Genetic susceptibility may modify the association between cell phone use and thyroid cancer: A population-based case-control study in Connecticut

Exploring temporal trends and influencing factors for thyroid cancer in Guangzhou, China: 2004-2018

PURPOSE

Describe and analyze the trends of thyroid cancer incidence and mortality in Guangzhou, explore the potential influencing factors, and provide evidence for the government to formulate prevention and treatment measures.

METHODS

Incident and death cases of thyroid cancer were retrieved from the Guangzhou cancer registry. The joinpoint regression models were used to estimate the incidence and mortality trends. Age-period-cohort models were used to estimate the age, period, and cohort effects on the time trends. Grey correlation analysis was performed to explore possible connections between thyroid cancer and social factors.

RESULTS

A total of 15,955 new cases of thyroid cancer were registered in Guangzhou during 2004-2018, the age-standardized incidence rate (ASIR) of thyroid cancer increased from 4.29/105 in 2004 to 22.36/105 in 2018, with the average annual percentage change (AAPC) of 13.40%. The overall increase can be attributed to the increase in the incidence of papillary thyroid carcinoma (PTC), which was dominated by tumors <2 cm. The ASIR was higher in women (16.12/105) compared to men (5.46/105), and young and middle-aged individuals had higher incidence rates than older people. The number of thyroid cancer deaths registered between 2010 and 2018 was 356, and the age-standardized mortality rates (ASMRs) were stable (approximately 0.42/105). Men's ASMR (0.34/105) and women's (0.49/105) were similar, and those 60 and older had greater mortality. The period and cohort relative risks showed an overall increasing trend. Furthermore, there was a strong positive correlation between the ASIRs and social determinants.

CONCLUSIONS

During the study period, the incidence rate of thyroid cancer among young and middle-aged people in Guangzhou showed a rapidly increasing trend, and the mortality was relatively stable. In the future, more effective preventive measures should be taken for this age group to reduce the burden of disease and avoid overdiagnosis.

Ulnar Nerve Entrapment Among Cell Phone Users: Cell Phone Elbow (Cubital Tunnel Syndrome)

Introduction Cell phone usage has tremendously increased, and to make usage comfortable, accessories such as Bluetooth earphones are available. But still, most people use cell phones for a long period of time by flexing their elbows near their ears. When the users flex the elbow to hold the phone near the ear, this results in increased pressure over the ulnar nerve since the ulnar nerve runs superficially at the level of the elbow. The extensive pressure over the ulnar nerve may result in nerve compression, which results in cubital tunnel syndrome, recently called the cell phone elbow. Hence, this study was undertaken to assess the ulnar nerve function among cell phone users in relation to the duration of usage. Materials and methods Young healthy volunteers (n = 30) aged between 20 and 25 years were selected for the study in order to prevent age-related neuropathic changes. After getting a history of mobile phone usage, the subjects were asked about neural symptoms such as tingling, numbness, and pain while using cell phones. Ulnar nerve function was assessed by Froment's sign and Wartenberg's sign. An ulnar nerve conduction study was done. Results Seventy percent of the subjects (n = 21) out of the 30 subjects participating in the study reported tingling and numbness during mobile phone usage. But Froment's sign and Wartenberg's sign were negative for all the subjects. There was a significant positive correlation (r = 0.913 and r = 0.8253) between the duration of mobile phone use and latency and a negative correlation (r = -0.8439) with conduction velocity. Conclusion The malposition of the elbow during prolonged cell phone use results in ulnar nerve entrapment. The continuous usage of cell phones without rest by flexing the elbow causes nerve compression. This can be taken as a warning sign to prevent further damage.

