Division of International and Environmental Health, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
Int J Epidemiol. 2011 Oct;40(5):1247-60. doi: 10.1093/ije/dyr115. Epub 2011 Jul 12.
Previous studies on childhood cancer and nuclear power plants (NPPs) produced conflicting results. We used a cohort approach to examine whether residence near NPPs was associated with leukaemia or any childhood cancer in Switzerland.
We computed person-years at risk for children aged 0-15 years born in Switzerland from 1985 to 2009, based on the Swiss censuses 1990 and 2000 and identified cancer cases from the Swiss Childhood Cancer Registry. We geo-coded place of residence at birth and calculated incidence rate ratios (IRRs) with 95% confidence intervals (CIs) comparing the risk of cancer in children born <5 km, 5-10 km and 10-15 km from the nearest NPP with children born >15 km away, using Poisson regression models.
We included 2925 children diagnosed with cancer during 21 117 524 person-years of follow-up; 953 (32.6%) had leukaemia. Eight and 12 children diagnosed with leukaemia at ages 0-4 and 0-15 years, and 18 and 31 children diagnosed with any cancer were born <5 km from a NPP. Compared with children born >15 km away, the IRRs (95% CI) for leukaemia in 0-4 and 0-15 year olds were 1.20 (0.60-2.41) and 1.05 (0.60-1.86), respectively. For any cancer, corresponding IRRs were 0.97 (0.61-1.54) and 0.89 (0.63-1.27). There was no evidence of a dose-response relationship with distance (P > 0.30). Results were similar for residence at diagnosis and at birth, and when adjusted for potential confounders. Results from sensitivity analyses were consistent with main results.
This nationwide cohort study found little evidence of an association between residence near NPPs and the risk of leukaemia or any childhood cancer.
先前关于儿童癌症与核电站（NPP）的研究结果相互矛盾。我们采用队列研究方法，在瑞士调查了儿童居住在核电站附近是否与白血病或任何类型的儿童癌症相关。
我们基于瑞士 1990 年和 2000 年的人口普查资料，计算了 1985 年至 2009 年期间在瑞士出生的 0-15 岁儿童的人年数，并从瑞士儿童癌症登记处确定了癌症病例。我们对出生时的居住地进行了地理编码，并使用泊松回归模型计算了距最近核电站<5km、5-10km 和 10-15km 处出生的儿童与距核电站>15km 处出生的儿童癌症发病风险比（IRR）及其 95%置信区间（CI）。
我们纳入了 2925 名在 21 117 524 人年随访期间诊断为癌症的儿童；953 名（32.6%）患有白血病。有 8 名和 12 名 0-4 岁和 0-15 岁儿童以及 18 名和 31 名任何年龄儿童被诊断患有白血病，他们出生时距离核电站<5km。与距核电站>15km 处出生的儿童相比，0-4 岁和 0-15 岁儿童白血病的 IRR（95%CI）分别为 1.20（0.60-2.41）和 1.05（0.60-1.86）。任何癌症的相应 IRR 分别为 0.97（0.61-1.54）和 0.89（0.63-1.27）。距离与发病风险之间没有剂量-反应关系（P>0.30）。在调整潜在混杂因素后，诊断时和出生时居住地的结果相似，敏感性分析结果与主要结果一致。
本项全国性队列研究发现，儿童居住在核电站附近与白血病或任何儿童癌症风险之间几乎没有关联。
