Child health: an epidemiological perspective

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Child health an epidemiological perspective

• Eve Roman
• Epidemiology and Genetics Unit
• Department of Health Sciences
• University of York

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Epidemiology

• Study of the distribution determinants of
  disease/states of health in human populations
• Concerned with frequencies and types of illness
  in groups of people - and with the factors that
  influence these distributions
• Who?
• Where?
• When?

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Epidemiology

• Fundamental assumption disease/health
• does not necessarily occur at random

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Gene pool
Cancer
Environment
Father
Mother
Fertilization
development growth
X-rays ? ? ? ?
Trisomy 21
DES ? ? ? ?
Birth
Hepatitis B ? ? ?
? Leukaemia
development growth
UV ? ? ? ? ?
? Vaginal adenocarcinoma
? Hepatocellular carcinoma
Reproduction
? ? Melanoma
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Gamete/fertilization errors Implantation
errors Fetal loss Intra-uterine growth
Congenital anomalies Child health e.g.
developmental disorders immune
response cancer Adult health e.g. fertility
heart disease cancer
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Estimated prevalence at birth
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Estimated prevalence per 1000 children
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Estimated cumulative incidence per 1000 0-14
years
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Childhood ALL

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United Kingdom Childhood Cancer Study(UKCCS)

• Management committee chaired by
• Professor Sir Richard Doll FRS 1992-2004
• Professor Nick Day FRS 2004 -

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UKCCS Main areas of study
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• Study population
• Children ( 15 years) registered for primary care
  with a General Practitioner (GP)
• Cases - ascertained from multiple sources-
• Treating/referring hospitals
• Cross-checks with cancer registries
• Controls selected from primary care population
  registers and individually matched to cases on-
• date of birth
• sex
• region of residence

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The study provides no evidence that exposure to
magnetic fields associated with electricity
supply in the UK increases risks for childhood
leukaemia, cancers of the central nervous system,
or any other childhood cancer.
94 of case homes and 94 of control homes were
not located near electricity supply equipment
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Gamete/fertilization errors Implantation
errors Fetal loss Intra-uterine growth
Congenital anomalies Child health e.g.
developmental disorders immune
response cancer Adult health e.g. fertility
heart disease cancer
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