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Orimoloye HT, Nguyen N, Deng C, Saechao C, Ritz B, Olsen J, Hansen J, Heck JE. Maternal autoimmune disease and its association with childhood cancer: A population-based case-control study in Denmark. EJC Paediatr Oncol 2024; 3:100145. [PMID: 38298419 PMCID: PMC10827341 DOI: 10.1016/j.ejcped.2024.100145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Background Autoimmune diseases have been linked to an increased risk of pregnancy-related complications. A family history of autoimmune diseases may be related to the risk of childhood cancer based on similar histocompatibility antigens. We utilized data from national registries in Denmark to examine associations between maternal autoimmune disease and cancer in their offspring. Methods We linked data from several national registries in Denmark to identify childhood cancer cases in children <20 years diagnosed between 1977 to 2016. Controls were selected from the Central Population Register and matched to cases by birth year and sex (25:1). Mothers with autoimmune disease diagnosed in pregnancy or prior were identified from the National Patient Register. Multivariable conditional logistic regression analyses were used to estimate associations between maternal autoimmune diseases and childhood cancer in offspring. Results Autoimmune diseases (all types) were positively associated with all childhood cancers combined (Odds Ratio (OR) = 1.25, 95% CI 1.06, 1.47), acute lymphoblastic leukemia (OR =1.52, 95% CI 1.09, 2.13), Burkitt lymphoma (OR = 2.69, 95% CI 1.04, 6.97), and central nervous system tumors (OR = 1.45, 95% CI 1.06, 1.99), especially astrocytoma (OR = 2.27, 95% CI 1.36, 3.77) and glioma (OR = 1.75, 95% CI 1.13, 2.73). When we examined mothers with rheumatoid arthritis, we observed an increased association for all cancers (OR = 2.15, 95% CI 1.40, 3.30), acute lymphoblastic leukemia (OR = 3.55, 95% CI 1.69, 7.47), and central nervous system tumors (OR = 2.91, 95% CI 1.46, 5.82), especially glioma (OR = 3.58, 95% CI 1.40, 9.18) in offspring. Conclusion There is a positive association between maternal autoimmune disease and childhood cancer. This association is especially prominent in the offspring of women with rheumatoid arthritis.
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Affiliation(s)
- Helen T. Orimoloye
- College of Health and Public Service, University of North Texas, Denton, TX, USA
| | - Nicholas Nguyen
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chuanjie Deng
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chai Saechao
- UCLA Health, University of California, Los Angeles
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Julia E. Heck
- College of Health and Public Service, University of North Texas, Denton, TX, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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Chen Y, Van Deventer D, Nianogo R, Vinceti M, Kang W, Cockburn M, Federman N, Heck JE. Maternal residential exposure to solvents from industrial sources during pregnancy and childhood cancer risk in California. Int J Hyg Environ Health 2024; 259:114388. [PMID: 38704950 DOI: 10.1016/j.ijheh.2024.114388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/09/2024] [Accepted: 04/23/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Maternal solvent exposure has been suspected to increase offspring cancer risk. The study aimed to evaluate the associations between maternal residential exposure to solvents from industrial pollution during pregnancy and childhood cancer. METHODS The present study included 15,744 cancer cases (aged 0-19 years at diagnosis) identified from California Cancer Registry and 283,141 controls randomly selected from California Birth Registry (20:1 frequency-matched by birth year: 1998-2016). We examined industrial releases of tetrachloroethylene and 1,1,1-trichloroethane within 3 km of the birth address, while we used a 5 km buffer for carbon disulfide. We calculated the total exposure from all linked Toxic Release Inventory sites during each index pregnancy and assigned "ever/never" and "high/low exposed/unexposed" exposure, using median values. We performed quadratic decay models to estimate cancer risks associated with maternal solvent exposure in pregnancy. RESULTS 1,1,1-Trichloroethane was associated with rhabdomyosarcoma (adjusted Odds Ratio (aOR): 1.96; 95% Confidence Interval (CI): 1.16, 3.32) in the "ever exposed" group. Ever exposure to carbon disulfide was associated with increased risks of medulloblastoma (OR = 1.85, 95% CI 1.01, 3.40) and ependymoma (OR = 1.63, 95% CI 0.97, 2.74). CONCLUSIONS Overall, our findings suggested maternal residential exposure to solvents from industrial sources might be associated with elevated childhood cancer risks.
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Affiliation(s)
- Yixin Chen
- Department of Epidemiology, Fielding School of Public Health, University of California, UCLA, Los Angeles, CA, 90095-1772, USA
| | - Darcy Van Deventer
- Department of Epidemiology, Fielding School of Public Health, University of California, UCLA, Los Angeles, CA, 90095-1772, USA
| | - Roch Nianogo
- Department of Epidemiology, Fielding School of Public Health, University of California, UCLA, Los Angeles, CA, 90095-1772, USA; California Center for Population Research, University of California, UCLA, Los Angeles, CA, USA
| | - Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA
| | - Wei Kang
- Department of Geography and the Environment, University of North Texas, Denton, TX, 76203-5017, USA
| | - Myles Cockburn
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Noah Federman
- Department of Pediatrics, Geffen School of Medicine, University of California, UCLA, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, UCLA, Los Angeles, CA, 90095-1772, USA; College of Health and Public Service, University of North Texas, Denton, TX, 76203-5017, USA.
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Heck JE, He D, Wing SE, Ritz B, Carey CD, Yang J, Stram DO, Le Marchand L, Park SL, Cheng I, Wu AH. Exposure to outdoor ambient air toxics and risk of breast cancer: The multiethnic cohort. Int J Hyg Environ Health 2024; 259:114362. [PMID: 38574449 DOI: 10.1016/j.ijheh.2024.114362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/01/2024] [Accepted: 03/24/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND A growing literature has reported associations between traffic-related air pollution and breast cancer, however there are fewer investigations into specific ambient agents and any putative risk of breast cancer development, particularly studies occurring in populations residing in higher pollution areas such as Los Angeles. OBJECTIVES To estimate breast cancer risks related to ambient air toxics exposure at residential addresses. METHODS We examined the relationships between ambient air toxics and breast cancer risk in the Multiethnic Cohort among 48,665 California female participants followed for cancer from 2003 through 2013. We obtained exposure data on chemicals acting as endocrine disruptors or mammary gland carcinogens from the National-Scale Air Toxics Assessment. Cox proportional hazards models were used to estimate breast cancer risk per one interquartile range (IQR) increase in air toxics exposure lagged by 5-years. Stratified analyses were conducted by race, ethnicity, and hormone receptor types. RESULTS Among all women, increased risks of invasive breast cancer were observed with toxicants related to industries [1,1,2,2-tetrachloroethane (hazard ratio [HR] = 4.22, 95% confidence interval [95% CI] 3.18-5.60), ethylene dichloride (HR = 2.81, 95% CI 2.20-3.59), and vinyl chloride (HR = 2.27, 95% CI 1.81, 2.85); these 3 agents were correlated (r2 = 0.45-0.77)]. Agents related to gasoline production or combustion were related to increased breast cancer risk [benzene (HR = 1.32, 95% CI 1.24, 1.41), ethylbenzene (HR = 1.20, 95% CI 1.13-1.28), toluene (HR = 1.29, 95% CI 1.20-1.38), naphthalene (HR = 1.11, 95% CI 1.02-2.22), acrolein (HR = 2.26, 95% CI 1.92, 2.65)]. Higher hazard ratios were observed in African Americans and Whites compared to other racial and ethnic groups (p-heterogeneity <0.05 for traffic-related air toxics, acrolein, and vinyl acetate). CONCLUSIONS Our findings suggest that specific toxic air pollutants may be associated with increase breast cancer risk.
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Affiliation(s)
- Julia E Heck
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA; College of Health and Public Service, University of North Texas, Denton, TX, USA; Center for Racial and Ethnic Equity in Health and Society, University of North Texas, Denton, TX, USA.
| | - Di He
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
| | - Sam E Wing
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
| | - Chandra D Carey
- College of Health and Public Service, University of North Texas, Denton, TX, USA; Center for Racial and Ethnic Equity in Health and Society, University of North Texas, Denton, TX, USA
| | - Juan Yang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Daniel O Stram
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Loïc Le Marchand
- Epidemiology Section, Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Sungshim Lani Park
- Epidemiology Section, Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA; University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Anna H Wu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Orimoloye HT, Hu YH, Federman N, Ritz B, Arah OA, Li CY, Lee PC, Heck JE. Effects of hypertension and use of antihypertensive drugs in pregnancy on the risks of childhood cancers in Taiwan. Cancer Causes Control 2024:10.1007/s10552-024-01864-6. [PMID: 38557933 DOI: 10.1007/s10552-024-01864-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 02/10/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Childhood cancers are associated with high mortality and morbidity, and some maternal prescription drug use during pregnancy has been implicated in cancer risk. There are few studies on the effects of hypertension, preeclampsia, and the use of antihypertensives in pregnancy on children's cancer risks. OBJECTIVE This population-based cohort study analyzed the relationship between hypertension, preeclampsia, and antihypertensives taken during pregnancy and the risks of childhood cancers in the offspring. METHODS Data on all children born in Taiwan between 2004 and 2015 (N = 2,294,292) were obtained from the Maternal and Child Health Database. This registry was linked with the National Health Insurance Database and Cancer Registry to get the records of maternal use of diuretics or other antihypertensives in pregnancy and records of children with cancer diagnosed before 13 years. We used Cox proportional hazard modeling to estimate the influence of maternal health conditions and antihypertensive drug exposure on the risks of developing childhood cancers. RESULTS Offspring of mothers with hypertension (chronic or gestational) had a higher risk of acute lymphocytic lymphoma [hazard ratio (HR) = 1.87, 95% Confidence Interval (CI) 1.32 - 2.65] and non-Hodgkin's lymphoma (HR = 1.96, 95% CI 1.34 - 2.86). We estimated only a weak increased cancer risk in children whose mothers used diuretics (HR = 1.16, 95% CI 0.77 - 1.74) or used antihypertensives other than diuretics (HR = 1.15, 95% CI 0.86 - 1.54) before birth. CONCLUSIONS In this cohort study, children whose mothers had chronic and gestational hypertension had an increased risk of developing childhood cancer.
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Affiliation(s)
- Helen T Orimoloye
- College of Health and Public Service, University of North Texas, Denton, TX, USA
| | - Ya-Hui Hu
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
| | - Noah Federman
- Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Department of Statistics and Data Science, College of Letters and Science, University of California, Los Angeles, CA, USA
- Research Unit for Epidemiology, Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Pei-Chen Lee
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan.
| | - Julia E Heck
- College of Health and Public Service, University of North Texas, Denton, TX, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
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Sirirungreung A, Lee PC, Hu YH, Liew Z, Ritz B, Heck JE. Maternal medically diagnosed infection and antibiotic prescription during pregnancy and risk of childhood cancer: A population-based cohort study in Taiwan, 2004 to 2015. Int J Cancer 2024; 154:626-635. [PMID: 37792464 PMCID: PMC10942658 DOI: 10.1002/ijc.34744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 10/05/2023]
Abstract
While associations between maternal infections during pregnancy and childhood leukemia in offspring have been extensively studied, the evidence for other types of childhood cancers is limited. Additionally, antibiotic exposure during pregnancy could potentially increase the risk of childhood cancers. Our study investigates associations between maternal infections and antibiotic prescriptions during pregnancy and the risk of childhood cancer in Taiwan. We conducted a population-based cohort study using the Taiwan Maternal and Child Health Database (TMCHD), linked with national health and cancer registries. The study included 2 267 186 mother-child pairs, and the median follow-up time was 7.96 years. Cox proportional hazard models were utilized to estimate effects. Maternal infections during pregnancy were associated with a moderate increase in the risk of childhood hepatoblastoma (adjusted hazard ratio [HR] = 1.34; 95% confidence interval [CI]: 0.90-1.98) and a weaker increase in the risk of childhood acute lymphoblastic leukemia (ALL) (adjusted HR = 1.15; 95% CI: 0.99-1.35). Antibiotic prescriptions during pregnancy were also associated with an elevated risk of childhood ALL (adjusted HR = 1.30; 95% CI: 1.04-1.63), particularly with tetracyclines (adjusted HR = 2.15; 95% CI: 1.34-3.45). Several specific antibiotics were also associated with an increased risk of hepatoblastoma and medulloblastoma. Children exposed in utero to antibiotic prescription or both infections and antibiotics during pregnancy were at higher risk of developing ALL. Our findings suggest that there are associations between maternal infections, antibiotic use during pregnancy and the risk of several childhood cancers in addition to ALL and highlight the importance of further research in this area.
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Affiliation(s)
- Anupong Sirirungreung
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Pei-Chen Lee
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Hui Hu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- College of Health and Public Service, University of North Texas, Denton, TX, USA
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Lupo PJ, Chambers TM, Mueller BA, Clavel J, Dockerty JD, Doody DR, Erdmann F, Ezzat S, Filippini T, Hansen J, Heck JE, Infante-Rivard C, Kang AY, Magnani C, Malagoli C, Metayer C, Bailey HD, Mora AM, Ntzani E, Petridou ET, Pombo-de-Oliveira MS, Rashed WM, Roman E, Schüz J, Wesseling C, Spector LG, Scheurer ME. Nonchromosomal birth defects and risk of childhood acute leukemia: An assessment in 15 000 leukemia cases and 46 000 controls from the Childhood Cancer and Leukemia International Consortium. Int J Cancer 2024; 154:434-447. [PMID: 37694915 PMCID: PMC11034994 DOI: 10.1002/ijc.34720] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/01/2023] [Accepted: 08/16/2023] [Indexed: 09/12/2023]
Abstract
Although recent studies have demonstrated associations between nonchromosomal birth defects and several pediatric cancers, less is known about their role on childhood leukemia susceptibility. Using data from the Childhood Cancer and Leukemia International Consortium, we evaluated associations between nonchromosomal birth defects and childhood leukemia. Pooling consortium data from 18 questionnaire-based and three registry-based case-control studies across 13 countries, we used multivariable logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between a spectrum of birth defects and leukemia. Our analyses included acute lymphoblastic leukemia (ALL, n = 13 115) and acute myeloid leukemia (AML, n = 2120) cases, along with 46 172 controls. We used the false discovery rate to account for multiple comparisons. In the questionnaire-based studies, the prevalence of birth defects was 5% among cases vs 4% in controls, whereas, in the registry-based studies, the prevalence was 11% among cases vs 7% in controls. In pooled adjusted analyses, there were several notable associations, including (1) digestive system defects and ALL (OR = 2.70, 95% CI: 1.46-4.98); (2) congenital anomalies of the heart and circulatory system and AML (OR = 2.86, 95% CI: 1.81-4.52) and (3) nervous system defects and AML (OR = 4.23, 95% CI: 1.50-11.89). Effect sizes were generally larger in registry-based studies. Overall, our results could point to novel genetic and environmental factors associated with birth defects that could also increase leukemia susceptibility. Additionally, differences between questionnaire- and registry-based studies point to the importance of complementary sources of birth defect phenotype data when exploring these associations.
