Abstract
PURPOSE: To achieve a better understanding of the environmental factors that contribute to childhood cancers, so as to inform future prevention efforts. METHODS: We conducted a comprehensive review of epidemiological studies on environmental risk factors and childhood cancer, which was published between January 2014 and March 2021. Potential exposure sources presented in this review include air pollution, radiation, and parental occupational exposures. We considered exposures during childhood and parental exposures occurring before the child's conception and during pregnancy in relation to all types of childhood cancer. RESULTS: Aggregated evidence is strong for associations between leukemia and parental/child exposure to traffic pollution, indoor paints, residential pesticides, and parental occupational/nonoccupational exposure to benzene. Evidence is also strong for associations between brain cancer and residential pesticides and parental occupational exposure to agricultural pesticides. Evidence of associations between leukemia and ionizing radiation from radon and nuclear power plants remains mixed, as does evidence of a link between electromagnetic fields (EMFs) and childhood leukemia. CONCLUSIONS: Clear associations have been demonstrated between childhood cancer and environmental factors, including parent/child exposure to traffic pollution, occupational/nonoccupational benzene, indoor paints, residential pesticides, and parental occupational exposure to agricultural pesticides. These associations can be used to inform further study of interventions and public health campaigns to reduce risk.