Evaluation of Erythrocyte Sedimentation Rate (ESR) of Motorcycle Workshop Worker Exposed to Benzene

Received: September 9, 2019 Revised: October 7, 2019 Accepted: October 12, 2019 Abstract Occupational exposure to benzene from fuel oil in workshop motorcycle workshop causes several health effects, depending upon the level and duration of exposure. Analysis of blood is important to access the status of worker’ health. The study aimed to assess the gather basic information required for protecting workers’ health and improve working conditions in the works sites by investigating the ESR levels. A comparative cross-sectional study conducted in Surabaya City, East Java-Indonesia, which involved 100 workers. The occupational data collected using a structured questionnaire while blood analysis parameters measured with an automated hematology analyzer. The result showed that leukocytes, erythrocytes, hemoglobin (HGB), hematocrit values (HCT), platelet, MCV, RDW, eosinophil, basophils, neutrophil rods, neutrophil segment, lymphocyte, monocytes were in normal value. Whereas, MCH, MCHC, ESR has shown in abnormal value as average 24.5 pg, 29.18 g/dL and 8.21 mm/h, respectively. Those value, especially in ESR value indicated the increasing concentration plasma viscosity. This is may cause by inflammation in the workers’ body. To prevent the hazardous effect of benzene exposure, occupational health should be implemented for workers in order to protect them from exposure to benzene.


INTRODUCTION
. Workers in sites exposure to benzene are more risk in occupational health (1,3

Study design
A comparative cross-sectional study of workers conducted at a workshop motorcycle workshop. The study subject involved 100 occupationally workshop motorcycle workers exposed to fuel oil. All worker require hematological parameters evaluation, especially in ESR levels. All workers were asked to give informed consent.

Data collection
Demographic and occupational data were collected using a structured questionnaire,

Data processing and analysis
All the data were cleaned, double entered into Microsoft Excel spreadsheets and analyzed using Stata software version 13 (StataCorp, College Station, TX, USA).

Ethical considerations
The proposal in this study was approved

General characteristics
Personal characteristics of the workshop motorcycle workers are presented in Table 1 They were comparable with regard to age and sex. 91% of workers were males. The average age of the workers was 28 years. Protective measures were poorly followed during work in workshop.  Based on this study, the possible routes of chemical entry into the body trough inhalation. It has shown in Figure 1 that the workers did not wear a mask during workpractice

DISCUSSION
The results presented here are based on the study in workshop motorcycle worker to evaluate the ESR value during benzene exposure in their worksites. Workshop motorcycle workers are exposed to different chemicals of fuel oil in their workshop.
Studies have found that they can be exposed to numerous types of heavy metals Duc as lead, chromium, and cadmium, including carcinogens such as benzena (1,9). Benzene was induced poisoning occurs almost entirely by inhalation of benzene vapors in the air.
Workshop motorcycle workers in our study exposed to benzene showed mean RBCs (average value is 5.07 10 6 /mm 3  It leads to plasma viscosity increased and red blood cell start to aggregate (10,11).
We assumed that raised ESR is observed in workshop motorcycle workers caused by benzene in fuel oil exposure. It is well known that benzene causes haematological toxins, such as aplastic anemia and leukemia. Recent studies demonstrated that low-level of benzene exposure (<1 ppm) has potential in hepatotoxicity (12).
Benzene is slightly soluble in water.
Hence, this is easy to circulating blood enters the tissue and fat tissue. The primary route of benzene exposure is entering the body from inhalation (13). This is caused by benzena which is very easy to evaporate into the air very quickly. Benzene will enter into the bloodstream, and travel into the entire organ.
In temporally, benzene can be stored in the bone marrow and fat. The metabolism benzene includes in oxidations of the benzene rings by cytochrome P450 monooxygenase.
This enzyme is primarily produced in liver cells. Therefore, accumulation of benzene in long periodic could affect liver function.
Normally, benzene is degraded into phenol (14). Further, phenol is absorbed into the blood and distributed to other tissue. This study has some limitations. We evaluated the hematological parameters, namely ESR in workshop motorcycle workers exposed to fuel oil. We did not measure the specific chemicals to which the workshop motorcycle workers were exposed.
It would be better to explore the effect of types of occupational chemical exposure on health in future studies.

CONCLUSIONS
Benzene contamination in the air may cause reduced MCH and MCHC level and ESR. It was possible that the workers' exposure to benzene in fuel oil during work.
The advice that can be given in this research is to reduce benzene exposure should install exhaust ventilation and workers using personal protective equipment such as gas masks and gloves.

ACKNOWLADGEMENTS
We would like to acknowledge all the workshop motorcycle workers who were willing to be respondents in this study.