Fatal collision? Are wireless headsets a risk in treating patients?

In this recently published article wireless headsets are discussed. There is no open access to the article, but abstract is as follows:

Wireless-enabled headsets that connect to the internet can provide remote transcribing of patient examination notes. Audio and video can be captured and transmitted by wireless signals sent from the computer screen in the frame of the glasses. But using wireless glass-type devices can expose the user to a specific absorption rates (SAR) of 1.11–1.46 W/kg of radiofrequency radiation. That RF intensity is as high as or higher than RF emissions of some cell phones.  Prolonged use of cell phones used ipsilaterally at the head has been associated with statistically significant increased risk of glioma and acoustic neuroma. Using wireless glasses for extended periods to teach, to perform surgery, or conduct patient exams will expose the medical professional to similar RF exposures which may impair brain performance, cognition and judgment, concentration and attention and increase the risk for brain tumors. The quality of medical care may be compromised by extended use of wireless-embedded devices in health care settings. Both medical professionals and their patients should know the risks of such devices and have a choice about allowing their use during patient exams. Transmission of sensitive patient data over wireless networks may increase the risk of hacking and security breaches leading to losses of private patient medical and financial data that are strictly protected under HIPPA health information privacy laws.

A detailed discussion is made of such items as: What are wireless headsets and why are healthcare professionals being encouraged to use them? What is the problem for the medical professional? What is the problem for the patient? What’s the advice to medical professionals?

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Increasing incidence of aggressive brain tumour (glioblastoma multiforme) in England during 1995-2015

A recent article describes increasing incidence of the most malignant type of brain tumor, glioblastoma multiforme (GBM) in England during 1995-2015. The number of patients increased from 2.4 to 5.0 per 100,000 during that time period. In total the yearly increase was from 983 to 2,531 patients, thus a substantial number. The incidence of low-grade glioma decreased but was stabilized from 2004, see figure 2. Thus the increasing incidence cannot be explained by low-grade glioma transforming to high-grade (GBM). The authors conclude that a general environmental factor must be the cause.

The increasing incidence is most pronounced for GBM in temporal or frontal parts of the brain, see figure 6. That is parts with highest exposure to radiofrequency radiation from the handheld wireless phone.

The increasing incidence of GBM was seen in all age groups but was most pronounced in those aged more than 55 years.

We published incidence data on brain tumours for the time period 1998-2015 based on the Swedish Cancer Register. In the age group 60-79 years the yearly incidence of high-grade glioma increased statistically significant in men with +1.68% (+0.39, +2.99 %) (n = 2,275) and in women with +1.38% (+0.32, +2.45%) (n = 1,585), see figures. Few patients were diagnosed in the age group 80+ yielding analysis less meaningful. High-grade glioma includes astrocytoma grades III and IV. Astrocytoma grade IV is the same as glioblastoma multiforme (GBM) with bad prognosis, survival about one year or less.

Our results are similar to those now published from England. All results are in agreement with wireless phones (mobile phones and cordless phones) causing glioma.

 

 

 

 

 

 

 

Increasing brain tumor rates in Sweden

Recently we published a new article on brain tumor rates in Sweden using the Inpatient Register for the time period 1998-2015. Also incidence data using the Swedish Cancer Register were analyzed for the same time period. The full article can be found here, see also abstract below.

