Abstract

Background

Although studies have consistently found an association between childhood leukaemia risk and magnetic fields, the associations between childhood leukaemia and distance to overhead power lines have been inconsistent. We pooled data from multiple studies to assess the association with distance and evaluate whether it is due to magnetic fields or other factors associated with distance from lines.

Methods

We present a pooled analysis combining individual-level data (29,049 cases and 68,231 controls) from 11 record-based studies.

Results

There was no material association between childhood leukaemia and distance to nearest overhead power line of any voltage. Among children living < 50 m from 200 + kV power lines, the adjusted odds ratio for childhood leukaemia was 1.33 (95% CI: 0.92–1.93). The odds ratio was higher among children diagnosed before age 5 years. There was no association with calculated magnetic fields. Odds ratios remained unchanged with adjustment for potential confounders.

Conclusions

In this first comprehensive pooled analysis of childhood leukaemia and distance to power lines, we found a small and imprecise risk for residences < 50 m of 200 + kV lines that was not explained by high magnetic fields. Reasons for the increased risk, found in this and many other studies, remains to be elucidated.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Additional information

Note: This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License.

References

  1. 1.

    Kheifets, L. & Swanson, J. Childhood leukemia and extremely low-frequency magnetic fields: critical evaluation of epidemiologic evidence using Hill’s framework. In: M. Roosli (eds). Epidemiology of Electromagnetic Fields (pp. 141–160. CRC Press, USA, 2014).

  2. 2.

    Ahlbom, A. et al. A pooled analysis of magnetic fields and childhood leukaemia. Br. J. Cancer 83, 692–698 (2000).

  3. 3.

    Greenland, S., Sheppard, A. R., Kaune, W. T., Poole, C. & Kelsh, M. A. A pooled analysis of magnetic fields, wire codes, and childhood leukemia. childhood leukemia-EMF study group. Epidemiology 11, 624–634 (2000).

  4. 4.

    Kheifets, L. et al. Pooled analysis of recent studies on magnetic fields and childhood leukaemia. Br. J. Cancer 103, 1128–1135 (2010).

  5. 5.

    Schuz, J. et al. Nighttime exposure to electromagnetic fields and childhood leukemia: an extended pooled analysis. Am. J. Epidemiol 166, 263–269 (2007).

  6. 6.

    Vergara, X. P. et al. Estimating magnetic fields of homes near transmission lines in the California power line study. Environ. Res. 140, 514–523 (2015).

  7. 7.

    Feychting, M. & Ahlbom, A. The authors reply. Am. J. Epidemiol. 140, 75 (1994).

  8. 8.

    Draper, G., Vincent, T., Kroll, M. E. & Swanson, J. Childhood cancer in relation to distance from high voltage power lines in England and Wales: a case-control study. BMJ. 330, 1290 (2005).

  9. 9.

    Burgi, A., Sagar, S., Struchen, B., Joss, S. & Roosli, M. Exposure modelling of extremely low-frequency magnetic fields from overhead power lines and its validation by measurements. Int. J. Environ. Res. Public Health 14, 949 (2017).

  10. 10.

    Swanson, J. Methods used to calculate exposures in two epidemiological studies of power lines in the UK. J. Radiol. Prot. 28, 45–59 (2008).

  11. 11.

    Kheifets, L., Feychting, M. & Schuz, J. Childhood cancer and power lines: results depend on chosen control group. BMJ 331, 635 (2005).

  12. 12.

    Bunch, K. J., Swanson, J., Vincent, T. J. & Murphy, M. F. Epidemiological study of power lines and childhood cancer in the UK: further analyses. J. Radiol. Prot. 36, 437–455 (2016).

  13. 13.

    Pedersen, C., Johansen, C., Schuz, J., Olsen, J. H. & Raaschou-Nielsen, O. Residential exposure to extremely low-frequency magnetic fields and risk of childhood leukaemia, CNS tumour and lymphoma in Denmark. Br. J. Cancer 113, 1370–1374 (2015).

