Spatial clustering of childhood leukaemia with the integration of the Paediatric Environmental History
| Autor: | Juan Antonio Ortega-García, Mayra Orozco-Llamas, Esther Tobarra-Sánchez, F.A. López-Hernández, Blanca Espinosa-López, Lizbeth Alvarez, Alberto Cárceles-Álvarez |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Risk Assessment Biochemistry Article Young Adult 03 medical and health sciences Spatio-Temporal Analysis 0302 clinical medicine Pregnancy hemic and lymphatic diseases 030225 pediatrics Epidemiology Humans Medicine Young adult Child General Environmental Science business.industry Incidence Incidence (epidemiology) Infant Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Childhood leukaemia El Niño Spain Child Preschool 030220 oncology & carcinogenesis Etiology Female business Risk assessment |
| Zdroj: | Environmental Research. 156:605-612 |
| ISSN: | 0013-9351 |
| DOI: | 10.1016/j.envres.2017.04.019 |
| Popis: | 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.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.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 (p0.05). 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. |
| Databáze: | OpenAIRE |
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