Abstract

BackgroundAetiology of childhood leukaemia and childhood neoplasm is poorly understood. Information on the prevalence of risk factors in the childhood population is limited. SETIL is a population based case–control study on childhood leukaemia, conducted with two companion studies on non-Hodgkin Lymphoma (NHL) and neuroblastoma. The study relies on questionnaire interviews and 50 Hz magnetic field (ELF-MF) indoor measurements. This paper discusses the SETIL study design and includes descriptive information.MethodsThe study was carried out in 14 Italian regions (78.3% of Italian population aged 0–10). It included leukaemia, NHL and neuroblastoma cases incident in 0–10 year olds in 1998–2001, registered by the Italian Association of Paediatric Haematology and Oncology (AIEOP) (accrual over 95% of estimated incidence). Two controls for each leukaemia case were randomly sampled from the Local Health Authorities rolls, matched by gender, birthdate and residence. The same controls were used in NHL and neuroblastoma studies. Parents were interviewed at home on: physical agents (ELF-MF and ionizing radiation), chemicals (smoking, solvents, traffic, insecticides), occupation, medical and personal history of children and parents, infectious diseases, immunizations and associated factors. Occupational exposure was collected using job specific modules. ELF-MF was measured in the main rooms (spot measurement) and close to child’s bed (48 hours measurement).ResultsThe study included: 683 leukaemia cases (87% ALL, 13% AnLL), 97 NHL, 155 neuroblastomas, and 1044 controls.ELF-MF long term measurements were obtained for 61.1% of controls and 81.6% of leukaemia cases; 8.8% of controls were exposed at over 0.1 microTesla (μT), 3.5% and 2.1% at respectively over 0.2 and 0.3 μT. 25% of controls’ fathers had smoked over 10 cigarettes/day during the year of conception, varying according to education and region. Maternal smoking was less common (71.4% did not smoke in pregnancy). Maternal passive smoking during pregnancy was reported by 31.2% of controls; the child’s passive smoking for 28.6%.Occupational exposure to solvents was estimated in 18.3% of controls’ fathers and 7.7% of mothers. Contact with public was more frequent among mothers (36.1%) than fathers (23.4%).ConclusionsSETIL represents a data source on exposure of Italian children to a broad array of potential carcinogenic factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s13052-014-0103-5) contains supplementary material, which is available to authorized users.

Highlights

  • Aetiology of childhood leukaemia and childhood neoplasm is poorly understood

  • Non-Hodgkin Lymphoma (NHL) and neuroblastoma in children aged 0–10 newly diagnosed between August 1998 and December 2001 were eligible for recruitment

  • In the study period the eligible cases were as follows: 745 children affected by leukaemia, 116 by non-Hodgkin Lymphoma (NHL) and 207 by neuroblastoma

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Summary

Introduction

Aetiology of childhood leukaemia and childhood neoplasm is poorly understood. Information on the prevalence of risk factors in the childhood population is limited. SETIL is a population based case–control study on childhood leukaemia, conducted with two companion studies on non-Hodgkin Lymphoma (NHL) and neuroblastoma. The aetiology of childhood neoplasms is still poorly known, even in the case of frequent tumour types such as leukaemia, non-Hodgkin Lymphomas (NHL) [1], and neuroblastoma [2]. Several possible risk factors in the aetiology of childhood leukaemia, have been investigated including ionizing radiations in pregnancy and after birth, Extremely Low-Frequency magnetic fields (ELF-MF) and radiofrequency fields, solvents, pesticides and other chemicals in the environment, infectious agents, immunizations and related factors. The aetiology of childhood NHL is poorly known, with the notable exception of Burkitt lymphoma and EBV [3]. Epidemiological studies on neuroblastoma investigated a wide range of putative risk factors, including: socioeconomic conditions, reproductive history, diagnostic x-rays, maternal exposures in pregnancy, child’s characteristics, parental occupation and related exposures, all with inconsistent results; a protective effect was observed from breastfeeding and folates in pregnancy [2]

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