Skip to main content
SpringerLink
Log in

Background gamma radiation and childhood cancer in Germany: an ecological study

  • Original Article
  • Published:
Radiation and Environmental Biophysics Aims and scope Submit manuscript

Abstract

The relationship of low-dose background gamma radiation and childhood leukaemia was investigated in a number of studies. Results from these studies are inconclusive. Therefore, in the present study 25 years of German childhood cancer data were analyzed using interpolated background annual gamma dose rate per community in an ecological study. The main question was leukaemia; as exploratory questions we investigate central nervous system (CNS) tumours, thyroid carcinomas and diagnoses less likely to be related to radiation. A Poisson regression model was applied and a fractional polynomial model building procedure. As the main sensitivity analysis a community deprivation index was included as a potential confounder. It was found that outdoor background gamma annual dose rates in Germany range roughly from 0.5–1.5 mSv/a with an average of 0.817 mSv/a. No association of annual ambient gamma dose rates with leukaemia incidence was found. Amongst the exploratory analyses, a strong association was found with CNS tumour incidence [rate ratio for 1.5 vs 0.5 mSv/a: 1.35; 95% confidence interval (1.17, 1.57)]. The community level deprivation index was not a confounder. It is concluded that the present study did not confirm an association of annual outdoor ambient gamma dose rate and childhood leukaemia, corresponding to some studies and contrasting others. An association with CNS incidence was found in the exploratory analyses. As this is an ecological study no causal interpretation is possible.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Ambler G, Royston P (2001) Fractional polynomial model selection procedures: investigation of Type I error rate. J Stat Comput Simul 69(1):89–108

    Article  MathSciNet  MATH  Google Scholar 

  • Bartier PM, Keller CP (1996) Multivariate interpolation to incorporate thematic surface data using inverse distance weighting (IDW). Comput Geosci 22:795–799

    Article  ADS  Google Scholar 

  • Bithell JF, Keegan TJ, Kroll ME, Murphy MF, Vincent TJ (2008) Childhood leukaemia near British nuclear installations: methodological issues and recent results. Radiat Prot Dosim 132 (2):191–197

    Article  Google Scholar 

  • Bithell JF, Murphy MF, Stiller CA, Toumpakari E, Vincent T, Wakeford R (2013) Leukaemia in young children in the vicinity of British nuclear power plants: a case-control study. Br J Cancer 109(11):2880–2885

    Article  Google Scholar 

  • Bleher M, Doll H, Harms W, Stöhlker U (2014) INTERCAL: long-term inter-comparison experiment for dose rate and spectrometric probes. Radiat Prot Dosim 160 (4):306–310

    Article  Google Scholar 

  • Bollaerts K, Simons K, Van Bladel L, De Smedt T, Sonck M, Fierens S, Poffijn A, Geraets D, Gosselin P, Van Oyen H, Francart J, Van Nieuwenhuyse A (2016) Childhood leukaemia near nuclear sites in Belgium, 2002–2008. Eur J Cancer Prev

  • Demoury C, Marquant F, Ielsch G, Goujon S, Debayle C, Faure L, Coste A, Laurent O, Guillevic J, Laurier D, Hemon D, Clavel J (2016) Residential exposure to natural background radiation and risk of childhood acute leukemia in France, 1990–2009. Environ Health Perspect

  • Evrard AS, Hemon D, Billon S, Laurier D, Jougla E, Tirmarche M, Clavel J (2006a) Childhood leukemia incidence and exposure to indoor radon, terrestrial and cosmic gamma radiation. Health Phys 90(6):569–579

    Article  Google Scholar 

  • Evrard AS, Hemon D, Morin A, Laurier D, Tirmarche M, Backe JC, Chartier M, Clavel J (2006b) Childhood leukaemia incidence around French nuclear installations using geographic zoning based on gaseous discharge dose estimates. Br J Cancer 94(9):1342–1347