  14. 14.

    Sermage-Faure, C., Demoury, C., Rudant, J., Goujon-Bellec, S., Guyot-Goubin, A. & Deschamps, F. et al. Childhood leukaemia close to high-voltage power lines—the Geocap study, 2002–2007. Br. J. Cancer 108, 1899–1906 (2013).

  15. 15.

    Crespi, C. M., Vergara, X. P., Hooper, C., Oksuzyan, S., Wu, S. & Cockburn, M. et al. Childhood leukaemia and distance from power lines in California: a population-based case-control study. Br. J. Cancer 115, 122–128 (2016).

  16. 16.

    Blaasaas, K. G. & Tynes, T. Comparison of three different ways of measuring distances between residences and high voltage power lines. Bioelectromagnetics 23, 288–291 (2002).

  17. 17.

    Verkasalo, P. K., Pukkala, E., Hongisto, M. Y., Valjus, J. E., Jarvinen, P. J. & Heikkila, K. V. et al. Risk of cancer in Finnish children living close to power lines. BMJ 307, 895–899 (1993).

  18. 18.

    Feychting, M. & Ahlbom, A. Magnetic fields and cancer in children residing near Swedish high-voltage power lines. Am. J. Epidemiol 138, 467–481 (1993).

  19. 19.

    Tynes, T. & Haldorsen, T. Electromagnetic fields and cancer in children residing near Norwegian high-voltage power lines. Am. J. Epidemiol. 145, 219–226 (1997).

  20. 20.

    Adam, M., Kuehni, C. E., Spoerri, A., Schmidlin, K., Gumy-Pause, F. & Brazzola, P. et al. Socioeconomic status and childhood leukemia incidence in Switzerland. Front. Oncol 5, 139 (2015).

  21. 21.

    Adam, M., Rebholz, C. E., Egger, M., Zwahlen, M. & Kuehni, C. E. Childhood leukaemia and socioeconomic status: what is the evidence? Radiat. Prot. Dosimetry 132, 246–254 (2008).

  22. 22.

    Poole, C., Greenland, S., Luetters, C., Kelsey, J. L. & Mezei, G. Socioeconomic status and childhood leukaemia: a review. Int. J. Epidemiol. 35(2), 370–384 (2006).

  23. 23.

    Oksuzyan S, Crespi CM, Cockburn M, Mezei G, Vergara X, Kheifets L. Socio-economic status and childhood leukemia in California. J. Cancer Prev. Curr. Res. 3, 2015.

  24. 24.

    Marquant, F., Goujon, S., Faure, L., Guissou, S., Orsi, L. & Hemon, D. et al. Risk of childhood cancer and socio-economic disparities: results of the french nationwide study geocap 2002–2010. Paediatr. Perinat. Epidemiol. 30, 612–622 (2016).

  25. 25.

    Slusky, D. A., Does, M., Metayer, C., Mezei, G., Selvin, S. & Buffler, P. A. Potential role of selection bias in the association between childhood leukemia and residential magnetic fields exposure: a population-based assessment. Cancer Epidemiol 38, 307–313 (2014).

  26. 26.

    Stiller, C. A. & Boyle, P. J. Effect of population mixing and socioeconomic status in England and Wales, 1979-85, on lymphoblastic leukaemia in children. BMJ 313(7068), 1297–1300 (1996).

  27. 27.

    Mezei, G. & Kheifets, L. Selection bias and its implications for case-control studies: a case study of magnetic field exposure and childhood leukaemia. Int. J. Epidemiol. 35, 397–406 (2006).

  28. 28.

    Langholz, B., Ebi, K. L., Thomas, D. C., Peters, J. M. & London, S. J. Traffic density and the risk of childhood leukemia in a Los Angeles case-control study. Ann. Epidemiol. 12, 482–487 (2002).

  29. 29.

