European Journal of Epidemiology

, Volume 30, Issue 12, pp 1263–1275 | Cite as

Childhood cancer and residential exposure to highways: a nationwide cohort study

  • Ben D. SpycherEmail author
  • Martin Feller
  • Martin Röösli
  • Roland A. Ammann
  • Manuel Diezi
  • Matthias Egger
  • Claudia E. Kuehni


Children living near highways are exposed to higher concentrations of traffic-related carcinogenic pollutants. Several studies reported an increased risk of childhood cancer associated with traffic exposure, but the published evidence is inconclusive. We investigated whether cancer risk is associated with proximity of residence to highways in a nation-wide cohort study including all children aged <16 years from Swiss national censuses in 1990 and 2000. Cancer incidence was investigated in time to event analyses (1990–2008) using Cox proportional hazards models and incidence density analyses (1985–2008) using Poisson regression. Adjustments were made for socio-economic factors, ionising background radiation and electromagnetic fields. In time to event analysis based on 532 cases the adjusted hazard ratio for leukaemia comparing children living <100 m from a highway with unexposed children (≥500 m) was 1.43 (95 % CI 0.79, 2.61). Results were similar in incidence density analysis including 1367 leukaemia cases (incidence rate ratio (IRR) 1.57; 95 % CI 1.09, 2.25). Associations were similar for acute lymphoblastic leukaemia (IRR 1.64; 95 % CI 1.10, 2.43) and stronger for leukaemia in children aged <5 years (IRR 1.92; 95 % CI 1.22, 3.04). Little evidence of association was found for other tumours. Our study suggests that young children living close to highways are at increased risk of developing leukaemia.


Leukaemia Lymphoma Traffic exhaust Air pollution Tumours of the central nervous system Vehicle emissions 



The authors thank Dr. Christian Kreis for his assistance in calculating distance to highways and creating the map. This work was supported by the Swiss Federal Office of Public Health (Grants 08.001616, 10.002946, 12.008357), Swiss Cancer League (Grant 02224-03-2008), and Swiss Cancer Research (Grants 3049-08-2012, 3515-08-2014). BD Spycher was supported by a Swiss National Science Foundation fellowship (PZ00P3_147987). The work of the Swiss Childhood Cancer Registry is supported by the Swiss Paediatric Oncology Group (, Schweizerische Konferenz der kantonalen Gesundheitsdirektorinnen und –direktoren (, Swiss Cancer Research (, Kinderkrebshilfe Schweiz (, Ernst-Göhner Stiftung, Stiftung Domarena and National Institute of Cancer Epidemiology and Registration (

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Approval of the study was granted through the general cancer registry permission of the Swiss Childhood Cancer Registry by the ethics committee of the canton of Bern.

Supplementary material

10654_2015_91_MOESM1_ESM.docx (5.5 mb)
Supplementary material 1 (docx 5619 kb)


