Evidence map›Paper›PMID 31017485›Full record

SynthesisEnvironmental health perspectives2019

Association between Outdoor Air Pollution and Childhood Leukemia: A Systematic Review and Dose-Response Meta-Analysis.

Tommaso Filippini, Elizabeth E Hatch, Kenneth J Rothman, Julia E Heck, Andrew S Park, Alessio Crippa, Nicola Orsini, Marco Vinceti

Open access · diamondAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Environmental health perspectives, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 11 pooled it
9.4field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 11 syntheses or guidelines pooled it, 162 citations in OpenAlex.

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  8. Exposure to outdoor air pollution at different periods and the risk of leukemia: a meta-analysis.Environmental science and pollution research international · 2021
    Pooled it
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  10. Environmental Risk Factors and Health: An Umbrella Review of Meta-Analyses.International journal of environmental research and public health · 2021
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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Tommaso Filippini1 Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia , Modena, Italy.
Elizabeth E Hatch2 Department of Epidemiology, Boston University School of Public Health , Boston, Massachusetts, USA.
Kenneth J Rothman2 Department of Epidemiology, Boston University School of Public Health , Boston, Massachusetts, USA.
Julia E Heck4 Department of Epidemiology, UCLA Fielding School of Public Health , Los Angeles, California, USA.
Andrew S Park4 Department of Epidemiology, UCLA Fielding School of Public Health , Los Angeles, California, USA.
Alessio Crippa5 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm, Sweden.
Nicola Orsini6 Department of Public Health Sciences, Karolinska Institutet , Stockholm, Sweden.
Marco Vinceti1 Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia , Modena, Italy.
Boston University · USKarolinska Institutet · SEUCLA Health · USUniversity of Modena and Reggio Emilia · IT

Funding

Air Pollution and Childhood Cancers in CaliforniaR21ES018960 · NIEHS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI HECK, JULIA · 2010 to 2011
$421k
NIEHS NIH HHS R21 ES018960
6 · The paper itself

Abstract

backgroundA causal link between outdoor air pollution and childhood leukemia has been proposed, but some older studies suffer from methodological drawbacks. To the best of our knowledge, no systematic reviews have summarized the most recently published evidence and no analyses have examined the dose-response relation.

objectiveWe investigated the extent to which outdoor air pollution, especially as resulting from traffic-related contaminants, affects the risk of childhood leukemia.

methodsWe searched all case-control and cohort studies that have investigated the risk of childhood leukemia in relation to exposure either to motorized traffic and related contaminants, based on various traffic-related metrics (number of vehicles in the closest roads, road density, and distance from major roads), or to measured or modeled levels of air contaminants such as benzene, nitrogen dioxide, 1,3-butadiene, and particulate matter. We carried out a meta-analysis of all eligible studies, including nine studies published since the last systematic review and, when possible, we fit a dose-response curve using a restricted cubic spline regression model.

resultsWe found 29 studies eligible to be included in our review. In the dose-response analysis, we found little association between disease risk and traffic indicators near the child's residence for most of the exposure range, with an indication of a possible excess risk only at the highest levels. In contrast, benzene exposure was positively and approximately linearly associated with risk of childhood leukemia, particularly for acute myeloid leukemia, among children under 6 y of age, and when exposure assessment at the time of diagnosis was used. Exposure to nitrogen dioxide showed little association with leukemia risk except at the highest levels. DISCUSSION: Overall, the epidemiologic literature appears to support an association between benzene and childhood leukemia risk, with no indication of any threshold effect. A role for other measured and unmeasured pollutants from motorized traffic is also possible. https://doi.org/10.1289/EHP4381.

Indexed as

Air PollutantsAir PollutionChildChild, PreschoolDose-Response Relationship, DrugEnvironmental ExposureFemaleHumansInfantInfant, NewbornLeukemiaMaleVehicle EmissionsAir PollutantsVehicle Emissions

Identifiers

PMID31017485
PMCPMC6785230
OpenAlexW2941058628

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.