Context
Exposure to elevated concentrations of traffic-related air pollutants in the near-road
environment is associated with numerous adverse human health effects, including childhood
cancer, which has been increasing since 1975. Results of individual epidemiologic
studies have been inconsistent. Therefore, a meta-analysis was performed to examine
the association between residential traffic exposure and childhood cancer.
Evidence acquisition
Studies published between January 1980 and July 2011 were retrieved from a systematic
search of 18 bibliographic databases. Nine studies meeting the inclusion criteria
were identified. Weighted summary ORs were calculated using a random effects model
for outcomes with four or more studies. Subgroup and sensitivity analyses were performed.
Evidence synthesis
Childhood leukemia was positively associated (summary OR=1.53, 95% CI=1.12, 2.10)
with residential traffic exposure among seven studies using a postnatal exposure window
(e.g., childhood period or diagnosis address) and there was no association (summary
OR=0.92, 95% CI=0.78, 1.09) among four studies using a prenatal exposure window (e.g.,
pregnancy period or birth address). There were too few studies to analyze other childhood
cancer outcomes.
Conclusions
Current evidence suggests that childhood leukemia is associated with residential traffic
exposure during the postnatal period, but not during the prenatal period. Additional
well-designed epidemiologic studies that use complete residential history to estimate
traffic exposure, examine leukemia subtypes, and control for potential confounding
factors are needed to confirm these findings. As many people reside near busy roads,
especially in urban areas, precautionary public health messages and interventions
designed to reduce population exposure to traffic might be warranted.
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