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Benítez L, Castro-Barquero S, Crispi F, Youssef L, Crovetto F, Fischer U, Kameri E, Bueno C, Camos M, Menéndez P, Heinäniemi M, Borkhardt A, Gratacós E. Maternal Lifestyle and Prenatal Risk Factors for Childhood Leukemia: A Review of the Existing Evidence. Fetal Diagn Ther 2024; 51:395-410. [PMID: 38710162 DOI: 10.1159/000539141] [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: 02/07/2024] [Accepted: 04/12/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Acute leukemia is the most common pediatric cancer, with an incidence peak at 2-5 years of age. Despite the medical advances improving survival rates, children suffer from significant side effects of treatments as well as its high social and economic impact. The frequent prenatal origin of this developmental disease follows the two-hit carcinogenesis model established in the 70s: a first hit in prenatal life with the creation of genetic fusion lesions or aneuploidy in hematopoietic progenitor/stem cells, and usually a second hit in the pediatric age that converts the preleukemic clone into clinical leukemia. Previous research has mostly focused on postnatal environmental factors triggering the second hit. SUMMARY There is scarce evidence on prenatal risk factors associated with the first hit. Mainly retrospective case-control studies suggested several environmental and lifestyle determinants as risk factors. If these associations could be confirmed, interventions focused on modifying prenatal factors might influence the subsequent risk of leukemia during childhood and reveal unexplored research avenues for the future. In this review, we aim to comprehensively summarize the currently available evidence on prenatal risk factors for the development of childhood leukemia. According to the findings of this review, parental age, ethnicity, maternal diet, folate intake, alcohol consumption, X-ray exposure, pesticides, perinatal infections, and fetal growth may have a significant role in the appearance of preleukemic lesions during fetal life. Other factors such as socioeconomic status, consumption of caffeinated beverages, and smoking consumption have been suggested with inconclusive evidence. Additionally, investigating the association between prenatal factors and genetic lesions associated with childhood leukemia at birth is crucial. Prospective studies evaluating the link between lifestyle factors and genetic alterations could provide indirect evidence supporting new research avenues for leukemia prevention. Maternal diet and lifestyle factors are modifiable determinants associated with adverse perinatal outcomes that could be also related to preleukemic lesions. KEY MESSAGES Parental age, ethnicity, maternal diet, folate intake, alcohol consumption, X-ray exposure, pesticides, perinatal infections, and fetal growth may have a significant role in the appearance of preleukemic lesions during fetal life. Dedicating efforts to studying maternal lifestyle during pregnancy and its association with genetic lesions leading to childhood leukemia could lead to novel prevention strategies.
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Affiliation(s)
- Leticia Benítez
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain,
| | - Sara Castro-Barquero
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Fàtima Crispi
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Lina Youssef
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Josep Carreras Leukemia Research Institute and Department of Biomedicine, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Francesca Crovetto
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ute Fischer
- Department of Pediatric Oncology, Hematology and Clinical Immunology, University Children's Hospital, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, Düsseldorf, Germany
| | - Ersen Kameri
- Department of Pediatric Oncology, Hematology and Clinical Immunology, University Children's Hospital, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Clara Bueno
- Stem Cell Biology, Developmental Leukemia and Immunotherapy Group, Josep Carreras Leukemia Research Institute, Barcelona, Spain
- RICORS-TERAV Network, ISCIII, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Barcelona, Spain
| | - Mireia Camos
- Department of Pediatric Oncology and Hematology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Pablo Menéndez
- Stem Cell Biology, Developmental Leukemia and Immunotherapy Group, Josep Carreras Leukemia Research Institute, Barcelona, Spain
- RICORS-TERAV Network, ISCIII, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Barcelona, Spain
- Department of Biomedicine, School of Medicine, University of Barcelona, Barcelona, Spain
- Instituciò Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Merja Heinäniemi
- Institute of Biomedicine, School of Medicine, University of Finland, Kuopio, Finland
| | - Arndt Borkhardt
- Department of Pediatric Oncology, Hematology and Clinical Immunology, University Children's Hospital, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, Düsseldorf, Germany
| | - Eduard Gratacós
- BCNatal Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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Janitz AE, Marcotte EL, Barr DB, Xu C, Peck JD, Campbell JE. Exposure to persistent organic pollutants in newborn dried blood spots and childhood acute myeloid leukemia. ENVIRONMENTAL RESEARCH 2024; 244:117954. [PMID: 38104918 PMCID: PMC10922559 DOI: 10.1016/j.envres.2023.117954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/21/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
Acute myeloid leukemia (AML) is a rare malignancy representing 15-20% of all leukemia diagnoses among children. Maternal exposure to persistent organic pollutants is suggestive of increased risk for childhood AML based on existing evidence. We aimed to evaluate the relationship between persistent organic pollutants and childhood AML using newborn dried bloodspots (DBS) from the Michigan BioTrust for Health. We obtained data on AML cases diagnosed prior to 15 years of age (n = 130) and controls (n = 130) matched to cases on week of birth from the Michigan Department of Health and Human Services. We quantified levels of dichlorodiphenyldichloroethylene (p,p'-DDE), hexachlorobenzene (HCB), and polybrominated diphenyl ether congener 47 (BDE-47) in newborn DBS. We also evaluated other organochlorine pesticides, polychlorinated biphenyls, polybrominated biphenyl congener 153, and polybrominated diphenyl ethers, though these were not further evaluated as >60% of observations were above the limit of detection for these chemicals. To evaluate the association between each chemical and AML, we used multivariable conditional logistic regression. In our multivariable model of HCB adjusted for month of birth, maternal age at delivery, and area poverty, we observed no association with AML (Odds Ratio [OR] per interquartile range increase: 1.17, 95% CI: 0.80, 1.69). For p,p'-DDE, ORs were significantly lower for those exposed to the highest tertile of p,'p-DDE (≥0.29 pg/mL, OR: 0.32, 95% CI: 0.11, 0.95) compared to the first tertile (<0.09 pg/mL). We observed no statistically significant associations between HCB and BDE-47 and AML. We observed a reduced odds of exposure to p,'p-DDE and an increased, though imprecise, odds of exposure to HCB among AML cases compared to controls. Future studies would benefit from a larger sample of AML patients and pooling newborn DBS across multiple states to allow for additional variability in exposures and evaluation of AML subtypes, which may have differing etiology.
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Affiliation(s)
- Amanda E Janitz
- University of Oklahoma Health Sciences Center, 801 NE 13th St., Oklahoma City, OK, 73104, USA.
| | - Erin L Marcotte
- University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Dana Boyd Barr
- Emory University, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA.
| | - Chao Xu
- University of Oklahoma Health Sciences Center, 801 NE 13th St., Oklahoma City, OK, 73104, USA.
| | - Jennifer D Peck
- University of Oklahoma Health Sciences Center, 801 NE 13th St., Oklahoma City, OK, 73104, USA.
| | - Janis E Campbell
- University of Oklahoma Health Sciences Center, 801 NE 13th St., Oklahoma City, OK, 73104, USA.
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3
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Nguyen A, Crespi CM, Vergara X, Kheifets L. Pesticides as a potential independent childhood leukemia risk factor and as a potential confounder for electromagnetic fields exposure. ENVIRONMENTAL RESEARCH 2023; 238:116899. [PMID: 37598846 DOI: 10.1016/j.envres.2023.116899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Both pesticides and high magnetic fields are suspected to be childhood leukemia risk factors. Pesticides are utilized at commercial plant nurseries, which sometimes occupy the areas underneath high-voltage powerlines. OBJECTIVES To evaluate whether potential pesticide exposures (intended use, chemical class, active ingredient) utilized at plant nurseries act as an independent childhood leukemia risk factor or as a confounder for proximity to, or magnetic fields exposure from, high-voltage powerlines. METHODS We conducted a state-wide records-based case-control study for California with 5788 childhood leukemia cases and 5788 controls that examined specific pesticide use, magnetic field exposures and distances to both powerlines and plant nurseries. Exposure assessment incorporated geographic information systems, aerial satellite images, and other historical information. RESULTS Childhood leukemia risk was potentially elevated for several active pesticide ingredients: permethrin (odds ratio (OR) 1.49, 95% confidence interval (CI) (0.83-2.67), chlorpyrifos (OR 1.29, 95% CI 0.89-1.87), dimethoate (OR 1.79, 95% CI 0.85-3.76), mancozeb (OR 1.41, 95% CI 0.85-2.33), oxyfluorfen (OR 1.41, 95% CI 0.75-2.66), oryzalin (OR 1.60, 95% CI 0.97-2.63), and pendimethalin (OR 1.82, 95% CI 0.81-2.25). Rodenticide (OR 1.42, 95% CI 0.78-2.56) and molluscicide (OR 1.22, 95% CI 0.82-1.81) exposure also presented potentially elevated childhood leukemia risks. Childhood leukemia associations with calculated fields or powerline proximity did not materially change after adjusting for pesticide exposure. Childhood leukemia risks with powerline proximity remained similar when pesticide exposures were excluded. DISCUSSION Pesticide exposure may be an independent childhood leukemia risk factor. Childhood leukemia risks for powerline proximity and magnetic fields exposure were not explained by pesticide exposure.
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Affiliation(s)
- A Nguyen
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA.
| | - C M Crespi
- Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA.
| | - X Vergara
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA.
| | - L Kheifets
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA.
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Ruth AL, Rehman U, Stewart P, Moore LE, Yucel R, Taylor Wilson R. Maternal and Paternal Household Pesticide Exposure During Pregnancy and Risk of Childhood Acute Lymphoblastic Leukemia. J Occup Environ Med 2023; 65:595-604. [PMID: 37015736 PMCID: PMC10464523 DOI: 10.1097/jom.0000000000002859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
OBJECTIVE The aim of this study was to investigate whether risk estimates for childhood acute lymphoblastic leukemia change when restricting model comparison groups to "nonpesticide exposure" (NPE10) households. METHODS Cases ( n = 1810) 15 years or younger were identified through Children's Cancer Group institutions between 1989 and 1993 and age-/sex-matched to controls ( n = 1951). Household pesticide use during pregnancy/month prior was collected via telephone. NPE10 comparison group reporting no parental exposure to 10 pesticide classes was identified. RESULTS Adjusted odds ratios increased from 15% to 49% when limiting the comparison to NPE10. Maternal termite insecticide exposure was associated with greatest risk (adjusted odds ratio, 4.21; 95% confidence interval, 2.00-8.88). There was minimal evidence of interaction by child sex or occupational pesticide exposure, and no monotonic dose-response pattern with frequency of use (times per year). CONCLUSIONS Elevated risks are consistent with published pooled-/meta-analyses and DNA damage. The consistency and magnitude of these associations warrant product labeling, exposure reduction interventions, or both.
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Affiliation(s)
- Alexandra L Ruth
- From the Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, Pennsylvania (A.R., U.R., R.Y., R.T.W.); Stewart Exposure Assessments, LLC, Arlington, Virginia (P.S.); and Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland (L.E.M.)
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Ward MH, Madrigal JM, Jones RR, Friesen MC, Falk RT, Koebel D, Metayer C. Glyphosate in house dust and risk of childhood acute lymphoblastic leukemia in California. ENVIRONMENT INTERNATIONAL 2023; 172:107777. [PMID: 36746112 DOI: 10.1016/j.envint.2023.107777] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Residential use of pesticides has been associated with increased risk of childhood acute lymphoblastic leukemia (ALL). We evaluated determinants of glyphosate concentrations in house dust and estimated ALL risk in the California Childhood Leukemia Study (CCLS). METHODS The CCLS is a population-based case-control study of childhood leukemia in California. Among those < 8-years (no move since diagnosis/reference date), we collected dust (2001-2007) from the room where the child spent the most time while awake and measured > 40 pesticides. Three-to-eight years later, we collected a second sample from non-movers. We used Ultra-Performance Liquid Chromatography Tandem Mass Spectrometry to measure glyphosate (µg/g dust) for 181 ALL cases and 225 controls and for 45 households with a second dust sample. We used multivariable Tobit regression to evaluate determinants of glyphosate concentrations. Odds ratios (ORs) and 95 % confidence intervals (CI) were calculated for ALL and quartiles of the concentration (first samples) using unconditional logistic regression. We computed the within- and between-home variance and intraclass correlation coefficient (ICC). RESULTS Glyphosate was frequently detected (cases: 98 %; controls: 99 %). Higher concentrations were associated with occupational pesticide exposure, nearby agricultural use, treatment for lawn weeds and bees/wasps, and sampling season. Increasing concentrations were not associated with ALL risk (adjusted ORQ4vsQ1 = 0.8, CI: 0.4-1.4). We observed similar null associations for boys and girls, Hispanics and non-Hispanic whites, and among those who resided in their home since birth (76 cases/117 controls) or age two (130 cases/176 controls). The ICC was 0.32 indicating high within-home temporal variability during the years of our study. CONCLUSIONS We observed higher concentrations in homes associated with expected predictors of exposure but no association with childhood ALL risk. Due to continuing use, potential exposure to young children is high. It will be important to evaluate risk in future studies with multiple dust measurements or biomarkers of exposure.
