Increased incidence rates for childhood leukaemia have been reported in municipalities close to the nuclear power plant (NPP) Krümmel (Geesthacht, Germany). Methodological challenges arise when analysing this association at ecological level. They include the use of an appropriate reference population, unstable estimates of standardised incidence ratios (SIRs), and the potential role of prevailing winds. The aim of our study is to address these challenges. The German Childhood Cancer Registry provided data on leukaemia in children under 15 years (2004–2019). The German Federal Statistical Office provided the population data. The study region included all municipalities with ≥ 75% surface area within 50 kms from the Krümmel NPP. We calculated SIRs using national and regional reference rates. Smoothed incidence relative rates (IRRs) were calculated and mapped to check for potential patterns associated with prevailing winds. Overall 356 cases of childhood leukaemia were observed in the study region (321 municipalities) during 2004–2019. SIRs based on national reference rates show nearly no difference to those calculated using the regional rates as reference. Increased SIR and IRR were observed in Geesthacht (observed-cases = eight; SIR = 2.29; 95% confidence interval: 0.99–4.51. IRR = 1.80; 95% credibility interval: 0.88–2.79). The analysis of the IRR map does not show patterns associated with prevailing winds. Using a regional population as the reference, we found evidence that there may still be an increased risk for childhood leukaemia in Geesthacht. However, IRR estimates are uncertain and credibility intervals are compatible with the absence of elevated risk. The persistent evidence of risk of childhood leukaemia in Geesthacht warrants further epidemiological surveillance.

据报道，在核电站 （NPP） Krümmel（德国 Geesthacht）附近的城市，儿童白血病的发病率增加。在生态层面分析这种关联时，会出现方法上的挑战。它们包括使用适当的参考人群、标准化发病率比 （SIR） 的不稳定估计以及盛行风的潜在作用。我们研究的目的是应对这些挑战。德国儿童癌症登记处提供了 15 岁以下儿童白血病的数据 （2004-2019）。德国联邦统计局提供了人口数据。研究区域包括距离 Krümmel NPP 50 公里范围内≥ 75% 表面积的所有城市。我们使用国家和地区参考率计算 SIR。计算并绘制平滑的发生率相对速率 （IRR） 以检查与盛行风相关的潜在模式。356 年至 2004 年期间，研究区域（321 个城市）共观察到 2019 例儿童白血病病例。基于国家参考汇率的 SIR 与使用地区汇率作为参考计算的 SIR 几乎没有差异。在 Geesthacht 中观察到 SIR 和 IRR 增加（观察到的病例 = 8;SIR = 2.29;95% 置信区间：0.99–4.51。内部收益率 = 1.80;95% 可信度区间：0.88-2.79）。IRR 地图的分析没有显示与盛行风相关的模式。使用区域人群作为参考，我们发现证据表明 Geesthacht 儿童白血病的风险可能仍会增加。然而，IRR 估计是不确定的，可信区间与没有升高的风险是相容的。 Geesthacht 儿童白血病风险的持续证据需要进一步的流行病学监测。