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; 100:1330-1363. [PMID: 38335529 DOI: 10.1080/09553002.2024.2306328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 12/20/2023] [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
|
Little MP, Wakeford R, Bouffler SD, Abalo K, Hauptmann M, Hamada N, Kendall GM. Cancer risks among studies of medical diagnostic radiation exposure in early life without quantitative estimates of dose. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 832:154723. [PMID: 35351505 PMCID: PMC9167801 DOI: 10.1016/j.scitotenv.2022.154723] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/22/2022] [Accepted: 03/17/2022] [Indexed: 04/14/2023]
Abstract
BACKGROUND There is accumulating evidence of excess risk of cancer in various populations exposed at acute doses below several tens of mSv or doses received over a protracted period. There is also evidence that relative risks are generally higher after radiation exposures in utero or in childhood. METHODS AND FINDINGS We reviewed and summarised evidence from 89 studies of cancer following medical diagnostic exposure in utero or in childhood, in which no direct estimates of radiation dose are available. In all of the populations studied exposure was to sparsely ionizing radiation (X-rays). Several of the early studies of in utero exposure exhibit modest but statistically significant excess risks of several types of childhood cancer. There is a highly significant (p < 0.0005) negative trend of odds ratio with calendar period of study, so that more recent studies tend to exhibit reduced excess risk. There is no significant inter-study heterogeneity (p > 0.3). In relation to postnatal exposure there are significant excess risks of leukaemia, brain and solid cancers, with indications of variations in risk by cancer type (p = 0.07) and type of exposure (p = 0.02), with fluoroscopy and computed tomography scans associated with the highest excess risk. However, there is highly significant inter-study heterogeneity (p < 0.01) for all cancer endpoints and all but one type of exposure, although no significant risk trend with calendar period of study. CONCLUSIONS Overall, this large body of data relating to medical diagnostic radiation exposure in utero provides support for an associated excess risk of childhood cancer. However, the pronounced heterogeneity in studies of postnatal diagnostic exposure, the implied uncertainty as to the meaning of summary measures, and the distinct possibilities of bias, substantially reduce the strength of the evidence from the associations we observe between radiation imaging in childhood and the subsequent risk of cancer being causally related to radiation exposure.
Collapse
Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA.
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester M13 9PL, UK
| | - Simon D Bouffler
- Radiation Effects Department, UK Health Security Agency (UKHSA), Chilton, Didcot OX11 0RQ, UK
| | - Kossi Abalo
- Laboratoire d'Épidémiologie, Institut de Radioprotection et de Sûreté Nucléaire, BP 17 92262 Fontenay-aux-Roses Cedex, France
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Strasse 38, 16816 Neuruppin, Germany
| | - Nobuyuki Hamada
- Radiation Safety Unit, Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo 201-8511, Japan
| | - Gerald M Kendall
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford OX3 7LF, UK
| |
Collapse
|
3
|
Wakeford R, Bithell JF. A review of the types of childhood cancer associated with a medical X-ray examination of the pregnant mother. Int J Radiat Biol 2021; 97:571-592. [PMID: 33787450 DOI: 10.1080/09553002.2021.1906463] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/11/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE For 65 years the interpretation of the statistical association between the risk of cancer in a child and a prior diagnostic X-ray examination of the abdomen of the pregnant mother has been debated. The objections to a direct cause-and-effect explanation of the association vary in their strength, but one of the most notable grounds for controversy is the finding from the first and largest case-control study reporting the association, the Oxford Survey of Childhood Cancers (OSCC), of an almost uniformly raised relative risk (RR) for nearly all of the types of cancer that are most frequent in children. Here we compare the antenatal X-ray associations found in the OSCC for different types of childhood cancer with the results of all other case-control and case-cohort studies appropriately combined in meta-analyses, and we also review the findings of the few cohort studies that have been conducted. CONCLUSIONS From the case-control/case-cohort studies other than the OSCC there are consistent and clear elevations of risk for all types of childhood cancer combined, all leukemia, and all cancers except leukemia combined. This compatibility of the findings of the OSCC with those of the combined other studies is less clear, or effectively absent, when some categories containing smaller numbers of incident cases/deaths are considered, but lack of precision of risk estimates due to sparse data presents inferential challenges, although there is a consistent absence of an association for bone tumors. Further, more recent studies almost certainly address lower intrauterine doses, with an anticipated decrease in estimated risks, which could be misleading when comparisons involve a limited number of studies that are mainly from later years, and a similar problem arises when having to employ all types of antenatal X-ray exposures for a study because data for abdominal exposures are absent. The problem of low statistical power is greater for cohort studies, and this, together with other shortcomings identified in the studies, limits the interpretational value of results. The findings of non-medical intrauterine exposure studies are constrained by sparse data and make a limited contribution to an understanding of the association. Certain aspects of the various studies require a need for caution in interpretation, but overall, the appropriate combination of all case-control/case-cohort studies other than the OSCC lends support to the inference that low-level exposure to radiation in utero proportionally increases the risk of the typical cancers of childhood to around the same level.
Collapse
Affiliation(s)
- Richard Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK
| | - John F Bithell
- Department of Statistics, University of Oxford, Oxford, UK
| |
Collapse
|
4
|
Pre- and Post- birth Causes of Acute Lymphoblastic Leukemia. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2018. [DOI: 10.5812/ijcm.66448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
5
|
Anderson D, Schmid TE, Baumgartner A. Male-mediated developmental toxicity. Asian J Androl 2014; 16:81-8. [PMID: 24369136 PMCID: PMC3901885 DOI: 10.4103/1008-682x.122342] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Revised: 09/28/2013] [Accepted: 10/10/2013] [Indexed: 01/06/2023] Open
Abstract
Male-mediated developmental toxicity has been of concern for many years. The public became aware of male-mediated developmental toxicity in the early 1990s when it was reported that men working at Sellafield might be causing leukemia in their children. Human and animal studies have contributed to our current understanding of male-mediated effects. Animal studies in the 1980s and 1990s suggested that genetic damage after radiation and chemical exposure might be transmitted to offspring. With the increasing understanding that there is histone retention and modification, protamine incorporation into the chromatin and DNA methylation in mature sperm and that spermatozoal RNA transcripts can play important roles in the epigenetic state of sperm, heritable studies began to be viewed differently. Recent reports using molecular approaches have demonstrated that DNA damage can be transmitted to babies from smoking fathers, and expanded simple tandem repeats minisatellite mutations were found in the germline of fathers who were exposed to radiation from the Chernobyl nuclear power plant disaster. In epidemiological studies, it is possible to clarify whether damage is transmitted to the sons after exposure of the fathers. Paternally transmitted damage to the offspring is now recognized as a complex issue with genetic as well as epigenetic components.
