 3.19 1 188.43 50 86.84 20 217.1 50 85.19 20
South Korea 3.19 1
MAK, Germany - - 188.43 50 86.84 20 217.1 50 85.19 20
AGS, Germany 1.92 0.6 - - - - - - - -
Netherlands (0.19*) 0.7 (0.06*) 0.22 150.74 40 214.07 49.3 217.1 50
Poland 1.6 0.5 99.87 26.5 198.87 45.8 99.86 23 49.84 11.7
United Kingdom 3.19 1 188.43 50 434.22 100 217.1 50 425.97 100
European Union 0.32 0.1 188.43 50 434.22 100 217.1 50 - -
REACH RAC 0.16 0.05 - - - - - - - -
REACH DNELs** 0.8 0.25 192 50 77 100 221 50 85 23.5
Iran 1.6 0.5 75.37 20 86.84 20 434.19 100 85.19 20
Turkey 0.32 0.1 188.43 50 434.22 100 217.1 50 - -

* Value corresponding to the proposed tolerable cancer risk, 4:1000 (value corresponding to the proposed preliminary acceptable cancer risk, 4:10000).

** DNELs – derived no-effect levels for workers with long-term inhalation exposure submitted by registrants (available at: https://echa.europa.eu/information-on-chemicals/registered-substances); values calculated to ppm by authors. ACGIH – American Conference of Governmental Industrial Hygienists; AGS – German Committee on Hazardous Substances (Ausschuss für Gefahrstoffe); MAK – German maximum workplace concentrations; NIOSH – National Institute for Occupational Safety and Health; OSHA – Occupational Safety and Health Administration; RAC – Committee for Risk Assessment; REACH – Registration, Evaluation, Authorisation and Restriction of Chemicals

Carcinogenicity is generally not considered critical for the other substances. However, the International Agency for Research on Cancer (IARC) has classified ethylbenzene as possibly carcinogenic to humans (group 2B) and styrene as probably carcinogenic to humans (group 2A). All of the reviewed substances are potentially neurotoxic, and most of the OELs for toluene, xylene, and styrene take into account some form of neurotoxicity and irritation as critical effects. Assignment of skin notation varies: ACGIH has a skin notation only for benzene, whereas the German MAK commission and SCOEL have assigned skin notations to all BTEX substances but not to styrene. All the substances have several biological guidance values, mostly in urine.

Overview of occupational exposure to BTEX and styrene in West Asian countries

Our review of the 49 full-text articles shows that occupational exposure levels to BTEX and styrene in West Asian countries have not been measured and reported in a structured or uniform manner, and that most reports refer to Iran. Furthermore, studies investigating occupational exposure to styrene are few and far between. The summary of the extracted data is available in Table 3 (2465). Most studies address exposure in oil-related industries (such as petrochemical, oil refineries, petrol and compressed natural gas stations, and petroleum depots), while the rest looks into exposure in the shoe factories, plastic industries, pesticides production factories, printing, electronics, or steel industries or among beauty salon workers, drivers, and traffic policemen. Average occupational exposure to benzene in oil-related industries is higher than the OELs recommended in Table 2. As shown in Table 4, the mean air concentrations of toluene, ethylbenzene, xylene isomers, and styrene reported by most studies are lower than the recommended OELs for the same country (if any, see Table 2).

Summary of occupational exposure to BTEX and styrene in West Asian countries from data gathered from 49 published articles between 1999 and 2021 (mean ± SD)

