Risk of neuroblastoma and residential proximity to industrial and urban sites: A case-control study.
Neuroblastoma is the most common extracranial solid tumor in children but its etiology is not clearly understood. While a small fraction of cases might be attributable to genetic factors, the role of environmental pollution factors needs to be assessed.



To ascertain the effect of residential proximity to both industrial and urban areas on neuroblastoma risk, taking into account industrial groups and toxic substances released.



We conducted a population-based case-control study of neuroblastoma in Spain, including 398 incident cases gathered from the Spanish Registry of Childhood Tumors (period 1996-2011), and 2388 controls individually matched by year of birth, sex, and region of residence. Distances were computed from the respective subject's residences to the 1271 industries and the 30 urban areas with ≥75,000 inhabitants located in the study area. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance (from 1km to 5km) to industrial and urban pollution sources were calculated, with adjustment for matching variables and socioeconomic confounders.



Excess risk (OR; 95%CI) of neuroblastoma was detected for the intersection between industrial and urban areas: (2.52; 1.20-5.30) for industrial distance of 1km, and (1.99; 1.17-3.37) for industrial distance of 2km. By industrial groups, excess risks were observed near 'Production of metals' (OR=2.05; 95%CI=1.16-3.64 at 1.5km), 'Surface treatment of metals' (OR=1.89; 95%CI=1.10-3.28 at 1km), 'Mines' (OR=5.82; 95%CI=1.04-32.43 at 1.5km), 'Explosives/pyrotechnics' (OR=4.04; 95%CI=1.31-12.42 at 4km), and 'Urban waste-water treatment plants' (OR=2.14; 95%CI=1.08-4.27 at 1.5km).



These findings support the need for more detailed exposure assessment of certain substances released by these industries.
Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain. Electronic address: jgarcia@isciii.es.
Javier
J
García-Pérez
Rare Disease Research Institute (IIER), Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Rare Diseases (CIBERER), Madrid, Spain. Electronic address: amorales@isciii.es.
Antonio
A
Morales-Piga
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain; National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. Electronic address: dgomez@externos.isciii.es.
Diana
D
Gómez-Barroso
Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain. Electronic address: ibontama@gmail.com.
Ibon
I
Tamayo-Uria
Spanish Registry of Childhood Tumors (RETI-SEHOP), University of Valencia, Valencia, Spain. Electronic address: elena.pardo@uv.es.
Elena
E
Pardo Romaguera
Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain. Electronic address: pfernandezn@isciii.es.
Pablo
P
Fernández-Navarro
Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain. Electronic address: glabente@isciii.es.
Gonzalo
G
López-Abente
Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain. Electronic address: rramis@isciii.es.
Rebeca
R
Ramis
D016022:Case-Control Studies; D002648:Child; D002947:Cities; D003710:Demography; D004787:Environmental Pollution / Q000009:adverse effects; D005260:Female; D006798:Housing; D006801:Humans; D016015:Logistic Models; D008297:Male; D009447:Neuroblastoma / Q000209:etiology*; D016017:Odds Ratio; D012111:Residence Characteristics; D012307:Risk Factors; D013030:Spain; D014504:Urban Health
Case-control study; Industrial pollution; Neuroblastoma; Pollutant release and transfer register; Residential proximity; Urban pollution