Do extremely low frequency magnetic fields enhance the effects of environmental carcinogens? A meta-analysis of experimental studies

50 Hz magnetic field influences caspase-3 activity and cell cycle distribution in ionizing radiation exposed SH-SY5Y neuroblastoma cells

PURPOSE

Earlier evidence suggests that extremely low frequency magnetic fields (ELF MFs) can modify the effects of carcinogenic agents. However, the studies conducted so far with ionizing radiation as the co-exposure agent are sparse and have provided inconclusive results. We investigated whether 50 Hz MFs alone, or in combination with ionizing radiation alter cell biological variables relevant to cancer and the biological effects of ionizing radiation.

MATERIALS AND METHODS

Human SH-SY5Y neuroblastoma cells were sham exposed or exposed to 100 or 500 µT MF for 24 h either before or after ionizing radiation exposure (0, 0.4 or 2 Gy). After the exposures, cells were assayed for viability, clonogenicity, reactive oxygen species, caspase-3 activity, and cell cycle distribution. Cell cycle distribution was assayed with propidium iodide staining followed by flow cytometry analysis and ROS levels were assayed together with cell viability by double staining with DeepRed and Sytox Blue followed by flow cytometry analysis.

RESULTS

Increased caspase-3 activity was observed in cells exposed to 500 µT MF before or after ionizing radiation. Furthermore, exposure to the 500 µT MF after the ionizing radiation decreased the percentage of cells in S-phase. No changes in the ROS levels, clonogenicity, or viability of the cells were observed in the MF exposed groups compared to the corresponding sham exposed groups, and no MF effects were observed in cells exposed at 100 µT.

CONCLUSIONS

Only the 500 µT magnetic flux density affected SH-SY5Y cells significantly. The effects were small but may nevertheless help to understand how MFs modify the effects of ionizing radiation. The increase in caspase-3 activity may not reflect effects on apoptosis, as no changes were observed in the subG1 phase of the cell cycle. In contrast to some earlier findings, 50 Hz MF exposure after ionizing radiation was not less effective than MF treatment given prior to ionizing radiation.

Commercial outdoor plant nurseries as a confounder for electromagnetic fields and childhood leukemia risk

BACKGROUND

Close residential proximity to powerlines and high magnetic fields exposure may be associated with elevated childhood leukemia risks as reported by prior studies and pooled analyses. Magnetic fields exposure from high-voltage powerlines is associated with proximity to these powerlines and consequently with any factor varying with distance. Areas underneath powerlines in California may be sites for commercial plant nurseries that can use pesticides, a potential childhood leukemia risk factor.

OBJECTIVES

Assess if potential pesticide exposure from commercial plant nurseries is a confounder or interacts with proximity or magnetic fields exposure from high-voltage powerlines to increase childhood leukemia risk.

METHODS

A comprehensive childhood leukemia record-based case-control study with 5788 cases and 5788 controls (born and diagnosed in California, 1986-2008) was conducted. Pesticide, powerline, and magnetic field exposure assessment utilized models that incorporated geographical information systems, aerial satellite images, site visits and other historical information.

RESULTS

The relationship for calculated fields with childhood leukemia (odds ratio (OR) 1.51, 95% confidence interval (CI) 0.70-3.23) slightly attenuated when controlling for nursery proximity (OR 1.43, 95% CI 0.65-3.16) or restricting analysis to subjects living far (>300 m) from nurseries (OR 1.43, 95% CI 0.79-2.60). A similar association pattern was observed between distance to high-voltage powerlines and childhood leukemia. The association between nursery proximity and childhood leukemia was unchanged or only slightly attenuated when controlling for calculated fields or powerline distance; ORs remained above 2 when excluding subjects with high calculated fields or close powerline proximity (OR 2.16, 95% CI 0.82-5.67 and OR 2.15, 95% CI 0.82-5.64, respectively). The observed relationships were robust to different time periods, reference categories, and cut points.

DISCUSSION

Close residential proximity to nurseries is suggested as an independent childhood leukemia risk factor. Our results do not support plant nurseries as an explanation for observed childhood leukemia risks for powerline proximity and magnetic fields exposure, although small numbers of subjects concurrently exposed to high magnetic fields, close powerline proximity and plant nurseries limited our ability to fully assess potential confounding.

An overview of the biological effects of extremely low frequency electromagnetic fields combined with ionizing radiation

By growing the electrical power networks and electronic devices, electromagnetic fields (EMF) have become an inseparable part of the modern world. Considering the inevitable exposure to a various range of EMFs, especially at extremely low frequencies (ELF-EMF), investigating the biological effects of ELF-EMFs on biological systems became a global issue. The possible adverse consequences of these exposures were studied, along with their potential therapeutic capabilities. Also, their biological impacts in combination with other chemical and physical agents, specifically ionizing radiation (IR), as a co-carcinogen or as adjuvant therapy in combination with radiotherapy were explored. Here, we review the results of several in-vitro and in-vivo studies and discuss some proposed possible mechanisms of ELF-EMFs' actions in combination with IR. The results of these experiments could be fruitful to develop more precise safety standards for environmental ELF-EMFs exposures. Furthermore, it could evaluate the therapeutic capacities of ELF-EMFs alone or as an improver of radiotherapy.