    Houot, J., Marquant, F., Goujon, S., Faure, L., Honore, C. & Roth, M. H. et al. Residential proximity to heavy-traffic roads, benzene exposure, and childhood leukemia—the GEOCAP Study, 2002–2007. Am. J. Epidemiol. 182, 685–693 (2015).

  30. 30.

    Feychting, M., Svensson, D. & Ahlbom, A. Exposure to motor vehicle exhaust and childhood cancer. Scand. J. Work Environ. Health 24, 8–11 (1998).

  31. 31.

    Boothe, V. L., Boehmer, T. K., Wendel, A. M. & Yip, F. Y. Residential traffic exposure and childhood leukemia: a systematic review and meta-analysis. Am. J. Prev. Med. 46, 413–422 (2014).

  32. 32.

    Filippini, T., Heck, J. E., Malagoli, C., Del Giovane, C. & Vinceti, M. A review and meta-analysis of outdoor air pollution and risk of childhood leukemia. J. Environ. Sci. Health C. Environ. Carcinog. Ecotoxicol. Rev. 33, 36–66 (2015).

  33. 33.

    Kheifets, L., Swanson, J., Yuan, Y., Kusters, C. & Vergara, X. Comparative analyses of studies of childhood leukemia and magnetic fields, radon and gamma radiation. J. Radiol. Prot. 37, 459–491 (2017).

  34. 34.

    Debray, T. P., Moons, K. G., van Valkenhoef, G., Efthimiou, O., Hummel, N. & Groenwold, R. H. et al. Get real in individual participant data (IPD) meta-analysis: a review of the methodology. Res. Synth. Methods 6, 293–309 (2015).

  35. 35.

    Stewart, G. B., Altman, D. G., Askie, L. M., Duley, L., Simmonds, M. C. & Stewart, L. A. Statistical analysis of individual participant data meta-analyses: a comparison of methods and recommendations for practice. PLoS ONE 7, e46042 (2012).

  36. 36.

    Wertheimer, N. & Leeper, E. Electrical wiring configurations and childhood cancer. Am. J. Epidemiol. 109, 273–284 (1979).

  37. 37.

    Fulton, J. P., Cobb, S., Preble, L., Leone, L. & Forman, E. Electrical wiring configurations and childhood leukemia in Rhode Island. Am. J. Epidemiol. 111, 292–296 (1980).

  38. 38.

    Savitz, D. A., Wachtel, H., Barnes, F. A., John, E. M. & Tvrdik, J. G. Case-control study of childhood cancer and exposure to 60-Hz magnetic fields. Am. J. Epidemiol. 128, 21–38 (1988).

  39. 39.

    London, S. J., Thomas, D. C., Bowman, J. D., Sobel, E., Cheng, T. C. & Peters, J. M. Exposure to residential electric and magnetic fields and risk of childhood leukemia. Am. J. Epidemiol. 134, 923–937 (1991).

  40. 40.

    Fajardo-Gutierrez, A., Navarrete-Martinez, A., Reynoso-Garcia, M., Zarzosa-Morales, M. E., Mejia-Arangure, M. & Yamamoto-Kimura, L. T. Incidence of malignant neoplasms in children attending Social Security Hospitals in Mexico City. Med. Pediatr. Oncol. 29, 208–212 (1997).

  41. 41.

    Linet, M. S., Hatch, E. E., Kleinerman, R. A., Robison, L. L., Kaune, W. T. & Friedman, D. R. et al. Residential exposure to magnetic fields and acute lymphoblastic leukemia in children. N. Engl. J. Med. 337, 1–7 (1997).

  42. 42.

    Green, L. M., Miller, A. B., Agnew, D. A., Greenberg, M. L., Li, J. & Villeneuve, P. J. et al. Childhood leukemia and personal monitoring of residential exposures to electric and magnetic fields in Ontario, Canada. Cancer Causes Control 10, 233–243 (1999).

