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Air pollution and childhood leukaemia: a nationwide case-control study in Italy
  1. C Badaloni1,
  2. A Ranucci2,
  3. G Cesaroni1,
  4. G Zanini4,
  5. D Vienneau5,6,7,
  6. F Al-Aidrous5,
  7. K De Hoogh5,
  8. C Magnani2,3,
  9. F Forastiere1,
  10. on behalf of the SETIL Study Group
  1. 1Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
  2. 2Cancer Epidemiology Unit, CPO Piedmont, Novara, Italy
  3. 3Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
  4. 4Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Bologna, Italy
  5. 5Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, Imperial College London, London, UK
  6. 6Swiss Tropical and Public Health Institute, Basel, Switzerland
  7. 7University of Basel, Basel, Switzerland
  1. Correspondence to Chiara Badaloni, Department of Epidemiology, Lazio Regional Health Service, Via di Santa Costanza 53, Rome 00198, Italy; c.badaloni{at}


Objectives Leukaemia is the most common cancer in children, but its aetiology is still poorly understood. We tested the hypothesis that traffic-related air pollution is associated with paediatric leukaemia because of chronic exposure to several potential carcinogens.

Methods The Italian SETIL study (Study on the aetiology of lymphohematopoietic malignancies in children) was conducted in 14 Italian regions. All incident cases of leukaemia in children aged ≤10 years from these regions (period 1998–2001) were eligible for enrolment. Two controls per case, matched on birth date, gender and region of residence were randomly selected from the local population registries. Exposure assessment at birth residence included traffic indicators (distance to main roads and length of main roads within 100 m) and estimates of pollutants concentrations (particulate matter -PM2.5 and PM10- and gases -NO2 and O3-) from national dispersion model and land use regression models. The association between the exposure variables and leukaemia was assessed by logistic regression analyses.

Results Participation rates were 91.4% among cases and 69.2% in controls; 620 cases (544 acute lymphocytic and 76 acute non-lymphocytic leukaemia) and 957 controls were included. Overall, when considering the residence at birth, 35.6% of cases and 42.4% of controls lived along busy roads, and the mean annual PM10 levels were 33.3 (SD=6.3) and 33.4 µg/m3 (SD=6.5), respectively. No association was found, and all ORs, independent of the method of assessment and the exposure windows, were close to the null value.

Conclusions Using various exposure assessment strategies, air pollution appears not to affect the incidence of childhood leukaemia.

  • Land use Regression Model
  • Children
  • Traffic Indicators
  • Dispersion Model

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