[儿童急性白血病风险与儿童及其父母的生活方式及家庭环境暴露之间的关系]

[Relationship between risk of childhood acute leukemia and children's and parents' lifestyles and household environment exposure].

作者信息

Chen Didi, Zhang Yan, Tian Ying, Shi Rong, Wang Xiaojin, Hu Yi, Ji Xiaofan, Han Kaiyi, Hu Shiyao, Mao Shuqian, Feng Jingyi, Gao Yu

机构信息

Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China.

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出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2015 Sep;49(9):792-9.

PMID:26733137

Abstract

OBJECTIVE

To investigate the association between children's and their parents' lifestyles, household environmental exposures and risk of childhood acute leukemia (AL).

METHODS

A 1:2 matched case-control study of childhood AL was conducted in Shanghai between April 2011 and January 2014. The study enrolled 66 cases aged < 15, diagnosed with AL and 132 controls matched by age, gender and residence. All of the controls had no hematological diseases or previous history of malignancy. Children who had been adopted and had congenital genetic syndromes such as Down's syndrome or a positive HIV test result were not eligible as either cases or controls. Information was obtained from standardized face-to-face interviews of their parents/guardians with detailed questions on demographic characteristics, lifestyle, and household environment. Conditional logistic regression models were used to analyze effecting factors of childhood AL, odds ratios (OR) and their 95% confidence intervals (CI) were calculated.

RESULTS

Among 198 cases, 66 cases were aged (5.0 ± 3.7) years old, and 132 controls were aged (6.0 ± 3.8) years old (t = 0.48, P = 0.523). The paternal drink frequencies of cases and controls were 57.6% (38/66), and 31.1% (41/132), respectively (χ² = 4.91, P = 0.027). And the frequencies of household insecticides usage in the last year in the two groups were 78.8% (52/66), and 65.2% (86/132) (χ² = 3.87, P = 0.049). Chemical exposure during childhood (OR = 4.76, 95% CI: 1.34-16.89), maternal exposure to chemicals (OR = 4.51, 95% CI: 1.65-12.33), household insecticides use during 0-3 years of child (OR = 2.90, 95% CI: 1.31-6.39), and renovating after their children's birth (OR = 3.12, 95% CI: 1.26-7.74) were associated with an increased risk of childhood AL and these differences between the cases and the controls have statistical significance. Besides, we found that frequent contaction with other children during 0-3 years old (OR = 0.32, 95% CI: 0.15-0.69) and ventilation during sleeping in summer (OR = 0.43, 95% CI: 0.18-0.98) were associated with a decreased risk of childhood AL.

CONCLUSION

Our results support the association between children's and their parents' lifestyles, household environmental exposures and childhood AL.

摘要

目的

探讨儿童及其父母的生活方式、家庭环境暴露与儿童急性白血病（AL）风险之间的关联。

方法

2011年4月至2014年1月在上海进行了一项1:2匹配的儿童AL病例对照研究。该研究纳入了66例年龄<15岁、诊断为AL的病例以及132例按年龄、性别和居住地匹配的对照。所有对照均无血液系统疾病或既往恶性肿瘤病史。被收养以及患有先天性遗传综合征（如下唐氏综合征）或HIV检测结果呈阳性的儿童不符合病例或对照的入选标准。通过对其父母/监护人进行标准化的面对面访谈获取信息，询问有关人口统计学特征、生活方式和家庭环境的详细问题。采用条件逻辑回归模型分析儿童AL的影响因素，计算比值比（OR）及其95%置信区间（CI）。

结果

在198例研究对象中，66例病例的年龄为（5.0±3.7）岁，132例对照的年龄为（6.0±3.8）岁（t=0.48，P=0.523）。病例组和对照组父亲的饮酒频率分别为57.6%（38/66）和31.1%（41/132）（χ²=4.91，P=0.027）。两组中过去一年家庭使用杀虫剂的频率分别为78.8%（52/66）和65.2%（86/132）（χ²=3.87，P=0.049）。儿童期化学物质暴露（OR=4.76，95%CI：1.34 - 16.89）、母亲化学物质暴露（OR=4.51，95%CI：1.65 - 12.33）、儿童0至3岁期间家庭使用杀虫剂（OR=2.90，95%CI：1.31 - 6.39）以及孩子出生后房屋装修（OR=3.12，95%CI：1.26 - 7.74）与儿童AL风险增加相关，病例组和对照组之间的这些差异具有统计学意义。此外，我们发现0至3岁期间与其他儿童频繁接触（OR=0.32，95%CI：0.15 - 0.69）以及夏季睡眠时通风（OR=0.43，95%CI：0.18 - 0.98）与儿童AL风险降低相关。