References Publication type Country Type of sampling Industry or workplace Number of workers (exposed vs unexposed) Concentration (ppm) Mean ± SD
Benzene Toluene Ethylbenzene Xylene Styrene
(Alabdulhadi et al., 2019) (24) Cross-sectional Kuwait Static Printing industry - 0.0028±0.076 0.062±0.101 0.118±0.071 0.311±0.174 -
(Alfoldy et al., 2019) (25) Cross-sectional Qatar Static Traffic Petrochemical police, - 0.038±0.025 0.07±0.05 0.007±0.009 0.009±0.007 -
(Al-Harbi et al., 2020) (7) Cross-sectional Kuwait Static Gasoline station - 0.23±0.062 0.144±0.07 0.085±0.07 0.16±0.12 -
(Azari et al., 2012) (26) Cross-sectional Iran Personal Shoe factory 12 (12:0) 1.33±0.11*,# 14.24±1.77 - - -
(Baghani et al., 2018) (27) Cross-sectional Iran Static Beauty salon - 0.01±0.009 0.0045±0.0041 0.0143±0.007 0.0031 ±0.002 -
(Bagham et al., 2019) (28) Cross-sectional Iran Static Gas station & CNG - 0.145±0.045 0.231±0.053 0.113±0.031 0.209±0.016 -
(Bahrami et al., 2007) (29) Cross-sectional Iran Personal Petrol station 145 (80:65) 1.41±0.80*,# - - - -
(Bakhtian et al., 2018) (30) Cross-sectional Iran Static Taxi driver - 0.088±0.008 0.088±0.011 0.073±0.009 0.126±0.015 -
(BakoIlu et al., 2004) (31) Cross-sectional Turkey Static Incinerator Waste - 1.33±0.08*,# 0.051±0.003 0.015±0.03 0.041 ±0.08 0.0057
(Dehgham et al., 2020) (32) Cohort Iran Personal Steel factory 372 (372:0) 2.17±0.11*,# 4.08±3.25 0.32±1.39 1.38± 1.35 -
(El-Hashemy and Ali, 2018) (33) Cross-sectional Arabia Saudi Static Printing copy centre and - 0.0067±0.002 0.253±0.032 0.022±0.005 0.73±0.005 -
(Farshad et al., 2014) (34) Cross-sectional Iran Static Waste hospital disposal in - 0.57±0.1*,# 1.23±1.1 1.18± 1.2 0.58±0.6 -
(Golbabaei et al., 2018) (35) Cross-sectional Iran Personal Automobile Industry 40 (36:4) 0.96±0.05*,# 0.28±0.08 2±0.2 3.02±0.08 -
(Golkhorshidi et al., 2019) (36) Cross-sectional Iran Static Bus terminal driver: - 0.108±0.001 0.235±0.002 0.188±0.001 0.304±0.06 -
(Hadei et al., 2018) (37) Case-control Iran Static Beauty salon - 0.0034±0.002 0.0026±0.0018 0.0054±0.004 0.0043±0.006 -
(Harati et al., 2018) (38) Case-control Iran Personal Automobile Industry 80 (40:40) 0.775±0.12*,# 1.2±2.08 45.8±8.5 42.5±23.9 -
(Harati et al., 2020) (39) Cross-sectional Iran Personal Petrochemical industry 50 (50:0) 2.12±0.95*,# 9.84±2.53 - 11.87±4.44 -
(Heibati et al., 2018) (4) Cross-sectional Iran Personal transfer Petroleum station 50 (50:0) 2.7±2.91*,# 4.07±3.65 0.535±0.412 0.752±0.812 -
(Hormozi et al., 2019) (9) Case-control Iran Personal Printing industry 84 (44:40) - 37.64±24.09*,# - 105±20.05*,# -
(Hosseini et al., 2015) (40) Cross-sectional Iran Personal Tyre Factory 100 (100:0) 1.88±1.37*,# 3.2±2.79 - - -
(Jalai et al., 2017) (10) Cross-sectional Iran Personal industry Chemical & police officer 260 (185:75) 1.56±0.34*,# - - -
(Javadi et al., 2017) (41) Cross-sectional Iran Personal Petrol station 24 (24:0) 0.56±0.102*,# 0.242±0.033 0.223±0.041 0.109±0.025 -
(Karbasi et al., 2020) (42) Cross-sectional Iran Personal Oil pit worker 40 (40:0) 0.82±0.38*,# - - - -
(Maghsodi Moghadam et al., 2013) (43) Cross-sectional Iran Personal Petrochemical industry 204 (204:0) 2.0±8.3*,# 0.27±0.50 0.16±0.59 0.8±2.7 -
(Mohamadyan et al., 2019) (44) Cross-sectional Iran Personal Plastic industry 53 (53:0) - - - - 19.56±9.03
(Mohammadyan and Baharfar, 2015) (45) Cross-sectional Iran Personal Pesticide production factory 100 (100:0) - 4.7±5.5 -
(Mohammadyan et al., 2019) (46) Cross-sectional Iran Personal Electronic industry 59 (59:0) - - - - 18.68±5.68
(Moradi et al., 2019) (47) Case-control Iran Personal Beauty salon 72 (36:36) 0.015±0.019 0.31±0.36 0.017±0.021 0.055±0.051 -
(Moradpour et al., 2017) (48) Cross-sectional Iran Personal Petrochemical industry 358 (358:0) 1.08±1.46*,# 9.19±1.68 11.56±2.94 8.88±2.46 8.45±8.29
(Moshiran et al., 2021) (49) Cross-sectional Iran Personal Petrochemical industry 50 (50:0) - - - - 0.455±0.392
(Moslem et al., 2020) (50) Cross-sectional Iran Static Surgery room - 0.003±0.0005 0.002±0.0004 0.004±0.0006 0.001±0.0003 -
(Nabizadeh et al., 2020) (51) Cross-sectional Iran Static Paper recycling - 0.27±0.01 0.28±0.01 0.151±0.02 1.7±0.007 -
(Nassiri and Golbabai, 1999) (52) Cross-sectional Iran Personal Paint industry 54 (54:0) - 11.2±7.3 20.2±4.1 -
(Nazarparvar-Noshadi et al., 2021) (11) Cross-sectional Iran Personal Tyre factory 38 (38:0) 2.306±2.63*,# 8.65±7.7 0.07±0.09 0.10±0.14 0.07±0.08
(Neghab et al., 2015) (12) Cross-sectional Iran Personal Petrol station 60 (60:0) 0.25±0.083 0.39±0.071 - 0.69±0.36 -
(Omidi et al., 2019) (53) Cross-sectional Iran Personal slaughterhouse Poultry 20 (20:0) 1.34±0.75*,# 3.65±1.12 15.4±0.68 - -
(Partovi et al., 2018) (54) Cross-sectional Israel Personal Petrol station 258 (258:0) 0.41±0.18*,# - - - -
(Rahimpoor et al., 2014) (1) Cross-sectional Iran Personal Petrochemical industry 104 (104:0) 1.19±0.63*,# 1.3±4.74 - 3.2±7.94 -
(Rahimpour et al., 2018) (55) Cross-sectional Iran Personal Petrochemical and petroleum depot industry 84 (84:0) 0.657±0.791*,# 12.42±5.95 - 32.24±22.1 -
(Ramadan, 2010) (56) Cross-sectional Kuwait Static Police officer - 0.004±0.001 0.01±0.008 0.0026±0.003 0.0138±0.008 -
(Rashnuodi et al., 2021) (57) Cross-sectional Iran Personal Petrochemical industry 30 (30:0) 1.28±2.10*,# 2.62±4.50 4.45±7.35 2.41 ±1.07 -
(Rezazadeh Azari et al., 2012) (58) Case-control Iran Personal Petroleum industry depot 78 (46:32) 1.63±3.92*,# 2.72±19.33 0.46±1.61 3.53±10.84 -
(Rostami et al., 2021) (59) Cross-sectional Iran Personal Printing copy centre and 136 (136:0) 0.029±0.019 0.039±0.026 0.007±0.0038 0.006±0.003 -
(Salama et al., 2020) (60) Cross-sectional Saudi Arabia Static Petrol station - 11.7±3.1* 4.09±1.09 - 3.97±2.25 -
(Salehpour et al., 2019) (61) Cross-sectional Iran Personal Petrochemical industry 80 (40:40) 1.03±1.40*,# 5.6±13.66 - 8.19±22.20 3.48±10.75
(Sarkhosh et al., 2012) (62) Cross-sectional Iran Static Printing copy centre and - 0.0257±0.029 0.0713±0.0328 0.0083±0.056 0.0063±0.024 0.0316±0.0352
(Shanh et al., 2017) (63) Cross-sectional Iran Personal Petrochemical industry 169 (169:0) 1.25±2.28*,# 1.21±4.17 2.975±6.125 3.6±4.32 1.97±3.01
(Yaghmaien et al., 2019) (64) Cross-sectional Iran Personal Landfill plant - 0.009±0.005 0.011±0.006 0.014±0.009 0.024±0.014 -
(Zoleikha et al., 2017) (65) Cross-sectional Iran Personal Petrol station 15 (15:0) 1.28±0.447*,# 0.337±0.71 0.124±0.13 0.092±0.012 -