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Affiliation(s)
- Philip J. Lupo
- Department of Pediatrics, Division of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - Tiffany M. Chambers
- Department of Pediatrics, Division of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - Beth A. Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Jacqueline Clavel
- CRESS, UMR-S1153, INSERM, Paris-Descartes University, Villejuif, France
| | - John D. Dockerty
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - David R. Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Friederike Erdmann
- International Agency for Research on Cancer (IARC), Section of Environment and Lifestyle Epidemiology, Lyon, France
- Division of Childhood Cancer Epidemiology, Institute for Medical Biostatistics, Epidemiology and Clinical Research, Department of Pediatrics, Informatics (IMBEI), Johannes Gutenberg University of Minnesota, Mainz, Germany
| | - Sameera Ezzat
- Department of Epidemiology and Preventive Medicine, NLISSI Collaborative Research Center, National Liver Institute, Menoufia University, Cairo, Egypt
| | - Tommaso Filippini
- CREAGEN Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Julia E. Heck
- College of Health and Public Service, University of North Texas, Denton, Texas, USA
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Alice Y. Kang
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Corrado Magnani
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, Piemonte, Novara, Italy
| | - Carlotta Malagoli
- CREAGEN Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Catherine Metayer
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Helen D. Bailey
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Nedlands, Australia
| | - Ana M. Mora
- Center for Environmental Research and Community Health (CERCH), School of Public Health University of California, Berkeley, Berkeley, California, USA
| | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, Medical School, University of Ioannina, Ioannina, Greece
- Center for Evidence Synthesis in Health, Policy and Practice, Center for Research Synthesis in Health, School of Public Health, Brown University, Providence, RI, United States
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece
| | | | | | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, United Kingdom
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), Section of Environment and Lifestyle Epidemiology, Lyon, France
| | - Catharina Wesseling
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Logan G. Spector
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michael E. Scheurer
- Department of Pediatrics, Division of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA
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He D, Huang X, Arah OA, Walker DI, Jones DP, Ritz B, Heck JE. A prediction model for classifying maternal pregnancy smoking using California state birth certificate information. Paediatr Perinat Epidemiol 2024; 38:102-110. [PMID: 37967567 PMCID: PMC10922711 DOI: 10.1111/ppe.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/16/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Systematically recorded smoking data are not always available in vital statistics records, and even when available it can underestimate true smoking rates. OBJECTIVE To develop a prediction model for maternal tobacco smoking in late pregnancy based on birth certificate information using a combination of self- or provider-reported smoking and biomarkers (smoking metabolites) in neonatal blood spots as the alloyed gold standard. METHODS We designed a case-control study where childhood cancer cases were identified from the California Cancer Registry and controls were from the California birth rolls between 1983 and 2011 who were cancer-free by the age of six. In this analysis, we included 894 control participants and performed high-resolution metabolomics analyses in their neonatal dried blood spots, where we extracted cotinine [mass-to-charge ratio (m/z) = 177.1023] and hydroxycotinine (m/z = 193.0973). Potential predictors of smoking were selected from California birth certificates. Logistic regression with stepwise backward selection was used to build a prediction model. Model performance was evaluated in a training sample, a bootstrapped sample, and an external validation sample. RESULTS Out of seven predictor variables entered into the logistic model, five were selected by the stepwise procedure: maternal race/ethnicity, maternal education, child's birth year, parity, and child's birth weight. We calculated an overall discrimination accuracy of 0.72 and an area under the receiver operating characteristic curve (AUC) of 0.81 (95% confidence interval [CI] 0.77, 0.84) in the training set. Similar accuracies were achieved in the internal (AUC 0.81, 95% CI 0.77, 0.84) and external (AUC 0.69, 95% CI 0.64, 0.74) validation sets. CONCLUSIONS This easy-to-apply model may benefit future birth registry-based studies when there is missing maternal smoking information; however, some smoking status misclassification remains a concern when only variables from the birth certificate are used to predict maternal smoking.
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Affiliation(s)
- Di He
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Xiwen Huang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Douglas I Walker
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Dean P Jones
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
- Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
- College of Health and Public Service, University of North Texas, Denton, Texas, USA
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8
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Orimoloye HT, He D, Li T, Janzen C, Barjaktarevic I, Wang X, Hansen J, Heck JE. Alpha-1 antitrypsin deficiency and pregnancy complications and birth outcomes: A population-based cohort study in Denmark. PLoS One 2024; 19:e0296434. [PMID: 38166066 PMCID: PMC10760838 DOI: 10.1371/journal.pone.0296434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 12/13/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Alpha-1 antitrypsin deficiency (AATD) is related to developing lung and liver disease, but no large-scale studies examine its association with birth outcomes. OBJECTIVE We investigated the risk of pregnancy complications and adverse birth outcomes in mothers and children with AATD. METHODS Using a large cohort data of Danish mothers and children with AATD from 1973 to 2013 (n = 2,027,229), with 559 cases (305 mothers and 254 children). We conducted Poisson regression to examine associations between alpha-1 antitrypsin deficiency, adverse birth outcomes, and pregnancy complications in mothers and children. RESULTS AATD was related to term low birth weight [<2500g; Risk Ratio(RR) = 2.04, 95% confidence interval (CI): 1.50-2.79], lowest quartile of abdominal circumference at birth in children of non-smoking mothers (RR = 1.55, 95% CI: 1.14-2.11), delivery via Cesarean-section (RR = 1.59, 95% CI: 1.05-2.40), preterm birth (RR = 1.54, 95% CI: 1.19-2.00) and preeclampsia (RR = 2.64, 95% CI: 1.76-3.94). CONCLUSIONS This emphasizes the need for mothers with AATD to be monitored closely during pregnancy to reduce the risk of adverse birth outcomes. Routine screening for alpha-1 antitrypsin in pregnancy may be considered among mothers with a pulmonary and liver disease history.
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Affiliation(s)
- Helen T. Orimoloye
- Department of Rehabilitation and Health Services, University of North Texas, Denton, Texas, United States of America
| | - Di He
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Tong Li
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Carla Janzen
- Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Igor Barjaktarevic
- Division of Pulmonary and Critical Care, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Xuexia Wang
- Department of Biostatistics, Florida International University, Miami, Florida, United States of America
| | | | - Julia E. Heck
- Department of Rehabilitation and Health Services, University of North Texas, Denton, Texas, United States of America
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
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9
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Askins L, Orimoloye HT, Deng C, Hansen J, Olsen J, Ritz B, Janzen C, Heck JE. Preeclampsia, antihypertensive medication use in pregnancy and risk of childhood cancer in offspring. Cancer Causes Control 2024; 35:43-53. [PMID: 37535154 PMCID: PMC10764520 DOI: 10.1007/s10552-023-01745-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 06/26/2023] [Indexed: 08/04/2023]
Abstract
PURPOSE Preeclampsia is a serious pregnancy complication that presents a significant risk to both the mother and the fetus. Preeclampsia and medications associated with its treatment are potentially linked to increased childhood cancer risk. Therefore, we examined the association between preeclampsia, antihypertensive medications, and childhood cancer in offspring. METHODS Cases (n = 6,420) and controls (n = 160,484) were obtained from Danish national registries. We performed conditional logistic regression analyses to estimate the association between preeclampsia and childhood cancer risk, and examined the effects of antihypertensive medication use in pregnancy in relation to childhood cancer risk in the offspring with adjustment for relevant covariates. RESULTS We observed an increased risk of acute lymphoblastic leukemia (ALL) among those whose mothers had preeclampsia (OR = 1.36, 95% CI 1.03, 1.79), especially for severe preeclampsia (OR = 2.36, 95% CI 1.37, 4.08). We also estimated an increased cancer risk in children born to mothers who were prescribed diuretics during pregnancy [OR = 2.09, 95% confidence interval (CI) 1.39, 3.14]. Intake of other antihypertensive medications was not associated with childhood cancer (OR = 0.78, 95% CI 0.50, 1.23). Among women who did not take diuretics in pregnancy, preeclampsia was associated with neuroblastoma (OR = 2.22, 95% CI 1.08, 4.55). CONCLUSION Our findings suggested an increased risk for certain types of cancer in the offspring of mothers with preeclampsia and an increased risk of cancer with diuretic intake during pregnancy.
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Affiliation(s)
- Lexie Askins
- Department of Epidemiology, Fielding School of Public Health, University of California (UCLA), Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Helen T Orimoloye
- College of Health and Public Service, University of North Texas, 1155 Union Circle #311340, Denton, TX, 76203-5017, USA
| | - Chuanjie Deng
- Department of Epidemiology, Fielding School of Public Health, University of California (UCLA), Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California (UCLA), Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Carla Janzen
- Department of Obstetrics and Gynecology, University of California, Box 951740, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California (UCLA), Box 951772, Los Angeles, CA, 90095-1772, USA.
- College of Health and Public Service, University of North Texas, 1155 Union Circle #311340, Denton, TX, 76203-5017, USA.
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Chen Y, Paul KC, Walker DI, Jones DP, Wang X, Ritz BR, Heck JE. Neonatal per- and polyfluoroalkyl substance exposure in relation to retinoblastoma. Environ Res 2024; 240:117435. [PMID: 37866539 PMCID: PMC10842486 DOI: 10.1016/j.envres.2023.117435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Neonatal per- and polyfluoroalkyl substance (PFAS) exposure can disrupt hormonal homeostasis and induce neuro- and immunotoxicity in children. In this exploratory study, we investigated associations between PFAS levels in neonatal dried blood spots and retinoblastoma risk. MATERIALS AND METHODS This study included 501 retinoblastoma cases born from 1983 to 2011 and 899 controls frequency-matched by birth year (20:1 matching ratio), born to 755 US-born and 366 Mexico-born mothers in California. Perfluorooctanesulfonic acid (PFOS), perflurooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) feature intensities were identified from neonatal blood spots from California newborn Genetic Disease Screening Program. Using logistic regression, we assessed whether an interquartile range (IQR) increase of PFAS levels or having above-mean levels of PFAS in blood affects retinoblastoma risk overall or its subtypes (i.e., unilateral, bilateral). We assessed children of US-born and Mexico-born mothers, separately. RESULTS AND DISCUSSION Among all children, above-mean PFOS levels at birth increased the odds of retinoblastoma overall by 29% (95% Confidence Interval (CI): 1.00, 1.67) and unilateral retinoblastoma by 42% (95% CI: 1.03, 1.97). For children of Mexico-born mothers, we estimated the highest odds of retinoblastoma overall (adjusted odds ratio (aOR): 1.67; 95% CI: 1.06, 2.66) and bilateral retinoblastoma (aOR: 2.06; 95% CI: 1.12, 3.92) with above-mean PFOS levels. Among children of US-born mothers, higher PFOS levels increased the odds of unilateral retinoblastoma by 15% (95% CI: 0.99, 1.35) for each IQR increase and by 71% among children with above-mean PFOS levels (95% CI: 1.04, 2.90). In addition, for children of US-born mothers, PFOA increased the odds of retinoblastoma overall (aOR: 1.41; 95% CI: 1.00, 2.02 for above-mean levels, aOR: 1.06; 95% CI: 0.98, 1.16 per IQR increase). PFNA was not associated with retinoblastoma risk. CONCLUSIONS Our results suggested that PFOS and PFOA might contribute to retinoblastoma risk in children born in California.
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Affiliation(s)
- Yixin Chen
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Kimberly C Paul
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Douglas I Walker
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dean P Jones
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Department of Medicine, Emory University, Atlanta, GA, USA
| | - Xuexia Wang
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Beate R Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; College of Health and Public Service, University of North Texas, Denton, TX, USA.
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11
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Orimoloye HT, Deng C, Hansen J, Olsen J, Saechao C, Ritz B, Heck JE. Hyperemesis gravidarum and the risk of childhood cancer - A case-control study in Denmark. Cancer Epidemiol 2023; 87:102472. [PMID: 37879293 PMCID: PMC10754053 DOI: 10.1016/j.canep.2023.102472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE Only a few studies have reported on the association between hyperemesis gravidarum and the risk of childhood cancer. We examined possible associations in this population-based study in Denmark. METHODS Pediatric cancer cases (n = 6420) were ascertained from the Denmark Cancer Registry among children born between 1977 and 2013. Twenty-five controls were matched to each case by sex and birth date from the Central Person Registry (n = 160500). Mothers with hyperemesis gravidarum were ascertained from the National Patient Register. The risk of childhood cancer was estimated using conditional logistic regression. In a separate analysis, we examined pregnancy prescription of antinauseant medications, ascertained from the National Pharmaceutical Register, to determine associations with childhood cancers. RESULTS In Denmark, hyperemesis gravidarum was associated with an increased risk of childhood cancer [all types combined; Odds Ratio (OR) = 1.43, 95% confidence interval (CI) 1.12, 1.81; n = 73 exposed cases). Hyperemesis gravidarum was also associated with an increased risk of neuroblastoma (OR = 2.52, 95% CI 1.00, 6.36; n = 5 exposed cases), acute lymphoblastic leukemia (OR = 1.63, 95% CI 0.98, 2.72; n = 16 exposed cases), and non-Hodgkin's lymphoma (OR = 2.41, 95% CI 0.95, 6.08; n = 5 exposed cases). We observed no childhood cancer risk increase from antinauseant prescriptions (OR = 1.05, 95% CI 0.84, 1.30; n = 91 exposed cases). CONCLUSION Our results are suggestive of an association between hyperemesis gravidarum and the overall cancer risk in offspring, particularly for neuroblastoma. Mothers with hyperemesis gravidarum should be closely monitored and receive appropriate treatment during pregnancy.
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Affiliation(s)
- Helen T Orimoloye
- College of Health and Public Service, University of North Texas, 1155 Union Circle # 311340, Denton, TX 76203-5017, USA
| | - Chuanjie Deng
- Department of Epidemiology, Fielding School of Public Health, Box 951772, University of California, Los Angeles, Los Angeles, CA, 900951772 USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Chai Saechao
- UCLA Health, University of California, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, Box 951772, University of California, Los Angeles, Los Angeles, CA, 900951772 USA
| | - Julia E Heck
- College of Health and Public Service, University of North Texas, 1155 Union Circle # 311340, Denton, TX 76203-5017, USA; Department of Epidemiology, Fielding School of Public Health, Box 951772, University of California, Los Angeles, Los Angeles, CA, 900951772 USA.