Common contributing factors to COVID-19 and inflammatory bowel disease

The devastating complications of coronavirus disease 2019 (COVID-19) result from an individual's dysfunctional immune response following the initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Multiple toxic stressors and behaviors contribute to underlying immune system dysfunction. SARS-CoV-2 exploits the dysfunctional immune system to trigger a chain of events ultimately leading to COVID-19. We have previously identified many contributing factors (CFs) (representing toxic exposure, lifestyle factors and psychosocial stressors) common to myriad chronic diseases. We hypothesized significant overlap between CFs associated with COVID-19 and inflammatory bowel disease (IBD), because of the strong role immune dysfunction plays in each disease. A streamlined dot-product approach was used to identify potential CFs to COVID-19 and IBD. Of the fifty CFs to COVID-19 that were validated for demonstration purposes, approximately half had direct impact on COVID-19 (the CF and COVID-19 were mentioned in the same record; i.e., CF---→COVID-19), and the other half had indirect impact. The nascent character of the COVID-19 core literature (∼ one year old) did not allow sufficient time for the direct impacts of many CFs on COVID-19 to be identified. Therefore, an immune system dysfunction (ID) literature directly related to the COVID-19 core literature was used to augment the COVID-19 core literature and provide the remaining CFs that impacted COVID-19 indirectly (i.e., CF---→immune system dysfunction---→COVID-19). Approximately 13000 potential CFs for myriad diseases (obtained from government and university toxic substance lists) served as the starting point for the dot-product identification process. These phrases were intersected (dot-product) with phrases extracted from a PubMed-derived IBD core literature, a nascent COVID-19 core literature, and the COVID-19-related immune system dysfunction (ID) core literature to identify common ID/COVID-19 and IBD CFs. Approximately 3000 potential CFs common to both ID and IBD, almost 2300 potential CFs common to ID and COVID-19, and over 1900 potential CFs common to IBD and COVID-19 were identified. As proof of concept, we validated fifty of these ∼3000 overlapping ID/IBD candidate CFs with biologic plausibility. We further validated 24 of the fifty as common CFs in the IBD and nascent COVID-19 core literatures. This significant finding demonstrated that the CFs indirectly related to COVID-19 -- identified with use of the immune system dysfunction literature -- are strong candidates to emerge eventually as CFs directly related to COVID-19. As discussed in the main text, many more CFs common to all these core literatures could be identified and validated. ID and IBD share many common risk/contributing factors, including behaviors and toxic exposures that impair immune function. A key component to immune system health is removal of those factors that contribute to immune system dysfunction in the first place. This requires a paradigm shift from traditional Western medicine, which often focuses on treatment, rather than prevention.

Epigenetic dysregulation in various types of cells exposed to extremely low-frequency magnetic fields

Epigenetic mechanisms regulate gene expression, without changing the DNA sequence, and establish cell-type-specific temporal and spatial expression patterns. Alterations of epigenetic marks have been observed in several pathological conditions, including cancer and neurological disorders. Emerging evidence indicates that a variety of environmental factors may cause epigenetic alterations and eventually influence disease risks. Humans are increasingly exposed to extremely low-frequency magnetic fields (ELF-MFs), which in 2002 were classified as possible carcinogens by the International Agency for Research on Cancer. This review summarizes the current knowledge of the link between the exposure to ELF-MFs and epigenetic alterations in various cell types. In spite of the limited number of publications, available evidence indicates that ELF-MF exposure can be associated with epigenetic changes, including DNA methylation, modifications of histones and microRNA expression. Further research is needed to investigate the molecular mechanisms underlying the observed phenomena.

Gaps in Knowledge Relevant to the "Guidelines for Limiting Exposure to Time-Varying Electric and Magnetic Fields (1 Hz-100 kHz)"

Sources of low-frequency fields are widely found in modern society. All wires or devices carrying or using electricity generate extremely low frequency (ELF) electric fields (EFs) and magnetic fields (MFs), but they decline rapidly with distance to the source. High magnetic flux densities are usually found in the vicinity of power lines and close to equipment using strong electrical currents, but can also be found in buildings with unbalanced return currents, or indoor transformer stations. For decades, epidemiological as well as experimental studies have addressed possible health effects of exposure to ELF-MFs. The main goal of ICNIRP is to protect people and the environment from detrimental exposure to all forms of non-ionizing radiation (NIR). To this end, ICNIRP provides advice and guidance by developing and disseminating exposure guidelines based on the available scientific research. Research in the low-frequency range began more than 40 years ago, and there is now a large body of literature available on which ICNIRP set its protection guidelines. A review of the literature has been carried out to identify possible relevant knowledge gaps, and the aim of this statement is to describe data gaps in research that would, if addressed, assist ICNIRP in further developing guidelines and setting revised recommendations on limiting exposure to electric and magnetic fields. It is articulated in two parts: the main document, which reviews the science related to LF data gaps, and the annex, which explains the methodology used to identify the data gaps.

Adverse health effects of 5G mobile networking technology under real-life conditions

This article identifies adverse effects of non-ionizing non-visible radiation (hereafter called wireless radiation) reported in the premier biomedical literature. It emphasizes that most of the laboratory experiments conducted to date are not designed to identify the more severe adverse effects reflective of the real-life operating environment in which wireless radiation systems operate. Many experiments do not include pulsing and modulation of the carrier signal. The vast majority do not account for synergistic adverse effects of other toxic stimuli (such as chemical and biological) acting in concert with the wireless radiation. This article also presents evidence that the nascent 5G mobile networking technology will affect not only the skin and eyes, as commonly believed, but will have adverse systemic effects as well.

Assessment of induced genomic instability in rat primary astrocytes exposed to intermediate frequency magnetic fields

We investigated whether exposure to intermediate frequency magnetic fields (IF MFs) could induce or enhance genomic instability in primary astrocytes. Rat primary astrocytes were exposed to vertical or horizontal 7.5 kHz, 300 μT MF for 24 h. To study possible combined effects with known genotoxic agents, the cells were exposed for 3 h to menadione or methyl methanesulfonate after the MF treatment. Induced genomic instability was evaluated 36 days after exposures using the Comet assay and flow cytometric scoring of micronuclei. Exposure to 7.5 kHz, 300 μT MF did not induce genomic instability alone or in combination with chemicals in measurements performed several cell generations after exposure.

Magnetocarcinogenesis: is there a mechanism for carcinogenic effects of weak magnetic fields?

Extremely low-frequency (ELF) magnetic fields have been classified as possibly carcinogenic, mainly based on rather consistent epidemiological findings suggesting a link between childhood leukaemia and 50-60 Hz magnetic fields from power lines. However, causality is not the only possible explanation for the epidemiological associations, as animal and in vitro experiments have provided only limited support for carcinogenic effects of ELF magnetic fields. Importantly, there is no generally accepted biophysical mechanism that could explain such effects. In this review, we discuss the possibility that carcinogenic effects are based on the radical pair mechanism (RPM), which seems to be involved in magnetoreception in birds and certain other animals, allowing navigation in the geomagnetic field. We review the current understanding of the RPM in magnetoreception, and discuss cryptochromes as the putative magnetosensitive molecules and their possible links to cancer-relevant biological processes. We then propose a hypothesis for explaining the link between ELF fields and childhood leukaemia, discuss the strengths and weaknesses of the current evidence, and make proposals for further research.

