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Pourvakhshoori N, Khankeh HR, Stueck M, Farrokhi M. The association between air pollution and cancers: controversial evidence of a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:38491-38500. [PMID: 32767014 DOI: 10.1007/s11356-020-10377-z] [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: 05/13/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
There are inconsistent reports on the association between air pollution and cancers. This systematic review was, therefore, conducted to ascertain the relationship between air pollution and some cancers. This is a systematic review study, which all articles published in this area were extracted from January 1, 1950 to December 31, 2018 from Web of Science, PubMed, Scopus, Cochrane Library, MEDLINE, EMBASE, Science Direct, Google scholar. Searching was performed independently by two search-method experts. The required data were extracted from the articles by an author-made questionnaire. Forty-eight articles were investigated. Evidence linking air pollution to some cancers is limited. Leukemia had the highest association with exposure to various air pollutants and bladder cancer had the lowest association. It is noteworthy that the specific type of pollutants in all studies was not specified. Based on the findings, the results are contradictory, and the role of air pollution in some cancers cannot be supported. Accordingly, studies are recommended to be performed at the individual level or multifactorial studies to specifically investigate the relationship between air pollution and these types of cancers. In this way, the role of air pollution in the incidence of these cancers can be determined more accurately.
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Affiliation(s)
- Negar Pourvakhshoori
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Reza Khankeh
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
| | - Marcus Stueck
- DFPA Academy of Work and Health, Leipzig, Germany
- International Research Academy BIONET, Leipzig, Germany
| | - Mehrdad Farrokhi
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Cao Y, Lu J, Lu J. Paternal Smoking Before Conception and During Pregnancy Is Associated With an Increased Risk of Childhood Acute Lymphoblastic Leukemia: A Systematic Review and Meta-Analysis of 17 Case-Control Studies. J Pediatr Hematol Oncol 2020; 42:32-40. [PMID: 31743318 PMCID: PMC6924935 DOI: 10.1097/mph.0000000000001657] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 10/03/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Current evidence regarding the association between paternal smoking before conception or during pregnancy and the risk of childhood acute lymphoblastic leukemia (ALL) are inconsistent. We aimed to systematically summarize the current evidence regarding this potential association. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Meta-analysis of Observational Studies in Epidemiology (MOOSE), we systematically retrieved PubMed, Embase, Web of Science, and Scopus, screened relevant literature, and assessed the methodologic quality of the included studies. We calculated the pooled estimates using random-effects models. We assessed statistical heterogeneity by I values and χ tests for the Cochrane Q statistic. We further investigate the dose-response relation using 2-stage nonlinear models. RESULTS A total of 17 case-control studies were identified, and the synthesized risk ratios (RRs) for smoking before conception (RR=1.15, 95% confidence interval: 1.04-1.27) and during pregnancy (RR=1.20, 95% confidence interval: 1.12-1.28) were both statistically significant. Moreover, the dose-response analysis showed a positive association as well. CONCLUSION Current evidence from observational studies suggests the association between paternal smoking before conception or during pregnancy and the increased risk of childhood ALL, which needs to be confirmed in prospective studies.
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Affiliation(s)
- Yue Cao
- Departments of Science and Technology
| | - Jing Lu
- Department of Pediatrics, West China Women’s and Children’s Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jing Lu
- Pharmacy, West China Hospital
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Chunxia D, Meifang W, Jianhua Z, Ruijuan Z, Xiue L, Zhuanzhen Z, Linhua Y. Tobacco smoke exposure and the risk of childhood acute lymphoblastic leukemia and acute myeloid leukemia: A meta-analysis. Medicine (Baltimore) 2019; 98:e16454. [PMID: 31305478 PMCID: PMC6641792 DOI: 10.1097/md.0000000000016454] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Tobacco smoke contains carcinogens known to damage somatic and germ cells. In this study, we investigated the effect of tobacco smoking on the risk of childhood acute lymphoblastic leukemia (ALL) and myeloid leukemia (AML). METHODS Information about tobacco smoking exposures of the mother before, during, and after pregnancy was collected via PubMed, Embase, and Web of Science databases through November 5, 2018. We performed to evaluate the association between smoking exposure and the risk of childhood ALL and AML. Study selection, data abstraction, and quality assessment were performed by 2 independent reviewers. Random effects models were used to obtain summary odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Nineteen case-control studies of childhood leukemia (age < 15 years) conducted in 9 countries from 1974 to 2018. Maternal smoking exposures did not a significant association with childhood ALL (OR = 1.004, 95% CI 0.953-1.058, P = .881) and AML (OR = 0.92, 95% CI 0.815-1.038, P = .177) during exposure time windows. However, there was an association with paternal smoking and ALL (OR = 1.15, 95% CI 1.038-1.275, P = .007). Paternal smoking in AML showed there was no association with smoking exposures and childhood AML (OR = 1.133, 95% CI 0.943-1.362, P = .181). Next, maternal daily cigarettes consumption showed no associations with ALL (OR = 1.08, 95% CI 1.000-1.168, P = .051) during pregnancy. No association with maternal daily smoking and AML (OR = 0.909, 95% CI 0.682-1.211, P = .514). Paternal daily cigarettes consumption was associated with increased risks of childhood ALL (OR = 1.200, 95% CI 1.112-1.302, P = .000). The higher consumption of paternal smoking (more than 10 per day) was significantly related to childhood ALL. Paternal daily smoking consumption also was related to AML (OR = 1.242, 95% CI 1.031-1.496, P = .022). CONCLUSION Maternal smoking before, during, or after pregnancy was not associated with childhood ALL or AML. However, paternal smoking was related to a significantly elevated risk of childhood ALL during pregnancy, but not for AML. Maternal daily smoking consumption was not associated with ALL or AML during pregnancy. The higher consumption of paternal smoking were, the higher the risk of childhood ALL or AML.
