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车辆加油、使用家用木暖炉与儿童脑肿瘤风险:一项澳大利亚病例对照研究的结果

Vehicle refuelling, use of domestic wood heaters and the risk of childhood brain tumours: Results from an Australian case-control study.

作者信息

Greenop Kathryn R, Hinwood Andrea L, Fritschi Lin, Scott Rodney J, Attia John, Ashton Lesley J, Heath John A, Armstrong Bruce K, Milne Elizabeth

机构信息

Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.

Centre for Ecosystem Management, Edith Cowan University, Perth, Western Australia, Australia.

出版信息

Pediatr Blood Cancer. 2015 Feb;62(2):229-234. doi: 10.1002/pbc.25268. Epub 2014 Oct 4.

Abstract

BACKGROUND

The aetiology of childhood brain tumours (CBT) is largely unknown. Damage to germ cells after parental exposure to airborne carcinogens, such as volatile organic compounds and polycyclic aromatic hydrocarbons is one plausible pathway. This analysis aimed to investigate whether parental refuelling of vehicles or the use of domestic wood heaters in key time periods relating to the child's birth was associated with an increased risk of CBT.

PROCEDURE

Cases <15 years of age were recruited through 10 paediatric oncology centres around Australia; controls were recruited through nationwide random-digit dialling, frequency matched to cases on age, sex and State of residence. Exposure to refuelling and wood heaters was ascertained through questionnaires from both parents. Odds ratios (ORs) and confidence intervals (CIs) were estimated using unconditional logistic regression, adjusting for relevant covariates.

RESULTS

Data were available for 306 case and 950 control families. Paternal refuelling ≥4 times/month was associated with an increased risk of CBT (OR 1.59, 95% CI: 1.11, 2.29), and a dose-dependent trend was observed (P = 0.004). No association was seen for maternal refuelling. Use of closed, but not open, wood heaters before (OR 1.51, 95% CI: 1.05, 2.15) and after (OR 1.44, 95% CI: 1.03, 2.01) the child's birth was associated with increased risk of CBT, but dose-response relationships were weak or absent.

CONCLUSIONS

Paternal refuelling of vehicles ≥4 times/month and the use of closed wood heaters before the child's birth may increase the risk of CBT. Replication in larger studies is needed. Pediatr Blood Cancer 2015;62:229-234. © 2014 Wiley Periodicals, Inc.

摘要

背景

儿童脑肿瘤(CBT)的病因在很大程度上尚不清楚。父母接触空气中的致癌物(如挥发性有机化合物和多环芳烃)后生殖细胞受损是一种可能的途径。本分析旨在调查在与孩子出生相关的关键时期,父母给车辆加油或使用家用木取暖器是否与儿童脑肿瘤风险增加有关。

程序

通过澳大利亚各地的10个儿科肿瘤中心招募15岁以下的病例;通过全国随机数字拨号招募对照,在年龄、性别和居住州方面与病例进行频率匹配。通过父母双方的问卷确定加油和使用木取暖器的情况。使用无条件逻辑回归估计比值比(OR)和置信区间(CI),并对相关协变量进行调整。

结果

有306个病例家庭和950个对照家庭的数据。父亲每月加油≥4次与儿童脑肿瘤风险增加相关(OR 1.59,95%CI:1.11,2.29),并观察到剂量依赖性趋势(P = 0.004)。母亲加油未发现关联。在孩子出生前(OR 1.51,95%CI:1.05,2.15)和出生后(OR 1.44,95%CI:1.03,2.01)使用封闭式而非开放式木取暖器与儿童脑肿瘤风险增加相关,但剂量反应关系较弱或不存在。

结论

父亲每月给车辆加油≥4次以及在孩子出生前使用封闭式木取暖器可能会增加儿童脑肿瘤的风险。需要在更大规模的研究中进行重复验证。《儿科血液与癌症》2015年;62:229 - 234。©2014威利期刊公司

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