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Crespi CM, Sudan M, Juutilainen J, Roivainen P, Hareuveny R, Huss A, Kandel S, Karim-Kos HE, Thuróczy G, Jakab Z, Spycher BD, Flueckiger B, Vermeulen R, Vergara X, Kheifets L. International study of childhood leukemia in residences near electrical transformer rooms. ENVIRONMENTAL RESEARCH 2024; 249:118459. [PMID: 38346482 DOI: 10.1016/j.envres.2024.118459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVES New epidemiologic approaches are needed to reduce the scientific uncertainty surrounding the association between extremely low frequency magnetic fields (ELF-MF) and childhood leukemia. While most previous studies focused on power lines, the Transformer Exposure study sought to assess this association using a multi-country study of children who had lived in buildings with built-in electrical transformers. ELF-MF in apartments above built-in transformers can be 5 times higher than in other apartments in the same building. This novel study design aimed to maximize the inclusion of highly exposed children while minimising the potential for selection bias. METHODS We assessed associations between residential proximity to transformers and risk of childhood leukemia using registry based matched case-control data collected in five countries. Exposure was based on the location of the subject's apartment relative to the transformer, coded as high (above or adjacent to transformer), intermediate (same floor as apartments in high category), or unexposed (other apartments). Relative risk (RR) for childhood leukemia was estimated using conditional logistic and mixed logistic regression with a random effect for case-control set. RESULTS Data pooling across countries yielded 16 intermediate and 3 highly exposed cases. RRs were 1.0 (95% CI: 0.5, 1.9) for intermediate and 1.1 (95% CI: 0.3, 3.8) for high exposure in the conditional logistic model. In the mixed logistic model, RRs were 1.4 (95% CI: 0.8, 2.5) for intermediate and 1.3 (95% CI: 0.4, 4.4) for high. Data of the most influential country showed RRs of 1.1 (95% CI: 0.5, 2.4) and 1.7 (95% CI: 0.4, 7.2) for intermediate (8 cases) and high (2 cases) exposure. DISCUSSION Overall, evidence for an elevated risk was weak. However, small numbers and wide confidence intervals preclude strong conclusions and a risk of the magnitude observed in power line studies cannot be excluded.
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Affiliation(s)
- Catherine M Crespi
- University of California Los Angeles Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.
| | - Madhuri Sudan
- University of California Los Angeles Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA; Kaweah Health Medical Center, Visalia, CA, USA.
| | - Jukka Juutilainen
- University of Eastern Finland, Department of Environmental and Biological Sciences, Kuopio, Finland.
| | - Päivi Roivainen
- University of Eastern Finland, Department of Environmental and Biological Sciences, Kuopio, Finland.
| | | | - Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | | | | | - György Thuróczy
- National Center for Public Health and Pharmacy, Budapest, Hungary.
| | - Zsuzsanna Jakab
- National Childhood Oncologic Registry, Department of Pediatrics, Semmelweis University, Budapest, Hungary.
| | - Ben D Spycher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
| | - Benjamin Flueckiger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Ximena Vergara
- University of California Los Angeles Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.
| | - Leeka Kheifets
- University of California Los Angeles Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.
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Malavolti M, Malagoli C, Wise LA, Poli M, Notari B, Taddei I, Fabbi S, Teggi S, Balboni E, Pancaldi A, Palazzi G, Vinceti M, Filippini T. Residential exposure to magnetic fields from transformer stations and risk of childhood leukemia. ENVIRONMENTAL RESEARCH 2024; 245:118043. [PMID: 38145739 DOI: 10.1016/j.envres.2023.118043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 12/23/2023] [Accepted: 12/23/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Several studies have documented an increased risk of leukemia among children exposed to magnetic fields from high-voltage power lines, with some evidence of dose-response relation. However, findings in some studies have been inconsistent, and data on the effects of different sources of exposure are lacking. In this study, we evaluated the relation of childhood leukemia risk to exposure to magnetic fields from transformer stations. METHODS We conducted a population-based case-control study in a pediatric population of two Northern Italian provinces of Modena and Reggio Emilia. We included 182 registry-identified childhood leukemia cases diagnosed during 1998-2019 and 726 population controls matched on sex, year of birth, and province of residence. We assessed exposure by calculating distance from childhood residence to the nearest transformer station within a geographical information system, computing disease odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression, adjusting for potential confounders. We evaluated exposure using two buffers (15 m and 25 m radius) and assessed two case groups: leukemia (all subtypes) and acute lymphoblastic leukemia (ALL). RESULTS Residing within 15 m of a transformer station (vs. ≥15 m) was not appreciably associated with risk of leukemia (all subtypes) or ALL. We found similar results using a less stringent exposure buffer (25 m). Among children aged ≥5 years, the adjusted ORs were 1.3 (95% CI 0.1-12.8) for leukemia and 1.3 (95% CI 0.1-12.4) for ALL using the 15 m buffer, while they were 1.7 (95% CI 0.4-7.0) for leukemia and 0.6 (95% CI 0.1-4.8) for ALL using the 25 m buffer. CONCLUSIONS While we found no overall association between residential proximity to transformer stations and childhood leukemia, there was some evidence for elevated risk of childhood leukemia among children aged ≥5 years. Precision was limited by the low numbers of exposed children.
