The aim of the study was to establish a correlation between biomarkers of exposure and cytogenetic test results in workers occupationally exposed to benzene and toluene, with special reference to confounding factors influencing the outcome of the cytogenetic test. The incidence of structural chromosome aberrations and sister chromatid exchanges was studied in the peripheral blood lymphocytes cell genome of 49 female shoe-makers, mean age 38 years, mean length of occupational exposure 17 years and in a group of 27 well-matched controls. Workers were exposed to concentrations of benzene up to 15ppm and of toluene up to 50ppm. The presence of benzene and toluene in the workers' blood samples, and the presence of phenol in pre-and post-shift urine were considered proof of occupational exposure. Chromosomal aberration analysis revealed a significant increase in dicentric incidence in the exposed group compared to the controls (P=0.004). However, significant correlation between cytogenetic test results and the exposure biomarkers was not established. On the contrary, correlation between the cytogenetic test results and data on confounding factors (e.g. age and alcohol consumption), was marked. The major point raised by this study is the influence of confounding factors on the cytogenetic test outcome. This imposes the need for caution in the interpretation of cytogenetic test results, and ultimately in the estimation of individual genotoxicity risk related to low level benzene exposure.