Upper bound on the biological effects of 50/60 Hz magnetic fields mediated by radical pairs

Prolonged exposure to weak (~1 μT) extremely-low-frequency (ELF, 50/60 Hz) magnetic fields has been associated with an increased risk of childhood leukaemia. One of the few biophysical mechanisms that might account for this link involves short-lived chemical reaction intermediates known as radical pairs. In this report, we use spin dynamics simulations to derive an upper bound of 10 parts per million on the effect of a 1 μT ELF magnetic field on the yield of a radical pair reaction. By comparing this figure with the corresponding effects of changes in the strength of the Earth’s magnetic field, we conclude that if exposure to such weak 50/60 Hz magnetic fields has any effect on human biology, and results from a radical pair mechanism, then the risk should be no greater than travelling a few kilometres towards or away from the geomagnetic north or south pole.

Genotoxicity of intermediate frequency magnetic fields in vitro and in vivo

We assessed genotoxic effects of intermediate frequency magnetic fields (MF) in vitro and in vivo. Rat primary astrocytes were exposed for 24 h to a 7.5 kHz MF at a magnetic flux density of 30 or 300 µT. Male C57BL/6 J mice were exposed continuously for 5 weeks to a 7.5 kHz MF at 12 or 120 μT, and blood samples were collected for the genotoxicity assays. To evaluate possible co-genotoxicity, the in vitro experiments included combined exposure with menadione (an agent that induces mitochondrial superoxide production and DNA damage) and methyl methanesulfonate (an alkylating agent). DNA damage and DNA repair (in vitro) were measured using the alkaline Comet assay and formation of micronuclei was assessed microscopically (in vivo) or using flow cytometry (in vitro). The results did not support genotoxicity or co-genotoxicity of 7.5 kHz MFs at magnetic flux densities up to 300 µT in vitro or in vivo. On the contrary, there was some evidence that exposure to 7.5 kHz MFs might reduce the level of genetic damage. Strongest indication of any biological effects was obtained from measurements of relative cell number, which was significantly and consistently increased after MF exposure in all in vitro experiments. Health implications of this finding are unclear, but it suggests that 7.5 kHz MFs may stimulate cell proliferation or suppress cell death.

Potential therapeutic mechanism of extremely low-frequency high-voltage electric fields in cells

The aim of this survey was to provide background theory based on previous research to elucidate the potential pathway by which medical devices using extremely low-frequency high-voltage electric fields (ELF-HVEF) exert therapeutic effects on the human body, and to increase understanding of the AC high-voltage electrotherapeutic apparatus for consumers and suppliers of the relevant devices. Our review revealed that an ELF field as weak as 1-10 μ V/m can induce diverse alterations of membrane proteins such as transporters and channel proteins, including changes in Ca + + binding to a specific site of the cell surface, changes in ion (e.g., Ca + + ) influx or efflux, and alterations in the ligand-receptor interaction. These alterations then induce cytoplasmic responses within cells (Ca + + , cAMP, kinases, etc.) that can have impacts on cell growth, differentiation, and other functional properties by promoting the synthesis of macromolecules. Moreover, increased cytoplasmic Ca + + involves calmodulin-dependent signaling and consequent Ca + + /calmodulin-dependent stimulation of nitric oxide synthesis. This event in turn induces the nitric oxide-cGMP-protein kinase G pathway, which may be an essential factor in the observed physiological and therapeutic responses.

LF-MF inhibits iron metabolism and suppresses lung cancer through activation of P53-miR-34a-E2F1/E2F3 pathway

Our previous studies showed that low frequency magnetic fields (LF-MF) suppressed tumor growth and influenced the function of immune system. Nevertheless the mechanisms behind the effect of LF-MF still remain to be elucidated. In this study, Tumor- bearing mice subcutaneously inoculated with Lewis lung cancer cells were exposed to a LF-MF (0.4T, 7.5 Hz) for 35 days and Survival rate, tumor growth and the tumor markers were measured. Results showed that tumor growth was obviously inhibited with a prolonged survival of tumor- bearing mice by LF-MF exposure. In vitro experiments, LF-MF was found to induce cell growth arrest, cell senescence and inhibit iron metabolism of lung cancer cells. Moreover, LF-MF stabilized p53 protein via inhibiting cell iron metabolism and the stabilized p53 protein enhanced miR-34a transcription. Furthermore, increased expression of miR-34a induced cell proliferation inhibition, cell cycle arrest and cell senescence of lung cancer cells by targeting E2F1/E2F3. We also detected the relevant indicator in tumor tissue such as the iron content, the level of miR-34a and related protein, corresponding results were obtained. Taken together, these observations imply that LF-MF suppressed lung cancer via inhibiting cell iron metabolism, stabilizing p53 protein and activation P53- miR-34a-E2F1/E2F3 pathway.

Cellular detection of 50 Hz magnetic fields and weak blue light: effects on superoxide levels and genotoxicity

PURPOSE

We tested the hypothesis that the effects of 50 Hz magnetic fields (MFs) on superoxide levels and genotoxicity depend on the presence of blue light.

MATERIALS AND METHODS

Human SH-SY5Y neuroblastoma cells were exposed to a 50 Hz, 100 μT MF with or without non-phototoxic level of blue light for 24 h. We also studied whether these treatments alter responses to menadione, an agent that induces mitochondrial superoxide (O₂^{• -}) production and DNA damage. Micronuclei, proliferation, viability, cytosolic and mitochondrial O₂^{• -} levels were assessed.

RESULTS

MF (without blue light) increased cytosolic O₂^{• -} production and blue light suppressed this effect. Mitochondrial O₂^{• -} production was reduced by both MF and blue light, but these effects were not additive. Micronucleus frequency was not affected by blue light or MF alone, but blue light (significantly when combined with MF) enhanced menadione-induced micronuclei.

CONCLUSIONS

The original simple hypothesis (blue light is needed for MF effects) was not supported, but interaction of MF and blue light was nevertheless observed. The results are consistent with MF effects on light-independent radical reactions.

