Radon Exposure and the Risk of Leukemia

Laurier, Dominique; Valenty, Madeleine; Tirmarche, M.

doi:10.1097/00004032-200109000-00009

Cited by 93 publications

(20 citation statements)

References 69 publications

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“…Previous case–control studies have reported participation < 55%, and exposure measurements were often limited to subsets of study participants (Cartwright et al 2002; Kaletsch et al 1999; Lubin et al 1998; Maged et al 2000; Steinbuch et al 1999; Stjernfeldt et al 1987). In contrast with ecological studies, we had information on a number of potential individual-level confounders (Laurier et al 2001; Tong et al 2012), although adjusting for these variables did not materially affect hazard ratios, suggesting little or no confounding by these factors although we cannot completely exclude residual confounding due to misclassification in the confounder variables. This is consistent with the current knowledge on childhood cancer etiology: There is evidence of increased risks among children with a genetic predisposition and among those exposed to high doses of ionizing radiation (e.g., applied for cancer treatment), but little evidence of environmental risk factors (Belson et al 2007; Eden 2010; McKinney 2005; Pollack and Jakacki 2011).…”

Section: Discussionmentioning

confidence: 99%

“…However, because these were population-level analyses, control for individual-level confounders was not possible. Results of case–control studies have been inconsistent (Laurier et al 2001; Tong et al 2012), with some studies reporting an association (Maged et al 2000; Raaschou-Nielsen et al 2008) and others not (Cartwright et al 2002; Kaletsch et al 1999; Kendall et al 2013; Lubin et al 1998; Steinbuch et al 1999; Stjernfeldt et al 1987). A recent analysis of a Danish case–control study reported evidence that air pollution from road traffic might enhance the association between radon and childhood leukemia (Bräuner et al 2012).…”

Section: Introductionmentioning

confidence: 99%

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Domestic Radon Exposure and Risk of Childhood Cancer: A Prospective Census-Based Cohort Study

Hauri

Spycher²,

Huss³

et al. 2013

Environ Health Perspect

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Background: In contrast with established evidence linking high doses of ionizing radiation with childhood cancer, research on low-dose ionizing radiation and childhood cancer has produced inconsistent results.Objective: We investigated the association between domestic radon exposure and childhood cancers, particularly leukemia and central nervous system (CNS) tumors.Methods: We conducted a nationwide census-based cohort study including all children < 16 years of age living in Switzerland on 5 December 2000, the date of the 2000 census. Follow-up lasted until the date of diagnosis, death, emigration, a child’s 16th birthday, or 31 December 2008. Domestic radon levels were estimated for each individual home address using a model developed and validated based on approximately 45,000 measurements taken throughout Switzerland. Data were analyzed with Cox proportional hazard models adjusted for child age, child sex, birth order, parents’ socioeconomic status, environmental gamma radiation, and period effects.Results: In total, 997 childhood cancer cases were included in the study. Compared with children exposed to a radon concentration below the median (< 77.7 Bq/m3), adjusted hazard ratios for children with exposure ≥ the 90th percentile (≥ 139.9 Bq/m3) were 0.93 (95% CI: 0.74, 1.16) for all cancers, 0.95 (95% CI: 0.63, 1.43) for all leukemias, 0.90 (95% CI: 0.56, 1.43) for acute lymphoblastic leukemia, and 1.05 (95% CI: 0.68, 1.61) for CNS tumors.Conclusions: We did not find evidence that domestic radon exposure is associated with childhood cancer, despite relatively high radon levels in Switzerland.Citation: Hauri D, Spycher B, Huss A, Zimmermann F, Grotzer M, von der Weid N, Weber D, Spoerri A, Kuehni C, Röösli M, for the Swiss National Cohort and the Swiss Paediatric Oncology Group (SPOG). 2013. Domestic radon exposure and risk of childhood cancer: a prospective census-based cohort study. Environ Health Perspect 121:1239–1244; http://dx.doi.org/10.1289/ehp.1306500

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Domestic Radon Exposure and Risk of Childhood Cancer: A Prospective Census-Based Cohort Study

Hauri

Spycher²,

Huss³

et al. 2013

Environ Health Perspect

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“…As stated in several reviews (Laurier et al 2001; Raaschou-Nielsen 2008; Tong et al 2012), most of the studies found positive correlations with radon, whereas no evidence was found for gamma radiation exposure. Population-based case–control studies that included interviews and in-home measurements have reported mixed results, mostly nonsignificant (Raaschou-Nielsen 2008), but their interpretation is hindered by the generally limited participation rates and the subsequent potential for selection bias.…”

