1
|
Stephens J, Moorhouse AJ, Craenen K, Schroeder E, Drenos F, Anderson R. A systematic review of human evidence for the intergenerational effects of exposure to ionizing radiation. Int J Radiat Biol 2024:1-34. [PMID: 38335529 DOI: 10.1080/09553002.2024.2306328] [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: 05/05/2023] [Accepted: 01/10/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To provide a synthesis of the published evidence pertaining to the intergenerational health effects of parental preconceptional exposure to ionizing radiation in humans. METHODS The study populations are the descendants of those who were exposed to ionizing radiation prior to conception. A Boolean search identified publications for review in accordance with Office of Health Assessment and Translation guidelines. Initially, a risk of bias assessment was conducted for each published study and relevant data extracted. Information was organized into adverse health outcome groups and exposure situations. To make an assessment from the body of evidence within each group, an initial confidence rating was assigned, before factors including inconsistencies between studies, magnitude of effect, dose response and confounders were considered. From this, 'an effect', 'no effect' or whether the evidence remained 'inadequate' to determine either effect or no effect, was ascertained. This assessment was based primarily upon the author's conclusions within that evidence-base and, by binomial probability testing of the direction of effect reported. RESULTS 2441 publications were identified for review which after screening was reduced to 127. For the majority of the adverse health groups, we find there to be inadequate evidence from which to determine whether the health effect was, or was not, associated with parental preconceptional radiation exposure. This was largely due to heterogeneity between individual study's findings and conclusions within each group and, the limited number of studies within each group. We did observe one health grouping (congenital abnormalities) in occupationally exposed populations, where an increase in effect relative to their controls or large magnitude of effects, were reported, although it is noted that the authors of these studies interpreted their findings as most likely not to be associated with parental radiation exposure. CONCLUSIONS We find there to be a lack of evidence to enable the formal assessment of radiation-related adverse effects in offspring of exposed humans. This is not the same as there being no clear evidence that effects may occur but does infer that if adverse health effects do arise in children of exposed parents, then these effects are small and difficult to reproducibly measure. Inconsistencies in designing studies are unavoidable, however we highlight the need for an element of standardization and, more sharing of primary datasets as part of open access initiatives, in order for future reviews to make reasonable conclusions. Overall, there is a need for future work to ensure comparable measures between studies where possible.
Collapse
Affiliation(s)
- Jade Stephens
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Alexander J Moorhouse
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
- School of Cellular and Molecular Medicine, University of Bristol, University Walk, Bristol, UK
- Department of Life Sciences, University of Bath, Bath, UK
| | - Kai Craenen
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Ewald Schroeder
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Fotios Drenos
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Rhona Anderson
- Centre for Health Effects of Radiological and Chemical Agents, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| |
Collapse
|
2
|
Parental occupational organic dust exposure and selected childhood cancers in Denmark 1968-2016. Cancer Epidemiol 2020; 65:101667. [PMID: 31955038 DOI: 10.1016/j.canep.2020.101667] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/27/2019] [Accepted: 12/31/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Parental occupational exposures are suggested as contributing causes of childhood cancer. METHODS Children age< = 19, born in Denmark and diagnosed with leukemia, central nervous system (CNS) cancers and likely prenatally initiated cancers [hepatoblastoma, medulloblastoma, Wilms tumor (nephroblastoma), neuroblastoma, retinoblastoma and acute lymphoid leukemia] n = 4268 were identified using Danish registries. We randomly selected twenty-five controls per case matched on birth year and sex. Parents and their employment histories were extracted from nationwide registries. We examined occupational dust exposures perinatally and postnatally in both parents. Odds ratios (ORs) and 95 % confidence intervals (95 % CI) were estimated using conditional logistic regression. RESULTS Maternal wood dust exposure from birth to diagnosis was associated with increased risks of leukemia (OR 1.44, 95 % CI 1.08-1.94) and acute myeloid leukemia (OR 2.14, 95 % CI 1.13-4.03); exposure to paper dust was associated with CNS cancer (OR 2.28, 95 % CI 1.22-4.2).. Paternal exposure to wood dust was associated with astrocytoma in both periods (OR 1.43, 95 % CI 1.05-1.96 and 1.42, 1.09-1.86, respectively) and CNS cancer (OR 1.24, 95 % CI 1.00-1.53) in the perinatal period. The increased risk observed for potentially prenatally-initiated cancers in relation to wood was driven by ORs for neuroblastoma (1.54, 95 % CI 1.03-2.29) and hepatoblastoma (2.41, 95 % CI 0.99-5.88). An OR of 2.58 (95 % CI 1.10-6.05) for CNS cancer was associated with both parents working in textile industries postnatally. CONCLUSION The study suggests that parental exposure to wood dust may increase risk of specific childhood cancers.
Collapse
|
3
|
Bunch KJ, Kendall GM, Stiller CA, Vincent TJ, Murphy MFG. Case-control study of paternal occupational exposures and childhood lymphoma in Great Britain, 1962-2010. Br J Cancer 2019; 120:1153-1161. [PMID: 31105271 PMCID: PMC6738046 DOI: 10.1038/s41416-019-0469-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This nationwide study investigates associations between paternal occupational exposure and childhood lymphoma. METHODS The UK National Registry of Childhood Tumours provided cases of childhood lymphoma born and diagnosed in Great Britain 1962-2010. Control births, unaffected by childhood cancer, were matched on sex, birth period and birth registration sub-district. Fathers' occupations were assigned to one or more of 33 exposure groups and also coded for occupational social class. RESULTS We analysed 5033 childhood lymphoma cases and 4990 controls. Total lymphoma and the subgroups Hodgkin, Burkitt and non-Hodgkin lymphoma were considered separately. No one exposure was significantly associated with increased risk within all subgroups and for total lymphoma. However, exposure to "ceramics and glass" was significantly associated with increased risk of total lymphoma, Hodgkin and non-Hodgkin lymphoma. Paternal lead exposure was associated with Burkitt lymphoma and exposure to metal fumes was associated with Hodgkin lymphoma. CONCLUSIONS This study provides no support for previous suggestions of an association between childhood lymphoma and paternal occupational exposure to pesticides, solvents/hydrocarbons or infections potentially transmitted by father's social contacts. An association with exposure to "ceramics and glass" was noted for the two major lymphoma subtypes together comprising 80% of total lymphoma.
Collapse
Affiliation(s)
- Kathryn J Bunch
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Gerald M Kendall
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Charles A Stiller
- National Cancer Registration and Analysis Service, Public Health England, Chancellor Court, Oxford Business Park South, Oxford, OX4 2GX, UK
| | - Timothy J Vincent
- Formerly of Childhood Cancer Research Group, University of Oxford, Oxford, UK
| | - Michael F G Murphy
- Nuffield Department of Women's and Reproductive Health John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, UK
| |
Collapse
|
4
|
Adewumi-Gunn TA, Ponce E, Flint N, Robbins W. A Preliminary Community-Based Occupational Health Survey of Black Hair Salon Workers in South Los Angeles. J Immigr Minor Health 2019; 20:164-170. [PMID: 27804012 DOI: 10.1007/s10903-016-0521-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Black hair-salon workers face serious health hazards from the product they use on clients and other health hazards at their work. Currently there is a significant research gap in understanding the prevalence of workplace related exposures and health outcomes. The primary objective of this study was to gather preliminary data on workplace exposures and health outcomes of hair care workers in South Los Angeles. We conducted 22 surveys of salon workers at 16 salons. The results suggest the need for proper health and safety training within the salon worker community, specifically around chemical hair services. The results also suggest ergonomic workstation assessments and recommendations would be beneficial to reduce musculoskeletal disorders. Willingness of stylists to learn more about workplace hazards and how to mitigate their risks was high. Our findings indicate the need for a larger community based participatory research study on the workplace exposures of Black salon workers.
Collapse
Affiliation(s)
- Teniope A Adewumi-Gunn
- Environmental Health Sciences, University of California at Los Angeles, Los Angeles, CA, 90066, USA.
| | | | | | - Wendie Robbins
- Environmental Health Sciences, University of California at Los Angeles, Los Angeles, CA, 90066, USA
| |
Collapse
|
5
|
Maternal exposure to gasoline and exhaust increases the risk of childhood leukaemia in offspring - a prospective study in the Norwegian Mother and Child Cohort Study. Br J Cancer 2018; 119:1028-1035. [PMID: 30318517 PMCID: PMC6203789 DOI: 10.1038/s41416-018-0295-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/24/2018] [Accepted: 09/19/2018] [Indexed: 12/12/2022] Open
Abstract
Background In the prospective population-based Norwegian Mother and Child Cohort Study (MoBa), comprising 113 754 offspring, we investigated the association between parental exposure to “gasoline or exhaust”, as a proxy for benzene exposure, and childhood leukaemia. Methods Around gestational week 17, mothers and fathers responded to a questionnaire on exposure to various agents during the last 6 months and 6 months pre-conception, respectively. Benzene exposure was assessed through self-reported exposure to “gasoline or exhaust”. Cases of childhood leukaemia (n = 70) were identified through linkage with the Cancer Registry of Norway. Risk was estimated by hazard ratios (HRs) with 95% confidence intervals (95%CI), comparing offspring from exposed and unexposed parents using a Cox regression model. Results Maternal exposure to "gasoline or exhaust" was associated with an increased risk of childhood leukaemia (HR = 2.59; 95%CI: 1.03, 6.48) and acute lymphatic leukaemia (HR = 2.71; 95%CI: 0.97, 7.58). There was an increasing risk for higher exposure (p value for trend = 0.032 and 0.027). The association did not change after adjustment for maternal smoking. Conclusion In spite of rather few cases, the findings in this prospective study, with the exposure metric defined a priori, support previous observations relating maternal exposure to benzene from gasoline and other petroleum-derived sources and the subsequent development of childhood leukaemia in the offspring.
