Association of childhood leukemia with residential exposure to petrochemical air pollution in taiwan

Population attributable fractions of cancer mortality related to indoor air pollution, animal contact, and water source as environmental risk factors: Findings from the Golestan Cohort Study

BACKGROUND

Environmental risk factors are significant contributors to cancer mortality, which are neglected.

PURPOSE

This study aimed to estimate the population attributable fraction of cancer mortality due to the environmental risk factors.

METHODS

Golestan cohort study is a population-base cohort on 50045 participants between 40-75 with about 18 years of follow up. We detected 2,196 cancer mortality and applied a multiple Cox model to compute the hazard ratio of environmental risk factor on all cancer and cancer-specific mortality. The population attributable fraction was calculated, accordingly.

RESULTS

Biomass fuels for cooking, as an indoor air pollution, increased the risk of colorectal, esophageal, gastric cancer, and all-cancer mortality by 84%, 66%, 37%, and 17% respectively. Using gas for cooking, particularly in rural areas, could save 6% [Population Attributable Fraction: 6.36(95%CI: 1.82, 10.70)] of esophageal cancer, 3% [Population Attributable Fraction: 3.43 (0, 7.33)] of gastric cancer, and 6% [Population Attributable Fraction: 6.25 (1.76, 13.63)] of colorectal cancer mortality. Using a healthy tap water source could save 5% [Population Attributable Fraction:5.50(0, 10.93)] of esophageal cancer mortality, particularly in rural areas. There was no significant association between indoor air pollution for heating purposes and animal contact with cancer mortality.

CONCLUSION

Considering the results of this study, eliminating solid fuel for most daily usage, among the population with specific cancer types, is required to successfully reduce cancer related mortality. Adopting appropriate strategies and interventions by policymakers such as educating the population, allocating resources for improving the healthy environment of the community, and cancer screening policies among susceptible populations could reduce cancer related mortalities.

Estimates of the global burden of cancer-related deaths attributable to residential exposure to petrochemical industrial complexes from 2020 to 2040

The petrochemical industry is a major industrial emitter of greenhouse gas (CO2) and environmental pollution, posing health risks to nearby communities. Although previous studies have indicated that residents living near petrochemical industrial complexes are at a higher risk of cancer, they have focused on local or regional burdens. This study aimed to estimate the global cancer burden attributable to residential exposure to petrochemical industrial complexes. The geographical coordinates of petrochemical plants and oil refineries were retrieved and verified from published sources. The ArcGIS software and global population data were used to estimate the number of people living within specific distances (exposed population). The exposure time window was framed as ranging from 1992 to 2035, extending to the latest period of the exposure time window for all cancer types to estimate the attributable deaths between 2020 and 2040. The relative risk of cancer was estimated from 15 published studies. Population attributable fraction (PAF) method was used to estimate the risk of cancer attributable to residential exposure and calculate the number of cancer-related deaths. Our findings indicate that >300 million people worldwide will be estimated to live near petrochemical industrial complexes by 2040. The overall global burden of cancer-related deaths was 19,083 in 2020, and it is estimated to increase to 27,366 deaths by 2040. The region with the highest attributable cancer deaths due to exposure is the high-income region, which had 10,584 deaths in 2020 and is expected to reach 13,414 deaths by 2040. Residential exposure to petrochemical industrial complexes could contribute to global cancer deaths, even if the proportion is relatively small, and proactive measures are required to mitigate the cancer burdens among these residents. Enforcing emissions regulations, improving monitoring, educating communities, and fostering collaboration are vital to protecting residents' health.

Evidence of spatial clustering of childhood acute lymphoblastic leukemia cases in Greater Mexico City: report from the Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia

Background

A heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC).

Methods

A population-based case-control study was conducted. Children <18 years old, newly diagnosed with ALL and residents of GMC were included. Controls were patients without leukemia recruited from second-level public hospitals, frequency-matched by sex, age, and health institution with the cases. The residence address where the patients lived during the last year before diagnosis (cases) or the interview (controls) was used for geolocation. Kulldorff's spatial scan statistic was used to detect spatial clusters (SCs). Relative risks (RR), associated p-value and number of cases included for each cluster were obtained.

Results

A total of 1054 cases with ALL were analyzed. Of these, 408 (38.7%) were distributed across eight SCs detected. A relative risk of 1.61 (p<0.0001) was observed for the main cluster. Similar results were noted for the remaining seven ones. Additionally, a proximity between SCs, electrical installations and petrochemical facilities was observed.

Conclusions

The identification of SCs in certain regions of GMC suggest the possible role of environmental factors in the etiology of childhood ALL.

