Éric Lavigne1, Marc-André Bélair2, Minh T Do3, David M Stieb4, Perry Hystad5, Aaron van Donkelaar6, Randall V Martin6, Daniel L Crouse7, Eric Crighton8, Hong Chen9, Jeffrey R Brook10, Richard T Burnett11, Scott Weichenthal12, Paul J Villeneuve13, Teresa To14, Sabit Cakmak11, Markey Johnson15, Abdool S Yasseen16, Kenneth C Johnson17, Marianna Ofner18, Lin Xie3, Mark Walker19. 1. Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: eric.lavigne@hc-sc.gc.ca. 2. Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada. 3. Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada. 4. School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada; Population Studies Division, Health Canada, Vancouver, British Columbia, Canada. 5. College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA. 6. Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada. 7. Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada. 8. Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada; Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada. 9. Public Health Ontario, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. 10. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Air Quality Research Division, Environment Canada, Downsview, Ontario, Canada. 11. Population Studies Division, Health Canada, Ottawa, Ontario, Canada. 12. Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada. 13. Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada. 14. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada. 15. Air Health Science Division, Health Canada, Ottawa, Ontario, Canada. 16. Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry and Network Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. 17. School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada. 18. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Global Health and Guideline Division, Public Health Agency of Canada, Toronto, Ontario, Canada. 19. Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry and Network Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada.
Abstract
BACKGROUND: There are increasing concerns regarding the role of exposure to ambient air pollution during pregnancy in the development of early childhood cancers. OBJECTIVE: This population based study examined whether prenatal and early life (<1year of age) exposures to ambient air pollutants, including nitrogen dioxide (NO2) and particulate matter with aerodynamic diameters ≤2.5μm (PM2.5), were associated with selected common early childhood cancers in Canada. METHODS: 2,350,898 singleton live births occurring between 1988 and 2012 were identified in the province of Ontario, Canada. We assigned temporally varying satellite-derived estimates of PM2.5 and land-use regression model estimates of NO2 to maternal residences during pregnancy. Incident cases of 13 subtypes of pediatric cancers among children up to age 6 until 2013 were ascertained through administrative health data linkages. Associations of trimester-specific, overall pregnancy and first year of life exposures were evaluated using Cox proportional hazards models, adjusting for potential confounders. RESULTS: A total of 2044 childhood cancers were identified. Exposure to PM2.5, per interquartile range increase, over the entire pregnancy, and during the first trimester was associated with an increased risk of astrocytoma (hazard ratio (HR) per 3.9μg/m3=1.38 (95% CI: 1.01, 1.88) and, HR per 4.0μg/m3=1.40 (95% CI: 1.05-1.86), respectively). We also found a positive association between first trimester NO2 and acute lymphoblastic leukemia (ALL) (HR=1.20 (95% CI: 1.02-1.41) per IQR (13.3ppb)). CONCLUSIONS: In this population-based study in the largest province of Canada, results suggest an association between exposure to ambient air pollution during pregnancy, especially in the first trimester and an increased risk of astrocytoma and ALL. Further studies are required to replicate the findings of this study with adjustment for important individual-level confounders. Crown
BACKGROUND: There are increasing concerns regarding the role of exposure to ambient air pollution during pregnancy in the development of early childhood cancers. OBJECTIVE: This population based study examined whether prenatal and early life (<1year of age) exposures to ambient air pollutants, including nitrogen dioxide (NO2) and particulate matter with aerodynamic diameters ≤2.5μm (PM2.5), were associated with selected common early childhood cancers in Canada. METHODS: 2,350,898 singleton live births occurring between 1988 and 2012 were identified in the province of Ontario, Canada. We assigned temporally varying satellite-derived estimates of PM2.5 and land-use regression model estimates of NO2 to maternal residences during pregnancy. Incident cases of 13 subtypes of pediatric cancers among children up to age 6 until 2013 were ascertained through administrative health data linkages. Associations of trimester-specific, overall pregnancy and first year of life exposures were evaluated using Cox proportional hazards models, adjusting for potential confounders. RESULTS: A total of 2044 childhood cancers were identified. Exposure to PM2.5, per interquartile range increase, over the entire pregnancy, and during the first trimester was associated with an increased risk of astrocytoma (hazard ratio (HR) per 3.9μg/m3=1.38 (95% CI: 1.01, 1.88) and, HR per 4.0μg/m3=1.40 (95% CI: 1.05-1.86), respectively). We also found a positive association between first trimester NO2 and acute lymphoblastic leukemia (ALL) (HR=1.20 (95% CI: 1.02-1.41) per IQR (13.3ppb)). CONCLUSIONS: In this population-based study in the largest province of Canada, results suggest an association between exposure to ambient air pollution during pregnancy, especially in the first trimester and an increased risk of astrocytoma and ALL. Further studies are required to replicate the findings of this study with adjustment for important individual-level confounders. Crown
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