  1. 1.
    HEI panel on the health effects of traffic-related air pollution. Traffic-related air pollution: a critical review of the literature on emissions, exposure, and health effects. Boston, MA (2010). Report no.: special report 17. Accessed 07 Aug 2015.
  2. 2.
    IARC. Diesel and gasoline engine exhausts and some nitroarenes, vol. 105. Lyon, France: International Agency for Research on Cancer (IARC); 2012. Accessed 07 Aug 2015.
  3. 3.
    IARC. A review of human carcinogens. Part F: chemical agents and related occupations, vol. 100F. Lyon, France: International Agency for Research on Cancer (IARC); 2012. Accessed 07 Aug 2015.
  4. 4.
    Zhou Y, Levy JI. Factors influencing the spatial extent of mobile source air pollution impacts: a meta-analysis. BMC Public Health. 2007;7:89.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Hagler GSW, Baldauf RW, Thoma ED, et al. Ultrafine particles near a major roadway in Raleigh, North Carolina: downwind attenuation and correlation with traffic-related pollutants. Atmos Environ. 2009;43:1229–34.CrossRefGoogle Scholar
  6. 6.
    Entec. Development of a methodology to assess population exposed to high levels of noise and air pollution close to major transport infrastructure. Final report for the European Commission. London, UK: Entec UK Limited 2006. Accessed 07 Aug 2015.
  7. 7.
    Pyatt D, Hays S. A review of the potential association between childhood leukemia and benzene. Chem Biol Interact. 2010;184:151–64.PubMedCrossRefGoogle Scholar
  8. 8.
    Raaschou-Nielsen O, Reynolds P. Air pollution and childhood cancer: a review of the epidemiological literature. Int J Cancer. 2006;118:2920–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Amigou A, Sermage-Faure C, Orsi L, et al. Road traffic and childhood leukemia: the ESCALE study (SFCE). Environ Health Perspect. 2011;119:566–72.PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Vinceti M, Rothman KJ, Crespi CM, et al. Leukemia risk in children exposed to benzene and PM10 from vehicular traffic: a case–control study in an Italian population. Eur J Epidemiol. 2012;27:781–90.PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Heck JE, Wu J, Lombardi C, et al. Childhood cancer and traffic-related air pollution exposure in pregnancy and early life. Environ Health Perspect. 2013;121:1385–91.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Badaloni C, Ranucci A, Cesaroni G, et al. Air pollution and childhood leukaemia: a nationwide case–control study in Italy. Occup Environ Med. 2013;70:876–83.PubMedCrossRefGoogle Scholar
  13. 13.
    Filippini T, Heck JE, Malagoli C, Giovane CD, Vinceti M. A review and meta-analysis of outdoor air pollution and risk of childhood leukemia. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2015;33:36–66.PubMedCrossRefGoogle Scholar
  14. 14.
    Bopp M, Spoerri A, Zwahlen M, et al. Cohort Profile: the Swiss National Cohort—a longitudinal study of 6.8 million people. Int J Epidemiol. 2009;38:379–84.PubMedCrossRefGoogle Scholar
  15. 15.
    Schindler M, Mitter V, Rueegg CS et al. Death certificate notations in the Swiss Childhood Cancer Registry: Validation of registration procedures and completeness. In: Towards a harmonised cancer information system in Europe. Ispra, Italy: European Network of Cancer Registries (ENCR); 2014. Accessed 07 Aug 2015.
  16. 16.
    Steliarova-Foucher E, Stiller C, Lacour B, Kaatsch P. International classification of childhood cancer, third edition. Cancer. 2005;103:1457–67.PubMedCrossRefGoogle Scholar
  17. 17.
    ARE. Nationales Güterverkehrsmodell des UVEK. Basismodell 2005: Modellbeschrieb und Validierung. Bern, Switzerland: Federal Office for Spatial Development (ARE) 2010. Accessed 07 Aug 2015.
  18. 18.
    Panczak R, Galobardes B, Voorpostel M, et al. A Swiss neighbourhood index of socioeconomic position: development and association with mortality. J Epidemiol Community Health. 2012;66:1129–36.PubMedCrossRefGoogle Scholar
  19. 19.
    Hauri D, Spycher B, Huss A, et al. Domestic radon exposure and risk of childhood cancer: a prospective census-based cohort study. Environ Health Perspect. 2013;121:1239–44.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Spycher BD, Lupatsch JE, Zwahlen M, et al. Background ionizing radiation and the risk of childhood cancer: a census-based nationwide cohort study. Environ Health Perspect. 2015;123:622–8.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Hauri DD, Spycher B, Huss A, et al. Exposure to radio-frequency electromagnetic fields from broadcast transmitters and risk of childhood cancer: a census-based cohort study. Am J Epidemiol. 2014;179:843–51.PubMedCrossRefGoogle Scholar
  22. 22.
    Spycher BD, Feller M, Zwahlen M, et al. Childhood cancer and nuclear power plants in Switzerland: a census-based cohort study. Int J Epidemiol. 2011;40:1247–60.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Wood SN. Generalized additive models—an introduction with R. Boca Raton: Chapman & Hall/CRC, Taylor & Francis Group; 2006.Google Scholar
  24. 24.
    Pearson RL, Wachtel H, Ebi KL. Distance-weighted traffic density in proximity to a home is a risk factor for leukemia and other childhood cancers. J Air Waste Manag Assoc. 2000;50:175–80.PubMedCrossRefGoogle Scholar
  25. 25.
