Parental occupational exposure to combustion products, metals, silica and asbestos and risk of childhood leukaemia: Findings from the Childhood Cancer and Leukaemia International Consortium (CLIC)
NARECHEM-ST Group
(2022) Environment international, volume 167, pp. 1 - 8
(Article)
Abstract
Parental occupational exposures around conception (father) or during pregnancy (mother) have been hypothesized as potential predisposing factors for childhood leukaemia. We investigated parental exposure to several known occupational carcinogens and childhood leukaemia risk. We conducted a pooled analysis using case-control data from four European countries (3362 childhood leukemia cases and
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6268 controls). Parental occupational exposures to polycyclic aromatic hydrocarbons (PAH), diesel engine exhaust (DEE), chromium, nickel, crystalline silica, and asbestos were assessed by a general population job-exposure matrix. We estimated odd ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression models for all childhood leukaemia combined, by leukaemia type (ALL and AML) and by ALL subtype (B-lineage and T-lineage). We found an association between high paternal occupational exposure to crystalline silica and childhood ALL (OR 2.20, CI 1.60-3.01) with increasing trend from no exposure to high exposure (P = <0.001), and also for AML (OR 2.03, CI 1.04-3.97; P for trend = 0.008). ORs were similar for B- and T-lineage ALL. For ALL, ORs were also slightly elevated with wide confidence intervals for high paternal occupational exposure to chromium (OR 1.23, CI 0.77-1.96), and DEE (OR 1.21, CI 0.82-1.77). No associations were observed for paternal exposures to nickel, PAH and asbestos. For maternal occupational exposure we found several slightly elevated odds ratios but mostly with very wide confidence intervals due to low numbers of exposed mothers. This is a first study suggesting an association between fathers' occupational exposure to crystalline silica and an increased risk of childhood leukaemia in their offspring. As this association was driven by certain occupations (field crop farmers and miners) where other potentially relevant exposures like pesticides and radon may also occur, more research is needed to confirm our findings of an association with crystalline silica, and if so, mechanistic studies to understand the pathways.
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Keywords: Childhood leukaemia, Crystalline silica, Job-exposure matrix, Parental occupational exposure, Pooled analysis, General Environmental Science
ISSN: 0160-4120
Publisher: Elsevier Limited
Note: Funding Information: The NARECHEM-ST study was supported in part by the Hellenic Society for Social Pediatrics and Health Promotion, Greece and in part by the National and Kapodistrian University of Athens Medical School, Athens, Greece. Funding Information: The German case-control study was funded by the German Federal Ministry for the Environment, Nuclear Safety, and Nature Preservation. Funding Information: The SETIL study was financially supported by research grants received from AIRC (the Italian Association on Research on Cancer) Coordinated Grant 1998–2002N. 954, MIUR (the Ministry for Instruction, University and Research) (Grant 2001164379), Ricerca Finalizzata 2009-Grant n.30258/DB2001 and the Ministry of Health and the Ministry of Labour, Piedmont Region. Funding Information: The authors would like to thank Veronique Luzon and Gilles Ferro (International Agency for Research on Cancer (IARC/WHO)) for their skilful data management for the CLIC Data Coordination Center. The authors are grateful to the staff of the French National Registry of Childhood Blood Malignancies, who contributed to case detection and verification, to the Institut CSA who coordinated the selection of the controls and conducted the interviews of cases and controls. The authors would also like to thank all of the Société Française de lutte contre les Cancers et les leucémies de l'Enfant et de l'Adolescent (SFCE) principal investigators: André Baruchel (Hôpital Saint-Louis/Hôpital Robert Debré, Paris), Claire