Childhood leukaemia in the Netherlands : a register based epidemiologic study

Abstract

Leukaemia, literally "white blood", is the most common type of malignancy in childhood (Birch et al., 1980). The clinical features are caused by abnormal proliferation of one or more of the blood-forming cellular elements. The immature malignant cells usually disturb normal haematopoiesis and often invade other organs or tissues. Since the 'seventies the survival of children with leukaemia, especially acute lymphocytic leukaemia (ALL), has improved and cure can be obtained in approximately 50% of the paediatric patients with ALL (Finkel, 1976; van der Does-van den Berg, 1980). Therefore morbidity rather than mortality data are needed for epidemiological studies on aetiological factors of childhood leukaemia. The impetus for this study was a suggestion originating in Germany, that childhood leukaemia occurs more frequently in children who lived near nuclear plants. In the Dutch Parliament questions were asked about the possible relation between proximity to nuclear plants and the development of leukaemia. In The Netherlands there are three such nuclear plants. The Dutch Childhood Leukaemia Study Group (DCLSG), in a letter to the Minister of Public Health and Environmental Hygiene, offered to initiate a study on environmental factors in childhood leukaemia, since this group maintains a morbidity register of childhood leukaemia from 1972 onwards. Subsequently the Ministry established a grant for this study (Persbericht Ministerie van Volksgezondheid en Milieuhygiene, 1979). In view of the specific nature of the study, the Institute of Epide~iology of the Erasmus University Rotterdam, was asked to cooperate