title: Investigating childhood leukemia in Churchill County, Nevada.
abstract: BACKGROUND
  Sixteen children diagnosed with acute leukemia between 1997 and 2002 lived in Churchill County, Nevada, at the time of or before their illness. Considering the county population and statewide cancer rate, fewer than two cases would be expected.
  
  
  OBJECTIVE
  In March 2001, the Centers for Disease Control and Prevention led federal, state, and local agencies in a cross-sectional, case-comparison study to determine if ongoing environmental exposures posed a health risk to residents and to compare levels of contaminants in environmental and biologic samples collected from participating families.
  
  
  METHODS
  Surveys with more than 500 variables were administered to 205 people in 69 families. Blood, urine, and cheek cell samples were collected and analyzed for 139 chemicals, eight viral markers, and several genetic polymorphisms. Air, water, soil, and dust samples were collected from almost 80 homes to measure more than 200 chemicals.
  
  
  RESULTS
  The scope of this cancer cluster investigation exceeded any previous study of pediatric leukemia. Nonetheless, no exposure consistent with leukemia risk was identified. Overall, tungsten and arsenic levels in urine and water samples were significantly higher than national comparison values; however, levels were similar among case and comparison groups.
  
  
  CONCLUSIONS
  Although the cases in this cancer cluster may in fact have a common etiology, their small number and the length of time between diagnosis and our exposure assessment lessen the ability to find an association between leukemia and environmental exposures. Given the limitations of individual cancer cluster investigations, it may prove more efficient to pool laboratory and questionnaire data from similar leukemia clusters.
authors: National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. crubin@cdc.gov
authors: Carol S
authors: CS
authors: Rubin
authors: Adrianne K
authors: AK
authors: Holmes
authors: Martin G
authors: MG
authors: Belson
authors: Robert L
authors: RL
authors: Jones
authors: W Dana
authors: WD
authors: Flanders
authors: Stephanie M
authors: SM
authors: Kieszak
authors: John
authors: J
authors: Osterloh
authors: George E
authors: GE
authors: Luber
authors: Benjamin C
authors: BC
authors: Blount
authors: Dana B
authors: DB
authors: Barr
authors: Karen K
authors: KK
authors: Steinberg
authors: Glen A
authors: GA
authors: Satten
authors: Michael A
authors: MA
authors: McGeehin
authors: Randall L
authors: RL
authors: Todd
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure / Q000032:analysis*; D004785:Environmental Pollutants / Q000032:analysis; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008670:Metals / Q000032:analysis; D009505:Nevada / Q000453:epidemiology; D010575:Pesticides / Q000032:analysis; D011078:Polychlorinated Biphenyls / Q000032:analysis; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000209:etiology*; D011839:Radiation, Ionizing; D012307:Risk Factors; D014881:Water Supply / Q000032:analysis
chemical_list: D004785:Environmental Pollutants; D008670:Metals; D010575:Pesticides; D011078:Polychlorinated Biphenyls