Evidence map›Paper›PMID 20110276›Full record

SynthesisInternational journal of epidemiology2010

A meta-analysis of the association between day-care attendance and childhood acute lymphoblastic leukaemia.

Kevin Y Urayama, Patricia A Buffler, Emily R Gallagher, Julie M Ayoob, Xiaomei Ma

Registry-linked trialOpen access · bronzeAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of epidemiology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00015587 (Chemical Exposures and Leukemia Risks and Childhood Leukemia and Environmental Exposure), which is not on this map. Cited by 70 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 6 pooled it
11.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00015587 completednot on this map

Chemical Exposures and Leukemia Risks and Childhood Leukemia and Environmental Exposure

TypeobservationalSponsorNational Institute of Environmental Health Sciences (NIEHS)Ran1995 to 2016Enrolled3,523ConditionsLeukemia, Acute Myelocytic Leukemia, Acute Lymphoblastic Leukemia, Acute Myelogenous Leukemia
3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 6 syntheses or guidelines pooled it, 138 citations in OpenAlex.

  1. Pooled it
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  6. Pooled it
  7. Trial
  8. BMJ open · 2026
    Article
  9. Review
  10. Review
  11. Childhood B cell leukemia: Intercepting the paths to progression.BioEssays : news and reviews in molecular, cellular and developmental biology · 2024
    Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Review
  19. Review
  20. Article

10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Kevin Y UrayamaSchool of Public Health, University of California, Berkeley, CA 94720, USA. urayamak@fellows.iarc.fr
Patricia A Buffler
Emily R Gallagher
Julie M Ayoob
Xiaomei Ma
University of California, San Francisco · US

Funding

Training CoreP42ES004705 · NIEHS · UNIVERSITY OF CALIFORNIA BERKELEY · PI MCHALE, CLIONA · 1987 to 2025
$74.6M
Environmental and Molecular Epidemiology of Childhood LeukemiaR01ES009137 · NIEHS · UNIVERSITY OF CALIFORNIA BERKELEY · PI METAYER, CATHERINE · 1999 to 2013
$21.1M
NIEHS NIH HHS PS42 ES04705NIEHS NIH HHS R01 ES09137
6 · The paper itself

Abstract

backgroundChildhood acute lymphoblastic leukaemia (ALL) may be the result of a rare response to common infection(s) acquired by personal contact with infected individuals. A meta-analysis was conducted to examine the relationship between day-care attendance and risk of childhood ALL, specifically to address whether early-life exposure to infection is protective against ALL.

methodsSearches of the PubMed database and bibliographies of publications on childhood leukaemia and infections were conducted. Observational studies of any size or location and published in English resulted in the inclusion of 14 case-control studies.

resultsThe combined odds ratio (OR) based on the random effects model indicated that day-care attendance is associated with a reduced risk of ALL [OR = 0.76, 95% confidence interval (CI): 0.67, 0.87]. In subgroup analyses evaluating the influence of timing of exposure, a similarly reduced effect was observed for both day-care attendance occurring early in life (< or =2 years of age) (OR = 0.79, 95% CI: 0.65, 0.95) and day-care attendance with unspecified timing (anytime prior to diagnosis) (OR = 0.81, 95% CI: 0.70, 0.94). Similar findings were observed with seven studies in which common ALL were analysed separately. The reduced risk estimates persisted in sensitivity analyses that examined the sources of study heterogeneity.

conclusionsThis analysis provides strong support for an association between exposure to common infections in early childhood and a reduced risk of ALL. Implications of a 'hygiene'-related aetiology suggest that some form of prophylactic intervention in infancy may be possible.

Indexed as

Case-Control StudiesChildChild Day Care CentersCommunicable DiseasesHumansPrecursor Cell Lymphoblastic Leukemia-LymphomaRisk Assessment

Identifiers

PMID20110276
PMCPMC2878455
OpenAlexW2103456856

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.