0911 Associations between the environment and childhood malignancies

Parental smoking, alcohol and caffeine consumption may play a role, directly or indirectly through their influence on metabolism, in the aetiology of childhood malignant central nervous system (CNS) tumours. The possible associations were investigated in the Epidemiological Study on childhood Cancer and Leukemia (ESCALE) study, a national population-based case-control study carried out in France in 2003-2004. This aspect of the study included 209 cases of CNS tumours and 1681 population-based age and sex matched controls. No associations were observed between maternal smoking or alcohol consumption during pregnancy and CNS tumours. However paternal smoking during the year before birth was associated with CNS tumours (p 0.04), particularly astrocytomas [OR: 3.1 (1.3-7.6)]. There was also a strong association between CNS tumours and the highest maternal consumption of both coffee and tea during pregnancy [OR: 4.4 (1.5-13)]. The results constitute additional evidence for a role of paternal smoking and suggest that maternal coffee and tea consumption during pregnancy may also increase the risk of subsequent CNS tumours. The study does not suggest an increased risk of CNS tumours related to alcohol consumption during pregnancy. The same ESCALE database was used to investigate other associations. These include the role of parental smoking and maternal alcohol consumption in the etiology of childhood hematopoietic malignancies (which showed that paternal smoking was significantly associated with childhood ALL (OR = 1.4 [1.1-1.7]), AML (OR = 1.5 [1.0-2.3]), Burkitt (OR = 2.0 [1.2-3.2]), and anaplastic large cell NHL (OR = 3.2 [1.2-9.1])). Associations between parental pesticide exposure and childhood hematopoietic malignancies were also studied, again showing a positive relationship. The latter have been confirmed in two recent meta-analyses. The most recent ESCALE database analysis has looked into the relationship between childhood acute leukemia and residence next to gas stations and automotive repair garage, once again demonstrating a positive association and increased cancer risk. The evidence aside, much still needs to be done e.g. to establish how these factors trigger or predispose to malignancy and whether multiple factors act summatively.

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