title: A case-control study on the association between environmental factors and the occurrence of acute leukemia among children in Klang Valley, Malaysia.
abstract: BACKGROUND
  In Malaysia, acute leukemia is the most common cancer among children below the age of 15. A case-control study was here conducted for cases from the Klang Valley, Malaysia, who received treatment at the National University of Malaysia Hospital (HUKM) and Kuala Lumpur General Hospital (GHKL). The main objective was to determine any association with environmental factors.
  
  
  METHODS
  Case subjects were children aged below 15 years and diagnosed with acute leukemia in HUKM and GHKL between January 1, 2001 and May 30, 2007. Control subjects were children aged below 15 years who were diagnosed with any non-cancerous acute illnesses in these hospitals. A total of 128 case subjects and 128 control subjects were enrolled in this study. The information was collected using a structured questionnaire and a global positioning system (GPS) device. All factors were analyzed using unmatched logistic regression.
  
  
  RESULTS
  The analysis showed that the occurrence of acute leukemia among children was strongly determined by the following factors: family income (odds ratio (OR) 0.19, 95% confidence interval (CI): 0.09-0.42), father with higher social contact (OR 7.61, 95% CI: 3.78-15.4), number of elder siblings (OR 0.36, 95% CI: 0.18-0.77), father who smokes (OR 2.78, 95% CI: 1.49-5.16), and the distance of the house from a power line (OR 2.30, 95% CI: 1.18-4.49).
  
  
  CONCLUSIONS
  Some socioeconomic, demographic, and environmental factors are strong predictors of the occurrence of acute leukemia among children in Klang Valley, Malaysia. In terms of environmental factors, it is recommended that future housing areas should be developed at least 200 m away from power lines.
authors.affiliation: Community Health Dept, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Hairul Izwan
authors.initials: HI
authors.lastname: Abdul Rahman
authors.forename: Shamsul Azhar
authors.initials: SA
authors.lastname: Shah
authors.forename: Hamidah
authors.initials: H
authors.lastname: Alias
authors.forename: Hishamshah Mohd
authors.initials: HM
authors.lastname: Ibrahim
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D016902:Air Pollution, Indoor / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003906:Developing Countries; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D004787:Environmental Pollution / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology* / Q000628:therapy; D016015:Logistic Models; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012959:Socioeconomic Factors; D016019:Survival Analysis