Michaelis J, Haaf H G, Zöllner J, Kaatsch P, Krummenauer F, Berthold F
Institut für Medizinische Statistik, Universität Mainz.
Klin Padiatr. 1996 Jul-Aug;208(4):172-8. doi: 10.1055/s-2008-1046469.
To explore possible causes of a 1988 incidence peak of infant neuroblastoma in west German regions which were contaminated with more than 6000 Bq/m2 Cs137 from the Chernobyl accident. The primary working hypothesis was that parents of the diseased children had been contaminated by an excessive intake of locally produced food, especially mushrooms or deer.
Case control study with 1:2 (cases:controls) matching. Data were collected from the children's parents by questionnaires and telephone interviews.
Nation-wide study (former FRG) based on the German Childhood Cancer Registry.
Cases born in 1988 and reported with a neuroblastoma to the registry until March 1992. Population-based healthy controls, matched for age, sex and residence at time of diagnosis.
The working hypothesis could not be confirmed by the study, because the parents of cases tended to eat less locally grown food than the parents of controls (RR = 0.63, 95% CI:0.20-1.97). Possible influence factors which previously have been described to be associated with neuroblastoma incidence could not be confirmed by the study. Parental exposure to herbicides and pesticides was associated with the occurrence of neuroblastoma (RR = 4.2, 95% CI:1.4-12.9). Neuroblastoma stage distribution in the contaminated regions was shifted towards lower stages as compared to the less contaminated regions and previous age cohorts.
The study does not show additional evidence that the observed increase in neuroblastoma incidence might have been caused by exposure to fallout from the Chernobyl accident. The observed shift towards lower clinical stages may rather indicate increased diagnostic awareness. The association between neuroblastoma and parental exposure with herbicides and pesticides resulted from an extensive exploratory data analysis and needs to be confirmed in further studies.
为探究1988年西德地区婴儿神经母细胞瘤发病率峰值的可能原因，这些地区受到切尔诺贝利事故中超过6000贝克勒尔/平方米铯-137的污染。主要工作假设是患病儿童的父母因过量摄入当地生产的食物，尤其是蘑菇或鹿肉而受到污染。
病例对照研究，病例与对照按1:2匹配。通过问卷调查和电话访谈从儿童父母处收集数据。
基于德国儿童癌症登记处的全国性研究（前联邦德国）。
1988年出生且截至1992年3月向登记处报告患神经母细胞瘤的病例。以人群为基础的健康对照，按年龄、性别和诊断时的居住地进行匹配。
该研究未能证实工作假设，因为病例组的父母比对照组的父母食用当地种植食物的量更少（相对危险度=0.63，95%可信区间：0.20-1.97）。该研究也未能证实先前描述的可能与神经母细胞瘤发病率相关的影响因素。父母接触除草剂和杀虫剂与神经母细胞瘤的发生有关（相对危险度=4.2，95%可信区间：1.4-12.9）。与污染较轻地区和先前年龄队列相比，污染地区神经母细胞瘤的分期分布向较低分期偏移。
该研究未显示出额外证据表明观察到的神经母细胞瘤发病率增加可能是由接触切尔诺贝利事故的放射性沉降物所致。观察到的向较低临床分期的偏移可能更表明诊断意识的提高。神经母细胞瘤与父母接触除草剂和杀虫剂之间的关联源于广泛的探索性数据分析，需要在进一步研究中得到证实。
