Risk of leukemia in relation to exposure to ambient air toxics in pregnancy and early childhood |
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| Institution: | 1. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA;2. Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA;3. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA;1. Department of Pediatrics, HC Andersen Children''s Hospital, Odense University Hospital, Denmark;2. International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Lyngby, Denmark;3. Environmental and Occupational Health Sciences Institute, Rutgers University, NJ, United States;4. IVL Swedish Environmental Research Institute, Göteborg, Sweden;5. SP Technical Research Institute of Sweden, Borås, Sweden;6. Department of Environmental and Occupational Medicine, University of Aarhus, Denmark;7. Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark;1. Department of Health Sciences, University of Genoa, Italy;2. Mutagenesis Unit, IRCCS University Hospital San Martino – IST National Research Cancer Institute, Genoa, Italy;1. Public Health Services, Ministry of Health, Israel;2. Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine of the University Erlangen-Nuremberg, Germany;3. Ben Gurion University of the Negev, Israel;4. Braun School of Public Health, Hebrew University-Hadassah, Israel;5. Bar Ilan University, Israel;6. Israel Center for Disease Control, Ministry of Health, Israel;1. Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS);2. Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional;3. Servicio de Hematología Pediátrica, Hospital General “Gaudencio González Garza”, CMN “La Raza”, IMSS;4. Servicio de Cirugía Pediátrica, Hospital General “Gaudencio González Garza”, CMN “La Raza”, IMSS;5. Departamento de Hemato-Oncología, Hospital Infantil de México Federico Gómez, Secretaria de Salud (SSa);6. Servicio de Hematología Pediátrica, Hospital General Regional (HGR) No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” IMSS;7. Servicio de Hematología, UMAE Hospital de Pediatría, CMN “Siglo XXI”, IMSS;8. Hospital Pediátrico de Iztacalco, SEDESA;9. Servicio de Hematología, Instituto Nacional de Pediatría (INP), SSa;10. Hospital Pediátrico de Iztapalapa, SEDESA;11. Servicio de Onco-Pediatría, Hospital Juárez de México, SSa;12. Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología “Dr. Daniel Méndez Hernández”, CMN “La Raza”, IMSS;13. Laboratorio de Biología Molecular, UMAE, Hospital de Pediatría, CMN “Siglo XXI”, IMSS;14. Coordinación de Investigación en Salud, CMN “Siglo XXI”, IMSS;15. Mexican Inter-Institutional Group for the Identification of the Causes of Childhood Leukaemia, Instituto Mexicano del Seguro Social, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado, Secretaría de Salud, Secretaría de Salud del Gobierno del Distrito Federal, Mexico City, México |
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| Abstract: | There are few established causes of leukemia, the most common type of cancer in children. Studies in adults suggest a role for specific environmental agents, but little is known about any effect from exposures in pregnancy to toxics in ambient air. In our case–control study, we ascertained 69 cases of acute lymphoblastic leukemia (ALL) and 46 cases of acute myeloid leukemia (AML) from California Cancer Registry records of children <age 6, and 19,209 controls from California birth records within 2 km (1.3 miles) (ALL) and 6 km (3.8 miles) (AML) of an air toxics monitoring station between 1990 and 2007. Information on air toxics exposures was taken from community air monitors. We used logistic regression to estimate the risk of leukemia associated with one interquartile range increase in air toxic exposure. Risk of ALL was elevated with 3rd trimester exposure to polycyclic aromatic hydrocarbons (OR = 1.16, 95% CI 1.04, 1.29), arsenic (OR = 1.33, 95% CI 1.02, 1.73), benzene (OR = 1.50, 95% CI 1.08, 2.09), and three other toxics related to fuel combustion. Risk of AML was increased with 3rd trimester exposure to chloroform (OR = 1.30, 95% CI 1.00, 1.69), benzene (1.75, 95% CI 1.04, 2.93), and two other traffic-related toxics. During the child's first year, exposure to butadiene, ortho-xylene, and toluene increased risk for AML and exposure to selenium increased risk for ALL. Benzene is an established cause of leukemia in adults; this study supports that ambient exposures to this and other chemicals in pregnancy and early life may also increase leukemia risk in children. |
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| Keywords: | Childhood leukemia Pregnancy Polycyclic aromatic hydrocarbons Benzene Toluene Lead Chloroform Xylenes Arsenic Childhood cancer epidemiology |
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