Problems in evaluating the health impacts of radio frequency radiation

In an effort to clarify the nature of causal evidence regarding the potential impacts of RFR on biological systems, this paper relies on a well-established framework for considering causation expanded from that of Bradford Hill, that combines experimental and epidemiological evidence on carcinogenesis of RFR. The Precautionary Principle, while not perfect, has been the effective lodestone for establishing public policy to guard the safety of the general public from potentially harmful materials, practices or technologies. Yet, when considering the exposure of the public to anthropogenic electromagnetic fields, especially those arising from mobile communications and their infrastructure, it seems to be ignored. The current exposure standards recommended by the Federal Communications Commission (FCC) and International Commission on Non-Ionizing Radiation Protection (ICNIRP) consider only thermal effects (tissue heating) as potentially harmful. However, there is mounting evidence of non-thermal effects of exposure to electromagnetic radiation in biological systems and human populations. We review the latest literature on in vitro and in vivo studies, on clinical studies on electromagnetic hypersensitivity, as well as the epidemiological evidence for cancer due to the action of mobile based radiation exposure. We question whether the current regulatory atmosphere truly serves the public good when considered in terms of the Precautionary Principle and the principles for deducing causation established by Bradford Hill. We conclude that there is substantial scientific evidence that RFR causes cancer, endocrinological, neurological and other adverse health effects. In light of this evidence the primary mission of public bodies, such as the FCC to protect public health has not been fulfilled. Rather, we find that industry convenience is being prioritized and thereby subjecting the public to avoidable risks.

Letter to Editor on "Impact of smart phone use on adolescence health in India"

This letter to the editor with reference to Mahalakshmi et al. (2023) provides two additional views. In a tech-savvy world study in this field is of importance yet there is a huge gap. Such study should also consider screen time engagement of hospitalized patients given their predisposed physical condition in addition to student survey. Genetic analysis should also be included along with the questionnaire and counselling-based surveys. Thus, considering the known study pipeline and focusing on the two afore-mentioned aspects such research should be considered as a "High Priority" area.

Interaction between Genetic Risks and Socioeconomic Factors on Thyroid Cancer: Evidence from 0.5 Million UK Biobank Participants

BACKGROUND

There is a research gap between genetic predisposition, socioeconomic factors, and their interactions on thyroid tumorigenesis.

METHODS

Individual and genetic data were obtained from UK Biobank. Logistic regression models were used to evaluate the association between genetic risk, socioeconomic factors, and thyroid cancer (TCa). A stratified analysis was conducted to estimate their joint effects. A two-sample Mendelian randomization (MR) analysis was further used to examine the potential causality.

RESULTS

A total of 502,394 participants were included in this study. Three index loci (rs4449583, rs7726159, and rs7725218) of telomerase reverse transcriptase (TERT) were found to be significantly related to incident TCa. Association analyses showed that high genetic risk, low household income, and high education level were independent risk factors, while unemployment and frequent social connection were suggestive risk factors for TCa. Interaction analyses showed that in participants with low genetic risk, low household income was significantly associated with TCa (odds ratio [OR] = 1.56, 95% confidence interval [CI]: 1.00-2.46). In participants with high genetic risk, those with a high education level (OR = 1.32, 95%CI: 1.06-1.65) and frequent social connection (OR = 1.36, 95%CI: 1.02-1.81) had a significantly increased risk of TCa. However, no causal relationship was observed in the MR analysis.

CONCLUSION

Interactions exist between genetic risk, household income, education level, and social connection and thyroid cancer.

Cell Phone Radiation Exposure Limits and Engineering Solutions

In the 1990s, the Institute of Electrical and Electronics Engineers (IEEE) restricted its risk assessment for human exposure to radiofrequency radiation (RFR) in seven ways: (1) Inappropriate focus on heat, ignoring sub-thermal effects. (2) Reliance on exposure experiments performed over very short times. (3) Overlooking time/amplitude characteristics of RFR signals. (4) Ignoring carcinogenicity, hypersensitivity, and other health conditions connected with RFR. (5) Measuring cellphone Specific Absorption Rates (SAR) at arbitrary distances from the head. (6) Averaging SAR doses at volumetric/mass scales irrelevant to health. (7) Using unrealistic simulations for cell phone SAR estimations. Low-cost software and hardware modifications are proposed here for cellular phone RFR exposure mitigation: (1) inhibiting RFR emissions in contact with the body, (2) use of antenna patterns reducing the Percent of Power absorbed in the Head (PPHead) and body and increasing the Percent of Power Radiated for communications (PPR), and (3) automated protocol-based reductions of the number of RFR emissions, their duration, or integrated dose. These inexpensive measures do not fundamentally alter cell phone functions or communications quality. A health threat is scientifically documented at many levels and acknowledged by industries. Yet mitigation of RFR exposures to users does not appear as a priority with most cell phone manufacturers.

