High ambient radiofrequency radiation at the Stockholm Hay Market in Sweden

We have published results on measurements of radiofrequency (RF) radiation in central parts of Stockholm, Sweden. The published article can be found here. Especially high levels were found at the Hay Market and Sergel Plaza; mean levels 10,728 and 7,768 microWatt/m2, respectively. Also at central streets high ambient RF radiation was found from nearby base stations.

The figure below shows the result for the Hay Market. We have inserted the 30-60 microWatt/m2 line for lowest level of biological effects (red line).

Environmental radiofrequency radiation at the Järntorget Square in Stockholm Old Town in Sweden compared with results on tumour risks in rats exposed to 1.8 GHz base station environmental emissions

We measured radiofrequency (RF) radiation at the Järntorget square in the Stockholm Old Town in a new study recently published.  In a previous study of the Old Town we found especially high RF radiation at that square. The maximum level in the present study was 11.6 V/m at the center of the square, where the antenna was focused. Järntorget’s mean value was 5.2 V/m, median 5.0 V/m, range 1.2-11.6 V/m.

Of interest is that this level can be compared to life-span carcinogenicity study on rats exposed to 1.8 GHz GSM environmental radiation performed at the Ramazzini Institute (RI) in Italy. A statistically significant increase in the incidence of malignant Schwannoma in the heart was found in male rats at the highest dose, 50 V/m. In treated female rats at the highest dose the incidence of malignant glial tumors was increased, although not statistically significant. In conclusion our study showed RF radiation levels at one square, Järntorget, in Sweden was only one order of magnitude lower than those showing increased incidence of tumours in the RI animal study. An increased cancer risk cannot be excluded for those working next to or at Järntorget for longer time periods.

These results indicate that it is pertinent to measure RF radiation levels in the environment and in homes. Such exposure levels should be declared for those intending to settle down in any dwelling.

Radiofrequency radiation from nearby base stations gives high levels in an apartment in Stockholm, Sweden: A case report

We measured radiofrequency radiation in an apartment in Stockholm. The study is open under open access. Due to nearby bases stations high radiation levels were measure both in the apartment and on balconies.

A total of 74,531 measurements were made corresponding to ~83 h of recording. The total mean RF radiation level was 3,811 μW/m2 (range 15.2‑112,318 μW/m2) for the measurement of the whole apartment, including balconies. Particularly high levels were measured on three balconies and 3 of 4 bedrooms. The total mean RF radiation level decreased by 98% when the measured down‑links from the base stations for 2, 3 and 4 G were disre­garded. The results are discussed in relation to the detrimental health effects of non‑thermal RF radiation. Due to the current high RF radiation, the apartment is not suitable for long‑term living, particularly for children who may be more sensitive than adults. For a definitive conclusion regarding the effect of RF radiation from nearby base stations, one option would be to turn them off and repeat the measurements. However, the simplest and safest solution would be to turn them off and dismantle them.

Thus, we concluded that of special concern is the levels in bedrooms, especially those two used by children, since they seem to be more vulnerable to adverse health effects than grown‑ups. They have also a longer expected life in which illnesses may later become manifest. The results indicate that this apartment is unsuitable for long‑term living based on current knowledge of the potential adverse effects on health of RF radiation.

Another conclusion is that RF radiation should be measured in homes, especially before moving into a new one.

Measurements of Radiofrequency Radiation with a Body-Borne Exposimeter in Swedish Schools with Wi-Fi

