Background:

Children living in upstream oil and natural gas (O&G) areas may be exposed to leukemogens and at increased risk for acute lymphoblastic leukemia (ALL).

Methods:

We conducted a case–control study of children born in Colorado between 1992 and 2019. We matched 451 children diagnosed with ALL at ages 2 to 9 years starting in 2002 to 2,706 controls based on birth month/year and Hispanic ethnicity. We estimated upstream O&G activity intensities from conception through a 10-year latency using our intensity-adjusted inverse distance weighted (IA-IDW) model. We applied logistic regression models adjusted for confounders to evaluate associations between ALL and IA-IDW.

Results:

For children within 5 km of an O&G well site, we observed a 62% [OR = 1.62; 95% confidence interval (CI), 0.964–2.62], 84% (OR = 1.84; 95% CI, 1.35–2.48), and 100% (OR = 2.00; 95% CI, 1.14–3.37) increase in ALL risk for low, medium, and high IA-IDW groups, compared with the referent group. Within 13 km, we observed a 59% (OR = 1.59; 95% CI, 1.03–2.37), 40% (OR = 1.40; 95% CI, 1.09–1.80), and 164% (OR = 2.64; 95% CI, 1.80–3.86) increase in ALL risk for low, medium, and high IA-IDW groups.

Conclusions:

Colorado’s children living within 13 km of O&G well sites are at increased risk for ALL, with children within 5 km bearing the greatest risk. Current setbacks between O&G well sites and residences may not be sufficient to protect the health of these children.

Impact:

Our results can be applied to policies to reduce childhood leukemogen exposures.

This content is only available via PDF.
©2025 The Authors; Published by the American Association for Cancer Research
2025
American Association for Cancer Research
This open access article is distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License .
Attribution-NonCommercial-NoDerivatives

Article PDF first page preview

First page of Exposures from Oil and Gas Development and Childhood Leukemia Risk in Colorado: A Population-Based Case–Control Study<alt-title alt-title-type="short">Oil and Gas Development and Childhood Leukemia in Colorado</alt-title>

Supplementary data

Supplementary Figure 1

Supplemental Figure 1 describes the estimation of IA-IDW prior to the year 2000

- pdf file
Supplementary Figure 2

Supplemental Figure 2 shows the distribution of log IA-IDW well count in 16.1 km buffer from conception to beginning of latent period where IA-IDW well count ≥1. The percentage of well counts is on the y-axis and the log of the IA-IDW well count is on the x-axis.

- pdf file
Supplementary Figure 3

Supplemental Figure 3 illustrates associations between IA-IDW summed from conception to latency in 16.1 km (10 mile) buffer and childhood acute lymphocytic leukemia for cases and controls born in Colorado between 1992 and 2019 for rural birth address, urban birth address, males, females, Hispanic mother and Non-Hispanic mother.

- pdf file
Supplementary Figure 4

Supplemental Figure 4 illustrates the association between IA-IDW summed from conception to latency in 16 km buffer and childhood acute lymphocytic leukemia for cases and controls born in Colorado between 1992 and 2019 for children aged 2 to 3, 4 to 5, and 6 to 9 years.

- pdf file
Supplementary Figure 5

Supplemental Figure 5 illustrates associations between IA-IDW summed from conception to latency in 16.1 km buffer and childhood acute lymphocytic leukemia for cases and controls born in Colorado between 1992 and 2019 for full term birth, no maternal smoking during pregnancy, Mothers found in LexisNexis, IA-IDW for other air pollution <90th percentile, no highway within 152 m, SES index >1 and <5, birth year >1999, and UV exposure <90th percentile.

- pdf file
Supplementary Table 1

Unadjusted logistic regression results for quintiles of IA-IDW.

- pdf file
Supplementary Table 2

Supplemental Data Table 2 describes the methods used to calculate SES index measurement for each zip code.

- pdf file
Supplementary Table 3

Study population exposure distributions between IA-IDW exposure groups within 16-km buffer by case-control status and exposure window (451 cases and 2,706 controls)

- pdf file
Supplementary Table 4

Case and control counts by IA-IDW and referent groups for Supplemental Figure 2 , 3, and 4

- pdf file
Supplementary Table 5

Populations to consider when developing epidemiological studies and O&G policies

- pdf file
Supplementary Table 6

Association between intensity adjusted O&G well site activity within 16-kilometer radius of maternal residence and ALL for cases and controls born between 1992 and 2019 in Colorado for mother’s residential address confirmed in commercial database.

- pdf file