National Cancer Database analysis of association between ambient air pollution and survival in childhood cancer
Exposure to particulate matter consisiting of fine particles measuring 2.5 microns or less in diameter (PM2.5), a component of air pollution, has been linked to adverse health outcomes. Analysis of the National Cancer Database identified 172,550 patients diagnosed with cancer between 2004 and 2019 before age 20 years. Among these patients, 27,456 (15.9%) resided in areas with annual PM2.5 concentrations above the US Environmental Protection Agency annual PM2.5 standard op 12 μg/m3. Residing in these high-pollution areas was associated with worse overall survival (aHR 1.06; 95% CI 1.01-1.10). Similarly, when PM2.5 was evaluated as a linear measure, each unit increase in PM2.5 exposure was associated with worse survival (aHR 1.011; 95% CI 1.005-1.017). Exposure to PM2.5 at levels above the EPA standard was significantly associated with worse overall survival among sociodemographic subgroups. The authors conclude that exposure to PM2.5 was associated with worse overall survival among children with cancer.