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Geographically based approaches can identify environmental causes of disease
  1. Manolis Kogevinas1,
  2. Neil Pearce2
  1. 1Respiratory and Environmental Health Research Unit, Municipal Institute of Medical Reseach (IMIM), Barcelona, Spain and Department of Social Medicine, Medical School, University of Crete, Herakleion, Greece
  2. 2Department of Biomedical Sciences and Human Oncology, University of Turin, Italy and Centre for Public Health Research, Massey University Wellington Campus, Wellington, New Zealand
  1. Correspondence to:
 Dr M Kogevinas
 Respiratory and Environmental Health Research Unit, Municipal Institute of Medical Reseach (IMIM), 80 Dr Aiguader Rd, Barcelona 08003, Spain;

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There is growing evidence to suggest the potential importance of specific environmental exposures in the causation of cancer in children.

The causes of child leukaemia and, more generally of malignant neoplasms in childhood have been long investigated. Various theories have been proposed on the aetiological mechanisms and risk factors for these neoplasms, including the influence of genetic, prenatal, and postnatal exposures. With a few exceptions, particularly for in utero exposure to ionising radiation and some genetic syndromes, strong and consistent evidence on the importance of specific risk factors has not been produced. One recent exception is the association of ambient air pollution with child leukaemia, an association that is also supported by experimental evidence. For example, a recent experimental study1 showed that filtration of particulate matter in ambient air significantly reduced heritable mutation rates in laboratory mice housed outdoors near a major highway and two integrated steel mills. On the other hand, extremely low frequency electromagnetic fields (ELF-EMF) emitted by power lines have received a great deal of attention in recent years, but the evidence of an association with childhood leukaemia remains uncertain; furthermore, even if ELF-EMF are causally associated with child leukaemia they could explain only a very small fraction of all child leukaemias, perhaps around 1%.2 Exposure to pesticides, both general and specific, has also been examined extensively in relation to childhood cancers, but the evidence is far from conclusive.3

The paper by George Knox in this issue4 follows other recent work examining proximity to industrial sources of exposure to toxic atmospheric emissions and childhood cancer.5 In this paper he expands on this work by evaluating the effects of specific exposures and their combinations.

Knox applies an approach that …

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  • Funding: Neil Pearce’s work on this paper was supported by the Health Research Council of New Zealand, and the Progetto Lagrange, Fondazione CRT/ISI. M Kogevinas was partially supported by ISCIII (Red de Centros RCESP C03/09), Madrid.

  • Competing interests: none.

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