Collapse
Affiliation(s)
- Diana Anderson
- Division of Medical Sciences, School of Life Sciences, University of Bradford, Bradford West Yorkshire, BD, UK
| | - Thomas E Schmid
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Adolf Baumgartner
- Division of Medical Sciences, School of Life Sciences, University of Bradford, Bradford West Yorkshire, BD, UK
| |
Collapse
|
6
|
Latino-Martel P, Chan DSM, Druesne-Pecollo N, Barrandon E, Hercberg S, Norat T. Maternal alcohol consumption during pregnancy and risk of childhood leukemia: systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 2010; 19:1238-60. [PMID: 20447918 DOI: 10.1158/1055-9965.epi-09-1110] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Leukemia is the most frequently occurring cancer in children. Although its etiology is largely unknown, leukemia is believed to result from an interaction between genetic and environmental factors. Among different potential risk factors, the possible role of maternal alcohol consumption during pregnancy has been questioned. METHODS To assess the association between maternal alcohol consumption during pregnancy and childhood leukemia, a systematic review and meta-analysis of published studies was done. RESULTS Twenty-one case-control studies were included in categorical and dose-response meta-analyses. No cohort study was identified. Analyses were conducted by type of leukemia, children's age at diagnosis, and type of alcoholic beverage and trimester of pregnancy at alcohol use. Alcohol intake during pregnancy (yes versus no) was statistically significantly associated with childhood acute myeloid leukemia (AML) [odds ratio (OR), 1.56; 95% confidence interval (CI), 1.13-2.15] but not with acute lymphoblastic leukemia (OR, 1.10; 95% CI, 0.93-1.29). Heterogeneity between studies was observed. The OR of AML for an increase of a drink per week was 1.24 (95% CI, 0.94-1.64). The association of alcohol intake during pregnancy with AML was observed for cancers diagnosed at age 0 to 4 years (OR, 2.68; 95% CI, 1.85-3.89) in five studies without heterogeneity (I2<or=0.1%). CONCLUSIONS The results of case-control studies indicate that maternal alcohol consumption during pregnancy is associated with a significantly increased risk of AML in young children. IMPACT Avoidance of maternal alcohol drinking during pregnancy might contribute to a decrease in the risk of childhood AML.
Collapse
|
7
|
Van Maele-Fabry G, Lantin AC, Hoet P, Lison D. Childhood leukaemia and parental occupational exposure to pesticides: a systematic review and meta-analysis. Cancer Causes Control 2010; 21:787-809. [PMID: 20467891 DOI: 10.1007/s10552-010-9516-7] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 01/23/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis of published studies on the association between parental occupational exposure to pesticides and childhood leukaemia. METHODS Studies were identified from a MEDLINE search through 31 July 2009 and from the reference lists of identified publications. Relative risk (RR) estimates were extracted from 25 studies published between 1985 and 2008. Meta-rate ratio estimates (mRR) were calculated according to fixed and random-effect meta-analysis models. Separate analyses were conducted after stratification for study design, definition of exposure (employment in a farm/agriculture assuming exposure to pesticides versus exposure to pesticides stipulated), exposed parent, window of exposure, type of leukaemia and biocide category. RESULTS No statistically significant association between childhood leukaemia and parental occupation as farmers/agricultural workers was observed. When exposure to pesticides was stipulated, positive associations were reported for maternal exposure for all studies combined (mRR: 1.62; 95% CI: 1.22-2.16), in all exposure windows considered and for acute non-lymphocytic leukaemia (ANLL). There was no association with paternal exposure when combining all studies (mRR: 1.14; 95% CI: 0.76-1.69). However, significant increased risks were seen for paternal exposure, in some exposure windows as well as for the biocide category. CONCLUSIONS The strongest evidence of an increased risk of childhood leukaemia comes from studies with maternal occupational exposure to pesticides. The associations with paternal exposure were weaker and less consistent. These results add to the evidence leading to recommend minimizing parental occupational exposure to pesticides. Our findings also support the need to rely more on studies that clearly stipulate exposure to pesticides rather than those that assume pesticide exposure because of farm/agriculture employment.
Collapse
Affiliation(s)
- Geneviève Van Maele-Fabry
- Louvain Center for Toxicology and Applied Pharmacology (LTAP), Université catholique de Louvain, Avenue E. Mounier 53.02, 1200, Brussels, Belgium.
| | | | | | | |
Collapse
|
8
|
Hagopian A, Lafta R, Hassan J, Davis S, Mirick D, Takaro T. Trends in childhood leukemia in Basrah, Iraq, 1993-2007. Am J Public Health 2010; 100:1081-7. [PMID: 20167894 DOI: 10.2105/ajph.2009.164236] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Through a sister-university relationship between the University of Basrah and the University of Washington, we analyzed Ibn Ghazwan Hospital's leukemia registry data to evaluate trends in childhood leukemia since 1993. METHODS We documented leukemia cases among children aged 0 to 14 years for each of the last 15 years. Population data were obtained from a 1997 census and various subsequent estimates to calculate rates. RESULTS We observed 698 cases of childhood leukemia between 1993 and 2007, ranging between 15 cases (2.6 per 100 000 annual rate) in the first year and 56 cases (6.9 per 100 000 annual rate) in the final year, reaching a peak of 97 cases in 2006 (12.2 per 100 000 annual rate). CONCLUSIONS Childhood leukemia rates in Basrah more than doubled over a 15-year period. The test for trend was significant (P = .03). Basrah's childhood leukemia rate compared unfavorably with neighboring Kuwait and nearby Oman, as well as the United States, the European Union, and other countries.
Collapse
Affiliation(s)
- Amy Hagopian
- Department of Global Health, School of Public Health, University of Washington, 4534 11th Avenue NE, Seattle, WA 98105, USA.
| | | | | | | | | | | |
Collapse
|
9
|
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
|
10
|
Wigle DT, Turner MC, Krewski D. A systematic review and meta-analysis of childhood leukemia and parental occupational pesticide exposure. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1505-13. [PMID: 20019898 PMCID: PMC2790502 DOI: 10.1289/ehp.0900582] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 05/19/2009] [Indexed: 05/02/2023]
Abstract
OBJECTIVES We conducted a systematic review and meta-analysis of childhood leukemia and parental occupational pesticide exposure. DATA SOURCES Searches of MEDLINE (1950-2009) and other electronic databases yielded 31 included studies. DATA EXTRACTION Two authors independently abstracted data and assessed the quality of each study. DATA SYNTHESIS Random effects models were used to obtain summary odds ratios (ORs) and 95% confidence intervals (CIs). There was no overall association between childhood leukemia and any paternal occupational pesticide exposure (OR = 1.09; 95% CI, 0.88-1.34); there were slightly elevated risks in subgroups of studies with low total-quality scores (OR = 1.39; 95% CI, 0.99-1.95), ill-defined exposure time windows (OR = 1.36; 95% CI, 1.00-1.85), and exposure information collected after offspring leukemia diagnosis (OR = 1.34; 95% CI, 1.05-1.70). Childhood leukemia was associated with prenatal maternal occupational pesticide exposure (OR = 2.09; 95% CI, 1.51-2.88); this association was slightly stronger for studies with high exposure-measurement-quality scores (OR = 2.45; 95% CI, 1.68-3.58), higher confounder control scores (OR = 2.38; 95% CI, 1.56-3.62), and farm-related exposures (OR = 2.44; 95% CI, 1.53-3.89). Childhood leukemia risk was also elevated for prenatal maternal occupational exposure to insecticides (OR = 2.72; 95% CI, 1.47-5.04) and herbicides (OR = 3.62; 95% CI, 1.28-10.3). CONCLUSIONS Childhood leukemia was associated with prenatal maternal occupational pesticide exposure in analyses of all studies combined and in several subgroups. Associations with paternal occupational pesticide exposure were weaker and less consistent. Research needs include improved pesticide exposure indices, continued follow-up of existing cohorts, genetic susceptibility assessment, and basic research on childhood leukemia initiation and progression.