  43. 43.

    McBride, M. L., Gallagher, R. P., Theriault, G., Armstrong, B. G., Tamaro, S. & Spinelli, J. J. et al. Power-frequency electric and magnetic fields and risk of childhood leukemia in Canada. Am. J. Epidemiol. 149, 831–842 (1999).

  44. 44.

    Wunsch-Filho, V., Pelissari, D. M., Barbieri, F. E., Sant'Anna, L., de Oliveira, C. T. & de Mata, J. F. et al. Exposure to magnetic fields and childhood acute lymphocytic leukemia in Sao Paulo, Brazil. Cancer Epidemiol 35, 534–539 (2011).

  45. 45.

    Pedersen, C., Raaschou-Nielsen, O., Rod, N. H., Frei, P., Poulsen, A. H. & Johansen, C. et al. Distance from residence to power line and risk of childhood leukemia: a population-based case-control study in Denmark. Cancer Causes Control 25, 171–177 (2014).

  46. 46.

    Bianchi, N., Crosignani, P., Rovelli, A., Tittarelli, A., Carnelli, C. A. & Rossitto, F. et al. Overhead electricity power lines and childhood leukemia: a registry-based, case-control study. Tumori 86, 195 (2000).

  47. 47.

    Malagoli, C., Fabbi, S., Teggi, S., Calzari, M., Poli, M. & Ballotti, E. et al. Risk of hematological malignancies associated with magnetic fields exposure from power lines: a case-control study in two municipalities of northern Italy. Environ. Health 9, 16 (2010).

  48. 48.

    Spycher, B. D., Feller, M., Zwahlen, M., Roosli, M., von der Weid, N. X. & Hengartner, H. et al. Childhood cancer and nuclear power plants in Switzerland: a census-based cohort study. Int. J. Epidemiol. 40, 1247–1260 (2011).

  49. 49.

    Lowenthal, R. M., Tuck, D. M. & Bray, I. C. Residential exposure to electric power transmission lines and risk of lymphoproliferative and myeloproliferative disorders: a case-control study. Intern. Med. J. 37, 614–619 (2007).

  50. 50.

    Bunch, K. J., Keegan, T. J., Swanson, J., Vincent, T. J. & Murphy, M. F. Residential distance at birth from overhead high-voltage powerlines: childhood cancer risk in Britain 1962-2008. Br. J. Cancer 110, 1402–1408 (2014).

  51. 51.

    Kabuto, M., Nitta, H., Yamamoto, S., Yamaguchi, N., Akiba, S. & Honda, Y. et al. Childhood leukemia and magnetic fields in Japan: A case-control study of childhood leukemia and residential power-frequency magnetic fields in Japan. Int. J. Cancer 199, 643–650 (2006).

  52. 52.

    Feizi, A. A. H. P. & Arabi, M. A. Acute childhood leukemias and exposure to magnetic fields generated by high voltage overhead power lines-a risk factor in Iran. Asian Pac. J. Cancer Prev. 8, 69 (2007).

  53. 53.

    Li, C. Y., Lee, W. & Lin, R. S. Risk of leukemia in children living near high-voltage transmission lines. J. Occup. Environ. Med. 40, 144–147 (1998).

  54. 54.

    Lin, R. S., Lee, W. C. & Li, C. Y. Risk of Childhood leukemia in households near high power lines. Med. Biol. Eng. Comput. 34, 131–132 (1996).

  55. 55.

    Mizoue, T., Onoe, Y., Moritake, H., Okamura, J., Sokejima, S. & Nitta, H. Residential proximity to high-voltage power lines and risk of childhood hematological malignancies. J. Epidemiol. 14, 118–123 (2004).

  56. 56.

    Petridou, E., Trichopoulos, D., Kravaritis, A., Pourtsidis, A., Dessypris, N. & Skalkidis, Y. et al. Electrical power lines and childhood leukemia: a study from Greece. Int. J. Cancer 73, 345–348 (1997).

