Environmental Pesticide Exposure in the Etiology of Pediatric Brain Tumors and Leukemia: A Scoping Review of Epidemiological Studies.

Pediatric cancer is a significant cause of morbidity and mortality in children. The etiologies of pediatric cancer are largely unknown, but environmental pesticide exposures are likely to contribute. Chronic low-dose exposure to pesticide mixtures through drinking water is a growing concern in agricultural communities. This review examines epidemiological studies published between January 1980 and September 2022 that have evaluated the relationship between pesticide exposure and the risk of childhood brain tumors and leukemia. Exposures to pesticides used in the home or ingested through drinking water, residential proximity to agricultural areas where pesticides are used, parental pesticide exposure, and metabolic genotypes are discussed. Findings have shown increased risks for childhood cancers in areas of high agricultural crop density, which may imply a link to increased pesticide applications and pesticide drift from neighboring farm fields. Noted knowledge gaps include the contribution of genetics, exposure through drinking water, individual-level exposures, and pesticide mixtures to the risk of pediatric cancer. Identifying distinctive genetic traits that influence the metabolism and detoxification of pesticide formulations, and their transformation products is crucial. This knowledge could inform preventive strategies and personalized interventions to reduce the burden of pediatric cancer and protect children's health.