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Stayner LT, Schullehner J, Semark BD, Jensen AS, Trabjerg BB, Pedersen M, Olsen J, Hansen B, Ward MH, Jones RR, Coffman VR, Pedersen CB, Sigsgaard T. Exposure to nitrate from drinking water and the risk of childhood cancer in Denmark. ENVIRONMENT INTERNATIONAL 2021; 155:106613. [PMID: 33965769 DOI: 10.1016/j.envint.2021.106613] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/24/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There is limited evidence that nitrate, a common contaminant in drinking water, increases the risk of childhood cancers. Our objective was to examine this association in Denmark. METHODS We conducted a nationwide case-control study based on all singletons liveborn to Danish-born parents from 1991 to 2015 (N = 1,219,140) that included 596 leukemias, 180 lymphomas, and 310 central nervous system cancers (CNC) who were ≤15 years of age at diagnosis and were identified from the Danish Cancer Registry. Approximately 100 controls were randomly selected and matched to each case on date of birth and sex. Nitrate measurements in public water systems were linked with an address registry to estimate individual average nitrate concentrations during preconception, prenatal, and postnatal periods. Odd ratios (OR) and 95% confidence intervals (95%CI) were estimated using conditional logistic regression controlling for the matching variables, and birth order, birthweight, urbanicity, maternal education, employment, income and smoking, and parental age. RESULTS There was no evidence of an association of nitrate with leukemia or lymphoma. An association between CNC and the highest category of nitrate exposure (>25 mg/L nitrate) was observed for preconception (OR = 1.82, 95%CI:1.09 to 3.04), prenatal (OR = 1.65, 95%CI:0.97 to 2.81), and postnatal exposure (OR = 1.48, 95%CI:0.82 to 2.68) in fully adjusted models. There was also some evidence of an exposure-response in models of continuous nitrate exposure and CNC. CONCLUSIONS Our findings provide some evidence that exposure to nitrate from drinking water may increase the risk of childhood CNC cancer, but not leukemia or lymphoma.
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Affiliation(s)
- Leslie T Stayner
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, USA.
| | - Jörg Schullehner
- Department of Groundwater and Quaternary Geology Mapping, Geological Survey of Denmark and Greenland, Aarhus, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Birgitte Dige Semark
- Department of Economics and Business Economics, National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
| | | | - Betina B Trabjerg
- Department of Economics and Business Economics, National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
| | - Marie Pedersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jørn Olsen
- Aarhus University Hospital, Department of Clinical Epidemiology, Aarhus, Denmark
| | - Birgitte Hansen
- Department of Groundwater and Quaternary Geology Mapping, Geological Survey of Denmark and Greenland, Aarhus, Denmark
| | - Mary H Ward
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, Rockville, MD, United States
| | - Rena R Jones
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, Rockville, MD, United States
| | - Vanessa R Coffman
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, USA
| | - Carsten B Pedersen
- Department of Economics and Business Economics, National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark; Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
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Wei T, Jiao R, Nakyeyune R, Zang Z, Shao Y, Shen Y, Niu C, Zhu L, Ruan X, Liu F. Exposure to outdoor air pollution at different periods and the risk of leukemia: a meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:35376-35391. [PMID: 34009571 DOI: 10.1007/s11356-021-14053-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
The causes of leukemia remain largely unknown; our aims were to examine the association between the exposure to outdoor air pollution and leukemia risk and to explore the effect of this exposure during different periods of pregnancy and early life. We searched for all case-control and cohort studies published before February 20, 2021, which measured the risk of leukemia in relation to exposure to the air pollutants: particulate matter, benzene, nitrogen dioxide (NO2), and nitrogen oxides (NOx). We then carried out a meta-analysis and calculated the summary relative risks (RRs) of leukemia by using a random-effects model. The potential dose-response relationship was further explored. The results showed that the highest exposure to benzene (RR: 1.20, 95%CI: 1.06-1.35) and NO2 (RR: 1.04, 95%CI; 1.02-1.08) were positively correlated with leukemia risk when compared to the lowest exposure categories for each air pollutant. During pregnancy, exposure to benzene in the third trimester, as well as exposure to NO2 in the second trimester and entire pregnancy, could also increase the risk of leukemia. In the dose-response analysis, benzene exposure and NO2 exposure were linearly associated with the risk of leukemia. Other air pollutants did not have a statistical correlation with leukemia risk. There was a certain degree of publication bias in studies on benzene. Overall, our results support a link between outdoor air pollution and leukemia risk, particularly due to benzene and NO2. Prospero Registration Number: PROSPERO CRD42020207025.
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Affiliation(s)
- Tong Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, 10# Xitoutiao, Youanmenwai Street, Beijing, 100069, China
| | - Rong Jiao
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, 10# Xitoutiao, Youanmenwai Street, Beijing, 100069, China
| | - Rena Nakyeyune
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, 10# Xitoutiao, Youanmenwai Street, Beijing, 100069, China
| | - Zhaoping Zang
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, 10# Xitoutiao, Youanmenwai Street, Beijing, 100069, China
| | - Yi Shao
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, 10# Xitoutiao, Youanmenwai Street, Beijing, 100069, China
| | - Yi Shen
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, 10# Xitoutiao, Youanmenwai Street, Beijing, 100069, China
| | - Chen Niu
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, 10# Xitoutiao, Youanmenwai Street, Beijing, 100069, China
| | - Lingyan Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, 10# Xitoutiao, Youanmenwai Street, Beijing, 100069, China
| | - Xiaoli Ruan
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, 10# Xitoutiao, Youanmenwai Street, Beijing, 100069, China
| | - Fen Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, 10# Xitoutiao, Youanmenwai Street, Beijing, 100069, China.
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Association with Ambient Air Pollutants and School Absence Due to Sickness in Schoolchildren: A Case-Crossover Study in a Provincial Town of Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126631. [PMID: 34203021 PMCID: PMC8296492 DOI: 10.3390/ijerph18126631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/17/2021] [Accepted: 06/19/2021] [Indexed: 11/16/2022]
Abstract
The effect of ambient air pollutants and Asian dust (AD) on absence from school due to sickness has not been well researched. By conducting a case-crossover study, this study investigated the influence of ambient air pollutants and desert sand dust particles from East Asia on absence from school due to sickness. From November 2016 to July 2018, the daily cases of absence due to sickness were recorded in five elementary schools in Matsue, Japan. During the study period, a total of 16,915 absence cases were recorded, which included 4865 fever cases and 2458 cough cases. The relative risk of overall absence in a 10-μg/m3 increment of PM2.5 and a 0.1-km-1 of desert sand dust particles from East Asia were found with 1.28 (95%CI: 1.15-1.42) and 2.15 (1.04-4.45) at lag0, respectively. The significant influence of PM2.5 persisted at lag5 and that of desert sand dust particles at lag2. NO2 had statistically significant effects at lag2, lag3, and lag4. However, there was no evidence of a positive association of Ox and SO2 with absence from school. These results suggested that PM2.5, NO2, and AD increased the risk of absence due to sickness in schoolchildren.
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Lim K, Thompson-Peach C, Thomas D. Neonatal heel prick mass spectrometry identifies metabolic predictors of AML latency. Leuk Res 2021; 109:106644. [PMID: 34175567 DOI: 10.1016/j.leukres.2021.106644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/08/2021] [Accepted: 06/12/2021] [Indexed: 12/22/2022]
Abstract
Ongoing research efforts that consider cancer as a disease of dramatically altered cellular metabolism have accelerated interest in snapshot metabolomics in various human tissues. In this issue of Leukemia Research, Petrick et al performed metabolomic analysis on newborn blood spots and found a number of unexpected ceramide and sphingolipid compounds that may play a role in the development and latency of pediatric acute myeloid leukemia (AML). The chemical complexity and range of cellular metabolites massively exceeds the relatively limited building blocks of the transcriptome or the proteome and has high potential to find novel leukemia-specific macromolecular synthesis pathways, metabolic vulnerabilities and biomarkers.
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Affiliation(s)
- Kelly Lim
- Adelaide Medical School, The University of Adelaide, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Chloe Thompson-Peach
- Adelaide Medical School, The University of Adelaide, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Daniel Thomas
- Adelaide Medical School, The University of Adelaide, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
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Lupo PJ, Petrick LM, Hoang TT, Janitz AE, Marcotte EL, Schraw JM, Arora M, Scheurer ME. Using primary teeth and archived dried spots for exposomic studies in children: Exploring new paths in the environmental epidemiology of pediatric cancer. Bioessays 2021; 43:e2100030. [PMID: 34106479 DOI: 10.1002/bies.202100030] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 12/14/2022]
Abstract
It is estimated that 300,000 children 0-14 years of age are diagnosed with cancer worldwide each year. While the absolute risk of cancer in children is low, it is the leading cause of death due to disease in children in high-income countries. In spite of this, the etiologies of pediatric cancer are largely unknown. Environmental exposures have long been thought to play an etiologic role. However, to date, there are few well-established environmental risk factors for pediatric malignancies, likely due to technical barriers in collecting biological samples prospectively in pediatric populations for direct measurements. In this review, we propose the use of novel or underutilized biospecimens (dried blood spots and teeth) and molecular approaches for exposure assessment (epigenetics, metabolomics, and somatic mutational profiles). Future epidemiologic studies of pediatric cancer should incorporate novel exposure assessment methodologies, data on molecular features of tumors, and a more complete assessment of gene-environment interactions.