  57. 57.

    Rahman, H. I. A., Shah, S. A., Alias, H. & Ibrahim, H. M. A case-control study on the association between environmental factors and the occurrence of acute leukemia among children in Klang Valley, Malaysia. Asian Pac. J. Cancer Prev. 9, 649–652 (2008).

  58. 58.

    Sohrabi, M. R., Tarjoman, T., Abadi, A. & Yavari, P. Living near overhead high voltage transmission power lines as a risk factor for childhood acute lymphoblastic leukemia: a case-control study. Asian Pac. J. Cancer Prev. 11, 423–427 (2010).

  59. 59.

    UK Childhood Cancer Study Investigators. Childhood cancer and residential proximity to power lines. Br. J. Cancer 83, 1573 (2000).

  60. 60.

    Burke, D. L., Ensor, J. & Riley, R. D. Meta-analysis using individual participant data: one-stage and two-stage approaches, and why they may differ. Stat. Med. 36, 855–875 (2017).

  61. 61.

    Law, G. R., Smith, A. G. & Roman, E., United Kingdom Childhood Cancer Study I. The importance of full participation: lessons from a national case-control study. Br. J. Cancer 86, 350–355 (2002).

Download references

Acknowledgements

C.M.C. was also partially supported by the National Cancer Institute at the National Institutes of Health (grant P30 CA16042). The Italy1 study was conducted by the National Cancer Institute of Milan, in collaboration with Health Local Unit (ASL) of Varese Province and of Regional Environmental Protection Agency (ARPA—Varese Province). The main collaborators were Crosignani P., Borgini A., Bertoldi M., Codazzi T., Bianchi N., Rovelli A. and Porro E. The Norwegian study was conducted by the Cancer Registry of Norway and supported by the Research Council of Norway. The UK study was supported by Children with Cancer UK; see original paper for other acknowledgements. The Tasmanian study was partly supported by the David Collins Leukaemia Foundation, the Clifford Craig Medical Research Trust and the Royal Hobart Hospital Medical Research Foundation. Acknowledgements go to Ray Lowenthal, Konrad Jamrozik, Anne Piaszczyk and Jean Panton. The Brazilian study was conducted under the EMF Project-SP, P&D project, with resources allocated by the Brazilian Association for Electromagnetic Compatibility (ABRICEM), and performed at the University of São Paulo School of Public Health. Italy2 was supported by the non-profit Associazione Sostegno Oncologia Ematologia Pediatrica (ASOEP). This work was supported by the Electric Power Research Institute.

Author information

Affiliations

  1. Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, 90095-1772, USA

    • Aryana T Amoon
    • , Megha Bhatnagar
    • , Madhuri Sudan
    • , Ximena Vergara
    •  & Leeka Kheifets
  2. Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, 90095-1772, USA

    • Catherine M Crespi
  3. Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    • Anders Ahlbom
    •  & Maria Feychting
  4. Department of Health and Social Sciences, University of the West of England, Bristol, BS16 1QY, UK

    • Isabelle Bray
  5. National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Headington, Oxford, OX3 7LF, UK

    • Kathryn J Bunch
  6. Epidemiology of Childhood and Adolescent Cancers, CRESS, INSERM, UMR 1153, Paris Descartes University, Villejuif, France

    • Jacqueline Clavel
    • , Denis Hémon
    •  & Fabienne Marquant
  7. National Registry of Childhood Cancers - Hematological Malignancies, Villejuif, France

    • Jacqueline Clavel
  8. The Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark

    • Christoffer Johansen
    • , Camilla Pedersen
    •  & Ole Raaschou-Nielsen
  9. Oncology Clinic, Finsen Center, Rigshospitalet 5073, 2100, Copenhagen, Denmark

    • Christoffer Johansen
  10. Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland

