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Prenatal Exposure to Air Toxics and Risk of Wilms' Tumor in 0- to 5-Year-Old Children

Shrestha, Anshu PhD; Ritz, Beate PhD; Wilhelm, Michelle PhD; Qiu, Jiaheng MS; Cockburn, Myles PhD; Heck, Julia E. PhD

Journal of Occupational and Environmental Medicine: June 2014 - Volume 56 - Issue 6 - p 573–578
doi: 10.1097/JOM.0000000000000167
Original Articles

Objective: To study prenatal air toxic exposure and Wilms' tumor in children.

Methods: We identified 337 Wilms' tumor cases among children younger than 6 years (1988 to 2008) from the California Cancer Registry, randomly selected 96,514 controls from California birth rolls in 20:1 ratio matched to all cancer cases, then linked birth addresses to air monitors within 15 miles to assess exposures. Multiple logistic regressions were applied to estimate effects.

Results: Children prenatally exposed to formaldehyde, polycyclic aromatic hydrocarbons, perchloroethylene, or acetaldehyde in the third trimester had an increased odds of Wilms' tumor per interquartile increase in concentration (odds ratio [95% confidence interval]: 1.28 [1.12 to 1.45], 1.10 [0.99 to 1.22], 1.09 [1.00 to 1.18], 1.25 [1.07 to 1.45], respectively).

Conclusions: We found positive associations for four air toxics. This is the first study of this kind. Future studies are needed to confirm our findings.

From the Department of Epidemiology (Drs Shrestha, Ritz, Wilhelm, and Heck), Fielding School of Public Health, University of California Los Angeles Precision Health Economics (Dr Shrestha); Department of Biostatistics (Mr Qiu), Fielding School of Public Health, University of California Los Angeles; and Department of Preventive Medicine (Dr Cockburn), Keck School of Medicine, University of Southern California, Los Angeles.

Address correspondence to: Julia Heck, PhD, 73-320 CHS, Los Angeles, CA 90095 (

This study was funded by grants from the National Institute of Environmental Health Sciences (R21ES018960, R21ES019986).

Authors Shrestha, Ritz, Wilhelm, Qiu, Cockburn, and Heck have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2014 by the American College of Occupational and Environmental Medicine