{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:55:17Z","timestamp":1791230117384,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T00:00:00Z","timestamp":1664928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The association between leukemia and proximity to nuclear\u2010power\u2010plants (NPPs) has been assessed in several countries with inconsistent results. A case\u2010control study from Germany had shown an increased risk for childhood leukemia (diagnoses 1980\u20102003) near NPPs. Germany began shutting down nuclear reactors in 2011, following the Fukushima disaster. We tested whether the previously observed association between leukemia and proximity to NPP persisted despite the shutdown. We used an ecological study design to investigate the incidence of leukemia during 2004 to 2019 in children aged 0 to 14\u2009years living near NPPs where at least one reactor was shut down in 2011. We defined study and control areas as municipalities whose surface area was at least 75% within 10\u00a0km or between 10 and 50\u2009km of NPPs, respectively. We calculated age\u2010standardized rates and incidence rate ratios (IRR) using control\u2010areas as the reference. We also computed standardized incidence ratios (SIR) separately for each NPP using incidence rates of the German population as a reference. IRR decreased from 1.20 (95% confidence interval: 0.81\u20101.77) in 2004 to 2011 to 1.12 (0.75\u20101.68) in 2012 to 2019. Analyses of single plants showed an excess of childhood leukemia during 2004 to 2019 for the Unterweser\u2010NPP, based only on three cases, and the Kr\u00fcmmel\u2010NPP (n\u00a0=\u00a014; SIR: 1.98, 1.17\u20103.35). We found slightly decreasing of leukemia incidence rate ratios after the shutdown of nuclear reactors in 2011. Due to the small number of cases, risk estimates have large uncertainty. Further research including a longer follow\u2010up is warranted. The consistent excess of incidence cases around Kr\u00fcmmel may require analytical epidemiological analysis.<\/jats:p>","DOI":"10.1002\/ijc.34303","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T10:33:45Z","timestamp":1664188425000},"page":"913-920","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Incidence of childhood leukemia before and after shut down of nuclear power plants in Germany in 2011: A population\u2010based register study during 2004 to 2019"],"prefix":"10.1002","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9395-6399","authenticated-orcid":false,"given":"Antonello","family":"Russo","sequence":"first","affiliation":[{"name":"Master of epidemiology student University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9064-9580","authenticated-orcid":false,"given":"Maria","family":"Blettner","sequence":"additional","affiliation":[{"name":"Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Center of the Johannes Gutenberg University of Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7299-3764","authenticated-orcid":false,"given":"Hiltrud","family":"Merzenich","sequence":"additional","affiliation":[{"name":"Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Center of the Johannes Gutenberg University of Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1009-259X","authenticated-orcid":false,"given":"Daniel","family":"Wollschlaeger","sequence":"additional","affiliation":[{"name":"Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Center of the Johannes Gutenberg University of Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9982-3300","authenticated-orcid":false,"given":"Friederike","family":"Erdmann","sequence":"additional","affiliation":[{"name":"Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Center of the Johannes Gutenberg University of Mainz  Mainz Germany"},{"name":"Department of Prevention and Evaluation Leibniz Institute for Prevention Research and Epidemiology\u2014BIPS  Bremen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3473-0752","authenticated-orcid":false,"given":"Emilio","family":"Gianicolo","sequence":"additional","affiliation":[{"name":"Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Center of the Johannes Gutenberg University of Mainz  Mainz Germany"},{"name":"Institute of Clinical Physiology, National Research Council  Lecce"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(18)30423\u20106"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcmed.2016.11.017"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14020382"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2014.09.013"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23330"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2007.10.024"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr115"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.27425"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.560"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1088\/0952\u20104746\/34\/3\/R53"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361\u20106498\/aa8ce9"},{"key":"e_1_2_12_13_1","unstructured":"Federal Ministry for the Environment 2022 Nature Conservation Nuclear Safety and Consumer Protection (BMUV): Nuclear power plants in Germany [Internet]. Bonn (DE).https:\/\/www.nuklearesicherheit.de\/en\/nuclear-facilities\/nuclear-power-plants-in-germany\/"},{"key":"e_1_2_12_14_1","unstructured":"Statistisches Bundesamt (Destatis) Genesis\u2010Online;2022."},{"key":"e_1_2_12_15_1","volume-title":"Sampling Techniques","author":"Cochran WG","year":"1977"},{"key":"e_1_2_12_16_1","volume-title":"Cancer Mortality for Selected Sites in 24 Countries (1950\u201357)","author":"Segi M","year":"1960"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000096"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.2307\/2530643"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyi060"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/app10072614"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552\u2010010\u20109528\u20103"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494815590499"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx322"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33402"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7139.1236"},{"key":"e_1_2_12_26_1","volume-title":"Experimental and Quasi\u2010Experimental Designs","author":"Shadish WR","year":"2002"},{"key":"e_1_2_12_27_1","unstructured":"Bornh\u00f6ftP DeggerichM DohmenFet al.Atomic nightmare: Kr\u00fcmmel accident puts question mark over Germany's nuclear future. 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