US EPA

1390864 

Technical Report 

Hematologic Disorders 

Jandl, JH 

1983 

NIOSH/00154101 

Recognizing and Preventing Work 

357-371 

Recognition and prevention of occupational hematologic disorders are discussed. The majority of hemolytic anemias are induced by occupational exposure to substituted benzene (71432) derivatives and other compounds possessing resonating ring structures. Glucose-6-phosphate-dehydrogenase (G6PD) deficient individuals are highly susceptible to certain compounds, mostly the chemical end products whose starting reagents are coal-tar (8007452) derivatives or synthetic benzene compounds. Such individuals can develop Heinz body hemolytic anemia at a rate of exposure several degrees lower than normal individuals. The sequence ending in Heinz body anemia is described. Hemolysis is primarily prevented by minimizing all atmospheric and cutaneous exposure to coal-tar products and derivatives, with preplacement testing for G6PD deficiency, which is done if exposure represents a significant risk. Screening procedures are enumerated. Hemolytic anemia caused by heavy metal exposure is examined. Consequences of arsine (7784421) poisoning and chronic and acute lead (7439921) toxicity are discussed. Treatment for arsine poisoning includes hydration, exchange transfusion when necessary, and monitoring. All industrial processes involving arsenic should be segregated from procedures involving open use of other metals. Chronic hemolysis develops with chronic hematologic toxicity. Typical changes in workers overexposed to lead include hypochromic, microcytic red cells, increased punctate basophilic stippling, reticulocytosis, and decreased osmotic fragility. Chronic lead poisoning is one of the causes of sideroblastic anemia. Screening tests for lead poisoning are summarized. Occupational aplastic anemia and leukemia and their relationship to benzene are examined. Only a few of the non lymphatic leukemia cases are traced to benzene, but periodic hematologic screening tests should be mandatory in working populations exposed to increased atmospheric benzene concentrations. 

DCN-139912; Accidents; Hazards; Safety monitoring; Work performance; Industrial exposures; Industrial environment; Safety education; Occupational hazards; Toxicology