A cluster of childhood leukemia near a nuclear reactor in northern Germany.

Between February 1990 and December 1995, professionals diagnosed six cases of childhood leukemia among residents of the small rural community of Elbmarsch in northern Germany. Five of these cases were diagnosed in only a 16-mo period between February 1990 and May 1991. All cases lived in close proximity (i.e., 500-4,500 m) to Germany's largest capacity nuclear boiling-water reactor. We calculated standardized incidence ratios and exact 95% confidence intervals for a 5-km-radius circular area around the plant. The standardized incidence ratio for the time period 1990-1995 was 460 (95% confidence interval: 210, 1,030). The analysis was restricted further to the years 1990 and 1991, and the standardized incidence ratio increased to 1,180 (95% confidence interval: 490, 2,830). Presently, this cluster of childhood leukemia cases cannot be explained in terms of established and putative risk factors--including radiation from medical sources--for childhood leukemia.

[1]  B. Macmahon,et al.  Prenatal x-ray exposure and childhood cancer. , 1962, Journal of the National Cancer Institute.

[2]  L M Schuman,et al.  Preconception, intrauterine, and postnatal irradiation as related to leukemia. , 1966, National Cancer Institute monograph.

[3]  R. Albert,et al.  Follow-up study of patients treated by x-ray epilation for tinea capitis. I. Population characteristics, posttreatment illnesses, and mortality experience. , 1968, Archives of environmental health.

[4]  A. Lilienfeld,et al.  Leukemia in children exposed to multiple risk factors. , 1968, The New England journal of medicine.

[5]  G W Kneale,et al.  Radiation dose effects in relation to obstetric x-rays and childhood cancers. , 1970, Lancet.

[6]  A. Stewart,et al.  Age-distribution of cancers caused by obstetric x-rays and their relevance to cancer latent periods. , 1970, Lancet.

[7]  A. Herbst,et al.  Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women. , 1971, The New England journal of medicine.

[8]  A. Lilienfeld,et al.  Irradiation in the epidemiology of leukemia among adults. , 1972, Journal of the National Cancer Institute.

[9]  I. Bross,et al.  Preconception radiation and leukemia. , 1973, Journal of medicine.

[10]  S. Koga,et al.  Radiation cancer in Japanese radiological workers. , 1973, Strahlentherapie.

[11]  A M Lilienfeld,et al.  The relationship of intra-uterine radiation to subsequent mortality and development of leukemia in children. A prospective study. , 1973, American journal of epidemiology.

[12]  Johnson Mn,et al.  Angiosarcoma of Liver in the Manufacture of Polyvinyl Chloride , 1974 .

[13]  B. Pasternack,et al.  Follow-up study of patients treated by X-ray epilation for Tinea capitis; resurvey of post-treatment illness and mortality experience. , 1976, Archives of environmental health.

[14]  J. Wagoner,et al.  LEUKÆMIA IN BENZENE WORKERS , 1977, The Lancet.

[15]  M. Ichimaru,et al.  Incidence of leukemia in atomic bomb survivors belonging to a fixed cohort in Hiroshima and Nagasaki, 1950--71. Radiation dose, years after exposure, age at exposure, and type of leukemia. , 1978, Journal of radiation research.

[16]  P. Nilsson,et al.  Occupational exposure to petroleum products in men with acute non-lymphocytic leukaemia. , 1978, British medical journal.

[17]  M. Aksoy,et al.  Followup study on the mortality and the development of leukemia in 44 pancytopenic patients with chronic exposure to benzene. , 1978 .

[18]  M. Klauber,et al.  Childhood leukemias associated with fallout from nuclear testing. , 1979, The New England journal of medicine.

[19]  N. Myrianthopoulos,et al.  Preconception radiation, intrauterine diagnostic radiation, and childhood neoplasia. , 1980, Journal of the National Cancer Institute.

[20]  G. Schmid,et al.  Toxic-shock syndrome in menstruating women: association with tampon use and Staphylococcus aureus and clinical features in 52 cases. , 1980, The New England journal of medicine.

[21]  G. Lyman,et al.  Association of leukemia with radium groundwater contamination. , 1985, JAMA.

[22]  N. Pearce,et al.  Leukemia among New Zealand agricultural workers. A cancer registry-based study. , 1986, American journal of epidemiology.

[23]  J. Dionian,et al.  Radiation doses to members of the public around AWRE, Aldermaston, ROF, Burghfield and AERE, Harwell , 1987 .

[24]  D. Ozonoff,et al.  Leukemias and blood dyscrasias following exposure to chlordane and heptachlor. , 1987, Teratogenesis, carcinogenesis, and mutagenesis.

[25]  R. Doll,et al.  Fallout, radiation doses near Dounreay, and childhood leukaemia. , 1987, British medical journal.