    • Christian Kreis
    •  & Ben D Spycher
  11. Research Center of Environmental (CREAGEN), Genetic and Nutritional Epidemiology University of Modena and Reggio Emilia, Modena, Italy

    • Carlotta Malagoli
    •  & Marco Vinceti
  12. Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark

    • Ole Raaschou-Nielsen
  13. Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland

    • Martin Röösli
  14. University of Basel, Petersgraben 1, Basel, Switzerland

    • Martin Röösli
  15. Department of Public Health, Aarhus University, Aarhus, Denmark

    • Madhuri Sudan
  16. College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, 91766-1854, USA

    • Madhuri Sudan
  17. National Grid, London, UK

    • John Swanson
  18. Cancer Registry Unit, National Cancer Institute, Milan, 20133, Italy

    • Andrea Tittarelli
  19. School of Medicine, University of Tasmania, Hobart, TAS, Australia

    • Deirdre M Tuck
  20. Royal Hobart Hospital, Hobart, TAS, Australia

    • Deirdre M Tuck
  21. Department of Occupational Health Surveillance, National Institute of Occupational Health, Oslo, Norway

    • Tore Tynes
  22. Energy and Environment Sector, Electric Power Research Institute, Palo Alto, CA, 94304, USA

    • Ximena Vergara
  23. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

    • Marco Vinceti
  24. Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, 01246-904, Brazil

    • Victor Wünsch-Filho

Authors

  1. Search for Aryana T Amoon in:

  2. Search for Catherine M Crespi in:

  3. Search for Anders Ahlbom in:

  4. Search for Megha Bhatnagar in:

  5. Search for Isabelle Bray in:

  6. Search for Kathryn J Bunch in:

  7. Search for Jacqueline Clavel in:

  8. Search for Maria Feychting in:

  9. Search for Denis Hémon in:

  10. Search for Christoffer Johansen in:

  11. Search for Christian Kreis in:

  12. Search for Carlotta Malagoli in:

  13. Search for Fabienne Marquant in:

  14. Search for Camilla Pedersen in:

  15. Search for Ole Raaschou-Nielsen in:

  16. Search for Martin Röösli in:

  17. Search for Ben D Spycher in:

  18. Search for Madhuri Sudan in:

  19. Search for John Swanson in:

  20. Search for Andrea Tittarelli in:

  21. Search for Deirdre M Tuck in:

  22. Search for Tore Tynes in:

  23. Search for Ximena Vergara in:

  24. Search for Marco Vinceti in:

  25. Search for Victor Wünsch-Filho in:

  26. Search for Leeka Kheifets in:

Contributions

A.T.A. and C.K. did the analyses and drafted the manuscript. L.K., J.S. and X.V. conceived of the work. L.K. designed the study, acquired data and had a key role in interpreting the results. M.S. and M.B. helped collect, organise and clean the data. Everyone else provided data. All authors had a role in interpretation of results, revised the manuscript, approved the final version and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Competing interests

M.F. is vice chairman of the International Commission on Non-Ionizing Radiation Protection (ICNIRP), an independent body setting guidelines for non-ionizing radiation protection. She serves as advisor to a number of national and international public advisory and research steering groups concerning the potential health effects of exposure to non-ionizing radiation. J.S. worked on this project as part of his employment by National Grid but no approval for the conduct of the study or the contents of the paper was necessary or sought from anyone else in National Grid. X.V. is an employee of the Electric Power Research Institute. M.V. is a paid consultant for two private multi-utility companies: IREN and HERA. All other authors declare no competing interests.

Ethics Approval and Consent to Participate

The study was approved by University of California, Los Angeles Office of the Human Research Protection Program.

Availability of data and materials

The data that supports the findings of this study are available from individual study centres, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of local ethics committees and/or other constraints.

Corresponding author

Correspondence to Leeka Kheifets.

Electronic supplementary material

About this article

Publication history

Received

Revised

Accepted

Published

DOI

https://doi.org/10.1038/s41416-018-0097-7