* above ACGIH OELs (benzene 0.5 ppm; toluene 20 ppm; ethylbenzene 20 ppm; xylene 100 ppm; styrene 20 ppm). #above national OELs. SD — standard deviation

Occupational exposure to BTEX and styrene reported for oil-related and solvent-related professions in West Asian countries (mean ± SD, where available)

Country National OELs Industry Benzene (ppm) Toluene (ppm) Ethylbenzene (ppm) Xylenes (ppm) Styrene (ppm)
Qatar No Oil-related 0.39 7.02 0.75 0.32 -
Solvent-related 0.004 0.012 0.0046 0.016 -
Kuwait No Oil-related 0.23 0.144 0.085 0.16 -
Solvent-related 0.003±0.038 0.03±0.05 0.0063±0.03 0.162±0.09 -
Iran Yes Oil-related 1.165±0.69*,# 5.87±8.18 2.28±8.93 12.104±17.7 3.588±4.52
Solvent-related 0.785±0.49*,# 4.53±4.01 4.34±5.11 10.56±12.28 9.585±3.70
Turkey Yes Oil-related 1.33*,# 0.051 0.015 0.041 0.0057
(except for styrene) Solvent-related - - - - -
Saudi No Oil-related 11.7* 4.09 - 3.97 -
Arabia Solvent-related 0.0067 0.253 0.022 0.73 -
Israel No Oil-related 0.41 - - - -
Solvent-related - - - - -

* above ACGIH OELs; # above national OELs; SD – standard deviation

Table 4 shows the analysis of reported occupational exposure to BTEX and styrene narrowed down to oil-related and solvent-related industries (such as shoe factories, printing, electronics, automobile industry, pesticide production factory, tyre factories, steel industries, chemical industry, plastic industry, and beauty salons).

