Inserm, UMR 1153 Center of Research in Epidemiology and StatisticS (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), 16 avenue Paul Vaillant Couturier, Hôpital Paul Brousse - Bât Leriche/porte 45, F-94807, Villejuif Cedex, France.
Université Paris Cité, Paris, France.
Environ Health. 2022 Oct 27;21(1):103. doi: 10.1186/s12940-022-00909-0.
Domestic and parental occupational pesticide exposures are suspected of involvement in the occurrence of childhood acute leukaemia (AL), but the role of exposure to agricultural activities is little known. In a previous ecological study conducted in France, we observed an increase in acute lymphoblastic leukaemia (ALL) incidence rate with increasing viticulture density in the municipalities of residence at diagnosis.
This study aimed to test the hypothesis that residential proximity to croplands at birth increases the risk of childhood AL, with a particular focus on vineyards.
We identified all the primary AL cases diagnosed before the age of 15 years in the cohorts of children born in the French municipalities between 1990 and 2015. We estimated crop densities in each municipality of residence at birth using agricultural census data, for ten crop types. Variations in standardized incidence ratios (SIR) were evaluated with Poisson regression models, for all AL, ALL and acute myeloid leukaemia (AML), separately.
Among the 19,809,700 children born and residing in mainland France at birth in 1990-2015, 8,747 AL cases (7,236 ALL and 1,335 AML) were diagnosed over the period. We did not evidence any statistically significant positive association between total crop density or any specific crop density in the municipality of residence at birth and all AL, ALL or AML. Interestingly, we observed a higher ALL incidence rate in the municipalities with the highest viticulture densities (SIR = 1.25 95%CI [1.01-1.54]). Adjusting for the main potential confounders did not change the results.
Our study does not support the hypothesis that residential proximity to croplands, particularly vineyards, around birth plays a role in childhood leukaemia. The slightly higher ALL incidence rate in children born in the municipalities with the highest viticulture densities may reflect the previously-observed association at diagnosis.
国内和父母的职业性农药暴露被怀疑与儿童急性白血病（AL）的发生有关，但农业活动暴露的作用知之甚少。在法国进行的一项先前的生态学研究中，我们观察到居住地的葡萄种植密度增加与诊断时急性淋巴细胞白血病（ALL）发病率的增加有关。
本研究旨在检验以下假设，即出生时居住在农田附近会增加儿童 AL 的风险，特别是与葡萄园有关的风险。
我们确定了所有在法国市镇出生的儿童队列中，1990 年至 2015 年期间诊断出的年龄在 15 岁以下的原发性 AL 病例。我们使用农业普查数据，估算了每个出生时居住地的十种农作物的密度。使用泊松回归模型，分别对所有 AL、ALL 和急性髓细胞白血病（AML），评估标准化发病率比（SIR）的变化。
在 1990-2015 年期间，出生于法国大陆并居住在法国市镇的 19809700 名儿童中，诊断出 8747 例 AL 病例（7236 例 ALL 和 1335 例 AML）。我们没有发现居住地的农作物总密度或任何特定农作物密度与所有 AL、ALL 或 AML 之间存在任何具有统计学意义的正相关关系。有趣的是，我们观察到在葡萄种植密度最高的市镇中 ALL 的发病率更高（SIR=1.25 95%CI [1.01-1.54]）。调整主要潜在混杂因素后，结果并未改变。
本研究不支持以下假设，即出生时居住在农田，特别是葡萄园附近，与儿童白血病有关。在葡萄种植密度最高的市镇中出生的儿童 ALL 发病率略高，可能反映了之前在诊断时观察到的相关性。