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Affiliation(s)
- Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Dr., Rockville, MD 20850, USA.
| | - Jessica M Madrigal
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Dr., Rockville, MD 20850, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Dr., Rockville, MD 20850, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Dr., Rockville, MD 20850, USA
| | - Roni T Falk
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Dr., Rockville, MD 20850, USA
| | | | - Catherine Metayer
- University of California, Berkeley, School of Public Health, 1995 University Ave, Suite 265, Berkeley, CA 94704, USA
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Khondkaryan L, Andreasyan D, Hakobyan Y, Bankoglu EE, Aroutiounian R, Stopper H, Babayan N. Incidence and Risk Factors of Acute Leukemias in Armenia: A Population-Based Study. Asian Pac J Cancer Prev 2022; 23:3869-3875. [PMID: 36444600 PMCID: PMC9930974 DOI: 10.31557/apjcp.2022.23.11.3869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Leukemia represents a serious public health concern as the incidence is increasing worldwide. In this study we aimed to describe the epidemiological profile of acute lymphoblastic (ALL) and myeloid (AML) leukemia, identify disease clusters and find association with possible risk factors. METHODS Data on leukemia cases were provided by the National Institute of Health of the Republic of Armenia for the period of 2012-2018. Age-standardized incidence rate was calculated using Segi World Population. SaTScan purely spatial analysis was applied to find leukemia clusters. To find association between leukemia and agricultural and mining activities and demographic data Poisson regression model was used. RESULTS During the studied period 259 new cases of ALL and 478 AML were recorded. The age-standardized incidence rate was 1.5 and 1.9 per 100,000 inhabitants with male to female ratio of 0.97 and 1.1 for ALL and AML, respectively. No significant changes in ALL or AML incidence trends were found. For ALL significant cluster encompassing Shirak, Lori, Tavush and Armavir provinces of Armenia was identified, while Kotayk and Ararat was provinces with the highest incidence of AML. We found significant positive association of ALL with crop density, while no elevated risk estimates were found between AML and exposure variables. CONCLUSION Altogether, our results suggested that acute leukemias incidence in Armenia follows the pattern described for developing countries.
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Affiliation(s)
- Lusine Khondkaryan
- Group of Cell Technologies, Institute of Molecular Biology, National Academy of Sciences of RA, Hasratyan Str. 7, 0014, Yerevan, Armenia.
| | - Diana Andreasyan
- Health Analytical Center, National Institute of Health named after academician S. Avdalbekyan of the Ministry of Health RA, Komitas Ave, 49/4, 0051, Yerevan, Armenia.
| | - Yervand Hakobyan
- Hematology and Transfusion Medicine Department, National Institute of Health named after academician S. Avdalbekyan of the Ministry of Health RA, Komitas Ave, 49/4, 0051, Yerevan, Armenia.
| | - Ezgi Eylül Bankoglu
- Department of Toxicology, Institute of Pharmacology and Toxicology, University of Wuerzburg, Versbacher Str. 9, 97078, Wuerzburg, Germany.
| | - Rouben Aroutiounian
- Department of Genetics and Cytology, Yerevan State University, A. Manookyan Str.1, 0025, Yerevan, Armenia.
| | - Helga Stopper
- Department of Toxicology, Institute of Pharmacology and Toxicology, University of Wuerzburg, Versbacher Str. 9, 97078, Wuerzburg, Germany.
| | - Nelly Babayan
- Group of Cell Technologies, Institute of Molecular Biology, National Academy of Sciences of RA, Hasratyan Str. 7, 0014, Yerevan, Armenia. ,Department of Genetics and Cytology, Yerevan State University, A. Manookyan Str.1, 0025, Yerevan, Armenia. ,For Correspondence:
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Nguyen A, Crespi CM, Vergara X, Kheifets L. Commercial outdoor plant nurseries as a confounder for electromagnetic fields and childhood leukemia risk. ENVIRONMENTAL RESEARCH 2022; 212:113446. [PMID: 35550811 DOI: 10.1016/j.envres.2022.113446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Close residential proximity to powerlines and high magnetic fields exposure may be associated with elevated childhood leukemia risks as reported by prior studies and pooled analyses. Magnetic fields exposure from high-voltage powerlines is associated with proximity to these powerlines and consequently with any factor varying with distance. Areas underneath powerlines in California may be sites for commercial plant nurseries that can use pesticides, a potential childhood leukemia risk factor. OBJECTIVES Assess if potential pesticide exposure from commercial plant nurseries is a confounder or interacts with proximity or magnetic fields exposure from high-voltage powerlines to increase childhood leukemia risk. METHODS A comprehensive childhood leukemia record-based case-control study with 5788 cases and 5788 controls (born and diagnosed in California, 1986-2008) was conducted. Pesticide, powerline, and magnetic field exposure assessment utilized models that incorporated geographical information systems, aerial satellite images, site visits and other historical information. RESULTS The relationship for calculated fields with childhood leukemia (odds ratio (OR) 1.51, 95% confidence interval (CI) 0.70-3.23) slightly attenuated when controlling for nursery proximity (OR 1.43, 95% CI 0.65-3.16) or restricting analysis to subjects living far (>300 m) from nurseries (OR 1.43, 95% CI 0.79-2.60). A similar association pattern was observed between distance to high-voltage powerlines and childhood leukemia. The association between nursery proximity and childhood leukemia was unchanged or only slightly attenuated when controlling for calculated fields or powerline distance; ORs remained above 2 when excluding subjects with high calculated fields or close powerline proximity (OR 2.16, 95% CI 0.82-5.67 and OR 2.15, 95% CI 0.82-5.64, respectively). The observed relationships were robust to different time periods, reference categories, and cut points. DISCUSSION Close residential proximity to nurseries is suggested as an independent childhood leukemia risk factor. Our results do not support plant nurseries as an explanation for observed childhood leukemia risks for powerline proximity and magnetic fields exposure, although small numbers of subjects concurrently exposed to high magnetic fields, close powerline proximity and plant nurseries limited our ability to fully assess potential confounding.
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Affiliation(s)
- A Nguyen
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA.
| | - C M Crespi
- Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA.
| | - X Vergara
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA.
| | - L Kheifets
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA.
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Iqbal S, Ali S, Ali I. Maternal pesticide exposure and its relation to childhood cancer: an umbrella review of meta-analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1609-1627. [PMID: 33745400 DOI: 10.1080/09603123.2021.1900550] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
This umbrella review summarizes the available meta-analyses elucidating the effects of maternal pesticide exposure on adverse health outcomes in children particularly the risk of childhood cancer. A literature search was conducted on PubMed and Scopus with 10-years temporal restriction and with search terms of ('pesticides') and ('maternal' or 'pregnancy' or 'gestational' or 'perinatal' or 'children' or 'infants' or 'birth weight' or 'gestational age' or 'cancer' or 'tumor' or 'malignancy' or 'carcinoma') and ('meta-analysis' or 'systematic review'). Using relative risk estimates, e.g., odds ratio (OR), relative risk (RR), ß coefficients, and 95% confidence interval (CI) as a prerequisite for inclusion/exclusion criteria a total of 19 eligible meta-analyses were included. The results showed that maternal domestic/occupational pesticide exposure increases the risk for childhood leukaemia. The overall OR regarding the risk of pesticide exposure and leukaemia was 1.23 to 1.57 with heterogeneity I2 values that varied between 12.9% and 73%. Some studies found that exposure to dichlorodiphenyldichloroethylene (p,p´-DDE) and polychlorinated biphenyls (PCB-153) pesticides appears to decrease infant birth weight to some extent [p,p´-DDE (ß = -0.007 to -0.008)] and [PCB-153 (ß = -0.15 to -0.17)]Needing more studies on this relationship, our study found that pesticide exposure is a risk factor for leukaemia in children.
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Affiliation(s)
- Sehar Iqbal
- Department of Environmental Health, Centre for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Nutrition and Dietetics, National University of Medical Sciences, Rawalpindi, Islamabad
| | - Shahbaz Ali
- Department of Anthropology, PMAS-Arid Agriculture University Rawalpindi, Pakistan
| | - Inayat Ali
- Department of Social and Cultural Anthropology, University of Vienna, Vienna, Austria
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Rashed WM, Marcotte EL, Spector LG. Germline De Novo Mutations as a Cause of Childhood Cancer. JCO Precis Oncol 2022; 6:e2100505. [PMID: 35820085 DOI: 10.1200/po.21.00505] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Germline de novo mutations (DNMs) represent one of the important topics that need extensive attention from epidemiologists, geneticists, and other relevant stakeholders. Advances in next-generation sequencing technologies allowed examination of parent-offspring trios to ascertain the frequency of germline DNMs. Many epidemiological risk factors for childhood cancer are indicative of DNMs as a mechanism. The aim of this review was to give an overview of germline DNMs, their causes in general, and to discuss their relation to childhood cancer risk. In addition, we highlighted existing gaps in knowledge in many topics of germline DNMs in childhood cancer that need exploration and collaborative efforts.
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Affiliation(s)
- Wafaa M Rashed
- Research Department, Children's Cancer Hospital-Egypt 57357 (CCHE-57357), Cairo, Egypt
| | - Erin L Marcotte
- Division of Epidemiology/Clinical, Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Logan G Spector
- Division of Epidemiology/Clinical, Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN
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Onyije FM, Olsson A, Baaken D, Erdmann F, Stanulla M, Wollschläger D, Schüz J. Environmental Risk Factors for Childhood Acute Lymphoblastic Leukemia: An Umbrella Review. Cancers (Basel) 2022; 14:382. [PMID: 35053543 PMCID: PMC8773598 DOI: 10.3390/cancers14020382] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 02/05/2023] Open
Abstract
Leukemia is the most common type of cancer among children and adolescents worldwide. The aim of this umbrella review was (1) to provide a synthesis of the environmental risk factors for the onset of childhood acute lymphoblastic leukemia (ALL) by exposure window, (2) evaluate their strength of evidence and magnitude of risk, and as an example (3) estimate the prevalence in the German population, which determines the relevance at the population level. Relevant systematic reviews and pooled analyses were identified and retrieved through PubMed, Web of Science databases and lists of references. Only two risk factors (low doses of ionizing radiation in early childhood and general pesticide exposure during maternal preconception/pregnancy) were convincingly associated with childhood ALL. Other risk factors including extremely low frequency electromagnetic field (ELF-MF), living in proximity to nuclear facilities, petroleum, benzene, solvent, and domestic paint exposure during early childhood, all showed some level of evidence of association. Maternal consumption of coffee (high consumption/>2 cups/day) and cola (high consumption) during pregnancy, paternal smoking during the pregnancy of the index child, maternal intake of fertility treatment, high birth weight (≥4000 g) and caesarean delivery were also found to have some level of evidence of association. Maternal folic acid and vitamins intake, breastfeeding (≥6 months) and day-care attendance, were inversely associated with childhood ALL with some evidence. The results of this umbrella review should be interpreted with caution; as the evidence stems almost exclusively from case-control studies, where selection and recall bias are potential concerns, and whether the empirically observed association reflect causal relationships remains an open question. Hence, improved exposure assessment methods including accurate and reliable measurement, probing questions and better interview techniques are required to establish causative risk factors of childhood leukemia, which is needed for the ultimate goal of primary prevention.
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Affiliation(s)
- Felix M. Onyije
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, CEDEX 08, 69372 Lyon, France; (A.O.); (F.E.); (J.S.)
| | - Ann Olsson
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, CEDEX 08, 69372 Lyon, France; (A.O.); (F.E.); (J.S.)
| | - Dan Baaken
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Langenbeckstraβe 1, 55131 Mainz, Germany; (D.B.); (D.W.)
| | - Friederike Erdmann
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, CEDEX 08, 69372 Lyon, France; (A.O.); (F.E.); (J.S.)
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Langenbeckstraβe 1, 55131 Mainz, Germany; (D.B.); (D.W.)
| | - Martin Stanulla
- Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany;
| | - Daniel Wollschläger
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Langenbeckstraβe 1, 55131 Mainz, Germany; (D.B.); (D.W.)
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, CEDEX 08, 69372 Lyon, France; (A.O.); (F.E.); (J.S.)
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Negrete-Bolagay D, Zamora-Ledezma C, Chuya-Sumba C, De Sousa FB, Whitehead D, Alexis F, Guerrero VH. Persistent organic pollutants: The trade-off between potential risks and sustainable remediation methods. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 300:113737. [PMID: 34536739 DOI: 10.1016/j.jenvman.2021.113737] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 06/13/2023]
Abstract
Persistent Organic Pollutants (POPs) have become a very serious issue for the environment because of their toxicity, resistance to conventional degradation mechanisms, and capacity to bioconcentrate, bioaccumulate and biomagnify. In this review article, the safety, regulatory, and remediation aspects of POPs including aromatic, chlorinated, pesticides, brominated, and fluorinated compounds, are discussed. Industrial and agricultural activities are identified as the main sources of these harmful chemicals, which are released to air, soil and water, impacting on social and economic development of society at a global scale. The main types of POPs are presented, illustrating their effects on wildlife and human beings, as well as the ways in which they contaminate the food chain. Some of the most promising and innovative technologies developed for the removal of POPs from water are discussed, contrasting their advantages and disadvantages with those of more conventional treatment processes. The promising methods presented in this work include bioremediation, advanced oxidation, ionizing radiation, and nanotechnology. Finally, some alternatives to define more efficient approaches to overcome the impacts that POPs cause in the hydric sources are pointed out. These alternatives include the formulation of policies, regulations and custom-made legislation for controlling the use of these pollutants.
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Affiliation(s)
- Daniela Negrete-Bolagay
- School of Biological Sciences and Engineering, Yachay Tech University, 100119, Urcuquí, Ecuador.
| | - Camilo Zamora-Ledezma
- Tissue Regeneration and Repair: Orthobiology, Biomaterials & Tissue Engineering Research Group, UCAM - Universidad Católica de Murcia, Avda. Los Jerónimos 135, Guadalupe, 30107, Murcia, Spain.
| | - Cristina Chuya-Sumba
- School of Biological Sciences and Engineering, Yachay Tech University, 100119, Urcuquí, Ecuador.
| | - Frederico B De Sousa
- Laboratório de Sistemas Poliméricos e Supramoleculares, Physics and Chemistry Institute, Federal University of Itajubá, 37500-903, Itajubá, Brazil.
| | - Daniel Whitehead
- Department of Chemistry, Clemson University, Clemson, SC, 29634, USA.
| | - Frank Alexis
- School of Biological Sciences and Engineering, Yachay Tech University, 100119, Urcuquí, Ecuador.
| | - Victor H Guerrero
- Department of Materials, Escuela Politécnica Nacional, Ladrón de Guevara E11-253, Quito, 170525, Ecuador.