Discussion

Our research shows that occupational exposure limits have been set only in Iran and Turkey, while other countries, even the oil-rich ones of the Persian Gulf, have not set or formally proposed any (Table 4).

Oil and gas industry is run by some of the largest companies in the world, many of which are based in West Asian countries (66) whose gross domestic product (GDP) and economic development significantly surpass that of other countries in the region. Highly developed industry has attracted migrant workers to the point that they make as much as 48.1 % of the total population of the Gulf Cooperation Council countries (67, 68, 69, 70). Yet, despite reports of occupational diseases among migrant workers in West Asian countries (70, 71, 72), levels of occupational exposure to BTEX and styrene are poorly reported.

OELs recommended by different organisations and countries are mostly the product of current scientific knowledge and reflect scientific judgment of those researchers who develop them and they should be reviewed periodically as this scientific knowledge grows (18, 73, 74, 75). Furthermore, it is necessary to assess and record new hypotheses, data, and methods used, as this guarantees the validity of the proposed OELs. Current scientific data and hypotheses used in regulating OELs of chemical compounds are ambiguous or completely unavailable in some countries (76, 77).

However, OEL regulations are not only evidence-based in terms of determining threshold exposure dose without adverse health effects. They also take into account economic and technical capability of the country that is to apply them (78), even though feasibility issues of achieving exposure lower than OELs should not drive decision making. Instead, industrial managers and health experts should be encouraged to lower occupational exposure below science-based limits through effective engineering control, replacement of production sore spots, administrative management control, separation, elimination, or personal protective equipment (PPE) as needed (18, 79).

Currently, however, data needed to accurately assess the risk of occupational exposure to BTEX and styrene are scarce. This information may be available to authorities and organisations in West Asian countries, which we could not access. To the best of our knowledge, in Iran, biological indicators that could help to accurately evaluate occupational exposure to BTEX and styrene during annual worker examinations are not available. Occupational exposure to chemical pollutants in any industry is not regularly monitored.

Our findings, we believe, point to a large problem with (or rather, lack of) occupational exposure and health monitoring in West Asian countries. What each country urgently needs is to identify its own weaknesses in collecting and reporting data from occupational medical surveillance, in economic and technical capabilities of their industries, and in exposure monitoring and control. In addition to respiratory exposure to BTEX and styrene, future studies should also include skin. There is also a need to study dose-response relationships and combined exposure, including alcohol and smoking. Namely, before OELs are adopted or adjusted, it is important to establish actual exposure and health effects in local workers.

Conclusion

For the time being, our results suggest that occupational exposure to benzene may present increased health risk in West Asian countries, whereas exposure to the other compounds is generally lower than the OELs given above. However, these data are random and do not provide a reliable picture of actual exposure in these countries. Given the industrial burden in each of these countries, but most particularly in those with developed oil industry, understanding the current state of exposure and adopting local OELs is crucial to protect the health of a vast number of workers.

Figure 1

Search steps to identify full-text articles about occupational exposure in West Asian countries
Search steps to identify full-text articles about occupational exposure in West Asian countries

Search strategy for articles on occupational exposure to BTEX and styrene across major literature databases (slight differences in search strings are owed to different functionality of these systems)