We used the Swedish Inpatient Register (IPR) to analyze rates of brain tumors of unknown type (D43) during 1998-2015. Average Annual Percentage Change (AAPC) per 100,000 increased with +2.06%, 95% confidence interval (CI) +1.27, +2.86% in both genders combined. A joinpoint was found in 2007 with Annual Percentage Change (APC) 1998-2007 of +0.16%, 95% CI -0.94, +1.28%, and 2007-2015 of +4.24%, 95% CI +2.87, +5.63%. Highest AAPC was found in the age group 20-39 years. In the Swedish Cancer Register the age-standardized incidence rate per 100,000 increased for brain tumors, ICD-code 193.0, during 1998-2015 with AAPC in men +0.49%, 95% CI +0.05, +0.94%, and in women +0.33%, 95% CI -0.29, +0.45%. The cases with brain tumor of unknown type lack morphological examination. Brain tumor diagnosis was based on cytology/histopathology in 83% for men and in 87% for women in 1980 in the Cancer Register. This frequency increased to 90% in men and 88% in women in 2015. During the same time period CT and MRI imaging techniques were introduced and morphology is not always necessary for diagnosis. If all brain tumors based on clinical diagnosis with CT or MRI had been reported to the Cancer Register the frequency of diagnoses based on cytology/histology would have decreased in the register. The results indicate underreporting of brain tumor cases to the Cancer Register. The real incidence would be higher. Thus, incidence trends based on the Cancer Register should be used with caution. Use of wireless phones should be considered in relation to the change of incidence rates.

Case-control study on occupational exposure to extremely low-frequency electromagnetic fields and glioma risk

Exposure to extremely low-frequency electromagnetic fields (ELF-EMF) was in 2002 classified as a possible human carcinogen, Group 2B, by the International Agency for Research on Cancer (IARC) at WHO. In the international Interphone study on mobile phone use and glioma risk, glioma was associated with occupational ELF-EMF exposure in recent time windows. The authors concluded that such exposure may play a role in late stage carcinogenesis of glioma.

We assessed life time occupations in case-control studies during 1997-2003 and 2007-2009 on e.g. use of wireless phones and glioma risk. An ELF-EMF Job-Exposure Matrix was used for associating occupations with ELF exposure (μT). Cumulative exposure (μT-years), average exposure (μT), and maximum exposed job (μT) were calculated.

Cumulative exposure gave for astrocytoma grade IV (glioblastoma multiforme) in the time window 1-14 years before diagnosis odds ratio (OR) = 1.9, 95% confidence interval (CI) = 1.4-2.6, p linear trend <0.001, and in the time window 15+ years OR = 0.9, 95% CI = 0.6-1.3, p linear trend = 0.44 in the highest exposure categories 2.75+ and 6.59+ μT-years, respectively.

We concluded that we found an increased risk in late stage (promotion/progression) of astrocytoma grade IV for occupational ELF-EMF exposure. No statistically significant interaction was found between exposure to ELF-EMF and use of wireless phones (exposure to radiofrequency radiation; RF-EMF). They were independent risk factors for astrocytoma grade IV.

World Health Organization, radiofrequency radiation and health – a hard nut to crack (Review)

In a new article by Dr Lennart Hardell health effects from radiofrequency radiation, ICNIRP and the WHO agenda are discussed. The whole article can be found here, see also abstract below.

Abstract. In May 2011 the International Agency for Research on Cancer (IARC) evaluated cancer risks from radiofrequency (RF) radiation. Human epidemiological studies gave
evidence of increased risk for glioma and acoustic neuroma. RF radiation was classified as Group 2B, a possible human carcinogen. Further epidemiological, animal and mechanistic
studies have strengthened the association. In spite of this, in most countries little or nothing has been done to reduce exposure and educate people on health hazards from RF
radiation. On the contrary ambient levels have increased. In 2014 the WHO launched a draft of a Monograph on RF fields and health for public comments. It turned out that five
of the six members of the Core Group in charge of the draft are affiliated with International Commission on Non-Ionizing Radiation Protection (ICNIRP), an industry loyal NGO, and
thus have a serious conflict of interest. Just as by ICNIRP, evaluation of non-thermal biological effects from RF radiation are dismissed as scientific evidence of adverse health effects in the Monograph. This has provoked many comments sent to the WHO. However, at a meeting on March 3, 2017 at the WHO Geneva office it was stated that the WHO has no intention to change the Core Group.

 

 

Increased risk for glioma associated with mobile phone use in Interphone Canada

Probabilistic multiple-bias modelling applied to the Canadian data from the INTERPHONE study of mobile phone use and risk of glioma, meningioma, acoustic neuroma, and parotid gland tumors.