Geospatial pattern of topsoil pollution and multi-endpoint toxicity in the petrochemical area of Augusta-Priolo (eastern Sicily, Italy)

The present study was aimed at identifying geospatial patterns of pollutants including concentrations and toxicity as complex environmental mixtures, in topsoil samples close to petrochemical facilities in the heavily industrialized area of Augusta and Priolo in south-eastern Sicily (Italy). Elemental analysis of soil was conducted by ICP-MS for 23 metals and 16 rare earth elements (REEs). Organic analyses were primarily focused on polycyclic aromatic hydrocarbons (PAHs) (16 parent homologs) and total aliphatic hydrocarbons (C10 - C40). Topsoil samples were tested for toxicity in multiple bioassay models including: 1) developmental defects and cytogenetic anomalies in sea urchin Sphaerechinus granularis early life stages; 2) growth inhibition of diatom Phaeodactylum tricornutum; 3) mortality in nematode Caenorhabditis elegans; and 4) induction of mitotic abnormalities in onion Allium cepa. Samples collected at sites closest to defined petrochemical facilities were highest in select pollutants and correlated with biological effects in different toxicity endpoints. A noteworthy finding was the increased level of total REEs in sites closest to petrochemical facilities, suggesting their contributions to identifying petrochemical sources of pollutants to the environment. The combined data obtained in the different bioassays allowed exploration of geospatial patterns of effect in biota as a function of contaminant levels. In conclusion, this study provides consistent data of soil toxicity, metal and REE contamination at Augusta-Priolo sampling sites, and may provide an appropriate baseline for epidemiological studies on high incidences of congenital birth defects in the area and identification of at-risk localities.

Effects of Benzene: Hematological and Hypersensitivity Manifestations in Resident Living in Oil Refinery Areas

Literature is teeming with publications on industrial pollution. Over the decades, the main industrial pollutants and their effects on human health have been widely framed. Among the various compounds involved, benzene plays a leading role in the onset of specific diseases. Two systems are mainly affected by the adverse health effects of benzene exposure, both acute and chronic: the respiratory and hematopoietic systems. The most suitable population targets for a proper damage assessment on these systems are oil refinery workers and residents near refining plants. Our work fits into this area of interest with the aim of reviewing the most relevant cases published in the literature related to the impairment of the aforementioned systems following benzene exposure. We perform an initial debate between the two clinical branches that see a high epidemiological expression in this slice of the population examined: residents near petroleum refinery areas worldwide. In addition, the discussion expands on highlighting the main immunological implications of benzene exposure, finding a common pathophysiological denominator in inflammation, oxidative stress, and DNA damage, thus helping to set the basis for an increasingly detailed characterization aimed at identifying common molecular patterns between the two clinical fields discussed.

The effect of exposure to crude oil on the immune system. Health implications for people living near oil exploration activities

People who reside near oil exploration activities may be exposed to toxins from gas flares or oil spills. The impact of such exposures on the human immune system has not been fully investigated. In this review, research investigating the effects of crude oil on the immune system is evaluated. The aim was to obtain a greater understanding of the possible immunological impact of living near oil exploration activities. In animals, the effect of exposure to crude oil on the immune system depends on the species, dose, exposure route, and type of oil. Important observations included; hematological changes resulting in anemia and alterations in white blood cell numbers, lymph node and splenic atrophy, genotoxicity in immune cells, modulation of cytokine gene expression and increased susceptibility to infectious diseases. In humans, there are reports that exposure to crude oil can increase the risk of developing certain types of cancer and cause immunomodulation.Abbreviations: A1AT: alpha-1 antitrypsin; ACH₅₀: hemolytic activity of the alternative pathway; AHR: aryl hydrocarbon receptor; BALF: bronchoalveolar lavage fluid; COPD: chronic obstructive pulmonary disease; CYP: cytochrome P450; DNFB: 2, 4-dinitro-1-fluorobenzene; G-CSF: granulocyte-colony stimulating factor; IFN: interferon; IL: interleukin; 8-IP: 8-isoprostane; ISG15: interferon stimulated gene; LPO: lipid peroxidation; LTB₄: leukotriene B₄; M-CSF: macrophage-colony stimulating factor; MMC: melanomacrophage center; MPV: mean platelet volume; NK: natural killer; OSPM: oil sail particulate matter; PAH: polycyclic aromatic hydrocarbon; PBMC: peripheral blood mononuclear cell; PCV: packed cell volume; RBC: red blood cell; ROS: reactive oxygen species; RR: relative risk; T_H: T helper; TNF: tumour necrosis factor; UV: ultraviolet; VNNV: Viral Nervous Necrosis Virus; WBC: white blood cell.

Cancer Incidence and Mortality among Petroleum Industry Workers and Residents Living in Oil Producing Communities: A Systematic Review and Meta-Analysis

Petroleum extraction and refining are major sources of various occupational exposures and of air pollution and may therefore contribute to the global cancer burden. This systematic review and meta-analysis is aimed at evaluating the cancer risk in petroleum-exposed workers and in residents living near petroleum facilities. Relevant studies were identified and retrieved through PubMed and Web of Science databases. Summary effect size (ES) and 95% confidence intervals (CI) were analysed using random effect models, and heterogeneity across studies was assessed (I2). Overall, petroleum industry work was associated with an increased risk of mesothelioma (ES = 2.09, CI: 1.58-2.76), skin melanoma (ES = 1.34, CI: 1.06-1.70 multiple myeloma (ES =1.81, CI: 1.28-2.55), and cancers of the prostate (ES = 1.13, Cl: 1.05-1.22) and urinary bladder (ES = 1.25, CI: 1.09-1.43) and a decreased risk of cancers of the esophagus, stomach, colon, rectum, and pancreas. Offshore petroleum work was associated with an increased risk of lung cancer (ES = 1.20; 95% CI: 1.03-1.39) and leukemia (ES = 1.47; 95% CI: 1.12-1.92) in stratified analysis. Residential proximity to petroleum facilities was associated with childhood leukemia (ES = 1.90, CI: 1.34-2.70). Very few studies examined specific exposures among petroleum industry workers or residents living in oil producing communities. The present review warrants further studies on specific exposure levels and pathways among petroleum-exposed workers and residents living near petroleum facilities.