Collapse
Affiliation(s)
- Donald T Wigle
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Ontario, Canada.
| | | | | |
Collapse
|
11
|
|
12
|
Dobrzyńska MM, Czajka U. Male-mediated developmental toxicity in mice after 8 weeks'exposure to low doses of X-rays. Int J Radiat Biol 2009; 81:793-9. [PMID: 16484148 DOI: 10.1080/09553000600554275] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of the study was to investigate the effects of subchronic irradiation of male mice on reproduction ability and induction of male-mediated teratogenesis. MATERIALS AND METHODS Male mice were irradiated to 0.05 Gy, 0.10 Gy and 0.20 Gy daily for 8 weeks, 5 days per week. The total doses were 2.00 Gy, 4.00 Gy and 8.00 Gy, respectively. After the end of exposure each male was caged with two untreated females. The females were sacrificed on day 17 based on the finding of a vaginal plug. Females were examined for the number of live and dead implantations and the incidence of congenital malformations of survival foetuses. RESULTS The fertilization ability of males was not diminished. The exposure to 0.20 Gy daily significantly decreased the percent of pregnant females and the number of total implantations. Exposure to 0.10 Gy and 0.20 Gy daily caused decreases in the number of live foetuses and induced dominant lethal mutations (over 50% at the highest dose). Exposure to each dose significantly enhanced the number of deaths (especially early) implants. The incidence of gross and skeletal malformations was not statistically significant, except for skeletal malformations at the highest dose. CONCLUSIONS Results confirmed that irradiation of male germ cells cause genetic effects which could be transmitted to the offspring. After subchronic exposure to low doses the majority of mutations caused premature death. Subchronic exposure to low doses of X-rays did not induce external and skeletal malformations of surviving foetuses.
Collapse
Affiliation(s)
- Małgorzata M Dobrzyńska
- Department of Radiation Protection and Radiobiology, National Institute of Hygiene, Warsaw, Poland.
| | | |
Collapse
|
13
|
Wakeford R. On pre- or postnatal diagnostic X-rays as a risk factor for childhood leukaemia. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2009; 48:237-241. [PMID: 19242714 DOI: 10.1007/s00411-009-0214-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Accepted: 02/07/2009] [Indexed: 05/27/2023]
|
14
|
Linet MS, Kim KP, Rajaraman P. Children's exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations. Pediatr Radiol 2009; 39 Suppl 1:S4-26. [PMID: 19083224 PMCID: PMC2814780 DOI: 10.1007/s00247-008-1026-3] [Citation(s) in RCA: 201] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Accepted: 09/19/2008] [Indexed: 10/24/2022]
Abstract
While the etiology of most childhood cancers is largely unknown, epidemiologic studies have consistently found an association between exposure to medical radiation during pregnancy and risk of childhood cancer in offspring. The relation between early life diagnostic radiation exposure and occurrence of pediatric cancer risks is less clear. This review summarizes current and historical estimated doses for common diagnostic radiologic procedures as well as the epidemiologic literature on the role of maternal prenatal, children's postnatal and parental preconception diagnostic radiologic procedures on subsequent risk of childhood malignancies. Risk estimates are presented according to factors such as the year of birth of the child, trimester and medical indication for the procedure, and the number of films taken. The paper also discusses limitations of the methods employed in epidemiologic studies to assess pediatric cancer risks, the effects on clinical practice of the results reported from the epidemiologic studies, and clinical and public health policy implications of the findings. Gaps in understanding and additional research needs are identified. Important research priorities include nationwide surveys to estimate fetal and childhood radiation doses from common diagnostic procedures, and epidemiologic studies to quantify pediatric and lifetime cancer risks from prenatal and early childhood exposures to diagnostic radiography, CT, and fluoroscopically guided procedures.
Collapse
Affiliation(s)
- Martha S Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-7238, USA.
| | | | | |
Collapse
|
15
|
Wakeford R. Childhood leukaemia following medical diagnostic exposure to ionizing radiation in utero or after birth. RADIATION PROTECTION DOSIMETRY 2008; 132:166-174. [PMID: 18922822 DOI: 10.1093/rpd/ncn272] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A statistical association between childhood leukaemia and an abdominal X-ray examination of the pregnant mother was first reported in 1956 from a case-control study of childhood cancer mortality conducted in Great Britain. This study, later called the Oxford Survey of Childhood Cancers (OSCC), was continued and eventually showed a highly statistically significant approximately 50% proportional increase in the risk of childhood leukaemia associated with antenatal diagnostic radiography. The association has been confirmed by many case-control studies carried out around the world, the appropriately combined results of which show a highly statistically significant increase in risk that is compatible with the OSCC finding. There is no doubt about the reality of the statistical association, but a causal interpretation has been questioned. On balance, however, the evidence points to low-level irradiation of the fetus increasing the risk of leukaemia in childhood, with an excess relative risk coefficient of around 50 Gy(-1) (equivalent to an excess absolute risk coefficient of about 3% Gy(-1)), although the uncertainty associated with these coefficients is considerable and they are likely to be overestimates. In contrast to exposure in utero, the evidence from case-control studies for an association between childhood leukaemia and postnatal exposure to medical diagnostic irradiation is equivocal and sometimes conflicting. Since standard radiation risk models predict that low-level exposure in the early years of life should produce an increased risk of childhood leukaemia that is roughly similar to that arising from fetal exposure, this absence of persuasive evidence is likely to be due to various problems with the studies. This is unfortunate given the rise in relatively high dose diagnostic procedures (e.g. paediatric CT scans) that would be predicted to materially increase the relative risk of childhood leukaemia.
Collapse
Affiliation(s)
- Richard Wakeford
- The Dalton Nuclear Institute, The University of Manchester, Pariser Building-G Floor, PO Box 88, Sackville Street, Manchester M60 1QD, UK.
| |
Collapse
|
16
|
Johnson KJ, Alexander BH, Doody MM, Sigurdson AJ, Linet MS, Spector LG, Hoffbeck W, Simon SL, Weinstock RM, Ross JA. Childhood cancer in the offspring born in 1921-1984 to US radiologic technologists. Br J Cancer 2008; 99:545-50. [PMID: 18665174 PMCID: PMC2527813 DOI: 10.1038/sj.bjc.6604516] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We examined the risk of childhood cancer (<20 years) among 105 950 offspring born in 1921-1984 to US radiologic technologist (USRT) cohort members. Parental occupational in utero and preconception ionising radiation (IR) testis or ovary doses were estimated from work history data, badge dose data, and literature doses (the latter doses before 1960). Female and male RTs reported a total of 111 and 34 haematopoietic malignancies and 115 and 34 solid tumours, respectively, in their offspring. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression. Leukaemia (n=63) and solid tumours (n=115) in offspring were not associated with maternal in utero or preconception radiation exposure. Risks for lymphoma (n=44) in those with estimated doses of <0.2, 0.2-1.0, and >1.0 mGy vs no exposure were non-significantly elevated with HRs of 2.3, 1.8, and 2.7. Paternal preconception exposure to estimated cumulative doses above the 95th percentile (82 mGy, n=6 cases) was associated with a non-significant risk of childhood cancer of 1.8 (95% CI 0.7-4.6). In conclusion, we found no convincing evidence of an increased risk of childhood cancer in the offspring of RTs in association with parental occupational radiation exposure.
