Pearce Mark S, Cotterill Simon J, Parker Louise
Paediatric and Lifecourse Epidemiology Research Group, School of Clinical Medical Sciences, University of Newcastle upon Tyne, UK.
Epidemiology. 2004 May;15(3):352-6. doi: 10.1097/01.ede.0000120883.24664.26.
There is evidence to suggest that childhood leukemia and non-Hodgkin lymphoma have an infective etiology. We investigated the risk of childhood leukemia and non-Hodgkin lymphoma in relation to paternal occupational contact with other individuals, a surrogate for potential exposure to infection.
We carried out a case-control study using 792 cases from the Northern Region Young Persons' Malignant Disease Registry, United Kingdom, 1968-1997, and 2 large population-based control groups. Paternal occupations at birth were classified as having standard, high, or very high levels of contact. Conditional logistic regression was used in the analysis.
There was an increased risk of childhood leukemia and non-Hodgkin lymphoma in those children whose fathers' occupational contacts were high or very high compared with standard (odds ratio = 1.3; 95% confidence interval = 1.0-1.5). The excess risk in the very high group was most pronounced for 245 cases of acute lymphoblastic leukemia aged 2 to 5 years at diagnosis (1.5; 1.1-2.1). The risk with paternal occupational contacts was greater in rural areas, although it was also present in urban areas. The risks of leukemia and non-Hodgkin lymphoma were also higher among the offspring of men employed as policemen, sales representatives, or teachers.
Our findings are consistent with the hypothesis of an infective etiology for childhood leukemia and non-Hodgkin lymphoma, and they add to the evidence that infections could be transmitted to children by adults.
有证据表明儿童白血病和非霍奇金淋巴瘤有感染性病因。我们调查了儿童白血病和非霍奇金淋巴瘤的患病风险与父亲职业性接触他人之间的关系,后者是潜在感染暴露的一个替代指标。
我们进行了一项病例对照研究,使用了来自英国北部地区青年恶性疾病登记处1968 - 1997年的792例病例,以及2个大型基于人群的对照组。将出生时父亲的职业分为接触水平标准、高或非常高。分析中使用条件逻辑回归。
与接触水平标准的情况相比,父亲职业接触水平高或非常高的儿童患儿童白血病和非霍奇金淋巴瘤的风险增加(比值比 = 1.3;95%置信区间 = 1.0 - 1.5)。在诊断时年龄为2至5岁的245例急性淋巴细胞白血病病例中,接触水平非常高组的额外风险最为明显(1.5;1.1 - 2.1)。父亲职业接触的风险在农村地区更大,尽管在城市地区也存在。在警察、销售代表或教师职业的男性后代中,白血病和非霍奇金淋巴瘤的风险也更高。
我们的研究结果与儿童白血病和非霍奇金淋巴瘤有感染性病因的假设一致,并且补充了感染可能由成人传播给儿童的证据。