Application of Bethesda terminology to categorize buccal epithelial smears among petroleum station workers in Taif city, KSA


  • Basem Hassan Elesawy Pathology department, faculty of medicine, Mansoura University, Egypt. Medical Laboratory Department, Faculty of Applied Medical Sciences, Taif University, KSA.
  • Amal Abd El hafez Pathology department, faculty of medicine, Mansoura University, Egypt.Basic Medical Sciences Department, College of Medicine, Al-farabi Colleges, Riyadh, KSA.
  • Abdelaty Shawky Mohamed Pathology Department, Faculty of Medicine, Mansoura University, Egypt.Al Maarefa College for Science and Technology, Riyadh, KSA.
  • Magdi Mansour A. Salih Department of Histopathology and Cytology, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan. Medical Laboratory Department, Faculty of Applied Medical Sciences, Taif University, KSA.





Benzene, Bethesda System Terminology, Buccal Mucosa, Carcinogenic, Smear.


Background and Objectives: Exposure to Petroleum products has a well-established mutagenicity and carcinogenicity of some compo-nents such as benzene. Buccal mucosal cells are capable of metabolizing the carcinogenic compounds to reactive chemicals. We investigated the buccal epithelial cell cytological changes resulting from the occupational exposure to Petroleum derivatives such as benzene.

Methods: Samples were obtained from 70 Petrol station workers in Taif city-KSA, examined using the Papanicolaou stained smears and categorized based on Bethesda Terminology System. Statistical analysis was carried out with the SPSS.

Results: About 38.6% of petrol station workers exhibited buccal cytological changes ranging from atypical squamous cells of undetermined significance (ASC-US) to high-grade squamous intraepithelial lesions (HSIL). Atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) was the most frequent cytological abnormality. Buccal smears with abnormal cytological findings dominated among smokers in contrast to non-smokers with a statistically significant difference (P = 0.026). No significant associations were detected between the category of buccal cytological changes and the duration of work or the participant's age.

Conclusion: Bethesda Terminology System can be efficiently applied to buccal smears. Petrol products induce precancerous epithelial changes in buccal epithelial cells indicating a potential health risk for Petrol station workers, thus annual checkup for those workers should be set as primary prevention of occupational-related cancer. Cigarette smoke is a co-factor that exacerbates the effects of Petrol derivatives.

Author Biography

Amal Abd El hafez, Pathology department, faculty of medicine, Mansoura University, Egypt.Basic Medical Sciences Department, College of Medicine, Al-farabi Colleges, Riyadh, KSA.


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