[26]  K. Rothman Clustering of disease. , 1987, American journal of public health.

[27]  L. Simonato,et al.  Epidemiological and environmental evidence of the health effects of exposure to erionite fibres: A four‐year study in the cappadocian region of turkey , 1987, International journal of cancer.

[28]  B. Modan,et al.  Mortality after radiotherapy for ringworm of the scalp. , 1988, American journal of epidemiology.

[29]  E. Knox,et al.  Pregnancy x-rays and childhood cancers: effects of exposure age and radiation dose , 1988 .

[30]  Richard Wakeford,et al.  Childhood Leukaemia and Nuclear Installations , 1989 .

[31]  Martin J. Gardner,et al.  Review of Reported Increases of Childhood Cancer Rates in the Vicinity of Nuclear Installations in the Uk , 1989 .

[32]  A. Barrett,et al.  GERM CELL INJURY AND CHILDHOOD LEUKAEMIA CLUSTERS , 1989, The Lancet.

[33]  B. Henderson,et al.  Diagnostic radiography as a risk factor for chronic myeloid and monocytic leukaemia (CML). , 1989, British Journal of Cancer.

[34]  M. Demuth Leukämieerkrankungen bei Kindern in der Umgebung von Atomanlagen , 1990 .

[35]  M Susser,et al.  Cancer near the Three Mile Island nuclear plant: radiation emissions. , 1990, American journal of epidemiology.

[36]  L. Brown,et al.  Pesticide exposures and other agricultural risk factors for leukemia among men in Iowa and Minnesota. , 1990, Cancer research.

[37]  R R Neutra,et al.  Counterpoint from a cluster buster. , 1990, American journal of epidemiology.

[38]  K J Rothman,et al.  A sobering start for the cluster busters' conference. , 1990, American journal of epidemiology.

[39]  R. B. Richardson,et al.  Radon as a causative factor in induction of myeloid leukaemia and other cancers , 1990, The Lancet.

[40]  H. Kato,et al.  Studies of the mortality of A-bomb survivors. 9. Mortality, 1950-1985: Part 2. Cancer mortality based on the recently revised doses (DS86). , 1990, Radiation research.

[41]  A J Hall,et al.  Results of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in West Cumbria. , 1990, BMJ.

[42]  D. Loomis,et al.  Childhood cancer mortality and radon concentration in drinking water in North Carolina. , 1991, British Journal of Cancer.

[43]  B. Shleien,et al.  Epidemiologic studies of cancer in populations near nuclear facilities. , 1991, Health physics.

[44]  H. Dieckmann Häfung von leukämieerkrankungen in der Elbmarsch , 1992 .

[45]  A. Ahlbom,et al.  Acute myeloid leukemia among petrol station attendants. , 1993, Archives of environmental health.

[46]  Case-control study of leukaemia and non-Hodgkin's lymphoma among children aged 0-4 years living in west Berkshire and north Hampshire health districts. , 1993, BMJ.

[47]  T. Sorahan,et al.  Childhood cancer and paternal exposure to ionizing radiation: preliminary findings from the Oxford Survey of Childhood Cancers. , 1993, American journal of industrial medicine.

[48]  Epidemiologic studies of electric and magnetic fields and cancer: strategies for extending knowledge. , 1993 .

[49]  G. Prindull,et al.  Cancer morbidity rates of children from the vicinity of the nuclear power plant of Würgassen (FRG). , 1993, Acta haematologica.

[50]  W. Hoffmann,et al.  Radium-226-contaminated drinking water: hypothesis on an exposure pathway in a population with elevated childhood leukemia. , 1993 .

[51]  A. Heimers,et al.  Leukaemia near water nuclear reactor , 1993, The Lancet.

[52]  D. Savitz,et al.  11 – Epidemiologic Evidence on Cancer in Relation to Residential and Occupational Exposures , 1994 .

[53]  X. Shu,et al.  Association of paternal diagnostic X-ray exposure with risk of infant leukemia. Investigators of the Childrens Cancer Group. , 1994, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[54]  J F Viel,et al.  Incidence of leukaemia in young people around the La Hague nuclear waste reprocessing plant: a sensitivity analysis. , 1995, Statistics in medicine.

[55]  D. Savitz,et al.  Home pesticide use and childhood cancer: a case-control study. , 1995, American journal of public health.

[56]  Jack Cuzick,et al.  Small-area studies: purpose and methods , 1996 .

[57]  Jack Cuzick,et al.  Geographical and Environmental Epidemiology , 1996 .

[58]  R. Knorr,et al.  Adult leukemia and proximity-based surrogates for exposure to Pilgrim plant's nuclear emissions. , 1996, Archives of environmental health.