Our research group published recently a study on radiofrequency (RF) radiation in schools using an exposimeter. RF emissions in the classroom were measured by the teachers in order to approximate the children’s exposure. Teachers in grades 7–12 carried a body-borne exposimeter, EME-Spy 200, in school during 1–4 days of work. Eighteen teachers from seven schools participated. The mean exposure to RF radiation ranged from 1.1 to 66.1 μW/m2. The highest mean level, 396.6 μW/m2, occurred during 5 min of a lesson when the teacher let the students stream and watch YouTube videos. Maximum peaks went up to 82,857 μW/m2 from mobile phone uplink.  The exposure levels varied between the different Wi-Fi systems, and if the students were allowed to use their own smartphones on the school’s Wi-Fi network or if they were connected to GSM/3G/4G base stations outside the school. An access point over the teacher’s head gave higher exposure compared with a school with a wired Internet connection for the teacher in the classroom. All values were far below International Commission on Non-Ionizing Radiation Protection’s reference values, but most mean levels measured were above the precautionary target level of 3–6 μW/m2 as proposed by the Bioinitiative Report. The length of time wireless devices are used is an essential determinant in overall exposure. Measures to minimize children’s exposure to RF radiation in school would include preferring wired connections, allowing laptops, tablets and mobile phones only in flight mode and deactivating Wi-Fi access points, when not used for learning purposes.

In Table 10 in the article examples of methods to reduce children’s exposure to RF radiation in schools are given

1. Wired connection to both teachers and students and no wireless networks or devices in school is the optimal choice. If this is not possible:
2. Wired connection to each classroom
a. to the teacher’s laptop,
b. for the students to download large files and videos.
3. To reduce exposure from Wi-Fi networks in school:
a. turn off Wi-Fi access points when not used for learning purposes,
b. position Wi-Fi access points outside of classrooms,
c. use directional Wi-Fi access points, which radiate into the direction of the client’s device.
4. Keep laptops and tablets in flight mode when Internet is not needed for learning purposes.
5. Wired connection to a landline telephone in each classroom could minimize the need for mobile phones for contact.
6. Mobile phones, including smart phones, could be left at home or collected in turned off mode. If allowed, they should be carried only in flight mode during school hours.

 

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.

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.

High radiofrequency radiation at Stockholm Old Town in Sweden

Exposure to radiofrequency (RF) radiation was classified as a possible human carcinogen, Group 2B, by the International Agency for Research on Cancer at WHO in 2011. Outdoor RF radiation levels were measured during five tours in Stockholm Old Town in April, 2016 using the EME Spy 200 exposimeter with 20 predefined frequencies. The results were based on 10,437 samples in total. The mean level of the total RF radiation was 4,293 μW/m2 (0.4293 μW/cm2). The highest mean levels were obtained for global system for mobile communications (GSM) + universal mobile telecommunications system (UMTS) 900 downlink and long‑term evolution (LTE) 2600 downlink (1,558 and 1,265 μW/m2, respectively). The town squares displayed highest total mean levels, with the example of Järntorget square with 24,277 μW/m2 (min 257, max 173,302 μW/m2). Measurements in the streets surrounding the Royal Castle were lower than the total for the Old Town, with a mean of 756 μW/m2 (min 0.3, max 50,967 μW/m2). The BioInitiative 2012 Report defined the scientific benchmark for possible health risks as 30‑60 μW/m2. Our results of outdoor RF radiation exposure at Stockholm Old Town are significantly above that level. The full report can be found here.

High radiofrequency radiation at the Stockholm Central Station in Sweden

We measured the radiofrequency (RF) radiation at the Stockholm Central Station in Sweden in November 2015. The full study can be read here. The exposimeter EME Spy 200 was used and it covers 20 different RF bands from 88 to 5,850 MHz. In total 1,669 data points were recorded. The median value for total exposure was 921 µW/m2 (or 0.092 μW/cm2; 1 μW/m2=0.0001 μW/cm2) with some outliers over 95,544 µW/m2 (6 V/m, upper detection limit). The mean total RF radiation level varied between 2,817 to 4,891 µW/m2 for each walking round.

Hot spots were identified, for example close to a wall mounted base station yielding over 95,544 µW/m2 and thus exceeding the exposimeter’s detection limit, see Figure below. A man is standing with his smartphone just a couple of meters below a base station (see arrow). In that area maximum measured power density in the GSM +UMTS 900 downlink band from the base station was 95,544 µW/m2, which is the upper limit of measurement for EME Spy 200.

imgp5647a

Almost all of the total measured levels were above the precautionary target level of 3 to 6 µW/m2 as proposed by the BioInitiative Working Group in 2012. That target level was one-tenth of the scientific benchmark providing a safety margin either for children, or chronic exposure conditions. Considering the rapid progress of this technology, including 5G that is to be launched in the near future, it is important to monitor current RF radiation exposure in the environment.

