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. 2004 May;112(6):766–771. doi: 10.1289/ehp.6592

Probability estimates for the unique childhood leukemia cluster in Fallon, Nevada, and risks near other U.S. Military aviation facilities.

Craig Steinmaus 1, Meng Lu 1, Randall L Todd 1, Allan H Smith 1
PMCID: PMC1241974  PMID: 15121523

Abstract

A unique cluster of childhood leukemia has recently occurred around the city of Fallon in Churchill County, Nevada. From 1999 to 2001, 11 cases were diagnosed in this county of 23,982 people. Exposures related to a nearby naval air station such as jet fuel or an infectious agent carried by naval aviators have been hypothesized as potential causes. The possibility that the cluster could be attributed to chance was also considered. We used data from the Surveillance, Epidemiology, and End Results Program (SEER) to examine the likelihood that chance could explain this cluster. We also used SEER and California Cancer Registry data to evaluate rates of childhood leukemia in other U.S. counties with military aviation facilities. The age-standardized rate ratio (RR) in Churchill County was 12.0 [95% confidence interval (CI), 6.0-21.4; p = 4.3 times symbol 10(-9)]. A cluster of this magnitude would be expected to occur in the United States by chance about once every 22,000 years. The age-standardized RR for the five cases diagnosed after the cluster was first reported was 11.2 (95% CI, 3.6-26.3). In contrast, the incidence rate was not increased in all other U.S. counties with military aviation bases (RR = 1.04; 95% CI, 0.97-1.12) or in the subset of rural counties with military aviation bases (RR = 0.72; 95% CI, 0.48-1.08). These findings suggest that the Churchill County cluster was unlikely due to chance, but no general increase in childhood leukemia was found in other U.S. counties with military aviation bases.

