Summary
A statistical model was developed based on Poisson regression of incidence of childhood leukaemia and non-Hodgkin’s lymphoma (NHL) in relation to population mixing among all 119 539 children born 1969–1989 to mothers living in Cumbria, north-west England, (excluding Seascale). This model was used to predict the number of cases in Seascale (the village adjacent to the Sellafield nuclear installation) children, born 1950–1989 and diagnosed before 1993. After allowing for age, the incidence of acute lymphoblastic leukaemia (ALL) and NHL was significantly higher among children born in areas with the highest levels of population mixing, relative risk (RR) = 11.7 (95% confidence interval (CI) 3.2–43) and was highest among children of incomers. The model predicted up to 3.0 (95% CI 1.3–6.0) cases of ALL/NHL in children born in Seascale compared to six observed and 2.0 (95% CI 1.0–3.4) cases in children resident, but not born, in Seascale compared to two observed. Population mixing is a significant risk factor for ALL/NHL, especially in young children, accounting for over 50% of cases in Cumbria and most cases in Seascale.
Similar content being viewed by others
Article PDF
Change history
16 November 2011
This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication
References
Alexander, FE, Chan, LC, Lam, TH, Yuen, P, Leung, NK, Ha, SY, Yuen, HL, Li, CK, Li, CK, Lau, YL & Greaves, MF (1997). Clustering of childhood leukaemia in Hong Kong: association with the childhood peak and common acute lymphoblastic leukaemia and with population mixing. Br J Cancer 75: 457–463.
Alexander, FE, Ricketts, TJ, McKinney, PA & Cartwright, RA (1990). Community lifestyle characteristics and risk of acute lymphoblastic leukaemia in children. Lancet 336: 1461–1465.
Armstrong, AA, Alexander, FE, Pinto Paes, R, Morad, NA, Gallagher, A, Krajewski, AS, Jones, DB, Angus, B, Adams, J, Cartwright, RA, Onions, DE & Jarrett, RF (1993). Association of Epstein–Barr virus with pediatric Hodgkin’s disease. Am J Pathol 142: 1683–1688.
Birch, JM & Marsden, HB (1987). A classification scheme for childhood cancer. Int J Cancer 40: 620–624.
Bithell, JF, Dutton, SJ, Neary, NM & Vincent, TJ (1995). Controlling for socioeconomic confounding using regression methods. J Epid Community Health 49: S15–S19.
Black, D (1984). Investigation of the Possible Increased Incidence of Cancer in West Cumbria. Report of the Independent Advisory Group. HMSO: London
COMARE (1996). Committee on Medical Aspects of Radiation in the Environment, Fourth Report 1996. Department of Health: London
Cutler, J (1983). Windscale, the Nuclear Laundry. Yorkshire Television
Cuzick, J & Hills, M (1991). Clustering and clusters – Summary. In: The Geographical Epidemiology of Childhood Leukaemia and Non Hodgkin Lymphomas in Great Britain 1966–83, Draper G. (ed), pp. 124–126. HMSO: London
Doll, R, Evans, HJ & Darby, SC (1994). Paternal exposure not to blame. Nature 367: 678–680.
Draper, GJ, Vincent, TJ, O’Connor, CM & Stiller, CA (1991). Socio-economic factors and variation in incidence rates between County Districts. In: The Geographical Epidemiology of Childhood Leukaemia and Non Hodgkin Lymphomas in Great Britain 1966–83. Draper G (ed), pp. 37–46. HMSO: London
Draper, GJ, Sanders, BM, Brownbill, PA & Hawkins, MM (1992). Patterns of hereditary retinoblastoma and applications to genetic counselling. Br J Cancer 66: 211–219.
Draper, GJ, Stiller, CA, Cartwright, RA, Craft, AW & Vincent, TJ (1993a). Cancer in Cumbria and in the vicinity of the Sellafield nuclear installation, 1963–1990. Br Med J 306: 89–94.
Draper, GJ, Stiller, CA, Cartwright, RA, Craft, AW & Vincent, TJ (1993b). Cancer in Cumbria and in the vicinity of the Sellafield nuclear installation, 1963–1990. Br Med J 306: 761
Efroymson, MA (1960). Multiple regression analysis. In: Mathematical Methods for Digital Computers. Ralston A and Wilf HS (eds), pp. 191–203. Wiley: New York
Gardner, MJ, Hall, AJ, Downes, S & Terrell, JD (1987). Follow up study of children born elsewhere but attending schools in Seascale, West Cumbria (schools cohort). Br Med J 295: 822–827.
Gardner, MJ, Snee, MP, Hall, AJ, Powell, CA, Downes, S & Terrel, JD (1990). Results of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in west Cumbria. Br Med J 300: 423–434.