ELF-MF exposure affects the robustness of epigenetic programming during granulopoiesis

Extremely-low-frequency magnetic fields (ELF-MF) have been classified as "possibly carcinogenic" to humans on the grounds of an epidemiological association of ELF-MF exposure with an increased risk of childhood leukaemia. Yet, underlying mechanisms have remained obscure. Genome instability seems an unlikely reason as the energy transmitted by ELF-MF is too low to damage DNA and induce cancer-promoting mutations. ELF-MF, however, may perturb the epigenetic code of genomes, which is well-known to be sensitive to environmental conditions and generally deranged in cancers, including leukaemia. We examined the potential of ELF-MF to influence key epigenetic modifications in leukaemic Jurkat cells and in human CD34+ haematopoietic stem cells undergoing in vitro differentiation into the neutrophilic lineage. During granulopoiesis, sensitive genome-wide profiling of multiple replicate experiments did not reveal any statistically significant, ELF-MF-dependent alterations in the patterns of active (H3K4me2) and repressive (H3K27me3) histone marks nor in DNA methylation. However, ELF-MF exposure showed consistent effects on the reproducibility of these histone and DNA modification profiles (replicate variability), which appear to be of a stochastic nature but show preferences for the genomic context. The data indicate that ELF-MF exposure stabilizes active chromatin, particularly during the transition from a repressive to an active state during cell differentiation.

Induction of micronuclei and superoxide production in neuroblastoma and glioma cell lines exposed to weak 50 Hz magnetic fields

Extremely low-frequency (ELF) magnetic fields (MF) have been associated with adverse health effects in epidemiological studies. However, there is no known mechanism for biological effects of weak environmental MFs. Previous studies indicate MF effects on DNA integrity and reactive oxygen species, but such evidence is limited to MFs higher (greater than or equal to 100 µT) than those generally found in the environment. Effects of 10 and 30 µT fields were studied in SH-SY5Y and C6 cells exposed to 50-Hz MFs for 24 h. Based on earlier findings, menadione (MQ) was used as a cofactor. Responses to MF were observed in both cell lines, but the effects differed between the cell lines. Micronuclei were significantly increased in SH-SY5Y cells at 30 µT. This effect was largest at the highest MQ dose used. Increased cytosolic and mitochondrial superoxide levels were observed in C6 cells. The effects on superoxide levels were independent of MQ, enabling further mechanistic studies without co-exposure to MQ. The micronucleus and mitochondrial superoxide data were consistent with a conventional rising exposure-response relationship. For cytosolic superoxide, the effect size was unexpectedly large at 10 µT. The results indicate that the threshold for biological effects of ELF MFs is 10 µT or less.

Genomic instability induced by 50Hz magnetic fields is a dynamically evolving process not blocked by antioxidant treatment

Increased level of micronuclei was observed in SH-SY5Y cells in a previous study at 8 and 15 days after exposure to extremely low frequency (ELF) magnetic fields (MF), indicating possible induction of genomic instability in the progeny of the exposed cells. The aim of this study was to further explore the induction of genomic instability by ELF MFs by increasing the follow-up time up to 45 days after exposure. Human SH-SY5Y neuroblastoma cells were exposed to a 50Hz, 100μT MF for 24h with or without co-exposure to menadione (MQ), a chemical agent that increases cellular superoxide production. Micronuclei, reactive oxygen species (ROS) and lipid peroxidation (LPO) were measured at 15, 30 and 45 days after exposure. To study the possible causal role of ROS in the delayed effects of MF, the antioxidant N-acetylcysteine (NAC) was administered before MF exposure. Consistently with the previous study, the level of micronuclei was statistically significantly elevated 15 days after exposure. A similar effect was observed at 30 days, but not at 45 days after exposure. The level of LPO was statically significantly decreased 30 and 45 days after exposure. Consistently with our previous findings, the MF effect did not depend on co-exposure to MQ. Treatment with NAC effectively decreased cellular ROS level and suppressed the effect of MQ on ROS, but it did not block the MF effect, indicating that increase in ROS is not needed as a causal link between MF exposure and induction of delayed effects. The results presented here are consistent with genomic instability that persists in the progeny of MF-exposed cells up to at least 30 days after exposure. Changes in LPO observed at 30 and 45 days after exposure indicates that the MF-initiated process may continue up to at least 45 days after exposure.

Magnetic resonance imaging (MRI): A review of genetic damage investigations

Magnetic resonance imaging (MRI) is a powerful, non-invasive diagnostic medical imaging technique widely used to acquire detailed information about anatomy and function of different organs in the body, in both health and disease. It utilizes electromagnetic fields of three different frequency bands: static magnetic field (SMF), time-varying gradient magnetic fields (GMF) in the kHz range and pulsed radiofrequency fields (RF) in the MHz range. There have been some investigations examining the extent of genetic damage following exposure of bacterial and human cells to all three frequency bands of electromagnetic fields, as used during MRI: the rationale for these studies is the well documented evidence of positive correlation between significantly increased genetic damage and carcinogenesis. Overall, the published data were not sufficiently informative and useful because of the small sample size, inappropriate comparison of experimental groups, etc. Besides, when an increased damage was observed in MRI-exposed cells, the fate of such lesions was not further explored from multiple 'down-stream' events. This review provides: (i) information on the basic principles used in MRI technology, (ii) detailed experimental protocols, results and critical comments on the genetic damage investigations thus far conducted using MRI equipment and, (iii) a discussion on several gaps in knowledge in the current scientific literature on MRI. Comprehensive, international, multi-centered collaborative studies, using a common and widely used MRI exposure protocol (cardiac or brain scan) incorporating several genetic/epigenetic damage end-points as well as epidemiological investigations, in large number of individuals/patients are warranted to reduce and perhaps, eliminate uncertainties raised in genetic damage investigations in cells exposed in vitro and in vivo to MRI.

The implications of non-linear biological oscillations on human electrophysiology for electrohypersensitivity (EHS) and multiple chemical sensitivity (MCS)