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Oldereid NB, Wennerholm UB, Pinborg A, Loft A, Laivuori H, Petzold M, Romundstad LB, Söderström-Anttila V, Bergh C. The effect of paternal factors on perinatal and paediatric outcomes: a systematic review and meta-analysis. Hum Reprod Update 2018; 24:320-389. [PMID: 29471389 DOI: 10.1093/humupd/dmy005] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/21/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Maternal factors, including increasing childbearing age and various life-style factors, are associated with poorer short- and long-term outcomes for children, whereas knowledge of paternal parameters is limited. Recently, increasing paternal age has been associated with adverse obstetric outcomes, birth defects, autism spectrum disorders and schizophrenia in children. OBJECTIVE AND RATIONALE The aim of this systematic review is to describe the influence of paternal factors on adverse short- and long-term child outcomes. SEARCH METHODS PubMed, Embase and Cochrane databases up to January 2017 were searched. Paternal factors examined included paternal age and life-style factors such as body mass index (BMI), adiposity and cigarette smoking. The outcome variables assessed were short-term outcomes such as preterm birth, low birth weight, small for gestational age (SGA), stillbirth, birth defects and chromosomal anomalies. Long-term outcome variables included mortality, cancers, psychiatric diseases/disorders and metabolic diseases. The systematic review follows PRISMA guidelines. Relevant meta-analyses were performed. OUTCOMES The search included 14 371 articles out of which 238 met the inclusion criteria, and 81 were included in quantitative synthesis (meta-analyses). Paternal age and paternal life-style factors have an association with adverse outcome in offspring. This is particularly evident for psychiatric disorders such as autism, autism spectrum disorders and schizophrenia, but an association is also found with stillbirth, any birth defects, orofacial clefts and trisomy 21. Paternal height, but not BMI, is associated with birth weight in offspring while paternal BMI is associated with BMI, weight and/or body fat in childhood. Paternal smoking is found to be associated with an increase in SGA, birth defects such as congenital heart defects, and orofacial clefts, cancers, brain tumours and acute lymphoblastic leukaemia. These associations are significant although moderate in size, with most pooled estimates between 1.05 and 1.5, and none exceeding 2.0. WIDER IMPLICATIONS Although the increased risks of adverse outcome in offspring associated with paternal factors and identified in this report represent serious health effects, the magnitude of these effects seems modest.
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Affiliation(s)
- Nan B Oldereid
- Livio IVF-klinikken Oslo, Sørkedalsveien 10A, 0369 Oslo, Norway
| | - Ulla-Britt Wennerholm
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital East, SE 416 85 Gothenburg, Sweden
| | - Anja Pinborg
- Department of Obstetrics and Gynecology, Hvidovre Hospital, Institute of Clinical Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Loft
- Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Hannele Laivuori
- Department of Obstetrics and Gynecology, Tampere University Hospital, Teiskontie 35, FI-33521 Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Arvo Ylpön katu 34, FI-33520 Tampere, Finland.,Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 8, FI-00290 Helsinki, Finland.,Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Tukhomankatu 8, FI-00290 Helsinki, Finland
| | - Max Petzold
- Swedish National Data Service and Health Metrics Unit, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Liv Bente Romundstad
- Spiren Fertility Clinic, Norwegian University of Science and Technology, Trondheim NO-7010, Norway.,Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
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Biases Inherent in Studies of Coffee Consumption in Early Pregnancy and the Risks of Subsequent Events. Nutrients 2018; 10:nu10091152. [PMID: 30142937 PMCID: PMC6163788 DOI: 10.3390/nu10091152] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/18/2018] [Accepted: 08/21/2018] [Indexed: 12/23/2022] Open
Abstract
Consumption of coffee by women early in their pregnancy has been viewed as potentially increasing the risk of miscarriage, low birth weight, and childhood leukemias. Many of these reports of epidemiologic studies have not acknowledged the potential biases inherent in studying the relationship between early-pregnancy-coffee consumption and subsequent events. I discuss five of these biases, recall bias, misclassification, residual confounding, reverse causation, and publication bias. Each might account for claims that attribute adversities to early-pregnancy-coffee consumption. To what extent these biases can be avoided remains to be determined. As a minimum, these biases need to be acknowledged wherever they might account for what is reported.