Web of Science (TS=(Benzene OR Toluene OR Ethylbenzene OR Xylenes OR Styrene OR Volatile Organic compound) AND TS=(Occupational exposure OR Industrial exposure OR Workplace exposure OR Chemical exposure) AND TS=(Threshold limit value OR Occupational exposure limit OR Recommended exposure level OR Permissible exposure limit) AND TS= (West Asia OR Middle east OR Iran OR Iraq OR Kuwait OR Syria OR Jordan OR Bahrain OR Lebanon OR Oman OR Qatar OR Saudi Arabia OR Afghanistan, Armenia OR Azerbaijan OR Yemen OR Israel OR Turkey OR Palestine) AND LANGUAGE: (English) Indexes=SCI-EXPANDED, SSCI, AND Time span=1980-2021
Scopus TITLE-ABS-KEY (Benzene OR Toluene OR Ethylbenzene OR Xylenes OR Styrene) AND TITLE-ABS-KEY (Occupational exposure OR Industrial exposure OR Workplace exposure OR Chemical exposure) AND TITLE-ABS-KEY (Threshold limit value OR Occupational exposure limit OR Recommended exposure level OR Permissible exposure limit) AND TITLE-ABS-KEY (West Asia OR Middle East OR Iran OR Afghanistan, Armenia OR Azerbaijan OR Yemen OR Israel OR Turkey OR Arab countries, Gulf Cooperation Council countries) AND PUBYEAR ≥ 1980
PubMed (Benzene [Title/Abstract] OR Toluene [Title/Abstract] OR Ethylbenzene [Title/Abstract] OR Xylenes [Title/Abstract] OR Styrene [Title/Abstract] OR Volatile Organic compound [Title/Abstract]) AND (Occupational exposure [Title/Abstract] OR Industrial exposure [Title/Abstract] OR Workplace exposure [Title/Abstract] OR Chemical exposure [Title/Abstract]) AND (Threshold limit value [Title/Abstract] OR Occupational exposure limit [Title/Abstract] OR Recommended exposure level [Title/Abstract] OR Permissible exposure limit [Title/Abstract]) AND (West Asia [All Fields] OR Middle East [All Fields] OR Iran [All Fields] OR Iraq [All Fields] OR Kuwait [All Fields] OR Syria [All Fields] OR Jordan [All Fields] OR Bahrain [All Fields] OR Lebanon [All Fields] OR Oman [All Fields] OR Qatar [All Fields] OR Saudi Arabia [All Fields] OR [All Fields] Afghanistan [All Fields], Armenia [All Fields] OR Azerbaijan [All Fields] OR Yemen [All Fields] OR Israel [All Fields] OR Turkey [All Fields] OR Palestine [All Fields]) Filters: from 1980/1/1 - 2020/6/30
Cochrane Library (Benzene [Title Abstract Keywords] OR Toluene [Title Abstract Keywords] OR Ethylbenzene [Title Abstract Keywords] OR Xylenes [Title Abstract Keywords] OR Styrene [Title Abstract Keywords] OR Volatile Organic compound [Title/Abstract]) AND (Occupational exposure [Title Abstract Keywords] OR Industrial exposure [Title Abstract Keywords] OR Workplace exposure [Title Abstract Keywords] OR Chemical exposure [Title Abstract Keywords]) AND (Threshold limit value [Title Abstract Keywords] OR Occupational exposure limit [Title Abstract Keywords] OR Recommended exposure level [Title Abstract Keywords] OR Permissible exposure limit [Title Abstract Keywords]) AND (West Asia [Title Abstract Keywords] OR Middle East [Title Abstract Keywords] OR Iran [Title Abstract Keywords] OR Afghanistan [Title Abstract Keywords], Armenia [Title Abstract Keywords] OR Azerbaijan [Title Abstract Keywords] OR Yemen [Title Abstract Keywords] OR Israel [Title Abstract Keywords] OR Turkey [Title Abstract Keywords] OR Arab countries [Title Abstract Keywords], Gulf Cooperation Council countries [Title Abstract Keywords]) Filters: from 1980/1/1 - 2020/6/30
CINAHL (EBSCO) (Benzene [Title/Abstract] OR Toluene [Title/Abstract] OR Ethylbenzene [Title/Abstract] OR Xylenes [Title/Abstract] OR Styrene [Title/Abstract] OR Volatile Organic compound [Title/Abstract]) AND (Occupational exposure [Title/Abstract] OR Industrial exposure [Title/Abstract] OR Workplace exposure [Title/Abstract] OR Chemical exposure [Title/Abstract]) AND (Threshold limit value [Title/Abstract] OR Occupational exposure limit [Title/Abstract] OR Recommended exposure level [Title/Abstract] OR Permissible exposure limit [Title/Abstract]) AND (West Asia [All Fields] OR Middle East [All Fields] OR Iran [All Fields] OR Iraq [All Fields] OR Kuwait [All Fields] OR Syria [All Fields] OR Jordan [All Fields] OR Bahrain [All Fields] OR Lebanon [All Fields] OR Oman [All Fields] OR Qatar [All Fields] OR Saudi Arabia [All Fields] OR [All Fields] Afghanistan [All Fields], Armenia [All Fields] OR Azerbaijan [All Fields] OR Yemen [All Fields] OR Israel [All Fields] OR Turkey [All Fields] OR Palestine [All Fields]) Filters: from 1980/1/1 - 2020/6/30
Embase TITLE-ABS-KEY (Benzene OR Toluene OR Ethylbenzene OR Xylenes OR Styrene OR Volatile Organic compound) AND TITLE-ABS-KEY (Occupational exposure OR Industrial exposure OR Workplace exposure OR Chemical exposure) AND TITLE-ABS-KEY (Threshold limit value OR TLV OR Occupational exposure limit OR OEL OR Recommended exposure level OR REL OR Permissible exposure limit OR PEL) AND TITLE-ABS-KEY (West Asia OR Middle East OR Iran OR Iraq OR Kuwait OR Syria OR Jordan OR Bahrain OR Lebanon OR Oman OR Qatar OR Saudi Arabia OR Afghanistan, Armenia OR AND Azerbaijan OR Yemen OR Israel OR Turkey OR Palestine) PUB YEAR ≥ 1980
Science direct from inception TITLE-ABS-KEY (Benzene OR Toluene OR Ethylbenzene OR Xylenes OR Styrene OR Volatile Organic compound) AND TITLE-ABS-KEY (Occupational exposure OR Industrial exposure OR Workplace exposure OR Chemical exposure) AND TITLE-ABS-KEY (Threshold limit value OR TLV OR Occupational exposure limit OR OEL OR Recommended exposure level OR REL OR Permissible exposure limit OR PEL) AND TITLE-ABS-KEY (West Asia OR Middle East OR Iran OR Iraq OR Kuwait OR Syria OR Jordan OR Bahrain OR Lebanon OR Oman OR Qatar OR Saudi Arabia OR Afghanistan, Armenia OR Azerbaijan OR Yemen OR Israel OR Turkey OR Palestine) AND PUB YEAR ≥ 1980