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Affiliation(s)
- Philip J Lupo
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Lauren M Petrick
- The Senator Frank R. Lautenberg Environmental Health Science Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Thanh T Hoang
- Epidemiology Branch, National Institutes of Health, Department of Health and Human Services, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Amanda E Janitz
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Erin L Marcotte
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jeremy M Schraw
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Manish Arora
- The Senator Frank R. Lautenberg Environmental Health Science Laboratory, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael E Scheurer
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
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Residential exposure to electromagnetic fields and risk of amyotrophic lateral sclerosis: a dose-response meta-analysis. Sci Rep 2021; 11:11939. [PMID: 34099747 PMCID: PMC8185090 DOI: 10.1038/s41598-021-91349-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/25/2021] [Indexed: 11/08/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is neurodegenerative disease characterized by a fatal prognosis and still unknown etiology. Some environmental risk factors have been suggested, including exposure to magnetic fields. Studies have suggested positive associations in occupationally-exposed populations, but the link with residential exposure is still debated as is the shape of such relation. Due to recent availability of advanced biostatistical tools for dose–response meta-analysis, we carried out a systematic review in order to assess the dose–response association between ALS and residential exposure to magnetic fields. We performed an online literature searching through April 30, 2021. Studies were included if they assessed residential exposure to electromagnetic fields, based either on distance from overhead power lines or on magnetic field modelling techniques, and if they reported risk estimates for ALS. We identified six eligible studies, four using distance-based and one modelling-based exposure assessment, and one both methods. Both distance-based and particularly modelling-based exposure estimates appeared to be associated with a decreased ALS risk in the highest exposure category, although estimates were very imprecise (summary RRs 0.87, 95% CI 0.63–1.20, and 0.27, 95% CI 0.05–1.36). Dose–response meta-analysis also showed little association between distance from power lines and ALS, with no evidence of any threshold. Overall, we found scant evidence of a positive association between residential magnetic fields exposure and ALS, although the available data were too limited to conduct a dose–response analysis for the modelled magnetic field estimates or to perform stratified analyses.
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Vinceti M, Filippini T, Wise LA, Rothman KJ. A systematic review and dose-response meta-analysis of exposure to environmental selenium and the risk of type 2 diabetes in nonexperimental studies. ENVIRONMENTAL RESEARCH 2021; 197:111210. [PMID: 33895112 DOI: 10.1016/j.envres.2021.111210] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/15/2021] [Accepted: 04/17/2021] [Indexed: 06/12/2023]
Abstract
Accumulating evidence from both experimental and nonexperimental human studies in the last 15 years indicates that exposure to high levels of the trace element selenium increases the risk of type 2 diabetes. However, the relation of dose to effect is not well understood because randomized controlled trials used only one dose (200 μg/day) of selenium supplementation. While no new trial on this topic has been published since 2018, several nonexperimental studies have appeared. We therefore updated a previous meta-analysis to include recently published observational studies, and incorporated the recently developed one-stage random-effects model to display the dose-response relation between selenium and type 2 diabetes. We retrieved 34 potentially eligible nonexperimental studies on selenium and diabetes risk up to April 15, 2021. The bulk of the evidence indicates a direct relation between blood, dietary and urinary levels of selenium and risk of diabetes, but not with nail selenium, which may be considered a less reliable biomarker. The association was nonlinear, with risk increasing above 80 μg/day of dietary selenium. Whole blood/plasma/serum selenium concentrations of 160 μg/L corresponded to a risk ratio of 1.96 (95% CI 1.27-3.03) compared with a concentration of 90 μg/L (approximately 60 μg of daily selenium intake). The cohort studies, which are less susceptible to reverse causation bias, indicated increased risk for both blood and urine selenium levels and dietary selenium intake, whereas no such pattern emerged from studies relying on nail selenium content. Overall, the nonexperimental studies agree with findings from randomized controlled trials, indicating that moderate to high levels of selenium exposure are associated with increased risk for type 2 diabetes.
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Affiliation(s)
- Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; RTI Health Solutions, Research Triangle Park, NC, USA
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Taj T, Poulsen AH, Ketzel M, Geels C, Brandt J, Christensen JH, Puett R, Hvidtfeldt UA, Sørensen M, Raaschou-Nielsen O. Exposure to PM 2.5 constituents and risk of adult leukemia in Denmark: A population-based case-control study. ENVIRONMENTAL RESEARCH 2021; 196:110418. [PMID: 33157111 DOI: 10.1016/j.envres.2020.110418] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Leukemia is one of the most common forms of hematologic malignancy, which can affect people of all ages. We previously showed an association between exposure to ambient particulate matter 2.5 μg (PM2.5) and risk for leukemia in adults. The aim of this study was to investigate which PM2.5 constituents were responsible for our previous observation. METHODS This is a nationwide register-based case-control study. We identified 14,983 persons diagnosed with leukemia at age 20 or above, 1989-2014, in the Danish Cancer Registry. We selected up to four sex and age-matched controls per case at random from the entire Danish population (n = 51,613). We modelled concentrations of ambient PM2.5 and its constituents at the addresses of cases and controls for the 10-year period before index date with a state-of-the-art multiscale air pollution modeling system. We used conditional logistic regression to estimate odds ratios (ORs) adjusted for individual and neighborhood level socio-demographic variables. RESULT The results showed higher risk for overall leukemia in association with interquartile range exposure to PM2.5 (OR = 1.09; 95% CI: 1.02, 1.17), black carbon (BC) (OR = 1.02; 95% CI: 1.00, 1.03), secondary inorganic aerosols (SIA) (OR = 1.15; 95% CI: 1.03, 1.29) and its components ammonium (NH4) (OR = 1.08; 95% CI: 1.00, 1.17) and nitrate (NO3) (OR = 1.08; 95% CI: 1.02, 1.14). In leukemia subtype analysis, statistically significant associations were found for AML with PM2.5 (OR = 1.14; 95% CI: 1.00, 1.29), BC (OR = 1.03; 95% CI: 1.00, 1.07), SIA (OR = 1.23; 95% CI: 1.01, 1.51), NH4 (OR = 1.16; 95% CI: 1.01, 1.34) and NO3 (OR = 1.12; 95% CI: 1.01, 1.24). The association between PM2.5 and leukemia persisted in two pollutants models including sum of primary emitted black and organic carbon (BC + OC), secondary organic aerosols (SOA), or sea-salt. The association between black carbon (BC) and leukemia persisted in two pollutants models including organic carbon (OC). The three pollutant model with sulfate (SO4), NH4 and NO3 showed an association with NO3 but not with SO4 or NH4. CONCLUSION Ambient concentrations of the PM2.5 components BC, NH4 and NO3 at the residence showed associations with risk of incident leukemia in adults.
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Affiliation(s)
- Tahir Taj
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark.
| | - Aslak Harbo Poulsen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000 Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, University of Surrey, Guildford GU2 7XH, UK
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000 Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000 Roskilde, Denmark
| | - Jesper Heile Christensen
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000 Roskilde, Denmark
| | - Robin Puett
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark; Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA
| | | | - Mette Sørensen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000 Roskilde, Denmark
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Petrick L, Imani P, Perttula K, Yano Y, Whitehead T, Metayer C, Schiffman C, Dolios G, Dudoit S, Rappaport S. Untargeted metabolomics of newborn dried blood spots reveals sex-specific associations with pediatric acute myeloid leukemia. Leuk Res 2021; 106:106585. [PMID: 33971561 PMCID: PMC8275155 DOI: 10.1016/j.leukres.2021.106585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 04/06/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023]
Abstract
The etiology of pediatric acute myeloid leukemia (AML) is largely unknown, but evidence for mutations in utero and long latency periods suggests that environmental factors play a role. Therefore, we used untargeted metabolomics of archived newborn dried blood spots (DBS) to investigate neonatal exposures as potential causal risk factors for AML. Untargeted metabolomics profiling was performed on DBS punches from 48 pediatric patients with AML and 46 healthy controls as part of the California Childhood Leukemia Study (CCLS). Because sex disparities are suggested by differences in AML incidence rates, metabolite features associated with AML were identified in analyses stratified by sex. There was no overlap between the 16 predictors of AML in females and 15 predictors in males, suggesting that neonatal metabolomic profiles of pediatric AML risk are sex-specific. In females, four predictors of AML were putatively annotated as ceramides, a class of metabolites that has been linked with cancer cell proliferation. In females, two metabolite predictors of AML were strongly correlated with breastfeeding duration, indicating a possible biological link between this putative protective risk factor and childhood leukemia. In males, a heterogeneous metabolite profile of AML predictors was observed. Replication with larger participant numbers is required to validate findings.
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Affiliation(s)
- Lauren Petrick
- The Institute of Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA; Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA, 94720, USA.
| | - Partow Imani
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Kelsi Perttula
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, 94720, USA; Department of Health Sciences, California State University East Bay, Hayward, CA, 94542, USA
| | - Yukiko Yano
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA, 94720, USA; Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Todd Whitehead
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA, 94720, USA; Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Catherine Metayer
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA, 94720, USA; Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Courtney Schiffman
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA, 94720, USA
| | - Georgia Dolios
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Sandrine Dudoit
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA, 94720, USA; Department of Statistics, University of California, Berkeley, CA, 94720, USA
| | - Stephen Rappaport
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA, 94720, USA; Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, 94720, USA
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Birth characteristics and childhood leukemia in Switzerland: a register-based case-control study. Cancer Causes Control 2021; 32:713-723. [PMID: 33877514 PMCID: PMC8184536 DOI: 10.1007/s10552-021-01423-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/23/2021] [Indexed: 11/18/2022]
Abstract
Purpose Initial genetic alterations in the development of childhood leukemia occur in utero or before conception; both genetic and environmental factors are suspected to play a role. We aimed to investigate the associations between childhood leukemia and perinatal characteristics including birth order, birth interval to older siblings, parental age, birth weight, and multiple birth. Methods We identified cases diagnosed between 1981 and 2015 and born in Switzerland between 1969 and 2015 from the Swiss Childhood Cancer Registry and randomly sampled five controls per case from national birth records matched on date of birth, sex, and municipality of residence at birth. We used conditional logistic regression to investigate associations between perinatal characteristics and leukemia at ages 0–15 and 0–4 years, and the subtypes acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Results The study included 1,403 cases of leukemia. We observed increased risks associated with high birth weight (adjusted OR 1.37, 95% CI 1.12–1.69) and multiple birth (1.89, 1.24–2.86). These associations were similar for ALL and stronger for leukemia at ages 0–4 years. For AML, we observed an increased risk for higher birth order (3.08, 0.43–22.03 for fourth or later born children). We found no associations with other perinatal characteristics. Conclusion This register-based case–control study adds to the existing evidence of a positive association between high birth weight and risk of childhood leukemia. Furthermore, it suggests children from multiple births are at an increased risk of leukemia. Supplementary Information The online version contains supplementary material available at 10.1007/s10552-021-01423-3.