Collapse
|
6
|
Metayer C, Scelo G, Kang AY, Gunier RB, Reinier K, Lea S, Chang JS, Selvin S, Kirsch J, Crouse V, Does M, Quinlan P, Hammond SK. A task-based assessment of parental occupational exposure to organic solvents and other compounds and the risk of childhood leukemia in California. ENVIRONMENTAL RESEARCH 2016; 151:174-183. [PMID: 27494537 PMCID: PMC5071154 DOI: 10.1016/j.envres.2016.06.047] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 06/22/2016] [Accepted: 06/30/2016] [Indexed: 05/22/2023]
Abstract
PURPOSE Data on parental occupational exposures and risk of childhood leukemia lack specificity. Using 19 task-based job modules, we examined the relationship between occupational exposure to organic solvents and other compounds and the risk of leukemia in children. METHODS Latino (48%) and non-Latino (52%) children with acute lymphoblastic leukemia (ALL; n=670), acute myeloid leukemia (AML; n=104), and controls (n=1021) were enrolled in a study in California (2000-2008). Logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for socio-demographic factors. RESULTS Among children with non-Latino fathers, none of the exposures evaluated were associated with risks of ALL and AML. In contrast, exposure to any organic solvents in Latino fathers was associated with an increased risk of childhood ALL (OR=1.48; 95% CI: 1.01-2.16); in multivariable analyses, the OR for chlorinated hydrocarbons was 2.28 (95% CI: 0.97-5.37) while the ORs were close to one for aromatic hydrocarbons, glycol ethers, and other hydrocarbon mixtures. We also observed an increased risk of ALL with exposure to combustion exhaust/polycyclic aromatic hydrocarbons (PAHs) (ORs=1.70; 95% CI: 1.16-2.57, and 1.46; 95% CI: 0.94-2.26 with and without adjustment for chlorinated hydrocarbons, respectively). Moderately elevated risks of ALL were seen with exposure to metals, paints, and wood dust, although not statistically significant. An increased risk was reported for asbestos based on small numbers of exposed Latino fathers. No associations were reported between maternal exposures to any exposures and childhood ALL and AML. CONCLUSIONS Our data support associations between paternal occupational exposures to chlorinated hydrocarbons, combustion exhaust, metals, and possibly asbestos and the risk of ALL in the children of Latino fathers only.
Collapse
Affiliation(s)
- Catherine Metayer
- University of California, Berkeley, School of Public Health, Division of Epidemiology, Berkeley, CA, USA.
| | | | - Alice Y Kang
- University of California, Berkeley, School of Public Health, Division of Epidemiology, Berkeley, CA, USA
| | - Robert B Gunier
- University of California, Berkeley, School of Public Health, Division of Environmental Health Sciences, Berkeley, CA, USA
| | - Kyndaron Reinier
- Cedars-Sinai Medical Center, Heart Institute, Los Angeles, CA, USA
| | - Suzanne Lea
- East Carolina University, Brody School of Medicine, Department of Public Health, Greenville, NC, USA
| | - Jeffrey S Chang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Steve Selvin
- University of California, Berkeley, School of Public Health, Division of Epidemiology, Berkeley, CA, USA
| | - Janice Kirsch
- Medical oncologist and hematologist, Berkeley, CA, USA
| | | | - Monique Does
- Division of Research, the Permanente Medical Group, Oakland, CA, USA
| | - Patricia Quinlan
- University of California, San Francisco, Department of Medicine, San Francisco, CA, USA
| | - S Katharine Hammond
- University of California, Berkeley, School of Public Health, Division of Environmental Health Sciences, Berkeley, CA, USA
| |
Collapse
|
7
|
Abstract
This paper gives an overview of the main quantitative research designs relevant to nursing and healthcare. It outlines some strengths and weaknesses of the designs, provides examples to illustrate the different designs and examines some of the relevant statistical concepts. The paper concludes with a brief discussion about the place of quantitative research in nursing.
Collapse
Affiliation(s)
- Kate Seers
- RCN Institute, Radcliffe Infirmary, Oxford
| | - Nicola Critelton
- RCN Development Centre, Faculty of Health, South Bank University, London
| |
Collapse
|
8
|
Schmitz-Feuerhake I, Busby C, Pflugbeil S. Genetic radiation risks: a neglected topic in the low dose debate. ENVIRONMENTAL HEALTH AND TOXICOLOGY 2016; 31:e2016001. [PMID: 26791091 PMCID: PMC4870760 DOI: 10.5620/eht.e2016001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 01/20/2016] [Indexed: 05/25/2023]
Abstract
OBJECTIVES To investigate the accuracy and scientific validity of the current very low risk factor for hereditary diseases in humans following exposures to ionizing radiation adopted by the United Nations Scientific Committee on the Effects of Atomic Radiation and the International Commission on Radiological Protection. The value is based on experiments on mice due to reportedly absent effects in the Japanese atomic bomb (Abomb) survivors. METHODS To review the published evidence for heritable effects after ionising radiation exposures particularly, but not restricted to, populations exposed to contamination from the Chernobyl accident and from atmospheric nuclear test fallout. To make a compilation of findings about early deaths, congenital malformations, Down's syndrome, cancer and other genetic effects observed in humans after the exposure of the parents. To also examine more closely the evidence from the Japanese A-bomb epidemiology and discuss its scientific validity. RESULTS Nearly all types of hereditary defects were found at doses as low as one to 10 mSv. We discuss the clash between the current risk model and these observations on the basis of biological mechanism and assumptions about linear relationships between dose and effect in neonatal and foetal epidemiology. The evidence supports a dose response relationship which is non-linear and is either biphasic or supralinear (hogs-back) and largely either saturates or falls above 10 mSv. CONCLUSIONS We conclude that the current risk model for heritable effects of radiation is unsafe. The dose response relationship is non-linear with the greatest effects at the lowest doses. Using Chernobyl data we derive an excess relative risk for all malformations of 1.0 per 10 mSv cumulative dose. The safety of the Japanese A-bomb epidemiology is argued to be both scientifically and philosophically questionable owing to errors in the choice of control groups, omission of internal exposure effects and assumptions about linear dose response.
Collapse
|
9
|
Carlos-Wallace FM, Zhang L, Smith MT, Rader G, Steinmaus C. Parental, In Utero, and Early-Life Exposure to Benzene and the Risk of Childhood Leukemia: A Meta-Analysis. Am J Epidemiol 2016; 183:1-14. [PMID: 26589707 DOI: 10.1093/aje/kwv120] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 04/27/2015] [Indexed: 02/06/2023] Open
Abstract
Benzene is an established cause of adult leukemia, but whether it is associated with childhood leukemia remains unclear. We conducted a meta-analysis in which we reviewed the epidemiologic literature on this topic and explored causal inference, bias, and heterogeneity. The exposure metrics that we evaluated included occupational and household use of benzenes and solvents, traffic density, and traffic-related air pollution. For studies of occupational and household product exposure published from 1987 to 2014, the summary relative risk for childhood leukemia was 1.96 (95% confidence interval (CI): 1.53, 2.52; n = 20). In these studies, the summary relative risk was higher for acute myeloid leukemia (summary relative risk (sRR) = 2.34, 95% CI: 1.72, 3.18; n = 6) than for acute lymphoblastic leukemia (sRR = 1.57; 95% CI: 1.21, 2.05; n = 14). The summary relative risk was higher for maternal versus paternal exposure, in studies that assessed benzene versus all solvents, and in studies of gestational exposure. In studies of traffic density or traffic-related air pollution published from 1999 to 2014, the summary relative risk was 1.48 (95% CI: 1.10, 1.99; n = 12); it was higher for acute myeloid leukemia (sRR = 2.07; 95% CI: 1.34, 3.20) than for acute lymphoblastic leukemia (sRR = 1.49; 95% CI: 1.07, 2.08) and in studies that involved detailed models of traffic pollution (sRR = 1.70; 95% CI: 1.16, 2.49). Overall, we identified evidence of associations between childhood leukemia and several different potential metrics of benzene exposure.
Collapse
|
10
|
Heck JE, Park AS, Qiu J, Cockburn M, Ritz B. Risk of leukemia in relation to exposure to ambient air toxics in pregnancy and early childhood. Int J Hyg Environ Health 2013; 217:662-8. [PMID: 24472648 DOI: 10.1016/j.ijheh.2013.12.003] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 12/17/2013] [Accepted: 12/19/2013] [Indexed: 12/23/2022]
Abstract
There are few established causes of leukemia, the most common type of cancer in children. Studies in adults suggest a role for specific environmental agents, but little is known about any effect from exposures in pregnancy to toxics in ambient air. In our case-control study, we ascertained 69 cases of acute lymphoblastic leukemia (ALL) and 46 cases of acute myeloid leukemia (AML) from California Cancer Registry records of children <age 6, and 19,209 controls from California birth records within 2 km (1.3 miles) (ALL) and 6 km (3.8 miles) (AML) of an air toxics monitoring station between 1990 and 2007. Information on air toxics exposures was taken from community air monitors. We used logistic regression to estimate the risk of leukemia associated with one interquartile range increase in air toxic exposure. Risk of ALL was elevated with 3(rd) trimester exposure to polycyclic aromatic hydrocarbons (OR=1.16, 95% CI 1.04, 1.29), arsenic (OR=1.33, 95% CI 1.02, 1.73), benzene (OR=1.50, 95% CI 1.08, 2.09), and three other toxics related to fuel combustion. Risk of AML was increased with 3rd trimester exposure to chloroform (OR=1.30, 95% CI 1.00, 1.69), benzene (1.75, 95% CI 1.04, 2.93), and two other traffic-related toxics. During the child's first year, exposure to butadiene, ortho-xylene, and toluene increased risk for AML and exposure to selenium increased risk for ALL. Benzene is an established cause of leukemia in adults; this study supports that ambient exposures to this and other chemicals in pregnancy and early life may also increase leukemia risk in children.