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Affiliation(s)
- Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Maurizio Poli
- Emilia-Romagna Regional Agency for Environmental Prevention and Energy (ARPAE), Emilia-Romagna Region, Italy
| | - Barbara Notari
- Emilia-Romagna Regional Agency for Environmental Prevention and Energy (ARPAE), Emilia-Romagna Region, Italy
| | - Irene Taddei
- Emilia-Romagna Regional Agency for Environmental Prevention and Energy (ARPAE), Emilia-Romagna Region, Italy
| | - Sara Fabbi
- Department of Engineering 'Enzo Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - Sergio Teggi
- Department of Engineering 'Enzo Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - Erica Balboni
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Health Physics Unit, Modena Policlinico University Hospital, Modena, Italy
| | - Alessia Pancaldi
- Pediatric Oncology and Hematology Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Palazzi
- Pediatric Oncology and Hematology Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA
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Khan MW, Juutilainen J, Auvinen A, Naarala J, Pukkala E, Roivainen P. A cohort study on adult hematological malignancies and brain tumors in relation to magnetic fields from indoor transformer stations. Int J Hyg Environ Health 2021; 233:113712. [PMID: 33601135 DOI: 10.1016/j.ijheh.2021.113712] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/12/2021] [Accepted: 02/05/2021] [Indexed: 12/14/2022]
Abstract
Extremely low frequency (ELF) magnetic fields (MF) have been classified as possibly carcinogenic. This classification was mainly based on studies indicating increased risk of leukemia in children living near power lines. Increased risks of adult hematological malignancies and brain tumors have also been reported, but the results are mixed. We assessed incidence of adult hematological malignancies and brain tumors associated with residential MF exposure. All cohort members had lived in buildings with indoor transformer stations (TS). MF exposure was assessed based on apartment location. Out of the 256,372 individuals, 9,636 (165,000 person-years of follow-up) living in apartments next to TSs were considered as exposed. Associations between MF exposure and neoplasms were examined using Cox proportional hazard models. The hazard ratio (HR) for MF exposure ≥ 1 month was below one for most hematological neoplasms (HR for any hematological neoplasm: 0.75; 95% CI: 0.54-1.03), and decreased with increasing duration of exposure (HR for exposure ≥ 10 years: 0.47; 95% CI: 0.22-0.99). However, the HR for acute lymphocytic leukemia (ALL) was 2.86 (95% CI: 1.00-8.15), based on 4 exposed cases; the risk increased with duration of exposure (HR for exposure ≥3 years: 3.61; 95% CI: 1.05-12.4) and was particularly associated with childhood exposure (2 exposed cases, HR for exposure during the first two years of life: 11.5; 95% CI: 1.92-68.9). The HR for meningioma was 0.46 (95% CI: 0.19-1.11), with no evidence of exposure-response gradient with increasing duration of exposure. The HR for glioma was 1.47 (95% CI: 0.84-2.57). The hypothesis of a positive association between ELF MFs and adult hematological malignancies was supported only for ALL. The results suggested decreased rather than increased risk of most hematological neoplasms.
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Affiliation(s)
- Muhammad Waseem Khan
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland; Department of Biotechnology, Balochistan University of Information Technology, Engineering & Management Sciences, Quetta, Pakistan
| | - Jukka Juutilainen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anssi Auvinen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland; STUK - Radiation and Nuclear Safety Authority, Helsinki, Finland
| | - Jonne Naarala
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Eero Pukkala
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland; Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Päivi Roivainen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland; STUK - Radiation and Nuclear Safety Authority, Helsinki, Finland.
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Khan MW, Juutilainen J, Roivainen P. Registry of Buildings With Transformer Stations as a Basis for Epidemiological Studies on Health Effects of Extremely Low‐Frequency Magnetic Fields. Bioelectromagnetics 2019; 41:34-40. [DOI: 10.1002/bem.22228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 10/22/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Muhammad Waseem Khan
- Department of Environmental and Biological SciencesUniversity of Eastern FinlandKuopio Finland
- Department of BiotechnologyBalochistan University of Information Technology, Engineering and Management SciencesQuetta Pakistan
| | - Jukka Juutilainen
- Department of Environmental and Biological SciencesUniversity of Eastern FinlandKuopio Finland
| | - Päivi Roivainen
- Department of Environmental and Biological SciencesUniversity of Eastern FinlandKuopio Finland
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