Collapse
Affiliation(s)
- K J Johnson
- Department of Pediatrics, Division of Epidemiology/Clinical Research, University of Minnesota, Minneapolis, MN 55455, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Infante-Rivard C, El-Zein M. Parental alcohol consumption and childhood cancers: a review. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2007; 10:101-29. [PMID: 18074306 DOI: 10.1080/10937400601034597] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The etiology of childhood cancers remains generally unknown. Given that the metabolites of alcohol are likely carcinogens and that leukemia, the most frequent childhood cancer, can arise in utero, the study of alcohol consumption as a potential risk factor for the development of childhood cancer is justified. This article summarizes the epidemiological evidence on the association between parental exposure to alcohol and the risk of childhood cancers. To do this, a thorough search of the literature from 1960 to 2003 using the PubMed database was carried out. It yielded 33 case-control studies published between 1982 and 2003, including 13 studies that considered paternal exposure in the preconceptional period. In 10 of the 33 studies at least 1 statistically significant risk increase was reported in relation with parental alcohol consumption; in 7 of these studies the increase was related to maternal consumption, whereas in 3 studies, it was related to paternal consumption. The cancers most often found associated with parental drinking were leukemia, brain tumors, and neuroblastoma. A few studies also reported a protective effect with maternal exposure at modest levels. Inconsistencies in the results and the low risks reported do not suggest an association between childhood cancer and parental consumption of alcohol. However, before reaching any definitive conclusions, methodological issues need to be addressed in future studies, as well as the role of genetic susceptibility. Moreover, subtypes of specific cancers need to be studied separately.
Collapse
Affiliation(s)
- Claire Infante-Rivard
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
| | | |
Collapse
|
18
|
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
|
19
|
Infante-Rivard C, Weichenthal S. Pesticides and childhood cancer: an update of Zahm and Ward's 1998 review. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2007; 10:81-99. [PMID: 18074305 DOI: 10.1080/10937400601034589] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Children are exposed to pesticides through a number of sources, including residential and agricultural applications. Parental occupational exposure to pesticides is also a concern because exposures occurring during pregnancy and carry-home residues also contribute to children's cumulative burden. A number of epidemiological studies consistently reported increased risks between pesticide exposures and childhood leukemia, brain cancer, neuroblastoma, non-Hodgkin's lymphoma, Wilms' tumor, and Ewing's sarcoma. An extensive review of these studies was published in 1998 (Zahm & Ward, 1998). Fifteen case-control studies, 4 cohort studies, and 2 ecological studies have been published since this review, and 15 of these 21 studies reported statistically significant increased risks between either childhood pesticide exposure or parental occupational exposure and childhood cancer. Therefore, one can confidently state that there is at least some association between pesticide exposure and childhood cancer. However, an unambiguous mechanistic cause-and-effect relationship between pesticide exposure and childhood cancer was not demonstrated in these studies, and modifying factors such as genetic predisposition, rarely considered in the reviewed studies, likely play an important role. While the time window of exposure may be a crucial determinant for biological effects associated with pesticide exposure on children, studies have not contributed definitive information on the most vulnerable period. Accurate exposure assessment remains a challenge; future epidemiological studies need to assess gene-environment interactions and use improved exposure measures, including separate parental interviews, specific pesticide exposure questions, and semiquantitative exposure measures that can be used to confirm information obtained through questionnaires.
Collapse
Affiliation(s)
- Claire Infante-Rivard
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
| | | |
Collapse
|
20
|
Poole C, Greenland S, Luetters C, Kelsey JL, Mezei G. Socioeconomic status and childhood leukaemia: a review. Int J Epidemiol 2005; 35:370-84. [PMID: 16308412 DOI: 10.1093/ije/dyi248] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A long-held view links higher socioeconomic status (SES) to higher rates of childhood leukaemia. Some recent studies exhibit associations in the opposite direction. METHODS We reviewed journal literature through August 2002 for associations between childhood leukaemia and socioeconomic measures. We determined the direction of each association and its P-value. We described the results with regard to study design, calendar period, geographic locale, and level of the socioeconomic measures (individual or ecological). For measures with sufficient number of results, we computed summary P-values across studies. RESULTS Case-control studies conducted in North America since 1980 have involved subject interviews or self-administered questionnaires and have consistently reported inverse (negative) associations of childhood leukaemia with individual-level measures of family income, mother's education, and father's education. In contrast, associations have been consistently positive with father's occupational class in record-based case-control studies and with average occupational class in ecological studies. CONCLUSIONS Connections of SES measures to childhood leukaemia are likely to vary with place and time. Validation studies are needed to estimate SES-related selection and participation in case-control studies. Because different socioeconomic measures (such as income and education) and individual-level and ecological-level measures may represent different risk factors, we advise researchers to report these measures separately rather than in summary indices of social class.
Collapse
Affiliation(s)
- Charles Poole
- Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, 27599-7435, USA.
| | | | | | | | | |
Collapse
|
21
|
Lightfoot TJ, Roman E. Causes of childhood leukaemia and lymphoma. Toxicol Appl Pharmacol 2004; 199:104-17. [PMID: 15313583 DOI: 10.1016/j.taap.2003.12.032] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2003] [Accepted: 12/08/2003] [Indexed: 11/25/2022]
Abstract
Childhood cancer is rare comprising less than 1% of all malignancies diagnosed each year in developed countries. Leukaemia is the commonest form of cancer in children accounting for around a third of all childhood cancer, with acute lymphoblastic leukaemia (ALL) being the most prevalent. Biologically specific subtypes of ALL and acute myeloblastic leukaemia (AML), the other major morphological type of childhood leukaemia, are characterised by chromosomal changes. Whilst over 200 genes have been associated with chromosomal translocations, to date, only MLL, TEL, and AML1 have been linked with childhood leukaemia. Interestingly, there is increasing evidence to support the theory that gene rearrangements such as these may originate in utero. As with many other human diseases, both genetic and environmental factors have been implicated in the aetiology of the disease. Although much has been documented with regard to diet, smoking, alcohol consumption and recreational and prescription drug use during pregnancy, there is no consistent evidence to support a link with any of these factors and childhood leukaemia. However, findings from studies investigating prenatal and early life exposures are often based on small numbers of cases as both the type of cancer and exposure are rare. Furthermore, accurate information relating to past exposures can be difficult to obtain and is often reliant on self-reporting. To further our understanding of the aetiology of childhood leukaemia and lymphoma, there are areas which clearly warrant investigation. These include collection of parental dietary folate data combined with genetic analysis of the folate related genes, in utero exposure to DNA topoisomerase II inhibitors, and the possible effects of assisted reproduction technology on disease susceptibility.
Collapse
Affiliation(s)
- Tracy J Lightfoot
- Leukaemia Research Fund Epidemiology and Genetics Unit, Department of Health Sciences, University of York, YO10 5DD, UK.
| | | |
Collapse
|
22
|
Flower KB, Hoppin JA, Lynch CF, Blair A, Knott C, Shore DL, Sandler DP. Cancer risk and parental pesticide application in children of Agricultural Health Study participants. ENVIRONMENTAL HEALTH PERSPECTIVES 2004; 112:631-5. [PMID: 15064173 PMCID: PMC1241933 DOI: 10.1289/ehp.6586] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Parental exposure to pesticides may contribute to childhood cancer risk. Through the Agricultural Health Study, a prospective study of pesticide applicators in Iowa and North Carolina, we examined childhood cancer risk and associations with parental pesticide application. Identifying information for 17,357 children of Iowa pesticide applicators was provided by parents via questionnaires (1993-1997) and matched against the Iowa Cancer Registry. Fifty incident childhood cancers were identified (1975-1998). Risk of all childhood cancers combined was increased [standardized incidence ratio (SIR) = 1.36; 95% confidence interval (CI), 1.03-1.79]. Risk of all lymphomas combined was also increased (SIR = 2.18; 95% CI, 1.13-4.19), as was risk of Hodgkin's lymphoma (SIR = 2.56; 95% CI, 1.06-6.14). We used logistic regression to explore associations between self-reported parental pesticide application practices and childhood cancer risk. No association was detected between frequency of parental pesticide application and childhood cancer risk. An increased risk of cancer was detected among children whose fathers did not use chemically resistant gloves [odds ratio (OR) = 1.98; 95% CI, 1.05-3.76] compared with children whose fathers used gloves. Of 16 specific pesticides used by fathers prenatally, ORs were increased for aldrin (OR = 2.66), dichlorvos (OR = 2.06), and ethyl dipropylthiocarbamate (OR = 1.91). However, these results were based on small numbers and not supported by prior biologic evidence. Identification of excess lymphoma risk suggests that farm exposures including pesticides may play a role in the etiology of childhood lymphoma.
