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.



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

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


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.

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.

Has the WHO EMF Project been hijacked by ICNIRP?

Recently the following appeal has been posted at

“Make your voice count

Sign this VOTE of NO CONFIDENCE in WHO’s EMF Project

We, the undersigned, being aware of and/or harmed by the adverse biological effects of EMFs, hereby declare our VOTE OF NO CONFIDENCE for WHO and its EMF Project, headed by industry-biased Emilie van Deventer—an electrical engineer (with no medical or health credentials), who has publicized her support for the wireless telecommunications industry and has a major conflict of interest, given her industry-funded research aimed at promoting and advancing wireless communication technology.

We demand that:

1. Emilie van Deventer be immediately replaced by a qualified independent professional who has the appropriate medical credentials and a medically informed understanding of and respect for the millions of individuals experiencing microwave sickness/electromagnetic sensitivity, and who will act on the body of science that confirms the adverse biological effects of electromagnetic fields (EMFs).

2. WHO and its EMF Project take immediate action to acknowledge, and make science-based decisions regarding, the proven harm caused by EMFs, without any bias or regard for commercial or industry interests, and with full disclosure to the public. With a mandate of preserving the health of the global population and, via its EMF Project, of ‘investigating the detrimental health effects from exposure of people to non-ionizing radiation’, WHO must ensure its complete freedom from industry bias and corruption.”

IARC as part of WHO evaluated radiofrequency (RF) radiation in May 2011 and concluded it to be a possible human carcinogen, Group 2B.  However, in a fact sheet issued by WHO in June 2011 shortly after the IARC decision it was stated that ‘To date, no adverse health effects have been established as being caused by mobile phone use’.

WHO has still not acknowledged health risks form RF radiation: ‘No major public health risks have emerged from several decades of EMF research, but uncertainties remain’.

WHO plans to publish in 2017 an Environmental Health Criteria Monograph on RF radiation. It has been open for comments and parts of our letter to WHO is shown below:


World Health Organization                                                                         15 December, 2014
Dr. T E van Deventer, Team Leader
Radiation Programme Department of Public Health, Environmental and Social
Determinants of Health, World Health Organization
Geneva, Switzerland
Via Email:

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

The following comments relate to section 12.1 Cancer Epidemiology. Due to the short time for submission of comments it is not possible to make a full review. That would require an in-depth review checking the original publications in detail.

Unfortunately the WHO draft does not state the names of the authors and any conflicts of interest. However, it must be clear that if any current or previous member of ICNIRP is part of this draft it would be a serious conflict of interest. ICNIRP has produced guidelines for radiofrequency electromagnetic (RF-EMF) exposure and accepts only thermal effects. Thus the large bulk of evidence on non-thermal effects is ignored, see the update of ICNIRP guidelines:

ICNIRP statement on the “Guidelines for limiting exposure to time-varying electric, magnetic and electromagnetic fields (up to 300 GHz)”. Health Physics. 2009; 97:257-8.

However, it is the opinion of ICNIRP that the scientific literature published since the 1998 guidelines has provided no evidence of any adverse effects below the basic restrictions and does not necessitate an immediate revision of its guidance on limiting exposure to high frequency electromagnetic fields…..With regard to non-thermal interactions, it is in principle impossible to disprove their possible existence but the plausibility of the various non-thermal mechanisms that have been proposed is very low. In addition, the recent in vitro and animal genotoxicity and carcinogenicity studies are rather consistent overall and indicate that such effects are unlikely at low levels of exposure. Therefore, ICNIRP reconfirms the 1998 basic restrictions in the frequency range 100 kHz–300 GHz until further notice.”

ICNIRP has not published any later statement. Thus, ICNIRP has not changed their guidelines in spite of increasing evidence of adverse health effects from RF-EMF exposure. Being a present or a former member of ICNIRP creates intellectual bias, not the least to adopt their evaluation in any further review outside ICNIRP. In fact, it would be remarkable if an ICNIRP member comes to a conclusion other than the ICNIRP paradigm of “no health effects.”

Another remarkable drawback of the draft is that the following important chapters are missing: Chapter 1: Summary and recommendations for further study. Chapter 13: Health risk assessment, Chapter 14: Protective measures. It is unclear why these chapters are excluded. Is it so that WHO aims to produce their conclusions without comments from the international scientific community?


Concluding remarks:

In conclusion the WHO draft is biased towards the null results. Findings on an association between use of wireless phones (mobile phones and cordless phones) and increased risk for brain tumours are misinterpreted, selectively reported and/or omitted in total. The draft cannot be used as science-based evaluation of increased risk. It needs to be re-written in a balanced way by scientists trained in epidemiology and oncology, not the least in medicine, and without conflicts of interest.

Lennart Hardell, MD, PhD                               Michael Carlberg, MSc
Department of Oncology                                 Department of Oncology
University Hospital                                          University Hospital
SE-701 85 Örebro                                           SE-701 85 Örebro
Sweden                                                           Sweden”


Later the members of the WHO core group has been presented, here also with their ICNIRP affiliation:

Simon Mann X X
Maria Feychting X X
Gunnhild Oftedal X X
Eric van Rongen X X
Maria Rosaria Scarfi X X*
Denis Zmirou X

WHO: World Health Organization
ICNIRP: International Commission on Non-Ionizing Radiation Protection

Thus, of the six members five are presently or have been members of ICNIRP. It is no wonder that at least the epidemiology part does not substantially differ from the ICNIRP ‘no risk’ paradigm. It should be noted that 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).

It is thus pertinent that those concerned about the WHO EMF project, that includes persons with obvious conflicts of interest, should consider the petition:

Pentachlorophenol is a human carcinogen, Group 1

In October 2016 18 scientists met at IARC for evaluation of pentachlorophenol (PCP) as a human carcinogen. The panel classified PCP as ‘carcinogenic to humans’ Group 1. PCP is a persistent organic pollutant under the Stockholm Convention. Chlorophenols, mostly PCP, have been used as wood preservatives. The use was banned in Sweden in 1978 with few exceptions. Wood impregnated with PCP may still entail a health hazard. In case-control studies we associated use of chlorophenols, as well as phenoxy herbicides, with increased risk for soft-tissue sarcoma (1979) and malignant lymphoma, both Hodgkin’s disease and non-Hodgkin lymphoma (1981). These results were the first studies in the world showing a carcinogenic potential of these agents, and further discussed in an article published in 1982.

Our results associated exposure to chlorophenols and the weed-killers phenoxy herbicides, with contaminating TCDD, with increased risk for soft-tissue sarcoma and malignant lymphoma. The results were soon questioned by industry and its allied experts including scientists with their own hidden agenda, even with funds from the Swedish Cancer Society aimed at preventing cancer, see


The lesson is that it took 37 years from the first publication showing PCP as a human carcinogen to establish causation, years that were lost for cancer prevention.