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12
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Luitjens J, Baur-Melnyk A. [Skeletal manifestations of systemic hematologic disorders]. Radiologe 2021; 61:1068-1077. [PMID: 34820696 DOI: 10.1007/s00117-021-00934-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bone marrow consists of connective tissue and stem cells, which generate blood cells. This includes erythropoiesis, leukopoiesis and thrombopoiesis. Thus, hematologic disorders first affect the bone marrow and secondarily the blood. METHODS Bone marrow changes can be sensitively detected using magnetic resonance imaging (MRI) and often represent the initial manifestation of the underlying disease. With longer duration of disease, changes can also be found on X‑ray or computed tomography (CT). RESULTS The findings on MRI and X‑ray/CT are often nonspecific and can only be interpreted in the context of clinical information. CONCLUSION In the following article, we provide a brief overview of the clinical manifestations and imaging changes to be expected in leukemia, anemia, and chronic myeloproliferative disorders.
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Affiliation(s)
- J Luitjens
- Klinik und Poliklinik für Radiologie, Klinikum der Universität München, LMU München, Marchioninistr. 15, 81377, München, Deutschland
| | - A Baur-Melnyk
- Klinik und Poliklinik für Radiologie, Klinikum der Universität München, LMU München, Marchioninistr. 15, 81377, München, Deutschland.
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Rodriguez-Cortez VC, Navarrete-Meneses MP, Molina O, Velasco-Hernandez T, Gonzalez J, Romecin P, Gutierrez-Aguera F, Roca-Ho H, Vinyoles M, Kowarz E, Marin P, Rodriguez-Perales S, Gomez-Marin C, Perez-Vera P, Cortes-Ledesma F, Bigas A, Terron A, Bueno C, Menendez P. The insecticides permethrin and chlorpyriphos show limited genotoxicity and no leukemogenic potential in human and murine hematopoietic stem progenitor cells. Haematologica 2021; 107:544-549. [PMID: 34706497 PMCID: PMC8804580 DOI: 10.3324/haematol.2021.279047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Virginia C Rodriguez-Cortez
- Josep Carreras Leukemia Research Institute. Department of Biomedicine. School of Medicine, University of Barcelona. Barcelona.
| | - Maria Pilar Navarrete-Meneses
- Laboratorio de Genetica y Cancer, Departamento de Genetica Humana, Instituto Nacional de Pediatria, Ciudad de Mexico
| | - Oscar Molina
- Josep Carreras Leukemia Research Institute. Department of Biomedicine. School of Medicine, University of Barcelona. Barcelona
| | - Talia Velasco-Hernandez
- Josep Carreras Leukemia Research Institute. Department of Biomedicine. School of Medicine, University of Barcelona. Barcelona
| | - Jessica Gonzalez
- Cancer Research Program, Institut Hospital del Mar d'Investigacions Mediques, Hospital del Mar, Barcelona
| | - Paola Romecin
- Josep Carreras Leukemia Research Institute. Department of Biomedicine. School of Medicine, University of Barcelona. Barcelona
| | - Francisco Gutierrez-Aguera
- Josep Carreras Leukemia Research Institute. Department of Biomedicine. School of Medicine, University of Barcelona. Barcelona
| | - Heleia Roca-Ho
- Josep Carreras Leukemia Research Institute. Department of Biomedicine. School of Medicine, University of Barcelona. Barcelona
| | - Meritxell Vinyoles
- Josep Carreras Leukemia Research Institute. Department of Biomedicine. School of Medicine, University of Barcelona. Barcelona
| | - Eric Kowarz
- Institute of Pharmaceutical Biology/DCAL, Goethe-University of Frankfurt, Biocenter, Max-von-Laue-Str. 9, D-60438, Frankfurt/Main
| | - Pedro Marin
- Hematology Department. Hospital Clinic de Barcelona
| | - Sandra Rodriguez-Perales
- Molecular Cytogenetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Center (CNIO), Madrid
| | - Carlos Gomez-Marin
- Topology and DNA breaks Group, Spanish National Cancer Center (CNIO), Madrid
| | - Patricia Perez-Vera
- Laboratorio de Genetica y Cancer, Departamento de Genetica Humana, Instituto Nacional de Pediatria, Ciudad de Mexico
| | | | - Anna Bigas
- Josep Carreras Leukemia Research Institute. Department of Biomedicine. School of Medicine, University of Barcelona. Barcelona, Spain; Cancer Research Program, Institut Hospital del Mar d'Investigacions Mediques, Hospital del Mar, Barcelona, Spain; Centro de Investigacion Biomedica en Red-Oncologia (CIBERONC)
| | | | - Clara Bueno
- Josep Carreras Leukemia Research Institute. Department of Biomedicine. School of Medicine, University of Barcelona. Barcelona, Spain; Centro de Investigacion Biomedica en Red-Oncologia (CIBERONC)
| | - Pablo Menendez
- Josep Carreras Leukemia Research Institute. Department of Biomedicine. School of Medicine, University of Barcelona. Barcelona, Spain; Centro de Investigacion Biomedica en Red-Oncologia (CIBERONC); Institucio Catalana de Recerca i Estudis Avancats (ICREA), Barcelona.
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Madrigal JM, Jones RR, Gunier RB, Whitehead TP, Reynolds P, Metayer C, Ward MH. Residential exposure to carbamate, organophosphate, and pyrethroid insecticides in house dust and risk of childhood acute lymphoblastic leukemia. ENVIRONMENTAL RESEARCH 2021; 201:111501. [PMID: 34139223 PMCID: PMC8478811 DOI: 10.1016/j.envres.2021.111501] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/02/2021] [Accepted: 06/07/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND Self-reported residential use of pesticides has consistently been associated with increased risk of childhood leukemia. However, these studies were limited in their ability to identify specific insecticide active ingredients that were associated with risk. OBJECTIVE We used household carpet dust measurements of 20 insecticides (two carbamate, 10 organophosphate, two organochlorine, and six pyrethroid) as indicators of exposure and evaluated associations with the risk of childhood acute lymphoblastic leukemia (ALL). METHODS We conducted a population-based case-control study of 252 ALL cases diagnosed from 1999 to 2007 and 306 birth certificate controls from 35 counties in Central and Northern California. Carpet dust was collected at a second interview (2001-2007) for cases who had not moved since diagnosis (comparable reference date for controls) using a specialized vacuum cleaner in the room where the child spent most of their time or from the household vacuum. Insecticides were categorized as detected (yes/no), or as tertiles or quartiles of their distributions among controls. We calculated odds ratios (OR) and 95% confidence intervals (CI) using unconditional logistic regression adjusting for demographic characteristics, interview year, and season of dust collection. RESULTS Permethrin, chlorpyrifos, diazinon, and carbaryl were the most frequently detected insecticide active ingredients. When we compared the highest quartile to the lowest or to non-detections, there was no association with ALL for permethrin (OR Q4 vs. Q1 = 0.81; 95% CI 0.50-1.31), carbaryl (OR Q4 vs. non-detects = 0.61, 95% CI 0.34-1.08) or chlorpyrifos (OR Q4 vs. Q1 = 0.60; 95% CI 0.36-1.00). The highest quartile of diazinon concentration was inversely associated with risk in the single pesticide model but without a monotonic exposure-response (p-trend = 0.14). After adjusting for other common insecticides, the OR was not significant (OR Q4 vs. Q1 = 0.58; 95% CI 0.33-1.05). None of the other insecticides were associated with risk. CONCLUSION Our results should be interpreted within the limitations of the case-control study design including the use of a single post-diagnosis dust sample and restriction to residentially stable participants, which may have resulted in selection bias. Although difficult to implement, additional studies with assessment of exposure to insecticide active and non-active ingredients are necessary to elucidate the role of these common exposures in childhood leukemia risk.
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Affiliation(s)
- Jessica M Madrigal
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Dr., Rockville, MD, 20850, USA.
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Dr., Rockville, MD, 20850, USA
| | - Robert B Gunier
- Center for Environmental Research and Children's Health (CERCH), University of California, School of Public Health, 1995 University Ave., Suite 265, Berkeley, CA, 94704, USA
| | - Todd P Whitehead
- University of California, School of Public Health, 1995 University Ave., Suite 460, Berkeley, CA, 94704, USA
| | - Peggy Reynolds
- University of California, Department of Epidemiology and Biostatistics, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, USA
| | - Catherine Metayer
- University of California, School of Public Health, 1995 University Ave., Suite 460, Berkeley, CA, 94704, USA
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Dr., Rockville, MD, 20850, USA
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15
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Stayner LT, Schullehner J, Semark BD, Jensen AS, Trabjerg BB, Pedersen M, Olsen J, Hansen B, Ward MH, Jones RR, Coffman VR, Pedersen CB, Sigsgaard T. Exposure to nitrate from drinking water and the risk of childhood cancer in Denmark. ENVIRONMENT INTERNATIONAL 2021; 155:106613. [PMID: 33965769 DOI: 10.1016/j.envint.2021.106613] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/24/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There is limited evidence that nitrate, a common contaminant in drinking water, increases the risk of childhood cancers. Our objective was to examine this association in Denmark. METHODS We conducted a nationwide case-control study based on all singletons liveborn to Danish-born parents from 1991 to 2015 (N = 1,219,140) that included 596 leukemias, 180 lymphomas, and 310 central nervous system cancers (CNC) who were ≤15 years of age at diagnosis and were identified from the Danish Cancer Registry. Approximately 100 controls were randomly selected and matched to each case on date of birth and sex. Nitrate measurements in public water systems were linked with an address registry to estimate individual average nitrate concentrations during preconception, prenatal, and postnatal periods. Odd ratios (OR) and 95% confidence intervals (95%CI) were estimated using conditional logistic regression controlling for the matching variables, and birth order, birthweight, urbanicity, maternal education, employment, income and smoking, and parental age. RESULTS There was no evidence of an association of nitrate with leukemia or lymphoma. An association between CNC and the highest category of nitrate exposure (>25 mg/L nitrate) was observed for preconception (OR = 1.82, 95%CI:1.09 to 3.04), prenatal (OR = 1.65, 95%CI:0.97 to 2.81), and postnatal exposure (OR = 1.48, 95%CI:0.82 to 2.68) in fully adjusted models. There was also some evidence of an exposure-response in models of continuous nitrate exposure and CNC. CONCLUSIONS Our findings provide some evidence that exposure to nitrate from drinking water may increase the risk of childhood CNC cancer, but not leukemia or lymphoma.
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Affiliation(s)
- Leslie T Stayner
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, USA.
| | - Jörg Schullehner
- Department of Groundwater and Quaternary Geology Mapping, Geological Survey of Denmark and Greenland, Aarhus, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Birgitte Dige Semark
- Department of Economics and Business Economics, National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
| | | | - Betina B Trabjerg
- Department of Economics and Business Economics, National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
| | - Marie Pedersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jørn Olsen
- Aarhus University Hospital, Department of Clinical Epidemiology, Aarhus, Denmark
| | - Birgitte Hansen
- Department of Groundwater and Quaternary Geology Mapping, Geological Survey of Denmark and Greenland, Aarhus, Denmark
| | - Mary H Ward
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, Rockville, MD, United States
| | - Rena R Jones
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, Rockville, MD, United States
| | - Vanessa R Coffman
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, USA
| | - Carsten B Pedersen
- Department of Economics and Business Economics, National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark; Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
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Karalexi MA, Tagkas CF, Markozannes G, Tseretopoulou X, Hernández AF, Schüz J, Halldorsson TI, Psaltopoulou T, Petridou ET, Tzoulaki I, Ntzani EE. Exposure to pesticides and childhood leukemia risk: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 285:117376. [PMID: 34380208 DOI: 10.1016/j.envpol.2021.117376] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/16/2021] [Accepted: 05/12/2021] [Indexed: 06/13/2023]
Abstract
Despite the abundance of epidemiological evidence concerning the association between pesticide exposure and adverse health outcomes including acute childhood leukemia (AL), evidence remains inconclusive, and is inherently limited by heterogeneous exposure assessment and multiple statistical testing. We performed a literature search of peer-reviewed studies, published until January 2021, without language restrictions. Summary odds ratios (OR) and 95% confidence intervals (CI) were derived from stratified random-effects meta-analyses by type of exposure and outcome, exposed populations and window of exposure to address the large heterogeneity of existing literature. Heterogeneity and small-study effects were also assessed. We identified 55 eligible studies (n = 48 case-control and n = 7 cohorts) from over 30 countries assessing >200 different exposures of pesticides (n = 160,924 participants). The summary OR for maternal environmental exposure to pesticides (broad term) during pregnancy and AL was 1.88 (95%CI: 1.15-3.08), reaching 2.51 for acute lymphoblastic leukemia (ALL; 95%CI: 1.39-4.55). Analysis by pesticide subtype yielded an increased risk for maternal herbicide (OR: 1.41, 95%CI: 1.00-1.99) and insecticide (OR: 1.60, 95%CI: 1.11-2.29) exposure during pregnancy and AL without heterogeneity (p = 0.12-0.34). Meta-analyses of infant leukemia were only feasible for maternal exposure to pesticides during pregnancy. Higher magnitude risks were observed for maternal pesticide exposure and infant ALL (OR: 2.18, 95%CI: 1.44-3.29), and the highest for infant acute myeloid leukemia (OR: 3.42, 95%CI: 1.98-5.91). Overall, the associations were stronger for maternal exposure during pregnancy compared to childhood exposure. For occupational or mixed exposures, parental, and specifically paternal, pesticide exposure was significantly associated with increased risk of AL (ORparental: 1.75, 95%CI: 1.08-2.85; ORpaternal: 1.20, 95%CI: 1.07-1.35). The epidemiological evidence, supported by mechanistic studies, suggests that pesticide exposure, mainly during pregnancy, increases the risk of childhood leukemia, particularly among infants. Sufficiently powered studies using repeated biomarker analyses are needed to confirm whether there is public health merit in reducing prenatal pesticide exposure.