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Maternal Exposure to Pesticides, Paternal Occupation in the Army/Police Force, and CYP2D6*4 Polymorphism in the Etiology of Childhood Acute Leukemia. J Pediatr Hematol Oncol 2018; 40:e207-e214. [PMID: 29432309 DOI: 10.1097/mph.0000000000001105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Epidemiologic studies have suggested that parental occupations, pesticide use, environmental factors, and genetic polymorphism are involved in the etiology of childhood acute leukemia (CAL). In total, 116 cases of CAL and 162 controls were recruited and submitted to blood drawing to assess the presence of genetic polymorphisms. Parental occupations, pesticides exposure, and other potential determinants were investigated. Increased risk for CAL was associated with prenatal maternal use of insecticides/rodenticides (odds ratio [OR]=1.87; 95% confidence intervals [CI], 1.04-3.33), with subjects living <100 m from pesticide-treated fields (OR=3.21; 95% CI, 1.37-7.53) and with a paternal occupation as traffic warden/policeman (OR=4.02; 95% CI, 1.63-9.87). Associations were found between CAL and genetic polymorphism of CYP2D6*4 for homozygous alleles (mutant type/mutant type: OR=6.39; 95% CI, 1.17-34.66). In conclusion, despite the small sample size, maternal prenatal exposure to pesticides, paternal occupation as a traffic warden/police officer, and CYP2D6*4 polymorphism could play a role in the etiology of CAL.
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Morra ME, Kien ND, Elmaraezy A, Abdelaziz OAM, Elsayed AL, Halhouli O, Montasr AM, Vu TLH, Ho C, Foly AS, Phi AP, Abdullah WM, Mikhail M, Milne E, Hirayama K, Huy NT. Early vaccination protects against childhood leukemia: A systematic review and meta-analysis. Sci Rep 2017; 7:15986. [PMID: 29167460 PMCID: PMC5700199 DOI: 10.1038/s41598-017-16067-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 11/02/2017] [Indexed: 02/06/2023] Open
Abstract
Leukemia is the most commonly diagnosed childhood cancer, although its etiology is still largely unknown. Growing evidence supports a role for infection in the etiology of acute lymphocytic leukemia (ALL), and the involvement of the immune system suggests that vaccination may also play a role. However, the findings presented in the published literature are inconsistent. Therefore, we conducted a PRISMA systematic review and meta-analysis. 14 studies were identified and meta-analyzed. Vaccinations studied comprised Bacillus Calmette-Guérin (BCG) vaccine, Triple vaccine, Hepatitis B vaccine (HBV), Polio, Measles, Rubella, Mumps, trivalent MMR vaccine and Haemophilus influenza type B (HiB) vaccine. We observed a protective association between any vaccination in the first year of life and risk of childhood leukemia (summary odds ratio (OR) 0.58 [95% confidence interval (CI) 0.36-0.91]). When individual vaccines were analysed, some evidence of an association was seen only for BCG (summary OR 0.73 [95% CI 0.50-1.08]). In conclusion, early vaccination appears to be associated with a reduced risk of childhood leukemia. This finding may be underpinned by the association observed for BCG. Given the relatively imprecise nature of the results of this meta-analysis, our findings should be interpreted cautiously and replicated in future studies.
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Affiliation(s)
| | - Nguyen Dang Kien
- Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 30000, Vietnam
| | - Ahmed Elmaraezy
- Faculty of Medicine, Al Azhar University, Cairo, 11884, Egypt
| | | | | | - Oday Halhouli
- University of Jordan, Faculty of Medicine, Amman, 11942, Jordan
| | | | - Tran Le-Huy Vu
- University of California, Los Angeles, CA, 90095, United States
| | - Chau Ho
- Hoan My Cuu Long Hospital, Can Tho, 900000, Vietnam
| | - Amr Sayed Foly
- Faculty of Medicine, Cairo University, Cairo, 11562, Egypt
| | - Anh Phan Phi
- Department of Pharmacology, Loyola University Chicago, Illinois, 60546, USA
| | | | - Marina Mikhail
- Department of Dermatology, Cairo University Hospital, Cairo, 11562, Egypt
| | - Elizabeth Milne
- Telethon Kids Institute, The University of Western Australia, Crawley, Australia.
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Nguyen Tien Huy
- Evidence Based Medicine Research Group & Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
- Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
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Magnani C, Ranucci A, Badaloni C, Cesaroni G, Ferrante D, Miligi L, Mattioli S, Rondelli R, Bisanti L, Zambon P, Cannizzaro S, Michelozzi P, Cocco P, Celentano E, Assennato G, Merlo DF, Mosciatti P, Minelli L, Cuttini M, Torregrossa MV, Lagorio S, Haupt R, Forastiere F. Road Traffic Pollution and Childhood Leukemia: A Nationwide Case-control Study in Italy. Arch Med Res 2017; 47:694-705. [PMID: 28476197 DOI: 10.1016/j.arcmed.2017.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 02/23/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND The association of childhood leukemia with traffic pollution was considered in a number of studies from 1989 onwards, with results not entirely consistent and little information regarding subtypes. AIM OF THE STUDY We used the data of the Italian SETIL case-control on childhood leukemia to explore the risk by leukemia subtypes associated to exposure to vehicular traffic. METHODS We included in the analyses 648 cases of childhood leukemia (565 Acute lymphoblastic-ALL and 80 Acute non lymphoblastic-AnLL) and 980 controls. Information on traffic exposure was collected from questionnaire interviews and from the geocoding of house addresses, for all periods of life of the children. RESULTS We observed an increase in risk for AnLL, and at a lower extent for ALL, with indicators of exposure to traffic pollutants. In particular, the risk was associated to the report of closeness of the house to traffic lights and to the passage of trucks (OR: 1.76; 95% CI 1.03-3.01 for ALL and 6.35; 95% CI 2.59-15.6 for AnLL). The association was shown also in the analyses limited to AML and in the stratified analyses and in respect to the house in different period of life. CONCLUSIONS Results from the SETIL study provide some support to the association of traffic related exposure and risk for AnLL, but at a lesser extent for ALL. Our conclusion highlights the need for leukemia type specific analyses in future studies. Results support the need of controlling exposure from traffic pollution, even if knowledge is not complete.
