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探讨城市绿地对儿童白血病发病率的交通暴露影响。

Exploring Urban Green Spaces' Effect against Traffic Exposure on Childhood Leukaemia Incidence.

机构信息

Guadalajara University Hospital, 19002 Guadalajara, 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.

出版信息

Int J Environ Res Public Health. 2023 Jan 31;20(3):2506. doi: 10.3390/ijerph20032506.

Abstract

BACKGROUND

Several environmental factors seem to be involved in childhood leukaemia incidence. Traffic exposure could increase the risk while urban green spaces (UGS) exposure could reduce it. However, there is no evidence how these two factors interact on this infant pathology.

OBJECTIVES

to evaluate how residential proximity to UGS could be an environmental protective factor against traffic exposure on childhood leukaemia incidence.

METHODS

A population-based case control study was conducted across thirty Spanish regions during the period 2000-2018. It included 2526 incident cases and 15,156, individually matched by sex, year-of-birth, and place-of-residence. Using the geographical coordinates of the participants' home residences, a 500 m proxy for exposure to UGS was built. Annual average daily traffic (AADT) was estimated for all types of roads 100 m near the children's residence. Odds ratios (ORs) and 95% confidence intervals (95% CIs), UGS, traffic exposure, and their possible interactions were calculated for overall childhood leukaemia, and the acute lymphoblastic (ALL) and acute myeloblastic leukaemia (AML) subtypes, with adjustment for socio-demographic covariates.

RESULTS

We found an increment of childhood leukaemia incidence related to traffic exposure, for every 100 AADT increase the incidence raised 1.1% (95% CI: 0.58-1.61%). UGS exposure showed an incidence reduction for the highest exposure level, Q5 (OR = 0.63; 95% CI = 0.54-0.72). Regression models with both traffic exposure and UGS exposure variables showed similar results but the interaction was not significant.

CONCLUSIONS

Despite their opposite effects on childhood leukaemia incidence individually, our results do not suggest a possible interaction between both exposures. This is the first study about the interaction of these two environmental factors; consequently, it is necessary to continue taking into account more individualized data and other possible environmental risk factors involved.

摘要

背景

有几个环境因素似乎与儿童白血病的发病率有关。交通暴露可能会增加风险,而城市绿地(UGS)暴露则可能降低风险。然而,目前还没有证据表明这两个因素如何相互作用于这种婴儿病理。

目的

评估居住在 UGS 附近的距离如何成为对抗交通暴露对儿童白血病发病率影响的环境保护因素。

方法

在 2000 年至 2018 年期间,在西班牙的三十个地区进行了一项基于人群的病例对照研究。它包括 2526 名确诊病例和 15156 名对照病例,通过性别、出生年份和居住地进行匹配。利用参与者家庭住址的地理坐标,构建了一个 500 米的 UGS 暴露代理。在儿童住所附近的 100 米范围内,估算了所有类型道路的年平均日交通量(AADT)。计算了总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)和 95%置信区间(95%CI)、UGS、交通暴露及其可能的相互作用,同时调整了社会人口学协变量。

结果

我们发现交通暴露与儿童白血病发病率的增加有关,AADT 每增加 100,发病率增加 1.1%(95%CI:0.58-1.61%)。UGS 暴露显示出随着暴露水平的增加而降低发病率的趋势,最高暴露水平 Q5(OR=0.63;95%CI=0.54-0.72)。同时包含交通暴露和 UGS 暴露变量的回归模型得出了相似的结果,但相互作用不显著。

结论

尽管交通暴露和 UGS 暴露对儿童白血病发病率的影响相反,但我们的结果并不表明这两种暴露之间可能存在相互作用。这是第一项关于这两种环境因素相互作用的研究;因此,有必要继续考虑更多个体化的数据和其他可能涉及的环境风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9bf/9915143/a9aa66ebc0c1/ijerph-20-02506-g001.jpg

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