Collapse
Affiliation(s)
- Kori B Flower
- Robert Wood Johnson Clinical Scholars Program and Division of Community Pediatrics, Department of Pediatrics, School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7105, USA.
| | | | | | | | | | | | | |
Collapse
|
23
|
Anderson D. Overview of male-mediated developmental toxicity. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2004; 518:11-24. [PMID: 12817673 DOI: 10.1007/978-1-4419-9190-4_2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- Diana Anderson
- Department of Biomedical Sciences, University of Bradford, Bradford, West Yorkshire, BD7 IDP, UK.
| |
Collapse
|
24
|
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
|
25
|
|
26
|
Dickinson HO, Parker L. Leukaemia and non-Hodgkin's lymphoma in children of male Sellafield radiation workers. Int J Cancer 2002; 99:437-44. [PMID: 11992415 DOI: 10.1002/ijc.10385] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Our objective was to investigate if there was (i) an excess risk of leukaemia/non-Hodgkin's lymphoma among children of male radiation workers at the Sellafield nuclear installation in Cumbria, northwest England; (ii) a dose-response relationship between fathers' preconceptional irradiation and their children's risk of leukaemia/non-Hodgkin's lymphoma; and (iii) whether any observed association could be explained by demographic factors. We performed a cohort study of live births, 1950-1991 in Cumbria, followed up to age 25 years or the end of 1991, comparing the risk of leukaemia/non-Hodgkin's lymphoma among all 9,859 children of male radiation workers to that among all 256,851 children of non-Sellafield fathers. Children of radiation workers had a higher risk of leukaemia/non-Hodgkin's lymphoma than other children [rate ratio (RR) = 1.9, 95% confidence interval (CI) 1.0-3.1, p = 0.05]. Adjustment for population mixing greatly reduced the excess risk in the village of Seascale, adjacent to Sellafield, but had little effect elsewhere. The risk increased significantly with father's total preconceptional external radiation dose (RR(100mSv) = 1.6, 95% CI 1.0-2.2, p = 0.05). This dose-response was not reduced by adjustment for population mixing. Although our 13 exposed cases included 10 considered previously (Gardner et al., BMJ 1990;300:423-34), we used a cohort rather than a case-control design, with wider temporal and geographic boundaries, and confirmed the statistical association between father's preconceptional irradiation and child's risk of leukaemia/non-Hodgkin's lymphoma that they reported. The possibility remains that paternal preconceptional irradiation may be a risk factor for leukaemia/non-Hodgkin's lymphoma, and this effect may not be confined to Seascale.
Collapse
Affiliation(s)
- Heather O Dickinson
- North of England Children's Cancer Research Unit, Department of Child Health, University of Newcastle, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
| | | |
Collapse
|
27
|
Abstract
This paper gives an overview of local work on the incidence of childhood leukaemia in West Berkshire since 1971. The most recently published figures show that between 1972-96, a total of 106 children contracted leukaemia when 81 cases would have been expected in the under 14s. Within ten kilometres of the nuclear establishments at Aldermaston and Burghfield, the risk of a child getting leukaemia, which is very small (400 children a year in the UK) is none the less doubled in under-fives meaning that one more child a year is affected. There is also an increased incidence of all cancers in this age group and geographical area. Theories as to why this should be abound, but until the cause of cancer is fully understood, and what the part of radiation in the process could be, no firm measures can be taken to redress the balance.
Collapse
Affiliation(s)
- C Barton
- Oxford and Anglia Multi-Research Ethics Committee
| |
Collapse
|
28
|
Anderson LM, Diwan BA, Fear NT, Roman E. Critical windows of exposure for children's health: cancer in human epidemiological studies and neoplasms in experimental animal models. ENVIRONMENTAL HEALTH PERSPECTIVES 2000; 108 Suppl 3:573-94. [PMID: 10852857 PMCID: PMC1637809 DOI: 10.1289/ehp.00108s3573] [Citation(s) in RCA: 195] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
In humans, cancer may be caused by genetics and environmental exposures; however, in the majority of instances the identification of the critical time window of exposure is problematic. The evidence for exposures occurring during the preconceptional period that have an association with childhood or adulthood cancers is equivocal. Agents definitely related to cancer in children, and adulthood if exposure occurs in utero, include: maternal exposure to ionizing radiation during pregnancy and childhood leukemia and certain other cancers, and maternal use of diethylstilbestrol during pregnancy and clear-cell adenocarcinoma of the vagina of their daughters. The list of environmental exposures that occur during the perinatal/postnatal period with potential to increase the risk of cancer is lengthening, but evidence available to date is inconsistent and inconclusive. In animal models, preconceptional carcinogenesis has been demonstrated for a variety of types of radiation and chemicals, with demonstrated sensitivity for all stages from fetal gonocytes to postmeiotic germ cells. Transplacental and neonatal carcinogenesis show marked ontogenetic stage specificity in some cases. Mechanistic factors include the number of cells at risk, the rate of cell division, the development of differentiated characteristics including the ability to activate and detoxify carcinogens, the presence of stem cells, and possibly others. Usefulness for human risk estimation would be strengthened by the study of these factors in more than one species, and by a focus on specific human risk issues.
Collapse
Affiliation(s)
- L M Anderson
- Laboratory of Comparative Carcinogenesis, National Cancer Institute, FCRDC, Frederick, Maryland, USA.
| | | | | | | |
Collapse
|
29
|
Boffetta P, Trédaniel J, Greco A. Risk of childhood cancer and adult lung cancer after childhood exposure to passive smoke: A meta-analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2000; 108:73-82. [PMID: 10620527 PMCID: PMC1637845 DOI: 10.1289/ehp.0010873] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
We identified more than 30 studies on the association between exposure to maternal tobacco smoke during pregnancy and cancer in childhood. We combined their results in meta-analyses based on a random effects model. The results of the meta-analyses suggest a small increase in risk of all neoplasms [relative risk (RR) 1.10; 95% confidence interval (CI), 1.03-1.19; based on 12 studies], but not of specific neoplasms such as leukemia (RR 1.05; CI, 0.82-1.34; 8 studies) and central nervous system tumors (RR 1.04; CI, 0.92-1. 18; 12 studies). Results for other specific neoplasms were sparse, but the available data did not suggest a strong association for any type of tumor. No clear evidence of dose response was present in the studies that addressed this issue. The results on exposure to maternal tobacco smoke before or after pregnancy are too sparse to allow a conclusion. The results on exposure to paternal tobacco smoke suggest an association with brain tumors (RR 1.22; CI, 1.05-1. 40; based on 10 studies) and lymphomas (RR 2.08; CI, 1.08-3.98; 4 studies). The data are too sparse for the other neoplasms, although the results of a few recent large studies are compatible with a weak carcinogenic effect of paternal smoke. For exposure from either maternal or paternal smoke, bias and confounding cannot yet be ruled out. Further studies are needed to confirm the hypothesis that parental tobacco smoke, from the father in particular, is a risk factor of childhood cancer. Results on the risk of lung cancer in adulthood and childhood passive smoking exposure are available from 11 studies: they do not provide evidence of an increased risk (summary RR 0.91; CI, 0.80-1.05).