Association between leukemia incidence and mortality and residential petrochemical exposure: A systematic review and meta-analysis

BACKGROUND

The global burden of leukemia, which grew by 19% from 2007 to 2017, poses a threat to human development and global cancer control. Factors contributing to this growth include massive industrial pollution, especially from large-scale petrochemical industry complexes (PICs). Globally, around 700 PICs are continuously operating. Data on the impact of PICs on leukemia incidence and mortality in residents are sparse and inconsistent.

OBJECTIVE

To determine the association between residential exposure to PICs and leukemia incidence and mortality using systematic review and meta-analysis.

METHODS

The studies were identified through seven databases (Clinical Key, Cochrane Library, EBSCOhost, Embase, PubMed, ScienceDirect, and Web of Science). We screened the eligibility of studies using following criteria: (1) observational studies that focused on residential exposure to PICs; (2) exposure group that was defined as residents living close to PICs; (3) outcome that was defined as all leukemia incidence and mortality; and (4) available population data. We applied the Grading of Recommendations Assessment, Development, and Evaluation to assess the certainty of evidence. The random-effects model used to estimate the pooled effects in the meta-analysis.

RESULTS

We identified thirteen epidemiologic studies (including eleven for leukemia incidence, one for leukemia mortality, and one for both), covering 125,580 individuals from Croatia, Finland, Italy, Serbia, Spain, Sweden, Taiwan, the United Kingdom, and the United States. We found moderate certainty of evidence indicated the risk of leukemia incidence (relative risk [RR] = 1.18; 95% CI = 1.03-1.35) and mortality (RR = 1.26; 95% CI = 1.10-1.45) in residents living close to PICs. Our subgroup analysis found increased RRs for leukemia incidence in studies using distance-based exposure indicator (RR = 1.11; 95% CI = 1.00-1.23), and with longer follow-up periods (RR = 1.24; 95% CI = 1.06-1.45).

CONCLUSION

Our analysis provides low-certainty evidence of increased leukemia incidence and moderate-certainty evidence of increased leukemia mortality among residents living close to PICs. While the global petrochemicals sector is growing, our findings suggest the need to consider disease prevention and pollution control measures during the development of PICs.

Childhood Leukemia in Small Geographical Areas and Proximity to Industrial Sources of Air Pollutants in Three Colombian Cities

Acute leukemia is the most common childhood cancer and has been associated with exposure to environmental carcinogens. This study aimed to identify clusters of acute childhood leukemia (ACL) cases and analyze their relationship with proximity to industrial sources of air pollution in three capital cities in Colombia during 2000-2015. Incident ACL cases were obtained from the population cancer registries for the cities of Bucaramanga, Cali, and Medellín. The inventory of industrial sources of emissions to the air was obtained from the regional environmental authorities and industrial conglomerates were identified. The Kulldorf's circular scan test was used to detect city clusters and to identify clusters around industrial conglomerates. Multivariable spatial modeling assessed the effect of distance and direction from the industrial conglomerates controlling for socioeconomic status. We identified industrials sectors within a buffer of 1 km around industrial conglomerates related to the ACL clusters. Incidence rates showed geographical heterogeneity with low spatial autocorrelation within cities. The spatio-temporal tests identified one cluster in each city. The industries located within 1 km around the ACL clusters identified in the three cities represent different sectors. Exposure to air pollution from industrial sources might be contributing to the incidence of ACL cases in urban settings in Colombia.

Proximity to Oil Refineries and Risk of Cancer: A Population-Based Analysis

Background

The association between proximity to oil refineries and cancer rate is largely unknown. We sought to compare the rate of cancer (bladder, breast, colon, lung, lymphoma, and prostate) according to proximity to an oil refinery in Texas.

Methods

A total of 6 302 265 persons aged 20 years or older resided within 30 miles of an oil refinery from 2010 to 2014. We used multilevel zero-inflated Poisson regression models to examine the association between proximity to an oil refinery and cancer rate.

Results

We observed that proximity to an oil refinery was associated with a statistically significantly increased risk of incident cancer diagnosis across all cancer types. For example, persons residing within 0-10 (risk ratio [RR] = 1.13, 95% confidence interval [CI] = 1.07 to 1.19) and 11-20 (RR = 1.05, 95% CI = 1.00 to 1.11) miles were statistically significantly more likely to be diagnosed with lymphoma than individuals who lived within 21-30 miles of an oil refinery. We also observed differences in stage of cancer at diagnosis according to proximity to an oil refinery. Moreover, persons residing within 0-10 miles were more likely to be diagnosed with distant metastasis and/or systemic disease than people residing 21-30 miles from an oil refinery. The greatest risk of distant disease was observed in patients diagnosed with bladder cancer living within 0-10 vs 21-30 miles (RR = 1.30, 95% CI = 1.02 to 1.65), respectively.

Conclusions

Proximity to an oil refinery was associated with an increased risk of multiple cancer types. We also observed statistically significantly increased risk of regional and distant/metastatic disease according to proximity to an oil refinery.