    Crosignani P, Tittarelli A, Borgini A, et al. Childhood leukemia and road traffic: a population-based case–control study. Int J Cancer. 2004;108:596–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Langholz B, Ebi KL, Thomas DC, Peters JM, London SJ. Traffic density and the risk of childhood leukemia in a Los Angeles case–control study. Ann Epidemiol. 2002;12:482–7.PubMedCrossRefGoogle Scholar
  27. 27.
    Harrison RM, Leung PL, Somervaille L, Smith R, Gilman E. Analysis of incidence of childhood cancer in the West Midlands of the United Kingdom in relation to proximity to main roads and petrol stations. Occup Environ Med. 1999;56:774–80.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Savitz DA, Feingold L. Association of childhood cancer with residential traffic density. Scand J Work Environ Health. 1989;15:360–3.PubMedCrossRefGoogle Scholar
  29. 29.
    Raaschou-Nielsen O, Hertel O, Thomsen BL, Olsen JH. Air pollution from traffic at the residence of children with cancer. Am J Epidemiol. 2001;153:433–43.PubMedCrossRefGoogle Scholar
  30. 30.
    Reynolds P, Von Behren J, Gunier RB, Goldberg DE, Hertz A. Residential exposure to traffic in California and childhood cancer. Epidemiology. 2004;15:6–12.PubMedCrossRefGoogle Scholar
  31. 31.
    Reynolds P, Von Behren J, Gunier RB, Goldberg DE, Hertz A, Smith D. Traffic patterns and childhood cancer incidence rates in California, United States. Cancer Cause Control. 2002;13:665–73.CrossRefGoogle Scholar
  32. 32.
    Von Behren J, Reynolds P, Gunier RB, et al. Residential traffic density and childhood leukemia risk. Cancer Epidemiol Biomark Prev. 2008;17:2298–301.CrossRefGoogle Scholar
  33. 33.
    Weng HH, Tsai SS, Chen CC, Chiu HF, Wu TN, Yang CY. Childhood leukemia development and correlation with traffic air pollution in Taiwan using nitrogen dioxide as an air pollutant marker. J Toxicol Environ Health A. 2008;71:434–8.PubMedCrossRefGoogle Scholar
  34. 34.
    Ghosh JK, Heck JE, Cockburn M, Su J, Jerrett M, Ritz B. Prenatal exposure to traffic-related air pollution and risk of early childhood cancers. Am J Epidemiol. 2013;178:1233–9.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Whitworth KW, Symanski E, Coker AL. Childhood lymphohematopoietic cancer incidence and hazardous air pollutants in southeast Texas, 1995–2004. Environ Health Perspect. 2008;116:1576–80.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Reynolds P, Von Behren J, Gunier RB, Goldberg DE, Hertz A, Smith DF. Childhood cancer incidence rates and hazardous air pollutants in California: an exploratory analysis. Environ Health Perspect. 2003;111:663–8.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Heck JE, Park AS, Qiu J, Cockburn M, Ritz B. Risk of leukemia in relation to exposure to ambient air toxics in pregnancy and early childhood. Int J Hyg Environ Health. 2014;217:662–8.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Venkatram A, Isakov V, Seila R, Baldauf R. Modeling the impacts of traffic emissions on air toxics concentrations near roadways. Atmos Environ. 2009;43:3191–9.CrossRefGoogle Scholar
  39. 39.
    Baldauf R, Thoma E, Hays M, et al. Traffic and meteorological impacts on near-road air quality: summary of methods and trends from the Raleigh near-road study. J Air Waste Manag Assoc. 2008;58:865–78.PubMedCrossRefGoogle Scholar
  40. 40.
    Bowker GE, Baldauf R, Isakov V, Khlystov A, Petersen W. The effects of roadside structures on the transport and dispersion of ultrafine particles from highways. Atmos Environ. 2007;41:8128–39.CrossRefGoogle Scholar
  41. 41.
    Stemmler K, Bugmann S, Buchmann B, Reimann S, Staehelin J. Large decrease of VOC emissions of Switzerland’s car fleet during the past decade: results from a highway tunnel study. Atmos Environ. 2005;39:1009–18.CrossRefGoogle Scholar
  42. 42.
    FOEN. Pollutant emissions from road transport, 1990 to 2035. Updated in 2010. Bern, Switzerland: Federal Office for the Environment (FOEN) 2010. Accessed 07 Aug 2015.
  43. 43.
    Ross Z, Kheirbek I, Clougherty JE, et al. Noise, air pollutants and traffic: continuous measurement and correlation at a high-traffic location in New York City. Environ Res. 2011;111:1054–63.PubMedCrossRefGoogle Scholar
  44. 44.
    Pascuan CG, Uran SL, Gonzalez-Murano MR, Wald MR, Guelman LR, Genaro AM. Immune alterations induced by chronic noise exposure: comparison with restraint stress in BALB/c and C57Bl/6 mice. J Immunotoxicol. 2014;11:78–83.PubMedCrossRefGoogle Scholar
  45. 45.
    Greaves M. Infection, immune responses and the aetiology of childhood leukaemia. Nat Rev Cancer. 2006;6:193–203.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Ben D. Spycher
    • 1
    Email author
  • Martin Feller
    • 1
    • 2
  • Martin Röösli
    • 3
    • 4
  • Roland A. Ammann
    • 5
  • Manuel Diezi
    • 6
  • Matthias Egger
    • 1
  • Claudia E. Kuehni
    • 1
  1. 1.Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
  2. 2.Department of General Internal MedicineBern University HospitalBernSwitzerland
  3. 3.Swiss Tropical and Public Health InstituteBaselSwitzerland
  4. 4.University of BaselBaselSwitzerland
  5. 5.Department of PaediatricsUniversity of BernBernSwitzerland
  6. 6.Paediatric Hemato-Oncology Unit, Department of PaediatricsUniversity Hospital of Lausanne (CHUV)LausanneSwitzerland

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