The 'informational content' of Earth's electromagnetic signaling is like a set of operating instructions for human life. These environmental cues are dynamic and involve exquisitely low inputs (intensities) of critical frequencies with which all life on Earth evolved. Circadian and other temporal biological rhythms depend on these fluctuating electromagnetic inputs to direct gene expression, cell communication and metabolism, neural development, brainwave activity, neural synchrony, a diversity of immune functions, sleep and wake cycles, behavior and cognition. Oscillation is also a universal phenomenon, and biological systems of the heart, brain and gut are dependent on the cooperative actions of cells that function according to principles of non-linear, coupled biological oscillations for their synchrony. They are dependent on exquisitely timed cues from the environment at vanishingly small levels. Altered 'informational content' of environmental cues can swamp natural electromagnetic cues and result in dysregulation of normal biological rhythms that direct growth, development, metabolism and repair mechanisms. Pulsed electromagnetic fields (PEMF) and radiofrequency radiation (RFR) can have the devastating biological effects of disrupting homeostasis and desynchronizing normal biological rhythms that maintain health. Non-linear, weak field biological oscillations govern body electrophysiology, organize cell and tissue functions and maintain organ systems. Artificial bioelectrical interference can give false information (disruptive signaling) sufficient to affect critical pacemaker cells (of the heart, gut and brain) and desynchronize functions of these important cells that orchestrate function and maintain health. Chronic physiological stress undermines homeostasis whether it is chemically induced or electromagnetically induced (or both exposures are simultaneous contributors). This can eventually break down adaptive biological responses critical to health maintenance; and resilience can be compromised. Electrohypersensitivity can be caused by successive assaults on human bioelectrochemical dynamics from exogenous electromagnetic fields (EMF) and RFR or a single acute exposure. Once sensitized, further exposures are widely reported to cause reactivity to lower and lower intensities of EMF/RFR, at which point thousand-fold lower levels can cause adverse health impacts to the electrosensitive person. Electrohypersensitivity (EHS) can be a precursor to, or linked with, multiple chemical sensitivity (MCS) based on reports of individuals who first develop one condition, then rapidly develop the other. Similarity of chemical biomarkers is seen in both conditions [histamines, markers of oxidative stress, auto-antibodies, heat shock protein (HSP), melatonin markers and leakage of the blood-brain barrier]. Low intensity pulsed microwave activation of voltage-gated calcium channels (VGCCs) is postulated as a mechanism of action for non-thermal health effects.

Absence of DNA damage after 60-Hz electromagnetic field exposure combined with ionizing radiation, hydrogen peroxide, or c-Myc overexpression

The principal objective of this study was to assess the DNA damage in a normal cell line system after exposure to 60 Hz of extremely low frequency magnetic field (ELF-MF) and particularly in combination with various external factors, via comet assays. NIH3T3 mouse fibroblast cells, WI-38 human lung fibroblast cells, L132 human lung epithelial cells, and MCF10A human mammary gland epithelial cells were exposed for 4 or 16 h to a 60-Hz, 1 mT uniform magnetic field in the presence or absence of ionizing radiation (IR, 1 Gy), H(2)O(2) (50 μM), or c-Myc oncogenic activation. The results obtained showed no significant differences between the cells exposed to ELF-MF alone and the unexposed cells. Moreover, no synergistic or additive effects were observed after 4 or 16 h of pre-exposure to 1 mT ELF-MF or simultaneous exposure to ELF-MF combined with IR, H(2)O(2), or c-Myc activation.

Potential health impacts of residential exposures to extremely low frequency magnetic fields in Europe

Over the last two decades residential exposure to extremely low frequency magnetic fields (ELF MF) has been associated with childhood leukaemia relatively consistently in epidemiological studies, though causality is still under investigation. We aimed to estimate the cases of childhood leukaemia that might be attributable to exposure to ELF MF in the European Union (EU27), if the associations seen in epidemiological studies were causal. We estimated distributions of ELF MF exposure using studies identified in the existing literature. Individual distributions of exposure were integrated using a probabilistic mixture distribution approach. Exposure-response functions were estimated from the most recently published pooled analysis of epidemiological data. Probabilistic simulation was used to estimate population attributable fractions (AFP) and attributable cases of childhood leukaemia in the EU27. By assigning the literature review-based exposure distribution to all EU27 countries, we estimated the total annual number of cases of leukaemia attributable to ELF MF at between ~50 (95% CIs: -14, 132) and ~60 (95% CIs: -9, 610), depending on whether exposure-response was modelled categorically or continuously, respectively, for a non-threshold effect. This corresponds to between ~1.5% and ~2.0% of all incident cases of childhood leukaemia occurring annually in the EU27. Considerable uncertainties are due to scarce data on exposure and the choice of exposure-response model, demonstrating the importance of further research into better understanding mechanisms of the potential association between ELF MF exposure and childhood leukaemia and the need for improved monitoring of residential exposures to ELF MF in Europe.

Indoor transformer stations and ELF magnetic field exposure: use of transformer structural characteristics to improve exposure assessment

Previous studies have shown that populations of multiapartment buildings with indoor transformer stations may serve as a basis for improved epidemiological studies on the relationship between childhood leukaemia and extremely-low-frequency (ELF) magnetic fields (MFs). This study investigated whether classification based on structural characteristics of the transformer stations would improve ELF MF exposure assessment. The data included MF measurements in apartments directly above transformer stations ("exposed" apartments) in 30 buildings in Finland, and reference apartments in the same buildings. Transformer structural characteristics (type and location of low-voltage conductors) were used to classify exposed apartments into high-exposure (HE) and intermediate-exposure (IE) categories. An exposure gradient was observed: both the time-average MF and time above a threshold (0.4 μT) were highest in the HE apartments and lowest in the reference apartments, showing a statistically significant trend. The differences between HE and IE apartments, however, were not statistically significant. A simulation exercise showed that the three-category classification did not perform better than a two-category classification (exposed and reference apartments) in detecting the existence of an increased risk. However, data on the structural characteristics of transformers is potentially useful for evaluating exposure-response relationship.

Autism and EMF? Plausibility of a pathophysiological link part II

Autism spectrum conditions (ASCs) are defined behaviorally, but they also involve multileveled disturbances of underlying biology that find striking parallels in the physiological impacts of electromagnetic frequency and radiofrequency radiation exposures (EMF/RFR). Part I (Vol 776) of this paper reviewed the critical contributions pathophysiology may make to the etiology, pathogenesis and ongoing generation of behaviors currently defined as being core features of ASCs. We reviewed pathophysiological damage to core cellular processes that are associated both with ASCs and with biological effects of EMF/RFR exposures that contribute to chronically disrupted homeostasis. Many studies of people with ASCs have identified oxidative stress and evidence of free radical damage, cellular stress proteins, and deficiencies of antioxidants such as glutathione. Elevated intracellular calcium in ASCs may be due to genetics or may be downstream of inflammation or environmental exposures. Cell membrane lipids may be peroxidized, mitochondria may be dysfunctional, and various kinds of immune system disturbances are common. Brain oxidative stress and inflammation as well as measures consistent with blood-brain barrier and brain perfusion compromise have been documented. Part II of this paper documents how behaviors in ASCs may emerge from alterations of electrophysiological oscillatory synchronization, how EMF/RFR could contribute to these by de-tuning the organism, and policy implications of these vulnerabilities. It details evidence for mitochondrial dysfunction, immune system dysregulation, neuroinflammation and brain blood flow alterations, altered electrophysiology, disruption of electromagnetic signaling, synchrony, and sensory processing, de-tuning of the brain and organism, with autistic behaviors as emergent properties emanating from this pathophysiology. Changes in brain and autonomic nervous system electrophysiological function and sensory processing predominate, seizures are common, and sleep disruption is close to universal. All of these phenomena also occur with EMF/RFR exposure that can add to system overload ('allostatic load') in ASCs by increasing risk, and can worsen challenging biological problems and symptoms; conversely, reducing exposure might ameliorate symptoms of ASCs by reducing obstruction of physiological repair. Various vital but vulnerable mechanisms such as calcium channels may be disrupted by environmental agents, various genes associated with autism or the interaction of both. With dramatic increases in reported ASCs that are coincident in time with the deployment of wireless technologies, we need aggressive investigation of potential ASC-EMF/RFR links. The evidence is sufficient to warrant new public exposure standards benchmarked to low-intensity (non-thermal) exposure levels now known to be biologically disruptive, and strong, interim precautionary practices are advocated.