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12
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Yan Q, He D, Walker DI, Uppal K, Wang X, Orimoloye HT, Jones DP, Ritz BR, Heck JE. The neonatal blood spot metabolome in retinoblastoma. EJC Paediatr Oncol 2023; 2:100123. [PMID: 38130370 PMCID: PMC10735245 DOI: 10.1016/j.ejcped.2023.100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Background Retinoblastoma is rare but nevertheless the most common pediatric eye cancer that occurs in children under age 5. High-resolution metabolomics (HRM) is a powerful analytical approach to profile metabolic features and pathways or identify metabolite biomarkers. To date, no studies have used pre-diagnosis blood samples from retinoblastoma cases and compared them to healthy controls to elucidate early perturbations in tumor pathways. Objectives Here, we report on metabolic profiles of neonatal blood comparing cases later in childhood diagnosed with retinoblastoma and controls. Methods We employed untargeted metabolomics analysis using neonatal dried blood spots for 1327 children (474 retinoblastoma cases and 853 healthy controls) born in California from 1983 to 2011. Cases were selected from the California Cancer Registry and controls, frequency matched to cases by birth year, from California birth rolls. We performed high-resolution metabolomics to extract metabolic features, partial least squares discriminant analysis (PLS-DA) and logistic regression to identify features associated with disease, and Mummichog pathway analysis to characterize enriched biological pathways. Results PLS-DA identified 1917 discriminative features associated with retinoblastoma and Mummichog identified 14 retinoblastoma-related enriched pathways including linoleate metabolism, pentose phosphate pathway, pyrimidine metabolism, fructose and mannose metabolism, vitamin A metabolism, as well as fatty acid and lipid metabolism. Interpretation Our findings linked a retinoblastoma diagnosis in early life to newborn blood metabolome perturbations indicating alterations in inflammatory pathways and energy metabolism. Neonatal blood spots may provide a venue for early detection for this or potentially other childhood cancers.
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Affiliation(s)
- Qi Yan
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Di He
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Douglas I. Walker
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Karan Uppal
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Xuexia Wang
- Department of Mathematics, University of North Texas, Denton, TX, USA
| | - Helen T. Orimoloye
- College of Health and Public Service, University of North Texas, Denton, TX, USA
| | - Dean P. Jones
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, Emory University, Atlanta, GA, USA
- Department of Medicine, Emory University, Atlanta, GA, USA
| | - Beate R. Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Neurology, UCLA School of Medicine, CA, USA
| | - Julia E. Heck
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- College of Health and Public Service, University of North Texas, Denton, TX, USA
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13
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He D, Yan Q, Uppal K, Walker DI, Jones DP, Ritz B, Heck JE. Metabolite Stability in Archived Neonatal Dried Blood Spots Used for Epidemiologic Research. Am J Epidemiol 2023; 192:1720-1730. [PMID: 37218607 PMCID: PMC11004922 DOI: 10.1093/aje/kwad122] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 09/01/2022] [Accepted: 05/17/2023] [Indexed: 05/24/2023] Open
Abstract
Epidemiologic studies of low-frequency exposures or outcomes using metabolomics analyses of neonatal dried blood spots (DBS) often require assembly of samples with substantial differences in duration of storage. Independent assessment of stability of metabolites in archived DBS will enable improved design and interpretation of epidemiologic research utilizing DBS. Neonatal DBS routinely collected and stored as part of the California Genetic Disease Screening Program between 1983 and 2011 were used. The study population included 899 children without cancer before age 6 years, born in California. High-resolution metabolomics with liquid-chromatography mass spectrometry was performed, and the relative ion intensities of common metabolites and selected xenobiotic metabolites of nicotine (cotinine and hydroxycotinine) were evaluated. In total, we detected 26,235 mass spectral features across 2 separate chromatography methods (C18 hydrophobic reversed-phase chromatography and hydrophilic-interaction liquid chromatography). For most of the 39 metabolites related to nutrition and health status, we found no statistically significant annual trends across the years of storage. Nicotine metabolites were captured in the DBS with relatively stable intensities. This study supports the usefulness of DBS stored long-term for epidemiologic studies of the metabolome. -Omics-based information gained from DBS may also provide a valuable tool for assessing prenatal environmental exposures in child health research.
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Affiliation(s)
| | | | | | | | | | | | - Julia E Heck
- Correspondence to Dr. Julia E. Heck, College of Health and Public Service, UNT 1155 Union Circle #311340, Denton, TX 76203-5017 (e-mail: )
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14
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Sirirungreung A, Hansen J, Ritz B, Heck JE. Association between medically diagnosed postnatal infection and childhood cancers: A matched case-control study in Denmark, 1978 to 2016. Int J Cancer 2023; 153:994-1002. [PMID: 37243370 PMCID: PMC10524667 DOI: 10.1002/ijc.34604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/28/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Although the association between infection and childhood cancer has been long investigated, there is limited information on rarer cancers. This article aimed to explore the association between postnatal infection and childhood cancers in the Danish population. A matched case-control study was conducted using Danish nationwide registries from 1978 to 2016. Each childhood cancer case was matched 1:25 with controls by birth date within a week and sex. Postnatal infections were identified from the Danish National Patient Registry, which lists diagnoses seen in hospital, specialist or emergency care services. Multivariable conditional logistic regression was used to estimate adjusted odds ratios (adj.OR) and 95% confidence intervals (CI). Specific types of infections and the number of infection episodes were also considered. The study included 4125 childhood cancer cases and 103 526 matched controls with ages ranging from 0 to 19 years. Medically diagnosed postnatal infections were positively associated with many types of childhood cancer including acute lymphoblastic leukemia (adj.OR = 1.42; 95% CI: 1.23-1.63), acute myeloid leukemia (adj.OR = 1.80; 95% CI: 1.28-2.52), non-Hodgkin lymphoma (adj.OR = 1.53; 95% CI: 1.19-1.97) and central nervous system tumors (adj.OR = 1.57; 95% CI: 1.39-1.77). A higher number of infection episodes were also associated with an increased risk of these cancers. Specific infections such as viral, enteric and urinary tract infections were also strongly associated with specific types of cancer. In conclusion, children who later develop cancer appear to have adverse reactions to infections necessitating referral to specialized health care services, perhaps indicating dysregulated immune function.
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Affiliation(s)
- Anupong Sirirungreung
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- College of Health and Public Service, University of North Texas, Denton, TX, USA
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15
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Heck JE, Ritz B, Cockburn M, Thompson S. Letter to the editor. Int J Hyg Environ Health 2023; 253:114122. [PMID: 36775729 DOI: 10.1016/j.ijheh.2023.114122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 02/13/2023]
Affiliation(s)
- Julia E Heck
- College of Health and Public Service, University of North Texas, Denton, TX, USA; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | | | - Shiraya Thompson
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
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16
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Orimoloye HT, Heck JE, Charles A, Saechao C, He D, Federman N, Olsen J, Ritz B, Hansen J. Maternal migraine and risk of pediatric cancers. Pediatr Blood Cancer 2023; 70:e30385. [PMID: 37101365 DOI: 10.1002/pbc.30385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/20/2023] [Accepted: 04/06/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Maternal migraine has been linked to adverse birth outcomes including low birth weight and preterm birth, as well as congenital anomalies in offspring. It has been speculated that this may be due to the use of medications in pregnancy, but lifestyle, genetic, hormonal, and neurochemical factors could also play a role. There is evidence for varying cancer incidences among adults with migraine. Here, we utilized data from national registries in Denmark to examine associations between maternal diagnoses of migraine and risk for cancer in offspring. METHODS We linked several national registries in Denmark to identify cases from the Cancer Registry among children less than 20 years (diagnoses 1996-2016) and controls from the Central Population Register, matched to cases by birth year and sex (25:1 matching rate). Migraine diagnoses were identified from the National Patient Register using International Classification of Diseases, versions 8 and 10 codes and migraine-specific acute or prophylactic treatment recorded in the National Pharmaceutical Register. We used logistic regression to estimate the risk of childhood cancers associated with maternal migraine. RESULTS Maternal migraine was positively associated with risk for non-Hodgkin lymphoma (odds ratio [OR] = 1.70, 95% confidence interval [CI]: 1.01-2.86), central nervous system tumors ([OR = 1.31, 95% CI: 1.02-1.68], particularly glioma [OR = 1.64, 95% CI: 1.12-2.40]), neuroblastoma (OR = 1.75, 95% CI: 1.00-3.08), and osteosarcoma (OR = 2.60, 95% CI: 1.18-5.76). CONCLUSIONS Associations with maternal migraine were observed for several childhood cancers, including neuronal tumors. Our findings raise questions about the role of lifestyle factors, sex hormones, genetic, and neurochemical factors in the relationship between migraine and childhood cancers.
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Affiliation(s)
- Helen T Orimoloye
- College of Health and Public Service, University of North Texas, Denton, Texas, USA
| | - Julia E Heck
- College of Health and Public Service, University of North Texas, Denton, Texas, USA
- Department of Epidemiology, Fielding School of Public Health, Los Angeles, California, USA
| | - Andrew Charles
- Goldberg Migraine Program, Department of Neurology, UCLA Geffen School of Medicine, Los Angeles, California, USA
| | - Chai Saechao
- UCLA Health, University of California, Los Angeles, California, USA
| | - Di He
- Department of Epidemiology, Fielding School of Public Health, Los Angeles, California, USA
| | - Noah Federman
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, Los Angeles, California, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
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Platamone C, Huang X, Mazumder R, Ritz B, Olsen J, Hansen J, Saechao C, Heck JE. Danish Population Based Study of Familial Epilepsy and Childhood Cancer. Res Sq 2023:rs.3.rs-2500755. [PMID: 37090596 PMCID: PMC10120770 DOI: 10.21203/rs.3.rs-2500755/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Objective Results from studies investigating the association between maternal or child epilepsy, use of anticonvulsants in pregnancy, and childhood cancer are inconsistent and at times contradictory. Methods Linking Danish national databases, we obtained epilepsy and childhood cancer diagnoses, and anticonvulsant use data. We estimated adjusted odds ratios of all or specific childhood cancers in relation to maternal or child epilepsy and anticonvulsant therapies using conditional logistic regression. Results Maternal epilepsy was positively associated with all childhood cancers in offspring, specifically, with acute lymphoblastic leukemia (Odds Ratio (OR) = 1.68, 95% Confidence Interval (CI) = 1.16, 2.43) and Wilms tumor (OR = 2.13, 95%CI = 0.97, 4.68). When considering maternal ever (lifetime) ingestion of anticonvulsants, a positive association was found with all cancers (OR = 1.15, 95%CI = 1.01, 1.31), and central nervous system tumors (OR = 1.32, 95%CI = 1.03, 1.69) as well as neuroblastoma (OR = 2.05, 95%CI = 1.29, 3.28) among offspring. Maternal anticonvulsant use before or during the index pregnancy was related to CNS tumors in offspring (OR = 1.78, 95%CI = 0.99, 3.21), however the confidence interval included the null. Significance Maternal use of certain anticonvulsant medications may be a risk factor for cancer in offspring. Medical providers may need to consider what type of treatments to prescribe to pregnant mothers with epilepsy.
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Affiliation(s)
- Corbin Platamone
- UCLA School of Public Health: University of California Los Angeles Jonathan and Karin Fielding School of Public Health
| | - Xiwen Huang
- UCLA School of Public Health: University of California Los Angeles Jonathan and Karin Fielding School of Public Health
| | - Rajarshi Mazumder
- David Geffen School of Medicine: University of California Los Angeles David Geffen School of Medicine
| | - Beate Ritz
- UCLA School of Public Health: University of California Los Angeles Jonathan and Karin Fielding School of Public Health
| | - Jorn Olsen
- Aarhus University Department of Clinical Medicine: Aarhus Universitet Institut for Klinisk Medicin
| | | | - Chai Saechao
- UCLA Health System: University of California Los Angeles Health System
| | - Julia E Heck
- UCLA School of Public Health: University of California Los Angeles Jonathan and Karin Fielding School of Public Health
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Sirirungreung A, Hansen J, He D, Huang X, Ritz B, Heck JE. Exposure to nitrosatable drugs during pregnancy and childhood cancer: A matched case-control study in Denmark, 1996-2016. Pharmacoepidemiol Drug Saf 2023; 32:496-505. [PMID: 36300575 PMCID: PMC10038857 DOI: 10.1002/pds.5557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/19/2022] [Accepted: 10/14/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Nitrosatable drugs can be synthesized to N-nitroso compounds in human stomach. In a pregnant woman, N-nitroso compounds can be translocated to the fetus through the placenta. Maternal exposure of nitrosatable compounds during pregnancy has been associated with childhood brain tumors and leukemia. However, few studies have investigated an association between nitrosatable drug exposure during pregnancy and childhood cancer. We examined if maternal prescriptions of nitrosatable drugs received during pregnancy are associated with childhood cancer. METHODS A matched case-control study was conducted using Danish nationwide registry data from 1995 to 2016. Each childhood cancer case was matched with twenty-five controls. Maternal exposure of nitrosatable drugs during pregnancy was identified from the Danish National Prescription Register. A multivariable conditional logistic regression model was used to estimate adjusted odds ratios (adj.OR) with 95% confidence intervals (CI) for each childhood cancer type. RESULTS Maternal prescriptions of nitrosatable drugs positively associate with central nervous system tumors (adj.OR = 1.25; 95% CI = 1.04-1.51) and neuroblastoma (adj.OR = 1.96; 95% CI = 1.34-2.85) in offspring. We also observed a positive association between perinatal exposure of nitrosatable drugs and acute lymphoblastic leukemia (adj.OR = 1.31; 95% CI = 1.07-1.59), however, it appeared to be due to confounding by indication, i.e., maternal infections. CONCLUSION Nitrosatable drug use during pregnancy potentially increased risk of central nervous system tumors and neuroblastoma. While a positive association between maternal prescriptions of nitrosatable drugs and acute lymphoblastic leukemia should be interpreted cautiously because of confounding by indication.