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Bamouni S, Hémon D, Faure L, Clavel J, Goujon S. Seasonal variations in childhood leukaemia incidence in France, 1990-2014. Cancer Causes Control 2021; 32:693-704. [PMID: 33829352 DOI: 10.1007/s10552-021-01421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 03/22/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Several studies have addressed the potential seasonality of childhood acute leukaemia (AL) without conclusive results. Using data from the National Registry of Childhood Cancers over 1990-2014 in mainland France, we investigated the seasonal variations in childhood AL taken together, and lymphoblastic (ALL) and myeloid (AML) leukaemia separately. METHODS Assuming constant variations over 1990-2014, we used a Poisson regression model to evaluate variations in standardized incidence ratios (SIRs) by month of birth or diagnosis. A scan method for temporal cluster detection was used to identify windows of several consecutive months with high or low SIR. The yearly reproducibility of the observed monthly variations was then evaluated. RESULTS We included 11,528 AL, of which 9493 ALL and 1,843 AML. No seasonal variation was detected for ALL. With a clear seasonal pattern, differences in AML incidence rates were evidenced between January-April and May-December birth periods (SIR = 0.85, 95% CI 0.77-0.94 and SIR = 1.07, 95% CI 1.01-1.14, respectively). AML incidence variations by month of diagnosis were less clear-cut. CONCLUSION Based on a large number of cases from a high-quality registry, we did not evidence any seasonality in ALL incidence rates but evidenced seasonal variations in AML incidence rates by month of birth.
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Affiliation(s)
- Sophie Bamouni
- Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers team (EPICEA), 16 Avenue Paul Vaillant Couturier - Bat 15/16, 94807, Villejuif Cedex, France. .,Université de Paris, Paris, France.
| | - Denis Hémon
- Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers team (EPICEA), 16 Avenue Paul Vaillant Couturier - Bat 15/16, 94807, Villejuif Cedex, France.,Université de Paris, Paris, France
| | - Laure Faure
- Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers team (EPICEA), 16 Avenue Paul Vaillant Couturier - Bat 15/16, 94807, Villejuif Cedex, France.,Université de Paris, Paris, France.,French National Registry of Childhood Hematological Malignancies (RNHE), 94807, Villejuif, France
| | - Jacqueline Clavel
- Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers team (EPICEA), 16 Avenue Paul Vaillant Couturier - Bat 15/16, 94807, Villejuif Cedex, France.,Université de Paris, Paris, France.,French National Registry of Childhood Hematological Malignancies (RNHE), 94807, Villejuif, France
| | - Stéphanie Goujon
- Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers team (EPICEA), 16 Avenue Paul Vaillant Couturier - Bat 15/16, 94807, Villejuif Cedex, France.,Université de Paris, Paris, France.,French National Registry of Childhood Hematological Malignancies (RNHE), 94807, Villejuif, France
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Demoury C, Faes C, De Schutter H, Carbonnelle S, Rosskamp M, Francart J, Van Damme N, Van Bladel L, Van Nieuwenhuyse A, De Clercq EM. Childhood leukemia near nuclear sites in Belgium: An ecological study at small geographical level. Cancer Epidemiol 2021; 72:101910. [PMID: 33735659 DOI: 10.1016/j.canep.2021.101910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/14/2021] [Accepted: 02/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND A previous investigation of the occurrence of childhood acute leukemia around the Belgian nuclear sites has shown positive associations around one nuclear site (Mol-Dessel). In the following years, the Belgian Cancer Registry has made data available at the smallest administrative unit for which demographic information exists in Belgium, i.e. the statistical sector. This offers the advantage to reduce the potential misclassification due to large geographical scales. METHODS The current study performed for the period 2006-2016 uses Poisson models to investigate (i) the incidence of childhood acute leukemia within 20 km around the four Belgian nuclear sites, (ii) exposure-response relationships between cancer incidence and surrogate exposures from the nuclear sites (distance, wind direction frequency and exposure by hypothetical radioactive discharges taking into account historical meteorological conditions). All analyses are carried out at statistical sector level. RESULTS Higher incidence rate ratios were found for children <15 years (7 cases, RR = 3.01, 95% CI: 1.43;6.35) and children <5 years (< 5 cases, RR = 3.62, 95% CI: 1.35;9.74) living less than 5 km from the site of Mol-Dessel. In addition, there was an indication for positive exposure-response relationships with the different types of surrogate exposures. CONCLUSION Results confirm an increased incidence of acute childhood leukemia around Mol-Dessel, but the number of cases remains very small. Random variation cannot be excluded and the ecological design does not allow concluding on causality. These findings emphasize the need for more in-depth research into the risk factors of childhood leukemia, for a better understanding of the etiology of this disease.
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Winter Air Pollution from Domestic Coal Fired Heating in Ulaanbaatar, Mongolia, Is Strongly Associated with a Major Seasonal Cyclic Decrease in Successful Fecundity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052750. [PMID: 33803108 PMCID: PMC7967474 DOI: 10.3390/ijerph18052750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 11/17/2022]
Abstract
Pollution of the environment is increasing and threatens the health and wellbeing of adults and children around the globe. The impact of air pollution on pulmonary and cardiovascular disease has been well documented, but it also has a deleterious effect on reproductive health. Ulaanbaatar, the capital city of Mongolia, has one of the highest levels of air pollution in the world. During the extreme winters when temperatures routinely fall below -20 °C the level of air pollution can reach 80 times the WHO recommended safe levels. Heating mainly comes from coal, which is burned both in power stations, and in stoves in the traditional Ger housing. We studied the impact of air pollution on conception rates and birth outcomes in Ulaanbaatar using a retrospective analysis of health data collected from the Urguu Maternity hospital in Ulaanbaatar, Mongolia. Daily levels of SO2, NO2, PM10, and PM2.5 were collected from the government Air Quality Monitoring Stations in Ulaanbaatar for the same period as the study. In January, the month of highest pollution, there is a 3.2-fold decrease in conceptions that lead to the successfully delivered infants compared to October. The seasonal variations in conceptions resulting in live births in this study in Ulaanbaatar are shown to be 2.03 ± 0.20 (10-sigma) times greater than those in the Denmark/North America study of Wesselink et al., 2020. The two obvious differences between Ulaanbaatar and Europe/North America are pollution and temperature both of which are extreme in Ulaanbaatar. The extreme low temperature is mitigated by burning coal, which is the main source of domestic heat especially in the ger districts. This drives the level of pollution so the two are inextricably linked. Infants conceived in the months of June-October had the greatest cumulative PM2.5 pollution exposure over total gestation, yet these were also the pregnancies with the lowest PM2.5 exposure for the month of conception and three months prior to conception. The delivered-infant conception rate shows a markedly negative association with exposure to PM2.5 prior to and during the first month of pregnancy. This overall reduction in fecundity of the population of Ulaanbaatar is therefore a preventable health risk. It is of great consequence that the air pollution in Ulaanbaatar affects health over an entire lifespan including reproductive health. This could be remedied with a clean source of heating.
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Filippini T, Mandrioli J, Malagoli C, Costanzini S, Cherubini A, Maffeis G, Vinceti M. Risk of Amyotrophic Lateral Sclerosis and Exposure to Particulate Matter from Vehicular Traffic: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030973. [PMID: 33499343 PMCID: PMC7908475 DOI: 10.3390/ijerph18030973] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 12/26/2022]
Abstract
(1) Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with still unknown etiology. Some occupational and environmental risk factors have been suggested, including long-term air pollutant exposure. We carried out a pilot case-control study in order to evaluate ALS risk due to particulate matter with a diameter of ≤10 µm (PM10) as a proxy of vehicular traffic exposure. (2) Methods: We recruited ALS patients and controls referred to the Modena Neurology ALS Care Center between 1994 and 2015. Using a geographical information system, we modeled PM10 concentrations due to traffic emissions at the geocoded residence address at the date of case diagnosis. We computed the odds ratio (OR) and 95% confidence interval (CI) of ALS according to increasing PM10 exposure, using an unconditional logistic regression model adjusted for age and sex. (3) Results: For the 132 study participants (52 cases and 80 controls), the average of annual median and maximum PM10 concentrations were 5.2 and 38.6 µg/m3, respectively. Using fixed cutpoints at 5, 10, and 20 of the annual median PM10 levels, and compared with exposure <5 µg/m3, we found no excess ALS risk at 5-10 µg/m3 (OR 0.87, 95% CI 0.39-1.96), 10-20 µg/m3 (0.94, 95% CI 0.24-3.70), and ≥20 µg/m3 (0.87, 95% CI 0.05-15.01). Based on maximum PM10 concentrations, we found a statistically unstable excess ALS risk for subjects exposed at 10-20 µg/m3 (OR 4.27, 95% CI 0.69-26.51) compared with those exposed <10 µg/m3. However, risk decreased at 20-50 µg/m3 (OR 1.49, 95% CI 0.39-5.75) and ≥50 µg/m3 (1.16, 95% CI 0.28-4.82). ALS risk in increasing tertiles of exposure showed a similar null association, while comparison between the highest and the three lowest quartiles lumped together showed little evidence for an excess risk at PM10 concentrations (OR 1.13, 95% CI 0.50-2.55). After restricting the analysis to subjects with stable residence, we found substantially similar results. (4) Conclusions: In this pilot study, we found limited evidence of an increased ALS risk due to long-term exposure at high PM10 concentration, though the high statistical imprecision of the risk estimates, due to the small sample size, particularly in some exposure categories, limited our capacity to detect small increases in risk, and further larger studies are needed to assess this relation.