    Article  Google Scholar 

  • Investigators UKCCS (2002) The United Kingdom Childhood Cancer Study of exposure to domestic sources of ionising radiation: 2: gamma radiation. Br J Cancer 86(11):1727–1731

    Article  Google Scholar 

  • Journy N, Rehel J, Ducou Le Pointe H, Lee C, Brisse H, Chateil J, Caer-Lorho S, Laurier D, Bernier M (2015) Are the studies on cancer risk from CT scans biased by indication? Elements of answer from a large-scale cohort study in France. Br J Cancer 112(1):185–193

    Article  Google Scholar 

  • Kaatsch P, Spix C (2014) German Childhood Cancer Registry—Annual Report 2013/2014 (1980–2013). Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz

    Google Scholar 

  • Kaatsch P, Kaletsch U, Meinert R, Michaelis J (1998) An extended study on childhood malignancies in the vicinity of German nuclear power plants. Cancer Cause Control 9 (5):529–533

    Article  Google Scholar 

  • Kaatsch P, Spix C, Schulze-Rath R, Schmiedel S, Blettner M (2008) Leukaemia in young children living in the vicinity of German nuclear power plants. Int J Cancer 122(4):721–726

    Article  Google Scholar 

  • Kendall G, Little MP, Wakeford R (2011) Numbers and proportions of leukemias in young people and adults induced by radiation of natural origin. Leukemia Res 35 (8):1039–1043

    Article  Google Scholar 

  • Kendall GM, Little MP, Wakeford R, Bunch KJ, Miles JC, Vincent TJ, Meara JR, Murphy MF (2013) A record-based case-control study of natural background radiation and the incidence of childhood leukaemia and other cancers in Great Britain during 1980–2006. Leukemia 27(1):3–9

    Article  Google Scholar 

  • Krille L, Dreger S, Schindel R, Albrecht T, Asmussen M, Barkhausen J, Berthold JD, Chavan A, Claussen C, Forsting M, Gianicolo EA, Jablonka K, Jahnen A, Langer M, Laniado M, Lotz J, Mentzel HJ, Queisser-Wahrendorf A, Rompel O, Schlick I, Schneider K, Schumacher M, Seidenbusch M, Spix C, Spors B, Staatz G, Vogl T, Wagner J, Weisser G, Zeeb H, Blettner M (2015) Risk of cancer incidence before the age of 15 years after exposure to ionising radiation from computed tomography: results from a German cohort study. Radiat Environ Biophys 54(1):1–12

    Article  Google Scholar 

  • Kroll ME, Stiller CA, Murphy MF, Carpenter LM (2011) Childhood leukaemia and socioeconomic status in England and Wales 1976–2005: evidence of higher incidence in relatively affluent communities persists over time. Br J Cancer 105(11):1783–1787

    Article  Google Scholar 

  • Laurent O, Ancelet S, Richardson DB, Hemon D, Ielsch G, Demoury C, Clavel J, Laurier D (2013) Potential impacts of radon, terrestrial gamma and cosmic rays on childhood leukemia in France: a quantitative risk assessment. Radiat Environ Biophys 52(2):195–209

    Article  Google Scholar 

  • Laurier D, Grosche B, Hall P (2002) Risk of childhood leukaemia in the vicinity of nuclear installations–findings and recent controversies. Acta Oncol 41(1):14–24

    Article  Google Scholar 

  • Little MP, Wakeford R, Kendall GM (2009) Updated estimates of the proportion of childhood leukaemia incidence in Great Britain that may be caused by natural background ionising radiation. J Radiol Prot 29(4):467–482

    Article  Google Scholar 

  • Little MP, Wakeford R, Lubin JH, Kendall GM (2010) The statistical power of epidemiological studies analyzing the relationship between exposure to ionizing radiation and cancer, with special reference to childhood leukemia and natural background radiation. Radiat Res 174(3):387–402

