Environmental exposure to gasoline and leukemia in children and young adults--an ecology study.

Benzene is an established cause of leukemia in adults, especially acute non-lymphocytic leukemia (ANLL). A few studies have indicated that exposure to gasoline is a cause of childhood leukemia. The purpose of this study was to investigate if environmental exposure to benzene from gasoline and car exhaust was associated with leukemia in children and young adults. The exposure to gasoline and car exhaust was estimated by the number of cars per area. In this ecology study, data on the incidence of cancer in each municipality of Sweden during an 11-year period (1975-1985) were compared with the number of cars per area. Data on the incidence of cancer for persons aged 0-24 years at diagnosis were collected from the National Swedish Cancer Register. The following diagnoses were studied: non-Hodgkin's lymphoma, acute lymphocytic leukemia (ALL), chronic myeloid leukemia (CML), and acute myeloid leukemia (AML). We found an association between AML and car density. In municipalities with more than 20 cars/km2 the incidence of AML was 5.5 [95% confidence interval (CI) 4.4-6.8, n = 89] as compared with 3.4 (95% CI 1.9-5.7, n = 15) cases per 1 million person-years in municipalities with less than 5 cars/km2 (P = 0.05). No association was found for the other sites of cancer studied. The association between AML in young adults and car density might be attributable to exposure to benzene from gasoline vapors and exhaust gases, but further investigations are necessary before any definite conclusion can be drawn.