Abstract
OBJECTIVES: The constant use of agrochemicals in avocado plantations, because of their susceptibility to pests and diseases, continuously exposes those who work or reside near these orchards to health risks. The purpose of this study was to investigate the association between childhood leukemia cases in Michoacán, paternal occupational exposure to agrochemicals, and environmental exposure due to residential proximity. METHODS: A retrospective observational cohort study was performed. We analyzed 430 cases of leukemia in children under 18 years of age diagnosed between 2010-2023. Logistic regression models were used to estimate odds ratios and 95% confidence intervals, adjusted for sociodemographic factors. Survival was analyzed using Kaplan-Meier curves. RESULTS: A total of 46.6% of the parents of children with leukemia in this study had jobs related to the use of agrochemicals (e.g., day laborers, peasants, farmers). Additionally, 65.4% of the leukemia cases occurred in municipalities producing avocado, the most important perennial crop in the state. Regarding the residential area analysis (mapping), many cases were found in contiguous zip codes and in areas densely occupied by avocado orchards. In addition, paternal occupations related to agrochemical use were associated with the avocado-growing zone, with an OR = 1.764 (95% CI [1.034-3.009], p = 0.0379). Interestingly, survival associated with agrochemical-related occupations has a higher mean survival (139.3 months) than all other parental occupations (p = 0.0148). CONCLUSIONS: The epidemiologic evidence found in this study supports the association between paternal occupational exposure to agrochemicals and childhood leukemia. Furthermore, children with leukemia who live in avocado-growing regions have a higher survival rate.