Increasing incidence of thyroid cancer in the Nordic countries

The incidence of thyroid cancer is increasing in many countries, especially the papillary type that is the most radiosensitive type. We used the Swedish Cancer Register and NORDCAN to study the incidence of thyroid cancer during 1970-2013 using joinpoint regression analysis. The incidence increased during the whole study period in both men and women. Based on NORDCAN data, there was a statistically significant increase in the incidence of thyroid cancer in the Nordic countries during the same time period. In both women and men one joinpoint was detected in 2006. The incidence increased substantially during 2006-2013 in women; annual percentage change (APC) +6.16 % (95 % CI +3.94, +8.42 %) and in men; APC +6.84 % (95 % CI +3.69, +10.08 %). These results were similar as in the Swedish Cancer Register. Analyses based on data from the Cancer Register showed that the increasing trend in Sweden was mainly caused by thyroid cancer of the papillary type. We postulate that the whole increase cannot be attributed to better diagnostic procedures. Increasing exposure to ionizing radiation, e.g. medical CT scans, and to radiofrequency radiation (non-ionizing radiation) should be further studied as causative factors to this emerging thyroid cancer health problem.

One aspect to be studied is the increasing use of mobile phones. The antenna was previously placed at the top of the phone but is usually now placed at the bottom in smartphones. This gives higher exposure of radiofrequency radiation to the thyroid gland, see figure. A smartphone can in addition have multiple antennas.

thyroid-cancer-incidence-figure-10

Letter to WHO regarding brain tumour risk associated with exposure to radiofrequency fields

We have previously commented on the many scientific mistakes in the WHO draft Monograph on radiofrequency fields and health effects. Since there has not been any reaction we have sent the following letter asking for revision. A similar letter was send to IARC asking for new cancer risk evaluation.

 

World Health Organization                                                              4 August, 2015

 

Dr Margaret Chan, Director General

World Health Organization

Avenue Appia 20, 1211 Geneva 27

Geneva, Switzerland

 

Emelie van Deventer, Team Leader

Radiation Programme Department of Public Health,

Environmental and Social Determinants of Health,

World Health Organization

Geneva, Switzerland

 

Dear Ms. Margaret Chan

Dear Ms. Emelie van Deventer

 

Further Comments on the WHO draft: Radio Frequency fields: Environmental Health Criteria Monograph

On 15 December, 2014 we submitted comments on the WHO draft on radio frequency fields and health. Since we have not got a satisfactory reply from WHO, not seen a revision of the draft, and adding to that more published studies that reinforce the increased risk for certain brain tumours associated with use of wireless phones we want to submit the following, additional comments.

The brain is the primary target organ for exposure to radiofrequency electromagnetic fields (RF-EMF) during the use of the handheld wireless phone. This has given concern of an increased risk for brain tumours. The carcinogenic effect of RF-EMF on humans was evaluated at a meeting during 24 – 31 May 2011 at the International Agency for Research on Cancer (IARC) at WHO in Lyon, France. One of us (LH) was part of the expert group. The Working Group categorised RF-EMF from mobile phones, and from other devices that emit similar non-ionising electromagnetic fields in the frequency range 30 kHz–300 GHz, as a Group 2B, i.e. a possible, human carcinogen (http://monographs.iarc.fr/ENG/Monographs/vol102/mono102.pdf).

Since then more studies have been published that strengthen the association between use of wireless phones (mobile and cordless phones) and increased risk for brain tumours. We have performed long-term research in this area and in the following we give a short up-dated summary of our findings based on research since the 1990’s. In our publications relevant information can be found also on other studies, as well as discussions of the current scientific evidence.

