CHILDHOOD LEUKEMIA AND ENVIRONMENTAL EXPOSURES

儿童白血病的病因在很大程度上仍不清楚。目的 这项建议的目的是扩大现有的病例对照研究 儿童白血病分子的大小、地理区域及精细化 计量家用化学品和杀虫剂的暴露量；以及 以评估暴露在电场和磁场中的情况。世俗的 暴露于环境因素的关系，包括饮食、 职业性和住宅性化学品暴露由使用情况决定 自我报告和面谈数据。分子生物学技术有 用来描述白血病的亚型和白血病的存在 基因变化。生物标本包括骨髓和 新诊断病例的外周血、口腔细胞样本 病例、其母亲和对照对象，以及存档的新生儿血液 来自加州出生的病例和对照将用于这一努力 以确定暴露的时间。家用杀虫剂是一种 环境暴露特别令人担忧，因为以前的研究已经 建议在怀孕期间接触化学物质和杀虫剂以及 出生后可能与随后的童年发展有关 白血病。这项研究将扩大目前资助的一项研究 儿童白血病，包括0-14岁的新诊断病例， 1995-1998年期间在湾区的四家转诊医院就诊。 这项提议将使预期样本数量翻一番，到#年达到400例。 包括在这些医院确诊的病例额外三年 并将研究范围扩大到包括三大主要疾病的患者 在加州中央山谷的临床中心工作了四年。 每个病例将获得两个匹配的对照组：Friend 控制措施和出生证明控制措施。朋友控件将是 从符合情况的家长提供的提名者中随机选择 关于年龄、性别、性别、确诊时居住的县和种族 母亲。出生证控制将从加利福尼亚州选择 在年龄、性别、性别、县等方面与案件相符的出生 出生地、居住地和种族。自填式问卷 并将获得个人面谈，以收集与 环境暴露的范围和其他风险因素，包括 饮食史、居住史和化学史 怀孕前和怀孕期间母亲和孩子的暴露情况， 母亲的职业史和生育史，以及健康 孩子的病史。后续曝光组件将重点放在 过去一年及以下期间接触家用杀虫剂 孕期与儿童出生后头两年的生命和措施 电场和磁场直接在家里和间接地通过 训练有素的员工对住宅布线配置进行编码。分子 白血病病例的特征允许对 白血病的生物学基础，并将促进 在分析中暴露于白血病亚型。拟议的研究， 它将试图将特定的化学成分与基因 在儿童白血病中发现的变化，将有助于降低 原因不明的白血病。

The causes of childhood leukemia remain largely unknown. The purpose of this proposal is to expand an existing case-control study of molecular of childhood leukemia in size and geographic region and refine the measurement of exposure to household chemicals and pesticides, and to assess exposure to electric and magnetic fields. The temporal relationship of exposure to environmental agents including dietary, occupational and residential chemical exposures are determined by use of self-report and interview data. Molecular biologic techniques are used to characterize the subtypes of leukemia and the presence of genetic changes. Biological specimens include bone marrow and peripheral blood of newly diagnosed cases, buccal cell specimens from cases, their mothers and control subjects, and archived newborn blood from cases and controls born in California will be used in the endeavor to identify the timing of exposures. Household pesticides are an environmental exposure of particular concern since previous studies have suggested that chemical and pesticide exposure during pregnancy and after birth may be related to the subsequent development of childhood leukemia. This research will expand a currently funded study of childhood leukemia which includes newly diagnosed cases ages 0-14 which present at four Bay Area referral hospitals during the period 1995-1998. This proposal will double the expected sample size to 400 cases by including cases ascertained at these hospitals an additional three years and expanding the study to include patients from the three major clinical centers for the central valleys of California for four years. Two matched control groups will be obtained for each case: friend controls and birth certificate controls. Friend controls will be randomly chosen from nominees provided by parents that match the case on age, sex, gender, county of residence at diagnosis, and ethnicity of mother. Birth certificate controls will be chosen from California births that match the case with respect to age, sex, gender, county of residence at birth, and ethnicity. A self-administered questionnaire and personal interview will be obtained to collect data related to a spectrum of environmental exposures and other risk factors including dietary history and residential history and history of chemical exposures of the mother prior to and during pregnancy and the child, occupational history and reproductive history of the mother, and health history of the child. A subsequent exposure component will focus on exposures to household pesticides during the past year and during pregnancy and the first two years of the child's life and measure electric and, magnetic fields directly in the home and indirectly by trained staff coding residential wiring configurations. Molecular characterization of leukemia cases allows for the subclassification of leukemias on a biological basis, and will facilitate the linkage of exposures with leukemia subtypes in the analysis. The proposed study, which will attempt to link specific chemical components with genetic changes found in childhood leukemia, will help to reduce the percentage of leukemias for which there is no known cause.