Health risks for the population living near petrochemical industrial complexes. 1. Cancer risks: A review of the scientific literature

Petrochemical complexes and oil refineries are well known sources of a wide range of environmental pollutants. Consequently, the potential harmful health effects of living near these facilities is a topic of concern among the population living in the neighborhood. Anyhow, the number of studies carried out on this issue is rather limited and, in some cases, results are even slightly contradictory. The present Review was aimed at assessing whether living in the vicinity of petrochemical industries and oil refineries is associated with a higher incidence of cancer and cancer mortality. In this sense, up to 23 investigations were found in PubMed and Scopus databases. According to the type of cancer, leukemia and other hematological malignancies were reported as the main types of cancer for populations living in the neighborhood of petrochemical industries. This was concluded based on studies performed in Taiwan, Spain, United Kingdom, Italy and Nigeria. In contrast, no association was found in 4 different investigations conducted in Sweden, Finland and USA with the same purpose. Other scientific studies reported a high incidence of lung and bladder cancer in Taiwan, Italy and USA, as well as an excess mortality of bone, brain, liver, pleural, larynx and pancreas cancers in individuals living near petrochemical complexes from Taiwan, Spain, Italy, United Kingdom and USA. Thus, human exposure to certain carcinogenic pollutants emitted from petrochemical industries might increase the incidence of some cancers and cancer mortality. Anyway, since the limited number of investigations conducted until now, further studies are required in order to corroborate -in a more generalized way-this conclusion.

Metabolomics of Children and Adolescents Exposed to Industrial Carcinogenic Pollutants

Studies on metabolomes of carcinogenic pollutants among children and adolescents are limited. We aim to identify metabolic perturbations in 107 children and adolescents (aged 9-15) exposed to multiple carcinogens in a polluted area surrounding the largest petrochemical complex in Taiwan. We measured urinary concentrations of eight carcinogen exposure biomarkers (heavy metals and polycyclic aromatic hydrocarbons (PAHs) represented by 1-hydroxypyrene), and urinary oxidative stress biomarkers and serum acylcarnitines as biomarkers of early health effects. Serum metabolomics was analyzed using a liquid chromatography mass spectrometry-based method. Pathway analysis and "meet-in-the-middle" approach were applied to identify potential metabolites and biological mechanisms linking carcinogens exposure with early health effects. We found 10 potential metabolites possibly linking increased exposure to IARC group 1 carcinogens (As, Cd, Cr, Ni) and group 2 carcinogens (V, Hg, PAHs) with elevated oxidative stress and deregulated serum acylcarnitines, including inosine monophosphate and adenosine monophosphate (purine metabolism), malic acid and oxoglutaric acid (citrate cycle), carnitine (fatty acid metabolism), and pyroglutamic acid (glutathione metabolism). Purine metabolism was identified as the possible mechanism affected by children and adolescents' exposure to carcinogens. These findings contribute to understanding the health effects of childhood and adolescence exposure to multiple industrial carcinogens during critical periods of development.

Residential proximity to environmental pollution sources and risk of rare tumors in children

BACKGROUND

Few epidemiologic studies have explored risk factors for rare tumors in children, and the role of environmental factors needs to be assessed.

OBJECTIVES

To ascertain the effect of residential proximity to both industrial and urban areas on childhood cancer risk, taking industrial groups into account.

METHODS

We conducted a population-based case-control study of five childhood cancers in Spain (retinoblastoma, hepatic tumors, soft tissue sarcomas, germ cell tumors, and other epithelial neoplasms/melanomas), including 557 incident cases from the Spanish Registry of Childhood Tumors (period 1996-2011), and 3342 controls individually matched by year of birth, sex, and region of residence. Distances were computed from the residences to the 1271 industries and the 30 urban areas with ≥75,000 inhabitants located in the study area. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance to industrial and urban pollution sources were calculated, with adjustment for matching variables and socioeconomic confounders.

RESULTS

Children living near industrial and urban areas as a whole showed no excess risk for any of the tumors analyzed. However, isolated statistical associations (OR; 95%CI) were found between retinoblastoma and proximity to industries involved in glass and mineral fibers (2.49; 1.01-6.12 at 3km) and organic chemical industries (2.54; 1.10-5.90 at 2km). Moreover, soft tissue sarcomas registered the lower risks in the environs of industries as a whole (0.59; 0.38-0.93 at 4km).

CONCLUSIONS

We have found isolated statistical associations between retinoblastoma and proximity to industries involved in glass and mineral fibers and organic chemical industries.

Risk of neuroblastoma and residential proximity to industrial and urban sites: A case-control study

BACKGROUND

Neuroblastoma is the most common extracranial solid tumor in children but its etiology is not clearly understood. While a small fraction of cases might be attributable to genetic factors, the role of environmental pollution factors needs to be assessed.

OBJECTIVES

To ascertain the effect of residential proximity to both industrial and urban areas on neuroblastoma risk, taking into account industrial groups and toxic substances released.

METHODS

We conducted a population-based case-control study of neuroblastoma in Spain, including 398 incident cases gathered from the Spanish Registry of Childhood Tumors (period 1996-2011), and 2388 controls individually matched by year of birth, sex, and region of residence. Distances were computed from the respective subject's residences to the 1271 industries and the 30 urban areas with ≥75,000 inhabitants located in the study area. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance (from 1km to 5km) to industrial and urban pollution sources were calculated, with adjustment for matching variables and socioeconomic confounders.