Collapse
Affiliation(s)
- P Boffetta
- International Agency for Research on Cancer, Lyon, France.
| | | | | |
Collapse
|
30
|
Maconochie N, Doyle P, Roman E, Davies G, Smith PG, Beral V. Nuclear industry family study:methods and description of a United Kingdom study linking occupational information held by employers to reproduction and child health. Occup Environ Med 1999; 56:798-808. [PMID: 10691340 PMCID: PMC1757695 DOI: 10.1136/oem.56.12.793] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To describe the methods used in the nuclear industry family study for which a comprehensive database has been assembled that links employment in the nuclear industry and dosimetry records to information on employees' reproductive health and the health of their children. To discuss the response rates and characteristics of the study population. METHODS Occupational cohort design leading to a retrospective cohort study of reproductive outcomes reported by 46 396 current and former employees of both sexes in the nuclear industry. Employees of nuclear establishments in the United Kingdom operated by the Atomic Energy Authority, the Atomic Weapons Establishment, and British Nuclear Fuels were surveyed with postal questionnaires ot collect information on pregnancies, children,and periods of infertility. Information on employment and monitoring for ionising radiation was supplied by the employing nuclear authority and was linked to pregnancies and periods of infertility with unique personal identification numbers. RESULTS The design and completion of this study resulted in high quality data on a representative population of the Atomic Energy Authority, Atomic Weapons Establishment, and British Nuclear Fuels workforces. The response to the survey was extremely good (82% for male workers and 88% for female workers, excluding undelivered questionnaires), and a unique relational database has been created which will enable infertility, pregnancy, and child health outcomes to be examined with respect to the employment and radiation monitoring characteristics of parents. CONCLUSION This is the first United Kingdom study to link detailed reproductive history data to occupational information held by employers. The methods developed for the study were found to be feasible and successful. The design can be adapted for other investigations of reproductive hazards to men and women in the workplace and is currently in use to survey over 100 000 armed forces personnel in an investigation of reproductive outcome among veterans of the Gulf war.
Collapse
Affiliation(s)
- N Maconochie
- London School of Hygiene and Tropical Medicine, University of London,
| | | | | | | | | | | |
Collapse
|
31
|
Abstract
Methodological considerations in the study of clusters and clustering of childhood cancer are reviewed briefly. A selection of 11 studies of individual clusters of childhood leukaemia which are either particularly notable or recent and have been reported in peer review journals is then considered. Focus is placed on sources of alerts, descriptive studies, field-work studies, conclusions and communication management. Some of these studies are probably essential but they are unlikely to yield firm conclusions; studies of large data sets are recommended. No causal factor has been identified which can explain a single cluster of childhood leukaemia.
Collapse
Affiliation(s)
- F E Alexander
- Department of Community Health Sciences, University of Edinburgh, UK
| |
Collapse
|
32
|
Roman E, Doyle P, Maconochie N, Davies G, Smith PG, Beral V. Cancer in children of nuclear industry employees: report on children aged under 25 years from nuclear industry family study. BMJ (CLINICAL RESEARCH ED.) 1999; 318:1443-50. [PMID: 10346768 PMCID: PMC27886 DOI: 10.1136/bmj.318.7196.1443] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/1999] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine whether children of men and women occupationally exposed to ionising radiation are at increased risk of developing leukaemia or other cancers before their 25th birthday. DESIGN Cohort study of children of nuclear industry employees. SETTING Nuclear establishments operated by the Atomic Energy Authority, Atomic Weapons Establishment, and British Nuclear Fuels. SUBJECTS 39 557 children of male employees and 8883 children of female employees. MAIN OUTCOME MEASURES Cancer incidence in offspring reported by parents. Employment and radiation monitoring data (including annual external dose) supplied by the nuclear authorities. RESULTS 111 cancers were reported, of which 28 were leukaemia. The estimated standardised incidence ratios for children of male and female employees who were born in 1965 or later were 98 (95% confidence interval 73 to 129) and 96 (50 to 168) for all malignancies and 109 (61 to 180) and 95 (20 to 277) for leukaemia. The leukaemia rate in children whose fathers had accumulated a preconceptual dose of >/=100 mSv was 5.8 times that in children conceived before their fathers' employment in the nuclear industry (95% confidence interval 1.3 to 24.8) but this was based on only three exposed cases. Two of these cases were included in the west Cumbrian ("Gardner") case-control study. No significant trends were found between increasing dose and leukaemia. CONCLUSIONS Cancer in young people is rare, and our results are based on small numbers of events. Overall, the findings suggest that the incidence of cancer and leukaemia among children of nuclear industry employees is similar to that in the general population. The possibility that exposure of fathers to relatively high doses of ionising radiation before their child's conception might be related to an increased risk of leukaemia in their offspring could not be disproved, but this result was based on only three cases, two of which have been previously reported. High conceptual doses are rare, and even if the occupational association were causal, the number of leukaemias involved would be small; in this study of over 46 000 children, fewer than three leukaemias could potentially be attributed to such an exposure.
Collapse
Affiliation(s)
- E Roman
- Leukaemia Research Fund, Institute of Epidemiology, University of Leeds, Leeds LS2 9LN.
| | | | | | | | | | | |
Collapse
|
33
|
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
|
34
|
|
35
|
Abstract
Comparative epidemiological studies have for a long time suggested a link (or links) between infectious agents and hematological malignancies in the young. Identification of Epstein-Barr virus (EBV) as the major cause of specific subtypes of Burkitt's lymphoma and Hodgkin's disease 20 and 10 years ago, respectively, and the recent involvement of human T-cell leukemia virus in non-Hodgkin's lymphomas of the T-cell lineage in young adults in Jamaica have given further credit to early presumptions that these diseases have an infectious etiology. The spectrum of possibly involved viruses: old, EBV, and new, herpesviruses 6, 7 and 8, and unknown retroviruses - as well as the list of partially or totally unresolved disease entities: Hodgkin's disease in adolescents, non-Hodgkin's lymphomas in the immunocompromised, and acute lymphocytic leukemia - is rapidly expanding. Both direct and indirect transforming effects of the above-mentioned viruses are being rapidly disclosed. However, the complex interaction between the different viruses and other causes of hematological malignancies in the young guarantees that many things remain to be discovered also in the future.
