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Overall environmental quality and incidence of childhood cancers
Citation:
Jagai, J., L. Messer, S. Grabich, K. Rappazzo, Y. Jian, C. Gray, AND D. Lobdell. Overall environmental quality and incidence of childhood cancers. Epidemiology Congress of the Americas 2016, Miami, FL, June 21 - 24, 2016.
Impact/Purpose:
The purpose of this study was to explore overall environmental quality in relation to childhood cancer incidence rates in the U.S., rural/urban distinctions. This study utilized the EPA created Environmental Quality Index.
Description:
Childhood cancer is associated with individual ambient environmental exposures such as hazardous air pollutants and pesticides. However, the role of cumulative ambient environmental exposures is not well-understood. To estimate cumulative environmental exposures, an Environmental Quality Index (EQI) for 2000-2005 was constructed representing five environmental domains (air, water, land, built and sociodemographic) for each U.S. county. Annual county-level, age-adjusted, childhood cancer incidence rates for 2006-2010 from Surveillance, Epidemiology, and End Results Program (SEER) 18 Registries were linked to the EQI. Random intercept fixed slope linear models, for the relationship between EQI quintiles and childhood cancer incidence, were estimated for counties for which data were available (n=611). Incidence rate differences (95% CI) comparing highest quintile/worst environmental quality to lowest quintile/best quality are reported. All cause childhood cancer was positively, though not significantly, associated with EQI (1.20(-2.60, 5.00)). Models were also stratified by four rural-urban continuum codes (RUCC) ranging from metropolitan urbanized (RUCC1) to rural (RUCC4). We observed positive associations between all cause childhood cancer and EQI (RUCC1: 1.79 (0.24, 3.34); RUCC2: 3.45 (-1.05, 5.84), RUCC3: 0.70 (-2.41, 3.81), RUCC4: 6.07 (-2.49, 14.63)). Significant positive associations were seen in only in the most urbanized areas. Further, when assessing associations by individual environmental domains, we observed positive associations in the land, built and sociodemographic domains (2.68 (0.37, 5.00), 0. 60 (-4.12, 5.32), 2.43 (-1.69, 6.56) respectively). These results suggest that cumulative environmental exposure is associated with childhood cancer risk, and associations vary by urbanicity. This abstract does not necessarily reflect EPA policy.