BACKGROUND Pesticide exposures are suspected of being a risk factor for several childhood cancers, particularly acute leukemia (AL). Most of the evidence is based on self-reported parental domestic use of pesticides, but some studies have also addressed associations with agricultural use of pesticides near the place of residence. OBJECTIVES The objective of the study was to evaluate the risk of AL in children living close to vines, a crop subject to intensive pesticide use. METHODS Data were drawn from the national registry-based GEOCAP study. We included all of the AL cases under the age of 15 years diagnosed in 2006-2013 (n=3,711) and 40,196 contemporary controls representative of the childhood population in France. The proximity of the vines (probability of presence within 200, 500, and 1,000m) and the viticulture density (area devoted to vines within 1,000m) were evaluated around the geocoded addresses in a geographic information system combining three national land use maps. Logistic regression models were used to estimate odds ratios (ORs) for all AL and for the lymphoblastic (ALL) and myeloid (AML) subtypes. Heterogeneity between regions was studied by stratified analyses. Sensitivity analyses were carried out to take into account, in particular, geocoding uncertainty, density of other crops and potential demographic and environmental confounders. RESULTS In all, about 10% of the controls lived within 1km of vines. While no evidence of association between proximity to vines and AL was found, viticulture density was positively associated with ALL [OR=1.05 (1.00-1.09) for a 10% increase in density], with a statistically significant heterogeneity across regions. No association with AML was observed. The results remained stable in all the sensitivity analyses. CONCLUSION We evidenced a slight increase in the risk of ALL in children living in areas with high viticulture density. This finding supports the hypothesis that environmental exposure to pesticides may be associated with childhood ALL. https://doi.org/10.1289/EHP12634.

中文翻译：

---

法国大陆居住地与葡萄栽培区的距离与儿童急性白血病风险之间的关联：GEOCAP 病例对照研究，2006-2013 年。

背景技术农药暴露被怀疑是多种儿童癌症、特别是急性白血病(AL)的危险因素。大多数证据都是基于父母家庭使用农药的自我报告，但一些研究也探讨了与居住地附近农业使用农药的关联。目的 该研究的目的是评估生活在葡萄树（一种大量使用农药的作物）附近的儿童患 AL 的风险。方法 数据取自基于国家登记的 GEOCAP 研究。我们纳入了 2006 年至 2013 年诊断的所有 15 岁以下 AL 病例 (n=3,711) 以及代表法国儿童人口的 40,196 名当代对照者。结合三个国家土地利用地图的地理信息系统中的地理编码地址，对葡萄藤的邻近度（200、500 和 1,000 m 范围内存在的概率）和葡萄栽培密度（1,000 m 范围内的葡萄藤种植面积）进行了评估。Logistic 回归模型用于估计所有 AL 以及淋巴母细胞 (ALL) 和骨髓 (AML) 亚型的比值比 (OR)。通过分层分析研究区域之间的异质性。进行了敏感性分析，特别考虑了地理编码的不确定性、其他作物的密度以及潜在的人口和环境混杂因素。结果 总的来说，大约 10% 的对照组居住在距离葡萄藤 1 公里以内的地方。虽然没有发现靠近葡萄树与 AL 之间存在关联的证据，但葡萄栽培密度与 ALL 呈正相关[对于密度增加 10%，OR=1.05 (1.00-1.09)]，各地区之间存在统计上显着的异质性。没有观察到与 AML 的关联。所有敏感性分析的结果保持稳定。结论 我们证明，生活在葡萄种植密度较高地区的儿童患 ALL 的风险略有增加。这一发现支持了这样的假设：环境中接触农药可能与儿童急性淋巴细胞白血病有关。https://doi.org/10.1289/EHP12634。