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Affiliation(s)
- Maria A Karalexi
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 45110, Greece
| | - Christos F Tagkas
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 45110, Greece
| | - Georgios Markozannes
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 45110, Greece
| | - Xanthippi Tseretopoulou
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 45110, Greece; Department of Pediatric Endocrinology, Addenbrooke's Hospital, Cambridge, UK
| | - Antonio F Hernández
- Department of Legal Medicine and Toxicology, School of Medicine, University of Granada, Avenida de La Investigación 11, 18016, Granada, Spain
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - Thorhallur I Halldorsson
- Unit for Nutrition Research, Landspitali, The National University Hospital of Iceland and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Eiriksgata 29, 101, Reykjavik, Iceland; Department of Epidemiology Research, Centre for Fetal Programming, Statens Serum Institut, 5, Artillerivej, 2300, Copenhagen S, Denmark
| | - Theodora Psaltopoulou
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Tzoulaki
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 45110, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Evangelia E Ntzani
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 45110, Greece; Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI, USA; Institute of Biosciences, University Research Center of Loannina, University of Ioannina, Ioannina, Greece.
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Cazzolla Gatti R. Why We Will Continue to Lose Our Battle with Cancers If We Do Not Stop Their Triggers from Environmental Pollution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6107. [PMID: 34198930 PMCID: PMC8201328 DOI: 10.3390/ijerph18116107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/21/2021] [Accepted: 06/01/2021] [Indexed: 12/11/2022]
Abstract
Besides our current health concerns due to COVID-19, cancer is a longer-lasting and even more dramatic pandemic that affects almost a third of the human population worldwide. Most of the emphasis on its causes has been posed on genetic predisposition, chance, and wrong lifestyles (mainly, obesity and smoking). Moreover, our medical weapons against cancers have not improved too much during the last century, although research is in progress. Once diagnosed with a malignant tumour, we still rely on surgery, radiotherapy, and chemotherapy. The main problem is that we have focused on fighting a difficult battle instead of preventing it by controlling its triggers. Quite the opposite, our knowledge of the links between environmental pollution and cancer has surged from the 1980s. Carcinogens in water, air, and soil have continued to accumulate disproportionally and grow in number and dose, bringing us to today's carnage. Here, a synthesis and critical review of the state of the knowledge of the links between cancer and environmental pollution in the three environmental compartments is provided, research gaps are briefly discussed, and some future directions are indicated. New evidence suggests that it is relevant to take into account not only the dose but also the time when we are exposed to carcinogens. The review ends by stressing that more dedication should be put into studying the environmental causes of cancers to prevent and avoid curing them, that the precautionary approach towards environmental pollutants must be much more reactionary, and that there is an urgent need to leave behind the outdated petrochemical-based industry and goods production.
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Affiliation(s)
- Roberto Cazzolla Gatti
- Konrad Lorenz Institute for Evolution and Cognition Research, 3400 Klosterneuburg, Austria;
- Biological Institute, Tomsk State University, 634050 Tomsk, Russia
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A Critical Review of the Status of Pesticide Exposure Management in Malawi. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186727. [PMID: 32942751 PMCID: PMC7557847 DOI: 10.3390/ijerph17186727] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 12/04/2022]
Abstract
Pesticides pose a significant risk to humans and the environment. This paper analyzes the measures used to manage pesticides in Malawi. Malawi’s regulatory authority of pesticides, the Pesticides Control Board (PCB), faces a number of challenges including lack of facilities for analyzing pesticides and inadequate personnel to conduct risk assessment of pesticides. The PCB needs to provide access to information and opportunities among the public to make contributions regarding requirements, processes and policies for assessing pesticide risk and efficacy. There is also a need to enhance the capacity of PCB to assess pesticide poisoning in workers, monitor pesticide residues in food and environmental contamination, as well as to control the illegal importation and sale of pesticides. Just like in other countries such as South Africa, India and Sri Lanka, Malawi urgently needs to implement measures that can restrict the importation, production, sale and use of very toxic pesticides. Malawi also needs to develop measures for the effective management of pesticide waste containers as well as obsolete pesticides, where potential solutions include reducing the purchase of (unneeded) pesticides, treatment of obsolete pesticides in high-temperature cement kilns, as well as requesting pesticide dealers to adopt life-cycle management of their products.
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19
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Rio Birth Cohort Study on Environmental Exposure and Childhood Development - PIPA Project. Ann Glob Health 2020; 86:59. [PMID: 32566487 PMCID: PMC7292139 DOI: 10.5334/aogh.2709] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background/Objective: As a developing country, Brazil presents a wide range of environmental risks that can constitute hazards to child health. The country also presents different socio-economic-cultural conditions that could be responsible for determining different vulnerability and susceptibility levels for the population, which can potentiate the effects of the environmental pollutants. The Rio Birth Cohort Study (PIPA project) is a prospective maternal-infant health study, hosted in the city of Rio de Janeiro (Southeastern Brazil), designed to investigate separate and combined effects of environmental chemical pollutants, as well as the interactions between these exposures and sociocultural environment and epigenetic patterns. This paper presents the learned lessons and strategies to address the shortcomings detected from this pilot study. Methods: The study population will be all children born at the Federal University of Rio de Janeiro Maternity Hospital from July 1st, 2020 to June 30th, 2021. The estimated population is of 2,500 children. The study will collect social, demographic, and health information from pregnant women and their children up to four years of age. Biological samples from both mothers and newborns will be collected to assess metal, pesticide and plasticizer exposure. All newborns will have their landmarks of physical, neurological, psychological, and cognitive development recorded at specific ages. Findings: A pilot study was carried out between September 2017 and August 2018, totaling 142 enrolled pregnant women, leading to 135 (95%) births and the collection of umbilical cord (126–93%,) and mother (139–98%) blood samples, as well as both mother (142–100%) and newborn (54–40%) urine samples and newborn meconium samples (117–86.7%). Conclusions: The study proposes a comprehensive assessment of pre- and postnatal exposure to environmental chemicals at multiple time points in a population living in a highly urbanized developing country. As far as we know, this is the only birth cohort in Brazil specifically designed for this purpose.
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Lupo PJ, Spector LG. Cancer Progress and Priorities: Childhood Cancer. Cancer Epidemiol Biomarkers Prev 2020; 29:1081-1094. [DOI: 10.1158/1055-9965.epi-19-0941] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 12/18/2019] [Accepted: 03/09/2020] [Indexed: 11/16/2022] Open
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Segal TR, Giudice LC. Before the beginning: environmental exposures and reproductive and obstetrical outcomes. Fertil Steril 2020; 112:613-621. [PMID: 31561863 DOI: 10.1016/j.fertnstert.2019.08.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/02/2019] [Accepted: 08/05/2019] [Indexed: 12/21/2022]
Abstract
There is growing consensus that preconception exposure to environmental toxins can adversely affect fertility, pregnancy, and fetal development, which may persist into the neonatal and adult periods and potentially have multigenerational effects. Here we review current data on preconception and prenatal exposure to several chemicals, including heavy metals, endocrine-disrupting chemicals, pesticides, and air pollution, and their associated obstetrical and reproductive health effects. Reproductive endocrinologists and affiliated health care providers have a unique opportunity to counsel patients before they get pregnant to minimize exposure to hazardous chemicals with the goal to improve reproductive outcomes and assure a healthy lifestyle overall. We provide practical tools and some publicly available resources for reproductive health professionals to assess a patient's risks and ways to reduce chemical and air pollution exposures during the critical preconception and prenatal periods.
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Affiliation(s)
- Thalia R Segal
- Center for Reproductive Health, University of California, San Francisco, California.
| | - Linda C Giudice
- Center for Reproductive Health, University of California, San Francisco, California
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Park AS, Ritz B, Yu F, Cockburn M, Heck JE. Prenatal pesticide exposure and childhood leukemia - A California statewide case-control study. Int J Hyg Environ Health 2020; 226:113486. [PMID: 32087503 DOI: 10.1016/j.ijheh.2020.113486] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 01/17/2020] [Accepted: 02/10/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND A number of epidemiologic studies with a variety of exposure assessment approaches have implicated pesticides as risk factors for childhood cancers. Here we explore the association of pesticide exposure in pregnancy and early childhood with childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) utilizing land use and pesticide use data in a sophisticated GIS tool. METHODS We identified cancer cases less than 6 years of age from the California Cancer Registry and cancer-free controls from birth certificates. Analyses were restricted to those living in rural areas and born 1998-2011, resulting in 162 cases of childhood leukemia and 9,805 controls. Possible carcinogens were selected from the Environmental Protection Agency's classifications and pesticide use was collected from the California Department of Pesticide Regulation's (CDPR) Pesticide Use Reporting (PUR) system and linked to land-use surveys. Exposures for subjects were assessed using a 4000m buffer around the geocoded residential addresses at birth. Unconditional logistic and hierarchical regression models were used to assess individual pesticide and pesticide class associations. RESULTS We observed elevated risks for ALL with exposure to any carcinogenic pesticide (adjusted Odds Ratio (aOR): 2.83, 95% CI: 1.67-4.82), diuron (Single-pesticide model, adjusted (OR): 2.38, 95% CI: 1.57-3.60), phosmet (OR: 2.10, 95% CI: 1.46-3.02), kresoxim-methyl (OR: 1.77, 95% CI: 1.14-2.75), and propanil (OR: 2.58, 95% CI: 1.44-4.63). Analyses based on chemical classes showed elevated risks for the group of 2,6-dinitroanilines (OR: 2.50, 95% CI: 1.56-3.99), anilides (OR: 2.16, 95% CI: 1.38-3.36), and ureas (OR: 2.18, 95% CI: 1.42-3.34). CONCLUSION Our findings suggest that in rural areas of California exposure to certain pesticides or pesticide classes during pregnancy due to residential proximity to agricultural applications may increase the risk of childhood ALL and AML. Future studies into the mechanisms of carcinogenicity of these pesticides may be beneficial.
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Affiliation(s)
- Andrew S Park
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Fei Yu
- Department of Biostatistics, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001, N. Soto Street, Suite 318-A, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA; Jonsson Comprehensive Cancer Center, University of California, Box 951781, Los Angeles, CA, 90095-1781, USA.
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Hernandez M, Hernández-Valero MA, García-Prieto C, Patterson DG, Hajek RA, Recinos I, Lopez DS, Li Y, Jones LA, Hawk E. A Pilot Study Evaluating Organochlorine and Organophosphate Pesticide Exposure in Children and Adolescents of Mexican Descent Residing in Hidalgo County, Texas. J Immigr Minor Health 2020; 21:751-760. [PMID: 30066057 DOI: 10.1007/s10903-018-0791-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Children and adolescents of Mexican descent residing in Hidalgo County (TX) were evaluated for exposure to organochlorine (OC) and organophosphate (OP) pesticides. A convenience sample of 60 participants enrolled in our pilot study. The lipid-adjusted serum concentrations of nine OC metabolites and creatinine-adjusted urinary concentrations of six OP metabolites were measured and compared with data from the Centers for Disease Control and Prevention's Fourth Report on Human Exposure to Environmental Chemicals. Descriptive statistics were used to summarize the concentration levels for each metabolite. Study participants were aged 5-18 years. For most of the OC and OP metabolites, our findings showed that participants had concentration levels within the distributional range of the national data. However, notable outlying levels (greater than the 95th percentile in the Fourth Report) were identified for the following OC metabolites: gamma-hexachlorocyclohexane, p,p'-dichlorodiphenyldichloroethene, and p,p'-dichlorodiphenyltrichloroethane. Among the children aged 5-11 years, one child had an outlying value for the OP metabolite: dimethylphosphate. Our findings on the levels of OC and OP pesticide exposure enhances the credibility of national estimates, and can serve as baselines for children and adolescents of Mexican descent residing in Lower Rio Grande Valley. Furthermore, our study contributes to the lacunae of knowledge regarding environmental exposures and presses further investigation of outlying OC and OP exposure levels.
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Affiliation(s)
- Mike Hernandez
- Department of Biostatistics, Unit 1411, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - María A Hernández-Valero
- Health Program, Department of Education Psychology, College of Education, University of Houston, 4800 Calhoun Rd., Houston, TX, 77204, USA
| | - Celia García-Prieto
- Department of Translational Molecular Pathology, Unit 2951, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Donald G Patterson
- Axys Analytical Services Ltd., 2045 Mills Road West, Sidney, BC, V8LL 5X2, Canada
| | - Richard A Hajek
- Gynecologic Oncology & Reproductive Medicine, Unit 1362, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Iris Recinos
- Institute of Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
| | - David S Lopez
- Department of Epidemiology, The University of Texas School of Public Health, P.O. Box 20186, Houston, TX, 77030, USA
| | - Yisheng Li
- Department of Biostatistics, Unit 1411, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Lovell A Jones
- College of Nursing, Prairie View A&M University, 100 University Dr., Prairie View, TX, 77446, USA
| | - Ernest Hawk
- Division of Cancer Prevention and Population Sciences, Unit 1370, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
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[Cancers and environmental exposures: Between uncertainties and certainties]. Bull Cancer 2019; 106:975-982. [PMID: 31607391 DOI: 10.1016/j.bulcan.2019.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/09/2019] [Accepted: 08/14/2019] [Indexed: 11/23/2022]
Abstract
While improvements in the environment and living conditions have contributed to a significant increase in human longevity for over a century, the role of environmental factors in the occurrence of cancer has become a public health concern. It is recognized that a number of environmental factors such as environmental quality (air, water, soil), or environmental changes contribute to the occurrence of certain cancers. Despite this awareness, their potential impacts on health raise many scientific questions. The development of new methodological tools for the characterization of exposure, the study of the association between environmental agents and cancer through an exposure-cancer approach and the health impacts associated, have led to changes in scientific paradigms including the concept of exposome. This concept, at the heart of health and environmental issues, takes into account the determinants of health related to the quality of populations' living environments and provides assistance in public policy decision-making. Ultimately, the aim is to develop measures likely to reduce exposure and prevent health risks and damage to the most vulnerable populations, both in their physical environment and in their living environment, including the economic and social determinants.