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Selected References

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  1. Alexander F. E., Chan L. C., Lam T. H., Yuen P., Leung N. K., Ha S. Y., Yuen H. L., Li C. K., Li C. K., Lau Y. L. Clustering of childhood leukaemia in Hong Kong: association with the childhood peak and common acute lymphoblastic leukaemia and with population mixing. Br J Cancer. 1997;75(3):457–463. doi: 10.1038/bjc.1997.77. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Carlton G. N., Smith L. B. Exposures to jet fuel and benzene during aircraft fuel tank repair in the U.S. Air Force. Appl Occup Environ Hyg. 2000 Jun;15(6):485–491. doi: 10.1080/104732200301278. [DOI] [PubMed] [Google Scholar]
  3. Dickinson H. O., Parker L. Quantifying the effect of population mixing on childhood leukaemia risk: the Seascale cluster. Br J Cancer. 1999 Sep;81(1):144–151. doi: 10.1038/sj.bjc.6690664. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Doll R. The Seascale cluster: a probable explanation. Br J Cancer. 1999 Sep;81(1):3–5. doi: 10.1038/sj.bjc.6690642. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Draper G. J., Stiller C. A., Cartwright R. A., Craft A. W., Vincent T. J. Cancer in Cumbria and in the vicinity of the Sellafield nuclear installation, 1963-90. BMJ. 1993 Jan 9;306(6870):89–94. doi: 10.1136/bmj.306.6870.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Duarte-Davidson R., Courage C., Rushton L., Levy L. Benzene in the environment: an assessment of the potential risks to the health of the population. Occup Environ Med. 2001 Jan;58(1):2–13. doi: 10.1136/oem.58.1.2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Grant G. M., Jackman S. M., Kolanko C. J., Stenger D. A. JP-8 jet fuel-induced DNA damage in H4IIE rat hepatoma cells. Mutat Res. 2001 Jan 25;490(1):67–75. doi: 10.1016/s1383-5718(00)00151-0. [DOI] [PubMed] [Google Scholar]
  8. Greaves M. Molecular genetics, natural history and the demise of childhood leukaemia. Eur J Cancer. 1999 Dec;35(14):1941–1953. doi: 10.1016/s0959-8049(99)00296-8. [DOI] [PubMed] [Google Scholar]
  9. Harris D. T., Sakiestewa D., Robledo R. F., Witten M. Immunotoxicological effects of JP-8 jet fuel exposure. Toxicol Ind Health. 1997 Jan-Feb;13(1):43–55. doi: 10.1177/074823379701300104. [DOI] [PubMed] [Google Scholar]
  10. Harris D. T., Sakiestewa D., Robledo R. F., Witten M. Short-term exposure to JP-8 jet fuel results in long-term immunotoxicity. Toxicol Ind Health. 1997 Sep-Oct;13(5):559–570. doi: 10.1177/074823379701300501. [DOI] [PubMed] [Google Scholar]
  11. Harris D. T., Sakiestewa D., Robledo R. F., Young R. S., Witten M. Effects of short-term JP-8 jet fuel exposure on cell-mediated immunity. Toxicol Ind Health. 2000 Feb;16(2):78–84. doi: 10.1177/074823370001600204. [DOI] [PubMed] [Google Scholar]
  12. Harris D. T., Sakiestewa D., Titone D., Robledo R. F., Young R. S., Witten M. Jet fuel-induced immunotoxicity. Toxicol Ind Health. 2000 Sep;16(7-8):261–265. doi: 10.1177/074823370001600702. [DOI] [PubMed] [Google Scholar]
  13. Hayes R. B., Songnian Y., Dosemeci M., Linet M. Benzene and lymphohematopoietic malignancies in humans. Am J Ind Med. 2001 Aug;40(2):117–126. doi: 10.1002/ajim.1078. [DOI] [PubMed] [Google Scholar]
  14. Heasman M. A., Kemp I. W., Urquhart J. D., Black R. Childhood leukaemia in northern Scotland. Lancet. 1986 Feb 1;1(8475):266–266. doi: 10.1016/s0140-6736(86)90794-4. [DOI] [PubMed] [Google Scholar]
  15. Jackman Shawna M., Grant Geraldine M., Kolanko Christopher J., Stenger David A., Nath Joginder. DNA damage assessment by comet assay of human lymphocytes exposed to jet propulsion fuels. Environ Mol Mutagen. 2002;40(1):18–23. doi: 10.1002/em.10082. [DOI] [PubMed] [Google Scholar]
  16. Kinlen L. J., Clarke K., Hudson C. Evidence from population mixing in British New Towns 1946-85 of an infective basis for childhood leukaemia. Lancet. 1990 Sep 8;336(8715):577–582. doi: 10.1016/0140-6736(90)93389-7. [DOI] [PubMed] [Google Scholar]
  17. Kinlen L. J., Dickson M., Stiller C. A. Childhood leukaemia and non-Hodgkin's lymphoma near large rural construction sites, with a comparison with Sellafield nuclear site. BMJ. 1995 Mar 25;310(6982):763–768. doi: 10.1136/bmj.310.6982.763. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kinlen L. J. Epidemiological evidence for an infective basis in childhood leukaemia. Br J Cancer. 1995 Jan;71(1):1–5. doi: 10.1038/bjc.1995.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Kinlen L. J., Hudson C. Childhood leukaemia and poliomyelitis in relation to military encampments in England and Wales in the period of national military service, 1950-63. BMJ. 1991 Nov 30;303(6814):1357–1362. doi: 10.1136/bmj.303.6814.1357. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Kinlen L. J., John S. M. Wartime evacuation and mortality from childhood leukaemia in England and Wales in 1945-9. BMJ. 1994 Nov 5;309(6963):1197–1202. doi: 10.1136/bmj.309.6963.1197. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Kinlen L. J., O'Brien F., Clarke K., Balkwill A., Matthews F. Rural population mixing and childhood leukaemia: effects of the North Sea oil industry in Scotland, including the area near Dounreay nuclear site. BMJ. 1993 Mar 20;306(6880):743–748. doi: 10.1136/bmj.306.6880.743. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Kinlen L. J., Petridou E. Childhood leukemia and rural population movements: Greece, Italy, and other countries. Cancer Causes Control. 1995 Sep;6(5):445–450. doi: 10.1007/BF00052185. [DOI] [PubMed] [Google Scholar]
  23. Kinlen L. Evidence for an infective cause of childhood leukaemia: comparison of a Scottish new town with nuclear reprocessing sites in Britain. Lancet. 1988 Dec 10;2(8624):1323–1327. doi: 10.1016/s0140-6736(88)90867-7. [DOI] [PubMed] [Google Scholar]
  24. Li C. Y., Lin R. S., Lin C. H. Urbanization and childhood leukaemia in Taiwan. Int J Epidemiol. 1998 Aug;27(4):587–591. doi: 10.1093/ije/27.4.587. [DOI] [PubMed] [Google Scholar]
  25. Moore Lee E., Lu Meng, Smith Allan H. Childhood cancer incidence and arsenic exposure in drinking water in Nevada. Arch Environ Health. 2002 May-Jun;57(3):201–206. doi: 10.1080/00039890209602937. [DOI] [PubMed] [Google Scholar]
  26. Neutra R. R. Counterpoint from a cluster buster. Am J Epidemiol. 1990 Jul;132(1):1–8. doi: 10.1093/oxfordjournals.aje.a115621. [DOI] [PubMed] [Google Scholar]
  27. Neutra R., Swan S., Mack T. Clusters galore: insights about environmental clusters from probability theory. Sci Total Environ. 1992 Dec 15;127(1-2):187–200. doi: 10.1016/0048-9697(92)90477-a. [DOI] [PubMed] [Google Scholar]
  28. Rhodes A. Gayle, LeMasters Grace Kawas, Lockey James E., Smith James W., Yiin James H., Egeghy Peter, Gibson Roger. The effects of jet fuel on immune cells of fuel system maintenance workers. J Occup Environ Med. 2003 Jan;45(1):79–86. doi: 10.1097/00043764-200301000-00016. [DOI] [PubMed] [Google Scholar]
  29. Rothman K. J. A sobering start for the cluster busters' conference. Am J Epidemiol. 1990 Jul;132(1 Suppl):S6–13. doi: 10.1093/oxfordjournals.aje.a115790. [DOI] [PubMed] [Google Scholar]
  30. Savitz D. A., Andrews K. W. Review of epidemiologic evidence on benzene and lymphatic and hematopoietic cancers. Am J Ind Med. 1997 Mar;31(3):287–295. doi: 10.1002/(sici)1097-0274(199703)31:3<287::aid-ajim4>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  31. 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. 1996 Nov 23;313(7068):1297–1300. doi: 10.1136/bmj.313.7068.1297. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Ullrich S. E. Dermal application of JP-8 jet fuel induces immune suppression. Toxicol Sci. 1999 Nov;52(1):61–67. doi: 10.1093/toxsci/52.1.61. [DOI] [PubMed] [Google Scholar]
  33. Waller L. A. A civil action and statistical assessments of the spatial pattern of disease: do we have a cluster? Regul Toxicol Pharmacol. 2000 Oct;32(2):174–183. doi: 10.1006/rtph.2000.1428. [DOI] [PubMed] [Google Scholar]

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