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Affiliation(s)
- Tommaso Filippini
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (C.M.)
| | - Jessica Mandrioli
- Neurology Unit, Department of Neuroscience, S. Agostino Estense Hospital, Azienda Ospedaliero Universitaria di Modena, 41126 Modena, Italy;
| | - Carlotta Malagoli
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (C.M.)
| | - Sofia Costanzini
- DIEF Department of Engineering “Enzo Ferrari,” University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | | | | | - Marco Vinceti
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (C.M.)
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
- Correspondence:
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Rojas-Rueda D, Morales-Zamora E, Alsufyani WA, Herbst CH, AlBalawi SM, Alsukait R, Alomran M. Environmental Risk Factors and Health: An Umbrella Review of Meta-Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020704. [PMID: 33467516 PMCID: PMC7830944 DOI: 10.3390/ijerph18020704] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/31/2020] [Accepted: 01/12/2021] [Indexed: 12/13/2022]
Abstract
Background: Environmental health is a growing area of knowledge, continually increasing and updating the body of evidence linking the environment to human health. Aim: This study summarizes the epidemiological evidence on environmental risk factors from meta-analyses through an umbrella review. Methods: An umbrella review was conducted on meta-analyses of cohort, case-control, case-crossover, and time-series studies that evaluated the associations between environmental risk factors and health outcomes defined as incidence, prevalence, and mortality. The specific search strategy was designed in PubMed using free text and Medical Subject Headings (MeSH) terms related to risk factors, environment, health outcomes, observational studies, and meta-analysis. The search was limited to English, Spanish, and French published articles and studies on humans. The search was conducted on September 20, 2020. Risk factors were defined as any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or death. The environment was defined as the external elements and conditions that surround, influence, and affect a human organism or population’s life and development. The environment definition included the physical environment such as nature, built environment, or pollution, but not the social environment. We excluded occupational exposures, microorganisms, water, sanitation and hygiene (WASH), behavioral risk factors, and no-natural disasters. Results: This umbrella review found 197 associations among 69 environmental exposures and 83 diseases and death causes reported in 103 publications. The environmental factors found in this review were air pollution, environmental tobacco smoke, heavy metals, chemicals, ambient temperature, noise, radiation, and urban residential surroundings. Among these, we identified 65 environmental exposures defined as risk factors and 4 environmental protective factors. In terms of study design, 57 included cohort and/or case-control studies, and 46 included time-series and/or case-crossover studies. In terms of the study population, 21 included children, and the rest included adult population and both sexes. In this review, the largest body of evidence was found in air pollution (91 associations among 14 air pollution definitions and 34 diseases and mortality diagnoses), followed by environmental tobacco smoke with 24 associations. Chemicals (including pesticides) were the third larger group of environmental exposures found among the meta-analyses included, with 19 associations. Conclusion: Environmental exposures are an important health determinant. This review provides an overview of an evolving research area and should be used as a complementary tool to understand the connections between the environment and human health. The evidence presented by this review should help to design public health interventions and the implementation of health in all policies approach aiming to improve populational health.
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Affiliation(s)
- David Rojas-Rueda
- Department of Environmental and Radiological Health Sciences, Colorado State University, Environmental Health Building, 1601 Campus Delivery, Fort Collins, CO 80523, USA
- Correspondence: ; Tel.: +1-(970)-491-7038; Fax: +1-(970)-491-2940
| | | | - Wael Abdullah Alsufyani
- Saudi Center for Disease Prevention and Control, 70 SCDC Building, Al Aarid, King Abdulaziz Rd, Riyadh 13354, Saudi Arabia; (W.A.A.); (S.M.A.); (M.A.)
| | - Christopher H. Herbst
- Health, Nutrition and Population Global Practice, The World Bank, Diplomatic Quarter, Riyadh Country Office, Riyadh 94623, Saudi Arabia; (C.H.H.); (R.A.)
| | - Salem M. AlBalawi
- Saudi Center for Disease Prevention and Control, 70 SCDC Building, Al Aarid, King Abdulaziz Rd, Riyadh 13354, Saudi Arabia; (W.A.A.); (S.M.A.); (M.A.)
| | - Reem Alsukait
- Health, Nutrition and Population Global Practice, The World Bank, Diplomatic Quarter, Riyadh Country Office, Riyadh 94623, Saudi Arabia; (C.H.H.); (R.A.)
- Community Health Department, King Saud University, Riyadh 11433, Saudi Arabia
| | - Mashael Alomran
- Saudi Center for Disease Prevention and Control, 70 SCDC Building, Al Aarid, King Abdulaziz Rd, Riyadh 13354, Saudi Arabia; (W.A.A.); (S.M.A.); (M.A.)
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Erdmann F, Hvidtfeldt UA, Feychting M, Sørensen M, Raaschou-Nielsen O. Is the risk of childhood leukaemia associated with socioeconomic measures in Denmark? A nationwide register-based case-control study. Int J Cancer 2020; 148:2227-2240. [PMID: 33210292 DOI: 10.1002/ijc.33402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/28/2020] [Accepted: 11/09/2020] [Indexed: 01/11/2023]
Abstract
The aetiology of childhood leukaemia is poorly understood. Knowledge about differences in risk by socioeconomic status (SES) may enhance etiologic insights. We conducted a nationwide register-based case-control study to evaluate socioeconomic differences in the risk of childhood leukaemia in Denmark and to access whether associations varied by different measures of SES, time point of assessment, leukaemia type and age at diagnosis. We identified all cases of leukaemia in children aged 0 to 19 years, born and diagnosed between 1980 and 2013 from the Danish Cancer Registry (N = 1336) and sampled four individually matched controls per case (N = 5330). We used conditional logistic regression models for analysis. Medium and high level of parental education was associated with a higher risk of acute myeloid leukaemia (AML) in the offspring, mainly driven by children diagnosed at ages 0 to 4 years [odds ratio (OR) for high maternal education = 3.07; 95% confidence interval (CI): 1.44-6.55]. We also observed a modestly increased risk for lymphoid leukaemia (LL) in association with higher level of parental education, but only in children diagnosed at ages 5 to 19 years. Higher parental income was associated with an increased risk of LL but not AML among children aged 5 to 19 years at diagnosis (OR for high maternal income = 2.78; 95% CI: 1.32-5.89). Results for neighbourhood SES measures indicated null associations. Bias or under-ascertainment of cases among families with low income or basic education are unlikely to explain the observed socioeconomic differences. Future research addressing explicitly the underlying mechanisms of our results may help to enhance etiologic insights of the disease.
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Affiliation(s)
- Friederike Erdmann
- Division of Childhood Cancer Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mette Sørensen
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.,Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.,Department of Environmental Science, Aarhus University, Roskilde, Denmark
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Boonhat H, Lin RT. Association between leukemia incidence and mortality and residential petrochemical exposure: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2020; 145:106090. [PMID: 32932064 DOI: 10.1016/j.envint.2020.106090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/12/2020] [Accepted: 08/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The global burden of leukemia, which grew by 19% from 2007 to 2017, poses a threat to human development and global cancer control. Factors contributing to this growth include massive industrial pollution, especially from large-scale petrochemical industry complexes (PICs). Globally, around 700 PICs are continuously operating. Data on the impact of PICs on leukemia incidence and mortality in residents are sparse and inconsistent. OBJECTIVE To determine the association between residential exposure to PICs and leukemia incidence and mortality using systematic review and meta-analysis. METHODS The studies were identified through seven databases (Clinical Key, Cochrane Library, EBSCOhost, Embase, PubMed, ScienceDirect, and Web of Science). We screened the eligibility of studies using following criteria: (1) observational studies that focused on residential exposure to PICs; (2) exposure group that was defined as residents living close to PICs; (3) outcome that was defined as all leukemia incidence and mortality; and (4) available population data. We applied the Grading of Recommendations Assessment, Development, and Evaluation to assess the certainty of evidence. The random-effects model used to estimate the pooled effects in the meta-analysis. RESULTS We identified thirteen epidemiologic studies (including eleven for leukemia incidence, one for leukemia mortality, and one for both), covering 125,580 individuals from Croatia, Finland, Italy, Serbia, Spain, Sweden, Taiwan, the United Kingdom, and the United States. We found moderate certainty of evidence indicated the risk of leukemia incidence (relative risk [RR] = 1.18; 95% CI = 1.03-1.35) and mortality (RR = 1.26; 95% CI = 1.10-1.45) in residents living close to PICs. Our subgroup analysis found increased RRs for leukemia incidence in studies using distance-based exposure indicator (RR = 1.11; 95% CI = 1.00-1.23), and with longer follow-up periods (RR = 1.24; 95% CI = 1.06-1.45). CONCLUSION Our analysis provides low-certainty evidence of increased leukemia incidence and moderate-certainty evidence of increased leukemia mortality among residents living close to PICs. While the global petrochemicals sector is growing, our findings suggest the need to consider disease prevention and pollution control measures during the development of PICs.