Momoli F, Siemiatycki J, McBride ML, Parent MÉ, Richardson L, Bedard D, Platt R, Vrijheid M, Cardis E, Krewski D.

Abstract

We undertook a re-analysis of the Canadian data from the thirteen-country INTERPHONE case-control study (2001-2004), which evaluated the association between mobile phone use and risk of brain, acoustic neuroma, and parotid gland tumors. The main publication of the multinational INTERPHONE study concluded that “biases and errors prevent a causal interpretation”. We applied a probabilistic multiple-bias model to address possible biases simultaneously, using validation data from billing records and non-participant questionnaires as information on recall error and selective participation. Our modelling sought to adjust for these sources of uncertainty and to facilitate interpretation. For glioma, the odds ratio comparing highest quartile of use (over 558 lifetime hours) to non-regular users was 2.0 (95% confidence interval: 1.2, 3.4). The odds ratio was 2.2 (95% confidence interval: 1.3, 4.1) when adjusted for selection and recall biases. There was little evidence of an increase in the risk of meningioma, acoustic neuroma, or parotid gland tumors in relation to mobile phone use. Adjustments for selection and recall biases did not materially affect interpretation in our Canadian results.

The article can be found here.

Comment:

It is noteworthy that statistically significant increased risk was found already at 558+ hours of cumulative use corresponding to 9 min per day during 10 years. This amount is much lower than now used for wireless phones. Total Interphone showed for cumulative call time, 1640 hours or more, odds ratio 1.40 (95% confidence interval 1.03–1.89) for glioma. This corresponds to less than half an hour per day (27 min) during 10 years.

Interphone Canada confirms the increased risk for glioma associated with use of wireless phones, see our recent review, Carlberg, Hardell 2017.

Effects of Mobile Phones on Children’s and Adolescents’ Health: A Commentary

Effects of Mobile Phones on Children’s and Adolescents’ Health: A Commentary

Author: Lennart Hardell

In: Special Section of Child Development. Contemporary Mobile Technology and Child and Adolescent Development, edited by Zheng Yan and Lennart Hardell, May 15, 2017.

Abstract

The use of digital technology has grown rapidly during the last couple of decades. During use, mobile phones and cordless phones emit radiofrequency (RF) radiation. No previous generation has been exposed during childhood and adolescence to this kind of radiation. The brain is the main target organ for RF emissions from the handheld wireless phone. An evaluation of the scientific evidence on the brain tumor risk was made in May 2011 by the International Agency for Research on Cancer at World Health Organization. The scientific panel reached the conclusion that RF radiation from devices that emit nonionizing RF radiation in the frequency range 30 kHz–300 GHz is a Group 2B, that is, a “possible” human carcinogen. With respect to health implications of digital (wireless) technologies, it is of importance that neurological diseases, physiological addiction, cognition, sleep, and behavioral problems are considered in addition to cancer. Well-being needs to be carefully evaluated as an effect of changed behavior in children and adolescents through their interactions with modern digital technologies.

Discussion

In spite of the IARC evaluation little has happened to reduce exposure to RF fields in most countries. The exposure guideline used by many agencies was established in 1998 by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) and was based on thermal (heating) effects from RF radiation neglecting non-thermal biological effects. It was updated in 2009 and still gives the guideline 2 to 10 W/m2 for RF radiation depending on frequency.

In contrast to ICNIRP the BioInitiative Report from 2007, updated in 2012, based the evaluation also on non-thermal health effects from RF radiation. The scientific benchmark for possible health risks was defined to be 30 to 60 µW/m2.  Thus, using the significantly higher guideline by ICNIRP gives a ‘green card’ to roll out the digital technology thereby not considering non-thermal health effects from RF radiation. Numerous health hazards are disregarded such as cancer, neurological diseases, psychological addiction, cognition, sleep and behavioral problems.

For obvious reasons the extent and severity of long-term health effects among children and adolescents using this technology are not know. However, there are already numerous peer-reviewed studies showing health hazards from wireless devices. Urgent action using the precautionary principle is needed.