The role of the environment in the etiology of childhood acute leukemia (AL) is currently investigated. In this context, the aim of the present work is to study the association between the incidence of AL and the proximity no nuclear power plants (NPP) and to high voltage overhead power lines (HV OLs). At first, the geographical variations of AL have been studied at the Département level.The cases included in the studies are all cases of AL of the French National Registry of Childhood Haemopatopoietic Malignancies on the studied periods: 1990-2004 for the study of incidence on Départements and 2002-2007 for the studies of association between incidence of AL and environmental exposure factors. Concerning those latter studies, a case-control approach has been used. The control sample, representative of the French pediatric population, contains 30,000 subjects and has been drawn by the INSEE. The precise localization of addresses of subjects and of exposure sources in relation with the type of sources is essential to build indicators of exposure reflecting the probability and intensity of exposure. • The study of AL by Département has highlighted neither trend nor spatial structure in the incidence at this geographical level globally as well as by age, gender and subtype of leukemia.• On 2002-2007, on the contrary of on previous periods, the incidence of AL at less than 5 km from a NPP was nearly twice higher than expected, with the case-control study as well as with the incidence approach. This result was not specific to any age group, NPP, a type of NPP and was not associated with the geographic zoning of gaseous discharges of NPPs. • The study of the proximity to HV OLs highlighted an association between the incidence of AL and the close proximity (< 50 m) of lines of more than 225 kV, association which was restricted to children of less than 5 y.o. or living in non-urban areas; but not with the proximity to lines of less than 150 kV.
