Childhood leukaemia in Europe after Chernobyl: 5 year follow-up

Abstract

Summary The European Childhood Leukaemia-Lymphoma Incidence Study (ECLIS) is designed to address concerns about a possible increase in the risk of cancer in Europe following the nuclear accident in Chernobyl in 1986. This paper reports results of surveillance of childhood leukaemia in cancer registry populations from 1980 up to the end of 1991. There was a slight increase in the incidence of childhood leukaemia in Europe during this period, but the overall geographical pattern of change bears no relation to estimated exposure to radiation resulting from the accident. We conclude that at this stage of follow-up any changes in incidence consequent upon the Chernobyl accident remain undetectable against the usual background rates. Our results are consistent with current estimates of the leukaemogenic risk of radiation exposure, which, outside the immediate vicinity of the accident, was small.

Spatial clustering of childhood leukaemia: summary results from the EUROCLUS project

“…Rates for the former socialist economies in Europe are lower than elsewhere, as has previously been reported (Parkin et al, 1996). There were substantial numbers of cases in Estonia with type not specified and, in consequence, Estonia has been excluded from all analyses of ALL.…”

“…There is currently little understanding of the causes of leukaemia (Doll, 1989), the most common childhood cancer (Parkin et al, 1988), and an important cause of childhood morbidity in developed countries. The geographical pattern may provide important clues to causative factors; until the mid-1970s attention was focused on infectious agents (Caldwell, 1990), which are the cause of most animal leukaemias (Temin, 1992), but in recent years the dominant theme has been fixed environmental hazards -including nuclear facilities (Gardner, 1989;Michaelis et al, 1992), contaminated water (Lagakos et al, 1986;Mulder et al, 1994) and electromagnetic fields (Ahlbom, 1993).…”

“…Acute lymphoblastic leukaemia (ALL) is the most frequent childhood leukaemia, accounting for 70-80% of cases in developed countries (Parkin et al, 1988), and shows a prominent childhood peak at ages 1-7 years (or, more specifically, 2-4 years) (Doll, 1989) that has emerged as societies have experienced economic development and that, it is suggested, may be attributable to specific patterns of exposure to one or more common infectious agents (Greaves and Alexander, 1993).…”

“…A single set of age-and sex-specific reference rates for the countries included has been derived from published data (Parkin et al, 1988). These rates have been used to compute expected numbers, but within each country the expected numbers for each small area have been multiplied by the ratio of the national (or regional) totals of observed to expected cases so that all analyses are conditional on the total observed numbers in each country or region.…”

The cancer epidemiology of radiation

“…The role of iodine deficiency (Shakhtarin et al, 2003), intense screening for thyroid cancer (Moysich et al, 2002) and short-lived radioisotopes other than 131 I complicate the derivation of risk estimates from the Chernobyl data (UNSCEAR, 2000), but the ERR coefficient for childhood thyroid cancer that may be derived from the children exposed to radioiodine in the former USSR is compatible with that obtained from external irradiation (Jacob et al, 2000). Little evidence has been found for an increased risk of childhood leukaemia associated with Chernobyl contamination (Parkin et al, 1996). There is, however, some suggestive evidence of a raised incidence of infant (o1 year of age) leukaemia after the Chernobyl accident in Greece (Petridou et al, 1996), West Germany (Steiner et al, 1998), Belarus (Ivanov et al, 1998) and Scotland (Gibson et al, 1988) that might be related to exposure to fallout, although the findings of these geographical correlation studies should be viewed with caution until the results of individual-based studies are available.…”