Levallois P
Centre de santé publique, Centre hospitalier de l'Université Laval, Québec, Canada.
Am J Prev Med. 1995 Jul-Aug;11(4):263-70.
The possibility of a causal relationship between exposure to electromagnetic fields and childhood leukemia has been studied for more than 10 years. This review evaluates the epidemiologic findings relevant to a possible causal association between exposure to power frequency magnetic fields during childhood and leukemia. The nine published studies on this topic were analyzed, with a focus on the selection of subjects, assessment of exposure, and control of confounding. Consistency of a positive association and dose-response relationship are evident for assessment of past exposure: among the five recent studies, relative risk estimates vary from 1.5 to 2.7 for past exposure assessment, and a significant dose-response relation was found in three studies. These observations cannot be explained by misclassification of exposure or consistent selection bias, and a confounder effect could hardly explain such results. Even if there is no currently understood biological plausibility for such an association, its possible causal nature cannot be dismissed. The impact on public health of such a possible causal association is difficult to assess precisely but could be significant. Therefore, it might be prudent to consider interim preventive measures while we await results of further research.
电磁场暴露与儿童白血病之间因果关系的可能性已被研究了10多年。本综述评估了与儿童期暴露于工频磁场和白血病之间可能的因果关联相关的流行病学研究结果。分析了关于该主题的九项已发表研究，重点关注研究对象的选择、暴露评估和混杂因素的控制。对于过去暴露的评估，正相关和剂量反应关系的一致性很明显：在最近的五项研究中，过去暴露评估的相对风险估计值在1.5至2.7之间，并且在三项研究中发现了显著的剂量反应关系。这些观察结果无法用暴露的错误分类或一致的选择偏倚来解释，并且混杂因素的影响也很难解释这样的结果。即使目前对于这种关联没有已知的生物学合理性，其可能的因果性质也不能被忽视。这种可能的因果关联对公众健康的影响难以精确评估，但可能是重大的。因此，在等待进一步研究结果的同时，考虑采取临时预防措施可能是谨慎的做法。