Collapse
Affiliation(s)
- Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
| | - Andrew S Park
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Jiaheng Qiu
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| |
Collapse
|
11
|
Keegan TJ, Bunch KJ, Vincent TJ, King JC, O'Neill KA, Kendall GM, MacCarthy A, Fear NT, Murphy MFG. Case-control study of paternal occupation and social class with risk of childhood central nervous system tumours in Great Britain, 1962-2006. Br J Cancer 2013; 108:1907-14. [PMID: 23612452 PMCID: PMC3658514 DOI: 10.1038/bjc.2013.171] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 03/22/2013] [Accepted: 03/25/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Paternal occupational exposures have been proposed as a risk factor for childhood central nervous system (CNS) tumours. This study investigates possible associations between paternal occupational exposure and childhood CNS tumours in Great Britain. METHODS The National Registry of Childhood Tumours provided all cases of childhood CNS tumours born and diagnosed in Great Britain from 1962 to 2006. Controls without cancer were matched on sex, period of birth and birth registration sub-district. Fathers' occupations were assigned to one or more of 33 exposure groups. A measure of social class was also derived from father's occupation at the time of the child's birth. RESULTS Of 11 119 cases of CNS tumours, 5 722 (51%) were astrocytomas or other gliomas, 2 286 (21%) were embryonal and 985 (9%) were ependymomas. There was an increased risk for CNS tumours overall with exposure to animals, odds ratio (OR) 1.40 (95% confidence intervals (CIs) 1.01, 1.94) and, after adjustment for occupational social class (OSC), with exposure to lead, OR 1.18 (1.01, 1.39). Exposure to metal-working oil mists was associated with reduced risk of CNS tumours, both before and after adjustment for OSC, OR 0.87 (0.75, 0.99).Risk of ependymomas was raised for exposure to solvents, OR 1.73 (1.02,2.92). For astrocytomas and other gliomas, risk was raised with high social contact, although this was only statistically significant before adjustment for OSC, OR 1.15 (1.01,1.31). Exposure to paints and metals appeared to reduce the risk of astrocytomas and embryonal tumours, respectively. However, as these results were the result of a number of statistical tests, it is possible they were generated by chance.Higher social class was a risk factor for all CNS tumours, OR 0.97 (0.95, 0.99). This was driven by increased risk for higher social classes within the major subtype astrocytoma, OR 0.95 (0.91, 0.98). CONCLUSION Our results provide little evidence that paternal occupation is a significant risk factor for childhood CNS tumours, either overall or for specific subtypes. However, these analyses suggest that OSC of the father may be associated with risk of some childhood CNS cancers.
Collapse
Affiliation(s)
- T J Keegan
- Furness Building, Lancaster Medical School, Lancaster University, LA1 4YG Lancaster, UK.
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Zheng R, Zhang Q, Zhang Q, Yang L, Zhang Z, Huang F. Occupational exposure to pentachlorophenol causing lymphoma and hematopoietic malignancy for two generations. Toxicol Ind Health 2013; 31:328-42. [DOI: 10.1177/0748233712472520] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: Pentachlorophenol (PCP) is characterized as likely carcinogen of lymphoma and hematopoietic neoplasm. But the carcinogenicity to human was uncertain based on population studies. A systematic review was conducted to explore two kinds of associations, one was between the workers exposed to PCP with lymphoma and hematopoietic neoplasm, the other was between childhood lymphoma and leukemia with their parents exposed to PCP. Methods: Systematic search for epidemiologic studies was carried out and the data were collected from MEDLINE database and from the reference lists of relevant studies. Data were extracted from 20 included studies published between 1986 and 2012. Results: The meta-analysis suggested a significant association between lymphoma and workers’ occupational exposing to PCP, for the pooled odds ratio = 2.57 (95% confidence interval (CI) = 1.52–4.35). The subgroup analysis indicated significant association for non-Hodgkin’s lymphoma, but not for Hodgkin’s disease. The cohort studies also showed comparatively higher relative risk (RR) and standardized mortality ratio (SMR). Two of the cohort studies found increased RR as the cumulative exposure time added. Another cohort study discovered that the white males had significantly elevated non-Hodgkin’s lymphoma mortality (SMR = 1.98, 95% CI = 1.15–3.17), and males of other races had increased leukemia mortality (SMR = 4.57, 95% CI = 1.25–11.7). For the relationship of childhood leukemia and parental exposure to PCP, three published studies suggested an increased risk of childhood leukemia because of their parental exposure to PCP at the preconception period. Conclusion: Our review provided the evidence that occupational exposure of workers to PCP might increase the risk of lymphoma and hematopoietic neoplasm in themselves and in their children.
Collapse
Affiliation(s)
- Ruizhi Zheng
- Department of Epidemiology and Health Statistics, Public Health of Anhui Medical University, Hefei, China
- Contributed equally
| | - Qian Zhang
- Department of Epidemiology and Health Statistics, Public Health of Anhui Medical University, Hefei, China
- Contributed equally
| | - Qinghe Zhang
- Department of Epidemiology and Health Statistics, Public Health of Anhui Medical University, Hefei, China
| | - Linsheng Yang
- Department of Epidemiology and Health Statistics, Public Health of Anhui Medical University, Hefei, China
| | - Zhihua Zhang
- Department of Epidemiology and Health Statistics, Public Health of Anhui Medical University, Hefei, China
| | - Fen Huang
- Department of Epidemiology and Health Statistics, Public Health of Anhui Medical University, Hefei, China
| |
Collapse
|
13
|
Case-control study of paternal occupation and childhood leukaemia in Great Britain, 1962-2006. Br J Cancer 2012; 107:1652-9. [PMID: 22968649 PMCID: PMC3493752 DOI: 10.1038/bjc.2012.359] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Paternal occupational exposures have been proposed as a risk factor for childhood leukaemia. This study investigates possible associations between paternal occupational exposure and childhood leukaemia in Great Britain. Methods: The National Registry of Childhood Tumours provided all cases of childhood leukaemia born and diagnosed in Great Britain between 1962 and 2006. Controls were matched on sex, period of birth and birth registration subdistrict. Fathers’ occupations were assigned to 1 or more of 33 exposure groups. Social class was derived from father’s occupation at the time of the child’s birth. Results: A total of 16 764 cases of childhood leukaemia were ascertained. One exposure group, paternal social contact, was associated with total childhood leukaemia (odds ratio 1.14, 1.05–1.23); this association remained significant when adjusted for social class. The subtypes lymphoid leukaemia (LL) and acute myeloid leukaemia showed increased risk with paternal exposure to social contact before adjustment for social class. Risk of other leukaemias was significantly increased by exposure to electromagnetic fields, persisting after adjustment for social class. For total leukaemia, the risks for exposure to lead and exhaust fumes were significantly <1. Occupationally derived social class was associated with risk of LL, with the risk being increased in the higher social classes. Conclusion: Our results showed some support for a positive association between childhood leukaemia risk and paternal occupation involving social contact. Additionally, LL risk increased with higher paternal occupational social class.
Collapse
|
14
|
Bailey HD, de Klerk NH, Fritschi L, Attia J, Daubenton JD, Armstrong BK, Milne E. Refuelling of vehicles, the use of wood burners and the risk of acute lymphoblastic leukaemia in childhood. Paediatr Perinat Epidemiol 2011; 25:528-39. [PMID: 21980942 DOI: 10.1111/j.1365-3016.2011.01224.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
It is plausible that exposure of the parents before birth or of the child to sources of benzene increases the risk of childhood acute lymphoblastic leukaemia (ALL). The aim of this analysis was to investigate whether refuelling a vehicle with petrol before birth or burning wood to heat the home before or after the child's birth increased the risk of childhood ALL. Data from 389 cases and 876 frequency-matched controls were analysed using unconditional logistic regression, adjusting for study matching factors and potential confounders. The odds ratio (OR) for the mother ever refuelling a vehicle with petrol for non-occupational purposes before or during the pregnancy was 0.97 [95% confidence interval (CI) 0.69, 1.38]. The OR for the father for this exposure in the year before conception was 0.88 [95% CI 0.52, 1.48]. The OR for use of a closed wood burner to heat the home in the year before or during pregnancy was 1.41 [95% CI 1.02, 1.94] and 1.25 [95% CI 0.92, 1.70] after birth. We found no evidence that non-occupational refuelling a vehicle with petrol in the year before or during pregnancy increased the risk of ALL in the offspring. There was weak evidence that burning wood in a closed burner to heat the home increased the risk, but there was no dose-response relationship and chance could explain the finding.
Collapse
Affiliation(s)
- Helen D Bailey
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia.
