Chronic lymphatic leukaemia in a worker with a long-term occupational exposure to petroleum product mixtures: a case report

Abstract

Following a regular occupational health checkup, a 63-year-old worker employed at petrol station for thirty years was diagnosed with chronic lymphocytic leukaemia (CLL). The patient’s occupational history revealed long-term daily exposure to petroleum-derived vapours. As part of a routine occupational health assessment, he underwent comprehensive laboratory testing, followed by further evaluation and treatment by a haematologist, including a myelogram, immunophenotyping of haemoblastosis, and bone marrow histopathology. Based on the completed diagnostic workup, the patient was diagnosed CLL with B-cell predominance. Due to the nature of the disease and job demands, the worker was declared permanently unfit for work at his current workplace. The diagnosis was recognised as an occupational disease by the Croatian Health Insurance Fund thanks to the expert opinion, issued by the occupational health specialist, who, after an extensive toxicological assessment and the exclusion of other possible causes, linked 30 years of occupational inhalation exposure to petroleum products containing benzene with the onset of this malignant disease. This case highlights systemic shortcomings in the assessment of occupational exposure to mixtures of petroleum products, inhalation of vapours, and potential dermal contact among petrol station workers, deficiencies in occupational safety measures, and the crucial role of occupational medicine specialists in the prevention, early detection, and risk management before disease progression, as well as in supporting the legal and occupational rights of affected workers.