Acute leukemia is the most common childhood cancer and has been associated with exposure to environmental carcinogens. This study aimed to identify clusters of acute childhood leukemia (ACL) cases and analyze their relationship with proximity to industrial sources of air pollution in three capital cities in Colombia during 2000–2015. Incident ACL cases were obtained from the population cancer registries for the cities of Bucaramanga, Cali, and Medellín. The inventory of industrial sources of emissions to the air was obtained from the regional environmental authorities and industrial conglomerates were identified. The Kulldorf’s circular scan test was used to detect city clusters and to identify clusters around industrial conglomerates. Multivariable spatial modeling assessed the effect of distance and direction from the industrial conglomerates controlling for socioeconomic status. We identified industrials sectors within a buffer of 1 km around industrial conglomerates related to the ACL clusters. Incidence rates showed geographical heterogeneity with low spatial autocorrelation within cities. The spatio-temporal tests identified one cluster in each city. The industries located within 1 km around the ACL clusters identified in the three cities represent different sectors. Exposure to air pollution from industrial sources might be contributing to the incidence of ACL cases in urban settings in Colombia.

BackgroundAir pollutants are considered carcinogenic to humans. In some European countries, an association with childhood cancer in children has been established. This phenomenon has not been addressed in Latin America, despite the spatial variability of air pollutants that may limit the extrapolation of the results to other geographical areas.ObjectiveTo conduct a spatial analysis of the relationship between childhood cancer and air pollution from industrial sources in a metropolitan area of Colombia.MethodsIncident cases of childhood cancers were obtained from the Population-based Cancer Registry of the Bucaramanga Metropolitan Area (2000-2015). Local and focused cluster tests were used for the detection of spatial clusters and the Poisson multivariable model was used to evaluate the combined effects of spatial variables.ResultsThe Kulldorff’s focused test found a significant spatial cluster (p=0.001) around one industrial agglomerate and the multivariable model results suggests that the distance effect is modified by the directional effect of the wind.ConclusionA spatial cluster of incident cases of childhood cancer occurred in the municipality of Bucaramanga. Our finding supports the hypothesis that childhood cancer might be related with industrial air pollution exposure in a Latin American city.

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