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Neves WBD, Brito AMD, Vasconcelos AP, Melo FCDBC, Melo RAM. Incidence and spatial distribution of Chronic Myeloid Leukemia by regions of economic development in the state of Pernambuco, Brazil. Hematol Transfus Cell Ther 2019; 41:212-215. [PMID: 31085146 PMCID: PMC6732521 DOI: 10.1016/j.htct.2018.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/22/2018] [Accepted: 08/29/2018] [Indexed: 01/22/2023] Open
Abstract
Background The establishment of regional development poles in the State of Pernambuco, Brazil was characterized by industrial expansion and consequent concerns about the increase in the occurrence of diseases, specifically those having long latency periods, as is the case of Chronic Myeloid Leukemia. Methods The study included 367 patients diagnosed with Chronic Myeloid Leukemia over a ten-year period at a reference treatment center. Records of patient charts and the TerraView software were used, respectively, for data collection and geographic mapping of the cases from the twelve established State development regions. Results A total incidence of 3.4 cases per 100,000 inhabitants was found, with a predominance of the disease among males, a median age of 47 years, a mestizo ethnicity, with elementary schooling and residence in urban area. Microregional incidence varied, but there was no significant variation in numbers over the years, and no relevant socio-environmental determinants were identified. Conclusion The present study determined the incidence and characterized the spatial distribution of Chronic Myeloid Leukemia cases over a decade in a northeastern Brazilian state. The variation in the incidence rate by region of development is compatible with a homogeneous distribution of the cases. The work is a baseline study to be used for present and future analyses of the impact of the state economic development poles and the occurrence of this chronic malignant disease.
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Affiliation(s)
| | | | | | | | - Raul Antônio Morais Melo
- Fundação Hemope (HEMOPE), Recife, PE, Brazil; Universidade de Pernambuco (UPE), Recife, PE, Brazil.
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Williams LA, Yang JJ, Hirsch BA, Marcotte EL, Spector LG. Is There Etiologic Heterogeneity between Subtypes of Childhood Acute Lymphoblastic Leukemia? A Review of Variation in Risk by Subtype. Cancer Epidemiol Biomarkers Prev 2019; 28:846-856. [PMID: 30770347 PMCID: PMC6500468 DOI: 10.1158/1055-9965.epi-18-0801] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/19/2018] [Accepted: 02/05/2019] [Indexed: 02/07/2023] Open
Abstract
Although substantial advances in the identification of cytogenomic subtypes of childhood acute lymphoblastic leukemia (ALL) have been made in recent decades, epidemiologic research characterizing the etiologic heterogeneity of ALL by subtype has not kept pace. The purpose of this review is to summarize the current literature concerning subtype-specific epidemiologic risk factor associations with ALL subtype defined by immunophenotype (e.g., B-cell vs. T-cell) and cytogenomics (including gross chromosomal events characterized by recurring numerical and structural abnormalities, along with cryptic balanced rearrangements, and focal gene deletions). In case-control analyses investigating nongenetic risk factors, home paint exposure is associated with hyperdiploid, MLL-rearranged, and ETV6-RUNX1 subtypes, yet there are few differences in risk factor associations between T- and B-ALL. Although the association between maternal smoking and ALL overall has been null, maternal smoking is associated with an increasing number of gene deletions among cases. GWAS-identified variants in ARID5B have been the most extensively studied and are strongly associated with hyperdiploid B-ALL. GATA3 single nucleotide variant rs3824662 shows a strong association with Ph-like ALL (OR = 3.14). However, there have been relatively few population-based studies of adequate sample size to uncover risk factors that may define etiologic heterogeneity between and within the currently defined cytogenomic ALL subtypes.
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Affiliation(s)
- Lindsay A Williams
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Jun J Yang
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Betsy A Hirsch
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Erin L Marcotte
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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Mansell E, Zareian N, Malouf C, Kapeni C, Brown N, Badie C, Baird D, Lane J, Ottersbach K, Blair A, Case CP. DNA damage signalling from the placenta to foetal blood as a potential mechanism for childhood leukaemia initiation. Sci Rep 2019; 9:4370. [PMID: 30867444 PMCID: PMC6416312 DOI: 10.1038/s41598-019-39552-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 11/05/2018] [Indexed: 01/08/2023] Open
Abstract
For many diseases with a foetal origin, the cause for the disease initiation remains unknown. Common childhood acute leukaemia is thought to be caused by two hits, the first in utero and the second in childhood in response to infection. The mechanism for the initial DNA damaging event are unknown. Here we have used in vitro, ex vivo and in vivo models to show that a placental barrier will respond to agents that are suspected of initiating childhood leukaemia by releasing factors that cause DNA damage in cord blood and bone marrow cells, including stem cells. We show that DNA damage caused by in utero exposure can reappear postnatally after an immune challenge. Furthermore, both foetal and postnatal DNA damage are prevented by prenatal exposure of the placenta to a mitochondrially-targeted antioxidant. We conclude that the placenta might contribute to the first hit towards leukaemia initiation by bystander-like signalling to foetal haematopoietic cells.
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Affiliation(s)
- Els Mansell
- School of Clinical Science, University of Bristol, Learning and Research Centre, Southmead Hospital, Bristol, UK.
| | - Nahid Zareian
- School of Clinical Science, University of Bristol, Learning and Research Centre, Southmead Hospital, Bristol, UK
| | - Camille Malouf
- MRC Centre for Regenerative Medicine, SCRM Building, The University of Edinburgh, Edinburgh Bioquarter 5 Little France Drive, Edinburgh, UK
| | - Chrysa Kapeni
- MRC Centre for Regenerative Medicine, SCRM Building, The University of Edinburgh, Edinburgh Bioquarter 5 Little France Drive, Edinburgh, UK
| | - Natalie Brown
- Cancer Mecanisms and Biomarkers, Department of Radiation Effects, Public Health England's Centre for Radiation, Chemical and Environmental Hazards (CRCE), Chilton, Didcot, Oxon, UK
| | - Christophe Badie
- Cancer Mecanisms and Biomarkers, Department of Radiation Effects, Public Health England's Centre for Radiation, Chemical and Environmental Hazards (CRCE), Chilton, Didcot, Oxon, UK
| | - Duncan Baird
- Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - Jon Lane
- School of Biochemistry, University of Bristol, Bristol, UK
| | - Katrin Ottersbach
- MRC Centre for Regenerative Medicine, SCRM Building, The University of Edinburgh, Edinburgh Bioquarter 5 Little France Drive, Edinburgh, UK
| | - Allison Blair
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK
- Bristol Institute for Transfusion Sciences, NHS Blood and Transplant, Filton, UK
| | - C Patrick Case
- School of Clinical Science, University of Bristol, Learning and Research Centre, Southmead Hospital, Bristol, UK
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Transplacental exposure to carcinogens and risks to children: evidence from biomarker studies and the utility of omic profiling. Arch Toxicol 2019; 93:833-857. [PMID: 30859261 DOI: 10.1007/s00204-019-02428-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/04/2019] [Indexed: 12/12/2022]
Abstract
The factors underlying the increasing rates and the geographic variation of childhood cancers are largely unknown. Epidemiological studies provide limited evidence for a possible role in the etiology of certain types of childhood cancer of the exposure of pregnant women to environmental carcinogens (e.g., tobacco smoke and pesticides); however, such evidence is inadequate to allow definitive conclusions. Complementary evidence can be obtained from biomarker-based population studies. Such studies have demonstrated that, following exposure of pregnant mothers, most environmental carcinogens reach the fetus and, in many cases, induce therein genotoxic damage which in adults is known to be associated with increased cancer risk, implying that environmental carcinogens may contribute to the etiology of childhood cancer. During recent years, intermediate disease biomarkers, obtained via omic profiling, have provided additional insights into the impact of transplacental exposures on fetal tissues which, in some cases, are also compatible with a precarcinogenic role of certain in utero exposures. Here we review the epidemiological and biomarker evidence and discuss how further research, especially utilizing high-density profiling, may allow a better evaluation of the links between in utero environmental exposures and cancer in children.
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Household exposure to pesticides and risk of leukemia in children and adolescents: Updated systematic review and meta-analysis. Int J Hyg Environ Health 2019; 222:49-67. [DOI: 10.1016/j.ijheh.2018.08.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/16/2018] [Accepted: 08/06/2018] [Indexed: 11/21/2022]
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Veríssimo G, Kós MI, Garcia TR, Ramos JADS, Souza CCD, Moreira JC, Meyer A. Pesticide exposure among students and their families in Nova Friburgo, Rio de Janeiro. CIENCIA & SAUDE COLETIVA 2018; 23:3903-3911. [PMID: 30427460 DOI: 10.1590/1413-812320182311.27592016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 11/25/2016] [Indexed: 11/22/2022] Open
Abstract
Farming is a risky occupation, especially family farming in developing country. The occupational hazards commonly used in such activity could affect all family members, including children and adolescents. This study describes the pattern of pesticide exposure among students and their families from a farming region located in Nova Friburgo, State of Rio de Janeiro, Brazil. Sociodemographic characteristics, habits, working practices and the degree of exposure to pesticides were assessed by a questionnaire. Our study population consisted of students and family members of both sexes, aged between 6 and 85 years old (N = 352) being 167 women and 185 men. There was a predominance of participants between 10-19 years (71.3%), singles (77.5%), and most had not completed primary education (54.5%). In terms of occupation, 45.5% reported to be farmers and 39.6% were students. The variables mostly associated with pesticide exposure were sex (p < 0.001), educational level (p < 0.001), and being a farmer (p < 0.001). Our results showed that children and teenagers seemed to have the same degree of exposure to pesticides as the adults. Our findings also suggest that sex, occupation and educational level, despite teachers were included, are directly associated with degree of exposure.
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Affiliation(s)
- Gesiele Veríssimo
- Instituto de Saúde Pública, Universidade Federal do Rio de Janeiro (UFRJ). Av. Horácio Macedo s/n, Fundão. 21941-598 Rio de Janeiro RJ Brasil..
| | | | - Tatiana Rodrigues Garcia
- Instituto de Saúde Pública, Universidade Federal do Rio de Janeiro (UFRJ). Av. Horácio Macedo s/n, Fundão. 21941-598 Rio de Janeiro RJ Brasil..
| | - Janinne Alves Dos Santos Ramos
- Instituto de Saúde Pública, Universidade Federal do Rio de Janeiro (UFRJ). Av. Horácio Macedo s/n, Fundão. 21941-598 Rio de Janeiro RJ Brasil..
| | - Carolyne Cosme de Souza
- Instituto de Saúde Pública, Universidade Federal do Rio de Janeiro (UFRJ). Av. Horácio Macedo s/n, Fundão. 21941-598 Rio de Janeiro RJ Brasil..
| | - Josino Costa Moreira
- Centro de Saúde do Trabalhador e Ecologia Humana, Escola Nacional de Saúde Pública Sérgio Arouca, Fiocruz. Rio de Janeiro RJ Brasil
| | - Armando Meyer
- Instituto de Saúde Pública, Universidade Federal do Rio de Janeiro (UFRJ). Av. Horácio Macedo s/n, Fundão. 21941-598 Rio de Janeiro RJ Brasil..
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Desforges JP, Bandoro C, Shehata L, Sonne C, Dietz R, Puryear WB, Runstadler JA. Environmental contaminant mixtures modulate in vitro influenza infection. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 634:20-28. [PMID: 29626767 DOI: 10.1016/j.scitotenv.2018.03.321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 03/26/2018] [Accepted: 03/26/2018] [Indexed: 05/17/2023]
Abstract
Environmental chemicals, particularly organochlorinated contaminants (OCs), are associated with a ranged of adverse health effects, including impairment of the immune system and antiviral immunity. Influenza A virus (IAV) is an infectious disease of major global public health concern and exposure to OCs can increase the susceptibility, morbidity, and mortality to disease. It is however unclear how pollutants are interacting and affecting the outcome of viral infections at the cellular level. In this study, we investigated the effects of a mixture of environmentally relevant OCs on IAV infectivity upon in vitro exposure in Madin Darby Canine Kidney (MDCK) cells and human lung epithelial cells (A549). Exposure to OCs reduced IAV infectivity in MDCK and A549 cells during both short (18-24h) and long-term (72h) infections at 0.05 and 0.5ppm, and effects were more pronounced in cells co-treated with OCs and IAV than pre-treated with OCs prior to IAV (p<0.001). Pre-treatment of host cells with OCs did not affect IAV cell surface attachment or entry. Visualization of IAV by transmission electron microscopy revealed increased envelope deformations and fewer intact virions during OC exposure. Taken together, our results suggest that disruption of IAV infection upon in vitro exposure to OCs was not due to host-cell effects influencing viral attachment and entry, but perhaps mediated by direct effects on viral particles or cellular processes involved in host-virus interactions. In vitro infectivity studies such as ours can shed light on the complex processes underlying host-pathogen-pollutant interactions.
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Affiliation(s)
- Jean-Pierre Desforges
- Department of Bioscience, Arctic Research Centre, Aarhus University, DK-4000 Roskilde, Denmark.
| | - Christopher Bandoro
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA 01536, United States; Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, United States
| | - Laila Shehata
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, United States
| | - Christian Sonne
- Department of Bioscience, Arctic Research Centre, Aarhus University, DK-4000 Roskilde, Denmark
| | - Rune Dietz
- Department of Bioscience, Arctic Research Centre, Aarhus University, DK-4000 Roskilde, Denmark
| | - Wendy B Puryear
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA 01536, United States
| | - Jonathan A Runstadler
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA 01536, United States
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Navarrete-Meneses MP, Pedraza-Meléndez AI, Salas-Labadía C, Moreno-Lorenzana D, Pérez-Vera P. Low concentrations of permethrin and malathion induce numerical and structural abnormalities in KMT2A and IGH genes in vitro. J Appl Toxicol 2018; 38:1262-1270. [PMID: 29741206 DOI: 10.1002/jat.3638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/22/2018] [Accepted: 03/30/2018] [Indexed: 11/09/2022]
Abstract
Pesticides are commonly used worldwide and almost every human is potentially exposed to these chemicals. Exposure to pesticides such as permethrin and malathion has been associated with hematological malignancies in epidemiological studies. However, biological evidence showing if these chemicals induce genetic aberrations involved in the etiology of leukemia and lymphoma is missing. In our previous work, we have shown that a single high exposure (200 μm, 24 hours) of permethrin and malathion induce damage in genes associated with hematological malignancies in peripheral blood mononuclear cells analyzed by interphase fluorescence in situ hybridization (FISH). In the present study, we assessed by FISH whether exposure to low concentrations (0.1 μm, 72 hours) of permethrin and malathion induce aberrations in KMT2A and IGH genes, which are involved in the etiology of leukemia and lymphoma. Peripheral blood mononuclear cells were exposed to the chemicals, and damage in these genes was assessed on interphases and metaphases. We observed that both chemicals at low concentration induced structural aberrations in KMT2A and IGH genes. A higher level of damage was observed in KMT2A gene with malathion treatment and in IGH gene with permethrin exposure. We also observed numerical aberrations induced by these chemicals. The most frequent aberrations detected on interphase FISH were also observed on metaphases. Our results show that permethrin and malathion induce genetic damage in genes associated with hematological cancer, at concentrations biologically relevant. In addition, damage was observed on dividing cells, which suggests that these cells maintain their proliferation capacity in spite of the genetic damage they possess.