Occupational exposure to BTEX and styrene reported for oil-related and solvent-related professions in West Asian countries (mean ± SD, where available)

Country National OELs Industry Benzene (ppm) Toluene (ppm) Ethylbenzene (ppm) Xylenes (ppm) Styrene (ppm)
Qatar No Oil-related 0.39 7.02 0.75 0.32 -
Solvent-related 0.004 0.012 0.0046 0.016 -
Kuwait No Oil-related 0.23 0.144 0.085 0.16 -
Solvent-related 0.003±0.038 0.03±0.05 0.0063±0.03 0.162±0.09 -
Iran Yes Oil-related 1.165±0.69*,# 5.87±8.18 2.28±8.93 12.104±17.7 3.588±4.52
Solvent-related 0.785±0.49*,# 4.53±4.01 4.34±5.11 10.56±12.28 9.585±3.70
Turkey Yes Oil-related 1.33*,# 0.051 0.015 0.041 0.0057
(except for styrene) Solvent-related - - - - -
Saudi No Oil-related 11.7* 4.09 - 3.97 -
Arabia Solvent-related 0.0067 0.253 0.022 0.73 -
Israel No Oil-related 0.41 - - - -
Solvent-related - - - - -

Summary of occupational exposure to BTEX and styrene in West Asian countries from data gathered from 49 published articles between 1999 and 2021 (mean ± SD)