Goodall, C (1990). A survey of smoothing techniques. In: Modern Methods of Data Analysis, Fox J and Long JS (eds), pp. 126–176. Sage Publications: Newbury Park, CA
Greaves, MF (1996). Infant leukaemia biology, aetiology and treatment. Leukaemia 10: 372–377.
Greaves, MF (1997). Aetiology of acute leukaemia. Lancet 349: 344–349.
Greenland, S & Drescher, K (1993). Maximum likelihood estimation of the attributable fraction from logistic models. Biometrics 49: 865–872.
Health and Safety Executive (1993). Investigation of Leukaemia and Other Cancers in the Children of Male Workers at Sellafield. Sudbury: HSE Books
Kinlen, L (1988). Evidence for an infective cause of childhood leukaemia: comparison of Scottish new town with nuclear reprocessing sites in Britain. Lancet 2: 1323–1327.
Kinlen, LJ (1993). Can paternal preconceptional radiation account for the increase of leukaemia and non-Hodgkin’s lymphoma in Seascale?. Br Med J 306: 1718–1721.
Kinlen, LJ (1995). Epidemiological evidence for an infective basis in childhood leukaemia. Br J Cancer 71: 1–5.
Kinlen, LJ, O’Brien, F, Clarke, K, Balkwill, A & Matthews, F (1993). Rural population mixing and childhood leukaemia: effects of the North Sea oil industry in Scotland, including the area near Dounreay nuclear site. Br Med J 306: 743–748.
Kinlen, LJ, Dickson, M & Stiller, CA (1995). Childhood leukaemia and non-Hodgkin’s lymphoma near large rural construction sites, with a comparison with Sellafield nuclear site. Br Med J 310: 763–768.
Kinlen, LJ, Craft, AW & Parker, L (1997). The excess of childhood leukaemia near Sellafield: a commentary on the fourth COMARE report. J Radiol Prot 17: 63–71.
Langford, I (1991). Childhood leukaemia mortality and population change in England and Wales 1969–73. Soc Sci Med (Oxford) 33: 435–440.
Magrath, IT (1989). Malignant non-Hodgkin’s lymphomas. In: Principles and Practice of Pediatric Oncology, Pizzo PA and Poplack DG (eds), pp. 415–456. Lippincott: Philadelphia
Mason, O (1986). Bartholomew Gazeteer of Places in Britain. John Bartholomew & Son Ltd: Edinburgh
McCullagh, P & Nelder, JA (1989). Generalised Linear Models. Chapman and Hall: London
Parker, L, Smith, J, Dickinson, H, Binks, K, Scott, L, McElvenny, D, Jones, S & Wakeford, R (1997). The creation of a database of children of workers at a nuclear facility: an exercise in record linkage. Appl Occupat Environ Hygiene 12: 40–45.
Rodrigues, L, Hills, M, McGale, P & Elliott, P (1991). Socio-economic factors in relation to childhood leukaemia and non-Hodgkin lymphomas: an analysis based on small area statistics for census tracts. In: The Geographical Epidemiology of Childhood Leukaemia and Non Hodgkin Lymphomas in Great Britain 1966–83, Draper G (ed), pp. 47–56. HMSO: London
Shannon, CE (1948). A mathematical theory of communication. Bell System Technical Journal 27: 379–423.
Smith, M (1997). Considerations on a possible viral etiology for B-precursor acute lymphoblastic leukaemia of childhood. J Immunother 20: 89–100.
Smith, MA, Chen, T & Simon, R (1997). Age-specific incidence of acute lymphoblastic leukaemia in US children: in utero initiation model. J Nat Cancer Inst 89: 1542–1544.
Stiller, CA & Boyle, PJ (1996). Effect of population mixing and socioeconomic status in England and Wales, 1979–85, on lymphoblastic leukaemia in children. Br Med J 313: 1297–1300.
Stine, R (1990). An introduction to bootstrap methods: examples and ideas. In: Modern Methods of Data Analysis, Fox J and Long JS (eds), pp. 353–373. Sage Publications: Newbury Park, CA
Author information
Authors and Affiliations
Rights and permissions
From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
About this article
Cite this article
Dickinson, H., Parker, L. Quantifying the effect of population mixing on childhood leukaemia risk: the Seascale cluster. Br J Cancer 81, 144–151 (1999). https://doi.org/10.1038/sj.bjc.6690664
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bjc.6690664
Keywords
This article is cited by
-
Childhood cancer research in oxford III: The work of CCRG on ionising radiation
British Journal of Cancer (2018)
-
Residential mobility and the risk of childhood leukemia
Cancer Causes & Control (2016)
-
Updated investigations of cancer excesses in individuals born or resident in the vicinity of Sellafield and Dounreay
British Journal of Cancer (2014)
-
Childhood leukaemia, nuclear sites, and population mixing
British Journal of Cancer (2011)
-
Population mixing, socioeconomic status and incidence of childhood acute lymphoblastic leukaemia in England and Wales: analysis by census ward
British Journal of Cancer (2008)