Collapse
Affiliation(s)
- T Lehtinen
- Department of Clinical Oncology, University of Tampere, National Public Health Institute, Helsinki, Finland
| | | |
Collapse
|
36
|
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
|
37
|
Zahm SH, Ward MH. Pesticides and childhood cancer. ENVIRONMENTAL HEALTH PERSPECTIVES 1998; 106 Suppl 3:893-908. [PMID: 9646054 PMCID: PMC1533072 DOI: 10.1289/ehp.98106893] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Children are exposed to potentially carcinogenic pesticides from use in homes, schools, other buildings, lawns and gardens, through food and contaminated drinking water, from agricultural application drift, overspray, or off-gassing, and from carry-home exposure of parents occupationally exposed to pesticides. Parental exposure during the child's gestation or even preconception may also be important. Malignancies linked to pesticides in case reports or case-control studies include leukemia, neuroblastoma, Wilms' tumor, soft-tissue sarcoma, Ewing's sarcoma, non-Hodgkin's lymphoma, and cancers of the brain, colorectum, and testes. Although these studies have been limited by nonspecific pesticide exposure information, small numbers of exposed subjects, and the potential for case-response bias, it is noteworthy that many of the reported increased risks are of greater magnitude than those observed in studies of pesticide-exposed adults, suggesting that children may be particularly sensitive to the carcinogenic effects of pesticides. Future research should include improved exposure assessment, evaluation of risk by age at exposure, and investigation of possible genetic-environment interactions. There is potential to prevent at least some childhood cancer by reducing or eliminating pesticide exposure.
Collapse
Affiliation(s)
- S H Zahm
- Occupational Epidemiology Branch, National Cancer Institute, Rockville, Maryland 20892, USA.
| | | |
Collapse
|
38
|
Alexander F. Cancer in the offspring of radiation workers. Connection between leukaemia and radiation needs to be considered. BMJ (CLINICAL RESEARCH ED.) 1998; 316:1672; author reply 1673. [PMID: 9603761 PMCID: PMC1113246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
39
|
Hoffmann W, Dieckmann H, Dieckmann H, Schmitz-Feuerhake I. A cluster of childhood leukemia near a nuclear reactor in northern Germany. ARCHIVES OF ENVIRONMENTAL HEALTH 1997; 52:275-80. [PMID: 9210727 DOI: 10.1080/00039899709602198] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Between February 1990 and December 1995, professionals diagnosed six cases of childhood leukemia among residents of the small rural community of Elbmarsch in northern Germany. Five of these cases were diagnosed in only a 16-mo period between February 1990 and May 1991. All cases lived in close proximity (i.e., 500-4,500 m) to Germany's largest capacity nuclear boiling-water reactor. We calculated standardized incidence ratios and exact 95% confidence intervals for a 5-km-radius circular area around the plant. The standardized incidence ratio for the time period 1990-1995 was 460 (95% confidence interval: 210, 1,030). The analysis was restricted further to the years 1990 and 1991, and the standardized incidence ratio increased to 1,180 (95% confidence interval: 490, 2,830). Presently, this cluster of childhood leukemia cases cannot be explained in terms of established and putative risk factors--including radiation from medical sources--for childhood leukemia.
Collapse
Affiliation(s)
- W Hoffmann
- Bremen Institute for Prevention Research and Social Medicine, Germany
| | | | | | | |
Collapse
|
40
|
Morris MS, Knorr RS. Adult leukemia and proximity-based surrogates for exposure to Pilgrim plant's nuclear emissions. ARCHIVES OF ENVIRONMENTAL HEALTH 1996; 51:266-74. [PMID: 8757406 DOI: 10.1080/00039896.1996.9936025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Possible associations between adult leukemia incidence and proximity-based surrogate measures of potential for exposure to radioactive emissions from the Pilgrim nuclear power plant in Plymouth, Massachusetts, were investigated. Included in this study were 105 nonchronic lymphocytic leukemia cases, diagnosed between 1978 and 1986 at age 13 y or older, that occurred in 22 towns near Pilgrim; population controls numbered 208. Residence within 4 mi (6.4 km) of Pilgrim during "high-emissions" years was related to case-control status (adjusted odds ratio [OR] = 3.88, 95% confidence interval [95% CI] = 0.81-10.64). A high "exposure" score (i.e., a value that accounted for downwind time) was also related to case-control status (OR = 3.46, 95% CI = 1.50-7.96). Some statistically significant dose-response trends were found. Cautious interpretation of associations is warranted in light of the low levels of reported emissions.
Collapse
Affiliation(s)
- M S Morris
- Massachusetts Department of Public Health, Boston 02108, USA
| | | |
Collapse
|
41
|
Iwasaki T, Hashimoto N, Endoh D, Imanisi T, Itakura C, Sato F. Life span and tumours in the first-generation offspring of the gamma-irradiated male mouse. Int J Radiat Biol 1996; 69:487-92. [PMID: 8627131 DOI: 10.1080/095530096145788] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
C57BL/6 male mice were exposed to 3 Gy 60Co gamma-rays and mated with unirradiated females after 15 days to produce F1 progeny produced following irradiation of the spermatids. After weaning the offsprings were allowed to live their normal life span. The mean litter size of the irradiated group significantly decreased from 7.1 to 4.9 (p < 0.01), but the sex ratio was not altered by the irradiation. No significant differences in the survival curve and mean life-span between the irradiated and control groups were noted. The only radiation effect in tumour incidence was a decrease of histiocytic sarcoma in female offspring of irradiated males. Except for this, there were no significant differences between the irradiated group and the control group in the incidence or age distribution of tumours.
Collapse
Affiliation(s)
- T Iwasaki
- Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | | | | | | | | | | |
Collapse
|
42
|
Wakeford R, Parker L. Leukaemia and non-Hodgkin's lymphoma in young persons resident in small areas of West Cumbria in relation to paternal preconceptional irradiation. Br J Cancer 1996; 73:672-9. [PMID: 8605106 PMCID: PMC2074332 DOI: 10.1038/bjc.1996.117] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The results of a previous study suggested that an association between childhood leukaemia and the radiation dose received occupationally by a father before the conception of his child might provide the explanation for the marked excess of childhood leukaemia and non-Hodgkin's lymphoma in the village of Seascale, West Cumbria. The present study identifies other small areas (electoral wards) in West Cumbria where excess cases of leukaemia and non-Hodgkin's lymphoma in young people have occurred and determines whether a recorded dose of radiation was received occupationally by the father before the conception of each of the affected individuals. Forty-one cases of leukaemia and non-Hodgkin's lymphoma were diagnosed during 1968-85 in young people under 25 years of age resident in the 49 electoral wards lying within the boundary of West Cumbria and the adjacent ward of Broughton. Raised incidence rate ratios (two-sided P<0.01) were found for acute lymphoblastic leukaemia among those aged 0-14 years (concentrated among those aged 0-4 years) in Seascale ward and among those aged 0-24 years (also concentrated among those aged 0-4 years) in Egremont North ward, for acute myeloid leukaemia among those aged 0-14 years in Sandwith ward, for all leukaemias among those aged 0-14 years in Broughton ward (South Lakeland) and for non-Hodgkin's lymphoma among those aged 0-14 years in Seascale ward. For West Cumbria as a whole, incidence rates were not usual. Apart from Seascale, for none of these electoral wards has a father of an affected child been linked definitely to an occupational dose of radiation recorded before the conception of the child. Particularly striking are the excesses of acute lymphoblastic leukaemia cases among young children living in the wards of Seascale and Egremont North, situated 11 km apart. The cases in Egremont North are not associated with recorded doses of radiation received occupationally by fathers before the conception of the affected children, even though the total numbers of children associated with such doses born in Seascale and Egremont North wards are similar. This finding is further evidence against a causal role for paternal preconceptional radiation exposure in the cases of childhood leukaemia in Seascale.
