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      Childhood leukaemia and ordnance factories in west Cumbria during the Second World War

      other
      1 , *
      British Journal of Cancer
      leukaemia, childhood, epidemiology, population mixing, infection, construction, rural, wartime

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          Abstract

          Much evidence has accumulated that childhood leukaemia (CL) is a rare response to a common, but unidentified, infection and in particular that situations involving the unusual mixing of urban and rural groups (approximating to, respectively, groups infected with, and susceptible to, the relevant microorganism) can produce localised epidemics with consequent increases of the infrequent leukaemic complication. During the Second World War, explosives production factories were built and operated at Drigg and Sellafield, and a shell filling factory at Bootle, in west Cumbria, England, requiring substantial numbers of construction workers to be brought into this remote and isolated area. Following the design of an earlier study of CL near large (post-war) rural construction sites, mortality from this disease was investigated with the help of the Office of National Statistics, in the area around these Cumbrian factories where local workers largely lived, during the construction period and with particular reference to the overlapping construction and operational phase when the mixing of local and migrant workers would have been greatest. An excess of leukaemia deaths at ages 1–14 was found during the construction period (observed 3; observed/expected (O/E) 2.2, 95% confidence interval (CI): 0.6, 6.0), which was more marked and statistically significant during the overlap with operations (O 3; O/E 4.5, 95% CI: 1.1, 12.2), especially at ages 1–4 (O 2; O/E 7.1, CI: 1.2, 23.6). A previous investigation did not detect this excess because it considered only a small part of west Cumbria that omitted the communities where most of the workforce lived, having incorrectly attributed the post-war expansion of the village of Seascale (situated between Drigg and Sellafield) to the wartime ordnance factories. The present findings are consistent with the results of the earlier study of rural construction projects and with the general evidence that marked rural–urban population mixing increases the risk of CL.

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          Most cited references30

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          Epidemiological evidence for an infective basis in childhood leukaemia.

          L Kinlen (1995)
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            Evidence for an infective cause of childhood leukaemia: comparison of a Scottish new town with nuclear reprocessing sites in Britain.

            L Kinlen (1988)
            Increases of leukaemia in young people that cannot be explained in terms of radiation have been recorded near both of Britain's nuclear reprocessing plants at Dounreay and Sellafield. These were built in unusually isolated places where herd immunity to a postulated widespread virus infection (to which leukaemia is a rare response) would tend to be lower than average. The large influxes of people in the 1950s to those areas might have been conducive to epidemics. The hypothesis has been tested in Scotland in an area identified at the outset as the only other rural area that received a large influx at the same time, when it was much more cut off from the nearest conurbation than at present--the New Town of Glenrothes. A significant increase of leukaemia below age 25 was found (10 observed, expected 3.6), with a greater excess below age 5 (7 observed, expected 1.5).
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              Evidence from population mixing in British New Towns 1946-85 of an infective basis for childhood leukaemia.

              Mortality from leukaemia under age 25 was studied in British New Towns to test the hypothesis that leukaemia represents a rare response to a much commoner (but unrecognised) infection, the transmission of which is facilitated when large numbers of people come together. The density of children was higher in the rural, but lower in the overspill, New Towns than in the areas from which their incomers originated. Residents of the rural New Towns had greater diversity of origin than those of the overspill towns of London and Glasgow. These two factors would encourage a greater rise in the postulated underlying infection in the rural towns, and in these a significant excess of leukaemia at ages 0-4 was found in 1946-65. In both sets of towns there was a significant deficit in other age groups consistent with immunising effects of the relevant infection. There are parallels with feline leukaemia virus infection, in which contrasting leukaemogenic and immunising effects occur in different social settings owing mainly to differences in intensity of viral exposure.
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                Author and article information

                Journal
                Br J Cancer
                British Journal of Cancer
                0007-0920
                1532-1827
                27 June 2006
                03 July 2006
                : 95
                : 1
                : 102-106
                Affiliations
                [1 ]Cancer Research UK Epidemiology Unit, University of Oxford , Richard Doll Building, Roosevelt Drive, Headington, Oxford OX3 7LF, UK
                Author notes
                [* ]Author for correspondence: leo.kinlen@ 123456dphpc.ox.ac.uk
                Article
                6603199
                10.1038/sj.bjc.6603199
                2360485
                16755299
                3a4c896a-4ccf-43ee-bc88-7d818a93bb6d
                Copyright 2006, Cancer Research UK
                History
                : 31 March 2006
                : 08 May 2006
                : 10 May 2006
                Categories
                Epidemiology

                Oncology & Radiotherapy
                wartime,population mixing,childhood,rural,leukaemia,infection,epidemiology,construction

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