The Public Health Agency of Sweden misleads about cancer risks from radiofrequency radiation

The mission of this Agency is according to their home page:

The Public Health Agency of Sweden has a national responsibility for public health issues and works to ensure good public health. The agency also works to ensure that the population is protected against communicable diseases and other health threats.

However, when it comes to radiofrequency radiation and health their report from 2017 gives a wrong evaluation of the state of knowledge. Cancer risks are denied. It was written by a former and a present member of ICNIRP so no doubt the message is not different from that provided by ICNIRP. Our critique is published only in Swedish but can be read here.

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.

 

 

 

 

 

 

 

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.

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.

Evaluation of mobile phone and cordless phone use and glioma risk

In a recent article published in a scientific journal we evaluated use of wireless phones (mobile phones and cordless phones; DECT) and glioma risk. Glioma is a brain tumour that is one of the most common types. We used the Sir Austin Bradford Hill nine viewpoints on association or causation published in 1965 at the height of the debate on smoking and lung cancer risk. The same method can be used for other environmental agents and cancer risk.

As Bradford Hill pointed out not all nine viewpoints need to be fulfilled. The current knowledge may not exist in certain aspects. However, certain aspects such as first exposure before the onset of the disease and a dose-response relationship should exist.

Our evaluation was based on human epidemiological studies and findings in laboratory studies on animals and in cell cultures. Our conclusion was all nine viewpoints by Bradford Hill are fulfilled and that glioma is caused by radiofrequency (RF) radiation:

The nine Bradford Hill viewpoints on association or causation regarding RF radiation and glioma risk seem to be fulfilled in this review. Based on that we conclude that glioma is caused by RF radiation. Revision of current guidelines for exposure to RF radiation is needed.

RF radiation as a human carcinogen was evaluated by the International Agency for Research on Cancer (IARC) at WHO in May 2011. The conclusion was that such exposure is a possible human carcinogen, Group 2B according to the definition by WHO. The scientific evidence has increased since then and RF radiation should now be regarded as a human carcinogen, Group 1. An updated new evaluation by IARC is urgently needed.

We discuss in our article scientific controversy in this area including industry influence and ties between researchers and industry. A key player is the International Commission on Non-Ionizing Radiation (ICNIRP), a private NGO based in Germany that selects its own members and that does not publish funding sources. The ICNIRP guideline for RF radiation is extremely high and only based on short time thermal (heating) effects. Non-thermal effects are disregarded, that is a vast majority of studies on negative health effects from RF radiation not based on tissue heating. This gives in practice a ‘green card’ to roll out this technology since the high ICNIRP guideline is rarely compromised. Several governmental organizations in different countries have adopted the high ICNIRP level for exposure.

A new Health Criteria (Monograph) on RF radiation and health is under production by WHO. As discussed previously this document is biased towards the no-risk paradigm thereby neglecting published health risks from RF radiation. It has turned out that almost all persons in the core group for the WHO Monograph are present or former members of ICNIRP, see Table.

 

Table. Members of WHO Monograph core group and their involvement in other groups

Name WHO ICNIRP UK/AGNIR SSM SCENIHR
Simon Mann X X X
Maria Feychting X X X X*
Gunnhild Oftedal X X
Eric van Rongen X X X
Maria Rosaria Scarfi X X* X X
Denis Zmirou X

*former

WHO: World Health Organization

ICNIRP: International Commission on Non-Ionizing Radiation Protection

AGNIR: Advisory Group on Non-Ionising Radiation

SSM: Strålsäkerhetsmyndigheten (Swedish Radiation Safety Authority)

SCENIHR: Scientific Committee on Emerging and Newly Identified Health Risks

 

Thus, this fact – being member of both ICNIRP and the core group – is a serious conflict of interest. One would rarely expect that the core group members would present an evaluation that is in conflict with their own evaluation in ICNIRP. It has been requested that these persons should be replaced by experts with no conflict of interest, a most reasonable viewpoint.

As a matter of fact the Ethical Board at the Karolinska Institute in Stockholm, Sweden, concluded already in 2008 that being a member of ICNIRP may be a conflict of interest that should be stated in scientific publications (Karolinska Institute Diary Number 3753-2008-609). This is not done as far as can be seen in publications by ICNIRP persons such as members of the WHO core group.

The fifth generation (5G) of RF radiation is now under establishment. This is done without proper dosimetry or studies on potential health effects. The major media attention is a ‘love song’ to all possibilities with this technology such as so called self-driving cars, internet of things etc. Consequences for human health and environment such as wild life and vegetation are not discussed. Politicians, governmental agencies and media are responsible for the skewed debate. The layman is not informed about opposite opinions on this development. Health effects from RF radiation in media is a ‘no issue’ at least in Sweden but also in most other countries.