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Association between polymorphisms of EPHX1 and XRCC1 genes and the risk of childhood acute lymphoblastic leukemia. Arch Toxicol 2011; 86:431-9. [DOI: 10.1007/s00204-011-0760-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 09/20/2011] [Indexed: 12/20/2022]
|
16
|
Reid A, Glass DC, Bailey HD, Milne E, de Klerk NH, Downie P, Fritschi L. Risk of childhood acute lymphoblastic leukaemia following parental occupational exposure to extremely low frequency electromagnetic fields. Br J Cancer 2011; 105:1409-13. [PMID: 21915123 PMCID: PMC3241544 DOI: 10.1038/bjc.2011.365] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Earlier studies have reported moderate increases in the risk of acute lymphoblastic leukaemia (ALL) among children whose mothers have been occupationally exposed to extremely low frequency (ELF) electromagnetic fields. Other studies examining parental occupational exposure to ELF and ALL have reported mixed results. Methods: In an Australian case–control study of ALL in children aged <15 years, parents were asked about tasks they undertook in each job. Exposure variables were created for any occupational exposure before the birth of the child, in jobs 2 years before birth, in jobs 1 year before birth and up to 1 year after birth. Results: In all, 379 case and 854 control mothers and 328 case and 748 control fathers completed an occupational history. Exposure to ELF in all time periods was similar in case and control mothers. There was no difference in exposure between case and control fathers. There was no association between maternal (odds ratio (OR)=0.96; 95% CI=0.74–1.25) or paternal (OR=0.78; 95% CI=0.56–1.09) exposure to ELF any time before the birth and risk of childhood ALL. Conclusion: We did not find an increased risk of ALL in offspring of parents with occupational exposure to ELF.
Collapse
Affiliation(s)
- A Reid
- Epidemiology Group, Western Australian Institute for Medical Research, University of Western Australia, Crawley, Western Australia 6009, Australia.
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Tumer TB, Yilmaz D, Tanrikut C, Sahin G, Ulusoy G, Arinç E. DNA repair XRCC1 Arg399Gln polymorphism alone, and in combination with CYP2E1 polymorphisms significantly contribute to the risk of development of childhood acute lymphoblastic leukemia. Leuk Res 2010; 34:1275-81. [DOI: 10.1016/j.leukres.2010.02.035] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 02/19/2010] [Accepted: 02/27/2010] [Indexed: 12/08/2022]
|
18
|
Pyatt D, Hays S. A review of the potential association between childhood leukemia and benzene. Chem Biol Interact 2010; 184:151-64. [PMID: 20067778 DOI: 10.1016/j.cbi.2010.01.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Revised: 12/24/2009] [Accepted: 01/04/2010] [Indexed: 10/20/2022]
Abstract
Chronic exposure to high concentrations of benzene is an established cause of acute myeloid leukemia (AML) in occupationally exposed workers. Based on this association, it is not unreasonable to assume that children could also get AML if they were exposed to comparable levels of benzene. Fortunately, reports of such exposures and subsequent AML development in children are non-existent. However, the question of whether children can develop leukemia at far lower, environmental levels of benzene remains. The existing scientific evidence relevant to this question will be addressed in this review. While positive findings have been reported, the collective literature does not indicate that exposure to environmental levels of benzene is related to an increased risk of childhood leukemia. Our understanding of this important issue would be strengthened by additional studies that accurately characterize exposures as well as differentiate between the various forms of leukemias observed in children.
Collapse
Affiliation(s)
- David Pyatt
- Summit Toxicology, LLP, United States, University of Colorado, Schools of Public Health and Pharmacy, United States.
| | | |
Collapse
|
19
|
Abstract
Benzene is a ubiquitous chemical in our environment that causes acute leukemia and probably other hematological cancers. Evidence for an association with childhood leukemia is growing. Exposure to benzene can lead to multiple alterations that contribute to the leukemogenic process, indicating a multimodal mechanism of action. Research is needed to elucidate the different roles of multiple metabolites in benzene toxicity and the pathways that lead to their formation. Studies to date have identified a number of polymorphisms in candidate genes that confer susceptibility to benzene hematotoxicity. However, a genome-wide study is needed to truly assess the role of genetic variation in susceptibility. Benzene affects the blood-forming system at low levels of occupational exposure, and there is no evidence of a threshold. There is probably no safe level of exposure to benzene, and all exposures constitute some risk in a linear, if not supralinear, and additive fashion.
Collapse
Affiliation(s)
- Martyn T Smith
- Superfund Research Program, Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California 94720-7356, USA.
| |
Collapse
|
20
|
Wen S, Kedem B. A semiparametric cluster detection method--a comprehensive power comparison with Kulldorff's method. Int J Health Geogr 2009; 8:73. [PMID: 20043837 PMCID: PMC2817681 DOI: 10.1186/1476-072x-8-73] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2009] [Accepted: 12/31/2009] [Indexed: 11/23/2022] Open
Abstract
Background A semiparametric density ratio method which borrows strength from two or more samples can be applied to moving window of variable size in cluster detection. The method requires neither the prior knowledge of the underlying distribution nor the number of cases before scanning. In this paper, the semiparametric cluster detection procedure is combined with Storey's q-value, a type of controlling false discovery rate (FDR) method, to take into account the multiple testing problem induced by the overlapping scanning windows. Results It is shown by simulations that for binary data, using Kulldorff's Northeastern benchmark data, the semiparametric method and Kulldorff's method performs similarly well. When the data are not binary, the semiparametric methodology still works in many cases, but Kulldorff's method requires the choices of a correct probability model, namely the correct scan statistic, in order to achieve comparable power as the semiparametric method achieves. Kulldorff's method with an inappropriate probability model may lose power. Conclusions The semiparametric method proposed in the paper can achieve good power when detecting localized cluster. The method does not require a specific distributional assumption other than the tilt function. In addition, it is possible to adapt other scan schemes (e.g., elliptic spatial scan, flexible shape scan) to search for clusters as well.
Collapse
Affiliation(s)
- Shihua Wen
- Abbott Laboratories, Abbott Park, IL, USA.
| | | |
Collapse
|
21
|
Benzene-initiated oxidative stress: Effects on embryonic signaling pathways. Chem Biol Interact 2009; 184:218-21. [PMID: 19913523 DOI: 10.1016/j.cbi.2009.11.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Revised: 11/04/2009] [Accepted: 11/05/2009] [Indexed: 12/19/2022]
Abstract
Approximately 90% of childhood cancers are of unknown etiology; however, it is hypothesized that in utero carcinogen exposure may contribute. Epidemiological studies have correlated parental exposure to benzene with an increased incidence of childhood leukemias. However, mechanisms of benzene-induced carcinogenesis following in utero exposure remain unknown. We hypothesize that in utero exposure to benzene causes alterations in the redox-sensitive signaling pathways involving c-Myb, Pim-1, AKT, ERK-MAPK, p38-MAPK, and NF-kappaB via the production of reactive oxygen species (ROS) as a possible mechanism of in utero-initiated carcinogenesis. Using a CD-1 mouse model we have shown increased oxidative stress in fetal tissue from embryos exposed in utero to benzene by measuring reduced to oxidized glutathione ratios, and increased levels of ROS in male fetuses using flow cytometry and the ROS sensitive fluorescent probe dichlorofluoroscein diacetate (DCFDA). In addition, using Western blotting techniques we observed increased expression of fetal Pim-1, Pim-1 phosphorylation, c-Myb, and phosphorylated p38-MAPK (activated form) and lower protein levels of IkappaBalpha, while phosphorylated ERK-MAPK and AKT protein levels did not change. Interestingly, we found male fetuses more susceptible to benzene-induced oxidative stress, which is in agreement with the literature suggesting that males are more susceptible to benzene toxicity. Further studies evaluating the reason for this gender difference are ongoing.
Collapse
|
22
|
Buffler PA, Kwan ML, Reynolds P, Urayama KY. Environmental and Genetic Risk Factors for Childhood Leukemia: Appraising the Evidence. Cancer Invest 2009. [DOI: 10.1081/cnv-46402] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
23
|
Wilbur S, Wohlers D, Paikoff S, Keith LS, Faroon O. ATSDR evaluation of health effects of benzene and relevance to public health. Toxicol Ind Health 2009; 24:263-398. [PMID: 19022880 DOI: 10.1177/0748233708090910] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
As part of its mandate, the Agency for Toxic Substances and Disease Registry (ATSDR) prepares toxicological profiles on hazardous chemicals found at Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) National Priorities List (NPL) sites that have the greatest public health impact. These profiles comprehensively summarize toxicological and environmental information. This article constitutes the release of portions of the Toxicological Profile for Benzene. The primary purpose of this article is to provide public health officials, physicians, toxicologists, and other interested individuals and groups with an overall perspective on the toxicology of benzene. It contains descriptions and evaluations of toxicological studies and epidemiological investigations and provides conclusions, where possible, on the relevance of toxicity and toxicokinetic data to public health.
Collapse
Affiliation(s)
- S Wilbur
- Agency for Toxic Substances and Disease Registry (ATSDR), U.S. Department of Health and Human Services, Atlanta, Georgia 30333, USA.
| | | | | | | | | |
Collapse
|
24
|
Abstract
It is becoming more evident that not only can drugs and environmental chemicals interfere with normal fetal development by causing structural malformations, such as limb defects, but that xenobiotic exposure during development can also cause biochemical and functional abnormalities that may ultimately lead to cancer later on in life. Fetal toxicity may be partly mediated by the embryonic bioactivation of xenobiotics to free radical intermediates that can lead to oxidative stress and potentially lead, in some cases, to carcinogenesis. Using a number of examples, this review will focus on the role of reactive oxygen species (ROS) in the mechanisms pertaining to in utero initiated cancers.
