Outdoor artificial light at night, air pollution, and risk of childhood acute lymphoblastic leukemia in the California Linkage Study of Early-Onset Cancers

Abstract

Acute lymphoblastic leukemia (ALL) is the most common type of cancer in children (age 0-14 years); however, the etiology remains incompletely understood. Several environmental exposures have been linked to risk of childhood ALL, including air pollution. Closely related to air pollution and human development is artificial light at night (ALAN), which is believed to disrupt circadian rhythm and impact health. We sought to evaluate outdoor ALAN and air pollution on risk of childhood ALL. The California Linkage Study of Early-Onset Cancers is a large population-based case-control in California that identifies and links cancer diagnoses from the California Cancer Registry to birth records. For each case, 50 controls with the same year of birth were obtained from birth records. A total of 2,782 ALL cases and 139,100 controls were identified during 2000-2015. ALAN was assessed with the New World Atlas of Artificial Night Sky Brightness and air pollution with an ensemble-based air pollution model of particulate matter smaller than 2.5 microns (PM_2.5). After adjusting for known and suspected risk factors, the highest tertile of ALAN was associated with an increased risk of ALL in Hispanic children (odds ratio [OR] = 1.15, 95% confidence interval [CI] 1.01-1.32). There also appeared to be a borderline association between PM_2.5 level and risk of ALL among non-Hispanic White children (OR per 10 µg/m³ = 1.24, 95% CI 0.98-1.56). We observed elevated risk of ALL in Hispanic children residing in areas of greater ALAN. Further work is needed to understand the role of ALAN and air pollution in the etiology of childhood ALL in different racial/ethnic groups.

Figure 1

Association between outdoor artificial light at night, air pollution, birth characteristics, and risk of childhood acute lymphoblastic leukemia among Hispanic children in the California Linkage Study of Early-Onset Cancers. *Adjusted odds ratios and 95% confidence intervals were derived from a multivariable logistic regression model that simultaneously included all variables listed in this figure.

Figure 2

Association between outdoor artificial light at night, air pollution, birth characteristics, and risk of childhood acute lymphoblastic leukemia among Non-Hispanic White children in the California Linkage Study of Early-Onset Cancers. *Adjusted odds ratios and 95% confidence intervals were derived from a multivariable logistic regression model that simultaneously included all variables listed in this figure.