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Affiliation(s)
- M P Navarrete-Meneses
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico.,Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - A I Pedraza-Meléndez
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - C Salas-Labadía
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | | | - P Pérez-Vera
- Laboratorio de Genética y Cáncer, Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
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Maternal Exposure to Pesticides, Paternal Occupation in the Army/Police Force, and CYP2D6*4 Polymorphism in the Etiology of Childhood Acute Leukemia. J Pediatr Hematol Oncol 2018; 40:e207-e214. [PMID: 29432309 DOI: 10.1097/mph.0000000000001105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Epidemiologic studies have suggested that parental occupations, pesticide use, environmental factors, and genetic polymorphism are involved in the etiology of childhood acute leukemia (CAL). In total, 116 cases of CAL and 162 controls were recruited and submitted to blood drawing to assess the presence of genetic polymorphisms. Parental occupations, pesticides exposure, and other potential determinants were investigated. Increased risk for CAL was associated with prenatal maternal use of insecticides/rodenticides (odds ratio [OR]=1.87; 95% confidence intervals [CI], 1.04-3.33), with subjects living <100 m from pesticide-treated fields (OR=3.21; 95% CI, 1.37-7.53) and with a paternal occupation as traffic warden/policeman (OR=4.02; 95% CI, 1.63-9.87). Associations were found between CAL and genetic polymorphism of CYP2D6*4 for homozygous alleles (mutant type/mutant type: OR=6.39; 95% CI, 1.17-34.66). In conclusion, despite the small sample size, maternal prenatal exposure to pesticides, paternal occupation as a traffic warden/police officer, and CYP2D6*4 polymorphism could play a role in the etiology of CAL.
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Jiménez-Hernández E, Fajardo-Gutiérrez A, Núñez-Enriquez JC, Martín-Trejo JA, Espinoza-Hernández LE, Flores-Lujano J, Arellano-Galindo J, Medina-Sanson A, Paredes-Aguilera R, Merino-Pasaye LE, Velázquez-Aviña MM, Torres-Nava JR, Espinosa-Elizondo RM, Amador-Sánchez R, Dosta-Herrera JJ, Mondragón-García JA, Valdés-Guzmán H, Mejía-Pérez L, Espinoza-Anrubio G, Paz-Bribiesca MM, Salcedo-Lozada P, Landa-García RÁ, Ramírez-Colorado R, Hernández-Mora L, Pérez-Saldivar ML, Santamaría-Ascencio M, López-Loyola A, Godoy-Esquivel AH, García-López LR, Anguiano-Ávalos AI, Mora-Rico K, Castañeda-Echevarría A, Rodríguez-Jiménez R, Cibrian-Cruz JA, Solís-Labastida KA, Cárdenas-Cardos R, Martínez-Avalos A, Flores-Villegas LV, Peñaloza-González JG, González-Ávila AI, Altamirano-García MB, López-Santiago N, Sánchez-Ruiz M, Rivera-Luna R, Rodríguez-Villalobos LR, Hernández-Pérez F, Olvera-Durán JÁ, García-Cortés LR, Mata-Rocha M, Sepúlveda-Robles OA, González-Bonilla CR, Bekker-Méndez VC, Jiménez-Morales S, Rosas-Vargas H, Mejía-Aranguré JM. A greater birthweight increases the risk of acute leukemias in Mexican children-experience from the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia (MIGICCL). Cancer Med 2018. [PMID: 29533016 PMCID: PMC5911591 DOI: 10.1002/cam4.1414] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In Mexico, due to the high rates of diabetes, overweight, and obesity, there has also been noted an increased newborn weight, which may be contributing to the elevated incidence rate of childhood acute leukemia (AL). We conducted a case-control study in public hospitals of Mexico City aimed to know whether a greater weight at birth is associated with a higher risk of developing leukemia. We included incident cases with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) diagnosed between 2010 and 2015. Controls were frequency-matched to the cases by age, sex, and health institution. Logistic regression analysis was performed adjusting risks by child's sex, overcrowding index, birth order, and mother's age at the time of pregnancy. Adjusted odds ratios (aORs) and 95% confidence intervals were calculated. A total of 1455 cases and 1455 controls were included. An evident association between ALL and child's birthweight ≥2500 g was found (aOR 2.06; 95% CI: 1.59, 2.66) and also, in those with birthweight ≥3500 g (aOR 1.19; 95% CI: 1.00, 1.41). In AML patients with birthweight ≥2500 g and ≥3500 g, an aOR of 1.77 (95% CI: 1.07, 2.94) and 1.42 (95% CI: 1.03-1.95) was observed, respectively. No association was noticed with either type of AL and a birthweight ≥4000 g. To sum up, we found a moderate association between not having a low birthweight and an increased risk of acute leukemias. Birthweight ≥3500 g was also a risk factor for both types of leukemia. This suggests that a greater birthweight may increase the risk of acute leukemias in Mexican children.
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Affiliation(s)
- Elva Jiménez-Hernández
- Health Research Coordination, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.,Pediatric Hematology Services, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS, Mexico City, Mexico
| | - Arturo Fajardo-Gutiérrez
- Medical Research Unit in Clinical Epidemiology, UMAE Hospital de Pediatría CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | - Juan Carlos Núñez-Enriquez
- Medical Research Unit in Clinical Epidemiology, UMAE Hospital de Pediatría CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | | | | | - Janet Flores-Lujano
- Medical Research Unit in Clinical Epidemiology, UMAE Hospital de Pediatría CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | - José Arellano-Galindo
- Children's Hospital of Mexico, Federico Gómez, Secretaria de Salud (SS), Mexico City, Mexico
| | - Aurora Medina-Sanson
- Children's Hospital of Mexico, Federico Gómez, Secretaria de Salud (SS), Mexico City, Mexico
| | | | - Laura Elizabeth Merino-Pasaye
- Pediatric Hematology Services, CMN "20 de Noviembre", Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | | | - José Refugio Torres-Nava
- Oncology Services, Hospital Pediátrico "Moctezuma", Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | | | - Raquel Amador-Sánchez
- Pediatric Hematology Service, Hospital General Regional (HGR) No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS, Mexico City, Mexico
| | - Juan José Dosta-Herrera
- Pediatric Surgery Service, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS, Mexico City, Mexico
| | | | | | | | - Gilberto Espinoza-Anrubio
- Servicio de Pediatría, Hospital General Zona (HGZ) No. 8 "Dr. Gilberto Flores Izquierdo" IMSS, Mexico City, Mexico
| | | | - Perla Salcedo-Lozada
- General Hospital of Ecatepec "Las Américas", Instituto de Salud del Estado de México (ISEM), Mexico City, Mexico
| | | | | | | | - María Luisa Pérez-Saldivar
- Medical Research Unit in Clinical Epidemiology, UMAE Hospital de Pediatría CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | | | | | | | | | | | - Karina Mora-Rico
- Pediatric Surgery Service, Hospital Regional "1° Octubre", ISSSTE, Mexico City, Mexico
| | | | - Roberto Rodríguez-Jiménez
- Pediatric Services, Hospital General de Zona con Medicina Familiar (HGZMF) No. 29 IMSS, Mexico City, Mexico
| | | | | | | | | | - Luz Victoria Flores-Villegas
- Pediatric Hematology Services, CMN "20 de Noviembre", Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | | | - Ana Itamar González-Ávila
- Pediatric Hematology Service, Hospital General Regional (HGR) No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS, Mexico City, Mexico
| | | | - Norma López-Santiago
- Hematology Services, Instituto Nacional de Pediatría (INP), SS, Mexico City, Mexico
| | - Martin Sánchez-Ruiz
- General Hospital of Ecatepec "Las Américas", Instituto de Salud del Estado de México (ISEM), Mexico City, Mexico
| | | | | | | | | | | | - Minerva Mata-Rocha
- Molecular Biology Laboratory, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | | | - Cesar Raúl González-Bonilla
- Laboratory of the Coordination of Epidemiological Surveillance and Support in Contingencies, Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología "Dr. Daniel Méndez Hernández", CMN "La Raza", IMSS, Mexico City, Mexico
| | - Vilma Carolina Bekker-Méndez
- Medical Research Unit in Immunology and Infectology, Hospital de Infectología "Dr. Daniel Méndez Hernández", CMN "La Raza", IMSS, Mexico City, Mexico
| | - Silvia Jiménez-Morales
- Cancer Genomics Laboratory, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Haydee Rosas-Vargas
- Medical Research Unit in Human Genetics, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | - Juan Manuel Mejía-Aranguré
- Health Research Coordination, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.,Medical Research Unit in Clinical Epidemiology, UMAE Hospital de Pediatría CMN "Siglo XXI", IMSS, Mexico City, Mexico.,Molecular Biology Laboratory, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS, Mexico City, Mexico
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Froes Asmus CIR, Camara VM, Landrigan PJ, Claudio L. A Systematic Review of Children's Environmental Health in Brazil. Ann Glob Health 2018; 82:132-48. [PMID: 27325071 DOI: 10.1016/j.aogh.2016.02.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
In the region of the Americas, approximately 100,000 children under the age of 5 years die each year due to environmental hazards. Brazil, due to its large size and wide range of environmental challenges, presents numerous hazards to children's health. The aim of this study was to systematically review the scientific literature that describes children's exposures to environmental pollutants in Brazil and their effects on Brazilian children's health. A systematic review of the scientific literature was performed without language restrictions and time of publication (years). The literature search was conducted in the following key resources: PubMed (MEDLINE), Scopus and Web of Science with the MeSH Terms: Environmental exposure AND Brazil (filters: Human, Child [birth to 18 years] and Affiliation Author). The Virtual Health Library was also employed to access the databases Scielo and Lilacs. The search strategy was [DeCS Terms]: Child OR adolescent AND Environmental exposure AND Brazil. Health effects in children associated with exposure to environmental pollutants in Brazil were reported in 74 studies, during the period between 1995 and 2015. The most frequently cited effect was hospital admission for respiratory causes including wheezing, asthma, and pneumonia among children living in areas with high concentrations of air pollutants. A broad spectrum of other health effects possibly linked to pollutants also was found such as prematurity, low birth weight, congenital abnormality (cryptorchidism, hypospadia, micropenis), poor performance in tests of psychomotor and mental development, and behavioral problems. Exposure to pesticides in utero and postnatally was associated with a high risk for leukemia in children <2 years old. These results show that there is a need in Brazil for stricter monitoring of pollutant emissions and for health surveillance programs especially among vulnerable populations such as pregnant women and young children.
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Affiliation(s)
- Carmen I R Froes Asmus
- Public Health Institute, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Preventive Medicine Department, Icahn School of Medicine of Mount Sinai, New York, NY.
| | - Volney M Camara
- Public Health Institute, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Philip J Landrigan
- Preventive Medicine Department, Icahn School of Medicine of Mount Sinai, New York, NY; Arnhold Global Health Institute, Icahn School of Medicine of Mount Sinai, New York, NY
| | - Luz Claudio
- Preventive Medicine Department, Icahn School of Medicine of Mount Sinai, New York, NY
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Pombo-de-Oliveira MS, Andrade FG, Brisson GD, Dos Santos Bueno FV, Cezar IS, Noronha EP. Acute myeloid leukaemia at an early age: Reviewing the interaction between pesticide exposure and KMT2A-rearrangement. Ecancermedicalscience 2017; 11:782. [PMID: 29225689 PMCID: PMC5718248 DOI: 10.3332/ecancer.2017.782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Indexed: 12/29/2022] Open
Abstract
Acute myeloid leukaemia (AML) in early childhood is characterised by a high frequency of recurrent genomic aberrations associated with distinct myeloid subtypes, clinical outcomes and pathogenesis. Genomic instability is the first step of pathogenic mechanism in early childhood AML. A sum of adverse events is necessary to the development of infant AML (i-AML), which includes latency of biochemical-molecular and cellular effects. Inherited genetic susceptibility associated with exposures to biotransformation substances can modulate the risk of DNA damage and it is a very important piece in the pathogenic puzzle. In this review, we have aimed to explore the chain of events in the time-points of the natural history of i-AML, which includes maternal exposures during pregnancy, the speculations about the formation of somatic mutations during foetal life and the secondary genomic aberrations associated with i-AML. The modulation of risk conferred by xenobiotic metabolism´s genes variants is the bottom line of the pathogenic process. Since we have conducted observational and molecular investigations in early childhood leukaemia, the data focused here is based on Brazilian findings with summarised results of our experience with epidemiological and molecular studies in early-age leukaemia.
