Alexander F, McKinney P A, Cartwright R A
Leukaemia Research Fund Centre for Clinical Epidemiology, Leeds.
J Public Health Med. 1991 May;13(2):96-100.
A study of childhood malignancies in North Humberside for 1974-1986 has revealed significant spatial aggregations. Though no specific reason was found, certain geographical areas, tumour groups and putative risks were identified for further study. One possible risk was a tin smelter to the west of Hull. A new method of analysis (Stone's conditional Poisson maximum) was used and showed some evidence of increased risk close to the smelter. This was accounted for by the solid tumours (primarily central nervous system malignancies) and was not apparent for the leukaemias. The Poisson maximum method is a special case of isotonic regression; a more general isotonic regression method, also due to Stone, Maximum Likelihood Ratio (MLR), is also available, and for reasons described elsewhere we prefer the more general method. The present study begins by applying this to the childhood data and then to data for corresponding adult disease (leukemias and central nervous system tumours) in the same area and time period. In both children and adults the results are negative for the leukaemias. For the remaining tumour categories, there is a significant increase in risk close to the smelter, but it is not possible to identify any aspect of the smelter or feature in its vicinity as causative.
一项对1974年至1986年北亨伯赛德儿童恶性肿瘤的研究发现了显著的空间聚集现象。尽管未找到具体原因,但确定了某些地理区域、肿瘤类别和假定风险以供进一步研究。一个可能的风险因素是位于赫尔以西的一家锡冶炼厂。研究采用了一种新的分析方法(斯通条件泊松极大值法),结果显示在冶炼厂附近有风险增加的迹象。这种情况在实体瘤(主要是中枢神经系统恶性肿瘤)中较为明显,而在白血病中并不明显。泊松极大值法是保序回归的一种特殊情况;还有一种更通用的保序回归方法,同样由斯通提出,即最大似然比法(MLR),出于其他地方所述的原因,我们更倾向于使用这种更通用的方法。本研究首先将此方法应用于儿童数据,然后应用于同一地区和时间段内相应成人疾病(白血病和中枢神经系统肿瘤)的数据。在儿童和成人中,白血病的研究结果均为阴性。对于其余肿瘤类别,在冶炼厂附近风险显著增加,但无法确定冶炼厂及其附近的任何方面或特征为致病因素。