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Affiliation(s)
- Hathaichon Boonhat
- Graduate Institute of Public Health, College of Public Health, China Medical University, Taichung 406, Taiwan
| | - Ro-Ting Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung 406, Taiwan.
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Lavigne E, Lima I, Hatzopoulou M, Van Ryswyk K, van Donkelaar A, Martin RV, Chen H, Stieb DM, Crighton E, Burnett RT, Weichenthal S. Ambient ultrafine particle concentrations and incidence of childhood cancers. ENVIRONMENT INTERNATIONAL 2020; 145:106135. [PMID: 32979813 DOI: 10.1016/j.envint.2020.106135] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/03/2020] [Accepted: 09/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Ambient air pollution has been associated with childhood cancer. However, little is known about the possible impact of ambient ultrafine particles (<0.1 μm) (UFPs) on childhood cancer incidence. OBJECTIVE This study aimed to evaluate the association between prenatal and childhood exposure to UFPs and development of childhood cancer. METHODS We conducted a population-based cohort study of within-city spatiotemporal variations in ambient UFPs across the City of Toronto, Canada using 653,702 singleton live births occurring between April 1, 1998 and March 31, 2017. Incident cases of 13 subtypes of paediatric cancers among children up to age 14 were ascertained using a cancer registry. Associations between ambient air pollutant concentrations and childhood cancer incidence were estimated using random-effects Cox proportional hazards models. We investigated both single- and multi-pollutant models accounting for co-exposures to PM2.5 and NO2. RESULTS A total of 1,066 childhood cancers were identified. We found that first trimester exposure to UFPs (Hazard Ratio (HR) per 10,000/cm3 increase = 1.13, 95% CI: 1.03-1.22) was associated with overall cancer incidence diagnosed before 6 years of age after adjusting for PM2.5, NO2, and for personal and neighborhood-level covariates. Association between UFPs and overall cancer incidence exhibited a linear shape. No statistically significant associations were found for specific cancer subtypes. CONCLUSION Ambient UFPs may represent a previously unrecognized risk factor in the aetiology of cancers in children. Our findings reinforce the importance of conducting further research on the effects of UFPs given their high prevalence of exposure in urban areas.
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Affiliation(s)
- Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
| | - Isac Lima
- Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Marianne Hatzopoulou
- Department of Civil Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Keith Van Ryswyk
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada; Harvard-Smithsonian Centre for Astrophysics, Cambridge, MA, USA; Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada; Harvard-Smithsonian Centre for Astrophysics, Cambridge, MA, USA; Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Hong Chen
- Population Studies Division, Health Canada, Ottawa, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - David M Stieb
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Population Studies Division, Health Canada, Vancouver, British Columbia, Canada
| | - Eric Crighton
- Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada; Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada
| | - Richard T Burnett
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Population Studies Division, Health Canada, Ottawa, Ontario, Canada
| | - Scott Weichenthal
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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Ahmadkhaniha R, Ghoochani M, Rastkari N. Application of biological monitoring for exposure assessment of 1.3 Butadiene. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2020; 18:1265-1269. [PMID: 33312640 PMCID: PMC7721966 DOI: 10.1007/s40201-020-00544-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND 1, 3-Butadiene is an important industrial compound. Based on sufficient evidence of carcinogenicity in laboratory animals and humans, the International Agency for Research on Cancer, in 1999, classified 1, 3-Butadiene as a probable carcinogen to humans (group 2A). The potential for exposure to vehicle exhaust containing these chemical compounds is very noticeable in urban locations. Exposure to incomplete combustion of gasoline has been a long time concern in many occupational fields, including policemen, service stations, and the petroleum industry but in Iran has rarely been studied. METHODS This study designed to determine the exposure levels for traffic policemen and gas station workers during routine work shift, by biological monitoring. With this aim, 25 policemen engaged in traffic control, 25 gas station workers and 25 occupationally non-exposed persons were investigated. Spot urine samples were obtained prior to and at the end of the work shift from each subject. The urinary levels of selected urinary metabolites (MHBMA and DHBMA) were determined by using LC-MS/MS. RESULTS There were significant differences among the mean urinary concentrations of DHBMA in pre-shift samples of policemen, gas station workers and occupationally non-exposed persons. The mean urinary concentrations of DHBMA differed significantly among post-shift samples of policemen and gas station (ANOVA: p < 0.05 and Kruskal-Wallis test: p < 0.05). CONCLUSIONS There was a significant difference in DHBMA concentrations between job categories (p < 0.05 by ANOVA and Kruskal-Wallis test), and policemen and gas station workers were found to be probably the most exposed groups in this study.
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Affiliation(s)
- Reza Ahmadkhaniha
- Department of Human Ecology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Ghoochani
- Environmental and Occupational Health Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Noushin Rastkari
- Center for Air Pollution Research, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, 1417993359 Iran
- Center for Water Quality Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
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Ribeiro AG, Vermeulen R, Cardoso MRA, Latorre MDRDDO, Hystad P, Downward GS, Nardocci AC. Residential traffic exposure and lymphohematopoietic malignancies among children in the city of São Paulo, Brazil: An ecological study. Cancer Epidemiol 2020; 70:101859. [PMID: 33232852 DOI: 10.1016/j.canep.2020.101859] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/31/2020] [Accepted: 11/01/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Despite widespread evidence that air pollution is carcinogenic, there is little evidence from low-middle income countries, especially related to childhood malignancies. We examined the role of traffic related pollution on lymphohematopoietic malignancies among under-14 s in Sao Paulo. METHODS All incident cases between 2002 and 2011 were collected from a population-based registry. Exposures were assigned on residential address at diagnosis via traffic density database (for the year 2008) and a satellite derived NO2 land use regression model (averaged between 1997 and 2011). Incidence rate ratios (IRRs) were calculated via Poisson Regression adjusted by age, gender and socioeconomic status (SES), with additional stratification by SES. RESULTS A positive association between traffic and NO2 with some lymphohematopoietic malignancies was observed with the degree of effect differing by SES. For example, lymphoid leukemia IRRs in the lower SES group were 1.21 (95 % CI: 1.06, 1.39) for traffic density and 1.38 (95 % CI: 1.13, 1.68) for NO2. In the higher group they were 1.06 (95 % CI: 1.00, 1.14) and 1.37 (95 % CI: 1.16, 1.62). CONCLUSION NO2 and traffic density were associated with Hodgkin lymphoma and lymphoid leukemia among children in São Paulo. Differing IRRs by gender and SES group indicate differences in underlying risk and/or exposure profiles.
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Affiliation(s)
- Adeylson Guimarães Ribeiro
- Educational and Research Institute, Barretos Cancer Hospital, R. Antenor Duarte Villela, 1331, Barretos, SP, CEP: 14784-400, Brazil.
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, the Netherlands.
| | - Maria Regina Alves Cardoso
- Department of Epidemiology, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, CEP01246-904, Brazil.
| | | | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, 20C Milam Hall, Corvallis, OR 97331, USA.
| | - George Stanley Downward
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, the Netherlands.
| | - Adelaide Cássia Nardocci
- Department of Environmental Health, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, CEP01246-904, Brazil.
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71
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Hvidtfeldt UA, Erdmann F, Urhøj SK, Brandt J, Geels C, Ketzel M, Frohn LM, Christensen JH, Sørensen M, Raaschou-Nielsen O. Air pollution exposure at the residence and risk of childhood cancers in Denmark: A nationwide register-based case-control study. EClinicalMedicine 2020; 28:100569. [PMID: 33294803 PMCID: PMC7700996 DOI: 10.1016/j.eclinm.2020.100569] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/14/2020] [Accepted: 09/14/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The etiology of childhood cancer is poorly understood. The role of environmental factors, including air pollution (AP) exposure, has been addressed previously, but results so far have been inconclusive. In this study, we investigate the association between long-term AP exposures in relation to childhood cancer subtypes in Denmark (1981-2013). METHODS We conducted a nationwide register-based case-control study. We identified 7745 incident cases of childhood cancers (<20 years) in the Danish Cancer Registry. Four randomly selected (cancer-free) controls were matched to each case according to sex and date of birth. We modelled concentrations of nitrogen dioxide (NO2), fine particles (PM2·5), and black carbon (BC) at all addresses and calculated a time-weighted average from birth to index-date with a state-of-the-art multiscale AP modelling system. We analyzed the risk of childhood cancer in conditional logistic regression models adjusted for socio-demographic variables obtained from registers at the individual and neighborhood level. FINDINGS The main analyses included 5045 cases and 18,179 controls. For all cancers combined, we observed odds ratios (ORs) and 95% confidence intervals (95% CI) of 0·97 (0·94, 1·01) per 10 µg/m3 NO2, 0·89 (0·82, 0·98) per 5 µg/m3 PM2·5, and 0·94 (0·88, 1·01) per 1 µg/m3 BC, respectively. Most notably, we observed a higher risk of Non-Hodgkin Lymphoma (NHL) with higher childhood AP exposure with ORs and 95% CIs of 1·21 (0·94, 1·55) per 10 µg/m3 NO2, 2·11 (1·10, 4·01) per 5 µg/m3 PM2·5, and 1·68 (1·06, 2·66) per 1 µg/m3 BC, respectively. We observed indications of increased risks for other types of childhood cancer, however, with very wide CIs including 1. INTERPRETATIONS The findings of this nation-wide study propose a role of AP in the development of childhood NHL, but more large-scale studies are needed. FUNDING NordForsk Project #75007.