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Affiliation(s)
- Maria S Pombo-de-Oliveira
- Pediatric Hematology-Oncology Program, Research Center, Instituto Nacional de Câncer (INCA), Rio de Janeiro 20231-050, Brazil
| | - Francianne Gomes Andrade
- Pediatric Hematology-Oncology Program, Research Center, Instituto Nacional de Câncer (INCA), Rio de Janeiro 20231-050, Brazil
| | - Gisele Dallapicola Brisson
- Pediatric Hematology-Oncology Program, Research Center, Instituto Nacional de Câncer (INCA), Rio de Janeiro 20231-050, Brazil
| | - Filipe Vicente Dos Santos Bueno
- Pediatric Hematology-Oncology Program, Research Center, Instituto Nacional de Câncer (INCA), Rio de Janeiro 20231-050, Brazil
| | - Ingrid Sardou Cezar
- Pediatric Hematology-Oncology Program, Research Center, Instituto Nacional de Câncer (INCA), Rio de Janeiro 20231-050, Brazil
| | - Elda Pereira Noronha
- Pediatric Hematology-Oncology Program, Research Center, Instituto Nacional de Câncer (INCA), Rio de Janeiro 20231-050, Brazil
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Ockleford C, Adriaanse P, Berny P, Brock T, Duquesne S, Grilli S, Hougaard S, Klein M, Kuhl T, Laskowski R, Machera K, Pelkonen O, Pieper S, Smith R, Stemmer M, Sundh I, Teodorovic I, Tiktak A, Topping CJ, Wolterink G, Bottai M, Halldorsson T, Hamey P, Rambourg MO, Tzoulaki I, Court Marques D, Crivellente F, Deluyker H, Hernandez-Jerez AF. Scientific Opinion of the PPR Panel on the follow-up of the findings of the External Scientific Report 'Literature review of epidemiological studies linking exposure to pesticides and health effects'. EFSA J 2017; 15:e05007. [PMID: 32625302 PMCID: PMC7009847 DOI: 10.2903/j.efsa.2017.5007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In 2013, EFSA published a comprehensive systematic review of epidemiological studies published from 2006 to 2012 investigating the association between pesticide exposure and many health outcomes. Despite the considerable amount of epidemiological information available, the quality of much of this evidence was rather low and many limitations likely affect the results so firm conclusions cannot be drawn. Studies that do not meet the 'recognised standards' mentioned in the Regulation (EU) No 1107/2009 are thus not suited for risk assessment. In this Scientific Opinion, the EFSA Panel on Plant Protection Products and their residues (PPR Panel) was requested to assess the methodological limitations of pesticide epidemiology studies and found that poor exposure characterisation primarily defined the major limitation. Frequent use of case-control studies as opposed to prospective studies was considered another limitation. Inadequate definition or deficiencies in health outcomes need to be avoided and reporting of findings could be improved in some cases. The PPR Panel proposed recommendations on how to improve the quality and reliability of pesticide epidemiology studies to overcome these limitations and to facilitate an appropriate use for risk assessment. The Panel recommended the conduct of systematic reviews and meta-analysis, where appropriate, of pesticide observational studies as useful methodology to understand the potential hazards of pesticides, exposure scenarios and methods for assessing exposure, exposure-response characterisation and risk characterisation. Finally, the PPR Panel proposed a methodological approach to integrate and weight multiple lines of evidence, including epidemiological data, for pesticide risk assessment. Biological plausibility can contribute to establishing causation.
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Van Maele-Fabry G, Gamet-Payrastre L, Lison D. Residential exposure to pesticides as risk factor for childhood and young adult brain tumors: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2017. [PMID: 28623811 DOI: 10.1016/j.envint.2017.05.018] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Accumulating evidence suggests a positive association between exposure to non-agricultural pesticides and childhood brain tumors (CBT). OBJECTIVE (1) To conduct a systematic review and meta-analysis of published studies on the association between residential/household/domestic exposure to pesticides and childhood brain tumors. (2) To clarify variables that could impact the results. METHODS Publications in English were identified from a MEDLINE search through 28 February 2017 and from the reference list of identified publications. Risk estimates were extracted from 18 case-control studies published between 1979 and 2016 and study quality assessments were performed. Summary odds ratios (mOR) were calculated according to fixed and random-effect meta-analysis models. Separate analyses were conducted after stratification for study quality, critical exposure period, exposure location, specific exposures, pesticide category, application methods, type of pest treated, type of CBT, child's age at diagnosis and geographic location. RESULTS Statistically significant associations were observed with CBT after combining all studies (mOR: 1.26; 95% CI: 1.13-1.40) without evidence of inconsistency between study results or publication bias. Specifically, increased risks were observed for several groupings and more particularly for gliomas and exposure involving insecticides. Statistical significance was also reached for high quality studies, for all exposure periods, for indoor exposure and, more particularly, during the prenatal period for all stratifications involving insecticides (except for outdoor use), for pet treatments, for flea/tick treatment, for studies from USA/Canada and studies from Europe (borderline) as well as for data from studies including children of up to 10years at diagnosis and of up to 15years. CONCLUSIONS Our findings support an association between residential exposure to pesticides and childhood brain tumors. Although causality cannot be established, these results add to the evidence leading to recommend limiting residential use of pesticides and to support public health policies serving this objective.
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Affiliation(s)
- Geneviève Van Maele-Fabry
- Université catholique de Louvain, Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Avenue E. Mounier 53.02, B-1200 Brussels, Belgium.
| | - Laurence Gamet-Payrastre
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS 180 chemin de Tournefeuille, BP 93173 Toulouse, France
| | - Dominique Lison
- Université catholique de Louvain, Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Avenue E. Mounier 53.02, B-1200 Brussels, Belgium
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Cárceles-Álvarez A, Ortega-García JA, López-Hernández FA, Orozco-Llamas M, Espinosa-López B, Tobarra-Sánchez E, Alvarez L. Spatial clustering of childhood leukaemia with the integration of the Paediatric Environmental History. ENVIRONMENTAL RESEARCH 2017; 156:605-612. [PMID: 28454012 PMCID: PMC5685499 DOI: 10.1016/j.envres.2017.04.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 03/30/2017] [Accepted: 04/16/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Leukaemia remains the most common type of paediatric cancer and its aetiology remains unknown, but considered to be multifactorial. It is suggested that the initiation in utero by relevant exposures and/or inherited genetic variants and, other promotional postnatal exposures are probably required to develop leukaemia. This study aimed to map the incidence and analyse possible clusters in the geographical distribution of childhood acute leukaemia during the critical periods and to evaluate the factors that may be involved in the aetiology by conducting community and individual risk assessments. MATERIALS AND METHODS We analysed all incident cases of acute childhood leukaemia (<15 years) diagnosed in a Spanish region during the period 1998-2013. At diagnosis, the addresses during pregnancy, early childhood and diagnosis were collected and codified to analyse the spatial distribution of acute leukaemia. Scan statistical test methodology was used for the identification of high-incidence spatial clusters. Once identified, individual and community risk assessments were conducted using the Paediatric Environmental History. RESULTS A total of 158 cases of acute leukaemia were analysed. The crude rate for the period was 42.7 cases per million children. Among subtypes, acute lymphoblastic leukaemia had the highest incidence (31.9 per million children). A spatial cluster of acute lymphoblastic leukaemia was detected using the pregnancy address (p<0.05). The most common environmental risk factors related with the aetiology of acute lymphoblastic leukaemia, identified by the Paediatric Environmental History were: prenatal exposure to tobacco (75%) and alcohol (50%); residential and community exposure to pesticides (62.5%); prenatal or neonatal ionizing radiation (42.8%); and parental workplace exposure (37.5%) CONCLUSIONS: Our study suggests that environmental exposures in utero may be important in the development of childhood leukaemia. Due to the presence of high-incidence clusters using pregnancy address, it is necessary to introduce this address into the childhood cancer registers. The Paediatric Environmental History which includes pregnancy address and a careful and comprehensive evaluation of the environmental exposures will allow us to build the knowledge of the causes of childhood leukaemia.
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Affiliation(s)
- Alberto Cárceles-Álvarez
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environment and Human Health (A5) Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, University of Murcia, Murcia, Spain
| | - Juan A Ortega-García
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environment and Human Health (A5) Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, University of Murcia, Murcia, Spain.
| | | | - Mayra Orozco-Llamas
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environment and Human Health (A5) Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, University of Murcia, Murcia, Spain
| | - Blanca Espinosa-López
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environment and Human Health (A5) Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, University of Murcia, Murcia, Spain
| | - Esther Tobarra-Sánchez
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environment and Human Health (A5) Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, University of Murcia, Murcia, Spain
| | - Lizbeth Alvarez
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environment and Human Health (A5) Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, University of Murcia, Murcia, Spain
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Fucic A, Guszak V, Mantovani A. Transplacental exposure to environmental carcinogens: Association with childhood cancer risks and the role of modulating factors. Reprod Toxicol 2017. [PMID: 28624605 DOI: 10.1016/j.reprotox.2017.06.044] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Biological responses to carcinogens from environmental exposure during adulthood are modulated over years or decades. Conversely, during transplacental exposure, the effects on the human foetus change within weeks, intertwining with developmental mechanisms: even short periods of transplacental exposure may be imprinted in the organism for a lifetime. The pathways leading to childhood and juvenile cancers, such as leukaemias, neuroblastoma/brain tumours, hepatoblastoma, and Willm's tumour involve prenatally-induced genomic, epigenomic and/or non-genomic effects caused by xenobiotics. Pregnant women most often live in complex environmental settings that cause transplacental exposure of the foetus to xenobiotic mixtures. Mother-child biomonitoring should integrate the analysis of chemicals/radiation present in the living and workplace environment with relevant risk modulators related to life style. The interdisciplinary approach for transplacental cancer risk assessment in high-pressure areas should be based on an integrated model for mother-child exposure estimation via profiling the exposure level by water quality analysis, usage of emission grids, and land use maps.
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Affiliation(s)
- A Fucic
- Institute for Medical Research and Occupational Health, Zagreb, Croatia.
| | - V Guszak
- University Clinical Centre "Zagreb", Zagreb, Croatia
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Omidakhsh N, Ganguly A, Bunin GR, von Ehrenstein OS, Ritz B, Heck JE. Residential Pesticide Exposures in Pregnancy and the Risk of Sporadic Retinoblastoma: A Report From the Children's Oncology Group. Am J Ophthalmol 2017; 176:166-173. [PMID: 28131887 PMCID: PMC5376525 DOI: 10.1016/j.ajo.2017.01.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine whether parental pesticide exposure contributes to the development of sporadic retinoblastoma. DESIGN Case-control study. METHODS Data were collected by a large multicenter study of sporadic retinoblastoma in which parents of 99 unilateral and 56 bilateral age-matched case-control pairs were interviewed by telephone. Retrospective exposure information was collected on the type, location, timing, and frequency of residential pesticide use. We used conditional logistic regression analyses to estimate odds ratios for maternal pesticide exposure in the month before or during pregnancy and to assess whether the type of product, and the circumstances under which it was applied, were associated with risk of disease. RESULTS Unilateral retinoblastoma was associated with parental insecticide use (odds ratio [OR], 2.8; confidence interval [CI], 1.1-6.7) and the use of professional lawn or landscape services (OR, 2.8; CI, 1.0-8.2). For bilateral disease we observed large point estimates for several exposures but the small number of cases rendered these results uninformative (ie, resulted in wide confidence intervals). Whether parents used the pesticide inside vs outside the home did not appear to modify risk estimates for unilateral retinoblastoma (OR, 2.5; CI, 0.9-7.0 vs OR, 2.5; CI, 1.0-6.5), nor did the type, frequency, timing related to pregnancy, or applicator of pesticide used influence estimates to an appreciable degree for disease. CONCLUSIONS Our results suggest that parental pesticide exposure before or during pregnancy may play a role in the development of childhood retinoblastoma. Retrospectively collected exposure data introduces the possibility of recall bias; therefore, results should be interpreted cautiously until additional studies are conducted.
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Affiliation(s)
- Negar Omidakhsh
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Arupa Ganguly
- Department of Genetics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Greta R Bunin
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ondine S von Ehrenstein
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
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Ockleford C, Adriaanse P, Berny P, Brock T, Duquesne S, Grilli S, Hernandez-Jerez AF, Bennekou SH, Klein M, Kuhl T, Laskowski R, Machera K, Pelkonen O, Pieper S, Smith R, Stemmer M, Sundh I, Teodorovic I, Tiktak A, Topping CJ, Wolterink G, Angeli K, Fritsche E, Hernandez-Jerez AF, Leist M, Mantovani A, Menendez P, Pelkonen O, Price A, Viviani B, Chiusolo A, Ruffo F, Terron A, Bennekou SH. Investigation into experimental toxicological properties of plant protection products having a potential link to Parkinson's disease and childhood leukaemia. EFSA J 2017; 15:e04691. [PMID: 32625422 PMCID: PMC7233269 DOI: 10.2903/j.efsa.2017.4691] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
In 2013, EFSA published a literature review on epidemiological studies linking exposure to pesticides and human health outcome. As a follow up, the EFSA Panel on Plant Protection Products and their residues (PPR Panel) was requested to investigate the plausible involvement of pesticide exposure as a risk factor for Parkinson's disease (PD) and childhood leukaemia (CHL). A systematic literature review on PD and CHL and mode of actions for pesticides was published by EFSA in 2016 and used as background documentation. The Panel used the Adverse Outcome Pathway (AOP) conceptual framework to define the biological plausibility in relation to epidemiological studies by means of identification of specific symptoms of the diseases as AO. The AOP combines multiple information and provides knowledge of biological pathways, highlights species differences and similarities, identifies research needs and supports regulatory decisions. In this context, the AOP approach could help in organising the available experimental knowledge to assess biological plausibility by describing the link between a molecular initiating event (MIE) and the AO through a series of biologically plausible and essential key events (KEs). As the AOP is chemically agnostic, tool chemical compounds were selected to empirically support the response and temporal concordance of the key event relationships (KERs). Three qualitative and one putative AOP were developed by the Panel using the results obtained. The Panel supports the use of the AOP framework to scientifically and transparently explore the biological plausibility of the association between pesticide exposure and human health outcomes, identify data gaps, define a tailored testing strategy and suggests an AOP's informed Integrated Approach for Testing and Assessment (IATA).
