Environmental Risk Factors for Pediatric Acute Leukemia: Methodology and Early Findings

Pardis Nematollahi; Sina Arabi; Marjan Mansourian; Saeed Yousefian; Alireza Moafi; Sayed Nassereddin Mostafavi; Amirmansour Alavi Naeini; Afshin Ebrahimi; Karim Ebrahimpour; Mohammad Mehdi Amin; Aryan Kavosh; Niayesh Radfar; Azar Naimi; Roya Kelishadi

doi:10.4103/ijpvm.ijpvm_348_22

Environmental Risk Factors for Pediatric Acute Leukemia: Methodology and Early Findings

Int J Prev Med. 2023 Aug 28:14:103. doi: 10.4103/ijpvm.ijpvm_348_22. eCollection 2023.

Affiliations

¹ Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
² Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
³ Department of Epidemiology and Biostatistics, School of Health, Isfahan university of medical sciences, Isfahan, Iran.
⁴ Department of pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
⁵ Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
⁶ Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
⁷ Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Acute leukemia is the most common type of malignancy in children, and no major environmental risk factors have been identified relating to its pathogenesis. This study has been conducted with the aim for identifying risk factors associated with this disease.

Methods: This study was conducted in 2016-2020 among children aged <15 years residing in Isfahan Province, Iran. Children with newly diagnosed Acute lymphoblastic leukemia, including Acute myeloid leukemia (ALL and AML) were considered a case group. The control group was selected among children hospitalized in orthopedic and surgery wards in the same region. Demographic data, parental occupational exposures and educational level, maternal obstetric history, type of feeding during infancy and parental smoking habits, exposure to pesticides, and hydrocarbons besides dietary habits (using a food frequency questionnaire) were evaluated.

Results: Overall, 497 children (195 cases and 302 controls) completed the survey. In the initial analysis, there was no significant difference between case and control groups about type of milk feeding (P = 0.34) or parental age (P = 0.56); however, an association between mothers' education and increased risk for ALL was observed (P = 0.02).

Conclusions: The results of this study can be helpful in better understanding the environmental risk factors involved in the incidence of acute leukemia. Future publications based on the analysis of the database created in the present study can lead to recognizing these factors. In addition, evaluating the effect of these factors on treatment outcomes is an important step in reducing the burden of the disease.

Keywords: Epidemiology; hematology; leukemia; pediatrics.