Infantile neuroblastoma and maternal occupational exposure to medical agents.

Yuhki Koga,Yuri Sonoda,Utako Oba,Koichi Kusuhara,Shouichi Ohga,Masafumi Sanefuji,Kentaro Nakashima,Maya Suzuki,Syunichiro Toya,Shunsuke Yamamoto,Hiroaki Ono,Masanobu Ogawa,Haruyuki Yamamoto

doi:10.1038/s41390-021-01634-z

Abstract

Healthcare workers are often exposed to hazardous agents and are at risk for adverse health consequences that affect not only themselves but also their infants. This study aimed to examine whether such occupational exposure increased the risk of childhood cancer in offspring. We used the dataset of the Japan Environment and Children's Study, a nationwide birth cohort involving over 100,000 mother-child pairs. Information was obtained via successive questionnaires that were completed until the child turned 1 year of age. The parents were asked whether they occupationally handled medical agents during pregnancy. A total of 26 infants developed neoplasms: neuroblastoma, leukemia, and brain tumor. The incidence of neuroblastoma was significantly higher in infants whose mothers were exposed to radiation (3/2142: 140.1 per 100,000 population) than in those who were not (12/90,384: 13.3 per 100,000 population). Multivariable regression analyses revealed a close association between maternal irradiation and the development of neuroblastoma (adjusted incident rate ratio: 10.68 [95% confidence interval: 2.98‒38.27]). The present study demonstrated, for the first time, a potential association between maternal occupational exposure and the occurrence of neuroblastoma in offspring. Further studies involving the large pediatric cancer registries are needed to confirm these preliminary results. Healthcare workers are often exposed to hazardous agents and are at risk for adverse health consequences that affect not only themselves but also their infants. This study examined the association between such occupational exposure and offspring's cancers that developed until the age of 1 year. Maternal exposure to ionizing radiation was associated with infantile neuroblastoma in offspring. Further studies involving the large pediatric cancer registries are needed to confirm these preliminary results.

Highlights

Cancer is rare in childhood but a severe life-threatening disease
The etiology of childhood cancer remains uncertain, several studies have suggested that parental exposure to various environmental factors plays a role in the development of cancers in offspring
Children who were exposed to anticancer drugs or anesthetics but not radiation did not develop subsequent neuroblastoma, suggesting that radiation was a requisite for the development of neuroblastoma

Summary

Introduction

Cancer is rare in childhood but a severe life-threatening disease. the etiology of childhood cancer remains uncertain, several studies have suggested that parental exposure to various environmental factors plays a role in the development of cancers in offspring. A large number of studies, which almost always used a case–control design, have reported that the environmental factors are suspected to be air pollution, pesticides, and cigarette smoke in the living environment of the parents.[1] In addition, some parents may be occupationally exposed to specific environment that has a potential carcinogenic effect on childhood cancer.[2] Among various occupations, healthcare workers often handle hazardous agents, such as ionizing radiation and anticancer drugs in their workplaces. It has previously been demonstrated that ionizing radiation promotes the development of childhood leukemia.[3] Anticancer drugs increase the risk of acute leukemia in the healthcare workers who handle them.[4] to our knowledge, no studies have comprehensively addressed the relationship between occupational exposure to such medical agents and infantile cancer in offspring. Further studies involving the large pediatric cancer registries are needed to confirm these preliminary results

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Conclusion