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Affiliation(s)
- Anupong Sirirungreung
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Di He
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Xiwen Huang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
- College of Health and Public Service, University of North Texas, Denton, Texas, USA
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19
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He D, Huang X, Uppal K, Coleman AL, Walker DD, Ritz B, Jones DP, Heck JE. BIOMARKERS OF MATERNAL SMOKING AND THE RISK OF RETINOBLASTOMA IN OFFSPRING. Retina 2023; 43:481-489. [PMID: 36730579 PMCID: PMC9974849 DOI: 10.1097/iae.0000000000003678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Previous studies examining the risk of retinoblastoma with maternal smoking were inconclusive, likely due in part to the reliance on self-reported maternal smoking. This study uses biomarkers of tobacco smoking in neonatal dried blood spots to investigate associations between maternal smoking and retinoblastoma in offspring. METHODS The authors randomly selected 498 retinoblastoma cases and 895 control subjects born between 1983 and 2011 from a population-based case-control study in California. Maternal pregnancy-related smoking was measured using the following three metrics: provider or self-reported smoking during pregnancy, cotinine, and hydroxycotinine in neonatal blood. The authors used multivariable logistic regression to estimate the effects of maternal tobacco smoking on retinoblastoma. RESULTS Using all metrics (biomarkers or self-report), maternal smoking late in pregnancy or early postpartum was related to retinoblastoma (all types; odds ratio = 1.44, 95% confidence interval: 1.00-2.09). Relying on cotinine or hydroxycotinine to ascertain smoking, maternal smoking was related to unilateral retinoblastoma (odds ratio = 1.66, 95% confidence interval: 1.08-2.57). CONCLUSION The results indicate that maternal smoking during pregnancy may be a risk factor for retinoblastoma, particularly among unilateral cases.
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Affiliation(s)
- Di He
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
| | - Xiwen Huang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
| | - Karan Uppal
- Division of Pulmonary, Allergy, and Critical Care Medicine, Clinical Biomarkers Laboratory, School of Medicine, Emory University, Atlanta, Georgia
| | - Anne L Coleman
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
- Stein Eye Institute, University of California, Los Angeles, California
| | - Douglas D Walker
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
| | - Dean P Jones
- Division of Pulmonary, Allergy, and Critical Care Medicine, Clinical Biomarkers Laboratory, School of Medicine, Emory University, Atlanta, Georgia
- Department of Medicine, Emory University, Atlanta, Georgia
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
- College of Health and Public Service, University of North Texas, Denton, Texas; and
- Center for Racial and Ethnic Equity in Health and Society, University of North Texas, Denton, Texas
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20
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Orimoloye HT, Qureshi N, Lee PC, Wu CK, Saechao C, Federman N, Li CY, Ritz B, Arah OA, Heck JE. Maternal anemia and the risk of childhood cancer: A population-based cohort study in Taiwan. Pediatr Blood Cancer 2023; 70:e30188. [PMID: 36600459 PMCID: PMC10773261 DOI: 10.1002/pbc.30188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Childhood cancer may be related to maternal health in pregnancy. Maternal anemia is a common condition in pregnancy, especially in low-income countries, but the association between maternal anemia and childhood cancer has not been widely studied. OBJECTIVE To examine the potential relation between maternal anemia during pregnancy and childhood cancers in a population-based cohort study in Taiwan. METHODS We examined the relationship between maternal anemia and childhood cancer in Taiwan (N = 2160 cancer cases, 2,076,877 noncases). Cases were taken from the National Cancer Registry, and noncases were selected from birth records. Using national health registries, we obtained maternal anemia diagnoses. We estimated the risks for childhood cancers using Cox proportional hazard analysis. RESULTS There was an increased risk of cancers in children born to mothers with nutritional anemia (hazard ratio (HR): 1.32, 95% CI 0.99, 1.76). Iron deficiency anemia (HR: 1.30, 95% CI 0.97-1.75) carried an increased risk, while non-nutritional anemias were not associated with childhood cancer risk. CONCLUSION Our results provide additional support for screening for anemia during pregnancy. Adequate nutrition and vitamin supplementation may help to prevent some childhood cancer.
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Affiliation(s)
- Helen T. Orimoloye
- College of Health and Public Service, University of North Texas, Denton, TX, USA
| | - Naveen Qureshi
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Pei-Chen Lee
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Centre for Research in Epidemiology and Population Health, Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Team “Exposome, heredity, cancer and health”, CESP, 94807, Villejuif, France
| | - Chia-Kai Wu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chai Saechao
- UCLA Health, University of California, Los Angeles
| | - Noah Federman
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA
- Department of Pediatrics, Geffen School of Medicine, University of California, UCLA, Los Angeles, California, USA
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Onyebuchi A. Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Julia E. Heck
- College of Health and Public Service, University of North Texas, Denton, TX, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA
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21
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Huang X, Hansen J, Lee PC, Wu CK, Federman N, Arah OA, Li CY, Olsen J, Ritz B, Heck JE. Maternal diabetes and childhood cancer risks in offspring: two population-based studies. Br J Cancer 2022; 127:1837-1842. [PMID: 36088507 PMCID: PMC9643384 DOI: 10.1038/s41416-022-01961-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The effect of maternal diabetes on childhood cancer has not been widely studied. METHODS We examined this in two population-based studies in Denmark (N = 6420 cancer cases, 160,484 controls) and Taiwan (N = 2160 cancer cases, 2,076,877 non-cases) using logistic regression and Cox proportional hazard regression adjusted for birth year, child's sex, maternal age and birth order. RESULTS Gestational diabetes in Denmark [odds ratio (OR) = 0.98, 95% confidence interval (CI): 0.71-1.35] or type II and gestational diabetes in Taiwan (type II: hazard ratio (HR) = 0.81, 95% CI: 0.63-1.05; gestational diabetes: HR = 1.06, 95% CI: 0.92-1.22) were not associated with cancer (all types combined). In Denmark, maternal type I diabetes was associated with the risk of glioma (OR = 2.33, 95% CI: 1.04-5.22), while in Taiwan, the risks of glioma (HR = 1.59, 95% CI: 1.01-2.50) were elevated among children whose mothers had gestational diabetes. There was a twofold increased risk for hepatoblastoma with maternal type II diabetes (HR = 2.02, 95% CI: 1.02-4.00). CONCLUSIONS Our results suggest that maternal diabetes is an important risk factor for certain types of childhood cancers, emphasising the need for effective interventions targeting maternal diabetes to prevent serious health effects in offspring.
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Affiliation(s)
- Xiwen Huang
- Department of Epidemiology, Fielding School of Public Health, and Jonsson Comprehensive Cancer Center, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095-1772, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen, Denmark
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, 89 Nei-Chiang St, Wan-Hua Dist, Taipei, 10845, Taiwan.
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Team "Exposome, heredity, cancer and health", CESP, 94807, Villejuif, France.
- Department of Public Health, National Cheng Kung University, #1, University Road, Tainan, 70101, Taiwan.
| | - Chia-Kai Wu
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Team "Exposome, heredity, cancer and health", CESP, 94807, Villejuif, France
| | - Noah Federman
- Department of Pediatrics, Geffen School of Medicine, UCLA, Los Angeles, CA, 90095-1752, USA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, and Jonsson Comprehensive Cancer Center, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095-1772, USA
- Department of Statistics, UCLA College of Letters and Science, Los Angeles, CA, USA
- Section for Epidemiology, Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Chung-Yi Li
- Department of Public Health, National Cheng Kung University, #1, University Road, Tainan, 70101, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Olof Palmes Allé 43-45 8200 Aarhus N, Aarhus, Denmark
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, and Jonsson Comprehensive Cancer Center, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095-1772, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, and Jonsson Comprehensive Cancer Center, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095-1772, USA.
- College of Health and Public Service, University of North Texas, 1155 Union Circle #305250, Denton, TX, 76203-5017, USA.
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22
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Omidakhsh N, Heck JE, Cockburn M, Ling C, Hershman JM, Harari A. Thyroid Cancer and Pesticide Use in a Central California Agricultural Area: A Case Control Study. J Clin Endocrinol Metab 2022; 107:e3574-e3582. [PMID: 35881539 DOI: 10.1210/clinem/dgac413] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine environmental factors that influence risk of thyroid cancer. METHODS We performed a case-control study utilizing thyroid cancer cases from the California Cancer Registry (1999-2012) and controls sampled in a population-based manner. Study participants were included if they were diagnosed with thyroid cancer, lived in the study area at their time of diagnosis, and were ≥35 years of age. Controls were recruited from the same area and eligible to participate if they were ≥35 years of age and had been living in California for at least 5 years prior to the interview. We examined residential exposure to 29 agricultural use pesticides, known to cause DNA damage in vitro or are known endocrine disruptors. We employed a validated geographic information system-based system to generate exposure estimates for each participant. RESULTS Our sample included 2067 cases and 1003 controls. In single pollutant models and within a 20-year exposure period, 10 out of 29 selected pesticides were associated with thyroid cancer, including several of the most applied pesticides in the United States such as paraquat dichloride [odds ratio (OR): 1.46 (95% CI: 1.23, 1.73)], glyphosate [OR: 1.33 (95% CI: 1.12, 1.58)], and oxyfluorfen [OR: 1.21 (95% CI: 1.02, 1.43)]. Risk of thyroid cancer increased proportionately to the total number of pesticides subjects were exposed to 20 years before diagnosis or interview. In all models, paraquat dichloride was associated with thyroid cancer. CONCLUSIONS Our study provides first evidence in support of the hypothesis that residential pesticide exposure from agricultural applications is associated with an increased risk of thyroid cancer.
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Affiliation(s)
- Negar Omidakhsh
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Julia E Heck
- College of Health and Public Service, University of North Texas, Denton, TX, USA
| | - Myles Cockburn
- Department of Preventative Medicine, Keck School of Medicine and Department of Geography, University of Southern California, Los Angeles, California, USA
| | - Chenxiao Ling
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Jerome M Hershman
- Department of Medicine, Section of Endocrinology, University of California Los Angeles, Los Angeles, CA, USA
| | - Avital Harari
- Department of Surgery, Section of Endocrine Surgery, University of California Los Angeles, Los Angeles, CA, USA
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23
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Thompson S, Ritz B, Cockburn M, Heck JE. Prenatal ambient pesticide exposure and childhood retinoblastoma. Int J Hyg Environ Health 2022; 245:114025. [PMID: 36037576 PMCID: PMC9901366 DOI: 10.1016/j.ijheh.2022.114025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 07/28/2022] [Accepted: 08/12/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Retinoblastoma is a rare tumor of the retina, most commonly found in young children. Due to the rarity of this childhood cancer, few studies have been able to examine prenatal pesticide exposure as a risk factor. OBJECTIVE To examine the relationship between childhood retinoblastoma and prenatal exposure to pesticides through residential proximity to agricultural pesticide applications. METHODS We conducted a population-based case-control study using cases aged 5 and younger identified from the California Cancer Registry, and controls randomly selected from California birth certificates. Frequency matching cases to controls by age resulted in 221 cases of unilateral retinoblastoma and 114 cases of bilateral retinoblastoma, totaling 335 cases and 123,166 controls. Based on addresses from birth certificates we employed Pesticide Use Reports and land use information within a geographic information system approach to individually assess exposures to specific pesticides within 4000 m of the residence reported on birth certificates. The associations between retinoblastoma (all types combined and stratified by laterality) and individual pesticides were expressed as odds ratios estimates obtained from unconditional logistic regression models including a single pesticide, and from a hierarchical logistic regression model including all pesticides. RESULTS We found that exposures to acephate (OR: 1.70, 95% CI: 1.20, 2.41) and bromacil (OR: 1.87, 95% CI: 1.07, 3.26) were associated with increased risk for unilateral retinoblastoma. In addition to acephate, we found that pymetrozine (OR: 1.45, 95% CI: 1.00, 2.08) and kresoxim-methyl (OR: 1.60, 95% CI: 1.00, 2.56) were associated with retinoblastoma (all types combined). CONCLUSION Our findings suggest that certain types of prenatal ambient pesticide exposure from residing near agricultural fields may play a role in the development of childhood retinoblastoma.
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Affiliation(s)
- Shiraya Thompson
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001, N. Soto Street, Suite 318-A, Los Angeles, CA, USA
| | - Julia E. Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA,Jonsson Comprehensive Cancer Center, University of California, Box 951781, Los Angeles, CA, 90095-1781, USA,College of Health and Public Service, University of North Texas, 1155 Union Circle #311340, Denton, TX, 76203-5017, USA,Center for Racial and Ethnic Equity in Health and Society (CREEHS), 1155 Union Circle, Denton, TX, 76201, USA,Corresponding author.1155 Union Circle #311340, Denton, TX, 76203-5017, USA. (J.E. Heck)
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24
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Yeh KW, He D, Hansen J, Carpenter CL, Ritz B, Olsen J, Heck JE. The risk of childhood brain tumors associated with delivery interventions: A Danish matched case-control study. Cancer Epidemiol 2022; 76:102077. [PMID: 34864576 PMCID: PMC8840805 DOI: 10.1016/j.canep.2021.102077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/17/2021] [Accepted: 11/23/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Head trauma has been associated with increased brain tumor risk in adults. Instrument assisted delivery can be a cause of head trauma in newborns. The goal of this study was to determine if instrument-assisted deliveries influenced the odds of childhood brain tumors in Denmark. METHODS We conducted a matched case-control study of childhood (<20 years) brain tumors in Denmark born between 1978 and 2013 and diagnosed 1978-2016. A total of 1678 brain tumor cases were identified and 25 controls were matched to each case based on the child's sex and birth date (N = 40,934). Conditional logistic regression was used to estimate effects (odds ratios (OR) and 95% confidence intervals (95%CI)) for variables of interest. RESULTS Compared to children birthed by spontaneous vaginal delivery, children who later developed ependymomas (N = 118) had a greater likelihood of having experienced vacuum assisted deliveries (OR=1.74, 95% CI 1.02-2.96). Forceps use was low, and declined across the study period. We did not observe an overall increase in all CNS tumors (combined) with either vacuum delivery (OR=0.99, 95% CI 0.84-1.18) or forceps delivery (OR=1.26, 95% CI 0.78-2.03). CONCLUSION Our findings suggest an association between vacuum assisted deliveries and ependymomas.