Wireless technologies, non-ionizing electromagnetic fields and children: Identifying and reducing health risks

Children today are conceived and live in a sea of wireless radiation that did not exist when their parents were born. The launch of the digital age continues to transform the capacity to respond to emergencies and extend global communications. At the same time that this increasingly ubiquitous technology continues to alter the nature of commerce, medicine, transport and modern life overall, its varied and changing forms have not been evaluated for their biological or environmental impacts. Standards for evaluating radiation from numerous wireless devices were first set in 1996 to avoid heating tissue and remain unchanged since then in the U.S. and many other nations. A wide range of evidence indicates that there are numerous non-thermal effects from wireless radiation on reproduction, development, and chronic illness. Many widely used devices such as phones and tablets function as two-way microwave radios, sending and receiving various frequencies of information-carrying microwave radiation on multiple simultaneously operating antennas. Expert groups advising governments on this matter do not agree on the best approaches to be taken. The American Academy of Pediatrics recommends limited screen time for children under the age of two, but more than half of all toddlers regularly have contact with screens, often without parental engagement. Young children of parents who frequently use devices as a form of childcare can experience delays in speech acquisition and bonding, while older children report feelings of disappointment due to 'technoference'-parental distraction due to technology. Children who begin using devices early in life can become socially, psychologically and physically addicted to the technology and experience withdrawal upon cessation. We review relevant experimental, epidemiological and clinical evidence on biological and other impacts of currently used wireless technology, including advice to include key questions at pediatric wellness checkups from infancy to young adulthood. We conclude that consistent with advice in pediatric radiology, an approach that recommends that microwave radiation exposures be As Low As Reasonably Achievable (ALARA) seems sensible and prudent, and that an independently-funded training, research and monitoring program should be carried out on the long term physical and psychological impacts of rapidly changing technological milieu, including ways to mitigate impacts through modifications in hardware and software. Current knowledge of electrohypersensitivity indicates the importance of reducing wireless exposures especially in schools and health care settings.

On radar and radio exposure and cancer in the military setting

INTRODUCTION

In 2018, we reported a case series of 47 patients diagnosed with cancer following several years of exposure to high-intensity whole-body radiofrequency radiation (RFR) using the parameter of percentage frequency (PF). Consistent high and statistically significant PFs of hematolymphoid (HL) cancers were found in this group and in four previous reports on RFR-exposed groups in Belgium, Poland and Israel together with increased all-cancers rates. In this paper we report a new series of 46 young cancer patients who were exposed during military service to such radiation.

MATERIALS AND METHODS

The new group of patients comprises Israeli soldiers previously exposed to occupational RFR. The patients were self-selected to enroll in the research in cooperation with an NGO assisting patients with administrative counseling and legal and social services. The new group of patients was studied with respect to distribution (proportion) of cancer types using the method of PF. When possible, cancer risk ratios (RR) were estimated too. The results are compared to those of other occupational groups in three countries.

RESULTS

Median age at diagnosis was 23 years; duration of exposure was between 1 and 3 years and the latencies were short, median 4.6 years. The PF of HL cancers was 41.3%, 95% CI (27%-57%), versus 22.7% expected in non-exposed subjects matched for age and gender profiles, p = 0.003; 19 out of the 46 patients had HL cancers. The PF of Hodgkin lymphoma cancers was 21.7%, 95%CI (11%-36%), versus 11.6% expected, p = 0.033. For a subgroup of 6 patients, the number of soldiers in the units was known, and we were able estimate approximately the overall cancer risk ratio (RR) after 8 years as being 8.0 with 95% CI (2.9, 17), p < 0.002, with only 0.75 cases expected from the Cancer Registry data. In this subgroup, there were 3 HL cancer cases and 3 non-HL cases. Sarcoma PF was higher than expected, 7 out of the 46 patients were diagnosed with sarcoma, PF = 15.2%, 95%CI (6.3%-28.9%), p = 0.04 versus the expected PF of 7%.

