Kinlen L J, Hudson C
Department of Public Health Medicine, University of Oxford, Radcliffe Infirmary.
BMJ. 1991 Nov 30;303(6814):1357-62. doi: 10.1136/bmj.303.6814.1357.
To determine if any excess of childhood leukaemia was associated with the large and increasing numbers of national military servicemen in 1949 and 1950, particularly in rural districts. This would be a further test of the hypothesis that childhood leukaemia can originate in an infection, the transmission of which is facilitated by an increased number of unaccustomed contacts in the community.
Rural and urban districts, aggregated by county, were ranked by proportion of servicemen, and five groups containing similar numbers of children were created. In addition, individual local authority districts were ranked and grouped in tenths. Mortality from childhood leukaemia 1950-3 was examined in these groups. Data on infectious diseases were also examined, as well as data on leukaemia in later periods.
England and Wales.
Children aged under 15 years.
In 1950-3 but not subsequently a significant excess of leukaemia in children under 15 was found in the fifth of county groupings with the highest proportions of servicemen. This was due mainly to a significant excess in children under 2 years (and especially in those under 1 year) in rural districts. It was confirmed among the tenth of local authority districts with the highest proportion of servicemen. These rural areas showed significantly more notifications of, and deaths from, poliomyelitis among children than the rural average.
The findings support the infection hypothesis. That the excess of leukaemia was greatest in children under 1 year suggests transmission of infection among adults and thence to the fetus. The pattern of spread of poliomyelitis may also have been influenced by the presence of large numbers of servicemen.
确定1949年和1950年大量且不断增加的国家军人数量,尤其是农村地区的军人数量,是否与儿童白血病的任何超额病例有关。这将是对儿童白血病可能起源于感染这一假说的进一步检验,即社区中不习惯接触的人数增加会促进感染的传播。
按县汇总的农村和城市地区按军人比例进行排名,并创建了五组儿童数量相近的组别。此外,对各个地方当局地区进行排名并分成十分之一组。对这些组中1950 - 1953年儿童白血病死亡率进行了检查。还检查了传染病数据以及后期白血病数据。
英格兰和威尔士。
15岁以下儿童。
在1950 - 1953年期间,但之后未发现,在军人比例最高的五分之一县级分组中,15岁以下儿童白血病显著超额。这主要是由于农村地区2岁以下儿童(尤其是1岁以下儿童)显著超额。在军人比例最高的十分之一地方当局地区也得到了证实。这些农村地区儿童脊髓灰质炎的报告病例数和死亡数显著高于农村平均水平。
研究结果支持感染假说。白血病超额在1岁以下儿童中最为严重,这表明感染在成年人之间传播,进而传播给胎儿。脊髓灰质炎的传播模式也可能受到大量军人存在的影响。