The health gains of maintaining a benzene threshold value in air in Germany below the European Union limit

• Published in: The Lancet (British edition) 2013-06, Vol.381 (S2), p.S138-S138
• Main Authors: Steckling, Nadine, MSc, Mekel, Odile, PhD, Tobollik, Myriam, BSc, McCall, Timothy, MSc, Terschüren, Claudia, PhD, Samson, Reinhard, Classen, Thomas, PhD, Hornberg, Claudia, Prof
• Format: Article
• Language: English
• Subjects: air; Benzene; carcinogens; disability-adjusted life year; dose response; Environmental effects; Environmental protection; Environmental stress; European Union; Internal Medicine; Leukemia; natural resources conservation; Nature conservation; Nuclear accidents & safety; Public health; risk; Risk assessment; Studies; traffic; uncertainty; uncertainty analysis
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(13)61392-6

Abstract Background Despite extensive regulations, the carcinogen benzene remains of high environmental and public health relevance. Benzene in ambient air is regulated by European Union (EU) directive 2008/50/EC (5 μg/m3 ). The current mean annual concentration in Germany meets the requirements, maintaining a value below the limit. The VegAS project (long title: Distribution-based analysis of the health effect of environmental stressors) estimated the burden of leukaemia due to benzene as well as health gains achieved by maintaining a lower benzene concentration than directed by the EU limit. Methods The environmental burden of disease approach was used to quantify disability-adjusted life-years (DALYs) of leukaemia attributable to the current benzene concentrations in indoors and ambient air in Germany. Evidence-based exposure–response relations were considered and we consulted national data sources for health and exposure information. We conducted uncertainty analyses for a range of uncertain parameters. A “what if” analysis using a hypothetical concentration of 5μg/m3 of benzene was used to estimate the health gains made from maintaining a mean benzene exposure lower than the EU limit. Findings From the total 103 322 DALYs presently lost due to leukaemia in Germany, an estimated 181 DALYs (0·22 DALYs per 100 000 population) are attributable to airborne benzene at a mean background exposure concentration of 1·83 μg/m3 . Varying alternative exposure–response relations yielded the widest range of uncertainty (2–341 DALYs). Assuming a benzene concentration of 5μg/m3 in indoor and ambient air yielded 484 DALYs. Consequently, health gains of 303 DALYs are expected to be attributable to maintaining a mean level significantly lower than 5μg/m3. Interpretation This analysis focused on a public health view of background benzene exposure. Keeping the current benzene concentration on average below 5μg/m3 lowered the leukaemia burden from benzene by nearly a third. This analysis did not consider peak exposures (eg, traffic) and the potentially higher risks of individuals (eg, smokers). Health gain analyses are vital for stimulating health-related environmental protection. Funding The VegAS project was funded by the Federal Ministry of Environment, Nature Conservation, and Nuclear Safety in the context of the Environment Research Plan 2009. The corresponding author had full access to all the data in the study and final responsibility for the decision to submit for p