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Affiliation(s)
- Karen W. Yeh
- Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Di He
- Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Catherine L. Carpenter
- Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Olof Palmes Alle 43-45, 8200 Aarhus N, Aarhus, Denmark
| | - Julia E. Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA,College of Health and Public Service, University of North Texas, 1155 Union Circle, Denton, TX, 76203, USA
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25
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Ritz B, Yan Q, He D, Wu J, Walker DI, Uppal K, Jones DP, Heck JE. Child serum metabolome and traffic-related air pollution exposure in pregnancy. Environ Res 2022; 203:111907. [PMID: 34419469 PMCID: PMC8926017 DOI: 10.1016/j.envres.2021.111907] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND Maternal exposure to traffic-related air pollution during pregnancy has been shown to increase the risk of adverse birth outcomes and childhood disorders. High-resolution metabolomics (HRM) has previously been employed to identify metabolic responses to traffic-related air pollution in adults, including pregnant women. Thus far, no studies have examined metabolic effects of air pollution exposure in utero on neonates. METHODS We retrieved stored neonatal blood spots for 241 children born in California between 1998 and 2007. These children were randomly selected from all California birth rolls to serve as birth-year matched controls for children with retinoblastoma identified from the California cancer registry for a case control study of childhood cancer. We estimated prenatal traffic-related air pollution exposure (particulate matter less than 2.5 μm (PM2.5)) during the third-trimester using the California Line Source Dispersion Model, version 4 (CALINE4) based on residential addresses recorded at birth. We employed untargeted HRM to obtain metabolic profiles, and metabolites associated with air pollution exposure were identified using partial least squares (PLS) regression and linear regressions. Biological effects were characterized using pathway enrichment analyses adjusting for potential confounders including maternal age, race/ethnicity, and education. RESULTS In total we extracted 4038 and 4957 metabolite features from neonatal blood spots in hydrophilic interaction (HILIC) chromatography (positive ion mode) and C18 reverse phase columns (negative ion mode), respectively. After controlling for confounding factors, partial least square regression (Variable Importance in Projection (VIP) ≥ 2) selected 402 HILIC positive and 182 C18 negative features as statistically significantly associated with increasing third trimester PM2.5 exposure. Using pathway enrichment analysis, we identified metabolites in oxidative stress and inflammation pathways as being altered, primarily involving lipid metabolism. CONCLUSION The metabolite features and pathways associated with air pollution exposure in neonates suggest that maternal exposure during late pregnancy contributes to oxidative stress and inflammation in newborn children.
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Affiliation(s)
- Beate Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Neurology, UCLA School of Medicine, CA, USA.
| | - Qi Yan
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Di He
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Jun Wu
- Program in Public Health, UCI Susan and Henry Samueli College of Health Sciences, Irvine, CA, USA
| | - Douglas I Walker
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Karan Uppal
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Dean P Jones
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Department of Medicine, Emory University, Atlanta, GA, USA
| | - Julia E Heck
- College of Health and Public Service, University of North Texas, Denton, TX, USA
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26
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Heck JE, Wu CK, Huang X, Chew KW, Tong M, Federman N, Ritz B, Arah OA, Li CY, Yu F, Olsen J, Hansen J, Lee PC. Cohort study of familial viral hepatitis and risks of paediatric cancers. Int J Epidemiol 2021; 51:448-457. [PMID: 34966942 PMCID: PMC9308392 DOI: 10.1093/ije/dyab262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/07/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Although viral hepatitis causes paediatric hepatocellular carcinoma and hepatic and extrahepatic cancers in adults, there are few epidemiologic studies on paediatric-cancer risks from parental viral hepatitis. In a nationwide study in a viral hepatitis endemic region and with confirmation in another population-based sample, we examined associations between parental hepatitis B (HBV) and C (HCV) infections and risks of cancers in offspring. METHODS We included all children born in Taiwan in 2004-2014 (N = 2 079 037) with 2160 cancer cases ascertained from the Cancer Registry. We estimated risks for paediatric cancers using Cox proportional-hazard regressions. We checked these associations in a nationwide case-control study in Denmark (6422 cases, 160 522 controls). RESULTS In Taiwan, paternal HBV was related to child's hepatoblastoma [hazard ratio (HR) = 1.77, 95% confidence interval (CI) = 1.05, 2.97] when identified at any time in the medical record, and when analyses were limited to hepatitis diagnoses occurring before the child's birth, risks increased (HR = 2.08, 95% CI = 1.13-3.80). Paternal HCV was related to child's non-Hodgkin lymphoma (HR = 2.06, 95% CI = 1.13-3.74). Maternal HCV was weakly related to increased risks of all childhood cancers [all types combined; HR = 1.45, 95% CI = 0.95-2.22]. The population-attributable fraction of hepatoblastoma for maternal, paternal and child HBV was 2.6%, 6.8% and 2.8%, respectively. CONCLUSIONS Parental HBV and HCV may be risk factors for hepatic and non-hepatic cancers in children. If associations are causal, then parental screening and treatment with antivirals may prevent some paediatric cancers.
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Affiliation(s)
- Julia E Heck
- Department of Rehabilitation and Health Services, College of Health and Public Service, University of North Texas, Denton, TX, USA,Center for Racial and Ethnic Equity in Health and Society, University of North Texas, Denton, TX, USA,Corresponding author. College of Health and Public Service, University of North Texas, 1155 Union Circle #311340, Denton, TX 76203-5017, USA. E-mail:
| | - Chia-Kai Wu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Beitou Dist, Taipei, Taiwan
| | - Xiwen Huang
- Center for Racial and Ethnic Equity in Health and Society, University of North Texas, Denton, TX, USA
| | - Kara W Chew
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Myron Tong
- Asian Liver Center, Geffen School of Medicine and Ronald Reagan Medical Center, UCLA, Los Angeles, CA, USA
| | - Noah Federman
- Department of Pediatrics, Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California (UCLA), Los Angeles, CA, USA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California (UCLA), Los Angeles, CA, USA,Department of Statistics, UCLA College of Letters and Science, Los Angeles, CA, USA,Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Chung-Yi Li
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Fei Yu
- Department of Biostatistics, Fielding School of Public Health UCLA, Los Angeles, CA, USA
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Aarhus N, Denmark
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Beitou Dist, Taipei, Taiwan,Department of Psychiatry, Taipei City Hospital, Taipei, Taiwan,Inserm U1018, Team ‘Exposome, Heredity, Cancer and Health’, CESP, Villejuif, France
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27
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Heck JE, Hansen J. World Trade Center Rescue and Recovery Workers: Cancer Increases Are Beginning to Emerge. J Natl Cancer Inst 2021; 114:172-173. [PMID: 34498080 DOI: 10.1093/jnci/djab164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Julia E Heck
- College of Health and Public Service, University of North Texas, Denton, TX, USA
| | - Johnni Hansen
- Diet, Genes, and Environment section, Danish Cancer Society Research Center, Copenhagen, Denmark
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Lin IC, Heck JE, Chen L, Feldman SR. Psoriasis Severity and Cardiometabolic Risk Factors in a Representative US National Study. Am J Clin Dermatol 2021; 22:719-730. [PMID: 33913115 DOI: 10.1007/s40257-021-00600-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Psoriasis is associated with metabolic syndrome; however, the relationship of psoriasis severity with individual cardiometabolic risk factors is not clear. There is a reporting gap between the cardiometabolic risks among patients with psoriasis and what has been reported in the literature using US samples. OBJECTIVES The objective of this study was to examine the disease burden of psoriasis and assess the associations of psoriasis severity and cardiometabolic risk factors in a nationally representative sample. METHODS We conducted a cross-sectional study using the weighted pooled data from the National Ambulatory Medical Care Survey (NAMCS) 2007 through 2016. The NAMCS data were collected from US office-based physicians. Each physician was randomly assigned a specific week to report a sample of their cases. Patients were categorized as severe psoriasis if they were prescribed at least one systemic therapy. We used logistic regression models adjusting for potential confounders to estimate the associations of psoriasis severity with individual cardiometabolic factors. RESULTS There were about 3.3 million office-based psoriasis visits per year with a mean age of 50 years, a female-to-male ratio of 1:1, and severe disease in 23%. We observed greater values of blood pressure, lipid profiles, and higher body mass index among patients with psoriasis, compared with patients without psoriasis. A higher proportion of the psoriasis patient group were overweight and obese (73.6% vs 62.9% in the non-psoriasis patient group). Compared to mild case groups, severe case groups tended to have a higher proportion of overweight/obese with a body mass index ≥ 25 kg/m2 (77% vs 73%). Obesity was weakly associated with psoriasis severity (adjusted odds ratio = 1.37, 95% confidence interval 0.98-1.91 for mild disease and adjusted odds ratio = 1.42, 95% confidence interval 0.80-2.52 for severe cases). CONCLUSIONS Cardiometabolic factors are related health issues in psoriasis, and obesity is associated with greater psoriasis severity.
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Affiliation(s)
- I-Chun Lin
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Dermatology, School of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Julia E Heck
- College of Health and Public Service, University of North Texas, Denton, TX, USA
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Steven R Feldman
- Department of Dermatology, Social Sciences and Health Policy, and Pathology, School of Medicine, Wake Forest University, Winston-Salem, NC, 27101, USA.
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Hall C, Hansen J, Olsen J, He D, von Ehrenstein OS, Ritz B, Heck JE. Parental occupation and childhood germ cell tumors: a case-control study in Denmark, 1968-2016. Cancer Causes Control 2021; 32:827-836. [PMID: 33907877 PMCID: PMC8236473 DOI: 10.1007/s10552-021-01434-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine associations between parental occupation and childhood germ cell tumors (GCTs) in offspring while distinguishing by common histologic subtype (i.e., yolk sac tumor and teratoma). METHODS This population-based case-control study included childhood GCT cases in Denmark diagnosed 1968-2015 (< 16 years old at diagnosis) and sex and birth year-matched controls. Demographic information and parental employment histories were obtained from Danish registries. Parental occupation was assessed by industry; job-exposure matrices were used to examine specific occupational exposures (i.e., potentially carcinogenic organic solvents and social contact). Conditional multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CIs). RESULTS Overall, 178 childhood GCT cases (50 yolk sac tumors; 65 teratomas) and 4,355 controls were included for analysis. Maternal employment in education during pregnancy was associated with offspring GCTs (OR 2.45, 95% CI 1.23-4.90), especially yolk sac tumors (OR 5.27, 95% CI 1.94-14.28). High levels of both maternal and paternal occupational social contact were also associated with offspring yolk sac tumors across all exposure periods (ORs 2.30-4.63). No signals were observed for paternal occupational solvent exposure, while imprecise associations were estimated for maternal exposure (e.g., dichloromethane exposure during pregnancy, OR 1.51, 95% CI 0.77-2.95). CONCLUSION Our findings suggest that parental occupation is associated with offspring GCTs, with most consistent evidence supporting an association between maternal employment in education or other high social contact jobs and offspring yolk sac tumors.
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Affiliation(s)
- Clinton Hall
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Jørn Olsen
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Di He
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ondine S von Ehrenstein
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
- College of Health and Public Service, University of North Texas, Denton, TX, USA.
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Lombardi C, Thompson S, Ritz B, Cockburn M, Heck JE. Residential proximity to pesticide application as a risk factor for childhood central nervous system tumors. Environ Res 2021; 197:111078. [PMID: 33798513 PMCID: PMC8212567 DOI: 10.1016/j.envres.2021.111078] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/18/2021] [Accepted: 03/21/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND Pesticide exposures have been examined previously as risk factors for childhood brain cancers, but few studies were able to assess risk from specific agents. OBJECTIVE To evaluate risks for childhood central nervous system tumors associated with residential proximity to agricultural pesticide applications. METHODS Using the California Cancer Registry, we identified cancer cases less than 6 years of age and frequency matched them by year of birth to 20 cancer-free controls identified from birth certificates. We restricted analyses to mothers living in rural areas and births occurring between 1998 and 2011, resulting in 667 cases of childhood central nervous system tumors and 123,158 controls. Possible carcinogens were selected per the Environmental Protection Agency's (US. EPA) classifications, and prenatal exposure was assessed according to pesticides reported by the California Department of Pesticide Regulation's (CDPR) Pesticide Use Reporting (PUR) system as being applied within 4000m of the maternal residence at birth. We computed odds ratios for individual pesticide associations using unconditional logistic and hierarchical regression models. RESULTS We observed elevated risks in the hierarchical models for diffuse astrocytoma with exposure to bromacil (OR: 2.12, 95% CI: 1.13-3.97), thiophanate-methyl (OR: 1.64, 95% CI: 1.02-2.66), triforine (OR: 2.38, 95% CI: 1.44-3.92), and kresoxim methyl (OR: 2.09, 95% CI: 1.03-4.21); elevated risks for medulloblastoma with exposure to chlorothalonil (OR: 1.78, 95% CI: 1.15-2.76), propiconazole (OR: 1.60, 95% CI: 1.02, 2.53), dimethoate (OR: 1.60, 95% CI: 1.06, 2.43), and linuron (OR: 2.52, 95% CI: 1.25, 5.11); and elevated risk for ependymoma with exposure to thiophanate-methyl (OR: 1.72, 95% CI: 1.10-2.68). CONCLUSION Our study suggests that exposure to certain pesticides through residential proximity to agricultural applications during pregnancy may increase the risk of childhood central nervous system tumors.
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Affiliation(s)
- Christina Lombardi
- Department of Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 700 N. San Vicente Blvd., Pacific Design Center, G599, West Hollywood, CA, 90069, USA
| | - Shiraya Thompson
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001, N. Soto Street, Suite 318-A, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA; Jonsson Comprehensive Cancer Center, University of California, Box 951781, Los Angeles, CA, 90095-1781, USA; College of Health and Public Service, University of North Texas, 1155 Union Circle #311340, Denton, TX, 76203-5017, USA.
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Kim JH, Yan Q, Uppal K, Cui X, Ling C, Walker DI, Heck JE, von Ehrenstein OS, Jones DP, Ritz B. Metabolomics analysis of maternal serum exposed to high air pollution during pregnancy and risk of autism spectrum disorder in offspring. Environ Res 2021; 196:110823. [PMID: 33548296 PMCID: PMC9059845 DOI: 10.1016/j.envres.2021.110823] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/27/2021] [Accepted: 01/27/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previously, numerous epidemiologic studies reported an association between autism spectrum disorder (ASD) and exposure to air pollution during pregnancy. However, there have been no metabolomics studies investigating the impact of pregnancy pollution exposure to ASD risk in offspring. OBJECTIVES To identify differences in maternal metabolism that may reflect a biological response to exposure to high air pollution in pregnancies of offspring who later did or did not develop ASD. METHODS We obtained stored mid-pregnancy serum from 214 mothers who lived in California's Central Valley and experienced the highest levels of air pollution during early pregnancy. We estimated each woman's average traffic-related air pollution exposure (carbon monoxide, nitric oxides, and particulate matter <2.5 μm) during the first trimester using the California Line Source Dispersion Model, version 4 (CALINE4). By utilizing liquid chromatography-high resolution mass spectrometry, we identified the metabolic profiles of maternal serum for 116 mothers with offspring who later developed ASD and 98 control mothers. Partial least squares discriminant analysis (PLS-DA) was employed to select metabolic features associated with air pollution exposure or autism risk in offspring. We also conducted extensive pathway enrichment analysis to elucidate potential ASD-related changes in the metabolome of pregnant women. RESULTS We extracted 4022 and 4945 metabolic features from maternal serum samples in hydrophilic interaction (HILIC) chromatography (positive ion mode) and C18 (negative ion mode) columns, respectively. After controlling for potential confounders, we identified 167 and 222 discriminative features (HILIC and C18, respectively). Pathway enrichment analysis to discriminate metabolic features associated with ASD risk indicated various metabolic pathway perturbations linked to the tricarboxylic acid (TCA) cycle and mitochondrial function, including carnitine shuttle, amino acid metabolism, bile acid metabolism, and vitamin A metabolism. CONCLUSION Using high resolution metabolomics, we identified several metabolic pathways disturbed in mothers with ASD offspring among women experiencing high exposure to traffic-related air pollution during pregnancy that were associated with mitochondrial dysfunction. These findings provide us with a better understanding of metabolic disturbances involved in the development of ASD under adverse environmental conditions.