Glioma:

Glioma is a malignant brain tumour (“brain cancer”), and the most common type is glioblastoma multiforme with a poor prognosis. We have published a statistically significant increased risk for glioma among users of both mobile and cordless phones. The risk increased with latency (time from first use of the phone until tumour diagnosis) and cumulative number of hours for use. Highest risk was found in the area of the brain with highest exposure to RF-EMF. All these results are of biological relevance; that is what would be expected for a causal association. The full paper can be read here:

http://www.pathophysiologyjournal.com/article/S0928-4680(14)00064-9/pdf

Meningioma:

Menigioma is mostly a benign brain tumour and accounts for about 30 % of all intracranial tumours. The incidence is approximately 2-times higher in women than in men. No conclusive evidence of an association between use of mobile and cordless phones and meningioma was found in our study. However, taking the long latency periods that have been reported for the increased meningioma risk associated with exposure to ionizing radiation it is still too early to make a definitive risk assessment. Results for even longer latency periods of wireless phone use than in our study are desirable, see more details here:

http://www.spandidos-publications.com/or/33/6/3093

Acoustic neuroma:

Acoustic neuroma or Vestibular Schwannoma is a rare benign tumour in the eighth cranial nerve that leads from the inner ear to the brain. It grows slowly and does not undergo malignant transformation, but may give compression of vital brain stem centres. Tinnitus and hearing problems are usual first symptoms of acoustic neuroma. We published a clear, statistically significant, association between use of mobile and cordless phones and acoustic neuroma. The risk increased with time since first use. For use of both mobile and cordless phones the risk was highest in the longest latency group. Tumour volume increased per 100 hours of cumulative use and year of latency for wireless phones indicating tumour progression from RF-EMF. The whole study can be read here:

http://www.spandidos-publications.com/ijo/43/4/1036

Brain tumour prognosis:

A causal association would be strengthened if use of wireless phones has an impact on the survival of glioma patients. We analyzed survival of 1,678 glioma patients in our case-control studies 1997-2003 and 2007-2009. Use of wireless phones in the > 20 years latency group (time since first use) yielded increased hazard ratio (HR) = 1.7, 95 % confidence interval (CI) = 1.2-2.3 for glioma, i.e. decreased survival. Increased HR was found for use of both mobile and cordless phones. Highest HR was found for cases with first use before the age of 20 years. These results strengthen a causal association between use of wireless phones and glioma. The publication can be read here:

http://www.mdpi.com/1660-4601/11/10/10790

Risk in different age groups of first use:

In our glioma study we found highest risk for subjects with first use of mobile or cordless phone before the age of 20, see Table 8 in the publication:

http://www.pathophysiologyjournal.com/article/S0928-4680(14)00064-9/pdf

We published similar results for acoustic neuroma and use of mobile phones, see Table 21.2:

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.433.7480&rep=rep1&type=pdf

Children and adolescents are more exposed to RF-EMF than adults due to thinner skull bone, higher conductivity in the brain tissue, and a smaller head. The developing brain is also more vulnerable than in adults and it is still developing until about 20 years of age. The finding of higher risk in young persons is worrying, not the least due to the high prevalence of use of wireless phones in children and adolescents.

Brain tumour incidence:

It is not correct to claim that the incidence of brain tumours has not increased in the Scandinavian countries. The age-standardized incidence of brain tumours increased dramatically in Denmark with +41.2 % among men and +46.1 % among women during 2003-2012 (http://www.ssi.dk/Aktuelt/Nyheder/2013/~/media/Indhold/DK – dansk/Sundhedsdata og it/NSF/Registre/Cancerregisteret/Cancerregisteret 2012.ashx).

Due to the well-known under-reporting of brain tumours to the Swedish Cancer Registry we studied brain tumour rates using the Swedish National Inpatient Register and the Causes of Death Register (see http://www.mdpi.com/1660-4601/12/4/3793/htm ). In summary we found a statistically significant increasing rate of not specified brain tumours from 2007 in the Inpatient Register and from 2008 in the Causes of Death Register. Our study indicated that several of these tumours were never reported to the Swedish Cancer Register. The results are in accordance with a reasonable latency period for use of wireless phones, e.g. mobile phones, see Figures 5 and 6 in our publication. Thus, the Swedish Cancer Register data cannot be used to dismiss an increased risk for brain tumours associated with use of wireless phones. On the contrary our study is consistent with an association considering a reasonable tumour induction period.

