Air pollution exposure at the residence and risk of childhood cancers in Denmark: A nationwide register-based case-control study
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Air pollution exposure at the residence and risk of childhood cancers in Denmark : A nationwide register-based case-control study. / Hvidtfeldt, Ulla Arthur; Erdmann, Friederike; Urhøj, Stine Kjær; Brandt, Jørgen; Geels, Camilla; Ketzel, Mattias; Frohn, Lise M.; Christensen, Jesper Heile; Sørensen, Mette; Raaschou-Nielsen, Ole.
I: EClinicalMedicine, Bind 28, 100569, 2020.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Air pollution exposure at the residence and risk of childhood cancers in Denmark
T2 - A nationwide register-based case-control study
AU - Hvidtfeldt, Ulla Arthur
AU - Erdmann, Friederike
AU - Urhøj, Stine Kjær
AU - Brandt, Jørgen
AU - Geels, Camilla
AU - Ketzel, Mattias
AU - Frohn, Lise M.
AU - Christensen, Jesper Heile
AU - Sørensen, Mette
AU - Raaschou-Nielsen, Ole
PY - 2020
Y1 - 2020
N2 - Background: The etiology of childhood cancer is poorly understood. The role of environmental factors, including air pollution (AP) exposure, has been addressed previously, but results so far have been inconclusive. In this study, we investigate the association between long-term AP exposures in relation to childhood cancer subtypes in Denmark (1981–2013). Methods: We conducted a nationwide register-based case-control study. We identified 7745 incident cases of childhood cancers (<20 years) in the Danish Cancer Registry. Four randomly selected (cancer-free) controls were matched to each case according to sex and date of birth. We modelled concentrations of nitrogen dioxide (NO2), fine particles (PM2·5), and black carbon (BC) at all addresses and calculated a time-weighted average from birth to index-date with a state-of-the-art multiscale AP modelling system. We analyzed the risk of childhood cancer in conditional logistic regression models adjusted for socio-demographic variables obtained from registers at the individual and neighborhood level. Findings: The main analyses included 5045 cases and 18,179 controls. For all cancers combined, we observed odds ratios (ORs) and 95% confidence intervals (95% CI) of 0·97 (0·94, 1·01) per 10 µg/m3 NO2, 0·89 (0·82, 0·98) per 5 µg/m3 PM2·5, and 0·94 (0·88, 1·01) per 1 µg/m3 BC, respectively. Most notably, we observed a higher risk of Non-Hodgkin Lymphoma (NHL) with higher childhood AP exposure with ORs and 95% CIs of 1·21 (0·94, 1·55) per 10 µg/m3 NO2, 2·11 (1·10, 4·01) per 5 µg/m3 PM2·5, and 1·68 (1·06, 2·66) per 1 µg/m3 BC, respectively. We observed indications of increased risks for other types of childhood cancer, however, with very wide CIs including 1. Interpretations: The findings of this nation-wide study propose a role of AP in the development of childhood NHL, but more large-scale studies are needed.
AB - Background: The etiology of childhood cancer is poorly understood. The role of environmental factors, including air pollution (AP) exposure, has been addressed previously, but results so far have been inconclusive. In this study, we investigate the association between long-term AP exposures in relation to childhood cancer subtypes in Denmark (1981–2013). Methods: We conducted a nationwide register-based case-control study. We identified 7745 incident cases of childhood cancers (<20 years) in the Danish Cancer Registry. Four randomly selected (cancer-free) controls were matched to each case according to sex and date of birth. We modelled concentrations of nitrogen dioxide (NO2), fine particles (PM2·5), and black carbon (BC) at all addresses and calculated a time-weighted average from birth to index-date with a state-of-the-art multiscale AP modelling system. We analyzed the risk of childhood cancer in conditional logistic regression models adjusted for socio-demographic variables obtained from registers at the individual and neighborhood level. Findings: The main analyses included 5045 cases and 18,179 controls. For all cancers combined, we observed odds ratios (ORs) and 95% confidence intervals (95% CI) of 0·97 (0·94, 1·01) per 10 µg/m3 NO2, 0·89 (0·82, 0·98) per 5 µg/m3 PM2·5, and 0·94 (0·88, 1·01) per 1 µg/m3 BC, respectively. Most notably, we observed a higher risk of Non-Hodgkin Lymphoma (NHL) with higher childhood AP exposure with ORs and 95% CIs of 1·21 (0·94, 1·55) per 10 µg/m3 NO2, 2·11 (1·10, 4·01) per 5 µg/m3 PM2·5, and 1·68 (1·06, 2·66) per 1 µg/m3 BC, respectively. We observed indications of increased risks for other types of childhood cancer, however, with very wide CIs including 1. Interpretations: The findings of this nation-wide study propose a role of AP in the development of childhood NHL, but more large-scale studies are needed.
KW - Air pollution
KW - Childhood cancer
KW - Denmark
KW - Register-based study
U2 - 10.1016/j.eclinm.2020.100569
DO - 10.1016/j.eclinm.2020.100569
M3 - Journal article
C2 - 33294803
AN - SCOPUS:85092040888
VL - 28
JO - EClinicalMedicine
JF - EClinicalMedicine
SN - 2589-5370
M1 - 100569
ER -
ID: 250341244