Brief communication: childhood leukemia in a residential small town near Barcelona

Between March 1991 and May 1995, physicians diagnosed four cases of acute lymphoblastic leukemia, one case of Hodgkin's disease, and one case of aplastic anemia among children who resided in a small town near Barcelona that contained 4,237 inhabitants. The four cases of acute lymphoblastic leukemia represented a significant excess of observed cases (26.4/100,000 for children age 0-14 y [p < .005]). The authors conducted an epidemiological study of the population to explore the possible "local" role of agents hypothesized or known to be potentially associated with acute lymphoblastic leukemia, as well as with other hematopoietic diseases. The small town in which the cases lived is a residential area without known or suspected industrial exposures associated with leukemia. However, it is located in a county ("Maresme") that boasts having the most flower-growing and agricultural undercover producing area in Catalonia; consequently, copious amounts of herbicides and pesticides are used. The small number of cases limited the testing of the hypothesis of a causal relationship between environmental pesticide exposure or a viral infection (the only factors common to the cases) and the excess of leukemia cases. Despite the weaknesses inherent in our study, the information gleaned from our research may be useful to researchers who define local health-related problems.