父母亲化学物质暴露与儿童急性白血病发病关系的探讨

Relationship between parental exposure to chemicals and risk of childhood acute leukemia

目的探讨父母亲化学物质暴露与儿童急性白血病发病的关系。方法选取2009年1月1日至2010年12月31日所有就诊于上海地区3家儿童医院年龄小于15周岁的201例新发急性白血病的儿童，在病例所在医院的儿童保健门诊或骨科选取同性别同年龄的对照儿童201例，对其母亲进行面对面的访谈式调查。结果母亲孕前3个月至孕期总化学物质（柴油、汽油、油漆、杀虫剂、农药、除草剂、化肥）接触史（OR=2．9，95％CI=1．1～7．8）及父亲在母亲孕前3个月接触杀虫剂（OR=10．1，95％CI=1．2～82．9）、化肥（OR=9．5，95％CI=1．1～79．6）；母亲孕前从事农业、林业工作（OR=8．4，95％CI=1．4～50．2）；孕前及孕期从事纺织、皮革、装潢、汽修（孕前：OR=3．0，95％CI=1．2-7．9；孕期：OR=3．2，95％CI=1．1～9．6）；父亲从事农业、林业（OR=9．6，95％CI=2．1～44．8）及纺织、皮革、装潢、汽修工作（OR=2．3，95％CI=1．1～5．0）等因素可能是儿童急性白血病发病的危险因素。结论父母亲化学物质暴露可能会增加后代患急性白血病的风险。

Objective To investigate the relationship between parental exposure to chemicals and the risk of childhood acute leukemia. Methods An exploratory case-control study was conducted among 201 new cases of childhood acute leukemia under 15 years old who went to 3 children＇s hospitals in Shanghai, China from January 1, 2009 to December 31,2010, as well as 201 sex-and age-matched children （as controls） who went to the child health care clinic or department of orthopedics in the above hospitals. A survey was performed by face-to-face interviews with children＇s mothers. Results The risk factors for childhood acute leukemia might include maternal exposure to total chemicals （diesel oil, gasoline, paints, insecticides, pesticides, herbicides, and chemical fertilizers） from 3 months before pregnancy to the end of pregnancy （OR=2.9, 95%CI=1.1-7.8）, paternal exposure to insecticides （OR=10.1, 95%CI=1.2-82.9） and chemical fertilizers （OR=9.5, 95%CI=1.1- 79.6） within 3 months before pregnancy, maternal working experiences in agriculture and forestry before pregnancy （OR=8,4, 95%CI=1.4-50.2） and in spinning, leather processing, decoration, and vehicle repair before pregnancy （OR=3.0, 95%CI=1.2-7.9） and during pregnancy （OR=3.2, 95%CI=1.1-9.6）, and paternal working experiences in agriculture and forestry （OR=9.6, 95%CI=2.1-44.8） and in spinning, leather processing, decoration, and vehicle repair （OR=2.3, 95%C1=1.1-5.0）. Conclusion Parental exposure to chemicals may increase the risk of childhood acute leukemia in their offspring.