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Affiliation(s)
- Corrado Magnani
- Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piedmont and University of Eastern Piedmont, Novara, Italy.
| | - Alessandra Ranucci
- Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piedmont and University of Eastern Piedmont, Novara, Italy
| | - Chiara Badaloni
- Department of Epidemiology, Lazio Regional Health Service, Roma, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, Roma, Italy
| | - Daniela Ferrante
- Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piedmont and University of Eastern Piedmont, Novara, Italy
| | - Lucia Miligi
- Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Stefano Mattioli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Roberto Rondelli
- Paediatric Oncology-Haematology Lalla Seràgnoli, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | | | | | - Santina Cannizzaro
- Lega Italiana per la Lotta contro i Tumori Onlus Sez. Provinciale di Ragusa, Ragusa Ibla, Italy
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Roma, Italy
| | - Pierluigi Cocco
- Department of Medical Sciences and Public Health, Occupational Health Section, University of Cagliari, Cagliari, Italy
| | - Egidio Celentano
- Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G.Pascale, IRCCS, Napoli, Italy
| | | | - Domenico Franco Merlo
- Clinical Epidemiology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Paola Mosciatti
- Università di Camerino, Dipartimento di Medicina Sperimentale e di Sanità Pubblica, Camerino, Italy
| | - Liliana Minelli
- Dipartimento di Medicina Sperimentale-Sezione di Sanità Pubblica, Università degli Studi di Perugia, Perugia, Italy
| | - Marina Cuttini
- Unità di Ricerca di Epidemiologia Perinatale, Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Maria Valeria Torregrossa
- Dipartimento di Scienze per la Promozione della Salute Sez.Igiene, Università degli Studi di Palermo, Palermo, Italy
| | - Susanna Lagorio
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Roma, Italy
| | - Riccardo Haupt
- Epidemiology and Biostatistics Unit, Istituto Giannina Gaslini, Genova, Italy
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Rumrich IK, Viluksela M, Vähäkangas K, Gissler M, Surcel HM, Hänninen O. Maternal Smoking and the Risk of Cancer in Early Life - A Meta-Analysis. PLoS One 2016; 11:e0165040. [PMID: 27824869 PMCID: PMC5100920 DOI: 10.1371/journal.pone.0165040] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 10/05/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In spite of the well-known harmful effects on the fetus, many women continue smoking during pregnancy. Smoking as an important source of toxic chemicals may contribute to the developmental origin of diseases. OBJECTIVES The aim of this work was to pursue the possible association between maternal smoking and cancer in early life. Specifically, we wanted to identify the associated early life cancer types, and to quantify the associations. METHODS In a systematic literature search 825 articles were identified in PubMed and Web of Science, and 55 more through the reference lists. Of these 62 fulfilled the criteria for inclusion in meta-analyses. Using Mantel-Haenszel or DerSimonian and Laird method, depending on heterogeneity of the studies, pooled estimates and 95% confidence intervals for eight cancer types were calculated. RESULTS Smoking during pregnancy was associated with an increased risk for for brain and central nervous system tumors (OR = 1.09; 95% CI = 1.02-1.17). Although the risk for lymphoma was also associated (OR = 1.21; 95% CI = 1.05-1.34), it did not hold up in subgroup analyses. Leukemia was not found to be associated with maternal smoking. Five other cancer types (bone, soft tissue, renal, hepatic, and germ cell cancer) were also examined, but the number of studies was too limited to exclude the possibility of maternal smoking as a risk factor for cancer in offspring. CONCLUSIONS According to our meta-analyses, maternal smoking is associated with nervous system cancers, but not with leukemia in early life. Confirming or rejecting associations of maternal smoking with lymphoma and the five other cancer types requires further studies.