Berger (Centre Hospitalier Universitaire, Saint-Etienne), Christophe Bergeron (Centre Léon Bérard, Lyon), Jean-Louis Bernard (Hôpital La Timone, Marseille), Yves Bertrand (Hôpital Debrousse, Lyon), Pierre Bordigoni (Centre Hospitalier Universitaire, Nancy), Patrick Boutard (Centre Hospitalier Régional Universitaire, Caen), Gérard Couillault (Hôpital d'Enfants, Dijon), Christophe Piguet (Centre Hospitalier Régional Universitaire, Limoges), Anne-Sophie Defachelles (Centre Oscar Lambret, Lille), François Demeocq (Hôpital Hôtel-Dieu, Clermont-Ferrand), Alain Fischer (Hôpital des Enfants Malades, Paris), Virginie Gandemer (Centre Hospitalier Universitaire – Hôpital Sud, Rennes), Dominique Valteau-Couanet (Institut Gustave Roussy, Villejuif), Jean-Pierre Lamagnere (Centre Gatien de Clocheville, Tours), Françoise Lapierre (Centre Hospitalier Universitaire Jean Bernard, Poitiers), Guy Leverger (Hôpital Armand-Trousseau, Paris), Patrick Lutz (Hôpital de Hautepierre, Strasbourg), Geneviève Margueritte (Hôpital Arnaud de Villeneuve, Montpellier), Françoise Mechinaud (Hôpital Mère et Enfants, Nantes), Gérard Michel (Hôpital La Timone, Marseille), Frédéric Millot (Centre Hospitalier Universitaire Jean Bernard, Poitiers), Martine Münzer (American Memorial Hospital, Reims), Brigitte Nelken (Hôpital Jeanne de Flandre, Lille), Hélène Pacquement (Institut Curie, Paris), Brigitte Pautard (Centre Hospitalier Universitaire, Amiens), Yves Perel (Hôpital Pellegrin Tripode, Bordeaux), Alain Pierre-Kahn (Hôpital Enfants Malades, Paris), Emmanuel Plouvier (Centre Hospitalier Régional, Besançon), Xavier Rialland (Centre Hospitalier Universitaire, Angers), Alain Robert (Hôpital des Enfants, Toulouse), Hervé Rubie (Hôpital des Enfants, Toulouse), Nicolas Sirvent (L'Archet, Nice), Christine Soler (Fondation Lenval, Nice), and Jean-Pierre Vannier (Hôpital Charles Nicolle, Rouen). The SETIL working group included: Corrado Magnani, Alessandra Ranucci, Assunta Rasulo, Daniela Ferrante, CPO Piemonte, Torino & Novara; Lucia Miligi, Sara Piro Environmental and Occupational Epidemiology Branch, Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network -ISPRO Florence, Italy Luigi Bisanti, ASL Milano, Milano; Paola Zambon, Daniele Monetti Registro Tumori del Veneto &, Istituto Oncologico Veneto IRCCS, Padova; Marina Cuttini, Unità di Epidemiologia, Ospedale Pediatrico Bambino Gesù, Roma; Stefano Mattioli, University of Bologna, Bologna; Domenico Franco Merlo, Istituto Nazionale per la Ricerca sul Cancro, Genova; Francesco Forastiere, Paola Michelozzi, Ursula Kirchmayer, Department of Epidemiology, Regional Health Authority, Lazio Region, Rome; Franco Pannelli, Paola Mosciatti, Dipartimento di Medicina Sperimentale e di Sanità Pubblica, Università di Camerino, Camerino; Manuela Chiavarini, Liliana Minelli, Dipartimento di Specialità Medico Chirurgiche e Sanità Pubblica, Università degli Studi di Perugia, Perugia; Egidio Celentano, Servizio di Epidemiologia, Istituto Nazionale Tumori di Napoli, Napoli; Luigi Gelli, Struttura Regionale dell'Autorità Ambientale della Regione Campania, Napoli; Giorgio Assennato, ARPA Puglia, Bari; Lorenzo Gafà, Santina Cannizzaro, Lega Italiana per la Lotta contro i Tumori Onlus, Sez. Provinciale di Ragusa, Ragusa Ibla; Valeria Torregrossa, Dipartimento di Scienze per la Promozione della Salute Università degli Studi di Palermo, Palermo; Pierluigi Cocco, Medicina del Lavoro, Università di Cagliari, Cagliari; Alberto Salvan, IASI-CNR, Rome; Susanna Lagorio, Serena Risica, Alessandro Polichetti, Istituto Superiore di Sanità, Roma; Lia Lidia Luzzatto, ASL 1, Torino; Riccardo Haupt, Istituto Giannina Gaslini, Genova Roberto Rondelli, Andrea Pession, Paediatric Oncology-Haematology, Policlinico S. Orsola-Malpighi, Bologna Alma Lippi, Gabriella Bernini, Dipartimento di Oncoematologia, Azienda Ospedaliera Universitaria Meyer, Firenze; Margherita Nardi, Dipartimento di Oncoematologia, Azienda Ospedaliera Universitaria di Pisa, Pisa; Antonio Acquaviva, Dipartimento di Oncoematologia, Azienda Ospedaliera Universitaria di Siena, Siena For occupational exposure assessment also: Francesco Barone Adesi, CPO