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Journal of Oncology
Volume 2011 (2011), Article ID 854584, 16 pages
Review Article

Paternal Smoking and Risk of Childhood Acute Lymphoblastic Leukemia: Systematic Review and Meta-Analysis

Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA

Received 16 November 2010; Accepted 8 March 2011

Academic Editor: Sushant Kachhap

Copyright © 2011 Ruiling Liu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To investigate the association between paternal smoking and childhood acute lymphoblastic leukemia (ALL). Method. We identified 18 published epidemiologic studies that reported data on both paternal smoking and childhood ALL risk. We performed a meta-analysis and analyzed dose-response relationships on ALL risk for smoking during preconception, during pregnancy, after birth, and ever smoking. Results. The summary odds ratio (OR) of childhood ALL associated with paternal smoking was 1.11 (95% Confidence Interval (CI): 1.05–1.18, %) during any time period, 1.25 (95% CI: 1.08–1.46, %) preconception; 1.24 (95% CI: 1.07–1.43, %) during pregnancy, and 1.24 (95% CI: 0.96–1.60, %) after birth, with a dose-response relationship between childhood ALL and paternal smoking preconception or after birth. Conclusion. The evidence supports a positive association between childhood ALL and paternal ever smoking and at each exposure time period examined. Future epidemiologic studies should assess paternal smoking during well-defined exposure windows and should include biomarkers to assess smoking exposure and toxicological mechanisms.