Maternal exposure to ambient air pollution and risk of early childhood cancers: A population-based study in Ontario, Canada

Éric Lavigne; Marc-André Bélair; Minh T Do; David M Stieb; Perry Hystad; Aaron van Donkelaar; Randall V Martin; Daniel L Crouse; Eric Crighton; Hong Chen; Jeffrey R Brook; Richard T Burnett; Scott Weichenthal; Paul J Villeneuve; Teresa To; Sabit Cakmak; Markey Johnson; Abdool S Yasseen 3rd; Kenneth C Johnson; Marianna Ofner; Lin Xie; Mark Walker

doi:10.1016/j.envint.2017.01.004

Maternal exposure to ambient air pollution and risk of early childhood cancers: A population-based study in Ontario, Canada

Environ Int. 2017 Mar:100:139-147. doi: 10.1016/j.envint.2017.01.004. Epub 2017 Jan 17.

Authors

Éric Lavigne¹, Marc-André Bélair², Minh T Do³, David M Stieb⁴, Perry Hystad⁵, Aaron van Donkelaar⁶, Randall V Martin⁶, Daniel L Crouse⁷, Eric Crighton⁸, Hong Chen⁹, Jeffrey R Brook¹⁰, Richard T Burnett¹¹, Scott Weichenthal¹², Paul J Villeneuve¹³, Teresa To¹⁴, Sabit Cakmak¹¹, Markey Johnson¹⁵, Abdool S Yasseen 3rd¹⁶, Kenneth C Johnson¹⁷, Marianna Ofner¹⁸, Lin Xie³, Mark Walker¹⁹

Affiliations

¹ Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: [email protected].
² Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada.
³ Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada.
⁴ School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada; Population Studies Division, Health Canada, Vancouver, British Columbia, Canada.
⁵ College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA.
⁶ Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada.
⁷ Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada.
⁸ Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada; Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada.
⁹ Public Health Ontario, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
¹⁰ Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Air Quality Research Division, Environment Canada, Downsview, Ontario, Canada.
¹¹ Population Studies Division, Health Canada, Ottawa, Ontario, Canada.
¹² Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
¹³ Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada.
¹⁴ Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁵ Air Health Science Division, Health Canada, Ottawa, Ontario, Canada.
¹⁶ Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry and Network Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
¹⁷ School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹⁸ Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Global Health and Guideline Division, Public Health Agency of Canada, Toronto, Ontario, Canada.
¹⁹ Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry and Network Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada.

PMID: 28108116
DOI: 10.1016/j.envint.2017.01.004

Abstract

Background: There are increasing concerns regarding the role of exposure to ambient air pollution during pregnancy in the development of early childhood cancers.

Objective: This population based study examined whether prenatal and early life (<1year of age) exposures to ambient air pollutants, including nitrogen dioxide (NO₂) and particulate matter with aerodynamic diameters ≤2.5μm (PM_2.5), were associated with selected common early childhood cancers in Canada.

Methods: 2,350,898 singleton live births occurring between 1988 and 2012 were identified in the province of Ontario, Canada. We assigned temporally varying satellite-derived estimates of PM_2.5 and land-use regression model estimates of NO₂ to maternal residences during pregnancy. Incident cases of 13 subtypes of pediatric cancers among children up to age 6 until 2013 were ascertained through administrative health data linkages. Associations of trimester-specific, overall pregnancy and first year of life exposures were evaluated using Cox proportional hazards models, adjusting for potential confounders.

Results: A total of 2044 childhood cancers were identified. Exposure to PM_2.5, per interquartile range increase, over the entire pregnancy, and during the first trimester was associated with an increased risk of astrocytoma (hazard ratio (HR) per 3.9μg/m3=1.38 (95% CI: 1.01, 1.88) and, HR per 4.0μg/m³=1.40 (95% CI: 1.05-1.86), respectively). We also found a positive association between first trimester NO₂ and acute lymphoblastic leukemia (ALL) (HR=1.20 (95% CI: 1.02-1.41) per IQR (13.3ppb)).

Conclusions: In this population-based study in the largest province of Canada, results suggest an association between exposure to ambient air pollution during pregnancy, especially in the first trimester and an increased risk of astrocytoma and ALL. Further studies are required to replicate the findings of this study with adjustment for important individual-level confounders.

Keywords: Air pollution; Childhood cancer; Maternal; Prenatal.

MeSH terms

Air Pollutants / toxicity*
Air Pollution*
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Maternal Exposure / adverse effects*
Neoplasms / chemically induced
Neoplasms / epidemiology*
Nitrogen Dioxide / toxicity
Ontario / epidemiology
Particulate Matter / toxicity
Pregnancy
Prenatal Exposure Delayed Effects / chemically induced
Prenatal Exposure Delayed Effects / epidemiology*
Risk

Substances

Air Pollutants
Particulate Matter
Nitrogen Dioxide