CONCLUSION

The HL PF was high and consistent with previous reports. Epidemiological studies on excess risk for HL and other cancers, brain tumors in cellphone users, and experimental studies on RFR and carcinogenicity strongly point to a cause-effect relationship. It is mandatory to reduce the RFR exposure of all personnel to that of the typical community levels, including the peak level of radar pulses. Radiation protection, safety instructions, cancer risk warnings and quantitative data on individual exposure together with regular medical monitoring must be instituted for all personnel exposed to such risks. The findings from our study add to the growing body of evidence underscoring the gross inadequacy of the International Commission on Non-Ionizing Radiation Protection (ICNIRP) thermal standards. Based on our findings and on the previous accumulated research, we endorse the recommendations to reclassify RFR exposure as a human carcinogen, International Agency for Research on Cancer (IARC) group 1.

Thyroid Carcinoma: A Review for 25 Years of Environmental Risk Factors Studies

Environmental factors are established contributors to thyroid carcinomas. Due to their known ability to cause cancer, exposure to several organic and inorganic chemical toxicants and radiation from nuclear weapons, fallout, or medical radiation poses a threat to global public health. Halogenated substances like organochlorines and pesticides can interfere with thyroid function. Like phthalates and bisphenolates, polychlorinated biphenyls and their metabolites, along with polybrominated diethyl ethers, impact thyroid hormones biosynthesis, transport, binding to target organs, and impair thyroid function. A deeper understanding of environmental exposure is crucial for managing and preventing thyroid cancer. This review aims to investigate the relationship between environmental factors and the development of thyroid cancer.

Scientific evidence invalidates health assumptions underlying the FCC and ICNIRP exposure limit determinations for radiofrequency radiation: implications for 5G

In the late-1990s, the FCC and ICNIRP adopted radiofrequency radiation (RFR) exposure limits to protect the public and workers from adverse effects of RFR. These limits were based on results from behavioral studies conducted in the 1980s involving 40-60-minute exposures in 5 monkeys and 8 rats, and then applying arbitrary safety factors to an apparent threshold specific absorption rate (SAR) of 4 W/kg. The limits were also based on two major assumptions: any biological effects were due to excessive tissue heating and no effects would occur below the putative threshold SAR, as well as twelve assumptions that were not specified by either the FCC or ICNIRP. In this paper, we show how the past 25 years of extensive research on RFR demonstrates that the assumptions underlying the FCC's and ICNIRP's exposure limits are invalid and continue to present a public health harm. Adverse effects observed at exposures below the assumed threshold SAR include non-thermal induction of reactive oxygen species, DNA damage, cardiomyopathy, carcinogenicity, sperm damage, and neurological effects, including electromagnetic hypersensitivity. Also, multiple human studies have found statistically significant associations between RFR exposure and increased brain and thyroid cancer risk. Yet, in 2020, and in light of the body of evidence reviewed in this article, the FCC and ICNIRP reaffirmed the same limits that were established in the 1990s. Consequently, these exposure limits, which are based on false suppositions, do not adequately protect workers, children, hypersensitive individuals, and the general population from short-term or long-term RFR exposures. Thus, urgently needed are health protective exposure limits for humans and the environment. These limits must be based on scientific evidence rather than on erroneous assumptions, especially given the increasing worldwide exposures of people and the environment to RFR, including novel forms of radiation from 5G telecommunications for which there are no adequate health effects studies.