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Affiliation(s)
- Ja Hyeong Kim
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, 44033, South Korea.
| | - Qi Yan
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA.
| | - Karan Uppal
- Computational Systems Medicine & Metabolomics Laboratory, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA, 30322, USA.
| | - Xin Cui
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA; Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, 94304, USA; California Perinatal Quality Care Collaborative, Palo Alto, CA, 94305, USA.
| | - Chenxiao Ling
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA.
| | - Douglas I Walker
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA.
| | - Ondine S von Ehrenstein
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA; Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA.
| | - Dean P Jones
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, Emory University, Atlanta, GA, 30322, USA.
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA; Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, 90095, USA; Department of Neurology, Geffen School of Medicine, University of California, Los Angeles, CA, 90095, USA.
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Abstract
OBJECTIVE Retinoblastoma is the most common primary intraocular tumor affecting children. We examine the role of parental occupational exposures and risk of retinoblastoma among offspring. METHODS Our population-based case-control study linked data from four nationwide Danish registries and included all cases of retinoblastoma diagnosed in Danish children (<5 y, n = 144) between 1975 and 2014. We focused on two biologically relevant time periods: 90 days preconception to conception for fathers; conception to birth for mothers. Parents were grouped into major industry headings created from Danish industry codes. RESULTS We observed increased risk of all retinoblastoma for children of fathers in the food and drink industry and iron and metal industry. Bilateral disease was associated with paternal work in manufacturing and land transportation. CONCLUSION Our results suggest that some occupational exposures may increase the risk of childhood sporadic retinoblastoma.
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Affiliation(s)
- Negar Omidakhsh
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Department of Environmental Health Sciences, School of Public Health, University of California, Los Angeles, CA, USA
| | - Anne L. Coleman
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Roberta McKean-Cowdin
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Julia E. Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
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Heck JE, Lee PC, Wu CK, Li CY, He D, Federman N, Yu F, Olsen J, Ritz B, Arah OA, Hansen J. Spina bifida and pediatric cancers. Pediatr Hematol Oncol 2020; 37:630-636. [PMID: 32364426 PMCID: PMC7577564 DOI: 10.1080/08880018.2020.1760409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Spina bifida has been reported to co-occur with pediatric cancer, but comprehensive evaluations remained elusive. We investigated this co-occurrence in two large, population-based studies in Taiwan (N = 1900 cancer cases, 2,077,137 controls) and Denmark (N = 5508 cases, 137,700 controls). Analyses in Denmark were restricted to the period before prenatal diagnostics became available (2004) and pregnancy terminations of fetuses with birth defects became more common. Using national patient and cancer registries, we linked spina bifida and cancer diagnoses among cases and non-cases. The risk of spina bifida among all cancer cases was increased and similar in Denmark [odds ratio (OR)=8.4, 95% confidence interval (CI) 5.1-13.8] and Taiwan (OR = 8.5, 95% CI 4.0-17.8), particularly for central nervous system (CNS) tumors (Denmark: OR = 16.3, 95% CI 8.1-33.0; Taiwan: OR = 26.6, 95% CI 8.5, 83.1), including benign CNS tumors (Denmark: OR = 41.5, 95% CI 21.2, 81.4). These findings suggest the need for comprehensive investigation of shared risk factors in the link between spina bifida and pediatric cancer.
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Affiliation(s)
- Julia E. Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chia-Kai Wu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Di He
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Noah Federman
- Department of Pediatrics, Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Fei Yu
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Jorn Olsen
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.,Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Onyebuchi A. Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
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He D, Hansen J, Federman N, Olsen J, Ritz B, Heck JE. Abstract 5778: Hernia and Ewing sarcoma. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-5778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Ewing sarcoma (ES) is a rare cancer with an incidence that peaks in adolescence and young adulthood. The tumor occurs in bone and soft tissue and the etiology is unclear. Several studies have observed increased ES risk in children and young adults with hernia, including umbilical and inguinal hernia, suggesting a mechanism for a common causal pathway. A meta-analysis of 3 case-control studies reported a threefold increased risk of ES among hernia patients. The purpose of this study is to examine the association between hernia and ES in a population-based study.
Methods: We ascertained Ewing sarcoma cases (age <20 years) from the Danish Cancer Registry (diagnoses 1977-2016; births 1977-2013), then randomly selected controls free of cancer at the date of corresponding cases diagnosis and matched (25:1) by sex and year of birth from the Central Population Register (N=4,160). Ewing sarcoma cases (N=122) were identified with the International Classification of Diseases for Oncology (ICD-O-1 and ICD-O-3 code 9260). Information on birth outcomes and gestational factors were taken from the Medical Birth Registry (1973+) and information on mother's and child's health was taken from the National Patient Register (1977+). We also searched this Register for diagnoses of hernia in the child based on procedure codes (a Nordic coding system from 1977-1995, and an extended version of ICD-10 thereafter). We used conditional logistic regression to determine associations for hernia and ES.
Results: 122 ES cases were identified, among whom 6 cases had a diagnosis of hernia (1 of them had hernia diagnosed within the first 3 years of life). Among controls, 203 (6.7%) had a diagnosis of hernia. Of all children diagnosed with hernia, 27 (12.9%) presented hernia during the first year of life and 74 (35.4%) presented during the first 3 years of life. In ES cases there was no increase in risk of hernia (OR= 0.53, 0.17-1.72). Adjustment for presence of other congenital malformations did not change the results for hernia (OR=0.65). Restriction to younger cases (diagnosed ≤15 years) showed similar results for hernia.
Conclusions: Previous studies have raised the possibility that inherited genes causing both developmental anomalies and cancer might be involved with the etiology of ES. However, based on registry and hospitalization data, we were not able to confirm previous associations with hernia. Either this study or earlier studies may have been influenced by small sample size. There is also a possibility that previous reports of positive associations are due to recall or publication biases.
Citation Format: Di He, Johnni Hansen, Noah Federman, Jorn Olsen, Beate Ritz, Julia E. Heck. Hernia and Ewing sarcoma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5778.
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Affiliation(s)
- Di He
- 1UCLA Fielding School of Public Health, Los Angeles, CA
| | - Johnni Hansen
- 2Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | | | - Beate Ritz
- 1UCLA Fielding School of Public Health, Los Angeles, CA
| | - Julia E. Heck
- 1UCLA Fielding School of Public Health, Los Angeles, CA
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Yeh K, Hansen J, Heck JE. Abstract 5779: The association of instrument assisted deliveries and the development of childhood brain tumors: A matched case control study. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-5779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Pediatric brain tumors are the second most common type of childhood cancer and have the highest mortality rate among all pediatric cancer types. New information on potentially preventative measures would be of great value. Previous studies have suggested that instrument-assisted delivery (forceps and vacuum) may be associated with an increased risk for childhood brain tumors. The goal of this study was to determine if there was an association of exposure to instrument-assisted deliveries with childhood brain tumors in Denmark. We additionally examined risk with emergency or planned cesarean section.
Methods: This was a matched case-control study with childhood brain tumor cases in Denmark diagnosed from 1978-2013. Cases were identified from the Danish Cancer Registry. Birth outcomes, maternal procedures and covariates were obtained from the Danish Medical Births Register and the nationwide Hospital Register. A total of 3,698 brain tumor cases were recruited and 25 controls were matched to each case based on child's sex and birth year (N=89,554). We used conditional logistic regression to determine associations of delivery instruments types with various childhood brain tumors.
Results: Compared to children birthed by spontaneous vaginal delivery, children who later developed ependymomas (N=136) had a greater likelihood of having been delivered by vacuum assisted deliveries (OR=1.69, 95% CI 1.01-2.83). An overall increased risk for cesarean section with any CNS tumor (OR= 1.20, 95% CI 1.06-1.36) dropped to 1.10 when we limited the age range to 4 or older (N=1,087). This suggests no clear increased risk for cancer with cesarean section, as there is a possibility that the CNS tumor was present before birth and influenced a larger head size, thus requiring a cesarean section. Planned cesarean and emergency cesarean section were not related to risk increases. While the use of forceps was rare in this population (1.2% in controls), we could not confirm previously reported associations with astrocytoma (OR=0.84), though there was a weak increase for ependymoma with wide confidence intervals (OR=2.69, 95% CI 0.77, 9.38).
Conclusions: Based on objective data, the findings in our study suggest that there might be an association between vacuum assisted deliveries and ependymomas. Our data did not support a strong association of childhood brain tumors with cesarean sections.
Citation Format: Karen Yeh, Johnni Hansen, Julia E. Heck. The association of instrument assisted deliveries and the development of childhood brain tumors: A matched case control study [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5779.
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Affiliation(s)
- Karen Yeh
- 1UCLA- Fielding School of Public Health, Los Angeles, CA
| | | | - Julia E. Heck
- 1UCLA- Fielding School of Public Health, Los Angeles, CA
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Karalexi MA, Dessypris N, Ma X, Spector LG, Marcotte E, Clavel J, Pombo-de-Oliveira MS, Heck JE, Roman E, Mueller BA, Hansen J, Auvinen A, Lee PC, Schüz J, Magnani C, Mora AM, Dockerty JD, Scheurer ME, Wang R, Bonaventure A, Kane E, Doody DR, Erdmann F, Kang AY, Metayer C, Milne E, Petridou ET. Age-, sex- and disease subtype-related foetal growth differentials in childhood acute myeloid leukaemia risk: A Childhood Leukemia International Consortium analysis. Eur J Cancer 2020; 130:1-11. [PMID: 32163883 DOI: 10.1016/j.ejca.2020.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 12/18/2019] [Accepted: 01/14/2020] [Indexed: 02/01/2023]
Abstract
AIM Evidence for an association of foetal growth with acute myeloid leukaemia (AML) is inconclusive. AML is a rare childhood cancer, relatively more frequent in girls, with distinct features in infancy. In the context of the Childhood Leukemia International Consortium (CLIC), we examined the hypothesis that the association may vary by age, sex and disease subtype using data from 22 studies and a total of 3564 AML cases. METHODS Pooled estimates by age, sex and overall for harmonised foetal growth markers in association with AML were calculated using the International Fetal and Newborn Growth Consortium for the 21st Century Project for 17 studies contributing individual-level data; meta-analyses were, thereafter, conducted with estimates provided ad hoc by five more studies because of administrative constraints. Subanalyses by AML subtype were also performed. RESULTS A nearly 50% increased risk was observed among large-for-gestational-age infant boys (odds ratio [OR]: 1.49, 95% confidence interval [CI]: 1.03-2.14), reduced to 34% in boys aged <2 years (OR: 1.34, 95% CI: 1.05-1.71) and 25% in boys aged 0-14 years (OR: 1.25, 95% CI: 1.06-1.46). The association of large for gestational age became stronger in boys with M0/M1subtype (OR: 1.80, 95% CI: 1.15-2.83). Large birth length for gestational age was also positively associated with AML (OR: 1.38, 95% CI: 1.00-1.92) in boys. By contrast, there were null associations in girls, as well as with respect to associations of decelerated foetal growth markers. CONCLUSIONS Accelerated foetal growth was associated with AML, especially in infant boys and those with minimally differentiated leukaemia. Further cytogenetic research would shed light into the underlying mechanisms.
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Affiliation(s)
- Maria A Karalexi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Cancer Prevention and Control, Yale Comprehensive Cancer Centre, Yale School of Medicine, CT, USA
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Erin Marcotte
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Jacqueline Clavel
- CRESS, UMR-S1153, INSERM, Paris-Descartes University, Villejuif, France; National Registry of Childhood Cancers, APHP, Hôpital Paul-Brousse, CHU de Nancy, France
| | | | - Julia E Heck
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anssi Auvinen
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), Section of Environment and Radiation, Lyon, France
| | - Corrado Magnani
- Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piedmont and University of Eastern Piedmont, Novara, Italy
| | - Ana M Mora
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - John D Dockerty
- Department of Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Michael E Scheurer
- Baylor College of Medicine, Department of Pediatrics Texas Children's Cancer Center, TX, USA
| | - Rong Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Cancer Prevention and Control, Yale Comprehensive Cancer Centre, Yale School of Medicine, CT, USA
| | | | - Eleanor Kane
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Friederike Erdmann
- International Agency for Research on Cancer (IARC), Section of Environment and Radiation, Lyon, France; Danish Cancer Society Research Center, Childhood Cancer Research Group, Copenhagen, Denmark
| | - Alice Y Kang
- School of Public Health, University of California, Berkeley, CA, USA
| | - Catherine Metayer
- School of Public Health, University of California, Berkeley, CA, USA
| | - Elizabeth Milne
- Telethon Institute for Child Health Research, Center for Child Health Research, University of Western Australia, WA, Australia
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
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Heck JE, Huang X, Calkins KL, Sun Y, Olsen J, Ritz B, Hansen J. Phototherapy and childhood cancer: Shared risk factors. Int J Cancer 2020; 146:2059-2062. [PMID: 31593310 DOI: 10.1002/ijc.32701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 09/10/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Julia E Heck
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA
| | - Xiwen Huang
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA
| | - Kara L Calkins
- Department of Pediatrics, Division of Neonatology and Developmental Biology, David Geffen School of Medicine, Mattel Children's Hospital, University of California, Los Angeles, CA
| | - Yuelian Sun
- Department of Neurology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.,National Center for Register-based Research, Department of Economics and Business Economics, Business and Social Science, Aarhus University, Aarhus, Denmark
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Beate Ritz
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
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Volk J, Heck JE, Schmiegelow K, Hansen J. Parental occupational exposure to diesel engine exhaust in relation to childhood leukaemia and central nervous system cancers: a register-based nested case-control study in Denmark 1968-2016. Occup Environ Med 2020; 76:809-817. [PMID: 31611302 DOI: 10.1136/oemed-2019-105847] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/31/2019] [Accepted: 08/25/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Using nationwide register data, we investigated the association between maternal and paternal perinatal employment in industries with exposure to diesel engine exhaust and risk of leukaemia and central nervous system (CNS) cancers, including certain subtypes. METHODS Children aged≤19 years and diagnosed with childhood cancer from 1968 to 2016 were identified in the Danish Cancer Registry and 25 randomly selected cancer-free controls per case were matched by age and sex. Parents were identified in the Danish Civil Registration System and employment histories were retrieved from a nationwide mandatory pension fund. The probability of exposure to diesel engine exhaust was assessed using a validated job exposure matrix. Conditional logistic regression was used for estimation of ORs, including their 95% CIs. RESULTS Maternal employment in industries with diesel engine exhaust exposure was associated with an increased risk of CNS cancers (OR 1.31, 95% CI 0.99 to 1.74) and of astrocytoma (OR 1.49, 95% CI 1.04 to 2.14) in offspring. The highest OR for these cancers were seen for mothers with highest probability of exposure to diesel engine exhaust. For fathers, ORs for cancers under study were close to one. No increased risks of leukaemias were found for either mothers or fathers employed in diesel industries. CONCLUSIONS Risks were increased for CNS and astrocytoma for maternal employment in industries with diesel engine exhaust.
