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A new study, authored by reasearchers spanning the globe, demonstrates that childhood leukemia rates more than doubled over a 15-year period in Basrah, a southern Iraqi province. During that period, three wars pummeled the area.

The authors of Trends in childhood leukemia in Basrah, Iraq (1993-2007), including Simon Fraser University professor Tim Takaro, say, “We hope our calculations pave the way for investigating why the rates have climbed so high. We also need to know why they are higher than the rates found in Kuwait, the European Union or the United States.”

Takaro, the paper’s senior author, collaborated with four researchers at the University of Washington, two Iraqi universities—Mustansiriya University in Baghdad and Basrah University—and the Fred Hutchinson Cancer Research Centre in Seattle.  Their findings are published in the Feb. issue of the American Journal of Public Health.

Using a hospital registry, the study documents 698 cases of leukemia in children aged 0-14, noting the peak number of cases was 211 in 2006. The study covered a 15-year period.

The leukemia rate jumped from three per 100,000 youngsters annually during the study's first three years to 8.5 per 100,000 in the final three years. Younger children had a higher leukemia rate than older children.

By comparison, the rate in the European Union and U.S., respectively, was four and five per 100,000 children. Nearby Kuwait’s rate was about two per 100,000.

Takaro says this study was necessary before he and his colleagues could proceed to investigating the cause of Iraq’s increased rate of childhood leukemia.

The researchers first needed to confirm that they would be working with credible and sufficient data, given Basrah’s war history during the period studied, uncertain access to population data and political turmoil.

“Studying childhood diseases in war situations is difficult,” notes Takaro. “We were constantly worried about the political risks our medical colleagues were taking by collecting and reporting these data.

The researchers were conservative in their calculation of leukemia rates to compensate for the fact that Basrah did not collect census data after the 2003 U.S. invasion of Iraq.

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Backgrounder: Study finds increased childhood leukemia in Iraq

SFU health scientist Tim Takaro and his international colleagues now seek to understand the cause of Iraq’s increased rate of childhood leukemia. They are conducting a case-control study to compare children who got leukemia in the period studied with those who did not.

“This helps researchers see, “if there are differences in exposures between the cases and the controls,” explains Takaro. “Exposures of interest could include the byproducts of regional petroleum fires and benzene, which would have been in gasoline sold by children on the side of the road. Children were also exposed to war-related nerve agents, pesticides and depleted uranium munitions.”

In the study leading up to this one, Takaro and his colleagues found the childhood leukemia rate in Oman, next to Iraq, was two or three cases per 100,000 children, ages 0-14, depending on the gender of the child.

The rate is higher among boys and children from higher socio-economic classes.

Basrah, Iraq’s rate was three per 100,000 during the first part of the study period and escalated to eight and a half per 100,000 in the final three years.

During the period studied, Basra and its highly populated surrounding area, which includes farmland and oil fields, became a modern battlefield, pummeled by three consecutive wars, including the 2003 American invasion of Iraq.

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