Collapse
Affiliation(s)
- Joanne Wan
- Department of Pharmacology and Toxicology, School of Environmental Studies, Queen's University, Kingston, Ontario, Canada
| | | |
Collapse
|
25
|
|
26
|
Belson M, Kingsley B, Holmes A. Risk factors for acute leukemia in children: a review. ENVIRONMENTAL HEALTH PERSPECTIVES 2007; 115:138-45. [PMID: 17366834 PMCID: PMC1817663 DOI: 10.1289/ehp.9023] [Citation(s) in RCA: 294] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Accepted: 07/13/2006] [Indexed: 05/02/2023]
Abstract
Although overall incidence is rare, leukemia is the most common type of childhood cancer. It accounts for 30% of all cancers diagnosed in children younger than 15 years. Within this population, acute lymphocytic leukemia (ALL) occurs approximately five times more frequently than acute myelogenous leukemia (AML) and accounts for approximately 78% of all childhood leukemia diagnoses. Epidemiologic studies of acute leukemias in children have examined possible risk factors, including genetic, infectious, and environmental, in an attempt to determine etiology. Only one environmental risk factor (ionizing radiation) has been significantly linked to ALL or AML. Most environmental risk factors have been found to be weakly and inconsistently associated with either form of acute childhood leukemia. Our review focuses on the demographics of childhood leukemia and the risk factors that have been associated with the development of childhood ALL or AML. The environmental risk factors discussed include ionizing radiation, non-ionizing radiation, hydrocarbons, pesticides, alcohol use, cigarette smoking, and illicit drug use. Knowledge of these particular risk factors can be used to support measures to reduce potentially harmful exposures and decrease the risk of disease. We also review genetic and infectious risk factors and other variables, including maternal reproductive history and birth characteristics.
Collapse
Affiliation(s)
- Martin Belson
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Health Studies Branch, Atlanta, Georgia 30341, USA.
| | | | | |
Collapse
|
27
|
Ali R, Yu CL, Wu MT, Ho CK, Pan BJ, Smith T, Christiani DC. A case-control study of parental occupation, leukemia, and brain tumors in an industrial city in Taiwan. J Occup Environ Med 2004; 46:985-92. [PMID: 15354065 DOI: 10.1097/01.jom.0000138913.75380.13] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We conducted a case-control study in an industrial city in Taiwan to determine whether parents of newly diagnosed patients who were younger than 30 years old with leukemia or brain tumors or the patients themselves were more likely to have been employed in certain occupations or industries. Job histories were collected for parents (and for subjects if they worked) on 103 newly diagnosed cases of leukemia, 74 newly diagnosed cases of brain tumors, and 417 controls matched for age and sex. All jobs since the age of 16 that the subjects held for more than 6 months, a total of approximately 4,000 jobs, were coded for occupation and industry according the standard four-digit system used in Taiwan. Matched-pair analyses were performed comparing cases and controls among all jobs held by subjects and both parents using four-digit occupation and industry codes. Separate analyses also were performed for parental jobs held during the preconception, perinatal, and postnatal periods. Odds ratios (ORs) were adjusted for subject smoking, parental smoking, and exposure to medical radiation. Certain industry and occupation four-digit codes were significantly associated with increased odds ratios of childhood tumors. Including work during any or all periods, leukemias were more common in children of fathers who had worked (1) as wood treaters (adjusted OR 16.03, 95% confidence interval CI = 1.77-145.5), and (2) as building finishers and related trades workers (adjusted OR 4.08, 95% CI = 1.12-14.8), whereas brain tumors were more common in children of mothers who had worked (1) in electronic parts and components manufacturing (adjusted OR 13.78, 95% CI = 1.47-129.0) and 2) as textile and garment workers (adjusted OR 7.25, 95% CI = 1.42-37.0), as well as in subjects who had worked with certain electronic parts and components (adjusted OR 28.67, 95% CI = 2.88-285.6). Leukemias were more common in children of fathers who had worked in the preconception period (1) as wood treaters (adjusted OR 12.17, 95% CI = 1.36-109.2), (2) as building finishers and related trades workers (adjusted OR 4.08, 95% CI = 1.12-14.8), (3) as electronic equipment assemblers (adjusted OR 4.56, 95% CI = I 1.05-19.9), and (4) as certain other assemblers (adjusted OR 10.24, 95% CI = 1.02-102.6). In addition, leukemias were more common in children of fathers who had worked in the perinatal period (1) as wood treaters (adjusted OR 13.08, 95% CI = 1.36-125.5) and (2) as building finishers and related trades workers (adjusted OR 4.51, 95% CI = 1.04-19.6). Brain tumors were more common in children of mothers who had worked in the preconception period (1) in electronic parts and components manufacturing (adjusted OR 11.81, 95% CI = 1.20-116.3), and (2) as textile and garment workers (adjusted OR 7.25, 95% CI = 1.18-31.0).
Collapse
Affiliation(s)
- Robbie Ali
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02115, USA
| | | | | | | | | | | | | |
Collapse
|
28
|
Steffen C, Auclerc MF, Auvrignon A, Baruchel A, Kebaili K, Lambilliotte A, Leverger G, Sommelet D, Vilmer E, Hémon D, Clavel J. Acute childhood leukaemia and environmental exposure to potential sources of benzene and other hydrocarbons; a case-control study. Occup Environ Med 2004; 61:773-8. [PMID: 15317919 PMCID: PMC1763669 DOI: 10.1136/oem.2003.010868] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To analyse the association between potential environmental exposure to hydrocarbons and the risk of acute childhood leukaemia. METHODS A hospital based multicentre case control study, stratified on centre, age, and sex, with 280 leukaemia cases and 285 controls was carried out. Data were collected by a standardised interview of the mothers. RESULTS No clear association was seen between maternal occupational exposure to hydrocarbons during pregnancy and leukaemia, or between residential traffic density and leukaemia. There was an association between dwellings neighbouring a petrol station or a repair garage during childhood and the risk of childhood leukaemia (OR 4.0, 95% CI 1.5 to 10.3), with a duration trend. The association, which appeared particularly strong for acute non-lymphocytic leukaemia (OR 7.7, 95% CI 1.7 to 34.3), was not altered by adjustment for potential confounding factors. CONCLUSIONS Results showed an association between acute childhood leukaemia and dwellings neighbouring auto repair garages and petrol stations, which are benzene emitting sources. These findings could be due to chance, although the strength of the association and the duration trend are arguments for a causal association.
Collapse
Affiliation(s)
- C Steffen
- French National Institute of Health and Medical Research, INSERM U170, Villejuif, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
McKinney PA, Fear NT, Stockton D. Parental occupation at periconception: findings from the United Kingdom Childhood Cancer Study. Occup Environ Med 2003; 60:901-9. [PMID: 14634180 PMCID: PMC1740441 DOI: 10.1136/oem.60.12.901] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To study the risk of childhood cancer in relation to parental occupation and related exposures. METHODS Self reported occupational data from mothers and fathers of 3838 children with cancer and 7629 control children were analysed. Odds ratios were calculated for 31 "occupational groups" by parent, diagnostic group (leukaemia, acute lymphoblastic leukaemia (ALL), central nervous system tumours, and other cancers) and time of exposure (periconception, birth, and diagnosis). RESULTS Findings did not support the hypothesis that occupational exposure of fathers to ionising radiation increases the risk of childhood cancer in their offspring. Specific examination of periconceptual chemical exposures showed small but statistically significant increased risks for leukaemia and ALL among children whose fathers were exposed to exhaust fumes, driving, and/or inhaled particulate hydrocarbons. In the remaining analyses, a fourfold increase in the risk of other cancers was observed among the children of fathers working with leather but based on small numbers. Both maternal and paternal exposure to textile dust was related to an increased risk of other cancers. CONCLUSION Results failed to produce any strong evidence to link parental occupational exposures with an increased risk of childhood cancer. No relation was found for paternal periconceptual exposure to ionising radiation. The consistency of the associations observed between childhood leukaemia and paternal occupational exposure to exhaust fumes, driving, and/or inhaled particulate hydrocarbons at periconception suggest a small risk for vehicle related exhaust. However, other explanations cannot be excluded and further research into the nature of the associations is required.
Collapse
Affiliation(s)
- P A McKinney
- Information and Statistics Division of the CSA for NHS Scotland, Trinity Park House, Edinburgh, UK.
| | | | | |
Collapse
|
30
|
Freedman DM, Stewart P, Kleinerman RA, Wacholder S, Hatch EE, Tarone RE, Robison LL, Linet MS. Household solvent exposures and childhood acute lymphoblastic leukemia. Am J Public Health 2001; 91:564-7. [PMID: 11291366 PMCID: PMC1446651 DOI: 10.2105/ajph.91.4.564] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study explored the risk of childhood acute lymphoblastic leukemia (ALL) associated with participation by household members in hobbies or other home projects involving organic solvents. METHODS Participants in this case-control study were 640 subjects with ALL and 640 matched controls. RESULTS Childhood ALL was associated with frequent (> 4 times/month) exposure to model building (odds ratio [OR] = 1.9; 95% confidence interval [95% CI] = 0.7, 5.8) and artwork using solvents (OR = 4.1; 95% CI = 1.1, 15.1). We also found elevated risk (OR = 1.7; 95% CI = 1.1, 2.7) among children whose mothers lived in homes painted extensively (> 4 rooms) in the year before the children's birth. CONCLUSIONS In this exploratory study, substantial participation by household members in some common household activities that involve organic solvents was associated with elevated risks of childhood ALL.
Collapse
Affiliation(s)
- D M Freedman
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Executive Plaza-South, Room 7087, 6120 Executive Blvd, Bethesda, MD 20892-7238, USA.