RESULTS

Excess risk (OR; 95%CI) of neuroblastoma was detected for the intersection between industrial and urban areas: (2.52; 1.20-5.30) for industrial distance of 1km, and (1.99; 1.17-3.37) for industrial distance of 2km. By industrial groups, excess risks were observed near 'Production of metals' (OR=2.05; 95%CI=1.16-3.64 at 1.5km), 'Surface treatment of metals' (OR=1.89; 95%CI=1.10-3.28 at 1km), 'Mines' (OR=5.82; 95%CI=1.04-32.43 at 1.5km), 'Explosives/pyrotechnics' (OR=4.04; 95%CI=1.31-12.42 at 4km), and 'Urban waste-water treatment plants' (OR=2.14; 95%CI=1.08-4.27 at 1.5km).

CONCLUSIONS

These findings support the need for more detailed exposure assessment of certain substances released by these industries.

Association between residential proximity to environmental pollution sources and childhood renal tumors

BACKGROUND

Few risk factors for childhood renal tumors are well established. While a small fraction of cases might be attributable to susceptibility genes and congenital anomalies, the role of environmental factors needs to be assessed.

OBJECTIVES

To explore the possible association between residential proximity to environmental pollution sources (industrial and urban areas, and agricultural crops) and childhood renal cancer, taking into account industrial groups and toxic substances released.

METHODS

We conducted a population-based case-control study of childhood renal cancer in Spain, including 213 incident cases gathered from the Spanish Registry of Childhood Tumors (period 1996-2011), and 1278 controls individually matched by year of birth, sex, and region of residence. Distances were computed from the respective subject's residences to the 1271 industries, the 30 urban areas with ≥75,000 inhabitants, and the agricultural crops located in the study area. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance to pollution sources were calculated, with adjustment for matching variables and socioeconomic confounders.

RESULTS

Excess risk (OR; 95%CI) of childhood renal tumors was observed for children living near (≤2.5km) industrial installations as a whole (1.97; 1.13-3.42) - particularly glass and mineral fibers (2.69; 1.19-6.08), galvanization (2.66; 1.14-6.22), hazardous waste (2.59; 1.25-5.37), ceramic (2.35; 1.06-5.21), surface treatment of metals (2.25; 1.24-4.08), organic chemical industry (2.22; 1.15-4.26), food and beverage sector (2.19; 1.18-4.07), urban and waste-water treatment plants (2.14; 1.07-4.30), and production and processing of metals (1.98; 1.03-3.82) -, and in the proximity of agricultural crops (3.16; 1.54-8.89 for children with percentage of crop surface ≥24.35% in a 1-km buffer around their residences).

CONCLUSIONS

Our study provides some epidemiological evidence that living near certain industrial areas and agricultural crops may be a risk factor for childhood renal cancer.

Urinary neutrophil gelatinase-associated lipocalin is associated with heavy metal exposure in welding workers

Metals cause nephrotoxicity with acute and/or chronic exposure; however, few epidemiological studies have examined impacts of exposure to metal fumes on renal injury in welding workers. In total, 66 welding workers and 12 office workers were recruited from a shipyard located in southern Taiwan. Urine samples from each subject were collected at the beginning (baseline) and end of the work week (1-week exposure). Personal exposure to PM_2.5 was measured. The 8-h mean PM_2.5 was 50.3 μg/m³ for welding workers and 27.4 μg/m³ for office workers. iTRAQs coupled with LC-MS/MS were used to discover the pathways in response to welding PM_2.5 in the urine, suggesting that extracellular matrix (ECM)-receptor interactions are a critical mechanism. ECM-receptor interaction-related biomarkers for renal injury, kidney injury molecule (KIM)-1 and neutrophil gelatinase-associated lipocalin (NGAL), were significantly elevated in welding workers post-exposure, as well as were urinary Al, Cr, Mn, Fe, Co, and Ni levels. NGAL was more significantly associated with Al (r = 0.737, p < 0.001), Cr (r = 0.705, p < 0.001), Fe (r = 0.709, p < 0.001), and Ni (r = 0.657, p < 0.001) than was KIM-1, suggesting that NGAL may be a urinary biomarker for welding PM_2.5 exposure. Nephrotoxicity (e.g., renal tubular injury) may be an emerging concern in occupational health.

Characterization of pulmonary protein profiles in response to zinc oxide nanoparticles in mice: a 24-hour and 28-day follow-up study

Although zinc oxide nanoparticles (ZnONPs) are recognized to cause systemic disorders, little is known about the mechanisms that underlie the time-dependent differences that occur after exposure. The objective of this study was to investigate the mechanistic differences at 24 hours and 28 days after the exposure of BALB/c mice to ZnONPs via intratracheal instillation. An isobaric tag for the relative and absolute quantitation coupled with liquid chromatography/tandem mass spectrometry was used to identify the differential protein expression, biological processes, molecular functions, and pathways. A total of 18 and 14 proteins displayed significant changes in the lung tissues at 24 hours and 28 days after exposure, respectively, with the most striking changes being observed for S100-A9 protein. Metabolic processes and catalytic activity were the main biological processes and molecular functions, respectively, in the responses at the 24-hour and 28-day follow-up times. The glycolysis/gluconeogenesis pathway was continuously downregulated from 24 hours to 28 days, whereas detoxification pathways were activated at the 28-day time-point after exposure. A comprehensive understanding of the potential time-dependent effects of exposure to ZnONPs was provided, which highlights the metabolic mechanisms that may be important in the responses to ZnONP.

