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Abstract
Previous epidemiology reviews of exposure to styrene and the risk of cancer considered studies published through 13 November 2013. Since then, additional relevant research has been published. No review has included meta-analyses. The current systematic review considered research published through June 2017; included meta-analyses of the relationship between any exposure to styrene and cancers identified as being of concern, including non-Hodgkin lymphoma (NHL), leukemia and cancers of the esophagus, pancreas, lung and kidney; and evaluated several other forms of cancer. Meta-relative risks for all studies were 1.14 (95% confidence interval (CI), 0.91–1.43) for NHL, 1.00 (95% CI, 0.80–1.26) for multiple myeloma, 0.98 (95% CI, 0.87–1.09) for all leukemia, 1.03 (95% CI, 0.92–1.15) for esophageal cancer, 1.02 (95% CI, 0.93–1.12) for pancreatic cancer, 1.09 (95% CI, 0.95–1.24) for lung cancer and 1.10 (95% CI, 0.99–1.22) for kidney cancer. Individual studies provided little evidence of exposure-response or induction time trends. Limitations of the available research and of the meta-analyses included reliance in most studies on mortality data rather than on incidence data, lack of quantitative estimates of styrene exposure for individual subjects and lack of information on lifestyle factors. Consideration of all pertinent data, including substantial recent research, indicates that the epidemiologic evidence on the potential carcinogenicity of styrene is inconclusive and does not establish that styrene causes any form of cancer in humans.
Acknowledgements
The authors gratefully acknowledge the insightful comments provided by reviewers selected by the Editor anonymous to the authors. These comments were very useful in revising the paper. The authors also thank Dr. Nalini Sathiakumar for providing supplementary data from the recent study of North American synthetic rubber industry workers.
Declaration of interest
In accordance with Taylor and Francis policy and ethical obligations as an epidemiologist, Dr. Collins reports that he received funding from the Styrene Research and Information Center, https://styrene.org/, a group with company members that may be affected by the research reported in the enclosed paper. Further, he worked as an epidemiologist until 2014 for the Dow Chemical Company, a company with interest in styrene. In his capacity, he was deposed several times for litigation against Dow for several chemical exposures but not styrene. Since 2014, he has been employed by Saginaw Valley State University in Michigan and has provided consulting for several companies and industry groups. He has not appeared or filed written comments in any regulatory proceedings in the past 5 years related to the contents of the paper. He did this work as an independent consultant.
Dr. Delzell currently is employed by Exponent, https://www.exponent.com/, a company that has provided consulting services on styrene-related issues. Exponent is a multi-disciplinary engineering and consulting firm. Her work on this review was supported by an agreement between Exponent and the Styrene Information and Research Center. Other relevant work for Exponent is an expert report prepared for a company that was a defendant in litigation pertaining to lung cancer and purported exposure to styrene in June 2014. Dr. Delzell is an unpaid collaborator on research to investigate mortality patterns among North American synthetic rubber manufacturing workers. That research is being done by the University of Alabama at Birmingham and is supported by a grant from the International Institute of Synthetic Rubber Producers and the American Chemical Council. She has not appeared or filed written comments in any regulatory proceedings in the past 5 years related to the contents of the paper.
Scientists from member companies of the Styrene Research and Information Center were given the opportunity to review the draft of original paper for technical accuracy. The conclusions drawn in this paper are the professional opinions of the authors and do not necessarily represent the views of the member companies of the Styrene Research and Information Center.
Supplementary material
Supplemental data for this article can be accessed here.
