Albacete University Hospital, 02006 Albacete, Spain.
Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Instituto de Salud Carlos III (Carlos III Institute of Health), 28029 Madrid, Spain.
Int J Environ Res Public Health. 2022 Apr 25;19(9):5232. doi: 10.3390/ijerph19095232.
Blue spaces have been a key part of human evolution, providing resources and helping economies develop. To date, no studies have been carried out to explore how they may be linked to paediatric oncological diseases.
To explore the possible relationship of residential proximity to natural and urban blue spaces on childhood leukaemia.
A population-based case-control study was conducted in four regions of Spain across the period 2000-2018. A total of 936 incident cases and 5616 controls were included, individually matched by sex, year of birth and place of residence. An exposure proxy with four distances (250 m, 500 m, 750 m, and 1 km) to blue spaces was built using the geographical coordinates of the participants' home residences. Odds ratios (ORs) and 95% confidence intervals (95%CIs) for blue-space exposure were calculated for overall childhood leukaemia, and the acute lymphoblastic (ALL) and acute myeloblastic leukaemia (AML) subtypes, with adjustment for socio-demographic and environmental covariates.
A decrease in overall childhood leukaemia and ALL-subtype incidence was found as we came nearer to children's places of residence, showing, for the study as a whole, a reduced incidence at 250 m (odds ratio (OR) = 0.77; 95%CI = 0.60-0.97), 500 m (OR = 0.78; 95%CI = 0.65-0.93), 750 m (OR = 0.80; 95%CI = 0.69-0.93), and 1000 m (OR = 0.84; 95%CI = 0.72-0.97). AML model results showed an increasing incidence at closest to subjects' homes (OR at 250m = 1.06; 95%CI=0.63-1.71).
Our results suggest a possible association between lower childhood leukaemia incidence and blue-space proximity. This study is a first approach to blue spaces' possible effects on childhood leukaemia incidence; consequently, it is necessary to continue studying these spaces-while taking into account more individualised data and other possible environmental risk factors.
蓝色空间一直是人类进化的关键部分，为人们提供资源并帮助经济发展。迄今为止，尚无研究探讨它们与儿科肿瘤疾病之间的可能联系。
探索居住环境与自然和城市蓝色空间的接近程度与儿童白血病之间的可能关系。
本研究在西班牙四个地区开展了一项基于人群的病例对照研究，研究时间为 2000 年至 2018 年。共纳入 936 例新发病例和 5616 例对照，按性别、出生年份和居住地进行个体匹配。使用参与者家庭住址的地理坐标构建了蓝色空间的四个距离（250m、500m、750m 和 1km）的暴露代理。计算了蓝色空间暴露与总体儿童白血病以及急性淋巴细胞白血病（ALL）和急性髓细胞白血病（AML）亚型的比值比（OR）及其 95%置信区间（95%CI），并对社会人口学和环境协变量进行了调整。
我们发现，随着儿童居住地的临近，总体儿童白血病和 ALL 亚型的发病率呈下降趋势，整体研究结果显示，在 250m（OR=0.77；95%CI=0.60-0.97）、500m（OR=0.78；95%CI=0.65-0.93）、750m（OR=0.80；95%CI=0.69-0.93）和 1000m（OR=0.84；95%CI=0.72-0.97）距离处，儿童白血病的发病率降低。AML 模型结果显示，在距离研究对象家最近处的发病率增加（OR 在 250m 处为 1.06；95%CI=0.63-1.71）。
我们的结果表明，儿童白血病发病率较低与蓝色空间接近度之间可能存在关联。本研究首次探讨了蓝色空间对儿童白血病发病率的可能影响，因此有必要继续研究这些空间，同时考虑到更个体化的数据和其他可能的环境风险因素。