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Affiliation(s)
- Isabell Katharina Rumrich
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Health Protection, National Institute of Health and Welfare, Kuopio, Finland
| | - Matti Viluksela
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Health Protection, National Institute of Health and Welfare, Kuopio, Finland
| | - Kirsi Vähäkangas
- School of Pharmacy/Toxicology, Faculty of Health Sciences, University of Eastern Finland, Kuopio Finland
| | - Mika Gissler
- Department of Information Services, National Institute for Health and Welfare, Helsinki, Finland and Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden
| | - Heljä-Marja Surcel
- Department of Health Protection, National Institute of Health and Welfare, Oulu, Finland
| | - Otto Hänninen
- Department of Health Protection, National Institute of Health and Welfare, Kuopio, Finland
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Kaur M, de Smith AJ, Selvin S, Zhang L, Cunningham M, Kang MW, Hansen HM, Cooper RM, McKean-Cowdin R, Wiemels JL, Metayer C. Tobacco Smoke and Ras Mutations Among Latino and Non-Latino Children with Acute Lymphoblastic Leukemia. Arch Med Res 2016; 47:677-683. [PMID: 28476195 PMCID: PMC5424620 DOI: 10.1016/j.arcmed.2016.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 11/23/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIMS Childhood acute lymphoblastic leukemia (ALL) is a biologically heterogeneous disease, and mutations in the KRAS and NRAS oncogenes are present at diagnosis in about one-fifth of cases. Ras mutations were previously associated with environmental exposures in leukemias as well as in many other cancer types. This study examined whether Ras mutation could define a unique etiologic group of childhood ALL associated with tobacco smoke, a well-established mutagen and carcinogen. METHODS We included 670 children with ALL enrolled in a case-control study in California (1995-2013), including 50.6% Latinos. Parental and child exposure to tobacco smoke was obtained from interviews. Sanger sequencing was used to detect the common KRAS and NRAS hotspot mutations in diagnostic bone marrow DNA. ALL cases were also characterized for common chromosome abnormalities. In case-case analyses, logistic regression analyses were used to estimate odds ratios to describe the association between tobacco smoke exposure and childhood ALL with Ras mutations. RESULTS KRAS or NRAS mutations were detected in ∼18% of children diagnosed with ALL. Ras mutations were more common among Latino cases compared with non-Latino whites and in high-hyperdiploid ALL. No associations were observed between parental smoking or child's passive exposure to smoke and Ras positive ALL. CONCLUSIONS The apparent lack of association between tobacco smoke and Ras mutation in childhood ALL suggests that Ras mutations do not specifically define a tobacco-related etiologic pathway. Reasons for racial and ethnic differences in ALL are not well understood and could reflect differences in etiology that warrant further examination.
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Affiliation(s)
- Maneet Kaur
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California
| | - Adam J de Smith
- Department of Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Steve Selvin
- Divison of Biostatistics, School of Public Health, University of California Berkeley, Berkeley, California
| | - Luoping Zhang
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, California
| | - Marc Cunningham
- Department of Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Michelle W Kang
- Department of Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Helen M Hansen
- Department of Neurological Surgery, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Robert M Cooper
- Department of Pediatric Hematology/Oncology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Roberta McKean-Cowdin
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Joseph L Wiemels
- Department of Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California; Department of Neurological Surgery, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Catherine Metayer
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California.
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Bailey HD, Infante-Rivard C, Metayer C, Clavel J, Lightfoot T, Kaatsch P, Roman E, Magnani C, Spector LG, Petridou E, Milne E, Dockerty JD, Miligi L, Armstrong BK, Rudant J, Fritschi L, Simpson J, Zhang L, Rondelli R, Baka M, Orsi L, Moschovi M, Kang AY, Schüz J. Home pesticide exposures and risk of childhood leukemia: Findings from the childhood leukemia international consortium. Int J Cancer 2015; 137:2644-63. [PMID: 26061779 PMCID: PMC4572913 DOI: 10.1002/ijc.29631] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 05/13/2015] [Accepted: 05/18/2015] [Indexed: 01/20/2023]
Abstract
Some previous studies have suggested that home pesticide exposure before birth and during a child's early years may increase the risk of childhood leukemia. To further investigate this, we pooled individual level data from 12 case-control studies in the Childhood Leukemia International Consortium. Exposure data were harmonized into compatible formats. Pooled analyses were undertaken using multivariable unconditional logistic regression. The odds ratio (ORs) for acute lymphoblastic leukemia (ALL) associated with any pesticide exposure shortly before conception, during pregnancy and after birth were 1.39 (95% confidence interval [CI]: 1.25, 1.55) (using 2,785 cases and 3,635 controls), 1.43 (95% CI: 1.32, 1.54) (5,055 cases and 7,370 controls) and 1.36 (95% CI: 1.23, 1.51) (4,162 cases and 5,179 controls), respectively. Corresponding ORs for risk of acute myeloid leukemia (AML) were 1.49 (95% CI: 1.02, 2.16) (173 cases and 1,789 controls), 1.55 (95% CI: 1.21, 1.99) (344 cases and 4,666 controls) and 1.08 (95% CI: 0.76, 1.53) (198 cases and 2,655 controls), respectively. There was little difference by type of pesticide used. The relative similarity in ORs between leukemia types, time periods and pesticide types may be explained by similar exposure patterns and effects across the time periods in ALL and AML, participants' exposure to multiple pesticides, or recall bias. Although some recall bias is likely, until a better study design can be found to investigate the associations between home pesticide use and childhood leukemia in an equally large sample, it would appear prudent to limit the use of home pesticides before and during pregnancy, and during childhood.