Piemonte, Torino; Fulvio Cavariani, Laboratorio di Igiene Industriale—Centro Regionale Amianto, AUSL Viterbo; Isabella Belletti, Epidemiology Unit, National Cancer Institute, Milan; Loredana Troeschel, Epidemiology Unit, National Cancer Institute, Milan; Roberto Calisti, ASUR Marche, Area Vasta Territoriale 3, SPreSAL—Civitanova Marche; Patrizia Legittimo, Stefano Silvestri & Alessandra Benvenuti, Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Firenze; Letizia Sommani, ASF Firenze, Firenze; Giuseppe Miceli, Azienda Sanitaria Locale 7, Ragusa; Andrea Farioli, Section of Occupational Medicine, University of Bologna; Giulio Andrea Tozzi, Occupational Health and Safety Local Unit, S.Pre.S.A.L, Az. USL 3, Genoa. NARECHEM-ST staff are grateful to clinicians from the Pediatric Haematology-Oncology Departments and Bone Marrow Transplantation Units (Margarita Baka, Helen Kosmidis, Maria Moschovi, Panagiota Kourou, Sophia Polychronopoulou, Vassiliki Tzotzola, Emmanuel Hatzipantelis, Eugenia Papakonstantinou, Maria Kourti, Vassiliki Sidi, Eftichia Stiakaki, Maria Kalmanti, Helen Dana, Stylianos Grafakos, Eugenios Goussettis) as well as to personnel from Immunology Units (Maria Kanariou, Marianna Tzanoudaki, Lola Anastasiou), Pediatric Radiology & Nuclear Medicine Department (Astero Malama, Maro Gavra), Children's & Adolescents’ Radiotherapy Department (Aikaterini Alexopoulou) and Medical School, University of Ioannina (Evangelia Ntzani, George Markozannes) who collaborated in the development of the leukemia dataset, whereas the controls series data were collected in collaboration with physicians from the Pediatrics, Pediatric Surgery and Pediatric Orthopedics Departments. The ESCALE study was supported by grants from INSERM, the Fondation de France, the Fondation ARC pour la Recherche sur le Cancer (ARC), the Agence Française de Sécurit ́ Sanitaire des Produits de Santé (AFSSAPS), the Agence Française de Sécurité Sanitaire de l'Environnement et du Travail (AFSSET), the association Cent pour sang la vie, the Institut National du Cancer (INCa), the Agence Nationale de la Recherche (ANR), and Cancéropôle Ile de France. Audrey Bonaventure was funded by the Fondation ARC pour la Recherche sur le Cancer. The SETIL study was financially supported by research grants received from AIRC (the Italian Association on Research on Cancer) Coordinated Grant 1998–2002N. 954, MIUR (the Ministry for Instruction, University and Research) (Grant 2001164379), Ricerca Finalizzata 2009-Grant n.30258/DB2001 and the Ministry of Health and the Ministry of Labour, Piedmont Region. The NARECHEM-ST study was supported in part by the Hellenic Society for Social Pediatrics and Health Promotion, Greece and in part by the National and Kapodistrian University of Athens Medical School, Athens, Greece. The German case-control study was funded by the German Federal Ministry for the Environment, Nuclear Safety, and Nature Preservation. AO and JS conceived the study. FMO drafted the manuscript. AO and JS verified the data. FMO provided the analysis, AO, FE, CM, EP, JC, LM, AB, SP, HK, and JS reviewed the manuscript, provided advice on methods and interpreted results. All other authors contributed data, developed exposure assessment tool, and reviewed the manuscript. Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization or their affiliated institutes, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the International Agency for Research on Cancer/World Health Organization or their affiliated institutes. Funding Information: The ESCALE study was supported by grants from INSERM, the Fondation de France, the Fondation ARC pour la Recherche sur le Cancer (ARC), the Agence Française de Sécurit ́ Sanitaire des Produits de Santé (AFSSAPS), the Agence Française de Sécurité Sanitaire de l’Environnement et du Travail (AFSSET), the association Cent pour sang la vie, the Institut National du Cancer (INCa), the Agence Nationale de la Recherche (ANR), and Cancéropôle Ile de France. Audrey Bonaventure was funded by the Fondation ARC pour la Recherche sur le Cancer. Publisher Copyright: © 2022
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