Mechanistic aspects:

Reactive oxygen species:

RF-EMFs do not cause direct DNA damage. On the other hand numerous studies have shown generation of reactive oxygen species (ROS) that can cause oxidative damage of DNA. This is a well-known mechanism in carcinogenesis for many agents. The broad biological potential of ROS and other free radicals makes radiofrequency radiation a potentially hazardous factor for human health, not only cancer risk but also other health effects. A recent update can be read here:

http://informahealthcare.com/doi/abs/10.3109/15368378.2015.1043557

-Tumour promotion:

Tumour promotion by RF-EMF exposure was reported in 2010 in a study on mice: http://www.ncbi.nlm.nih.gov/pubmed/20545575. These findings were recently replicated and add to the relevance of tumour risk: http://www.ncbi.nlm.nih.gov/pubmed/25749340

-p53:

The p53 protein is a transcription factor that plays a vital role in regulating cell growth, DNA repair and apoptosis, and p53 mutations are involved in disease progression. In a recent study it was found that use of mobile phones for ≥3 hours a day was associated with increased risk for the mutant type of p53 gene expression in the peripheral zone of astrocytoma grade IV (glioblastoma multiforme), and that this increase was statistically significant correlated with shorter overall survival time:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4178273/

 These results are in agreement with the decreased survival for patients with astrocytoma grade IV (glioblastoma multiforme) associated with long-term use of mobile phones and cordless phones that we reported in 2014, see above the section on prognosis.

Causality:

To further evaluate strengths of evidence Sir Austin Bradford Hill wrote in the 1960’s a famous article on association or causation at the height of the tobacco and lung cancer controversy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1898525/pdf/procrsmed00196-0010.pdf

Hill offered a list of nine aspects of an association to be considered when deciding if an association is causal. However, he did not request all nine viewpoints to be fulfilled for causality. We used the Hill criteria to evaluate the causality on brain tumour risk from RF-EMF emitted from wireless phones. We concluded that based on the Hill criteria, glioma and acoustic neuroma should be considered to be caused by RF-EMF emissions from wireless phones and regarded as carcinogenic to humans, classifying it as Group 1 according to the IARC classification. See more here:

http://www.degruyter.com/view/j/reveh.2013.28.issue-2-3/reveh-2013-0006/reveh-2013-0006.xml

Conclusion:

Our results are in agreement with other studies such as the international Interphone study and the French CERENAT study. This is discussed in more detail in e.g. our article on glioma risk, see also:

http://www.pathophysiologyjournal.com/article/S0928-4680(12)00110-1/pdf

The so called Danish cohort study on mobile phone users has been taken as evidence of no risk. However, the many shortcomings as reviewed elsewhere makes the study inconclusive regarding assessment of cancer risk. It should not be cited as evidence of no risk, for more details see: http://www.degruyter.com/view/j/reveh.2012.27.issue-1/reveh-2012-0004/reveh-2012-0004.xml?format=INT

In summary there is consistent evidence of increased risk for glioma and acoustic neuroma associated with use of mobile phones and cordless phones. Furthermore, the risk is highest for persons with first use before the age of 20, which is of special concern. Our conclusion is that RF-EMF should be regarded as a human carcinogen. The IARC classification should be updated to at least Group 2A, a probable human carcinogen. Current guidelines for exposure need to be urgently revised. The WHO Monograph draft on this issue is based on selective inclusion of studies and wrong assessment of the evidence of increased risk. Thus the Danish cohort study on mobile phone users and the Swedish Cancer Register data cannot be used as evidence of no increased risk. It is important that the public and decision makers are given correct information about the cancer risk so that they can make decisions based on correct data and take precautions. Otherwise there is an obvious risk of forthcoming increasing impairment of human health and increasing numbers of cancer in the population. We anticipate correction of the Monograph and your reply to this letter no later than 15 September, 2015. If you so wish our research group may of course give a presentation at WHO on this topic.

Yours sincerely,

 

Lennart Hardell, MD, PhD

Department of Oncology

University Hospital

SE-701 85 Örebro

Sweden

 

Michael Carlberg, MSc

Department of Oncology

University Hospital

SE-701 85 Örebro

Sweden