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Duarte-Davidson R, Courage C, Rushton L, Levy L. Benzene in the environment: an assessment of the potential risks to the health of the population. Occup Environ Med 2001; 58:2-13. [PMID: 11119628 PMCID: PMC1740026 DOI: 10.1136/oem.58.1.2] [Citation(s) in RCA: 137] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Benzene has long been recognised as a carcinogen and recent concern has centred on the effects of continuous exposure to low concentrations of benzene both occupationally and environmentally. This paper presents an overview of the current knowledge about human exposure to benzene in the United Kingdom population based on recently published data, summarises the known human health effects, and uses this information to provide a risk evaluation for sections of the general United Kingdom population. METHOD Given the minor contribution that non-inhalation sources make to the overall daily intake of benzene to humans, only exposure from inhalation has been considered when estimating the daily exposure of the general population to benzene. Exposure of adults, children, and infants to benzene has been estimated for different exposure scenarios with time-activity patterns and inhalation and absorption rates in conjunction with measured benzene concentrations for a range of relevant microenvironments. Exposures during refuelling and driving, as well as the contribution of active and passive tobacco smoke, have been considered as part of the characterisation of risk of the general population. RESULTS Infants (<1 years old), the average child (11 years old), and non-occupationally exposed adults, receive average daily doses in the range of 15-26, 29-50, and 75-522 microg of benzene, respectively, which correspond to average ranges to benzene in air of 3.40-5.76 microg/m(3), 3.37-5.67 microg/m(3), and 3.7-41 microg/m(3) for infants, children, and adults, respectively. Infants and children exposed to environmental tobacco smoke have concentrations of exposure to benzene comparable with those of an adult passive smoker. This is a significant source of exposure as a 1995 United Kingdom survey has shown that 47% of children aged 2-15 years live in households where at least one person smokes. The consequence of exposure to benzene in infants is more significant than for children or adults owing to their lower body weight, resulting in a higher daily intake for infants compared with children or non-smoking adults. A worst case scenario for exposure to benzene in the general population is that of an urban smoker who works adjacent to a busy road for 8 hours/day-for example, a maintenance worker-who can receive a mean daily exposure of about 820 microg (equal to an estimated exposure of 41 microg/m(3)). The major health risk associated with low concentrations of exposure to benzene has been shown to be leukaemia, in particular acute non-lymphocytic leukaemia. The lowest concentration of exposure at which an increased incidence of acute non-lymphocytic leukaemia among occupationally exposed workers has been reliably detected, has been estimated to be in the range of 32-80 mg/m(3). Although some studies have suggested that effects may occur at lower concentrations, clear estimates of risk have not been determined, partly because of the inadequacy of exposure data and the few cases. CONCLUSIONS Overall the evidence from human studies suggests that any risk of leukaemia at concentrations of exposure in the general population of 3.7-42 microg/m(3)-that is at concentrations three orders of magnitude less than the occupational lowest observed effect level-is likely to be exceedingly small and probably not detectable with current methods. This is also likely to be true for infants and children who may be exposed continuously to concentrations of 3.4-5.7 microg/m(3). As yet there is no evidence to suggest that continuous exposures to these environmental concentrations of benzene manifest as any other adverse health effect.
Collapse
Affiliation(s)
- R Duarte-Davidson
- National Centre for Risk Analysis and Opotions Appraisal, Steel House, 11 Tothill Street, London, UK
| | | | | | | |
Collapse
|
32
|
Wainwright AM. Shielding reproductive organs of orthopaedic patients during pelvic radiography. Ann R Coll Surg Engl 2000; 82:318-21. [PMID: 11041029 PMCID: PMC2503612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
The use of gonadal shielding has been advocated for patients undergoing pelvic radiography before and during the reproductive years. The aim of this study is to look at the adequacy of gonadal shielding used in a district general hospital for young patients having pelvic radiographs. A total of 200 radiographs were reviewed of 49 patients below the age of 45 years. Full coverage was achieved in only 36% of cases. Amongst females, only 22% received adequate shielding. None of the patients in their reproductive years (16-45 years) had gonad shields. The reasons for inadequate coverage were, in order of frequency: (i) no shielding was used; (ii) malposition of the shielding device; and (iii) the use of inappropriately shaped or sized devices. Suggestions for improvement are proposed.
Collapse
|
33
|
Heacock H, Hertzman C, Demers PA, Gallagher R, Hogg RS, Teschke K, Hershler R, Bajdik CD, Dimich-Ward H, Marion SA, Ostry A, Kelly S. Childhood cancer in the offspring of male sawmill workers occupationally exposed to chlorophenate fungicides. ENVIRONMENTAL HEALTH PERSPECTIVES 2000; 108:499-503. [PMID: 10856022 PMCID: PMC1638138 DOI: 10.1289/ehp.00108499] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The objective of this study was to determine whether paternal occupational exposure to chlorophenol fungicides and their dioxin contaminants is associated with childhood cancer in the offspring of sawmill workers. We used data from 23,829 British Columbian sawmill workers employed for at least 1 continuous year between 1950 and 1985 in 11 sawmills that used chlorophenates. Probabilistic linkage of the sawmill worker cohort to the provincial marriage and birth files produced an offspring cohort of 19,674 children born at least 1 year after the initiation of employment in the period 1952-1988. We then linked the offspring cohort to the British Columbia Cancer Registry. We included all malignancies in cases younger than 20 years of age that appeared on the cancer registry between 1969 and 1993. We calculated standardized incidence ratios (SIRs) using the British Columbia population as a reference. A nested case-control analysis assessed the effects of paternal cumulative exposure and windows of exposure on the risk of developing cancer in the offspring. We identified 40 cases of cancer during 259,919 person-years of follow-up. The all-cancer SIR was 1.0 [95% confidence interval (CI), 0.7-1.4]; the SIR for leukemia was 1.0 (CI, 0.5-1.8); and the SIR for brain cancer was 1.3 (CI, 0.6-2.5). The nested case-control analysis showed slightly increased risks in the highest categories of chlorophenol exposure, although none was statistically significant. Our analyses provide little evidence to support a relationship between the risk of childhood cancer and paternal occupational exposure to chlorophenate fungicides in British Columbian sawmills.
Collapse
Affiliation(s)
- H Heacock
- Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Abstract
This paper explores the hypothesis that there is an association between risk of childhood kidney cancer and paternal employment in occupations that have potential for exposure to herbicides and/or pesticides. In contrast to a previous study using paternal occupations at the time of the child's death, no significant association was found between such potential paternal exposures (using paternal occupations at the time of the child's birth) and the risk of cancer of the kidney in childhood (OR 0.88, 95% CI 0.20-3.84). In addition, this paper quantifies the extent to which paternal occupational information on death certificates can be used as a proxy for paternal occupation at birth and how such misclassification could affect risk estimates. An example is given showing how a recently reported association between kidney cancer and paternal agricultural employment may have been overestimated as a result of the use of death certificate information.
Collapse
Affiliation(s)
- M S Pearce
- Department of Child Health, University of Newcastle upon Tyne, Royal Victoria Infirmary, UK.
| | | |
Collapse
|
35
|
Neel JV. Two recent radiation-related genetic false alarms: leukemia in West Cumbria, England, and minisatellite mutations in Belarus. TERATOLOGY 1999; 59:302-6. [PMID: 10331534 DOI: 10.1002/(sici)1096-9926(199904)59:4<302::aid-tera17>3.0.co;2-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- J V Neel
- Department of Human Genetics, University of Michigan, Ann Arbor 48109-0618, USA
| |
Collapse
|
36
|
Smith MT, Zhang L. Biomarkers of leukemia risk: benzene as a model. ENVIRONMENTAL HEALTH PERSPECTIVES 1998; 106 Suppl 4:937-46. [PMID: 9703476 PMCID: PMC1533331 DOI: 10.1289/ehp.98106s4937] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Although relatively rare, leukemias place a considerable financial burden on society and cause psychologic trauma to many families. Leukemia is the most common cancer in children. The causes of leukemia in adults and children are largely unknown, but occupational and environmental factors are strongly suspected. Genetic predisposition may also play a major role. Our aim is to use molecular epidemiology and toxicology to find the cause of leukemia and develop biomarkers of leukemia risk. We have studied benzene as a model chemical leukemogen, and we have identified risk factors for susceptibility to benzene toxicity. Numerous studies have associated exposure to benzene with increased levels of chromosome aberrations in circulating lymphocytes of exposed workers. Increased levels of chromosome aberrations have, in turn, been correlated with a heightened risk of cancer, especially for hematologic malignancy, in two recent cohort studies in Europe. Conventional chromosome analysis is laborious, however, and requires highly trained personnel. Further, it lacks statistical power, as only a small number of cells can be examined. The recently developed fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR)-based technologies have allowed the detection of specific chromosome aberrations. These techniques are far less time consuming and are more sensitive than classical chromosomal analysis. Because leukemias commonly show a variety of specific chromosome aberrations, detection of these aberrations by FISH and PCR in peripheral blood may provide improved biomarkers of leukemia risk.