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Affiliation(s)
- Helen D Bailey
- International Agency for Research on Cancer (IARC), Section of Environment and Radiation, Lyon, France
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Canada
| | - Catherine Metayer
- University of California, Berkeley, School of Public Health, Berkeley, United States
| | - Jacqueline Clavel
- Inserm U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France
- Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, France
- RNHE - National Registry of Childhood cancers, Villejuif, France
| | - Tracy Lightfoot
- Department of Health Sciences, University of York, York, United Kingdom
| | - Peter Kaatsch
- German Childhood Cancer Registry (GCCR) at the Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Germany
| | - Eve Roman
- Department of Health Sciences, University of York, York, United Kingdom
| | - Corrado Magnani
- Dipartimento di Medicina Traslazionale – Universita` del Piemonte Orientale, AOU Maggiore della Carita` e CPO – Piemonte, Novara, Italy
| | - Logan G Spector
- Division of Epidemiology Clinical Research, University of Minnesota, Minneapolis, United States
- Department of Pediatrics and Masonic Cancer Center, University of Minnesota, Minneapolis, United States
| | - Eleni Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Elizabeth Milne
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - John D Dockerty
- Dean's Department and Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Lucia Miligi
- ISPO-Cancer Prevention and Research Institute, Occupational and Environmental Epidemiology Unit, Florence, Italy
| | - Bruce K Armstrong
- Sydney School of Public Health, University of Sydney, New South Wales, Australia
- Sax Institute, Ultimo, NSW, Australia
| | - Jérémie Rudant
- Inserm U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France
- Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, France
- RNHE - National Registry of Childhood cancers, Villejuif, France
| | - Lin Fritschi
- Curtin University, School of Public Health, Perth, Australia
| | - Jill Simpson
- Department of Health Sciences, University of York, York, United Kingdom
| | - Luoping Zhang
- University of California, Berkeley, School of Public Health, Berkeley, United States
| | - Roberto Rondelli
- Paediatric Haematology -Oncology, Lalla Seràgnoli, Policlinico Sant’Orsola Malpighi Bologna Italy
| | - Margarita Baka
- Department of Pediatric Hematology-Oncology, ‘‘Pan.&Agl. Kyriakou’’ Children’s Hospital, Athens, Greece
| | - Laurent Orsi
- Inserm U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Epidemiology of childhood and adolescent cancers team (EPICEA), Villejuif, France
- Paris-Descartes University, UMRS-1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, France
| | - Maria Moschovi
- Hematology-Oncology Unit, First Department of Pediatrics, Athens University Medical School, ‘‘Aghia Sophia’’ General Children’s Hospital, Athens, Greece
| | - Alice Y Kang
- University of California, Berkeley, School of Public Health, Berkeley, United States
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), Section of Environment and Radiation, Lyon, France
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12
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Yan K, Xu X, Liu X, Wang X, Hua S, Wang C, Liu X. The associations between maternal factors during pregnancy and the risk of childhood acute lymphoblastic leukemia: A meta-analysis. Pediatr Blood Cancer 2015; 62:1162-70. [PMID: 25728190 DOI: 10.1002/pbc.25443] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 12/26/2014] [Indexed: 01/25/2023]
Abstract
BACKGROUND Although genetic and environmental factors are considered to be the main causes of acute lymphoblastic leukemia, the associations between maternal factors during pregnancy and the childhood ALL is still unclear. PROCEDURE In this study, meta-analysis was used. Medline, PubMed, and Web of Science were searched. The result was assessed based on pooled odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS The pooled ORs showed that there were associations between childhood ALL and the birth order (The first vs others, OR = 1.08, 95%CI = 1.00-1.16), the education of pregnant woman (>high school vs ≤ high school, OR = 0.82, 95%CI = 0.77-0.86), smoking (Ever vs never, OR = 1.10, 95%CI = 1.02-1.19). CONCLUSIONS Our meta-analysis showed that there were important associations between childhood ALL and the birth order, the education of pregnant woman, smoking.
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Affiliation(s)
- Kangkang Yan
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xuejing Xu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiaodong Liu
- Key Laboratory of Radiobiology (Ministry of Health), School of Public Health, Jilin University, Changchun, China
| | - Xikui Wang
- Department of Statistics, University of Manitoba, Winnipeg, Canada
| | - Shucheng Hua
- The First Hospital of Jilin University, Changchun, China
| | - Chunpeng Wang
- School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China
| | - Xin Liu
- Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China
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13
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Orsi L, Rudant J, Ajrouche R, Leverger G, Baruchel A, Nelken B, Pasquet M, Michel G, Bertrand Y, Ducassou S, Gandemer V, Lutz P, Saumet L, Moreau P, Hemon D, Clavel J. Parental smoking, maternal alcohol, coffee and tea consumption during pregnancy, and childhood acute leukemia: the ESTELLE study. Cancer Causes Control 2015; 26:1003-17. [DOI: 10.1007/s10552-015-0593-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 04/22/2015] [Indexed: 10/23/2022]
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14
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Salvan A, Ranucci A, Lagorio S, Magnani C. Childhood leukemia and 50 Hz magnetic fields: findings from the Italian SETIL case-control study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:2184-204. [PMID: 25689995 PMCID: PMC4344719 DOI: 10.3390/ijerph120202184] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 01/29/2015] [Accepted: 02/05/2015] [Indexed: 11/29/2022]
Abstract
We report on an Italian case-control study on childhood leukemia and exposure to extremely low frequency magnetic fields (ELF-MF). Eligible for inclusion were 745 leukemia cases, aged 0–10 years at diagnosis in 1998–2001, and 1475 sex- and age-matched population controls. Parents of 683 cases and 1044 controls (92% vs. 71%) were interviewed. ELF-MF measurements (24–48 h), in the child’s bedroom of the dwelling inhabited one year before diagnosis, were available for 412 cases and 587 controls included in the main conditional regression analyses. The magnetic field induction was 0.04 μT on average (geometric mean), with 0.6% of cases and 1.6% of controls exposed to >0.3 μT. The impact of changes in the statistical model, exposure metric, and data-set restriction criteria was explored via sensitivity analyses. No exposure-disease association was observed in analyses based on continuous exposure, while analyses based on categorical variables were characterized by incoherent exposure-outcome relationships. In conclusion, our results may be affected by several sources of bias and they are noninformative at exposure levels >0.3 μT. Nonetheless, the study may contribute to future meta- or pooled analyses. Furthermore, exposure levels among population controls are useful to estimate attributable risk.
