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            "title": "Unconventional Oil and Gas Development Exposure and Risk of Childhood Acute Lymphoblastic Leukemia: A Case–Control Study in Pennsylvania, 2009–2017",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "Cassandra J.",
                    "lastName": "Clark"
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                {
                    "creatorType": "author",
                    "firstName": "Nicholaus P.",
                    "lastName": "Johnson"
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                {
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                    "firstName": "Mario",
                    "lastName": "Soriano"
                },
                {
                    "creatorType": "author",
                    "firstName": "Joshua L.",
                    "lastName": "Warren"
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                {
                    "creatorType": "author",
                    "firstName": "Keli M.",
                    "lastName": "Sorrentino"
                },
                {
                    "creatorType": "author",
                    "firstName": "-Lottick Nina S.",
                    "lastName": "Kadan"
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                {
                    "creatorType": "author",
                    "firstName": "James E.",
                    "lastName": "Saiers"
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                {
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                    "firstName": "Xiaomei",
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                    "firstName": "Nicole C.",
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            "abstractNote": "Background:\n\nUnconventional oil and gas development (UOGD) releases chemicals that have been linked to cancer and childhood leukemia. Studies of UOGD exposure and childhood leukemia are extremely limited.\n\nObjective:\n\nThe objective of this study was to evaluate potential associations between residential proximity to UOGD and risk of acute lymphoblastic leukemia (ALL), the most common form of childhood leukemia, in a large regional sample using UOGD-specific metrics, including a novel metric to represent the water pathway.\n\nMethods:\n\nWe conducted a registry-based case–control study of 405 children ages 2–7 y diagnosed with ALL in Pennsylvania between 2009–2017, and 2,080 controls matched on birth year. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between residential proximity to UOGD (including a new water pathway-specific proximity metric) and ALL in two exposure windows: a primary window (3 months preconception to 1 y prior to diagnosis/reference date) and a perinatal window (preconception to birth).\n\nResults:\n\nChildren with at least one UOG well within \n2km\n2\nkm\n of their birth residence during the primary window had 1.98 times the odds of developing ALL in comparison with those with no UOG wells [95% confidence interval (CI): 1.06, 3.69]. Children with at least one vs. no UOG wells within \n2km\n2\nkm\n during the perinatal window had 2.80 times the odds of developing ALL (95% CI: 1.11, 7.05). These relationships were slightly attenuated after adjusting for maternal race and socio-economic status [odds ratio (OR) \n=1.74\n=\n1.74\n (95% CI: 0.93, 3.27) and \nOR=2.35\nOR\n=\n2.35\n (95% CI: 0.93, 5.95)], respectively). The ORs produced by models using the water pathway-specific metric were similar in magnitude to the aggregate metric.\n\nDiscussion:\n\nOur study including a novel UOGD metric found UOGD to be a risk factor for childhood ALL. This work adds to mounting evidence of UOGD’s impacts on children’s health, providing additional support for limiting UOGD near residences. https://doi.org/10.1289/EHP11092",
            "publicationTitle": "Environmental Health Perspectives",
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