A global systematic evaluation of the impact of air pollution on pediatric cancer development

Increasing evidence links childhood cancers to environmental pollutants, especially air pollutants. This systematic review examined the relationship between various environmental pollutants and the risk of childhood cancers during the prenatal and pediatric periods. A systematic search of Scopus, Web of Science, PubMed, Embase, Medline, Epistemonikos, and Cochrane databases using standard keywords identified 41,858 studies, of which 89 were ultimately included in the final analysis. The trend in studies from 1984 to 2025 indicates a growing focus on specific pollutants, including PM_2.5, volatile organic compounds (VOCs), and benzene. Some studies reported statistically significant odds ratios (ORs) linking exposure to VOCs with the development of leukemia and other childhood cancers. Traffic sources were identified as the primary contributors to pollution associated with pediatric cancers, followed by industrial and indoor sources. Although data on prenatal exposures were sometimes sparse and inconclusive, there is more substantial evidence linking childhood exposures, particularly in urban and industrial areas, to the development of childhood cancers; however, the strength of this association varies depending on the type of pollutant and cancer. Geographically, the majority of studies have been conducted in high-income countries, which limits the generalizability of the findings to low- and middle-income regions. These findings underscore the need for targeted public health policies to mitigate pollutant emissions and safeguard children, particularly in urban and industrial areas. Future studies should prioritize precise individual exposure assessments and robust methodologies to elucidate causal pathways and enhance prevention strategies.