Exploring Urban Green Spaces' Effect against Traffic Exposure on Childhood Leukaemia Incidence

Int J Environ Res Public Health. 2023 Jan 31;20(3):2506. doi: 10.3390/ijerph20032506.

Abstract

Background: Several environmental factors seem to be involved in childhood leukaemia incidence. Traffic exposure could increase the risk while urban green spaces (UGS) exposure could reduce it. However, there is no evidence how these two factors interact on this infant pathology.

Objectives: to evaluate how residential proximity to UGS could be an environmental protective factor against traffic exposure on childhood leukaemia incidence.

Methods: A population-based case control study was conducted across thirty Spanish regions during the period 2000-2018. It included 2526 incident cases and 15,156, individually matched by sex, year-of-birth, and place-of-residence. Using the geographical coordinates of the participants' home residences, a 500 m proxy for exposure to UGS was built. Annual average daily traffic (AADT) was estimated for all types of roads 100 m near the children's residence. Odds ratios (ORs) and 95% confidence intervals (95% CIs), UGS, traffic exposure, and their possible interactions were calculated for overall childhood leukaemia, and the acute lymphoblastic (ALL) and acute myeloblastic leukaemia (AML) subtypes, with adjustment for socio-demographic covariates.

Results: We found an increment of childhood leukaemia incidence related to traffic exposure, for every 100 AADT increase the incidence raised 1.1% (95% CI: 0.58-1.61%). UGS exposure showed an incidence reduction for the highest exposure level, Q5 (OR = 0.63; 95% CI = 0.54-0.72). Regression models with both traffic exposure and UGS exposure variables showed similar results but the interaction was not significant.

Conclusions: Despite their opposite effects on childhood leukaemia incidence individually, our results do not suggest a possible interaction between both exposures. This is the first study about the interaction of these two environmental factors; consequently, it is necessary to continue taking into account more individualized data and other possible environmental risk factors involved.

Keywords: childhood cancer; childhood leukaemia; environmental factors; incidence; spatial epidemiology; traffic exposure; urban green spaces.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Child
  • Environmental Exposure
  • Female
  • Housing
  • Humans
  • Incidence
  • Infant
  • Leukemia, Myeloid, Acute*
  • Parks, Recreational*

Grants and funding

This study was funded by Carlos III Institute of Health, Spain (grant numbers PI19CIII/00025, PI16CIII/00009 and EPY-505/19-PFIS), and Spain’s Health Research Fund (Fondo de Investigación Sanitaria—FIS grant number 12/01416). The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.