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Affiliation(s)
- Alberto Salvan
- Institute for Systems Analysis and Computer Science "Antonio Ruberti", IASI-CNR, Via dei Taurini 19, 00185 Rome, Italy.
| | - Alessandra Ranucci
- Medical Statistics & Cancer Epidemiology Unit-Department of Translational Medicine, CPO Piemonte and University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy.
| | - Susanna Lagorio
- National Centre for Epidemiology, Surveillance and Health Promotion-National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Corrado Magnani
- Medical Statistics & Cancer Epidemiology Unit-Department of Translational Medicine, CPO Piemonte and University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy.
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15
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Magnani C, Mattioli S, Miligi L, Ranucci A, Rondelli R, Salvan A, Bisanti L, Masera G, Rizzari C, Zambon P, Cannizzaro S, Gafà L, Luzzatto LL, Benvenuti A, Michelozzi P, Kirchmayer U, Cocco P, Biddau P, Galassi C, Celentano E, Guarino E, Assennato G, de Nichilo G, Merlo DF, Bocchini V, Pannelli F, Mosciatti P, Minelli L, Chiavarini M, Cuttini M, Casotto V, Torregrossa MV, Valenti RM, Forastiere F, Haupt R, Lagorio S, Risica S, Polichetti A. SETIL: Italian multicentric epidemiological case-control study on risk factors for childhood leukaemia, non hodgkin lymphoma and neuroblastoma: study population and prevalence of risk factors in Italy. Ital J Pediatr 2014; 40:103. [PMID: 25539823 PMCID: PMC4310183 DOI: 10.1186/s13052-014-0103-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 12/04/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aetiology of childhood leukaemia and childhood neoplasm is poorly understood. Information on the prevalence of risk factors in the childhood population is limited. SETIL is a population based case-control study on childhood leukaemia, conducted with two companion studies on non-Hodgkin Lymphoma (NHL) and neuroblastoma. The study relies on questionnaire interviews and 50 Hz magnetic field (ELF-MF) indoor measurements. This paper discusses the SETIL study design and includes descriptive information. METHODS The study was carried out in 14 Italian regions (78.3% of Italian population aged 0-10). It included leukaemia, NHL and neuroblastoma cases incident in 0-10 year olds in 1998-2001, registered by the Italian Association of Paediatric Haematology and Oncology (AIEOP) (accrual over 95% of estimated incidence). Two controls for each leukaemia case were randomly sampled from the Local Health Authorities rolls, matched by gender, birthdate and residence. The same controls were used in NHL and neuroblastoma studies. Parents were interviewed at home on: physical agents (ELF-MF and ionizing radiation), chemicals (smoking, solvents, traffic, insecticides), occupation, medical and personal history of children and parents, infectious diseases, immunizations and associated factors. Occupational exposure was collected using job specific modules. ELF-MF was measured in the main rooms (spot measurement) and close to child's bed (48 hours measurement). RESULTS The study included: 683 leukaemia cases (87% ALL, 13% AnLL), 97 NHL, 155 neuroblastomas, and 1044 controls. CONCLUSIONS SETIL represents a data source on exposure of Italian children to a broad array of potential carcinogenic factors.
