Abstract The health effects of styrene have been extensively investigated during the past 40 years. Acute exposure to styrene is lethal only at high concentrations (inhalation LC50s range from 2,700 to 6,000 ppm; oral LD50s from 316 to 5,000 mg/kg). Styrene is no more than moderately irritating to skin on a single exposure, but repeated exposures can cause defatting and dermatitis. Eye irritation is produced by contact with liquid styrene or by prolonged exposure to styrene vapour concentrations of approximately 100 ppm. Similarly, styrene vapours produce nasal irritation. A styrene vapour concentration of 160 ppm caused a 50% decrease in the respiratory rate in mice, an indication of sensory irritation. Because of the irritant nature of styrene vapour this must be included in any criteria for establishing the occupational exposure limit. Styrene is well absorbed by all routes of exposure and once absorbed is distributed throughout the body, especially concentrating in the fat. Styrene is cleared relatively rapidly from the body, and at low doses there is no tendency towards bioaccumulation in any organ or tissue. Studies examining the potential for specific organic toxicities in humans were negative for the haematopoietic system, immune system, kidney, urinary tract, gastrointestinal tract, liver, cardiovacscular and respiratory systems and the endocrine organs (WHO, 1983). Slight effects on the respiratory tract have been noted in some studies although the major responses have been noted on the central nervous system. High styrene exposure concentrations can cause acute, transient effects on the central nervous system. Pre-narcotic symptoms (headache, dizziness, nausea) and feelings such as fatigue and tiredness occur at exposure concentrations of 100 ppm or greater. Exposure to 1 00 ppm or greater may result in mild sensory impairment (5-10%) in the peripheral nerves, measured by nerve conduction velocity or sensory amplitude. Some reduction may be observed already between 50 and 100 ppm. There is no evidence of any permanent or irreversible effects that persist after exposures have been discontinued and styrene and its metabolites have been cleared. Based on the available data the effect of styrene on the CNS is an important factor in establishing an occupational exposure limit. Styrene is metabolised mostly through epoxidation of the vinyl side chain, forming styrene-7,8- epoxide (SO). Once formed, SO is either conjugated with glutathione or converted to styrene glycol, which is further metabolised to mandelic acid, phenylglyoxylic acid, benzoic acid, and/or hippuric acid which are excreted in the urine. Formation and excretion of styrene metabolises is species specific and influenced by many environmental and lifestyle factors; therefore, measurement of urinary metabolises gives an unreliable estimation of styrene exposure. Recent studies show that mice have the greatest capacity and humans the least to form SO from styrene. In addition, human liver is more effective at hydrolysing low levels of SO formed from styrene. Consequently, at any given styrene exposure concentration, SO levels in humans will be lower than in rodents. Studies indicate that styrene is not a teratogen. Some studies report embryotoxic or foetotoxic effects, but only at doses toxic to the parents. Initial human studies suggested an association between styrene exposure, congenital CNS malformation and spontaneous abortion. These assertions have been disproved by the same authors in more complete follow-up studies. Overall, there is no evidence that styrene exerts specific developmental or reproductive toxicity. Scott and Preston (1994) reported that 18 of 52 cytogenetic studies (chromosomal aberrations, micronuclei, sister chromatid exchanges) on peripheral blood lymphocytes of workers in industries in which there is exposure to styrene have reported significant increases in chromosome damage compared with non-exposed controls. The remaining investigations reported negative results. The data suggesting a positive association of clastogenic effects with styrene exposure are however very far from demonstrating convincingly that styrene produces chromosomal damage in exposed individuals. Reason for this include: (i) many of the studies are based on extremely small numbers of cases; (ii) the only two reports involving relatively large numbers have shown no association between styrene exposure and clastogenic effects e.g. the most recent data from an extensive EEC supported biomonitoring program showed that styrene exposure concentrations in the range of 5 to 182 ppm did not result in chromosome damage; (iii) a number of studies report relatively high levels of clastogenic effects which are implausibly high bearing in mind the rest of the published data; (iv) notwithstanding the large number of studies there is no quantitative relationship between styrene exposure and chromosomal damage; the lack of a dose-effect relationship in such a large group of data is a major confounder for accepting causality between styrene exposure and clastogenic effects. Support for the proposition that styrene is not responsible for the clastogenic effects reported in workers can be found in the in vivo animal data. An examination of the results show that studies in which exposures have been much higher than those encountered in the workplace the results have been overwhelmingly negative. A recent study conducted under the auspices of the US-EPA (Kligerman et al, 1992 and 1993) and CIIT (Preston 1993) showed that mice and rats exposed to styrene concentrations up to 500 ppm for two wk and rats exposed to 1,000 ppm for 4 wk showed no evidence of an increase in micronuclei or chromosomal aberrations. It is well possible that styrene exposure is not responsible for the observed chromosomal changes. Other factors which could be responsible for the results including co-exposure to other chemicals, cigarette smoking, life style etc; confounding factors that could not be excluded in the studies reported (Scott, 1993). Styrene is not a direct-acting mutagen in in vitro bacterial and eukaryotic cell assay systems. With activation, styrene is either non-mutagenic or very weakly mutagenic. Macromoiecular binding studies have shown that styrene and styrene oxide have very low potential to react with haemoglobin or DNA. Because of the many inconsistencies and imponderables associated with the available mutagenic and cytogenetic data it is probably inappropriate to use such information to reach a health based decision on a suitable occupational exposure limit. The available animal and human data do not indicate that styrene is a carcinogen and it should not be classified as such. A total of nine long-term bioassays have been conducted on styrene, and two additional studies have been performed using a mixture of styrene and beta-nitrostyrene. Some of these studies have specific deficiencies and limitations that preclude definitive conclusions. The available data provide no evidence of a carcinogenic response related to styrene exposure. Additional long-term animal studies are currently in progress. Although there have been some epidemiological studies which suggest there may be an association between styrene exposure and an increased risk of leukaemia and lymphoma the evidence is generally weak. The majority of the studies show no evidence for a causal relationship between styrene exposure and leukaemia and any other form of cancer. The combined weight of evidence of these epidemiological studies, including nearly 50,000 workers in the time period 1940 to 1986, argues against a carcinogenic role for styrene. This conclusion is supported by a study conducted by the International Agency for Research on Cancer (Kogevinas et al, 1993) involving over 40,000 workers from the European reinforced plastics industry and an update of the American reinforced plastics industry which included approximately 16,000 workers (Wong, 1994). While the body of evidence from both of these large studies is quite complex the overall result is not supporting the causal link between styrene and cancer, including the occurrence of tumours of the lymphatic and haematopoietic tissues.