Exposure to pesticides and childhood cancer risk: has there been any progress in epidemiological studies?
OBJECTIVE
In Europe and the United States, cancer is a major cause of death among children aged 5-14 years. The role of environmental exposure to pesticides in carcinogenesis, although strongly postulated, is still unknown. Pesticides have been used since the early days of modern agriculture. They are biologically active compounds, which may pose health risk during or after their use.


METHODS
Epidemiological studies focused on childhood cancer and exposure to pesticides, conducted over the last seven years, were identified through searching PUBMED, MEDLINE and EBSCO literature bases. From each study, the following information was abstracted: type of cancer, type of exposure, study design, risk estimate, and study population. This review will try to answer the question on whether any further progress in epidemiology of childhood cancer due to pesticide exposure has been made.


RESULTS
Leukemia, brain cancer, non-Hodgkin's lymphoma and neuroblastoma are mentioned as potentially associated with pesticide exposure among children. Despite an increasing evidence in support of this finding, it is still limited because of the weakness of research methodology. The substantial weak points of numerous epidemiological studies of pesticide-related health effects are problems faced in exposure assessment, small numbers of exposed subjects, a limited number of studies focused on the majority of cancers, and difficulties in estimating critical windows of exposure.


CONCLUSIONS
In the light of existing, although still limited evidence of adverse effects of pesticide exposure, it is necessary to reduce exposure to pesticides. The literature review suggests a great need to increase awareness among people occupationally or environmentally exposed to pesticides about their potential negative influence on health of their children.
Jurewicz
Joanna
J
Department of Environmental Epdemiology, Nofer Institute of Occupational Medicine, Lódź, Poland. joannaj@imp.lodz.pl
Hanke
Wojciech
W
D000293:Adolescent; D001932:Brain Neoplasms / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure; D016021:Epidemiologic Studies; D006801:Humans; D007938:Leukemia / Q000453:epidemiology / Q000209:etiology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000209:etiology; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D009423:Nervous System Neoplasms / Q000453:epidemiology / Q000209:etiology; D009447:Neuroblastoma / Q000453:epidemiology / Q000209:etiology; D010575:Pesticides / Q000633:toxicity*; D012307:Risk Factors; D009396:Wilms Tumor / Q000453:epidemiology / Q000209:etiology
D010575:Pesticides