Collapse
|
43
|
Watanabe H, Takahashi T, Lee JY, Ohtaki M, Roy G, Ando Y, Yamada K, Gotoh T, Kurisu K, Fujimoto N, Satow Y, Ito A. Influence of paternal (252) Cf neutron exposure on abnormal sperm, embryonal lethality, and liver tumorigenesis in the F(1) offspring of mice. Jpn J Cancer Res 1996; 87:51-7. [PMID: 8609049 PMCID: PMC5920979 DOI: 10.1111/j.1349-7006.1996.tb00199.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Experiments were conducted to determine whether neutron-induced genetic damage in parental germline cells can lead to development of cancer in the offspring. Seven-week-old C3H male mice were irradiated with (252) Cf neutrons at a dose of 0, 50, 100, or 200 cGy. Two weeks or three months after irradiation, the male mice were mated with virgin 9-week-old C57BL females. Two weeks after irradiation, the irradiated male mice showed an increased incidence of sperm abnormalities, which led to embryo lethalities in a dose-dependent manner when they were mated with unirradiated female mice. Furthermore, liver tumors in male offspring of male mice in the 50 cGy group were significantly increased in 19 of 44 (43.2%) animals, in clear contrast to the unirradiated group (1 of 31; 3.2%) (P < 0.01). In the 100 cGy group, 6 of 39 (15%) mice had lesions. At 3 months after irradiation abnormal sperm and embryonal lethality were not significantly increased. The incidences of liver tumors in male offspring from the 50 cGy, 100 and 200 cGy groups were 6 of 20 (30%), 5 of 22 (23%) and 1 of 19 (5%), respectively, which are not significantly increased compared with the control. It is concluded that increased hepatic tumor risk in the F(1) generation may be caused by genetic transmission of hepatoma-associated trait(s) induced by (252) Cf neutron irradiation.
Collapse
Affiliation(s)
- H Watanabe
- Department of Cancer Research, Research Institute for Radiation Biology and Medicine, Hiroshima University
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
In November 1895, when Conrad Röntgen serendipitously discovered X-rays, epidemiology was effectively limited to the study of infectious disease. What little epidemiological work was done in other fields was done as part of clinical medicine or under the heading of geographical pathology. The risks from exposure to X-rays and subsequently from other types of ionising radiation were consequently discovered by qualitative association or animal experiment. They did not begin to be quantified in humans until half a century later, when epidemiology emerged as a scientific discipline capable of quantifying risks of non-infectious disease and the scientific world was alerted to the need for assessing the effects of the radiation to which large populations might be exposed by the use of nuclear energy in peace and war.
Collapse
|
45
|
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
|
46
|
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
|
47
|
Hoyes KP, Johnson C, Johnston RE, Lendon RG, Hendry JH, Sharma HL, Morris ID. Testicular toxicity of the transferrin binding radionuclide 114mIn in adult and neonatal rats. Reprod Toxicol 1995; 9:297-305. [PMID: 7579915 DOI: 10.1016/0890-6238(95)00012-y] [Citation(s) in RCA: 9] [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
Adult (70 d) and neonatal (7 d) male rats were dosed (i.p.) with 37 MBq/kg (1 mCi/kg; approximately 1 microgram elemental indium/kg) 114mIn, a transferrin-binding radionuclide. In adults, approximately 0.25% of the injected activity localised within the testis by 48 h postinjection and remained constant for up to 63 d. In neonates, 0.06% of the activity was in the testis by 48 h, and this declined such that by 63 d only 0.03% remained. At 63 d, treated rats had reduced sperm head counts and abnormal testicular histology that was more marked in animals dosed as adults than as neonates. In vitro, uptake of 114mIn into seminiferous tubules isolated from 7-, 20-, or 70-d-old rats was compared with that of 125I. Both radionuclides were readily accumulated by the tubules. Whilst 114In uptake into 20- and 70-d tubules was inhibited by excess transferrin, uptake into 7-d tubules was unchanged. 125I uptake was not affected by excess transferrin. These data support the contention that some radionuclides may cross the blood-testis barrier by utilisation of the physiologic iron-transferrin pathway, which may lead to greater testicular damage in adult compared to neonatal animals.
Collapse
Affiliation(s)
- K P Hoyes
- Cancer Research Campaign Department of Experimental Radiation Oncology, Paterson Institute for Cancer Research, Manchester, UK
| | | | | | | | | | | | | |
Collapse
|
48
|
Olshan AF. Lessons learned from epidemiologic studies of environmental exposure and genetic disease. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 1995; 25 Suppl 26:74-80. [PMID: 7789365 DOI: 10.1002/em.2850250611] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The induction of germ cell mutations with ionizing radiation and chemicals has been clearly demonstrated in experimental animal test systems. Less is known about the effects of environmental and other exposures on human germ cells. Epidemiologic studies of atomic bomb and childhood cancer survivors and their offspring have generally not indicated an excess risk for a variety of adverse reproductive outcomes and childhood diseases, including those due to germ cell mutations. Other epidemiologic studies, including the investigation of cancer among the offspring of fathers employed at the Sellafield nuclear facility in Great Britain and studies of paternal occupation and birth defects, have found associations. This paper reviews these studies and the methodologic problems inherent in the epidemiologic approach to evaluating environmentally induced germ cell mutagenesis in humans. Epidemiologic studies incorporating newly developed techniques for the detection of mutations and abnormalities in sperm may provide the sensitivity needed to determine precisely the magnitude of risk.
Collapse
Affiliation(s)
- A F Olshan
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| |
Collapse
|
49
|
Roman E, Watson A, Bull D, Baker K. Leukaemia risk and social contact in children aged 0-4 years in southern England. J Epidemiol Community Health 1994; 48:601-2. [PMID: 7830017 PMCID: PMC1060041 DOI: 10.1136/jech.48.6.601] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- E Roman
- ICRF Cancer Epidemiology Unit, Radcliffe Infirmary, Oxford
| | | | | | | |
Collapse
|
50
|
Bithell JF, Dutton SJ, Draper GJ, Neary NM. Distribution of childhood leukaemias and non-Hodgkin's lymphomas near nuclear installations in England and Wales. BMJ (CLINICAL RESEARCH ED.) 1994; 309:501-5. [PMID: 8086902 PMCID: PMC2542713 DOI: 10.1136/bmj.309.6953.501] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To examine the relation between the risk of childhood leukaemia and non-Hodgkin's lymphoma and proximity of residence to nuclear installations in England and Wales. DESIGN Observed and expected numbers of cases were calculated and analysed by standard methods based on ratios of observed to expected counts and by a new statistical test, the linear risk score test, based on ranks and designed to be sensitive to excess incidence in close proximity to a putative source of risk. SETTING Electoral wards within 25 km of 23 nuclear installations and six control sites that had been investigated for suitability for generating stations but never used. SUBJECTS Children below age 15 in England and Wales, 1966-87. MAIN OUTCOME MEASURE Registration of any leukaemia or non-Hodgkin's lymphoma. RESULTS In none of the 25 km circles around the installations was the incidence ratio significantly greater than 1.0. The only significant results for the linear risk score test were for Sellafield (P = 0.00002) and Burghfield (P = 0.031). The circles for Aldermaston and Burghfield overlap; the incidence ratio was 1.10 in each. One of the control sites gave a significant linear risk score test result (P = 0.020). All the tests carried out were one sided with P values estimated by simulation. CONCLUSION There is no evidence of a general increase of childhood leukaemia or non-Hodgkin's lymphoma around nuclear installations. Apart from Sellafield, the evidence for distance related risk is very weak.
Collapse
Affiliation(s)
- J F Bithell
- Department of Statistics, University of Oxford
| | | | | | | |
Collapse
|