References Publication type Country Type of sampling Industry or workplace Number of workers (exposed vs unexposed) Concentration (ppm) Mean ± SD
Benzene Toluene Ethylbenzene Xylene Styrene
(Alabdulhadi et al., 2019) (24) Cross-sectional Kuwait Static Printing industry - 0.0028±0.076 0.062±0.101 0.118±0.071 0.311±0.174 -
(Alfoldy et al., 2019) (25) Cross-sectional Qatar Static Traffic Petrochemical police, - 0.038±0.025 0.07±0.05 0.007±0.009 0.009±0.007 -
(Al-Harbi et al., 2020) (7) Cross-sectional Kuwait Static Gasoline station - 0.23±0.062 0.144±0.07 0.085±0.07 0.16±0.12 -
(Azari et al., 2012) (26) Cross-sectional Iran Personal Shoe factory 12 (12:0) 1.33±0.11*,# 14.24±1.77 - - -
(Baghani et al., 2018) (27) Cross-sectional Iran Static Beauty salon - 0.01±0.009 0.0045±0.0041 0.0143±0.007 0.0031 ±0.002 -
(Bagham et al., 2019) (28) Cross-sectional Iran Static Gas station & CNG - 0.145±0.045 0.231±0.053 0.113±0.031 0.209±0.016 -
(Bahrami et al., 2007) (29) Cross-sectional Iran Personal Petrol station 145 (80:65) 1.41±0.80*,# - - - -
(Bakhtian et al., 2018) (30) Cross-sectional Iran Static Taxi driver - 0.088±0.008 0.088±0.011 0.073±0.009 0.126±0.015 -
(BakoIlu et al., 2004) (31) Cross-sectional Turkey Static Incinerator Waste - 1.33±0.08*,# 0.051±0.003 0.015±0.03 0.041 ±0.08 0.0057
(Dehgham et al., 2020) (32) Cohort Iran Personal Steel factory 372 (372:0) 2.17±0.11*,# 4.08±3.25 0.32±1.39 1.38± 1.35 -
(El-Hashemy and Ali, 2018) (33) Cross-sectional Arabia Saudi Static Printing copy centre and - 0.0067±0.002 0.253±0.032 0.022±0.005 0.73±0.005 -
(Farshad et al., 2014) (34) Cross-sectional Iran Static Waste hospital disposal in - 0.57±0.1*,# 1.23±1.1 1.18± 1.2 0.58±0.6 -
(Golbabaei et al., 2018) (35) Cross-sectional Iran Personal Automobile Industry 40 (36:4) 0.96±0.05*,# 0.28±0.08 2±0.2 3.02±0.08 -
(Golkhorshidi et al., 2019) (36) Cross-sectional Iran Static Bus terminal driver: - 0.108±0.001 0.235±0.002 0.188±0.001 0.304±0.06 -
(Hadei et al., 2018) (37) Case-control Iran Static Beauty salon - 0.0034±0.002 0.0026±0.0018 0.0054±0.004 0.0043±0.006 -
(Harati et al., 2018) (38) Case-control Iran Personal Automobile Industry 80 (40:40) 0.775±0.12*,# 1.2±2.08 45.8±8.5 42.5±23.9 -
(Harati et al., 2020) (39) Cross-sectional Iran Personal Petrochemical industry 50 (50:0) 2.12±0.95*,# 9.84±2.53 - 11.87±4.44 -
(Heibati et al., 2018) (4) Cross-sectional Iran Personal transfer Petroleum station 50 (50:0) 2.7±2.91*,# 4.07±3.65 0.535±0.412 0.752±0.812 -
(Hormozi et al., 2019) (9) Case-control Iran Personal Printing industry 84 (44:40) - 37.64±24.09*,# - 105±20.05*,# -
(Hosseini et al., 2015) (40) Cross-sectional Iran Personal Tyre Factory 100 (100:0) 1.88±1.37*,# 3.2±2.79 - - -
(Jalai et al., 2017) (10) Cross-sectional Iran Personal industry Chemical & police officer 260 (185:75) 1.56±0.34*,# - - -
(Javadi et al., 2017) (41) Cross-sectional Iran Personal Petrol station 24 (24:0) 0.56±0.102*,# 0.242±0.033 0.223±0.041 0.109±0.025 -
(Karbasi et al., 2020) (42) Cross-sectional Iran Personal Oil pit worker 40 (40:0) 0.82±0.38*,# - - - -
(Maghsodi Moghadam et al., 2013) (43) Cross-sectional Iran Personal Petrochemical industry 204 (204:0) 2.0±8.3*,# 0.27±0.50 0.16±0.59 0.8±2.7 -
(Mohamadyan et al., 2019) (44) Cross-sectional Iran Personal Plastic industry 53 (53:0) - - - - 19.56±9.03
(Mohammadyan and Baharfar, 2015) (45) Cross-sectional Iran Personal Pesticide production factory 100 (100:0) - 4.7±5.5 -
(Mohammadyan et al., 2019) (46) Cross-sectional Iran Personal Electronic industry 59 (59:0) - - - - 18.68±5.68
(Moradi et al., 2019) (47) Case-control Iran Personal Beauty salon 72 (36:36) 0.015±0.019 0.31±0.36 0.017±0.021 0.055±0.051 -
(Moradpour et al., 2017) (48) Cross-sectional Iran Personal Petrochemical industry 358 (358:0) 1.08±1.46*,# 9.19±1.68 11.56±2.94 8.88±2.46 8.45±8.29
(Moshiran et al., 2021) (49) Cross-sectional Iran Personal Petrochemical industry 50 (50:0) - - - - 0.455±0.392
(Moslem et al., 2020) (50) Cross-sectional Iran Static Surgery room - 0.003±0.0005 0.002±0.0004 0.004±0.0006 0.001±0.0003 -
(Nabizadeh et al., 2020) (51) Cross-sectional Iran Static Paper recycling - 0.27±0.01 0.28±0.01 0.151±0.02 1.7±0.007 -
(Nassiri and Golbabai, 1999) (52) Cross-sectional Iran Personal Paint industry 54 (54:0) - 11.2±7.3 20.2±4.1 -
(Nazarparvar-Noshadi et al., 2021) (11) Cross-sectional Iran Personal Tyre factory 38 (38:0) 2.306±2.63*,# 8.65±7.7 0.07±0.09 0.10±0.14 0.07±0.08
(Neghab et al., 2015) (12) Cross-sectional Iran Personal Petrol station 60 (60:0) 0.25±0.083 0.39±0.071 - 0.69±0.36 -
(Omidi et al., 2019) (53) Cross-sectional Iran Personal slaughterhouse Poultry 20 (20:0) 1.34±0.75*,# 3.65±1.12 15.4±0.68 - -
(Partovi et al., 2018) (54) Cross-sectional Israel Personal Petrol station 258 (258:0) 0.41±0.18*,# - - - -
(Rahimpoor et al., 2014) (1) Cross-sectional Iran Personal Petrochemical industry 104 (104:0) 1.19±0.63*,# 1.3±4.74 - 3.2±7.94 -
(Rahimpour et al., 2018) (55) Cross-sectional Iran Personal Petrochemical and petroleum depot industry 84 (84:0) 0.657±0.791*,# 12.42±5.95 - 32.24±22.1 -
(Ramadan, 2010) (56) Cross-sectional Kuwait Static Police officer - 0.004±0.001 0.01±0.008 0.0026±0.003 0.0138±0.008 -
(Rashnuodi et al., 2021) (57) Cross-sectional Iran Personal Petrochemical industry 30 (30:0) 1.28±2.10*,# 2.62±4.50 4.45±7.35 2.41 ±1.07 -
(Rezazadeh Azari et al., 2012) (58) Case-control Iran Personal Petroleum industry depot 78 (46:32) 1.63±3.92*,# 2.72±19.33 0.46±1.61 3.53±10.84 -
(Rostami et al., 2021) (59) Cross-sectional Iran Personal Printing copy centre and 136 (136:0) 0.029±0.019 0.039±0.026 0.007±0.0038 0.006±0.003 -
(Salama et al., 2020) (60) Cross-sectional Saudi Arabia Static Petrol station - 11.7±3.1* 4.09±1.09 - 3.97±2.25 -
(Salehpour et al., 2019) (61) Cross-sectional Iran Personal Petrochemical industry 80 (40:40) 1.03±1.40*,# 5.6±13.66 - 8.19±22.20 3.48±10.75
(Sarkhosh et al., 2012) (62) Cross-sectional Iran Static Printing copy centre and - 0.0257±0.029 0.0713±0.0328 0.0083±0.056 0.0063±0.024 0.0316±0.0352
(Shanh et al., 2017) (63) Cross-sectional Iran Personal Petrochemical industry 169 (169:0) 1.25±2.28*,# 1.21±4.17 2.975±6.125 3.6±4.32 1.97±3.01
(Yaghmaien et al., 2019) (64) Cross-sectional Iran Personal Landfill plant - 0.009±0.005 0.011±0.006 0.014±0.009 0.024±0.014 -
(Zoleikha et al., 2017) (65) Cross-sectional Iran Personal Petrol station 15 (15:0) 1.28±0.447*,# 0.337±0.71 0.124±0.13 0.092±0.012 -