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Affiliation(s)
- Ulla Arthur Hvidtfeldt
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen DK-2100, Denmark
- Corresponding author.
| | - Friederike Erdmann
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 69, Mainz 55131, Germany
| | - Stine Kjær Urhøj
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, P.O. Box 2099, Copenhagen K DK-1014, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P. O. Box 358, Roskilde 4000, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P. O. Box 358, Roskilde 4000, Denmark
| | - Mattias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P. O. Box 358, Roskilde 4000, Denmark
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, University of Surrey, Guildford, United Kingdom
| | - Lise M. Frohn
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 69, Mainz 55131, Germany
| | - Jesper Heile Christensen
- German Childhood Cancer Registry, Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University Mainz, Obere Zahlbacher Str. 69, Mainz 55131, Germany
| | - Mette Sørensen
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen DK-2100, Denmark
- Department of Natural Science and Environment, Roskilde University, Universitetsvej 1, P.O. Box 260, Roskilde 4000, Denmark
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen DK-2100, Denmark
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P. O. Box 358, Roskilde 4000, Denmark
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72
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Puett RC, Poulsen AH, Taj T, Ketzel M, Geels C, Brandt J, Christensen JH, Sørensen M, Roswall N, Hvidtfeldt U, Raaschou-Nielsen O. Relationship of leukaemias with long-term ambient air pollution exposures in the adult Danish population. Br J Cancer 2020; 123:1818-1824. [PMID: 32939055 PMCID: PMC7722932 DOI: 10.1038/s41416-020-01058-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/11/2020] [Accepted: 08/26/2020] [Indexed: 12/24/2022] Open
Abstract
Background Few population-based epidemiological studies of adults have examined the relationship between air pollution and leukaemias. Methods Using Danish National Cancer Registry data and Danish DEHM-UBM-AirGIS system-modelled air pollution exposures, we examined whether particulate matter (PM2.5), black carbon (BC), nitrogen dioxide (NO2) and ozone (O3) averaged over 1, 5 or 10 years were associated with adult leukaemia in general or by subtype. In all, 14,986 adult cases diagnosed 1989–2014 and 51,624 age, sex and time-matched controls were included. Separate conditional logistic regression models, adjusted for socio-demographic factors, assessed exposure to each pollutant with leukaemias. Results Fully adjusted models showed a higher risk of leukaemia with higher 1-, 5- and 10-year-average exposures to PM2.5 prior to diagnosis (e.g. OR per 10 µg/m3 for 10-year average: 1.17, 95% CI: 1.03, 1.32), and a positive relationship with 1-year average BC. Results were driven by participants 70 years and older (OR per 10 µg/m3 for 10-year average: 1.35, 95% CI: 1.15–1.58). Null findings for younger participants. Higher 1-year average PM2.5 exposures were associated with higher risks for acute myeloid and chronic lymphoblastic leukaemia. Conclusion Among older adults, higher risk for leukaemia was associated with higher residential PM2.5 concentrations averaged over 1, 5 and 10 years prior to diagnosis.
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Affiliation(s)
- Robin C Puett
- Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA. .,Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Aslak Harbo Poulsen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Tahir Taj
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000, Roskilde, Denmark.,Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, GU2 7XH, UK
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000, Roskilde, Denmark
| | - Jesper H Christensen
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000, Roskilde, Denmark
| | - Mette Sørensen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Nina Roswall
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Ulla Hvidtfeldt
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O. Box. 358, DK-4000, Roskilde, Denmark
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73
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Filippini T, Torres D, Lopes C, Carvalho C, Moreira P, Naska A, Kasdagli MI, Malavolti M, Orsini N, Vinceti M. Cadmium exposure and risk of breast cancer: A dose-response meta-analysis of cohort studies. ENVIRONMENT INTERNATIONAL 2020; 142:105879. [PMID: 32599354 DOI: 10.1016/j.envint.2020.105879] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Cadmium is a toxic heavy metal that has been implicated in breast cancer etiology, albeit with inconsistent results. OBJECTIVE To investigate the shape of the relation between cadmium exposure and breast cancer incidence and mortality in cohort studies. DATA SOURCES Following a literature search through April 14, 2020, we carried out a systematic review and dose-response meta-analysis to investigate the shape of the relation between cadmium exposure (assessed either through diet or urine excretion) and disease incidence and mortality. STUDY ELIGIBILITY CRITERIA For inclusion, a study had to report incidence or mortality for breast cancer according to baseline cadmium exposure category; be a prospective cohort, case-cohort or nested case-control study with a minimum one-year follow-up, and reporting effect estimates for all exposure categories. STUDY APPRAISAL AND SYNTHESIS METHODS Studies were evaluated using the ROBINS-E risk of bias tool. The effects in humans were assessed quantitatively using one-stage dose-response meta-analysis in a random effects meta-analytical model. RESULTS We identified 10 studies eligible for inclusion in the dose-response meta-analysis, six based on cadmium dietary intake, and four on urinary excretion levels. We found a marginal and imprecise positive relation between dietary cadmium intake and breast cancer, and no association when urinary cadmium excretion was used for exposure assessment. Compared to no exposure, at 20 µg/day of cadmium intake the summary risk ratio was 1.12 (95% confidence interval 0.80-1.56), while at 2 µg/g creatinine of cadmium excretion the summary risk ratio was 0.89 (95% confidence interval 0.38-2.14). Analysis restricted to post-menopausal women showed no association between either dietary or urinary cadmium and subsequent breast cancer incidence and mortality. LIMITATIONS AND CONCLUSIONS Overall, we found scant evidence of a positive association between cadmium and breast cancer. Available data were too limited to carry out stratified analyses according to age, smoking and hormone receptor status. Therefore, possible associations between cadmium exposure and breast cancer in selected subgroups cannot be entirely ruled out.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Duarte Torres
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Faculty of Food and Nutrition Sciences, University of Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Catarina Carvalho
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Faculty of Food and Nutrition Sciences, University of Porto, Porto, Portugal
| | - Pedro Moreira
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Faculty of Food and Nutrition Sciences, University of Porto, Porto, Portugal
| | - Androniki Naska
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Maria-Iosifina Kasdagli
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, USA.
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74
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Turner MC, Andersen ZJ, Baccarelli A, Diver WR, Gapstur SM, Pope CA, Prada D, Samet J, Thurston G, Cohen A. Outdoor air pollution and cancer: An overview of the current evidence and public health recommendations. CA Cancer J Clin 2020; 70:10.3322/caac.21632. [PMID: 32964460 PMCID: PMC7904962 DOI: 10.3322/caac.21632] [Citation(s) in RCA: 284] [Impact Index Per Article: 71.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/24/2022] Open
Abstract
Outdoor air pollution is a major contributor to the burden of disease worldwide. Most of the global population resides in places where air pollution levels, because of emissions from industry, power generation, transportation, and domestic burning, considerably exceed the World Health Organization's health-based air-quality guidelines. Outdoor air pollution poses an urgent worldwide public health challenge because it is ubiquitous and has numerous serious adverse human health effects, including cancer. Currently, there is substantial evidence from studies of humans and experimental animals as well as mechanistic evidence to support a causal link between outdoor (ambient) air pollution, and especially particulate matter (PM) in outdoor air, with lung cancer incidence and mortality. It is estimated that hundreds of thousands of lung cancer deaths annually worldwide are attributable to PM air pollution. Epidemiological evidence on outdoor air pollution and the risk of other types of cancer, such as bladder cancer or breast cancer, is more limited. Outdoor air pollution may also be associated with poorer cancer survival, although further research is needed. This report presents an overview of outdoor air pollutants, sources, and global levels, as well as a description of epidemiological evidence linking outdoor air pollution with cancer incidence and mortality. Biological mechanisms of air pollution-derived carcinogenesis are also described. This report concludes by summarizing public health/policy recommendations, including multilevel interventions aimed at individual, community, and regional scales. Specific roles for medical and health care communities with regard to prevention and advocacy and recommendations for further research are also described.
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Affiliation(s)
- Michelle C. Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Ontario, Canada
| | - Zorana J. Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andrea Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, United States
| | - W. Ryan Diver
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, United States
| | - Susan M. Gapstur
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, United States
| | - C. Arden Pope
- Department of Economics, Brigham Young University, Provo, Utah, United States
| | - Diddier Prada
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, United States
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Jonathan Samet
- Colorado School of Public Health, Aurora, Colorado, United States
| | - George Thurston
- New York University School of Medicine, New York, New York, United States
| | - Aaron Cohen
- Health Effects Institute, Boston, Massachusetts, United States
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States
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75
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Alsultan A, Essa M, Aljefri A, Ayas M, Alharbi M, Alkhayat N, Al-Anzi F, Yassin F, Alkasim F, Alharbi Q, Abdullah S, Jastaniah W. Frequency of pathogenic/likely pathogenic germline variants in cancer-related genes among children with acute leukemia in Saudi Arabia. Pediatr Blood Cancer 2020; 67:e28340. [PMID: 32359129 DOI: 10.1002/pbc.28340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/09/2020] [Accepted: 03/30/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The frequency of pathogenic/likely pathogenic (P/LP) germline mutations in cancer-related genes among children with cancer in highly consanguineous populations is not well studied. METHODS Whole-exome sequencing of germline DNA was performed in 60 children with acute leukemia. We used the St. Jude Pediatric Cancer Variant Pathogenicity Information Exchange (PeCanPIE) data portal for the classification of germline variants by the St. Jude Medal Ceremony pipeline. RESULTS Fifty-seven patients had acute lymphoblastic leukemia (ALL) and three patients had acute myeloid leukemia. Parental consanguinity was present in 27 (45%) patients. All patients were of Arab ancestry. Three patients (5%) had a history of cancer in their siblings. Five patients (8.3%) had P/LP germline mutations in cancer-related genes. Three patients with B-ALL had heterozygous pathogenic mutations in TP53, BRCA1, and BRCA2; one patient with B-ALL had homozygous pathogenic mutation in PMS2; and one patient with T-ALL had LP homozygous mutation in AK2 that was associated with reticular dysgenesis. Among patients who had history of parental consanguinity, three (11%) had P/LP germline mutations compared with two (8%) in the absence of parental consanguinity. Fourteen (23%) patients had gold medal variants in cancer-related genes, 13 were heterozygous, and one was homozygous. Silver medal variants were present in 35 (58%) patients; all were heterozygous except one homozygous. CONCLUSIONS Children with acute leukemia in Saudi Arabia had low frequency of P/LP mutations in cancer-related genes despite the high rate of consanguinity. Larger studies using whole-genome sequencing are needed to further explore the heritability of childhood leukemia.