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Affiliation(s)
- Julie Volk
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Julia E Heck
- Department of Epidemiology, University of California, Los Angeles, California, USA
| | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Johnni Hansen
- Institute of Cancer Epidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
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Park AS, Ritz B, Yu F, Cockburn M, Heck JE. Prenatal pesticide exposure and childhood leukemia - A California statewide case-control study. Int J Hyg Environ Health 2020; 226:113486. [PMID: 32087503 DOI: 10.1016/j.ijheh.2020.113486] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 01/17/2020] [Accepted: 02/10/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND A number of epidemiologic studies with a variety of exposure assessment approaches have implicated pesticides as risk factors for childhood cancers. Here we explore the association of pesticide exposure in pregnancy and early childhood with childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) utilizing land use and pesticide use data in a sophisticated GIS tool. METHODS We identified cancer cases less than 6 years of age from the California Cancer Registry and cancer-free controls from birth certificates. Analyses were restricted to those living in rural areas and born 1998-2011, resulting in 162 cases of childhood leukemia and 9,805 controls. Possible carcinogens were selected from the Environmental Protection Agency's classifications and pesticide use was collected from the California Department of Pesticide Regulation's (CDPR) Pesticide Use Reporting (PUR) system and linked to land-use surveys. Exposures for subjects were assessed using a 4000m buffer around the geocoded residential addresses at birth. Unconditional logistic and hierarchical regression models were used to assess individual pesticide and pesticide class associations. RESULTS We observed elevated risks for ALL with exposure to any carcinogenic pesticide (adjusted Odds Ratio (aOR): 2.83, 95% CI: 1.67-4.82), diuron (Single-pesticide model, adjusted (OR): 2.38, 95% CI: 1.57-3.60), phosmet (OR: 2.10, 95% CI: 1.46-3.02), kresoxim-methyl (OR: 1.77, 95% CI: 1.14-2.75), and propanil (OR: 2.58, 95% CI: 1.44-4.63). Analyses based on chemical classes showed elevated risks for the group of 2,6-dinitroanilines (OR: 2.50, 95% CI: 1.56-3.99), anilides (OR: 2.16, 95% CI: 1.38-3.36), and ureas (OR: 2.18, 95% CI: 1.42-3.34). CONCLUSION Our findings suggest that in rural areas of California exposure to certain pesticides or pesticide classes during pregnancy due to residential proximity to agricultural applications may increase the risk of childhood ALL and AML. Future studies into the mechanisms of carcinogenicity of these pesticides may be beneficial.
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Affiliation(s)
- Andrew S Park
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Fei Yu
- Department of Biostatistics, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001, N. Soto Street, Suite 318-A, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA; Jonsson Comprehensive Cancer Center, University of California, Box 951781, Los Angeles, CA, 90095-1781, USA.
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Heck JE, Lee PC, Wu CK, Tsai HY, Ritz B, Arah OA, Li CY. Gestational risk factors and childhood cancers: A cohort study in Taiwan. Int J Cancer 2020; 147:1343-1353. [PMID: 32020595 DOI: 10.1002/ijc.32905] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/05/2019] [Accepted: 01/13/2020] [Indexed: 12/18/2022]
Abstract
Gestational risk factors such as birth weight, gestational age and parity have been repeatedly found to be related to pediatric cancers, but few reports have emerged from Asian countries. Here we report on demographic and gestational factors in a Taiwanese cohort. Our study included all children born in Taiwan 2004-2014 for whom there was a birth record (n = 2,079,037), of which 1900 children had been diagnosed with cancer prior to age 12. We conducted multivariable hazard regression to examine associations between demographic and gestational factors with cancer. Greater parity (family with 2+ older children) was related to acute myeloid leukemia [Hazard ratio (HR) = 2.15, 95% confidence interval (CI): 1.31, 3.55), central nervous system tumors (HR = 1.67, CI: 1.13, 2.48) and neuroblastoma (HR = 1.67, CI: 1.07, 2.63). Hepatoblastoma cases had a higher risk of low birth weight (<2,500 g; HR = 3.01, CI: 1.85, 4.91), very preterm birth (<33 weeks gestation; HR = 13.71, CI: 7.45, 25.23), plural pregnancies (HR = 2.37, CI: 1.10, 5.14) and both small (HR = 2.13, CI: 1.23, 3.67) and large (HR = 1.83, CI: 1.01, 3.32) for gestational age. Germ cell tumors were more common among children born in rural areas (HR = 1.63, CI: 1.02, 2.60). Despite that Taiwan has lower rates of both high and low birthweight compared to other developed nations, we observed several similar associations to those reported in Western Countries. Further research should examine unique exposures in Taiwan that may be contributing to higher incidence of certain cancer types.
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Affiliation(s)
- Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA.,Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chia-Kai Wu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Hsin-Yun Tsai
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA.,Department of Statistics, UCLA College of Letters and Science, Los Angeles, CA.,Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Chung-Yi Li
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Hall C, Hansen J, von Ehrenstein OS, He D, Olsen J, Ritz B, Heck JE. Occupational livestock or animal dust exposure and offspring cancer risk in Denmark, 1968-2016. Int Arch Occup Environ Health 2020; 93:659-668. [PMID: 32025796 DOI: 10.1007/s00420-020-01524-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 01/28/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To examine associations with occupational livestock or other animal dust exposure and offspring cancer risk. METHODS In this population-based case-control study of Danish children aged < 17 years old, 5078 childhood cancer cases diagnosed 1968-2016 were matched to cancer-free controls by birth year and sex (n = 123,228). Occupational livestock or animal dust exposure was identified using a job-exposure matrix. We employed multivariable conditional logistic regression models to estimate associations with offspring cancer for births 1968-2016 and 1989-2016, with the latter timeframe reflecting a period of presumed higher exposure due to changes in Danish farming practices. Sensitivity analyses considered place of birth (urban areas vs. rural areas and small towns). RESULTS For births 1968-2016, paternal exposure from offspring birth to cancer diagnosis was associated with central nervous system tumors (adjusted odds ratio [OR] = 1.30, 95% confidence interval [CI] 1.04-1.63) and germ cell tumors (OR = 1.82, 95% CI 1.05-3.27), while maternal pregnancy exposure was associated with astrocytoma (OR = 1.89, 95% CI 1.00-3.57). For births 1989-2016, paternal exposure from offspring birth to cancer diagnosis was negatively associated with acute lymphoid leukemia (OR = 0.58, 95% CI 0.33-1.00). For births in rural areas only, maternal exposure from offspring birth to cancer diagnosis was positively associated with acute myeloid leukemia (OR = 2.16, 95% CI 1.09-4.29). CONCLUSIONS This study suggests that paternal occupational animal exposure is associated with offspring germ cell tumors, and maternal pregnancy exposure with astrocytomas. Our results are mixed with respect to leukemia subtypes.
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Affiliation(s)
- Clinton Hall
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Ondine S von Ehrenstein
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.,Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Di He
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jørn Olsen
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.,Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
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Xu X, Ritz B, Coleman A, Liew Z, Deapen D, Lee E, Bernstein L, Pinder R, Marshall S, Heck JE. Hypertension, antihypertensive medications use and risk of age-related macular degeneration in California Teachers Cohort. J Hum Hypertens 2019; 34:568-576. [PMID: 31595025 DOI: 10.1038/s41371-019-0269-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/19/2019] [Accepted: 09/25/2019] [Indexed: 01/02/2023]
Abstract
Sustained and inadequately controlled hypertension can promote the development of age-related macular degeneration (AMD) through multiple biologic pathways. Epidemiologic studies of high blood pressure, antihypertensive therapies, and the risk of AMD thus far have been inconclusive. However, few studies evaluated risks according to the use of different classes of antihypertensive drugs or took combinations of use into account. We performed a prospective cohort study by linking the California Teachers Study (CTS) cohort (N = 88 481) to statewide hospital discharge records up to December 31, 2012. History of high blood pressure, regular use of antihypertensive medications, and comprehensive risk factor information was collected via self-administered questionnaires at baseline in 1995-1996, and information on specific classes of antihypertensive drugs was provided by a subsample of CTS participants who completed a follow-up questionnaire in 2000. We identified 1762 female teachers with AMD during 14.8 years of follow-up on average. Applying Cox proportional hazard regression, we estimated increased risks of AMD among women treated for hypertension at baseline (HR = 1.15, 95% CI: 1.03, 1.30); the magnitude of the association increased with longer duration of antihypertensive treatment. In the subsample with more specific information on type of medication use, we estimated a 45% increased risk of AMD among women receiving diuretics as monotherapy compared to women with medications more potent than diuretics (HR = 1.45, 95% CI 1.10, 1.90). In women treated with a combination of antihypertensive drugs, we observed no increased risk of AMD for any individual class of drugs.
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Affiliation(s)
- Xiaoqing Xu
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Anne Coleman
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA.,Jules Stein Eye Institute, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Zeyan Liew
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Dennis Deapen
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Eunjung Lee
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Leslie Bernstein
- Division of Cancer Etiology, Department of Population Sciences, City of Hope National Medical Center and Comprehensive Cancer Center, Duarte, CA, USA
| | - Rich Pinder
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Sarah Marshall
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA.
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43
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Omidakhsh N, Hansen J, Ritz B, Olsen J, Heck JE. High parental occupational social contact and risk of childhood hematopoietic, brain and bone cancers. Cancer Epidemiol 2019; 62:101575. [PMID: 31369943 PMCID: PMC6771419 DOI: 10.1016/j.canep.2019.101575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/18/2019] [Accepted: 07/22/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The etiology of childhood cancer is largely unknown, though some research suggests an infectious origin of hematopoietic, central nervous system (CNS) and bone cancers. METHODS We examined parental occupational social contact as a proxy for exposure to infectious agents and risk of childhood cancer. This population-based case-control study utilized a linkage of four Danish data-registries, and included 3581 cases (<17 years, diagnosed 1973-2012) and 358,100 age-matched controls. We examined the risks of leukemia, lymphoma, CNS and bone cancer related to high occupational social contact from (1) conception to birth and (2) birth to diagnosis. RESULTS Acute lymphoblastic leukemia (ALL) and bone cancer were inversely associated with high maternal social contact from conception to birth (OR: 0.86, 95% CI: 0.67-1.10) and birth to diagnosis (OR: 0.54, 95% CI: 0.34-0.86). Children of fathers with high social contact from birth to diagnosis had an increased risk of bone cancers, particularly in rural areas (OR: 1.65, 95% CI: 1.03-2.63). Parental social contact was associated with increased risk of astrocytoma, with strongest associations found in first-born children (maternal: OR: 1.54, 95% CI: 1.02-2.32; paternal: OR: 1.82, 95% CI: 1.05-3.17). CONCLUSION Our results support the notion of a role of infections for some cancer types.
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Affiliation(s)
- Negar Omidakhsh
- Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.
| | - Johnni Hansen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA; Center for Occupational and Environmental Health, Fielding School of Public Health, University of California, 650 Charles E Young Drive, Los Angeles, CA, 90095, USA.
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Olof Palmes Alle 43-45, 8200 Aarhus N, Aarhus, Denmark.
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA; Center for Occupational and Environmental Health, Fielding School of Public Health, University of California, 650 Charles E Young Drive, Los Angeles, CA, 90095, USA.
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44
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Yan Q, Liew Z, Uppal K, Cui X, Ling C, Heck JE, von Ehrenstein OS, Wu J, Walker DI, Jones DP, Ritz B. Maternal serum metabolome and traffic-related air pollution exposure in pregnancy. Environ Int 2019; 130:104872. [PMID: 31228787 PMCID: PMC7017857 DOI: 10.1016/j.envint.2019.05.066] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/23/2019] [Accepted: 05/24/2019] [Indexed: 05/19/2023]
Abstract
BACKGROUND Maternal exposure to traffic-related air pollution during pregnancy has been shown to increase the risk of adverse birth outcomes and neurodevelopmental disorders. By utilizing high-resolution metabolomics (HRM), we investigated perturbations of the maternal serum metabolome in response to traffic-related air pollution to identify biological mechanisms. METHODS We retrieved stored mid-pregnancy serum samples from 160 mothers who lived in the Central Valley of California known for high air particulate levels. We estimated prenatal traffic-related air pollution exposure (carbon monoxide, nitric oxides, and particulate matter <2.5 μm) during first-trimester using the California Line Source Dispersion Model, version 4 (CALINE4) based on residential addresses recorded at birth. We used liquid chromatography-high resolution mass spectrometry to obtain untargeted metabolic profiles and partial least squares discriminant analysis (PLS-DA) to select metabolic features associated with air pollution exposure. Pathway analyses were employed to identify biologic pathways related to air pollution exposure. As potential confounders we included maternal age, maternal race/ethnicity, and maternal education. RESULTS In total we extracted 4038 and 4957 metabolic features from maternal serum samples in hydrophilic interaction (HILIC) chromatography (positive ion mode) and C18 (negative ion mode) columns, respectively. After controlling for confounding factors, PLS-DA (Variable Importance in Projection (VIP) ≥2) yielded 181 and 251 metabolic features (HILIC and C18, respectively) that discriminated between the high (n = 98) and low exposed (n = 62). Pathway enrichment analysis for discriminatory features associated with air pollution indicated that in maternal serum oxidative stress and inflammation related pathways were altered, including linoleate, leukotriene, and prostaglandin pathways. CONCLUSION The metabolomic features and pathways we found to be associated with air pollution exposure suggest that maternal exposure during pregnancy induces oxidative stress and inflammation pathways previously implicated in pregnancy complications and adverse outcomes.