Collapse
Affiliation(s)
- M T Smith
- School of Public Health, Division of Environmental Health Sciences, University of California, Berkeley 94720-7360, USA.
| | | |
Collapse
|
37
|
Colt JS, Blair A. Parental occupational exposures and risk of childhood cancer. ENVIRONMENTAL HEALTH PERSPECTIVES 1998; 106 Suppl 3:909-25. [PMID: 9646055 PMCID: PMC1533069 DOI: 10.1289/ehp.98106909] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Occupational exposures of parents might be related to cancer in their offspring. Forty-eight published studies on this topic have reported relative risks for over 1000 specific occupation/cancer combinations. Virtually all of the studies employed the case-control design. Occupations and exposures of fathers were investigated much more frequently than those of the mother. Information about parental occupations was derived through interviews or from birth certificates and other administrative records. Specific exposures were typically estimated by industrial hygienists or were self-reported. The studies have several limitations related to the quality of the exposure assessment, small numbers of exposed cases, multiple comparisons, and possible bias toward the reporting of positive results. Despite these limitations, they provide evidence that certain parental exposures may be harmful to children and deserve further study. The strongest evidence is for childhood leukemia and paternal exposure to solvents, paints, and employment in motor vehicle-related occupations; and childhood nervous system cancers and paternal exposure to paints. To more clearly evaluate the importance of these and other exposures in future investigations, we need improvements in four areas: a) more careful attention must be paid to maternal exposures; b) studies should employ more sophisticated exposure assessment techniques; c) careful attention must be paid to the postulated mechanism, timing, and route of exposure; and d) if postnatal exposures are evaluated, studies should provide evidence that the exposure is actually transferred from the workplace to the child's environment.
Collapse
Affiliation(s)
- J S Colt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland 20892, USA.
| | | |
Collapse
|
38
|
Cancers des enfants et contaminants de l’environnement. Canadian Journal of Public Health 1998. [DOI: 10.1007/bf03405097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
39
|
Wakeford R. The risk of childhood cancer from intrauterine and preconceptional exposure to ionizing radiation. ENVIRONMENTAL HEALTH PERSPECTIVES 1995; 103:1018-1025. [PMID: 8605850 PMCID: PMC1519200 DOI: 10.1289/ehp.951031018] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The findings of studies investigating whether exposures to ionizing radiation before birth, either pre- or post-conception, increase the risk of childhood cancer have provoked much scientific controversy. An epidemiological association between the abdominal exposure of pregnant women to diagnostic X-rays and childhood cancer was first reported in the 1950s, while an association between the recorded dose of radiation received occupationally by fathers before the conception of their offspring and childhood leukemia was reported only recently in 1990. The scientific interpretation of these particular statistical associations is by no means straightforward, but the latest analyses of intrauterine irradiation and childhood cancer indicate that a causal inference is likely. Scientific committees have adopted risk coefficients for the intrauterine exposure of somatic tissues, which for childhood leukemia are comparable to those accepted for exposure in infancy, although questions remain about the level of risk of childhood solid tumors imparted by exposure to radiation in utero and shortly after birth. In contrast, the association between paternal preconceptional radiation dose and childhood leukemia has not been confirmed by studies using objectively determined doses. The original association has been found to be restricted to children born in one village, it does not extend to cancers other than leukemia, and it is markedly inconsistent with the established body of knowledge on radiation-induced hereditary disease. A causal interpretation of this association has effectively been abandoned by scientific authorities.
Collapse
|
40
|
Sorahan T, Lancashire RJ, Temperton DH, Heighway WP. Childhood cancer and paternal exposure to ionizing radiation: a second report from the Oxford Survey of Childhood Cancers. Am J Ind Med 1995; 28:71-8. [PMID: 7573076 DOI: 10.1002/ajim.4700280106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Paternal occupational data already collected as part of the Oxford Survey of Childhood Cancers have been reviewed. Information on paternal occupation was available for 14,869 children dying from cancer in England, Wales, and Scotland in the period 1953-81 and for an equal number of matched controls. The importance of fathers working, at any time before or after conception of the survey child, in any of the following occupations was assessed: radiologists (clinical), surgeons and anesthetists, veterinary surgeons, dental surgeons, nuclear industry workers, industrial radiographers. There was no indication that preconception employment in any of these occupations was more important than postconception employment with regard to the risks of all childhood cancers or all childhood leukemias. Findings were consistent with neither paternal preconception exposure to external ionizing radiation nor exposure to unsealed sources of radionuclides being an important risk factor for childhood leukemia or for the overall grouping of all childhood cancers.
Collapse
Affiliation(s)
- T Sorahan
- Institute of Occupational Health, University of Birmingham, Edgbaston, UK
| | | | | | | |
Collapse
|
41
|
Cocco P, Bernardinelli L, Biddau P, Montomoli C, Murgia G, Rapallo M, Targhetta R, Capocaccia R, Fadda D, Frova L. Childhood Acute Lymphoblastic Leukemia: A Cluster in Southwestern Sardinia (Italy). INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 1995; 1:232-238. [PMID: 9990161 DOI: 10.1179/oeh.1995.1.3.232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
In response to public concern about an increase in the incidence of leukemia among children in southwestern Sardinia (Italy), incident cases of childhood cancer (ages 0-14) were ascertained among residents in the province of Cagliari, which comprises all of southern Sardinia, in 1974-89. Completeness of the ascertainment of leukemia cases was validated by comparison with estimates derived from official statistics of mortality and survival curves. A significant excess risk of childhood acute lymphoblastic leukemia (cALL) was found for children residing in the town of Carbonia. The risk was highest in 1983-85, when seven cases occurred versus 0.8 expected. No birth-cohort effect was observed. The cALL incidence rate was significantly higher among children born and residing in Carbonia than among children born in Carbonia but residing elsewhere. However, the cALL cases did not cluster within the town of Carbonia. The proximity of the largest industrial settlement in the region of Sardinia raised the suspicion that environmental pollution was responsible for the observed excess. Information about industrial emissions from this settlement prior to the appearance of the cALL cluster was not sufficient to reject or confirm the hypothesis.
Collapse
Affiliation(s)
- P Cocco
- Occupational Studies Section, Environmental Epidemiology Branch, National Cancer Institute, 6130 Executive Boulevard, EPN room 418, Bethesda, MD 20892, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Sans S, Elliott P, Kleinschmidt I, Shaddick G, Pattenden S, Walls P, Grundy C, Dolk H. Cancer incidence and mortality near the Baglan Bay petrochemical works, South Wales. Occup Environ Med 1995; 52:217-24. [PMID: 7795735 PMCID: PMC1128198 DOI: 10.1136/oem.52.4.217] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To study incidence and mortality of leukaemias, cancer of the larynx, and other cancers near the petrochemical plant at Baglan Bay, in response to local concerns of an alleged cluster of cancers in the vicinity. METHODS This is a small area study of cancer incidence, 1974-84 and of mortality, 1981-91 based on the national postcoded data held by the Small Area Health Statistics Unit and with population and socioeconomic data from the 1981 census. The study is centred on BP Chemicals Ltd, Baglan Bay, Port Talbot, West Glamorgan, South Wales and includes a general population sample of 115,721 people (1981 census) living within 7.5 km of the plant. Cancer incidence and mortality for all cancers, leukaemias, and cancer of the larynx were examined within 7.5 km and 3 km of the plant, and tests for decline in risk of these cancers with distance from the plant were carried out. Mortality from several other cancers possibly associated with the petrochemical industry was also studied. RESULTS There were 5417 incident cancer cases and 2458 cancer deaths within 7.5 km of the plant during the periods of study. There was an 8% excess incidence of all cancers within 7.5 km, and a 24% excess of cancer of the larynx, consistent with a general excess of these cancers in West Glamorgan, but no apparent decline in incidence with distance from the plant, nor excess mortality. There was also no evidence of decline in leukaemia incidence or mortality with distance, at all ages or in children. Among the other causes included in the mortality study, there was an excess of multiple myeloma within 7.5 km, especially among women, and a significant decline in mortality from non-Hodgkin's lymphomas although there was no excess overall within 7.5 km. CONCLUSIONS The apparent excess incidence of all cancers and cancer of the larynx within 7.5 km of the BP Chemical Ltd works was consistent with an excess more generally in West Glamorgan, possibly related, at least to some extent, to cancer registration in Wales. There was no excess mortality from these cancers. The results for multiple myeloma and especially non-Hodgkin's lymphomas may have been chance findings in view of the multiple tests of significance carried out in the study. A study of lymphatic and haematopoietic cancers near oil refineries in Great Britain is to be undertaken that will help put the findings of the present study in wider context.
Collapse
Affiliation(s)
- S Sans
- Department of Public Health and Policy, London School of Hygiene and Tropical Medicine
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Abstract
I derive two new statistics, Ipop and Ipop*, that adjust Moran's I to study clustering of disease cases in areas (for example, counties) with different, known population densities. A simulation of Lyme disease in Georgia suggests that these new statistics can be more powerful than those currently in use. This is because they consider both spatial pattern and non-binomial variance in rates as evidence supporting disease clusters.