Section: Introductionmentioning

confidence: 92%

Residential Exposure to Natural Background Radiation and Risk of Childhood Acute Leukemia in France, 1990–2009

Demoury

Marquant

Ielsch

et al. 2017

Environ Health Perspect

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Background:Exposures to high-dose ionizing radiation and high-dose rate ionizing radiation are established risk factors for childhood acute leukemia (AL). The risk of AL following exposure to lower doses due to natural background radiation (NBR) has yet to be conclusively determined.Methods:AL cases diagnosed over 1990–2009 (9,056 cases) were identified and their municipality of residence at diagnosis collected by the National Registry of Childhood Cancers. The Geocap study, which included the 2,763 cases in 2002–2007 and 30,000 population controls, was used for complementary analyses. NBR exposures were modeled on a fine scale (36,326 municipalities) based on measurement campaigns and geological data. The power to detect an association between AL and dose to the red bone marrow (RBM) fitting UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation) predictions was 92%, 45% and 99% for exposure to natural gamma radiation, radon and total radiation, respectively.Results:AL risk, irrespective of subtype and age group, was not associated with the exposure of municipalities to radon or gamma radiation in terms of yearly exposure at age reached, cumulative exposure or RBM dose. There was no confounding effect of census-based socio-demographic indicators, or environmental factors (road traffic, high voltage power lines, vicinity of nuclear plants) related to AL in the Geocap study.Conclusions:Our findings do not support the hypothesis that residential exposure to NBR increases the risk of AL, despite the large size of the study, fine scale exposure estimates and wide range of exposures over France. However, our results at the time of diagnosis do not rule out a slight association with gamma radiation at the time of birth, which would be more in line with the recent findings in the UK and Switzerland.Citation:Demoury C, Marquant F, Ielsch G, Goujon S, Debayle C, Faure L, Coste A, Laurent O, Guillevic J, Laurier D, Hémon D, Clavel J. 2017. Residential exposure to natural background radiation and risk of childhood acute leukemia in France, 1990–2009. Environ Health Perspect 125:714–720; http://dx.doi.org/10.1289/EHP296

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“…Nevertheless, at present, no effect other than lung cancer can be ascribed to radon exposure [50]. For leukaemia, numerous studies have been performed, but a positive association suggested by ecological studies has not been confirmed by studies based on individual data [60, 61]. …”

Section: Review Of Health and Biological Effectsmentioning

confidence: 99%

Human exposure to high natural background radiation: what can it teach us about radiation risks?

et al. 2009

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Natural radiation is the major source of human exposure to ionising radiation, and its largest contributing component to effective dose arises from inhalation of 222Rn and its radioactive progeny. However, despite extensive knowledge of radiation risks gained through epidemiologic investigations and mechanistic considerations, the health effects of chronic low-level radiation exposure are still poorly understood. The present paper reviews the possible contribution of studies of populations living in high natural background radiation (HNBR) areas (Guarapari, Brazil; Kerala, India; Ramsar, Iran; Yangjiang, China), including radon-prone areas, to low dose risk estimation. Much of the direct information about risk related to HNBR comes from case–control studies of radon and lung cancer, which provide convincing evidence of an association between long-term protracted radiation exposures in the general population and disease incidence. The success of these studies is mainly due to the careful organ dose reconstruction (with relatively high doses to the lung), and to the fact that large-scale collaborative studies have been conducted to maximise the statistical power and to ensure the systematic collection of information on potential confounding factors. In contrast, studies in other (non-radon) HNBR areas have provided little information, relying mainly on ecological designs and very rough effective dose categorisations. Recent steps taken in China and India to establish cohorts for follow-up and to conduct nested case–control studies may provide useful information about risks in the future, provided that careful organ dose reconstruction is possible and information is collected on potential confounding factors.

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Radon Exposure and the Risk of Leukemia

Cited by 93 publications

References 69 publications

Domestic Radon Exposure and Risk of Childhood Cancer: A Prospective Census-Based Cohort Study

Domestic Radon Exposure and Risk of Childhood Cancer: A Prospective Census-Based Cohort Study

Residential Exposure to Natural Background Radiation and Risk of Childhood Acute Leukemia in France, 1990–2009

Human exposure to high natural background radiation: what can it teach us about radiation risks?

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