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Urban-rural status affects associations between domains of environmental quality and childhood cancer
Citation:
Jagai, J., L. Messer, K. Rappazzo, Y. Jian, C. Gray, S. Grabich, AND D. Lobdell. Urban-rural status affects associations between domains of environmental quality and childhood cancer. American Public Health Association, Denver, CO, October 29 - November 02, 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. An Environmental Quality Index (EQI) for 2000-2005 was constructed to estimate cumulative environmental exposures. The EQI represents five environmental domains (air, water, land, built and sociodemographic) for each U.S. county. Annual county-level, age-adjusted, childhood (≤ 19 years) 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 were used to estimate the relationship between EQI quintiles and childhood cancer incidence for counties for which data were available (n=611). Incidence rate differences (95% confidence intervals (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 thinly-populated (RUCC4). We observed positive associations between all cause childhood cancer and EQI by RUCC; however, significant positive associations were seen in only in the most urbanized areas (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)).Further, when assessing associations by individual environmental domains, we observed significant 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). In addition, we assessed associations between EQI and the top three causes of childhood cancer. These results suggest that cumulative environmental exposure is associated with childhood cancer risk and that associations vary by urbanicity. These results can inform public health programs and intervention planning to reduce rates of childhood cancer. This abstract does not necessarily reflect EPA policy.Learning objectives:After the presentation/poster session, the attendant will be able to:1. Describe the association between overall environmental quality and childhood cancer incidence..2. Understand that the association between overall environmental quality and childhood cancer incidence varies by urban/rural status.