Air pollution, light at night and greenness as risk factors of childhood leukemia: a study in the Modena population, Northern Italy

Several environmental factors, such as air pollution, climate factors, as well as new built environment-related determinants, have been linked to several adverse effects on human health, including a risk of childhood cancer. In particular, recent evidence suggests that environmental factors may play a major role in leukemia risk. In this project, we aim at evaluating the effects of exposure to environmental and climate factors, namely outdoor air pollution, greenness, and artificial light at night (ALAN) on childhood leukemia. We will take advantage of an established population-based case-control study with identification of all cases of childhood leukemia diagnosed from 1998-2019 in Modena (Emilia-Romagna, Northern Italy) and four controls matched on sex and year of birth. Within the project we will also update the study population adding recently diagnosed cases from 2020 to 2022. With the use of a geographical information system (GIS) each participant's residence will be geocoded and exposure to outdoor air pollution, greenness, and ALAN will be assessed by environmental engineers using advanced modeling methodologies and satellite-based datasets. Data analyses will be performed by public health professionals using conditional logistic regression models, adjusted for potential confounders and using also nonlinear modeling through restricted cubic splines. Analysis will be performed taking into account both individual and combined exposure to the investigated factors in order to evaluate also dose-response relations. The project results will be extensively disseminated in both scientific community through publication in international scientific journals (in open access format) and conferences as well as at national and local level during patients and public involvement-PPI activities, e.g. meetings of associations of parents like ASEOP (Associazione Sostegno Emato-Oncologia Pediatrica of Modena).