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Affiliation(s)
- Abdulrahman Alsultan
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Essa
- Department of Pediatric Hematology/Oncology, King Abdullah Specialist Children's Hospital, Riyadh, Saudi Arabia.,College of Medicine, Ministry of National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah Aljefri
- Department of Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mouhab Ayas
- Department of Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Musa Alharbi
- Department of Pediatric Hematology/Oncology, Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Nawaf Alkhayat
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Faisal Al-Anzi
- Prince Faisal Bin Bandar Cancer Center, Qassim, Saudi Arabia
| | - Fawwaz Yassin
- Department of Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | | | - Qasim Alharbi
- Department of Pediatric Hematology/Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Shaker Abdullah
- Department of Oncology, Princess Noorah Oncology Center, King Saud Bin Abdulaziz University and King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Wasil Jastaniah
- Department of Oncology, Princess Noorah Oncology Center, King Saud Bin Abdulaziz University and King Abdulaziz Medical City, Jeddah, Saudi Arabia.,Department of Pediatrics, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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76
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Filippini T, Naska A, Kasdagli MI, Torres D, Lopes C, Carvalho C, Moreira P, Malavolti M, Orsini N, Whelton PK, Vinceti M. Potassium Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2020; 9:e015719. [PMID: 32500831 PMCID: PMC7429027 DOI: 10.1161/jaha.119.015719] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Epidemiologic studies, including trials, suggest an association between potassium intake and blood pressure (BP). However, the strength and shape of this relationship is uncertain. Methods and Results We performed a meta‐analysis to explore the dose‐response relationship between potassium supplementation and BP in randomized‐controlled trials with a duration ≥4 weeks using the recently developed 1‐stage cubic spline regression model. This model allows use of trials with at least 2 exposure categories. We identified 32 eligible trials. Most were conducted in adults with hypertension using a crossover design and potassium supplementation doses that ranged from 30 to 140 mmol/d. We observed a U‐shaped relationship between 24‐hour active and control arm differences in potassium excretion and BP levels, with weakening of the BP reduction effect above differences of 30 mmol/d and a BP increase above differences ≈80 mmol/d. Achieved potassium excretion analysis also identified a U‐shaped relationship. The BP‐lowering effects of potassium supplementation were stronger in participants with hypertension and at higher levels of sodium intake. The BP increase with high potassium excretion was noted in participants with antihypertensive drug‐treated hypertension but not in their untreated counterparts. Conclusions We identified a nonlinear relationship between potassium intake and both systolic and diastolic BP, although estimates for BP effects of high potassium intakes should be interpreted with caution because of limited availability of trials. Our findings indicate an adequate intake of potassium is desirable to achieve a lower BP level but suggest excessive potassium supplementation should be avoided, particularly in specific subgroups.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy
| | - Androniki Naska
- Department of Hygiene, Epidemiology and Medical Statistics School of Medicine National and Kapodistrian University of Athens Athens Greece
| | - Maria-Iosifina Kasdagli
- Department of Hygiene, Epidemiology and Medical Statistics School of Medicine National and Kapodistrian University of Athens Athens Greece
| | - Duarte Torres
- EPIUnit-Institute of Public Health University of Porto Portugal.,Faculty of Nutrition and Food Sciences University of Porto Portugal
| | - Carla Lopes
- EPIUnit-Institute of Public Health University of Porto Portugal.,Unit of Epidemiology Department of Public Health and Forensic Sciences, and Medical Education Faculty of Medicine University of Porto Portugal
| | - Catarina Carvalho
- EPIUnit-Institute of Public Health University of Porto Portugal.,Faculty of Nutrition and Food Sciences University of Porto Portugal
| | - Pedro Moreira
- EPIUnit-Institute of Public Health University of Porto Portugal.,Faculty of Nutrition and Food Sciences University of Porto Portugal
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy
| | - Nicola Orsini
- Department of Global Public Health Karolinska Institute Stockholm Sweden
| | - Paul K Whelton
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine, and School of Medicine New Orleans LA
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy.,Department of Epidemiology Boston University School of Public Health Boston MA
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Lupo PJ, Spector LG. Cancer Progress and Priorities: Childhood Cancer. Cancer Epidemiol Biomarkers Prev 2020; 29:1081-1094. [DOI: 10.1158/1055-9965.epi-19-0941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 12/18/2019] [Accepted: 03/09/2020] [Indexed: 11/16/2022] Open
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78
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Konstantinoudis G, Schuhmacher D, Ammann RA, Diesch T, Kuehni CE, Spycher BD. Bayesian spatial modelling of childhood cancer incidence in Switzerland using exact point data: a nationwide study during 1985-2015. Int J Health Geogr 2020; 19:15. [PMID: 32303231 PMCID: PMC7165384 DOI: 10.1186/s12942-020-00211-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/11/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The aetiology of most childhood cancers is largely unknown. Spatially varying environmental factors such as traffic-related air pollution, background radiation and agricultural pesticides might contribute to the development of childhood cancer. This study is the first investigation of the spatial disease mapping of childhood cancers using exact geocodes of place of residence. METHODS We included 5947 children diagnosed with cancer in Switzerland during 1985-2015 at 0-15 years of age from the Swiss Childhood Cancer Registry. We modelled cancer risk using log-Gaussian Cox processes and indirect standardisation to adjust for age and year of diagnosis. We examined whether the spatial variation of risk can be explained by modelled ambient air concentration of NO2, modelled exposure to background ionising radiation, area-based socio-economic position (SEP), linguistic region, duration in years of general cancer registration in the canton or degree of urbanisation. RESULTS For all childhood cancers combined, the posterior median relative risk (RR), compared to the national level, varied by location from 0.83 to 1.13 (min to max). Corresponding ranges were 0.96 to 1.09 for leukaemia, 0.90 to 1.13 for lymphoma, and 0.82 to 1.23 for central nervous system (CNS) tumours. The covariates considered explained 72% of the observed spatial variation for all cancers, 81% for leukaemia, 82% for lymphoma and 64% for CNS tumours. There was weak evidence of an association of CNS tumour incidence with modelled exposure to background ionising radiation (RR per SD difference 1.17; 0.98-1.40) and with SEP (1.6; 1.00-1.13). CONCLUSION Of the investigated diagnostic groups, childhood CNS tumours showed the largest spatial variation. The selected covariates only partially explained the observed variation of CNS tumours suggesting that other environmental factors also play a role.
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Affiliation(s)
- Garyfallos Konstantinoudis
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
- Epidemiology and Biostatistics Department, School of Public Health, Imperial College London, London, UK.
| | - Dominic Schuhmacher
- Institute for Mathematical Stochastics, University of Göttingen, Göttingen, Germany
| | - Roland A Ammann
- Department of Paediatrics Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tamara Diesch
- Division of Paediatric Oncology/Haematology, University Children's Hospital Basel, Basel, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Ben D Spycher
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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79
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Lee SHF, Cunningham A, Gharif R, Koh D, Lai L, Petra DH, Wong J, Yussof SR. Brunei Darussalam: country report on children's environmental health. REVIEWS ON ENVIRONMENTAL HEALTH 2020; 35:15-25. [PMID: 31934879 DOI: 10.1515/reveh-2019-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/04/2019] [Indexed: 06/10/2023]
Abstract
This is the country report for Brunei Darussalam pertaining to children's environmental health. It covers the current landscape of environmental risk factors which affect children's health, existing local policies, as well as strategies for moving forward in alignment with the United Nation's Sustainable Development Goals (SDGs).
