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儿童癌症与居住临近加油站的关系:瑞士全国性基于登记的病例对照研究和更新的荟萃分析。

Childhood cancer and residential proximity to petrol stations: a nationwide registry-based case-control study in Switzerland and an updated meta-analysis.

机构信息

Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.

MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.

出版信息

Int Arch Occup Environ Health. 2022 Jul;95(5):927-938. doi: 10.1007/s00420-021-01767-y. Epub 2021 Oct 15.

Abstract

PURPOSE

Benzene is a known carcinogen for adult leukemia. Exposure to benzene through parental occupation and the use of household products has been associated with childhood leukemia (CL). Ambient benzene has also been associated with CL and central nervous system (CNS) tumors. We aimed to investigate whether the higher ambient levels of benzene in proximity of petrol stations are associated with a greater risk of childhood cancers, leukemia, and CNS tumors.

METHODS

We identified children diagnosed with cancer at age 0-15 years during 1985-2015 from the Swiss Childhood Cancer Registry and selected 10 age and sex-matched controls per case from national censuses. We calculated the distance from children's home to the nearest petrol station using precise geocodes. We estimated odds ratios using conditional logistic regression adjusting for ambient levels of NO, distance to highways, level of urbanization, and presence of a cantonal cancer registry. In addition, we ran a meta-analysis pooling current results for CL with those of previous studies.

RESULTS

We identified 6129 cases, of which 1880 were leukemias and 1290 CNS tumors. 24 cases lived within 50 m from a petrol station. The adjusted odds ratio of a cancer diagnosis for children thus exposed compared to unexposed children (> 500 m) was 1.29 (0.84-1.98) for all cancers combined, 1.08 (0.46-2.51) for leukemia, and 1.30 (0.51-3.35) for CNS tumors. During 2000-2015, when exposure assessment was more precise, the adjusted odds ratio for any cancer diagnosis was 1.77 (1.05-2.98). The summary relative risk estimate for CL in the meta-analysis including four studies was 2.01 (1.25-3.22).

CONCLUSIONS

Our study provides weak support for an increased risk of childhood cancers among children living close to petrol stations. A meta-analysis including our study suggests an increased risk for CL.

摘要

目的

苯是一种已知的成人白血病致癌物。通过父母职业接触和使用家用产品接触苯与儿童白血病(CL)有关。环境中的苯也与 CL 和中枢神经系统(CNS)肿瘤有关。我们旨在调查加油站附近较高的环境苯水平是否与儿童癌症、白血病和 CNS 肿瘤的风险增加有关。

方法

我们从瑞士儿童癌症登记处确定了 1985 年至 2015 年期间年龄在 0-15 岁的癌症患儿,并从全国人口普查中选择了每例病例 10 名年龄和性别匹配的对照。我们使用精确的地理编码计算了儿童家庭与最近加油站的距离。我们使用条件逻辑回归计算了比值比,调整了环境 NO 水平、与高速公路的距离、城市化水平和是否存在州癌症登记处等因素。此外,我们还进行了荟萃分析,将当前 CL 的研究结果与以前的研究结果进行了汇总。

结果

我们确定了 6129 例病例,其中 1880 例为白血病,1290 例为 CNS 肿瘤。24 例患儿居住在距离加油站 50 米以内。与未暴露于加油站的儿童(>500 米)相比,暴露于此的儿童癌症诊断的调整比值比为所有癌症的 1.29(0.84-1.98)、白血病的 1.08(0.46-2.51)和 CNS 肿瘤的 1.30(0.51-3.35)。在 2000-2015 年期间,当暴露评估更加精确时,任何癌症诊断的调整比值比为 1.77(1.05-2.98)。包括四项研究的荟萃分析的汇总相对风险估计值为 2.01(1.25-3.22)。

结论

我们的研究为儿童在靠近加油站的地方生活时,儿童癌症的风险增加提供了微弱的支持。包括我们研究在内的荟萃分析表明 CL 的风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e72a/9203398/2acd76993d9e/420_2021_1767_Fig1_HTML.jpg

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