Collapse
Affiliation(s)
- N Oden
- EMMES Corporation, Potomac, MD 20854
| |
Collapse
|
44
|
Nussbaum RH, Köhnlein W. Inconsistencies and open questions regarding low-dose health effects of ionizing radiation. ENVIRONMENTAL HEALTH PERSPECTIVES 1994; 102:656-667. [PMID: 7895705 PMCID: PMC1567333 DOI: 10.1289/ehp.94102656] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The effects on human health of exposures to ionizing radiation at low doses have long been the subject of dispute. In this paper we focus on open questions regarding the health effects of low-dose exposures that require further investigations. Seemingly contradictory findings of radiation health effects have been reported for the same exposed populations, or inconsistent estimates of radiation risks were found when different populations and exposure conditions were compared. Such discrepancies may be indicative of differences in sensitivities among the applied methods of epidemiological analysis or indicative of significant discrepancies in health consequences after comparable total exposures of different populations under varying conditions. We focus first on inconsistencies and contradictions in presentations of the state of knowledge by different authoritative experts. We then review studies that found positive associations between exposure and risks in dose ranges where traditional notions (generalized primarily from high-dose studies of A-bomb survivors or exposed animals) would have predicted negligible effects. One persistent notion in many reviews of low-dose effects is the hypothesis of reduced biological effectiveness of fractionated low-dose exposures, compared to that of the same acute dose. This assumption is not supported by data on human populations. From studies of populations that live in contaminated areas, more and more evidence is accumulating on unusual rates of various diseases other than radiation-induced malignancies, health effects that are suspected to be associated with relatively low levels of internal exposures originating from radioactive fallout. Such effects include congenital defects, neonatal mortality, stillbirths, and possibly genetically transmitted disease. A range of open questions challenges scientists to test imaginative hypotheses about induction of disease by radiation with novel research strategies.
Collapse
Affiliation(s)
- R H Nussbaum
- Physics Department, Portland State University, OR 97207-0751
| | | |
Collapse
|
45
|
Arnstein PM, Richards AM, Putney R. The risk from radiation exposure during operative X-ray screening in hand surgery. JOURNAL OF HAND SURGERY (EDINBURGH, SCOTLAND) 1994; 19:393-6. [PMID: 8077836 DOI: 10.1016/0266-7681(94)90097-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In response to legislation concerning the use of ionizing radiation, and to a case in which a patient developed multiple skin malignancies as a result of over-exposure to ionizing radiation, we set up an investigation to attempt to quantify the radiation dosage to which theatre personnel are exposed during X-ray fluoroscopy (screening) in hand surgery. It was found that the risk was small if sensible precautions were taken, but increased significantly if they were ignored. From these results specific measures are outlined which, when implemented, reduce the dose of scattered radiation to which theatre personnel and patients are subjected during screening in hand surgery.
Collapse
Affiliation(s)
- P M Arnstein
- Department of Plastic and Reconstructive Surgery, Queen Victoria Hospital, East Grinstead, UK
| | | | | |
Collapse
|
46
|
Neel JV. Problem of "false positive" conclusions in genetic epidemiology: lessons from the leukemia cluster near the Sellafield nuclear installation. Genet Epidemiol 1994; 11:213-33. [PMID: 8088504 DOI: 10.1002/gepi.1370110302] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- J V Neel
- Department of Human Genetics, University of Michigan, Ann Arbor 48109-0618
| |
Collapse
|
47
|
McLaughlin JR, King WD, Anderson TW, Clarke EA, Ashmore JP. Paternal radiation exposure and leukaemia in offspring: the Ontario case-control study. BMJ (CLINICAL RESEARCH ED.) 1993; 307:959-66. [PMID: 8241906 PMCID: PMC1679166 DOI: 10.1136/bmj.307.6910.959] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To test the hypothesis that there is an association between childhood leukaemia and the occupational exposure of fathers to ionising radiation before a child's conception. DESIGN Case-control study with eight matched controls per case. SETTING Regions of Ontario, Canada, with an operating nuclear facility. SUBJECTS Cases were children (age 0-14) who died from or were diagnosed as having leukaemia from 1950 to 1988 and were born to mothers living in the vicinity of an operating nuclear facility. Controls were identified from birth certificates, matched by date of birth and residence at birth. There were 112 cases and 890 controls. MAIN OUTCOME MEASURES Paternal radiation exposure was determined by a record linkage to the Canadian National Dose Registry. RESULTS Six fathers of cases and 53 fathers of controls had had a total whole body dose > 0.0 mSv before the child's conception, resulting in an odds ratio of 0.87 (95% confidence interval 0.32 to 2.34). There was no evidence of an increased leukaemia risk in relation to any exposure period (lifetime or six months or three months before conception) or exposure type (total whole body dose, external whole body dose, or tritium dose), except for radon exposure to uranium miners, which had a large odds ratio that was not significantly different from the null value. CONCLUSIONS The findings of this study in Ontario did not support the hypothesis that childhood leukaemia is associated with the occupational exposure of fathers to ionising radiation before the child's conception.
Collapse
Affiliation(s)
- J R McLaughlin
- Division of Epidemiology and Statistics, Ontario Cancer Treatment and Research Foundation, Toronto, Canada
| | | | | | | | | |
Collapse
|
48
|
Roman E, Watson A, Beral V, Buckle S, Bull D, Baker K, Ryder H, Barton C. Case-control study of leukaemia and non-Hodgkin's lymphoma among children aged 0-4 years living in west Berkshire and north Hampshire health districts. BMJ (CLINICAL RESEARCH ED.) 1993; 306:615-21. [PMID: 8461811 PMCID: PMC1676930 DOI: 10.1136/bmj.306.6878.615] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To investigate the relation between parental employment in the nuclear industry and childhood leukaemia and non-Hodgkin's lymphoma. DESIGN Case-control study. SETTING-West Berkshire and Basingstoke and North Hampshire District Health Authorities. SUBJECTS 54 children aged 0-4 years who had leukaemia or non-Hodgkin's lymphoma diagnosed during 1972-89, who were born in the study area and were resident there when cancer was diagnosed. Six controls were selected for each case: four from hospital delivery registers and two from livebirth registers maintained by the NHS central register. Controls were matched for sex, date of birth (within six months), and area of residence at birth and time of diagnosis. MAIN OUTCOME MEASURES Parents' employment by the nuclear industry and exposure to ionising radiation at work. RESULTS Five (9%) of the 54 cases and 14 (4%) of the 324 controls had fathers or mothers, or both, who had been employed by the nuclear industry (relative risk 2.2, 95% confidence interval 0.6 to 6.9). Nuclear industry employees who work in areas where exposure to radiation is possible are given film badges to monitor their exposure to external penetrating ionising radiation. Three fathers of cases and two fathers of controls (and no mothers of either) had been monitored in this way before their child was conceived (relative risk 9.0, 95% confidence interval 1.0 to 107.8). No father (of a case or control) had accumulated a recorded dose of more than 5 mSv before his child was conceived, and no father had been monitored at any time in the four years before his child was conceived. A dose-response relation was not evident among fathers who had been monitored. CONCLUSIONS These results suggest that the children of fathers who had been monitored for exposure to external penetrating ionising radiation in the nuclear industry may be at increased risk of developing leukaemia before their fifth birthday. The finding is based on small numbers and could be due to chance. If the relationship is real the mechanisms are far from clear, except that the effect is unlikely to be due to external radiation; the possibility that it could be due to internal contamination by radioactive substances or some other exposure at work should be pursued. The above average rates of leukaemia in the study area cannot be accounted for by these findings.
Collapse
Affiliation(s)
- E Roman
- Imperial Cancer Research Fund, Cancer Epidemiology Unit, Radcliffe Infirmary, Oxford
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Abstract
Clusters of childhood leukaemia have, during a lengthy and controversial history, focussed attention on two alternative putative aetiological agents: infections and localised environmental pollution. In the United Kingdom emphasis is currently placed on the latter because of reports of localised clusters in the vicinity of two nuclear reprocessing plants. Now the most recent studies of spatial clustering in the United Kingdom also support the hypothesis that a substantial population of cases of childhood acute lymphoblastic leukaemia (ALL) arise as a rare host response to certain patterns of exposure to common infectious agents--the aberrant response model. Relevant aspects of the epidemiology of ALL are reviewed from this perspective and the hypothesis shown to be capable of unifying reported associations with different types of risk factor. It is probable that specific agent(s) are involved though none have been identified and these may share many epidemiological characteristics of herpes viruses. The possible relevance of these results to associations with prenatal parental occupational exposures to dusts and ionising radiation is explored.
Collapse
Affiliation(s)
- F E Alexander
- Leukaemia Research Centre for Clinical Epidemiology (Universities of Leeds and Southampton), Royal South Hants Hospital, Hampshire, U.K
| |
Collapse
|
50
|
Abstract
OBJECTIVE To determine whether gonad shields are correctly positioned on the pelvic radiographs of children with slipped capital femoral epiphysis. DESIGN Retrospective study of radiographs taken of children treated by in situ pinning of slipped capital femoral epiphysis between 1 January 1983 and 31 December 1988. SETTING Three teaching hospitals in north west England. PATIENTS 32 patients with complete set of radiographs. RESULTS An average of 10.8 anteroposterior pelvic radiographs plus 8.9 lateral hip radiographs had been performed per patient. Gonad shields had been completely omitted in 137 (40%) anteroposterior pelvic radiographs performed on the 32 patients at the time of completion of the study. In 100 (29%) the gonad shields were adequately protecting the gonads, but in 109 (31%) the gonad shields were not protecting the gonads due to incorrect positioning of the shield. The incorrect positioning of the gonad shields was more commonly found in girls than boys (64 vs 45; p less than 0.012), presumably because of the difficulty in determining gonadal position in relation to surface landmarks. Absence of gonad shields was also more commonly seen in girls (82 v 55; p less than 0.005), but this is not easily explained. CONCLUSIONS Gonad shields are not protecting the gonads in a large percentage of anteroposterior pelvic radiographs (71%) because they have been omitted or inadequately placed. This avoidable excess radiation exposure to the gonads, combined with the inability to shield the gonads in lateral hip radiographs and the large number of radiographs performed, results in the gonads receiving a higher dose of radiation than may otherwise be the case, and may increase the potential for disease in the future offspring of these patients.
Collapse
Affiliation(s)
- N Kenny
- Ancoats Hospital, Manchester
| | | |
Collapse
|