Geographic Variation in Cancer Incidence among Children and Adolescents in Taiwan (1995-2009)

BACKGROUND

Evidence from our recent study suggested that the overall trend for cancer incidence in children and adolescents has been increasing in Taiwan.

METHODS

To analyze geographic variations in this trend, cancer frequencies and incidence rates of disease groups were quantified according to geographic areas among 12,633 patients aged <20 years during 1995-2009 by using the population-based Taiwan Cancer Registry. Three geographic levels were defined, namely county or city, region (Northern, Central, Southern, and Eastern Taiwan), and local administrative area (special municipality, provincial city, county-administered city, township, and aboriginal area).

RESULTS

Of the regions, Northern Taiwan had the highest incidence rate at 139.6 per million person-years, followed by Central (132.8), Southern (131.8), and Eastern (128.4) Taiwan. Significantly higher standardized rate ratios (SRRs) were observed in Northern Taiwan (SRR = 1.06, 95% confidence interval [CI] = 1.02-1.10) and at the township level (SRR = 1.07, 95% CI = 1.03-1.11). Of the cities or counties, New Taipei City yielded the highest SRR (1.08), followed by Taipei City (SRR = 1.07). A comparison of the rates in the four regions and the remainder of Taiwan according to cancer type revealed that only the rate of neuroblastomas in Eastern Taiwan was significantly low. Trend analysis showed that the most significant increase in incidence rate was observed at the township level, with an annual percent change of 1.8% during the 15-year study period.

CONCLUSIONS

The high rate of childhood cancer in Northern Taiwan and at the township level deserves further attention. The potential impacts of environmental factors on the upward trend of childhood cancer incidence rate in townships warrant further investigation.

Childhood leukemia and residential proximity to industrial and urban sites

BACKGROUND

Few risk factors for the childhood leukemia are well established. While a small fraction of cases of childhood leukemia might be partially attributable to some diseases or ionizing radiation exposure, the role of industrial and urban pollution also needs to be assessed.

OBJECTIVES

To ascertain the possible effect of residential proximity to both industrial and urban areas on childhood leukemia, taking into account industrial groups and toxic substances released.

METHODS

We conducted a population-based case-control study of childhood leukemia in Spain, covering 638 incident cases gathered from the Spanish Registry of Childhood Tumors and for those Autonomous Regions with 100% coverage (period 1990-2011), and 13,188 controls, individually matched by year of birth, sex, and autonomous region of residence. Distances were computed from the respective subject's residences to the 1068 industries and the 157 urban areas with ≥10,000 inhabitants, located in the study area. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance to industrial and urban pollution sources were calculated, with adjustment for matching variables.

RESULTS

Excess risk of childhood leukemia was observed for children living near (≤2.5 km) industries (OR=1.31; 95%CI=1.03-1.67) - particularly glass and mineral fibers (OR=2.42; 95%CI=1.49-3.92), surface treatment using organic solvents (OR=1.87; 95%CI=1.24-2.83), galvanization (OR=1.86; 95%CI=1.07-3.21), production and processing of metals (OR=1.69; 95%CI=1.22-2.34), and surface treatment of metals (OR=1.62; 95%CI=1.22-2.15) - , and urban areas (OR=1.36; 95%CI=1.02-1.80).

CONCLUSIONS

Our study furnishes some evidence that living in the proximity of industrial and urban sites may be a risk factor for childhood leukemia.

Risk of death for hematological malignancies for residents close to an Italian petrochemical refinery: a population-based case-control study

PURPOSE

We investigated the risk of death for hematological malignancies (HMs) in the area surrounding an Italian petrochemical refinery, where atmospheric concentrations of benzene (known carcinogen) had not been adequately monitored in the past.

METHODS

We performed a population-based case-control study, using conditional logistic regression to estimate odds ratios (ORs) of HM death, with 95 % confidence intervals (CIs), and p trends, in relation to tertiles of time-weighted average residential proximity to the refinery. We identified 177 HM deaths and 349 sex- and age-matched controls from municipal files. Confounding factors were investigated from interviews with consenting relatives for 109 HM deaths and 178 matched controls.

RESULTS

For males and females combined, risk of HM death was unrelated to residential proximity. For females, ORs of HM death by increasing tertiles of proximity were 1, 2.74 (95 % CI 1.48-5.09, significant) and 1.49 (95 % CI 0.76-2.92) (p trend 0.184). For the subgroup of persons who plausibly spent most of their time at home (long-term retired, homemakers or unemployed, 53 cases, 79 controls), the ORs of leukemia plus non-Hodgkin lymphoma death (38 cases, 56 controls) by increasing tertiles of proximity were 1, 3.44 (95 % CI 1.04-11.37, significant) and 3.25 (95 % CI 0.82-12.87) (p trend 0.083).

CONCLUSIONS

No increased risk of HM death for males and females combined living close to the refinery was found. However, the findings for females and a subgroup plausibly spending most of their time at home suggest a relation between increased risk of HM death and residential proximity to the refinery.

