Methodological approaches to the study of cancer risk in the vicinity of pollution sources: the experience of a population-based case–control study of childhood cancer
Keywords: 
Materias Investigacion::Ciencias de la Salud::Oncología
Cancer risk
Childhood cancer
Methodology
Industrial pollution
Urban pollution
Case–control study
Issue Date: 
2019
Publisher: 
Springer Science and Business Media LLC
ISSN: 
1476-072X
Note: 
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Citation: 
García-Pérez, J. (Javier); Gómez-Barroso, D. (Diana); Tamayo-Uria, I. (Ibon); et al. "Methodological approaches to the study of cancer risk in the vicinity of pollution sources: the experience of a population-based case–control study of childhood cancer". International Journal of Health Geographics. 18 (12), 2019, 1 - 18
Abstract
Background: Environmental exposures are related to the risk of some types of cancer, and children are the most vulnerable group of people. This study seeks to present the methodological approaches used in the papers of our group about risk of childhood cancers in the vicinity of pollution sources (industrial and urban sites). A populationbased case–control study of incident childhood cancers in Spain and their relationship with residential proximity to industrial and urban areas was designed. Two methodological approaches using mixed multiple unconditional logistic regression models to estimate odds ratios (ORs) and 95% confdence intervals (95% CIs) were developed: (a) “near vs. far” analysis, where possible excess risks of cancers in children living near (“near”) versus those living far (“far”) from industrial and urban areas were assessed; and (b) “risk gradient” analysis, where the risk gradient in the vicinity of industries was assessed. For each one of the two approaches, three strategies of analysis were implemented: “joint”, “stratifed”, and “individualized” analysis. Incident cases were obtained from the Spanish Registry of Childhood Cancer (between 1996 and 2011). Results: Applying this methodology, associations between proximity (≤2 km) to specifc industrial and urban zones and risk (OR; 95% CI) of leukemias (1.31; 1.04–1.65 for industrial areas, and 1.28; 1.00–1.53 for urban areas), neuroblastoma (2.12; 1.18–3.83 for both industrial and urban areas), and renal (2.02; 1.16–3.52 for industrial areas) and bone (4.02; 1.73–9.34 for urban areas) tumors have been suggested. Conclusions: The two methodological approaches were used as a very useful and fexible tool to analyze the excess risk of childhood cancers in the vicinity of industrial and urban areas, which can be extrapolated and generalized to other cancers and chronic diseases, and adapted to other types of pollution sources.

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