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Affiliation(s)
- Shirley H F Lee
- UBD PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei-Muara, Brunei Darussalam
| | - Anne Cunningham
- UBD PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei-Muara, Brunei Darussalam
| | - Rafidah Gharif
- UBD PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei-Muara, Brunei Darussalam
- Community Health, Ministry of Health, Brunei-Muara, Brunei Darussalam
| | - David Koh
- UBD PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei-Muara, Brunei Darussalam
| | - Linda Lai
- Child Health Services, Department of Health Services, Ministry of Health, Brunei-Muara, Brunei Darussalam
| | - Dk Haryanti Petra
- Department of Environment, Parks and Recreation, Ministry of Development, Brunei-Muara, Brunei Darussalam
| | - Justin Wong
- Public Health, Ministry of Health, Brunei-Muara, Brunei Darussalam
- Health Promotion Centre, Ministry of Health, Brunei-Muara, Brunei Darussalam
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80
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Adani G, Filippini T, Wise LA, Halldorsson TI, Blaha L, Vinceti M. Dietary Intake of Acrylamide and Risk of Breast, Endometrial, and Ovarian Cancers: A Systematic Review and Dose-Response Meta-analysis. Cancer Epidemiol Biomarkers Prev 2020; 29:1095-1106. [PMID: 32169997 DOI: 10.1158/1055-9965.epi-19-1628] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/25/2020] [Accepted: 03/10/2020] [Indexed: 11/16/2022] Open
Abstract
Acrylamide is a probable human carcinogen. Aside from occupational exposures and smoking, diet is the main source of exposure in humans. We performed a systematic review of the association between estimated dietary intake of acrylamide and risk of female breast, endometrial, and ovarian cancers in nonexperimental studies published through February 25, 2020, and conducted a dose-response meta-analysis. We identified 18 papers covering 10 different study populations: 16 cohort and two case-control studies. Acrylamide intake was associated with a slightly increased risk of ovarian cancer, particularly among never smokers. For endometrial cancer, risk was highest at intermediate levels of exposure, whereas the association was more linear and positive among never smokers. For breast cancer, we found evidence of a null or inverse relation between exposure and risk, particularly among never smokers and postmenopausal women. In a subgroup analysis limited to premenopausal women, breast cancer risk increased linearly with acrylamide intake starting at 20 μg/day of intake. High acrylamide intake was associated with increased risks of ovarian and endometrial cancers in a relatively linear manner, especially among never smokers. Conversely, little association was observed between acrylamide intake and breast cancer risk, with the exception of premenopausal women.
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Affiliation(s)
- Giorgia Adani
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Thorhallur I Halldorsson
- Centre for Fetal Programming, Department of Epidemiology Research, Copenhagen, Denmark.,Unit for Nutrition Research, Faculty of Food Science and Nutrition, University of Iceland, Reykjavík, Iceland
| | - Ludek Blaha
- Masaryk University, Faculty of Science, RECETOX, Brno, Czech Republic
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. .,Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
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81
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Vorläufiger Leitwert für Benzol in der Innenraumluft. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:361-367. [DOI: 10.1007/s00103-019-03089-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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82
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Mazzei-Abba A, Folly CL, Coste A, Wakeford R, Little MP, Raaschou-Nielsen O, Kendall G, Hémon D, Nikkilä A, Spix C, Auvinen A, Spycher BD. Epidemiological studies of natural sources of radiation and childhood cancer: current challenges and future perspectives. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2020; 40:R1-R23. [PMID: 31751953 PMCID: PMC10654695 DOI: 10.1088/1361-6498/ab5a38] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The empirical estimation of cancer risks in children associated with low-dose ionising radiation (<100 mSv) remains a challenge. The main reason is that the required combination of large sample sizes with accurate and comprehensive exposure assessment is difficult to achieve. An international scientific workshop, 'Childhood cancer and background radiation', organised by the Institute of Social and Preventive Medicine of the University of Bern, brought together researchers in this field to evaluate how epidemiological studies of background radiation and childhood cancer can best improve our understanding of the effects of low-dose ionising radiation. This review summarises and evaluates the findings of these studies with regard to their methodological differences, identifies key limitations and challenges, and proposes ways to move forward. Large childhood cancer registries, such as those in Great Britain, France and Germany, now permit the conducting of studies that should have sufficient statistical power to detect the effects predicted by standard risk models. Nevertheless, larger studies or pooled studies will be needed to investigate disease subgroups. The main challenge is to accurately assess children's individual exposure to radiation from natural sources and from other sources, as well as potentially confounding non-radiation exposures, in such large study populations. For this, the study groups should learn from each other to improve exposure estimation and develop new ways to validate exposure models with personal dosimetry.
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Affiliation(s)
- Antonella Mazzei-Abba
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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83
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Lin CK, Hsu YT, Brown KD, Pokharel B, Wei Y, Chen ST. Residential exposure to petrochemical industrial complexes and the risk of leukemia: A systematic review and exposure-response meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 258:113476. [PMID: 31902537 DOI: 10.1016/j.envpol.2019.113476] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/17/2019] [Accepted: 10/22/2019] [Indexed: 06/10/2023]
Abstract
Exposure to chemicals produced by petrochemical industrial complexes (PICs), such as benzene, ionizing radiation, and particulate matters, may contribute to the development of leukemia. However, epidemiological studies showed controversial results. This systematic review and meta-analysis aimed to summarize the association between residential exposure to PICs and the risk of leukemia incidence, focusing on exposure-response effects. We searched PubMed, Embase, Web of Science, and Cochrane Library databases for studies published before September 1st, 2019. Observational studies investigating residential exposure to PICs and the risk of leukemia were included. The outcome of interest was the incidence of leukemia comparing to reference groups. Relative risk (RR) was used as the summary effect measure, synthesized by characteristics of populations, distance to PICs, and calendar time in meta-regression. We identified 7 observational studies, including 2322 leukemia cases and substantial reference groups, in this meta-analysis. Residential exposure to PICs within a maximal 8-km distance had a 36% increased risk of leukemia (pooled RR = 1.36, 95% CI = 1.14-1.62) compared to controls, regardless of sex and age. In terms of leukemia subtypes, residential exposure to PICs was associated with the risks of acute myeloid leukemia (AML, pooled RR = 1.61, 95% CI = 1.12-2.31) and chronic lymphocytic leukemia (CLL, pooled RR = 1.85, 95% CI = 1.11-6.42). In meta-regression, the positive association occurred after 10 years of follow-up with a pooled RRs of 1.21 (95% CI = 1.02-1.44) and then slightly increased to 1.77 (95% CI = 1.35-2.33) at 30 years after follow-up. No effect modification was found by sex, age, and geographic locations.
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Affiliation(s)
- Cheng-Kuan Lin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Yu-Tien Hsu
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Kristen D Brown
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Behavioral Neuroscience Program, Northeastern University, Boston, MA, USA
| | - Bibhaw Pokharel
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Szu-Ta Chen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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84
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Air Pollution as a Cause of Obesity: Micro-Level Evidence from Chinese Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214296. [PMID: 31694267 PMCID: PMC6862654 DOI: 10.3390/ijerph16214296] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/01/2019] [Accepted: 11/03/2019] [Indexed: 01/16/2023]
Abstract
Chinese air pollution is obviously increasing, and the government makes efforts to strengthen air pollution treatment. Although adverse health effects gradually emerge, research determining individual vulnerability is limited. This study estimated the relationship between air pollution and obesity. Individual information of 13,414 respondents from 125 cities is used in the analysis. This study employs ordinary least squares (OLS) and multinomial logit model (m-logit) to estimate the impact of air pollution on obesity. We choose different air pollution and Body Mass Index (BMI) indicators for estimation. Empirical results show Air Quality Index (AQI) is significantly positively associated with the BMI score. As AQI adds one unit, the BMI score increases 0.031 (SE = 0.002; p < 0.001). The influence coefficients of particle size smaller than 2.5 μm (PM2.5), particle size smaller than 10 μm (PM10), carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), and sulfur dioxide (SO2) to the BMI score are 0.034 (SE = 0.002; p < 0.001), 0.023 (SE = 0.001; p < 0.001), 0.52 (SE = 0.095; p < 0.001), 0.045 (SE = 0.004; p < 0.001), 0.021 (SE = 0.002; p < 0.001), 0.008 (SE = 0.003; p = 0.015), respectively. Generally, air pollution has an adverse effect on body weight. CO is the most influential pollutant, and female, middle-aged, and low-education populations are more severely affected. The results confirm that the adverse health effects of air pollution should be considered when making the air pollution policies. Findings also provide justification for health interventions, especially for people with obesity.
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85
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Heck JE, He D, Contreras ZA, Ritz B, Olsen J, Hansen J. Parental occupational exposure to benzene and the risk of childhood and adolescent acute lymphoblastic leukaemia: a population-based study. Occup Environ Med 2019; 76:527-529. [PMID: 31138675 DOI: 10.1136/oemed-2019-105738] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/26/2019] [Accepted: 05/05/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Only a small number of studies have reported on the association of parental occupational exposure to benzene and risk of childhood and adolescent leukaemias. We examined associations with acute lymphoblastic leukaemia (ALL) in this population-based study in Denmark. METHODS Benzene was largely banned from Danish workplaces after 1975, thus this case-control study focused on the immediately prior years. Paediatric cancer cases (<age 20) were ascertained from the Danish Cancer Registry among children born 1968-1974, and controls were selected from population records. Paternal occupation within the 3 months preconception and maternal pregnancy occupation were identified from nationwide pension fund records. Blinded, we assigned benzene exposure using a job-exposure matrix that had been developed for the Danish population. Risk for ALL was estimated using conditional logistic regression. In an exploratory analysis, we also examined other cancers with at least five case parents exposed. RESULTS We identified 217 employed case fathers and 169 employed case mothers, of which 22 (10.1%) and 11 (6.5%), respectively, were exposed to benzene (vs 6.7% and 2.9% of control fathers and mothers). Most exposed parents worked as machine or engine mechanics, or in the shoe industry. Maternal occupational exposure to benzene in pregnancy was related to increased risk of ALL in offspring (adjusted OR=2.28, 95% CI 1.17 to 4.41), while paternal preconceptional benzene exposure was not as strongly associated (adjusted OR=1.40, 95% CI 0.88 to 2.22). CONCLUSIONS Our study supports an increased risk for ALL with parental occupational benzene exposure.
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Affiliation(s)
- Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.,Center for Occupational and Environmental Health, University of California, Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
| | - Di He
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Zuelma Arellano Contreras
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.,Center for Occupational and Environmental Health, University of California, Los Angeles, CA, USA
| | - Jørn Olsen
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.,Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Johnni Hansen
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
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