道路交通与儿童白血病：ESCALE 研究（SFCE）。
Road traffic and childhood leukemia: the ESCALE study (SFCE).
机构信息
INSERM (Institut National de la Santé et de la Recherche Médicale), CESP (Centre de recherche en Epidémiologie et Santé des Populations) Environmental Epidemiology of Cancer, Villejuif, France.
出版信息
Environ Health Perspect. 2011 Apr;119(4):566-72. doi: 10.1289/ehp.1002429. Epub 2010 Dec 8.
BACKGROUND
Traffic is a source of environmental exposures, including benzene, which may be related to childhood leukemia.
OBJECTIVES
A national registry-based case-control study [ESCALE (Etude Sur les Cancers et les Leucémies de l'Enfant, Study on Environmental and Genetic Risk Factors of Childhood Cancers and Leukemia)] carried out in France was used to assess the effect of exposure to road traffic exhaust fumes on the risk of childhood leukemia.
METHODS
Over the study period, 2003-2004, 763 cases and 1,681 controls < 15 years old were included, and the controls were frequency matched with the cases on age and sex. The ESCALE data were collected by a standardized telephone interview of the mothers. Various indicators of exposure to traffic and pollution were determined using the geocoded addresses at the time of diagnosis for the cases and of interview for the controls. Indicators of the distance from, and density of, main roads and traffic nitrogen dioxide (NO(2)) concentrations derived from traffic emission data were used. Odds ratios (ORs) were estimated using unconditional regression models adjusted for potential confounders.
RESULTS
Acute leukemia (AL) was significantly associated with estimates of traffic NO(2) concentration at the place of residence > 27.7 µg/m(3) compared with NO(2) concentration < 21.9 µg/m(3) [OR=1.2; confidence interval (CI), 1.0-1.5] and with the presence of a heavy-traffic road within 500 m compared with the absence of a heavy-traffic road in the same area (OR=2.0; 95% CI, 1.0-3.6). There was a significant association between AL and a high density of heavy-traffic roads within 500 m compared with the reference category with no heavy-traffic road within 500 m (OR=2.2; 95% CI, 1.1-4.2), with a significant positive linear trend of the association of AL with the total length of heavy-traffic road within 500 m.
CONCLUSION
This study supports the hypothesis that living close to heavy-traffic roads may increase the risk of childhood leukemia.
背景
交通是环境暴露的一个来源，包括苯，它可能与儿童白血病有关。
目的
在法国进行的一项基于全国登记的病例对照研究（ESCALE [儿童癌症和白血病的环境和遗传风险因素研究]）用于评估道路交通废气暴露对儿童白血病风险的影响。
方法
在研究期间（2003-2004 年），纳入了 763 例病例和 1681 例对照<15 岁，对照按年龄和性别与病例进行频数匹配。ESCALE 数据通过对母亲进行标准化电话访谈收集。使用病例诊断时和对照访谈时的地理编码地址确定交通和污染的各种暴露指标。使用来自交通排放数据的主要道路的距离和密度指标以及交通氮氧化物（NO2）浓度。使用非条件回归模型估计比值比（OR），并调整潜在混杂因素。
结果
与 NO2浓度<21.9 µg/m3相比，居住地的交通 NO2浓度>27.7 µg/m3与急性白血病（AL）显著相关[OR=1.2；95%置信区间（CI），1.0-1.5]，与同一区域内 500 m 内有交通繁忙的道路相比，同一区域内无交通繁忙的道路的存在显著相关[OR=2.0；95% CI，1.0-3.6]。AL 与 500 m 内高密度交通繁忙道路之间存在显著关联，与 500 m 内无交通繁忙道路的参考类别相比[OR=2.2；95% CI，1.1-4.2]，AL 与 500 m 内交通繁忙道路总长度之间呈正线性趋势。
结论
本研究支持了这样的假设，即居住在交通繁忙的道路附近可能会增加儿童白血病的风险。
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