An Exploration of the Effects of Radiofrequency Radiation Emitted by Mobile Phones and Extremely Low Frequency Radiation on Thyroid Hormones and Thyroid Gland Histopathology

The use of mobile phones has widely increased over the last two decades. Mobile phones produce a radiofrequency electromagnetic field (RF-EMF), a form of non-ionizing radiation. In contrast to the ionizing radiation proven to cause DNA damage, the harmful effects of non-ionizing radiation on the human body have not been discovered yet. The thyroid gland is among the most susceptible organs to mobile phone radiation due to its location in the anterior neck. Our purpose in this literature review is to explore the effects of the electromagnetic field (EMF), especially radiofrequency emitted from mobile phones, on thyroid hormones and thyroid gland histopathology. We searched PubMed and Google Scholar databases for relevant studies published after the year 2000, using the following keywords: ‘cell phones', ‘mobile phones', ‘telephones', ‘electromagnetic fields', ‘radiofrequency radiation', ‘microwaves', ‘thyroid gland', ‘thyroid hormones', and ‘thyroid cancer'. Our review revealed that mobile phone radiofrequency radiation (RFR) might be associated with thyroid gland insufficiency and alterations in serum thyroid hormone levels, with a possible disruption in the hypothalamic-pituitary-thyroid axis. The review also showed histopathological changes in the thyroid gland follicles after exposure of rats to non-ionizing radiation. The results were directly related to the amount and duration of exposure to EMF radiation. Further human studies exploring thyroid gland hormones, microscopic morphology, and thyroid cancer are highly recommended for future researches.

Development of health-based exposure limits for radiofrequency radiation from wireless devices using a benchmark dose approach

BACKGROUND

Epidemiological studies and research on laboratory animals link radiofrequency radiation (RFR) with impacts on the heart, brain, and other organs. Data from the large-scale animal studies conducted by the U.S. National Toxicology Program (NTP) and the Ramazzini Institute support the need for updated health-based guidelines for general population RFR exposure.

OBJECTIVES

The development of RFR exposure limits expressed in whole-body Specific Absorption Rate (SAR), a metric of RFR energy absorbed by biological tissues.

METHODS

Using frequentist and Bayesian averaging modeling of non-neoplastic lesion incidence data from the NTP study, we calculated the benchmark doses (BMD) that elicited a 10% response above background (BMD₁₀) and the lower confidence limits on the BMD at 10% extra risk (BMDL₁₀). Incidence data for individual neoplasms and combined tumor incidence were modeled for 5% and 10% response above background.

RESULTS

Cardiomyopathy and increased risk of neoplasms in male rats were the most sensitive health outcomes following RFR exposures at 900 MHz frequency with Code Division Multiple Access (CDMA) and Global System for Mobile Communications (GSM) modulations. BMDL₁₀ for all sites cardiomyopathy in male rats following 19 weeks of exposure, calculated with Bayesian model averaging, corresponded to 0.27-0.42 W/kg whole-body SAR for CDMA and 0.20-0.29 W/kg for GSM modulation. BMDL₁₀ for right ventricle cardiomyopathy in female rats following 2 years of exposure corresponded to 2.7-5.16 W/kg whole-body SAR for CDMA and 1.91-2.18 W/kg for GSM modulation. For multi-site tumor modeling using the multistage cancer model with a 5% extra risk, BMDL₅ in male rats corresponded to 0.31 W/kg for CDMA and 0.21 W/kg for GSM modulation.

CONCLUSION

BMDL₁₀ range of 0.2-0.4 W/kg for all sites cardiomyopathy in male rats was selected as a point of departure. Applying two ten-fold safety factors for interspecies and intraspecies variability, we derived a whole-body SAR limit of 2 to 4 mW/kg, an exposure level that is 20-40-fold lower than the legally permissible level of 0.08 W/kg for whole-body SAR under the current U.S. regulations. Use of an additional ten-fold children's health safety factor points to a whole-body SAR limit of 0.2-0.4 mW/kg for young children.

Changing incidence and projections of thyroid cancer in mainland China, 1983-2032: evidence from Cancer Incidence in Five Continents

PURPOSE

An increasing incidence of thyroid cancer has been seen in China during the past several decades. The aim of this study was to analyze potential age, period, and cohort effects on the incidence of thyroid cancer in mainland China and to predict new cases up to 2032.

