Boutou O, Guizard A-V, Slama R, Pottier D, Spira A
Ecole Nationale de la Santé Publique, département Egeries, avenue du Professeur Léon Bernard, CS 74312, 35043 Rennes cedex, France.
Br J Cancer. 2002 Sep 23;87(7):740-5. doi: 10.1038/sj.bjc.6600529.
In order to investigate for an association between population mixing and the occurrence of leukaemia in young people (less than 25 years), a geographical study was conducted, for the years 1979 to 1998, in Nord Cotentin (France). This area experienced between the years 1978 and 1992 a major influx of workers for the construction of a nuclear power station and a new nuclear waste reprocessing unit. A population mixing index was defined on the basis of the number of workers born outside the French department of 'La Manche' and living in each 'commune', the basic geographical unit under study. The analyses were done with indirect standardisation and Poisson regression model allowing or not for extra-Poisson variation. Urban 'communes' were considered as the reference population. The Incidence Rate Ratio was 2.7 in rural 'communes' belonging to the highest tertile of population mixing (95% Bayesian credible interval, 95%BCI=1.2-5.9). A positive trend was observed among rural strata with increasing population mixing index (IRR for trend=1.4, 95%BCI=1.1-1.8). The risk became stronger for Acute Lymphoblastic Leukaemia in children 1-6 years old in the highest tertile of population mixing (IRR=5.5, 95%BCI=1.4-23.3). These findings provide further support for a possible infective basis of childhood leukaemia.
为了调查人群混合与年轻人(25岁以下)白血病发生之间的关联,于1979年至1998年在法国北科唐坦进行了一项地理研究。该地区在1978年至1992年期间经历了大量工人涌入,以建设一座核电站和一个新的核废料后处理厂。根据出生在法国“芒什省”以外且居住在每个“市镇”(所研究的基本地理单位)的工人数量定义了一个人群混合指数。分析采用间接标准化和泊松回归模型,允许或不允许超泊松变异。城市“市镇”被视为参考人群。在人群混合处于最高三分位数的农村“市镇”中,发病率比为2.7(95%贝叶斯可信区间,95%BCI = 1.2 - 5.9)。在农村阶层中观察到随着人群混合指数增加呈正相关趋势(趋势的发病率比 = 1.4,95%BCI = 1.1 - 1.8)。在人群混合处于最高三分位数的1 - 6岁儿童中,急性淋巴细胞白血病的风险更强(发病率比 = 5.5,95%BCI = 1.4 - 23.3)。这些发现为儿童白血病可能的感染基础提供了进一步支持。