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Affiliation(s)
- Corrado Magnani
- />Medical Statistics & Cancer Epidemiology Unit - Department of Translational Medicine, CPO Piemonte and University of Eastern Piedmont, V. Solaroli 17, Novara, 28100 Italy
| | - Stefano Mattioli
- />Section of Occupational Medicine, Department of Internal Medicine, Geriatrics and Nephrology, University of Bologna, Bologna, Italy
| | - Lucia Miligi
- />Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | | | - Roberto Rondelli
- />Paediatric Oncology-Haematology “Lalla Seràgnoli”, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | | | | | - Giuseppe Masera
- />Clinica Pediatrica, Università Milano Bicocca, Monza, Italy
| | | | - Paola Zambon
- />Registro Tumori del Veneto, Università di Padova, Padova, Italy
| | - Santina Cannizzaro
- />Lega Italiana per la Lotta contro i Tumori Onlus Sez, Provinciale di Ragusa, Ragusa Ibla, Italy
| | - Lorenzo Gafà
- />Lega Italiana per la Lotta contro i Tumori Onlus Sez, Provinciale di Ragusa, Ragusa Ibla, Italy
| | | | - Alessandra Benvenuti
- />Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute Firenze, Firenze, Italy
| | - Paola Michelozzi
- />UOC Epidemiologia Ambientale, Dipartimento Epidemiologia Regione Lazio, Roma, Italy
| | | | - Pierluigi Cocco
- />Dipartimento di Sanità Pubblica, Sezione di Medicina del Lavoro, Università di Cagliari, Cagliari, Italy
| | - Pierfranco Biddau
- />Servizio di Oncoematologia Pediatrica, Ospedale Microcitemico Cagliari, Cagliari, Italy
| | | | - Egidio Celentano
- />S. O. Analisi e Monitoraggio, ARSAN - Agenzia Regionale Sanitaria della Campania, Napoli, Italy
| | | | | | | | - Domenico Franco Merlo
- />Epidemiology, Biostatistics and Clinical Trials, IRCCS Azienda Ospedaliera Universitaria San Martino- IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Vittorio Bocchini
- />Epidemiology, Biostatistics and Clinical Trials, IRCCS AOU San Martino- IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Franco Pannelli
- />Registro Tumori di Macerata e Università di Camerino, Camerino, Italy
| | - Paola Mosciatti
- />Università di Camerino, Dipartimento di Medicina Sperimentale e di Sanità Pubblica, Camerino, Italy
| | - Liliana Minelli
- />Dipartimento di Medicina Sperimentale - Sezione di Sanità Pubblica Università degli Studi di Perugia, Perugia, Italy
| | - Manuela Chiavarini
- />Dipartimento di Medicina Sperimentale - Sezione di Sanità Pubblica, Università degli Studi di Perugia, Perugia, Italy
| | - Marina Cuttini
- />Unità di Unità di Ricerca di Epidemiologia Perinatale, Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | | | - Maria Valeria Torregrossa
- />Dipartimento di Scienze per la Promozione della Salute Sez.Igiene, Università degli Studi di Palermo, Palermo, Italy
| | - Rosalia Maria Valenti
- />Dipartimento di Scienze per la Promozione della Salute Sez.Igiene, Università degli Studi di Palermo, Palermo, Italy
| | - Francesco Forastiere
- />UOC Epidemiologia Ambientale, Dipartimento Epidemiologia Regione Lazio, Roma, Italy
| | | | - Susanna Lagorio
- />National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
| | - Serena Risica
- />Retired, formerly: Department of Technology and Health, National Institute of Health, Rome, Italy
| | - Alessandro Polichetti
- />Retired, formerly: Department of Technology and Health, National Institute of Health, Rome, Italy
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16
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Mattioli S, Farioli A, Legittimo P, Miligi L, Benvenuti A, Ranucci A, Salvan A, Rondelli R, Magnani C. Tobacco smoke and risk of childhood acute non-lymphocytic leukemia: findings from the SETIL study. PLoS One 2014; 9:e111028. [PMID: 25401754 PMCID: PMC4234298 DOI: 10.1371/journal.pone.0111028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 09/23/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Parental smoking and exposure of the mother or the child to environmental tobacco smoke (ETS) as risk factors for Acute non-Lymphocytic Leukemia (AnLL) were investigated. METHODS Incident cases of childhood AnLL were enrolled in 14 Italian Regions during 1998-2001. We estimated odds ratios (OR) and 95% confidence intervals (95%CI) conducting logistic regression models including 82 cases of AnLL and 1,044 controls. Inverse probability weighting was applied adjusting for: age; sex; provenience; birth order; birth weight; breastfeeding; parental educational level age, birth year, and occupational exposure to benzene. RESULTS Paternal smoke in the conception period was associated with AnLL (OR for ≥ 11 cigarettes/day = 1.79, 95% CI 1.01-3.15; P trend 0.05). An apparent effect modification by maternal age was identified: only children of mothers aged below 30 presented increased risks. We found weak statistical evidence of an association of AnLL with maternal exposure to ETS (OR for exposure>3 hours/day = 1.85, 95%CI 0.97-3.52; P trend 0.07). No association was observed between AnLL and either maternal smoking during pregnancy or child exposure to ETS. CONCLUSIONS This study is consistent with the hypothesis that paternal smoke is associated with AnLL. We observed statistical evidence of an association between maternal exposure to ETS and AnLL, but believe bias might have inflated our estimates.
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Affiliation(s)
- Stefano Mattioli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Andrea Farioli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Patrizia Legittimo
- Unit of Occupational Medicine, S.Orsola-Malpighi University Hospital, Bologna, Italy
- Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Lucia Miligi
- Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Alessandra Benvenuti
- Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Alessandra Ranucci
- Cancer Epidemiology Unit - Department of Translational Medicine, CPO Piemonte and University of Eastern Piedmont, Novara, Italy
| | | | - Roberto Rondelli
- Paediatric Oncology-Haematology “Lalla Seràgnoli”, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | - Corrado Magnani
- Cancer Epidemiology Unit - Department of Translational Medicine, CPO Piemonte and University of Eastern Piedmont, Novara, Italy
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