Population density and childhood leukaemia: results of the EUROCLUS study

Alexander, Freda E.; Boyle, Peter; Carli, P. M.; Coebergh, Jan Willem; Ekbom, Anders; Levi, Fabio; McKinney, P A; McWhirter, W.; Michaelis, Jörg; Peris-Bonet, Rafael; Petridou, Eleni; Pompe-Kirn, Vera; Pleško, I; Pukkala, Eero; Rahu, Mati; Stiller, C.A.; Storm, Hans H.; Terracini, Benedetto; Vatten, L; Wray, Naomi R.

doi:10.1016/s0959-8049(98)00385-2

Cited by 42 publications

(30 citation statements)

References 19 publications

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“…27 In Western countries, neighborhoods with residential density greater than 500 persons/km 2 are usually classified as densely populated areas for epidemiologic studies. 28 However, in China, a residential density of 500 persons/km 2 may be considered a sparsely populated area. This is likely to be an important factor contributing to the differences in the associations of residential density with physical activity in this study compared previously reported studies from Western countries.…”

Section: Discussionmentioning

confidence: 99%

Associations of Residential Density with Adolescents’ Physical Activity in a Rapidly Urbanizing Area of Mainland China

Liang

et al. 2009

J Urban Health

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In the context of recent social and economic transitions in China, lack of physical activity among adolescents is an emerging health risk, particularly so in rapidly expanding urban areas. Evidence from Western countries suggests that built environment attributes can influence the physical activity participation of young people, but whether or not this is the case for China is unknown. We recruited high school students from ten urban districts in Nanjing, Mainland China (n=2,375; mean age=13.9± 1.0 years old; 46% boys; survey response rate=89%). The outcome variable was selfreported recreational physical activity time; the primary explanatory variable was the residential density of the urban districts. Analysis was conducted using mixed-effects logistic regression models. After adjustment for potential confounding variables, including sedentary behavior and green space, there was a consistent and graduated association between residential density and physical activity; residential density was significantly negatively associated with recreational physical activity time for students from the higher tertile of residential density (OR; 95% CI=0.64; 0.42 to 0.97) compared to those from the lower tertile. The direction and magnitude of the negative association between residential density and physical activity was similar for boys and girls. It should be a public health priority to identify the particular urban environment attributes that can encourage and support young people's participation in physical activity.

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Section: Discussionmentioning

confidence: 99%

Associations of Residential Density with Adolescents’ Physical Activity in a Rapidly Urbanizing Area of Mainland China

Liang

et al. 2009

J Urban Health

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“…The EUROCLUS study evidenced the influence of population density on the incidence of childhood acute leukaemia (Alexander et al, 1999). An extra-Poisson variation was actually observed in the areas with o500 inhabitants km À2 while the moderately densely populated areas were associated with the highest incidence rates.…”

Section: Discussionmentioning

confidence: 99%

Spatial and space–time clustering of childhood acute leukaemia in France from 1990 to 2000: a nationwide study

et al. 2006

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This study aimed to investigate the spatial and space -time distributions of cases of childhood acute leukaemia (CL) during 1990 -2000 over the whole French territory. A global spatial heterogeneity and a spatial autocorrelation were first considered using the methods proposed by Potthoff and Whittinghill, Moran and Rogerson methods. The presence of space -time interaction between the places of residence and the dates of diagnosis was investigated with the Knox's test. Finally, the Kulldorff's statistic permitted to scan the whole territory in search for localised clusters. Two time periods were considered (1990 -1994, 1995 -2000). Overall, a statistically significant spatial heterogeneity of a very small magnitude was observed in the incidence of CL over 1990 -1994, but neither over 1995 -2000 nor over the whole time period. Moreover, a significant overdispersion of 5.5% was evidenced for 0 -4 year children living in isolated areas with more than 50 inhabitants per km 2 . Cases older than 10 years living in the same area at diagnosis also tended to cluster within 6 months.

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“…Properties of rural areas include low population density, relative isolation, limited commuting or visitation from other areas, etc, although specific definitions vary by county. Others have explored the use of population density as the predictor of high cancer rates (rather than population mixing) with somewhat mixed results (Alexander et al, 1990(Alexander et al, , 1998b(Alexander et al, , 1999Ross et al, 1999). One recent paper provided somewhat contradictory results, showing that increased risk of childhood leukaemia associated with inward migration was more marked in urban than rural areas (Dickinson et al, 2002a).…”

Section: Discussionmentioning

confidence: 99%

Childhood leukaemia incidence and the population mixing hypothesis in US SEER data

Wartenberg¹,

Schneider

Brown

2004

Br J Cancer

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We evaluated the infectious aetiology hypothesis of childhood leukaemia that rapid population influx into rural areas is associated with increased risk. Using data from the US SEER program, we found that in changes in rural county population sizes from 1980 to 1989 were associated with incidence rates for childhood acute lymphocytic leukaemia (ALL). The observed associations were strongest among children 0 -4 years of age, born in the same state as diagnosis, in extremely rural counties, and when counties adjacent to nonrural counties were excluded. Similar analyses for brain and central nervous system (CNS) cancer in children, a disease less linked to this infectious hypothesis, provide evidence against methodologic bias. Similar evaluations for other decades were not meaningful due to limited sample sizes and, perhaps, increased population mobility.

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Population density and childhood leukaemia: results of the EUROCLUS study

Cited by 42 publications

References 19 publications

Associations of Residential Density with Adolescents’ Physical Activity in a Rapidly Urbanizing Area of Mainland China

Associations of Residential Density with Adolescents’ Physical Activity in a Rapidly Urbanizing Area of Mainland China

Spatial and space–time clustering of childhood acute leukaemia in France from 1990 to 2000: a nationwide study

Childhood leukaemia incidence and the population mixing hypothesis in US SEER data

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