Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS); Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional.
Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS).
Arch Med Res. 2016 Nov;47(8):684-693. doi: 10.1016/j.arcmed.2016.12.006.
Occupational exposure of parents to carcinogens is of great interest in the etiology of leukemias. Evidence of the impact of such exposure on infants or small children is scarce. Here we estimated whether occupational exposure of parents to carcinogens could be a risk factor for leukemias in their children.
Cases of acute leukemia (AL) in infants ≤24 months old diagnosed in Mexico City (1998-2013) were included in a population-based, case-control study. Each of the 195 cases was matched with at least one healthy child (n = 369). For each of four exposure windows studied, the degree of exposure to carcinogens was determined for both parents by using a validated occupational exposure index. An unconditional logistic regression was carried out.
Odds ratios (OR) and the 95% confidence intervals (CI) of the overall occupational exposure for parents during the four exposure windows indicated no association with risk of AL in their children. Pre-conception, the OR by the father 0.77 (0.49-1.21), by the mother 1.03 (0.50-2.11); during pregnancy, father 0.66 (0.38-1.15), mother 1.79 (0.46-6.90); during breastfeeding, father 0.75 (0.43-1.30), mother 0.96 (0.21-4.30); and after birth, father 0.74 (0.45-1.22), mother 0.90 (0.24-3.32). The statistical power of the sample size to identify an OR ≥2 and an exposure of ≥10% among controls was 78%.
These data support the idea that parents' occupational exposure during any of the periods studied was not a risk factor contributing to the etiology of AL in infants ≤24 months of age.
父母接触致癌物质会增加儿童白血病的发病风险，这一现象引起了广泛关注。目前，关于此类接触对婴儿或幼儿的影响的证据还很有限。本研究旨在评估父母接触致癌物质是否会成为 24 个月以下婴儿白血病的危险因素。
该研究为基于人群的病例对照研究，纳入了 1998-2013 年在墨西哥城诊断的 24 个月以下婴儿急性白血病（AL）病例。每个病例都匹配了至少一名健康儿童（n=369）。在四个暴露窗口中，通过使用经过验证的职业暴露指数来确定父母双方的致癌物质暴露程度。采用无条件逻辑回归进行分析。
在四个暴露窗口中，父母的整体职业暴露比值比（OR）及其 95%置信区间（CI）均未显示与儿童 AL 风险之间存在关联。在受孕前，父亲的 OR 值为 0.77（0.49-1.21），母亲为 1.03（0.50-2.11）；在怀孕期间，父亲的 OR 值为 0.66（0.38-1.15），母亲为 1.79（0.46-6.90）；在母乳喂养期间，父亲的 OR 值为 0.75（0.43-1.30），母亲为 0.96（0.21-4.30）；在婴儿出生后，父亲的 OR 值为 0.74（0.45-1.22），母亲为 0.90（0.24-3.32）。样本量足以识别比值比≥2 和对照组中暴露率≥10%的统计效力为 78%。
这些数据支持这样的观点，即父母在研究期间任何时期的职业暴露都不是导致 24 个月以下婴儿 AL 发病的危险因素。