Autism and EMF? Plausibility of a pathophysiological link - Part I

Although autism spectrum conditions (ASCs) are defined behaviorally, they also involve multileveled disturbances of underlying biology that find striking parallels in the physiological impacts of electromagnetic frequency and radiofrequency exposures (EMF/RFR). Part I of this paper will review the critical contributions pathophysiology may make to the etiology, pathogenesis and ongoing generation of core features of ASCs. We will review pathophysiological damage to core cellular processes that are associated both with ASCs and with biological effects of EMF/RFR exposures that contribute to chronically disrupted homeostasis. Many studies of people with ASCs have identified oxidative stress and evidence of free radical damage, cellular stress proteins, and deficiencies of antioxidants such as glutathione. Elevated intracellular calcium in ASCs may be due to genetics or may be downstream of inflammation or environmental exposures. Cell membrane lipids may be peroxidized, mitochondria may be dysfunctional, and various kinds of immune system disturbances are common. Brain oxidative stress and inflammation as well as measures consistent with blood-brain barrier and brain perfusion compromise have been documented. Part II of this paper will review how behaviors in ASCs may emerge from alterations of electrophysiological oscillatory synchronization, how EMF/RFR could contribute to these by de-tuning the organism, and policy implications of these vulnerabilities. Changes in brain and autonomic nervous system electrophysiological function and sensory processing predominate, seizures are common, and sleep disruption is close to universal. All of these phenomena also occur with EMF/RFR exposure that can add to system overload ('allostatic load') in ASCs by increasing risk, and worsening challenging biological problems and symptoms; conversely, reducing exposure might ameliorate symptoms of ASCs by reducing obstruction of physiological repair. Various vital but vulnerable mechanisms such as calcium channels may be disrupted by environmental agents, various genes associated with autism or the interaction of both. With dramatic increases in reported ASCs that are coincident in time with the deployment of wireless technologies, we need aggressive investigation of potential ASC - EMF/RFR links. The evidence is sufficient to warrant new public exposure standards benchmarked to low-intensity (non-thermal) exposure levels now known to be biologically disruptive, and strong, interim precautionary practices are advocated.

Investigation of transcriptional responses of juvenile mouse bone marrow to power frequency magnetic fields

To seek alterations in gene transcription in bone marrow cells following in vivo exposure of juvenile mice to power frequency magnetic fields, young (21-24-day old) C57BL/6 mice were exposed to a 100μT 50Hz magnetic field for 2h. Transcription was analysed by three methods, High Coverage Expression Profiling (HiCEP), Illumina microarrays and quantitative real-time polymerase chain reaction (QRT-PCR). A pilot HiCEP experiment with 6 exposed (E) and 6 non-exposed (NE) mice identified four candidate responsive transcripts (two unknown transcripts (AK152075 and F10-NED), phosphatidylinositol binding clathrin assembly protein (Picalm) and exportin 7 (Xpo7)). A larger experiment compared 19 E and 15 NE mice using two independent QRT-PCR assays and repeated microarray assays. No significant field-dependent changes were seen, although Picalm showed a trend to significance in one QRT-PCR assay (E/NE=0.91; P=0.06). However, the study was underpowered to detect an effect of this magnitude (52% power at P=0.05). These data indicate the current experimental constraints in detecting small changes in transcription that may occur in response to magnetic fields. These constraints result from technical limitations in the accuracy of assays and biological variation, which together were sufficient to account statistically for the number of differentially expressed transcripts identified in the pilot experiment.

Assessing LINE-1 retrotransposition activity in neuroblastoma cells exposed to extremely low-frequency pulsed magnetic fields

Mobile genetic elements represent an important source of mutation and genomic instability, and their activity can be influenced by several chemical and physical agents. In this research we address the question whether exposure to extremely low-frequency pulsed magnetic fields (EMF-PMF) could affect the mobility of the human LINE-1(RP) retrotransposon. To this purpose, an in vitro retrotransposition assay was used on human neuroblastoma BE(2) cells exposed for 48h to 1mT, 50Hz PMF, or sham-exposed. Moreover, since it is well known that retrotransposition causes DNA double-strand breaks (DSB), an estimation of γ-H2AX foci, which is a marker of DNA DSB, was carried out on PMF- and sham-exposed samples. The results show that PMF-exposed cells had a lower number of both retrotransposition events and DNA DSB compared with sham-exposed samples. These results suggest that exposure to PMF can interfere with retrotransposition activity by inducing a decrease of retrotransposition events.

Effects on micronuclei formation of 60-Hz electromagnetic field exposure with ionizing radiation, hydrogen peroxide, or c-Myc overexpression

PURPOSE

Epidemiological studies have demonstrated a possible correlation between exposure to extremely low-frequency magnetic fields (ELF-MF) and cancer. However, this correlation has yet to be definitively confirmed by epidemiological studies. The principal objective of this study was to assess the effects of 60 Hz magnetic fields in a normal cell line system, and particularly in combination with various external factors, via micronucleus (MN) assays.

MATERIALS AND METHODS

Mouse embryonic fibroblast NIH3T3 cells and human lung fibroblast WI-38 cells were exposed for 4 h to a 60 Hz, 1 mT uniform magnetic field with or without ionizing radiation (IR, 2 Gy), H(2)O(2) (100 μM) and cellular myelocytomatosis oncogene (c-Myc) activation.