    Article  Google Scholar 

  • Luff R, Zähringer M, Harms W, Bleher M, Prommer B, Stöhlker U (2014) Open source database and Web-application for gamma dose rate Network operation. Rad Prot Dosim 160:252

    Article  Google Scholar 

  • Maier W, Fairburn J, Mielck A (2012) Regional deprivation and mortality in Bavaria. Development of a community-based index of multiple deprivation. Gesundheitswesen 74(7):416–425

    Article  Google Scholar 

  • Maier W, Holle R, Hunger M, Peters A, Meisinger C, Greiser KH, Kluttig A, Volzke H, Schipf S, Moebus S, Bokhof B, Berger K, Mueller G, Rathmann W, Tamayo T, Mielck A, Consortium D-C (2013) The impact of regional deprivation and individual socio-economic status on the prevalence of Type 2 diabetes in Germany. A pooled analysis of five population-based studies. Diabetic Med 30 (3):e78–86.

    Article  Google Scholar 

  • Mathews JD, Forsythe AV, Brady Z, Butler MW, Goergen SK, Byrnes GB, Giles GG, Wallace AB, Anderson PR, Guiver TA, McGale P, Cain TM, Dowty JG, Bickerstaffe AC, Darby SC (2013) Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. Br Med J 346:f2360.

  • National Research Council Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation, Board on Radiation Effects Research, Sciences DoEaL (2006) Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2. National Academies Press, Washington, DC

    Google Scholar 

  • Ozasa K, Shimizu Y, Suyama A, Kasagi F, Soda M, Grant EJ, Sakata R, Sugiyama H, Kodama K (2012) Studies of the mortality of atomic bomb survivors, Report 14, 1950–2003: an overview of cancer and noncancer diseases. Radiat Res 177(3):229–243

    Article  Google Scholar 

  • Portier C (2008) Risk factors for childhood leukaemia. Discussion and summary. Rad Prot Dosim 132 (2):273–274

    Article  Google Scholar 

  • Richardson S, Monfort C, Green M, Draper G, Muirhead C (1995) Spatial variation of natural radiation and childhood leukaemia incidence in Great Britain. Stat Med 14(21–22):2487–2501

    Article  Google Scholar 

  • Royston P, Sauerbrei W (2008) Multivariable model-building: a pragmatic approach to regression anaylsis based on fractional polynomials for modelling continuous variables, vol 777. John Wiley & Sons

  • Schmiedel S, Blettner M, Kaatsch P, Schuz J (2010) Spatial clustering and space-time clusters of leukemia among children in Germany, 1987–2007. Eur J Epidemiol 25 (9):627–633.

    Article  Google Scholar 

  • Sermage-Faure C, Laurier D, Goujon-Bellec S, Chartier M, Guyot-Goubin A, Rudant J, Hemon D, Clavel J (2012) Childhood leukemia around French nuclear power plants–the Geocap study, 2002–2007. Int J Cancer 131 (5):E769–780

    Article  Google Scholar 

  • Smith A, Roman E, Simpson J, Ansell P, Fear NT, Eden T (2006) Childhood leukaemia and socioeconomic status: fact or artefact? A report from the United Kingdom childhood cancer study (UKCCS). Int J Epidemiol 35 (6):1504–1513

    Article  Google Scholar 

  • Spix C, Eletr D, Blettner M, Kaatsch P (2008a) Temporal trends in the incidence rate of childhood cancer in Germany 1987–2004. Int J Cancer 122 (8):1859–1867

    Article  Google Scholar 

  • Spix C, Schmiedel S, Kaatsch P, Schulze-Rath R, Blettner M (2008b) Case-control study on childhood cancer in the vicinity of nuclear power plants in Germany 1980–2003. Eur J Cancer 44(2):275–284

    Article  Google Scholar 

  • Spix C, Schulze-Rath R, Kaatsch P, Blettner M (2009) Case-control study on risk factors for leukaemia and brain tumours in children under 5 years in Germany. Klin Padiatr 221(6):362–368