Malondialdehyde-deoxyguanosine and bulky DNA adducts in schoolchildren resident in the proximity of the Sarroch industrial estate on Sardinia Island, Italy

Air quality is a primary environmental concern in highly industrialised areas, with potential health effects in children residing nearby. The Sarroch industrial estate in Cagliari province, Sardinia Island, Italy, hosts the world's largest power plant and the second largest European oil refinery and petrochemical park. This industrial estate produces a complex mixture of air pollutants, including benzene, heavy metals and polycyclic aromatic hydrocarbons. Thus, we conducted a cross-sectional study to evaluate the prevalence of malondialdehyde-deoxyguanosine adducts in the nasal epithelium of 75 representative children, aged 6-14 years, attending primary and secondary schools in Sarroch in comparison with 73 rural controls. Additionally, the levels of bulky DNA adducts were analysed in a subset of 62 study children. DNA damage was measured by (32)P-postlabelling methodologies. The air concentrations of benzene and ethyl benzene were measured in the school gardens of Sarroch and a rural village by diffusive samplers. Outdoor measurements were also performed in other Sarroch areas and in the proximity of the industrial estate. The outdoor levels of benzene and ethyl benzene were significantly higher in the school gardens of Sarroch than in the rural village. Higher concentrations were also found in other Sarroch areas and in the vicinity of the industrial park. The mean levels of malondialdehyde-deoxyguanosine adducts per 10(8) normal nucleotides ± standard error (SE) were 74.6±9.1 and 34.1±4.4 in the children from Sarroch and the rural village, respectively. The mean ratio was 2.53, 95% confidence interval (CI): 1.71-2.89, P < 0.001, versus rural controls. Similarly, the levels of bulky DNA adducts per 10(8) normal nucleotides ± SE were 2.9±0.4 and 1.6±0.2 in the schoolchildren from Sarroch and the rural village, respectively. The means ratio was 1.90, 95% CI: 1.25-2.89, P = 0.003 versus rural controls. Our study indicates that children residing near the industrial estate have a significant increment of DNA damage.

Cytogenetic profile of 1,863 Ph/BCR-ABL-positive chronic myelogenous leukemia patients from the Chinese population

Cytogenetic analyses of chronic myelogenous leukemia (CML) have been performed previously in a large number of reports, but systematical research based on large sample sizes from the Chinese population is seldom available. In this study, we analyzed the cytogenetic profiles of 1,863 Philadelphia (Ph)/BCR-ABL-positive CML patients from a research center in China. Of 1,266 newly diagnosed CML patients, the median age was 41 years, which is younger than the median age of diagnosis in western populations. The incidence of additional chromosome abnormalities (ACA) was 3.1% in newly diagnosed chronic phase (CP), 9.1% in CP after therapy, 35.4% in accelerated phase, and 52.9% in blast crisis (BC), reflecting cytogenetic evolution with CML progression. A higher prevalence of ACA was observed in variant Ph translocations than in standard t(9;22) in the disease progression, especially in BC (88.2% vs. 50%, P = 0.002). Moreover, a hyperdiploid karyotype and trisomy 8 were closely correlated with myeloid BC, while a hypodiploid karyotype and monosomy 7 were associated with lymphoid-BC. Among subsets of myeloid-BC, myeloid-BC with minimal differentiation had a higher ACA rate than myeloid-BC with granulocytic differentiation (80% vs. 46.8%, P = 0.009) and myeloid-BC with monocytic differentiation (80% vs. 42.9%, P = 0.006). These data provide novel insights into cytogenetics of CML within the Chinese population.

Leukemia-related mortality in towns lying in the vicinity of metal production and processing installations

BACKGROUND

Releases to the environment of toxic substances stemming from industrial metal production and processing installations can pose a health problem to populations in their vicinity.

OBJECTIVES

To investigate whether there might be excess leukemia-related mortality in populations residing in towns in the vicinity of Spanish metal industries included in the European Pollutant Emission Register.

METHODS

Ecologic study designed to examine mortality due to leukemia at a municipal level, during the period 1994-2003. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Using Poisson regression models, we analyzed: risk of dying from leukemia in a 5-kilometer zone around installations which had become operational prior to 1990; effect of pollution discharge route and type of industrial activity; and risk gradient within a 50-kilometer radius of such installations.

RESULTS

Excess mortality (relative risk, 95% confidence interval) was detected in the vicinity of pre-1990 installations (1.07, 1.02-1.13 in men; 1.05, 1.00-1.11 in women), with this being more elevated in the case of installations that released pollution to air versus water. On stratifying by type of industrial activity, statistically significant associations were also observed among women residing in the vicinity of galvanizing installations (1.58, 1.09-2.29) and surface-treatment installations using an electrolytic or chemical process (1.34, 1.10-1.62), which released pollution to air. There was an effect whereby risk increased with proximity to certain installations.

CONCLUSIONS

The results suggest an association between risk of dying due to leukemia and proximity to Spanish metal industries.

Cancer incidence in a petrochemical industry area in Sweden

Emissions from petrochemical industries may contain suspected or established carcinogens. As increased incidence of cancer in residential areas close to petrochemical industries has been reported in the literature, we conducted a study of cancer incidence in Stenungsund, Sweden, where petrochemical industries were established in the mid 1960s. A number of cancer cases in the central parts of Stenungsund were collected from the regional cancer registry for each year between 1974 and 2005. In addition to the total number of cases, the numbers of leukemia, lymphoma, liver cancer, lung cancer, and brain cancer were also collected. Expected numbers for each year were calculated based on age- and sex-specific incidence rates in reference areas. Levels of carcinogenic volatile hydrocarbons (VOC) were estimated from measurements and emission data. A dispersion model was used to classify Stenungsund into a "low" and "high" ethylene level area. Standardized Incidence Ratio (SIR) for all cancer for the entire period was 1.02 (95% CI 0.97-1.08). The occurrence of leukemia, lymphoma, and cancer in the central nervous system was slightly lower than expected for the entire period. SIR for lung cancer was 1.37 (95% CI 1.10-1.69), and SIR for liver cancer was 1.50 (0.82-2.53). VOC levels were low. Taking estimated exposure and demographic factors into account, our assessment is that occurrence of cancer was not affected by industrial emissions in any of the studied sites.