RESULTS

The results obtained showed no significant differences between the cells exposed to ELF-MF alone and the unexposed cells. Moreover, no synergistic effects were observed when ELF-MF was combined with IR, H(2)O(2), and c-Myc activation.

CONCLUSIONS

Our results demonstrate that ELF-MF did not enhance MN frequency by IR, H(2)O(2) and c-Myc activation.

Combined effects of 60 Hz electromagnetic field exposure with various stress factors on cellular transformation in NIH3T3 cells

Epidemiological studies have suggested that extremely low-frequency magnetic fields (ELF-MF) are associated with an increased incidence of cancer. Studies using in vitro systems have reported mixed results for the effects of ELF-MF alone, and the World Health Organization (WHO) Research Agenda published in 2007 suggested that high priority research should include an evaluation of the co-carcinogenic effects of ELF-MF exposure using in vitro models. Here, the carcinogenic potential of ELF-MF exposure alone and in combination with various stress factors was investigated in NIH3T3 mouse fibroblasts using an in vitro cellular transformation assay. NIH3T3 cells were exposed to a 60 Hz ELF-MF (1 mT) alone or in combination with ionizing radiation (IR), hydrogen peroxide (H₂O₂), or c-Myc overexpression, and the resulting number of anchorage-independent colonies was counted. A 4 h exposure of NIH3T3 cells to ELF-MF alone produced no cell transformation. Moreover, ELF exposure did not influence the transformation activity of IR, H₂O₂, or activated c-Myc in our in vitro assay system, suggesting that 1 mT ELF-MF did not affect any additive or synergistic transformation activities in combination with stress factors such as IR, H₂O₂, or activated c-Myc in NIH3T3 cells.

Involvement of midkine expression in the inhibitory effects of low-frequency magnetic fields on cancer cells

Effects of magnetic fields (MFs) on cancer cells may depend on cell type and exposure conditions. Gene expression levels are different among cancer cells. However, the effect of MFs on cancer cells with different gene expressions is still unclear. In this study, the cancer cell lines BGC-823, MKN-45, MKN-28, A549, SPC-A1, and LOVO were exposed to a low-frequency MF. Specific parameters of MFs were determined. Furthermore, the potential of the MF to influence cancer cell growth with midkine (MK) expression was evaluated. Cell proliferation and cell cycle were detected using the CCK-8 assay and flow cytometry. Cell ultrastructure was observed by transmission electron microscopy. BGC-823 cells with over-expression of MK (BGC-MK cells) and stanniocalcin-1 were generated by plasmid construction and transfection. Results showed that exposure to a 0.4-T, 7.5 Hz MF inhibited the proliferation of BGC-823, MKN-28, A549, and LOVO cells, but not MKN-45 and SPC-A1 cells. Moreover, the inhibitory effect of the MF on BGC-MK cells was lower (12.3%) than that of BGC-823 cells (20.3%). Analysis of the cell cycle showed that exposure to the MF led to a significant increase in the S phase in BGC-823 cells, but not in BGC-MK cells. In addition, organelle morphology was modified in BGC-823 cells exposed to the MF. These results suggest that exposure to a 0.4-T, 7.5 Hz MF could inhibit tumor cell proliferation and disturb the cell cycle. The alteration of MK expression in cancer cells may be related to the inhibitory effect of the MF on these cells.

Pre-exposure to 50 Hz magnetic fields modifies menadione-induced genotoxic effects in human SH-SY5Y neuroblastoma cells

BACKGROUND

Extremely low frequency (ELF) magnetic fields (MF) are generated by power lines and various electric appliances. They have been classified as possibly carcinogenic by the International Agency for Research on Cancer, but a mechanistic explanation for carcinogenic effects is lacking. A previous study in our laboratory showed that pre-exposure to ELF MF altered cancer-relevant cellular responses (cell cycle arrest, apoptosis) to menadione-induced DNA damage, but it did not include endpoints measuring actual genetic damage. In the present study, we examined whether pre-exposure to ELF MF affects chemically induced DNA damage level, DNA repair rate, or micronucleus frequency in human SH-SY5Y neuroblastoma cells.

METHODOLOGY/PRINCIPAL FINDINGS

Exposure to 50 Hz MF was conducted at 100 µT for 24 hours, followed by chemical exposure for 3 hours. The chemicals used for inducing DNA damage and subsequent micronucleus formation were menadione and methyl methanesulphonate (MMS). Pre-treatment with MF enhanced menadione-induced DNA damage, DNA repair rate, and micronucleus formation in human SH-SY5Y neuroblastoma cells. Although the results with MMS indicated similar effects, the differences were not statistically significant. No effects were observed after MF exposure alone.

CONCLUSIONS

The results confirm our previous findings showing that pre-exposure to MFs as low as 100 µT alters cellular responses to menadione, and show that increased genotoxicity results from such interaction. The present findings also indicate that complementary data at several chronological points may be critical for understanding the MF effects on DNA damage, repair, and post-repair integrity of the genome.

Effects of extremely low-frequency magnetic field on caspase activities and oxidative stress values in rat brain

This study was aimed to investigate the effect of extremely low-frequency magnetic field (ELF-MF) on apoptosis and oxidative stress values in the brain of rat. Rats were exposed to 100 and 500 µT ELF-MF, which are the safety standards of public and occupational exposure for 2 h/day for 10 months. Brain tissues were immunohistochemically stained for the active (cleaved) caspase-3 in order to measure the apoptotic index by a semi-quantitative scoring system. In addition, the levels of catalase (CAT), malondialdehyde (MDA), myeloperoxidase (MPO), total antioxidative capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) were measured in rat brain. Final score of apoptosis and MPO activity were not significantly different between the groups. CAT activity decreased in both exposure groups (p < 0.05), while TAC was found to be lower in ELF 500 group than those in ELF-100 and sham groups (p < 0.05). MDA, TOS, and OSI values were found to be higher in ELF-500 group than those in ELF-100 and sham groups (p < 0.05). In conclusion, apoptosis was not changed by long-term ELF-MF exposure, while both 100 and 500 µT ELF-MF exposure induced toxic effect in the rat brain by increasing oxidative stress and diminishing antioxidant defense system.

Effect of 2.45 mT sinusoidal 50 Hz magnetic field on Saccharomyces cerevisiae strains deficient in DNA strand breaks repair

PURPOSE

To investigate whether extremely-low frequency magnetic field (MF) exposure produce alterations in the growth, cell cycle, survival and DNA damage of wild type (wt) and mutant yeast strains.

