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Case-control study of leukaemia among young people near La Hague nuclear reprocessing plant: the environmental hypothesis revisited

BMJ 1997; 314 doi: (Published 11 January 1997) Cite this as: BMJ 1997;314:101
  1. Dominique Pobel, research epidemiologista,
  2. Jean-Francois Viel, professor of biostatistics and epidemiologya
  1. a Faculty of Medicine, Department of Public Health, Biostatistics and Epidemiology Unit, 25030 Besançon, France
  1. Correspondence to: Dr Viel
  • Accepted 28 October 1996


Objective: To investigate the association between childhood leukaemia and established risk factors or other factors related to La Hague nuclear waste reprocessing plant.

Design: Case-control study.

Setting: Area within a 35 km radius of La Hague, Normandy, France.

Subjects: Twenty seven cases of leukaemia diagnosed during the period 1978-93 in people aged under 25 years and 192 controls matched for sex, age, place of birth, and residence at time of diagnosis.

Main outcome measures: Antenatal and postnatal exposure tox rays and viral infections, occupational exposure of parents (particularly ionising radiation), living conditions, lifestyle of parents and children.

Results: Increased trends were found for use of local beaches by mothers and children (P<0.01); relative risks 2.87 (95% confidence intervals 1.05 to 8.72) and 4.49 (1.52 to 15.23) when categories were aggregated in two levels (more or less than once a month). Consumption of local fish and shellfish also showed an increased trend (P 0.01); relative risk 2.66 (0.91 to 9.51) when categories were grouped in two levels (more or less than once a week). A relative risk of 1.18 a year (1.03 to 1.42) was observed for length of residence in a granite-built house or in a granitic area. No association was shown with occupational radiation exposure in parents.

Conclusions: There is some convincing evidence in childhood leukaemia of a causal role for environmental radiation exposure from recreational activities on beaches. New methods for identifying the environmental pathways, focusing on marine ecosystems, are warranted.

Key messages

  • The reasons for leukaemia clusters around nuclear installations remain unknown

  • La Hague in France (the other two are Sellafield and Dounreay in Britain) is one of the three nuclear reprocessing plants operating in the world on an industrial scale, and offers an independent opportunity for research

  • Some lifestyle risk factors (use of local beaches, consumption of fish and shellfish) were associated with the development of leukaemia among young people

  • Some convincing evidence was found of a causal role for environmental radiation exposure, whereas no association was found with fathers' occupational exposure to radiation


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