Predictors of residential mobility and its impact on air pollution exposure among children diagnosed with early childhood leukemia


Epidemiology studies relying on one address to assign exposures over time share common methodological limitations in failing to account for mobility that may introduce potential exposure misclassification. Using Texas birth certificate and cancer registry data, we identified predictors of residential mobility among mothers of children diagnosed with early childhood leukemia in Texas from 1995 to 2011. We used U.S. Environmental Protection Agency (EPA) National Air Toxics Assessment data to estimate residential levels of benzene and 1,3-butadiene based on addresses at birth and diagnosis and applied mixed-effects ordinal logistic regression models to evaluate differences in exposure classification between the two time periods. In total, 55% of children moved from time of birth to diagnosis, although they generally did not move far (median distance moved was 8 km). Predictors of mobility, at delivery, included younger age, being unmarried and living in neighborhoods with high benzene levels, and, at diagnosis, increasing child’s age and living in neighborhoods with low poverty rates. We observed that the odds of being assigned to a higher exposure quartile at diagnosis relative to the time of birth decreased by 31% for 1,3-butadiene (OR = 0.69, 95% CI 0.59–0.82) and by 12% for benzene (OR = 0.88, 95% CI 0.75, 1.05).

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This study was supported by a grant from the National Cancer Institute (grant number, 5R03CA162172). Funding for this study was provided by the National Institutes of Health, National Cancer Institute (5R03CA162172). With IRB approvals from the Texas Department of State Health Services and University of Texas Health Science Center at Houston, data were provided by the Texas Cancer Registry, Birth Defects Registry, and Vital Statistics.

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Correspondence to Elaine Symanski.

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Tee Lewis, P.G., Chen, TY., Chan, W. et al. Predictors of residential mobility and its impact on air pollution exposure among children diagnosed with early childhood leukemia. J Expo Sci Environ Epidemiol 29, 510–519 (2019).

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  • Air Pollution
  • Benzene
  • Butadiene
  • Leukemia
  • Exposure
  • Misclassification

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