    Article  Google Scholar 

  • Spycher BD, Feller M, Zwahlen M, Roosli M, von der Weid NX, Hengartner H, Egger M, Kuehni CE, Swiss Paediatric Oncology G, Swiss National CohortStudy G (2011) Childhood cancer and nuclear power plants in Switzerland: a census-based cohort study. Int J Epidemiol 40(5):1247–1260

    Article  Google Scholar 

  • Spycher BD, Lupatsch JE, Zwahlen M, Roosli M, Niggli F, Grotzer MA, Rischewski J, Egger M, Kuehni CE, Swiss Pediatric Oncology G, Swiss National CohortStudy G (2015) Background ionizing radiation and the risk of childhood cancer: a census-based nationwide cohort study. Environ Health Persp 123 (6):622–628

    Google Scholar 

  • Steliarova-Foucher E, Stiller C, Lacour B, Kaatsch P (2005) International Classification of Childhood Cancer, third edition. Cancer 103(7):1457–1467

    Article  Google Scholar 

  • Stiller CA, Kroll ME, Boyle PJ, Feng Z (2008) Population mixing, socioeconomic status and incidence of childhood acute lymphoblastic leukaemia in England and Wales: analysis by census ward. Br J Cancer 98(5):1006–1011

    Article  Google Scholar 

  • Walsh L, Kaiser JC (2011) Multi-model inference of adult and childhood leukaemia excess relative risks based on the Japanese A-bomb survivors mortality data (1950–2000). Radiat Environ Biophys 50(1):21–35

    Article  Google Scholar 

  • White-Koning ML, Hemon D, Laurier D, Tirmarche M, Jougla E, Goubin A, Clavel J (2004) Incidence of childhood leukaemia in the vicinity of nuclear sites in France, 1990–1998. Br J Cancer 91(5):916–922

    Google Scholar 

  • Ziegelberger G, Dehos A, Grosche B, Hornhardt S, Jung T, Weiss W (2011) Childhood leukemia–risk factors and the need for an interdisciplinary research agenda. Prog Biophys Mol Bio 107 (3):312–314

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank Dr. Werner Maier, MPH, EMPH, Dipl.-Geogr., Institute of Health Economics and Health Care Management, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany, for providing the data of the German Index of Multiple Deprivation (GIMD). Thanks also to Mr. Thomas Ziegler for the preparation of the data, especially for the handling of the different community definitions, and to Mrs. Irene Jung for help with the maps.

Author information

Authors and Affiliations

  1. German Childhood Cancer Registry at the Institute for Medical Biometry, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, 55101, Mainz, Germany

    Claudia Spix & Peter Kaatsch

  2. Federal Office for Radiation Protection, 85764, Oberschleissheim, Germany

    Bernd Grosche & Martin Bleher

  3. Institute for Medical Biometry, Epidemiology and Informatics, University Medical center of the Johannes Gutenberg-University Mainz, 55101, Mainz, Germany

    Peter Scholz-Kreisel & Maria Blettner

Authors
  1. Claudia Spix
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bernd Grosche
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin Bleher
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter Kaatsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peter Scholz-Kreisel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria Blettner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Claudia Spix.

Ethics declarations

Role of the funding source

This paper was not funded by a specific funding source. The childhood cancer data were provided by the Childhood Cancer Registry at the Institute for Medical Biometry, Epidemiology and Informatics in the University Medical Center Mainz, Germany; the registry is funded by the German government. The radiation data were provided by the Federal Office for Radiation Protection, an agency of the Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety. The deprivation data were provided by the Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, a research institution funded by the German government.

Conflict of interest

All authors declare they have no actual or potential conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Spix, C., Grosche, B., Bleher, M. et al. Background gamma radiation and childhood cancer in Germany: an ecological study. Radiat Environ Biophys 56, 127–138 (2017). https://doi.org/10.1007/s00411-017-0689-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00411-017-0689-2

Keywords

Search

Navigation