Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, 90095-1772, USA.
Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, 90095-1772, USA.
Environ Res. 2021 Sep;200:111388. doi: 10.1016/j.envres.2021.111388. Epub 2021 May 29.
Pesticides are a potential risk factor for childhood leukemia. Studies evaluating the role of prenatal and/or early life exposure to pesticides in the development of childhood leukemia have produced a range of results. In addition to indoor use of pesticides, higher risks have been reported for children born near agricultural crops. No studies have looked at pesticide exposure based on proximity of birth residence to commercial plant nurseries, even though nurseries are located much closer to residences than agricultural crops and can potentially result in chronic year-round pesticide exposure.
To evaluate whether risk of childhood leukemia is associated with pesticide use as determined by distance of residence at birth to commercial, outdoor plant nurseries.
We conducted a large statewide, record-based case-control study of childhood leukemia in California, which included 5788 childhood leukemia cases and an equal number of controls. Pesticide exposure was based on a spatial proximity model, which combined geographic information system data with aerial satellite imagery.
Overall, the results supported an increased childhood leukemia risk only for birth residences very close to nurseries. For birth residences less than 75 m from plant nurseries, we found an increased risk of childhood leukemia (odds ratio (OR) 2.40, 95% confidence interval (CI) 0.99-5.82) that was stronger for acute lymphocytic leukemia (OR 3.09, 95% CI 1.14-8.34).
The association was robust to choices of reference group, cut points and data quality. Our findings suggest that close proximity to plant nurseries may be a risk factor for childhood leukemia and that this relationship should be further evaluated.
农药是儿童白血病的潜在危险因素。评估产前和/或生命早期接触农药对儿童白血病发展影响的研究结果不一。除了室内使用农药外，还报道了在靠近农作物的地区出生的儿童风险更高。尽管苗圃比农作物更靠近住所，并且可能会导致常年慢性接触农药，但尚无研究根据出生住所与商业植物苗圃的接近程度来评估农药暴露情况。
评估儿童白血病的风险是否与通过出生时居住距离来确定的商业户外植物苗圃的农药使用有关。
我们在加利福尼亚州进行了一项针对儿童白血病的全州范围内的大型基于记录的病例对照研究，该研究包括 5788 例儿童白血病病例和相同数量的对照。农药暴露是基于空间接近模型确定的，该模型结合了地理信息系统数据和航空卫星图像。
总体而言，结果仅支持出生住所非常靠近苗圃的儿童白血病风险增加。对于距离苗圃小于 75 米的出生住所，我们发现儿童白血病的风险增加（比值比（OR）2.40，95%置信区间（CI）0.99-5.82），急性淋巴细胞白血病（OR 3.09，95% CI 1.14-8.34）的风险更高。
该关联在选择参考组、临界点和数据质量方面是稳健的。我们的研究结果表明，靠近植物苗圃可能是儿童白血病的一个危险因素，应进一步评估这种关系。
