Childhood Leukemia: A Preventable Disease

Abstract

In contrast to most pediatric cancers, there is a growing body of literature, nationally and internationally, that has implicated the role of several environmental indoor and outdoor hazards in the etiology of childhood leukemia. For example, exposures to solvents, traffic, pesticides, and tobacco smoke have consistently demonstrated positive associations with the risk of developing childhood leukemia. Intake of vitamins and folate supplementation during the preconception period or pregnancy has been demonstrated to have a protective effect. Despite the strength of these findings, the dissemination of this knowledge to clinicians has been limited. Some children may be more vulnerable than others as documented by the high and increasing incidence of childhood leukemia in Hispanics. To protect children’s health, it is prudent to establish programs to alter exposure to those factors with well-established associations with leukemia risk rather than to suspend judgment until no uncertainty remains. This is particularly true because other serious health outcomes (both negative and positive) have been associated with the same exposures. We draw from historical examples to put in perspective the arguments of association versus causation, as well as to discuss benefits versus risks of immediate and long-term preventive actions.

Parental occupational exposure to pesticides, animals and organic dust and risk of childhood leukemia and central nervous system tumors: Findings from the International Childhood Cancer Cohort Consortium (I4C)

“…However, AML has been associated with maternal pesticide exposures and other parental occupational exposures, especially benzene and other solvents, as well as certain chemotherapy drugs . Like many pesticides, these exposures may cause chromosomal alterations and mutations . Our finding of an inverse association between paternal organic dust exposure and ALL is novel but the biologically plausibility for this association is unclear.…”

Spatial clustering of childhood leukaemia with the integration of the Paediatric Environmental History

“…Compared to adults, the time between the foetal stage until the age of two has a greater sensitivity to mutagenic action of 10-fold risk and a 3-fold adjustment for years 3-15 (Preston, 2004). In recent years there has been an increase in studies linking environmental exposures during pregnancy and the subsequent development of childhood leukaemia (Carlos-Wallace et al, 2016; Heck et al, 2014; Metayer et al, 2016a; Vinson et al, 2011.). This point, associated with the increasingly accepted hypotheses that leukaemia emerges from precursor mutations initially developed in utero, makes it necessary to introduce the address during pregnancy in childhood cancer registries in order to perform more complete studies that help to improve the knowledge of the causes of childhood leukaemia.…”

“…Among the factors with inconclusive evidence, the most common are prenatal exposure to tobacco smoke, alcohol, and solvents and paints by occupational exposures (Metayer et al, 2016a; Wiggle et al, 2009). Some other factors included the short duration of breastfeeding and virus infections before diagnosis (Amitay and Keinan-Boker, 2015; Marcotte et al, 2014).…”

Childhood Leukemia and Primary Prevention

“…Recently, our research group has suggested that the time is right to develop activities focused on primary prevention of childhood leukemia. 185,186 …”