More results from Interphone confirm glioma risk associated with use of mobile phones

The Interphone study on use of mobile phones and brain tumour risk included 13 countries during the study period 2000 – 2004. The major results were published after a delay of 6 years in 2010. In the last decile of cumulative exposure > 1,640 h a statistically significant increased risk for glioma was found, OR = 1.40, 95 % CI =1.03-1.89. In the other categories of cumulative use a decreased risk was found. Bias and confounding were discussed as potential reasons for that. Analysing only subjects with regular use of a mobile phone yielded OR = 1.82, 95 % CI = 1.15-2.89 in the group with highest cumulative use.

There was an age difference between cases and controls in the Interphone study and furthermore cases and the matched controls were interviewed at different time periods, controls usually later than cases. This is problematic for mobile phone use with rapid penetration of the use in the population. In a recently published alternative analysis, cases and controls nearest in age and time for interview were included. The association between mobile phone use and glioma was strengthened thereby. Thus, among regular users in the 10th decile (> 1,640 h) cumulative use gave OR = 2.82, 95 % CI = 1.09-7.32. The authors concluded that there was ‘stronger positive association among long-term users and those in the highest categories of cumulative call time and number of calls.’.

Since the IARC evaluation in 2011 on exposure to radiofrequency radiation form mobile phones, and other devices that emit such radiation, and brain tumour risk additional research has strengthened the association. It is by now time to re-evaluate the scientific evidence on the cancer risk from radiofrequency radiation.

New results from Interphone confirm glioma risk associated with use of mobile phones

The Interphone study included 13 countries during the study period 2000 – 2004. The major results were published after a delay of 6 years in 2010. In a new publication 12 years after the study period, the intracranial distribution of glioma in relation to radiofrequency (RF) radiation from mobile phones was analyzed. Tumour localization for 792 regular mobile phone users was analyzed in relation to distance from preferred ear for mobile phone use.

In Table 2 five categories for the distance were used with > 115.01 mm as the reference category (α = 1.0).  An association with distance from preferred side of mobile phone use to center of tumour was found; the closer the distance the higher the risk. The highest risk was found in the group with the closest distance (0-55 mm) yielding α = 2.37, 95 % Confidence Interval (CI) = 1.56-4.56.

The same association was seen if distance was based on point with highest Specific Absorption Rate (SAR) instead of preferred ear and if using a model assuming that the preferred side of phone use was not exclusively used (“mixing proportion”). The latter model generated higher risk estimates than the other two but with wider confidence intervals.

In Table 3 tumour size, duration of phone use, cumulative phone use, cumulative number of calls were analyzed. Although not statistically significant, higher risks with decreasing distance were found in the upper levels of these dichotomized covariates.

α and 95 % CI in shortest distance group 0-55 mm from preferred ear to tumour center

Tumour size                        α                    95 % CI

≤18 cm3                              1.96               1.51 – 3.66

18 cm3                                4.09               1.90 – 12.0

Duration of phone use

<6 years                              2.02               1.31 – 4.28

≥6 years                              3.27               1.92 – 11.3

Cumulative phone use

<200 hours                          1.57                1.29 – 3.36

≥200 hours                          4.06                2.03 – 11.6

Cumulative number of calls

<4,000                                 1.55                  1.25 – 3.42

≥4,000                                 3.56                 2.05 – 9.88

The authors concluded that ‘Taken together, our results suggest that ever using a mobile phone regularly is associated with glioma localization in the sense that more gliomas occurred closer to the ear on the side of the head where the mobile phone was reported to have been used the most. However, this trend was not related to amount of mobile phone use, making it less likely that the association observed is caused by a relationship between mobile phone use and cancer risk.’

The first part although correct is misleading. The correct statement would be that the risk was highest for glioma closer to the ear as would be expected based on the exposure to RF radiation. The last sentence should have indicated that although not statistically significant, the risk was highest in the group with longest duration of phone use, highest cumulative phone use and number of calls. This is a pattern one would expect if there is an association between mobile phone use and glioma.

A similar tendency to not correctly downplaying the association is found in the abstract: ‘The association was independent of the cumulative call time and cumulative number of calls.’ Since many persons read only the abstract, as also presented in PubMed, correct presentation of the results including αs and 95 % CIs would have been more relevant.

The correct interpretation of this study is simply that it confirms an increased risk for glioma associated with mobile phone use.

 

Footnote: The α values represent the change in risk of observing a tumor within the given interval in comparison with the baseline intensity.