Tesis

Association of Benzene Exposure and Myeloproliferative Neoplasm in Oil and Gas Worker: An Evidence-Based Case Report.

Background: A 48-years old male, oil and gas worker was diagnosed with myelofibrosis, part of myeloproliferative neoplasm. The patient worked as an operator for 15 years, where one of the hazards was low level of benzene exposure. Hence, this case report is aimed to find the association of benzene exposure with myeloproliferative neoplasm in oil and gas worker. Method: The following is PICO analysis to formulate clinical question from this case report; Population: worker, intervention/exposure: benzene, comparison: not exposed to benzene, outcomes: myeloproliferative neoplasm. Literature searching strategies for answering the clinical question used electronic database in PubMed, Google Scholar, and list of references. The inclusion criteria is etiologic research study, while the exclusion criteria are chronic myeloid leukaemia and essential thrombocythemia. The selected papers were then critically appraised to determine whether the article is valid, meaningful, and applicable to the patient using relevant criteria bye the Oxford Centre for Evidence-based Medicine for etiological study. Result: Finally, one study was selected; a case control study by Glass et al, 2014 (n=30 cases with n=124 matched controls), the outcome of this study was OR of 1.57 (95% CI 0.55-2.78) for cumulative benzene exposure, p 0.49 and OR of 4.4 (95% CI 1.29-15) for a 2-20 years benzene exposure, p 0.018. After a critical appraisal, it was found that this article was valid, the study has high quality and precise benzene exposure metrics based on exposure of individual job. However, there were potential limitations on confounders data such as not available data on smoking habit, alcohol use, radiation exposure and/or genetic susceptibility. Conclusion: Based on the case analysis through 7 (seven) steps of occupational disease diagnosis and journal critical appraisal, it can be concluded that the myelofibrosis may be related to exposure to benzene at the workplace.
Keyword: benzene, myelofibrosis, myeloproliferative neoplasm, worker