METHODS

We calculated age-adjusted and age-specific incidence rates of thyroid cancer, conducted an age-period-cohort analysis of 35,037 thyroid cancer incidence cases reported to Cancer Incidence in Five Continents from 1983 to 2012 in mainland China, and predicted incidence up to 2032 using the Bayesian age-period-cohort method.

RESULTS

The age-adjusted overall incidence rate of thyroid cancer increased from 1.93/100,000 in 1983-1987 to 12.18/100,000 in 2008-2012 among females and from 0.77/100,000 in 1983-1987 to 3.89/100,000 in 2008-2012 among males, with a female-to-male ratio of approximately 3.0 during the three decades. Strong birth cohort and period effects on the incidence of thyroid cancer were observed for both sexes, and such an increasing trend is predicted to continue for at least the next 20 years. More than 3.7 million new cases are projected in the 2028-2032 period.

CONCLUSION

The increasing trend of thyroid cancer in mainland China will cause a great burden in the future. In addition to the potential impact of improvement in medical diagnostics, potential exposure to risk factors have played a role in the observed rising trend. Further population-based epidemiologic studies are required to identify risk factors to aid in thyroid cancer prevention and control.

Exposure to 2.45 GHz radiofrequency modulates calcitonin-dependent activity and HSP-90 protein in parafollicular cells of rat thyroid gland

In this study we analyzed the response of parafollicular cells in rat thyroid gland after exposure to radiofrequency at 2.45 GHz using a subthermal experimental diathermy model. Forty-two Sprague Dawley rats, divided into two groups of 21 rats each, were individually exposed at 0 (control), 3 or 12 W in a Gigahertz Transverse Electro-Magnetic (GTEM) chamber for 30 min. After radiation, we used simple or fluorescence immunohistochemistry to measure calcitonin cells or cellular stress levels, indicated by the presence hyperplasia of parafollicular cells, heat shock protein (HSP) 90. Immunomarking of calcitonin-positive cells was statistically significant higher in the thyroid tissue of rats exposed to 2.45 GHz radiofrequency and cell hyperplasia appeared 90 min after radiation at the SAR levels studied. At the same time, co-localized expression of HSP-90 and calcitonin in parafollicular cells was statistically significant attenuated 90 min after radiation and remained statistically significantly low 24 h after radiation, even though parafollicular cell levels normalized. These facts indicate that subthermal radiofrequency (RF) at 2.45 GHz constitutes a negative external stress stimulus that alters the activity and homeostasis of parafollicular cells in the rat thyroid gland. However, further research is needed to determine if there is toxic action in human C cells.

Is the Increasing Incidence of Thyroid Cancer in the Nordic Countries Caused by Use of Mobile Phones?

The International Agency for Research on Cancer (IARC) at the World Health Organization (WHO) categorized in 2011 radiofrequency (RF) as a possible human carcinogen, Group 2B. During use of the handheld wireless phone, especially the smartphone, the thyroid gland is a target organ. During the 21st century, the incidence of thyroid cancer is increasing in many countries. We used the Swedish Cancer Register to study trends from 1970 to 2017. During that time period, the incidence increased statistically significantly in women with average annual percentage change (AAPC) +2.13%, 95% confidence interval (CI) +1.43, +2.83%. The increase was especially pronounced during 2010-2017 with annual percentage change (APC) +9.65%, 95% CI +6.68, +12.71%. In men, AAPC increased during 1970-2017 with +1.49%, 95% CI +0.71, +2.28%. Highest increase was found for the time period 2001-2017 with APC +5.26%, 95% CI +4.05, +6.49%. Similar results were found for all Nordic countries based on NORDCAN 1970-2016 with APC +5.83%, 95% CI +4.56, +7.12 in women from 2006 to 2016 and APC + 5.48%, 95% CI +3.92, +7.06% in men from 2005 to 2016. According to the Swedish Cancer Register, the increasing incidence was similar for tumors ≤4 cm as for tumors >4 cm, indicating that the increase cannot be explained by overdiagnosis. These results are in agreement with recent results on increased thyroid cancer risk associated with the use of mobile phones. We postulate that RF radiation is a causative factor for the increasing thyroid cancer incidence.