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      Cancer in the offspring of female radiation workers: a record linkage study

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          Abstract

          This study uses record linkage between the National Registry of Childhood Tumours (NRCT) and the National Registry for Radiation Workers to re-assess our earlier finding that the offspring of women radiation workers exposed to ionising radiation before the child's conception may be at an increased risk of childhood cancer. An additional 16 964 childhood cancer patients taken from the NRCT, together with the same number of matched controls, are included. Pooled analyses, based on the new and original datasets, include 52 612 cases and their matched controls. Relative risks (RRs) for maternal employment as a radiation worker, maternal exposure or not during the relevant pregnancy and pattern of employment relative to conception and diagnosis dates were calculated.

          The new data provide no evidence of an increased risk of childhood cancer associated with maternal preconception radiation work and thus do not support our earlier finding of a raised risk in the offspring of female radiation workers. Considering the pooled data, a weak association was found between maternal radiation work during pregnancy and childhood cancer in offspring although the evidence is limited by the small numbers of linked cases and controls.

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          Most cited references28

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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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              An infectious aetiology for childhood acute leukaemia: a review of the evidence.

              There are three current hypotheses concerning infectious mechanisms in the aetiology of childhood leukaemia: exposure in utero or around the time of birth, delayed exposure beyond the first year of life to common infections and unusual population mixing. No specific virus has been definitively linked with childhood leukaemia and there is no evidence to date of viral genomic inclusions within leukaemic cells. The case-control and cohort studies have revealed equivocal results. Maternal infection during pregnancy has been linked with increased risk whilst breast feeding and day care attendance in the first year of life appear to be protective. There is inconclusive evidence from studies on early childhood infectious exposures, vaccination and social mixing. Some supportive evidence for an infectious aetiology is provided by the findings of space-time clustering and seasonal variation. Spatial clustering suggests that higher incidence is confined to specific areas with increased levels of population mixing, particularly in previously isolated populations. Ecological studies have also shown excess incidence with higher population mixing. The marked childhood peak in resource-rich countries and an increased incidence of the childhood peak in acute lymphoblastic leukaemia (ALL) (occurring at ages 2-6 years predominantly with precursor B-cell ALL) is supportive of the concept that reduced early infection may play a role. Genetically determined individual response to infection may be critical in the proliferation of preleukaemic clones as evidenced by the human leucocyte antigen class II polymorphic variant association with precursor B-cell and T-cell ALL.
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                Author and article information

                Journal
                Br J Cancer
                British Journal of Cancer
                Nature Publishing Group
                0007-0920
                1532-1827
                06 January 2009
                13 January 2009
                : 100
                : 1
                : 213-218
                Affiliations
                [1 ]University of Oxford, Childhood Cancer Research Group 57 Woodstock Road, Oxford OX2 6HJ, UK
                [2 ]Radiation Protection Division, Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Chilton, Didcot Oxfordshire OX11 0RQ, UK
                Author notes
                [* ]Author for correspondence: kathryn.bunch@ 123456ccrg.ox.ac.uk
                Article
                6604841
                10.1038/sj.bjc.6604841
                2634667
                19127273
                c0713986-fb1b-480b-bbb8-306487acf75a
                Copyright 2009, Cancer Research UK
                History
                : 02 September 2008
                : 28 November 2008
                Categories
                Epidemiology

                Oncology & Radiotherapy
                ionising radiation,in utero exposure,childhood cancer,preconception irradiation,occupational exposure

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