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Household pesticide exposure and the risk of childhood acute leukemia in Shanghai, China


Childhood acute leukemia (AL) is the most common malignant tumor in children, but its etiology remains largely unknown. We investigated the relationship between household exposure to pesticides and childhood AL. Between 2009 and 2010 in Shanghai, a total of 248 newly diagnosed cases of AL and 111 gender-, age-, and hospital-matched controls were included. Five nonspecific dialkyl phosphate (DAP) metabolites of organophosphate pesticides (OPPs) [including dimethyl phosphate (DMP), diethyl phosphate (DEP), dimethyl thiophosphate (DMTP), diethyl thiophosphate (DETP), and diethyl dithiophosphate (DEDTP)] in the urine were analyzed by gas chromatography. The results showed that the median DMP, DEP, DMTP, DETP, and DEDEP levels adjusted for creatinine (Cr) in cases (13.2, 10.0, 31.3, 8.5, and 6.1 μg g−1, respectively) were all significantly elevated compared with those in controls (3.6, 3.6, 13.3, 2.7, and 1.7 μg g−1, respectively) (P < 0.05). The household use of mosquito repellent was significantly associated with an increased risk of childhood AL (odds ratio (OR) = 1.9; 95 % confidence interval (CI) 1.2–3.1). Moreover, higher exposures were significantly associated with an elevated risk of childhood AL for DMs, DEs, and DAPs. Our findings support the notion that the household use of pesticides may play a role in the etiology of childhood AL and provide some evidence to warrant further investigation of the link between household pesticide exposures and childhood AL in Shanghai.

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We are extremely grateful to all the mothers and children who took part and to the doctors and nurses in the Shanghai Children’s Hospital, Xinhua Hospital, Shanghai Children Medical Center, and the Children’s Hospital of Fudan University for their cooperation and help. We gratefully acknowledge the contribution of Professor Shilu Tong (School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology) for his comments and English editing on our manuscript. We also thank the staff and students of the Department of Environmental Health, Shanghai Jiao Tong University, whose efforts made the study possible. The study was supported by grants from the Natural Science Foundation of China (Grant Nos. 30901171 and 81172625), the Science and Technology Commission of Shanghai Municipality (Grant Nos. 09ZR141650 and 12ZR1416100), Shanghai Key Discipline Construction Project of Shanghai Municipal Public Health (Grant No. 12GWZX0401), and the Shanghai Jiaotong University School of Medicine Foundation (Grant Nos. 12XJ10006 and 12XJ10042).

Author information

Correspondence to Yu Gao or Ying Tian.

Additional information

Responsible editor: Philippe Garrigues

Electronic supplementary material

Below is the link to the electronic supplementary material.

Electronic Supplementary Material Table 1

Demographic information for the whole participants by unconditional logistic regression (DOC 65 kb)

Electronic Supplementary Material Table 2

Demographic information for ALL (n = 199) and AML (n = 49) by unconditional logistic regression (DOC 52 kb)

Electronic Supplementary Material Table 3

Household use of pesticides between ALL and AML cases (DOC 46 kb)

Electronic Supplementary Material Table 4

Urinary DAP metabolite measurements in ALL (n = 199) and AML (n = 49) (DOC 36 kb)

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Zhang, Y., Gao, Y., Shi, R. et al. Household pesticide exposure and the risk of childhood acute leukemia in Shanghai, China. Environ Sci Pollut Res 22, 11755–11763 (2015). https://doi.org/10.1007/s11356-015-4362-5

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  • Child
  • Acute leukemia
  • Household
  • Pesticides
  • Case-control
  • China