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Affiliation(s)
- Qi Yan
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Karan Uppal
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Xin Cui
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA; California Perinatal Quality Care Collaborative, Palo Alto, CA, USA
| | - Chenxiao Ling
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | | | - Jun Wu
- Program in Public Health, UCI Susan and Henry Samueli College of Health Sciences, Irvine, CA, USA
| | - Douglas I Walker
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dean P Jones
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Department of Medicine, Emory University, Atlanta, GA, USA
| | - Beate Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Neurology, UCLA School of Medicine, CA, USA.
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Ling C, Heck JE, Cockburn M, Liew Z, Marcotte E, Ritz B. Residential mobility in early childhood and the impact on misclassification in pesticide exposures. Environ Res 2019; 173:212-220. [PMID: 30928851 PMCID: PMC6553500 DOI: 10.1016/j.envres.2019.03.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 03/13/2019] [Accepted: 03/17/2019] [Indexed: 05/28/2023]
Abstract
Studies of environmental exposures and childhood cancers that rely on records often only use maternal address at birth or address at cancer diagnosis to assess exposures in early childhood, possibly leading to exposure misclassification and questionable validity due to residential mobility during early childhood. Our objective was to assess patterns and identify factors that may predict residential mobility in early childhood, and examine the impact of mobility on early childhood exposure assessment for agriculturally applied pesticides and childhood cancers in California. We obtained the addresses at diagnosis of all childhood cancer cases born in 1998-2011 and diagnosed at 0-5 years of age (n = 6478) from the California Cancer Registry (CCR), and their birth addresses from linked birth certificates. Controls were randomly selected from California birth records and frequency matched (20:1) to all cases by year of birth. We obtained residential histories from a public-record database LexisNexis for both case (n = 3877 with age at diagnosis 1-5 years) and control (n = 99,262) families. Logistic regression analyses were conducted to assess the socio-demographic factors in relation to residential mobility in early childhood. We employed a Geographic Information System (GIS)-based system to estimate children's first year of life exposures to agriculturally applied pesticides based on birth vs diagnosis address or residential histories based upon Lexis-Nexis Public Records and assessed agreement between exposure measures using Spearman correlations and kappa statistics. Over 20% of case and control children moved in their first year of life, and 55% of children with cancer moved between birth and diagnosis. Older age at diagnosis, younger maternal age, lower maternal education, not having a Hispanic ethnic background, use of public health insurance, and non-metropolitan residence at birth were predictors of higher residential mobility. There was moderate to strong correlation (Spearman correlation = 0.76-0.83) and good agreement (kappa = 0.75-0.81) between the first year of life exposure estimates for agricultural pesticides applied within 2 km of a residence relying on an address at birth or at diagnosis or LexisNexis addresses; this did not differ by outcome status, but agreement decreased with decreasing buffer size, and increasing distance moved or age at diagnosis. These findings suggest that residential addresses collected at one point in time may represent residential history in early childhood to a reasonable extent; nevertheless, they exposure misclassification in the first year of life remains an issue. Also, the highest proportion of women not captured by LexisNexis were Hispanic women born in Mexico and those living in the lowest SES neighborhoods, i.e. possibly those with the higher environmental exposures, as well as younger women and those with less than high school education. Though LexisNexis only captures a sub-population, its data may be useful for augmenting address information and assessing the extent of exposure misclassification when estimating environmental exposures in large record linkage studies. Future research should investigate how to correct for exposure misclassification introduced by residential mobility that is not being captured by records.
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Affiliation(s)
- Chenxiao Ling
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USA; Cancer Prevention and Control Program, Colorado Comprehensive Cancer Center, University of Colorado, Aurora, CO, USA
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, USA; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, USA
| | - Erin Marcotte
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA.
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Abstract
OBJECTIVE To assess prenatal air toxics exposure and risk for childhood germ cell tumors (GCTs) by histological subtype (yolk sac tumor and teratoma). METHODS In this case-control study, GCT cases less than 6 years (n = 243) identified from California Cancer Registry records were matched by birth year to cancer-free population controls (n = 147,100), 1984 to 2013. Routinely monitored air toxic exposures were linked to subjects' birth address. Logistic regression estimated GCT risks per interquartile range increase in exposure. RESULTS Prenatal exposure to various highly-correlated, traffic-related air toxics during the second trimester increased GCT risk, particularly 1,3-butadiene (odds ratio [OR] = 1.51; 95% confidence interval [CI] = 1.01, 2.26) and meta/para-xylene (OR = 1.56; 95% CI = 1.10, 2.21). Analyses by subtype indicated elevated ORs for yolk sac tumors but not teratomas. CONCLUSION Our estimated ORs are consistent with positive associations between some prenatal traffic-related air toxics and GCT risk, notably yolk sac tumors.
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Affiliation(s)
- Clinton Hall
- Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California (Dr Hall, Dr von Ehrenstein, Dr Ritz, Dr Heck); Department of Environmental Health Sciences, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California (Dr Ritz); Department of Community Health Sciences, University of California, Los Angeles, Fielding School of Public Health, Los Angeles, California (Dr von Ehrenstein); Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California (Dr Cockburn); Spatial Sciences Institute, Dornsife College of Arts, Letters and Sciences, University of Southern California, Los Angeles, California (Dr Escobedo); Leidos, Inc., San Diego, California (Dr Hall)
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Heck JE, He D, Contreras ZA, Ritz B, Olsen J, Hansen J. Parental occupational exposure to benzene and the risk of childhood and adolescent acute lymphoblastic leukaemia: a population-based study. Occup Environ Med 2019; 76:527-529. [PMID: 31138675 DOI: 10.1136/oemed-2019-105738] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/26/2019] [Accepted: 05/05/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Only a small number of studies have reported on the association of parental occupational exposure to benzene and risk of childhood and adolescent leukaemias. We examined associations with acute lymphoblastic leukaemia (ALL) in this population-based study in Denmark. METHODS Benzene was largely banned from Danish workplaces after 1975, thus this case-control study focused on the immediately prior years. Paediatric cancer cases (<age 20) were ascertained from the Danish Cancer Registry among children born 1968-1974, and controls were selected from population records. Paternal occupation within the 3 months preconception and maternal pregnancy occupation were identified from nationwide pension fund records. Blinded, we assigned benzene exposure using a job-exposure matrix that had been developed for the Danish population. Risk for ALL was estimated using conditional logistic regression. In an exploratory analysis, we also examined other cancers with at least five case parents exposed. RESULTS We identified 217 employed case fathers and 169 employed case mothers, of which 22 (10.1%) and 11 (6.5%), respectively, were exposed to benzene (vs 6.7% and 2.9% of control fathers and mothers). Most exposed parents worked as machine or engine mechanics, or in the shoe industry. Maternal occupational exposure to benzene in pregnancy was related to increased risk of ALL in offspring (adjusted OR=2.28, 95% CI 1.17 to 4.41), while paternal preconceptional benzene exposure was not as strongly associated (adjusted OR=1.40, 95% CI 0.88 to 2.22). CONCLUSIONS Our study supports an increased risk for ALL with parental occupational benzene exposure.
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Affiliation(s)
- Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.,Center for Occupational and Environmental Health, University of California, Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
| | - Di He
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Zuelma Arellano Contreras
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.,Center for Occupational and Environmental Health, University of California, Los Angeles, CA, USA
| | - Jørn Olsen
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA.,Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Johnni Hansen
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
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Filippini T, Hatch EE, Rothman KJ, Heck JE, Park AS, Crippa A, Orsini N, Vinceti M. Association between Outdoor Air Pollution and Childhood Leukemia: A Systematic Review and Dose-Response Meta-Analysis. Environ Health Perspect 2019; 127:46002. [PMID: 31017485 PMCID: PMC6785230 DOI: 10.1289/ehp4381] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 05/28/2023]
Abstract
BACKGROUND A causal link between outdoor air pollution and childhood leukemia has been proposed, but some older studies suffer from methodological drawbacks. To the best of our knowledge, no systematic reviews have summarized the most recently published evidence and no analyses have examined the dose-response relation. OBJECTIVE We investigated the extent to which outdoor air pollution, especially as resulting from traffic-related contaminants, affects the risk of childhood leukemia. METHODS We searched all case-control and cohort studies that have investigated the risk of childhood leukemia in relation to exposure either to motorized traffic and related contaminants, based on various traffic-related metrics (number of vehicles in the closest roads, road density, and distance from major roads), or to measured or modeled levels of air contaminants such as benzene, nitrogen dioxide, 1,3-butadiene, and particulate matter. We carried out a meta-analysis of all eligible studies, including nine studies published since the last systematic review and, when possible, we fit a dose-response curve using a restricted cubic spline regression model. RESULTS We found 29 studies eligible to be included in our review. In the dose-response analysis, we found little association between disease risk and traffic indicators near the child's residence for most of the exposure range, with an indication of a possible excess risk only at the highest levels. In contrast, benzene exposure was positively and approximately linearly associated with risk of childhood leukemia, particularly for acute myeloid leukemia, among children under 6 y of age, and when exposure assessment at the time of diagnosis was used. Exposure to nitrogen dioxide showed little association with leukemia risk except at the highest levels. DISCUSSION Overall, the epidemiologic literature appears to support an association between benzene and childhood leukemia risk, with no indication of any threshold effect. A role for other measured and unmeasured pollutants from motorized traffic is also possible. https://doi.org/10.1289/EHP4381.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Elizabeth E. Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Kenneth J. Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
- RTI Health Solutions, Research Triangle Park, North Carolina, USA
| | - Julia E. Heck
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Andrew S. Park
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Alessio Crippa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Nicola Orsini
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), 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, Massachusetts, USA
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49
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Panagopoulou P, Skalkidou A, Marcotte E, Erdmann F, Ma X, Heck JE, Auvinen A, Mueller BA, Spector LG, Roman E, Metayer C, Magnani C, Pombo-de-Oliveira MS, Scheurer ME, Mora AM, Dockerty JD, Hansen J, Kang AY, Wang R, Doody DR, Kane E, Schüz J, Christodoulakis C, Ntzani E, Petridou ET. Parental age and the risk of childhood acute myeloid leukemia: results from the Childhood Leukemia International Consortium. Cancer Epidemiol 2019; 59:158-165. [PMID: 30776582 PMCID: PMC7098424 DOI: 10.1016/j.canep.2019.01.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Parental age has been associated with several childhood cancers, albeit the evidence is still inconsistent. AIM To examine the associations of parental age at birth with acute myeloid leukemia (AML) among children aged 0-14 years using individual-level data from the Childhood Leukemia International Consortium (CLIC) and non-CLIC studies. MATERIAL/METHODS We analyzed data of 3182 incident AML cases and 8377 controls from 17 studies [seven registry-based case-control (RCC) studies and ten questionnaire-based case-control (QCC) studies]. AML risk in association with parental age was calculated using multiple logistic regression, meta-analyses, and pooled-effect estimates. Models were stratified by age at diagnosis (infants <1 year-old vs. children 1-14 years-old) and by study design, using five-year parental age increments and controlling for sex, ethnicity, birthweight, prematurity, multiple gestation, birth order, maternal smoking and education, age at diagnosis (cases aged 1-14 years), and recruitment time period. RESULTS Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) derived from RCC, but not from the QCC, studies showed a higher AML risk for infants of mothers ≥40-year-old (OR = 6.87; 95% CI: 2.12-22.25). There were no associations observed between any other maternal or paternal age group and AML risk for children older than one year. CONCLUSIONS An increased risk of infant AML with advanced maternal age was found using data from RCC, but not from QCC studies; no parental age-AML associations were observed for older children.
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Affiliation(s)
- Paraskevi Panagopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Erin Marcotte
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, U
| | - Friederike Erdmann
- International Agency for Research on Cancer, Section of Environment and Radiation, Lyon, France; Danish Cancer Society Research Center, Childhood Cancer Research Group, Copenhagen, Denmark
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Cancer Prevention and Control, Yale Comprehensive Cancer Center, Yale School of Medicine, CT, USA
| | - Julia E Heck
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
| | - Anssi Auvinen
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, U
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Catherine Metayer
- School of Public Health, University of California, Berkeley, CA, USA
| | - Corrado Magnani
- Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piedmont and University of Eastern Piedmont, Novara, Italy
| | - Maria S Pombo-de-Oliveira
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, United Kingdom; Pediatric Hematology-Oncology Program, Instituto Nacional de Cancer, Rio de Janeiro, Brazil
| | - Michael E Scheurer
- Baylor College of Medicine, Department of Pediatrics Texas Children's Cancer Center, TX, USA
| | - Ana-Maria Mora
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - John D Dockerty
- School of Public Health, University of California, Berkeley, CA, USA; Department of Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Alice Y Kang
- School of Public Health, University of California, Berkeley, CA, USA
| | - Rong Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Cancer Prevention and Control, Yale Comprehensive Cancer Center, Yale School of Medicine, CT, USA
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Eleanor Kane
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Joachim Schüz
- International Agency for Research on Cancer, Section of Environment and Radiation, Lyon, France
| | - Christos Christodoulakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Greece; Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI, USA
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
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Volk J, Heck JE, Schmiegelow K, Hansen J. Risk of selected childhood cancers and parental employment in painting and printing industries: A register-based case‒control study in Denmark 1968-2015. Scand J Work Environ Health 2019; 45:475-482. [PMID: 30838423 DOI: 10.5271/sjweh.3811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objectives Parental exposures and offspring's risk of cancer have been studied with inconsistent results. We investigated parental employment in painting and printing industries and risk of childhood leukemia, central nervous system (CNS) cancers, and prenatal cancers (acute lymphoblastic leukemia, Wilms tumor, medulloblastoma, neuroblastoma, retinoblastoma, and hepatoblastoma). Methods Using Danish registries, children aged ≤19 years diagnosed from 1968-2015 with leukemia (N=1999), CNS cancers (N=1111) or prenatal cancers (N=2704) were linked to parents and their employment history one year before birth to birth for fathers, and one year before birth to one year after for mothers. Twenty randomly selected controls per case were matched by age and sex. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using conditional logistic regression. Results For fathers, we found increased risks for acute myeloid leukemia (AML) consistent in painting (OR 2.26, 95% CI 1.07-4.80) and printing industries (OR 2.43, 95% CI 0.94-6.23) and these industries combined (OR 2.10, 95% CI 1.14-3.87). For mothers, increased risks of CNS cancers were found for painting industries (OR 2.34, 95% CI 1.10-4.95) and painting and printing combined (OR 1.97, 95% CI 1.08-3.64). For fathers working in combined industries, the OR for CNS was increased (OR 1.54, 95% CI 1.02-2.31), most prominently in printing industries (OR 2.09, 95% CI 1.17-3.75). Conclusion We observed increased risks of CNS tumors in offspring after parental employment in painting and printing industries. Children of fathers employed in painting and printing industries had a two-fold increase in AML.
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Affiliation(s)
- Julie Volk
- The Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen Ø, Denmark.
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