MATERIALS AND METHODS

wt and high affinity DNA binding factor 1 (hdf1), radiation sensitive 52 (rad52), rad52 hdf1 mutant Saccharomyces cerevisiae strains were exposed to 2.45 mT, sinusoidal 50 Hz MF for 96 h. MF was generated by a pair of Helmholtz coils. During this time the growth was monitored by measuring the optical density at 600 nm and cell cycle evolution were analysed by microscopic morphological analysis. Then, yeast survival was assayed by the drop test and DNA was extracted and electrophoresed.

RESULTS

A significant increase in the growth was observed for rad52 strain (P = 0.005, Analysis of Variance [ANOVA]) and close to significance for rad52 hdf1 strain (P = 0.069, ANOVA). In addition, the surviving fraction values obtained for MF-exposed samples were in all cases less than for the controls, being the P value obtained for the whole set of MF-treated strains close to significance (P = 0.066, Student's t-test). In contrast, the cell cycle evolution and the DNA pattern obtained for wt and the mutant strains were not altered after exposure to MF.

CONCLUSIONS

The data presented in the current report show that the applied MF (2.45 mT, sinusoidal 50 Hz, 96 h) induces alterations in the growth and survival of S. cerevisiae strains deficient in DNA strand breaks repair. In contrast, the MF treatment does not induce alterations in the cell cycle and does not cause DNA damage.

Can animal models of disease reliably inform human studies?

H. Bart van der Worp and colleagues discuss the controversies and possibilities of translating the results of animal experiments into human clinical trials.

A Study on the effects of 50 Hz magnetic fields on UV-induced radical reactions in murine fibroblasts

The aim of this study was to test the hypothesis that the "radical pair mechanism" (magnetic field effect on recombination rate of radical pairs) explains our previous findings indicating that 50 Hz magnetic fields (MF) of about 100 µT modify biological responses to ultraviolet (UV) radiation. In the present study, the effects of 50 Hz MF on cellular oxidative processes induced by UV radiation were investigated. Murine L929 fibroblast cells were exposed to 50 Hz MF of 100 or 300 µT during a 1-h UV exposure or for 24 h before it. The decay kinetics of oxidative reactions were analysed by measuring ultraweak chemiluminescence (photon emissions) of the exposed cells by scintillation counter in the out-of-coincidence mode. No significant MF effects were found. The results do not support the hypothesis that 100-300 µT MF modify biological responses to UV radiation by causing an overall change in oxidative reactions at cellular level.

Biological effects and safety in magnetic resonance imaging: a review

Since the introduction of Magnetic Resonance Imaging (MRI) as a diagnostic technique, the number of people exposed to electromagnetic fields (EMF) has increased dramatically. In this review, based on the results of a pioneer study showing in vitro and in vivo genotoxic effects of MRI scans, we report an updated survey about the effects of non-ionizing EMF employed in MRI, relevant for patients' and workers' safety. While the whole data does not confirm a risk hypothesis, it suggests a need for further studies and prudent use in order to avoid unnecessary examinations, according to the precautionary principle.

Why are so many epidemiology associations inflated or wrong? Does poorly conducted animal research suggest implausible hypotheses?

There is growing concern among epidemiologists that most discovered associations are either inflated or false. The reasons for this concern have focused on methodological issues in the conduct and publication of epidemiologic research. This commentary suggests that another reason for discrepant findings may be that animal research is producing implausible hypotheses. Many animal studies are methodologically weak, and the animal literature is not systematically reviewed and synthesized. Moreover, most bodies of animal literature may be so heterogeneous that they can be used selectively to support the plausibility of almost any epidemiology study result. Epidemiologists themselves also do not consistently conduct systematic reviews of bodies of biological evidence which might point to sources of bias in an evidence base. Animal research will likely continue to provide the biological basis for epidemiological investigation, but substantial improvement is needed in how it is conducted and synthesized to improve the predictability of animal studies for the human condition.

Maternal occupational exposure to extremely low frequency magnetic fields and the risk of brain cancer in the offspring

OBJECTIVES

To examine the contribution of maternal occupational exposure to extremely low frequency magnetic fields (ELF-MF) shortly before and during pregnancy on the incidence of childhood brain tumors.

METHODS

A total of 548 incident cases and 760 healthy controls recruited between 1980 and 2002 from two Canadian provinces (Québec and Ontario) were included in this study, and their mothers were interviewed. Quantitative occupational ELF-MF exposure in microTesla units was estimated using individual exposure estimations or a job exposure matrix. We used three metrics to analyze exposure: cumulative, average, and maximum level attained.

RESULTS

Using the average exposure metric measured before conception, an increased risk was observed for astroglial tumors (OR = 1.5, 95% CI = 1.0-2.4). During the entire pregnancy period, a significantly increased risk was observed for astroglial tumors as well as for all childhood brain tumors with the average metric (OR = 1.6, 95% CI = 1.1-2.5 and OR = 1.5, 95% CI = 1.1-2.2, respectively). Based on job titles, a twofold risk increase was observed for astroglial tumors (OR = 2.3, 95% CI = 0.8-6.3) and for all childhood brain tumors (OR = 2.3, 95% CI = 1.0-5.4) among sewing machine operators.

CONCLUSIONS

Results are suggestive of a possible association between maternal occupational ELF-MF exposure and certain brain tumors in their offspring.

Interspecies extrapolation in environmental exposure standard setting: A Bayesian synthesis approach

Currently the extrapolation of evidence from studies of non-human species to the setting of environmental exposure standards for humans includes the imposition of a variety of uncertainty factors reflecting unknown aspects of the procedure, including the relevance of evidence from one species to impacts in another. This paper develops and explores more flexible modelling of aspects of this extrapolation, using models proposed by DuMouchel [DuMouchel, W.H., Harris, J.E., 1983. Bayes methods for combining the results of cancer studies in humans and other species (with comment). J. Am. Statist. Assoc. 78, 293-308.] The approaches are based on Bayesian meta-analysis methods involving explicit modelling of relevance in the prior distributions, estimated using Markov chain Monte Carlo (MCMC) methods. The methods are applied to evidence relating chlorinated by-products exposure to adverse reproductive health effects. The relative merits of various approaches are discussed, and developments and next steps are outlined.