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.

WHO Monograph on Radiofrequency Radiation and ICNIRP

There is growing international concern on the biased representation of persons in the preparation of the WHO Monograph on Radiofrequency Radiation. As discussed earlier the group is dominated by members of ICNIRP. In 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).

A recent letter to WHO written by members of the BioInitiative Working Group describes the unbalanced ‘no-risk’ group at WHO preparing the document. The full text may be read here.

Has the WHO EMF Project been hijacked by ICNIRP?

Recently the following appeal has been posted at http://olgasheean.com/who-emf/:

“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: vandeventere@who.int

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:

Name WHO ICNIRP
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

*former
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:

http://olgasheean.com/who-emf/

Portable Screen-Based Media Devices and Sleep

In a new report analysis was made of studies on use of e.g. mobile phones and tablets and sleep and tiredness. The report included analysis of 20 cross-sectional studies of children and adolescents aged 6-19 years, in total more than 125,000 subjects. Use of media devices during bedtime gave about doubled risk for inadequate sleep, poor sleep and tiredness daytime. Also if these devices were not actively used an increased risk, although lower, was found for these health problems.

In USA 72 % of children and 89 % of adolescents have access to at least one media device. Most of them use it during bedtime.

Various pathways were discussed for the negative sleep impact: “First, they may negatively influence sleep by directly displacing, delaying, or interrupting sleep time. Second, the content can be psychologically stimulating, and, third, the light emitted from devices affects circadian timing, physiological sleep, and alertness.”

It is remarkable that the authors do not discuss exposure to radiofrequency (RF) fields (electromagnetic radiation) as a contributing factor. Wireless devices such as mobile phones (smartphones) emit RF radiation also when they are not used; updating apps, internet, SMS etc. This passive exposure may have contributed to the sleep disturbances in persons that did not actively use them. The authors seem to have been unwilling to discuss RF radiation. In fact studies on electromagnetic radiation were excluded. Also wireless use of desktops and computers would have been of interest. The authors stated:

“The exclusion criteria were studies of stationary exposures, such as televisions or desktop or personal computers, or studies investigating electromagnetic 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.