American Journal of Epidemiology Vol. 152, No. 12 : 1136-1144
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Early Child-Care and Preschool Experiences and the Risk of Childhood Acute Lymphoblastic Leukemia
1 Department of Social and Preventive Medicine, University at Buffalo, State of New York, Buffalo, NY.
2 Department of Pediatrics, Roswell Park Cancer Institute, Buffalo, NY.
3 Present address: Department of Physical Medicine and Rehabilitation, State University of New York Upstate Medical University, Syracuse, NY.
An infectious etiology for childhood acute lymphoblastic leukemia (ALL) has been suggested, yet few studies have focused on the role of early child care. Day-care histories were examined in a case-control study of ALL in New York State. Cases (n = 255) were diagnosed at one of four referral centers between 1980 and 1991; controls (n = 760) were randomly selected from livebirths in the 31 counties served by the referral centers. Self-administered questionnaires were mailed to the parents of cases and controls in 1995. Day-care histories were censored at the age of diagnosis for cases and at an equivalent date for controls. The odds ratio for children who stayed at home compared with those who attended day care for >36 months was 1.32 (95% confidence interval (CI): 0.70, 2.52); the odds ratios for 1–18 and 19–36 months of day care were 1.74 (95% CI: 0.89, 3.42) and 1.32 (95% CI: 0.64, 2.71), respectively. Elimination of cases with T-cell ALL enhanced the risk. Starting care at an earlier age was not associated with a decreased risk of ALL. These findings do not support the hypothesis that infrequent contact with peers during early childhood could delay exposure to infectious diseases and increase the risk of ALL.
case-control studies; child day care centers; infection; leukemia, lymphocytic, acute; schools, nursery
Abbreviations: ALL, acute lymphoblastic leukemia; SD, standard deviation
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