Comparison of existing OELs and DNELs of BTEX and styrene by institutions and countries

Institution or country Benzene Toluene Ethylbenzene Xylene (isomers) Styrene
mg/m3 ppm mg/m3 ppm mg/m3 ppm mg/m3 ppm mg/m3 ppm
ACGIH, USA 1.6 0.5 75.37 20 86.84 20 434.19 100 85.19 20
OSHA, USA 3.19 1 376.85 100 434.22 100 434.19 100 212.99 50
NIOSH, USA 0.32 0.1 753.7 200 434.22 100 434.19 100 425.97 100
Australia 3.19 1 188.43 50 434.22 100 347.35 80 (monomer) 212.99 (monomer) 50
Brazil - - 293.94 78 338.69 78 338.67 78 - -
Canada 1.6 0.5 75.37 20 86.84 20 434.19 100 (monomer) 149.09 (monomer) 35
Japan 3.19 1 188.43 50 86.84 20 217.1 50 85.19 20
South Korea 3.19 1
MAK, Germany - - 188.43 50 86.84 20 217.1 50 85.19 20
AGS, Germany 1.92 0.6 - - - - - - - -
Netherlands (0.19*) 0.7 (0.06*) 0.22 150.74 40 214.07 49.3 217.1 50
Poland 1.6 0.5 99.87 26.5 198.87 45.8 99.86 23 49.84 11.7
United Kingdom 3.19 1 188.43 50 434.22 100 217.1 50 425.97 100
European Union 0.32 0.1 188.43 50 434.22 100 217.1 50 - -
REACH RAC 0.16 0.05 - - - - - - - -
REACH DNELs** 0.8 0.25 192 50 77 100 221 50 85 23.5
Iran 1.6 0.5 75.37 20 86.84 20 434.19 100 85.19 20
Turkey 0.32 0.1 188.43 50 434.22 100 217.1 50 - -

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