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Barrington-Trimis JL, Cockburn M, Metayer C, Gauderman WJ, Wiemels J, McKean-Cowdin R. Trends in childhood leukemia incidence over two decades from 1992 to 2013. Int J Cancer 2017; 140:1000-1008. [PMID: 27778348 PMCID: PMC5550103 DOI: 10.1002/ijc.30487] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/28/2016] [Accepted: 10/07/2016] [Indexed: 12/24/2022]
Abstract
Incidence rates of childhood leukemia in the United States have steadily increased over the last several decades, but only recently have disparities in the increase in incidence been recognized. In the current analysis, Surveillance, Epidemiology and End Results (SEER) data were used to evaluate recent trends in the incidence of childhood leukemia diagnosed at age 0-19 years from 1992 to 2013, overall and by age, race/ethnicity, gender and histologic subtype. Hispanic White children were more likely than non-Hispanic White, non-Hispanic Black or non-Hispanic Asian children to be diagnosed with acute lymphocytic leukemia (ALL) from 2009 to 2013. From 1992 to 2013, a significant increase in ALL incidence was observed for Hispanic White children [annual percent change (APC)Hispanic = 1.08, 95% CI: 0.59, 1.58]; no significant increase was observed for non-Hispanic White, Black or Asian children. ALL incidence increased by about 3% per year from 1992 to 2013 for Hispanic White children diagnosed from 15 to 19 years (APC = 2.67; 95% CI: 0.88, 4.49) and by 2% for those 10-14 years (APC = 2.09; 95% CI: 0.57, 3.63), while no significant increases in incidence were observed in non-Hispanic White, Black, or Asian children of the same age. Acute myeloid leukemia (AML) incidence increased among non-Hispanic White children under 1 year at diagnosis, and among Hispanic White children diagnosed at age 1-4. The increase in incidence rates of childhood ALL appears to be driven by rising rates in older Hispanic children (10-14, and 15-19 years). Future studies are needed to evaluate reasons for the increase in ALL among older Hispanic children.
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Affiliation(s)
- Jessica L Barrington-Trimis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Catherine Metayer
- School of Public Health, University of California Berkeley (UCB), Berkeley, CA
| | - W James Gauderman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Joseph Wiemels
- Department of Epidemiology and Biostatistics, University of California San Francisco (UCSF), San Francisco, CA
| | - Roberta McKean-Cowdin
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
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44
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Perlroth NH, Castelo Branco CW. Current knowledge of environmental exposure in children during the sensitive developmental periods. J Pediatr (Rio J) 2017; 93:17-27. [PMID: 27821252 DOI: 10.1016/j.jped.2016.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 07/19/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE This study aims to identify the scientific evidence on the risks and effects of exposure to environmental contaminants in children during sensitive developmental periods. DATA SOURCE The search was performed in the Bireme database, using the terms: children's health, environmental exposure, health vulnerability, toxicity pathways and developmental disabilities in the LILACS, MEDLINE and SciELO systems. DATA SYNTHESIS Children differ from adults in their unique physiological and behavioral characteristics and the potential exposure to risks caused by several threats in the environment. Exposure to toxic agents is analyzed through toxicokinetic processes in the several systems and organs during the sensitive phases of child development. The caused effects are reflected in the increased prevalence of congenital malformations, diarrhea, asthma, cancer, endocrine and neurological disorders, among others, with negative impacts throughout adult life. CONCLUSION To identify the causes and understand the mechanisms involved in the genesis of these diseases is a challenge for science, as there is still a lack of knowledge on children's susceptibility to many environmental contaminants. Prevention policies and more research on child environmental health, improving the recording and surveillance of environmental risks to children's health, should be an ongoing priority in the public health field.
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Affiliation(s)
- Norma Helena Perlroth
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Programa de Pós-Graduação em Enfermagem e Biociências, Rio de Janeiro, RJ, Brazil; Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Departamento de Medicina Geral/Pediatria, Rio de Janeiro, RJ, Brazil.
| | - Christina Wyss Castelo Branco
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Programa de Pós-Graduação em Enfermagem e Biociências, Rio de Janeiro, RJ, Brazil; Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Departamento de Ciências Naturais, Rio de Janeiro, RJ, Brazil
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Perlroth NH, Branco CWC. Current knowledge of environmental exposure in children during the sensitive developmental periods. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2016.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Heffernan AL, English K, Toms L, Calafat AM, Valentin-Blasini L, Hobson P, Broomhall S, Ware RS, Jagals P, Sly PD, Mueller JF. Cross-sectional biomonitoring study of pesticide exposures in Queensland, Australia, using pooled urine samples. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:23436-23448. [PMID: 27613627 DOI: 10.1007/s11356-016-7571-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 08/31/2016] [Indexed: 06/06/2023]
Abstract
A range of pesticides are available in Australia for use in agricultural and domestic settings to control pests, including organophosphate and pyrethroid insecticides, herbicides, and insect repellents, such as N,N-diethyl-meta-toluamide (DEET). The aim of this study was to provide a cost-effective preliminary assessment of background exposure to a range of pesticides among a convenience sample of Australian residents. De-identified urine specimens stratified by age and sex were obtained from a community-based pathology laboratory and pooled (n = 24 pools of 100 specimens). Concentrations of urinary pesticide biomarkers were quantified using solid-phase extraction coupled with isotope dilution high-performance liquid chromatography-tandem mass spectrometry. Geometric mean biomarker concentrations ranged from <0.1 to 36.8 ng/mL for organophosphate insecticides, <0.1 to 5.5 ng/mL for pyrethroid insecticides, and <0.1 to 8.51 ng/mL for all other biomarkers with the exception of the DEET metabolite 3-diethylcarbamoyl benzoic acid (4.23 to 850 ng/mL). We observed no association between age and concentration for most biomarkers measured but noted a "U-shaped" trend for five organophosphate metabolites, with the highest concentrations observed in the youngest and oldest age strata, perhaps related to age-specific differences in behavior or physiology. The fact that concentrations of specific and non-specific metabolites of the organophosphate insecticide chlorpyrifos were higher than reported in USA and Canada may relate to differences in registered applications among countries. Additional biomonitoring programs of the general population and focusing on vulnerable populations would improve the exposure assessment and the monitoring of temporal exposure trends as usage patterns of pesticide products in Australia change over time.
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Affiliation(s)
- A L Heffernan
- National Research Centre for Environmental Toxicology, The University of Queensland, 39 Kessels Rd, Coopers Plains, QLD, 4108, Australia.
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.
| | - K English
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Lml Toms
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - A M Calafat
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - P Hobson
- Sullivan Nicolaides Pathology Taringa, Taringa, QLD, Australia
| | - S Broomhall
- Australian Government Department of the Environment, Canberra, ACT, Australia
| | - R S Ware
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - P Jagals
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - P D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - J F Mueller
- National Research Centre for Environmental Toxicology, The University of Queensland, 39 Kessels Rd, Coopers Plains, QLD, 4108, Australia
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Kriebel D, Hoppin PJ, Jacobs MM, Clapp RW. Environmental and Economic Strategies for Primary Prevention of Cancer in Early Life. Pediatrics 2016; 138:S56-S64. [PMID: 27940978 DOI: 10.1542/peds.2015-4268i] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 11/24/2022] Open
Abstract
This article summarizes the evidence for environmental toxic exposures contributing to cancers in early life, focusing on the most common cancer sites in this age group. It provides examples of widespread avoidable exposures to human carcinogens through air, water, and food and then describes recent examples of successful initiatives to reduce exposure to chemicals linked to these cancer sites, through government policy, industry initiatives, and consumer activism. State government initiatives to reduce toxic chemical exposures have made important gains; the Toxics Use Reduction Act of Massachusetts is now 25 years old and has been a major success story. There are a growing number of corporate initiatives to eliminate toxics, especially carcinogens, from the products they manufacture and sell. Another important opportunity for cancer prevention is provided by online databases that list chemicals, their toxicity, and lower-toxicity alternatives; these can be used by businesses, health care institutions, consumers, and workers to reduce exposures to chemicals of concern. The article concludes by inviting pediatricians and public health professionals to include elimination of carcinogen exposures in their work to promote primary prevention of cancer in early life.
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Affiliation(s)
- David Kriebel
- Lowell Center for Sustainable Production, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Polly J Hoppin
- Lowell Center for Sustainable Production, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Molly M Jacobs
- Lowell Center for Sustainable Production, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Richard W Clapp
- Lowell Center for Sustainable Production, University of Massachusetts Lowell, Lowell, Massachusetts
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Massetti GM, Thomas CC, Ragan KR. Disparities in the Context of Opportunities for Cancer Prevention in Early Life. Pediatrics 2016; 138:S65-S77. [PMID: 27940979 PMCID: PMC5161109 DOI: 10.1542/peds.2015-4268j] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 11/24/2022] Open
Abstract
Persistent health disparities are a major contributor to disproportionate burden of cancer for some populations. Health disparities in cancer incidence and mortality may reflect differences in exposures to risk factors early in life. Understanding the distribution of exposures to early life risk and protective factors for cancer across different populations can shed light on opportunities to promote health equity at earlier developmental stages. Disparities may differentially influence risk for cancer during early life and create opportunities to promote health equity. Potential risk and protective factors for cancer in early life reveal patterns of disparities in their exposure. These disparities in exposures can manifest in downstream disparities in risk for cancer. These risk and protective factors include adverse childhood experiences; maternal alcohol consumption in pregnancy; childhood obesity; high or low birth weight; benzene exposure; use of assisted reproductive technologies; pesticide and insecticide exposure; isolated cryptorchidism; early pubertal timing; exposure to radiation; exposure to tobacco in utero and in early life; allergies, asthma, and atopy; and early exposure to infection. Disparities on the basis of racial and ethnic minority status, economic disadvantage, disability status, sex, geography, and nation of origin can occur in these risk and protective factors. Vulnerable populations experience disproportionally greater exposure to risk factors in early life. Addressing disparities in risk factors in early life can advance opportunities for prevention, promote health equity, and possibly reduce risk for subsequent development of cancer.
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Affiliation(s)
- Greta M. Massetti
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cheryll C. Thomas
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen R. Ragan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Whitehead TP, Metayer C, Wiemels JL, Singer AW, Miller MD. Childhood Leukemia and Primary Prevention. Curr Probl Pediatr Adolesc Health Care 2016; 46:317-352. [PMID: 27968954 PMCID: PMC5161115 DOI: 10.1016/j.cppeds.2016.08.004] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Leukemia is the most common pediatric cancer, affecting 3800 children per year in the United States. Its annual incidence has increased over the last decades, especially among Latinos. Although most children diagnosed with leukemia are now cured, many suffer long-term complications, and primary prevention efforts are urgently needed. The early onset of leukemia-usually before 5 years of age-and the presence at birth of "pre-leukemic" genetic signatures indicate that pre- and postnatal events are critical to the development of the disease. In contrast to most pediatric cancers, there is a growing body of literature-in the United States and internationally-that has implicated several environmental, infectious, and dietary risk factors in the etiology of childhood leukemia, mainly for acute lymphoblastic leukemia, the most common subtype. For example, exposures to pesticides, tobacco smoke, solvents, and traffic emissions have consistently demonstrated positive associations with the risk of developing childhood leukemia. In contrast, intake of vitamins and folate supplementation during the preconception period or pregnancy, breastfeeding, and exposure to routine childhood infections have been shown to reduce the risk of childhood leukemia. Some children may be especially vulnerable to these risk factors, as demonstrated by a disproportionate burden of childhood leukemia in the Latino population of California. The evidence supporting the associations between childhood leukemia and its risk factors-including pooled analyses from around the world and systematic reviews-is strong; however, the dissemination of this knowledge to clinicians has been limited. To protect children's health, it is prudent to initiate programs designed to alter exposure to well-established leukemia risk factors rather than to suspend judgment until no uncertainty remains. Primary prevention programs for childhood leukemia would also result in the significant co-benefits of reductions in other adverse health outcomes that are common in children, such as detriments to neurocognitive development.
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Affiliation(s)
- Todd P Whitehead
- Department of Epidemiology, School of Public Health, University of California, Berkeley, CA; Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA.
| | - Catherine Metayer
- Department of Epidemiology, School of Public Health, University of California, Berkeley, CA; Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA
| | - Joseph L Wiemels
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA; Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA
| | - Amanda W Singer
- Department of Epidemiology, School of Public Health, University of California, Berkeley, CA
| | - Mark D Miller
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California, Berkeley, CA; Western States Pediatric Environmental Health Specialty Unit, University of California, San Francisco, CA
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50
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Passive exposure to agricultural pesticides and risk of childhood leukemia in an Italian community. Int J Hyg Environ Health 2016; 219:742-748. [PMID: 27693118 DOI: 10.1016/j.ijheh.2016.09.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/16/2016] [Accepted: 09/20/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Exposure to pesticides has been suggested as a risk factor for childhood leukemia, but definitive evidence on this relation and the specific pesticides involved is still not clear. OBJECTIVE We carried out a population-based case-control study in a Northern Italy community to assess the possible relation between passive exposure to agricultural pesticides and risk of acute childhood leukemia. METHODS We assessed passive pesticide exposure of 111 childhood leukemia cases and 444 matched controls by determining density and type of agricultural land use within a 100-m radius buffer around children's homes. We focused on four common crop types, arable, orchard, vineyard and vegetable, characterized by the use of specific pesticides that are potentially involved in childhood induced leukemia. The use of these pesticides was validated within the present study. We computed the odds ratios (OR) of the disease and their 95% confidence intervals (CI) according to type and density of crops around the children's homes, also taking into account traffic pollution and high-voltage power line magnetic field exposure. RESULTS Childhood leukemia risk did not increase in relation with any of the crop types with the exception of arable crops, characterized by the use of 2.4-D, MCPA, glyphosate, dicamba, triazine and cypermethrin. The very few children (n=11) residing close to arable crops had an OR for childhood leukemia of 2.04 (95% CI 0.50-8.35), and such excess risk was further enhanced among children aged <5 years. CONCLUSIONS Despite the null association with most crop types and the statistical imprecision of the estimates, the increased leukemia risk among children residing close to arable crops indicates the need to further investigate the involvement in disease etiology of passive exposure to herbicides and pyrethroids, though such exposure is unlikely to play a role in the vast majority of cases.
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