Air pollution and non-respiratory health hazards for children

Air pollution is a global health issue with serious public health implications, particularly for children. Usually respiratory effects of air pollutants are considered, but this review highlights the importance of non-respiratory health hazards. In addition to short-term effects, exposure to criteria air pollutants from early life might be associated with low birth weight, increase in oxidative stress and endothelial dysfunction, which in turn might have long-term effects on chronic non-communicable diseases. In view of the emerging epidemic of chronic disease in low- and middle- income countries, the vicious cycle of rapid urbanization and increasing levels of air pollution, public health and regulatory policies for air quality protection should be integrated into the main priorities of the primary health care system and into the educational curriculum of health professionals.

A review of the potential association between childhood leukemia and benzene

Chronic exposure to high concentrations of benzene is an established cause of acute myeloid leukemia (AML) in occupationally exposed workers. Based on this association, it is not unreasonable to assume that children could also get AML if they were exposed to comparable levels of benzene. Fortunately, reports of such exposures and subsequent AML development in children are non-existent. However, the question of whether children can develop leukemia at far lower, environmental levels of benzene remains. The existing scientific evidence relevant to this question will be addressed in this review. While positive findings have been reported, the collective literature does not indicate that exposure to environmental levels of benzene is related to an increased risk of childhood leukemia. Our understanding of this important issue would be strengthened by additional studies that accurately characterize exposures as well as differentiate between the various forms of leukemias observed in children.

Leukaemia incidence in people living close to an oil refinery

OBJECTIVES

To assess the incidence of leukaemia in an area downwind of a large oil refinery emitting carcinogenic volatile organic compounds (VOCs) including benzene.

METHODS

Using a dispersion model and the prevailing wind direction, two parishes with about 5000 inhabitants were a priori considered to be exposed to VOCs from the refinery. Numbers of observed and expected leukaemia cases in 1975-2004 were calculated using regional sex- and age-specific incidence rates. In addition, five nearby parishes (12000 inhabitants), considered unaffected by the emissions, served as a local reference area. Based on emission data, dispersion modelling and VOC measurements, the refinery's contribution to the population's exposure to carcinogenic VOCs was estimated. Published "unit risks" for carcinogenic VOCs were used to estimate the expected excess leukaemia risk.

RESULTS

The incidence of leukaemia in the "exposed parishes" was significantly increased in 1975-2004 (33 cases v. 22 expected cases), owing to an increase in the last 10-year period, from 1995 to 2004 (19 cases v. 8.5 expected cases). The leukaemia incidence in the local control area was normal (50 cases v. 56 expected cases). The estimated contribution from the refinery to VOC concentrations was, however, only about 2 microg/m(3) (yearly average) for benzene, 2 microg/m(3) for ethylene, 0.5 microg/m(3) for 1,3-butadiene and 5 microg/m(3) for propene. Calculations of expected excess risk using published risk estimates would indicate a much lower excess risk in the exposed parishes.

CONCLUSIONS

Using risk estimates extrapolated from high-level exposure, we would not expect an increase of leukaemia at low exposure to VOC emissions. Nevertheless, the clear elevation of leukaemia in the priori selected, exposed parishes was remarkable. Our finding may reflect a causal association due to emissions, but it could also be due to unknown confounding, or chance.

Association of bladder cancer with residential exposure to petrochemical air pollutant emissions in Taiwan

To investigate the relationship between petrochemical air pollution and risk of death due to bladder cancer, studies were conducted using a matched cancer case-control model based upon deaths that occurred in Taiwan from 1995 through 2005. Data on all eligible bladder cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of individuals who died from causes other than neoplasms or diseases associated with genitourinary problems. The controls were pair matched to the cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. The proportion of a municipality's total population employed in the petrochemical industry in a municipality was used as an indicator of a resident's exposure to air emissions from the petrochemical industry. The subjects were divided into three levels (< or =25th percentile; 25th-50th percentile; >50th percentile). Subjects who lived in the group of municipalities characterized by the high levels of petrochemical air pollution had a significantly higher risk of death attributed to bladder cancer than subjects in the group that lived in municipalities with the lowest petrochemical air pollution levels, after controlling for possible confounders. The findings of this study warrant further investigation of the role of petrochemical air pollution in the etiology of bladder cancer.

Chemical risk factors and childhood leukaemia: a review of recent studies

The search for chemical risks factors as determinants of childhood leukaemia has been ongoing for over two decades. Results of epidemiological studies, published from 1998 to the present, evaluating parental smoking, outdoor sources of pollution, indoor contaminants and chemicals from drinking water are reported. Overall, results were mostly negative. This may be due to the relatively small study sizes to detect environmental effects, usually measured imprecisely. Another reason may be that such effects, which may be revealed among the genetically susceptible, have rarely accounted for genetic susceptibility. The few studies that have are also reported here. Suggestions are made for work in the immediate future, which include pooling of data and of analyses, as well as carrying out in-depth reviews of studies with the goal of understanding the reasons for discrepant results.