Abstract
Background: A French ecological study based on 20 years of registration and 9,082 ALL described a positive association between Precursor B-cell childhood acute lymphoblastic leukemia (ALL) and residential solar ultraviolet (UV) light at diagnosis. Objective: The aim of the present study was to determine if this association was modified after taking into account established or suspected individual risk factors of ALL. Material & Methods: Two French population-based case-control studies with already collected personal information on established and suspected risk factor for ALL were completed by information on residential exposure to solar UV and included in a pooled analysis. The ESCALE (2003-2004) and ESTELLE studies (2010-2011) included respectively 764 and 740 leukemia, 1681 and 1423 controls with on average the same age and sex as the cases, selected in the general population with a quota sampling method. A selection of variables available in both studies as established or suspected risk factors of AL was performed. Results: A positive association between exposure to residential UV and Pre B-cell ALL was observed (OR 3 last deciles vs 7 first ones as reference = 1.30 [1.16-1.45]), that was qualitatively and quantitatively similar to the ecological association, and similar in both studies. Domestic use of pesticides by the mother, day-care attendance before 1 year and repeated early infections were associated with residential exposure to UV among controls in at least one study. The pooled analysis of the association between UV exposure and Pre B-cell ALL that took into account established of suspected ALL risk factors revealed no modification of this association. Conclusion: In these individual studies, a positive association between the ecologically defined residential UV exposure and Pre B-cell ALL was observed. It was not modified after taking account of established of suspected risk factors of ALL.
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