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Leukaemia clusters in Great Britain. 1. Space-time interactions
1Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, United Kingdom.
Study Objective:
The aim was to test a large set of childhood leukaemia and lymphoma registrations for the presence of clusters in space and in time.
Design:
The study was a space-time cluster analysis.
Setting:
England, Wales and Scotland.
Patients:
All registrations for leukaemia and lymphoma between 1966 and 1983 in children aged 0 to 14 years were examined. The records included date and age of registration, sex, diagnosis, and the map reference of the postcode of residence. Of the 9411 registrations, 8888 were suitable for inclusion.
Main Results:
There was a statistically significant excess of case pairs occurring jointly within 0.5 km and 60 d of each other: 68 pairs compared with 50.0 expected. The excess was detectable in central England, in the north of England and Scotland, but not in the south west of England. It was concentrated within the age band 4 to 7 years and among the lymphatic leukaemias. Several potential artefacts were considered and excluded, but the possibility remained that clustered detections might be triggered by haematological examinations undertaken for some communicable disease.
Conclusions:
There was strong evidence of joint spatial-temporal clustering, with an excess of pairs separated by very short time and distance intervals. The causes are probably biological rather than artefactual, but further work will be necessary in order to exclude the latter.