Elevated risk of Alzheimer's disease among workers with likely electromagnetic field exposure

Low Intensity Electromagnetic Fields Act via Voltage-Gated Calcium Channel (VGCC) Activation to Cause Very Early Onset Alzheimer's Disease: 18 Distinct Types of Evidence

Electronically generated electromagnetic fields (EMFs) including those used in wireless communication such as cell phones, Wi-Fi and smart meters, are coherent, producing very high electric and magnetic forces which act on the voltage sensor of voltage-gated calcium channels to produce increases in intracellular calcium [Ca2+]i. The calcium hypothesis of Alzheimer's disease (AD) has shown that each of the important AD-specific and nonspecific causal elements are produced by excessive [Ca2+]i. [Ca2+]i acts in AD via excessive calcium signaling and the peroxynitrite/oxidative stress/inflammation pathway which are each elevated by EMFs. An apparent vicious cycle in AD involves amyloid-beta protein (A) and [Ca2+]i. Three types of epidemiology each suggest EMF causation of AD including early onset AD. Extensive animal model studies show that low intensity EMFs cause neurodegeneration including AD, with AD animals having elevated levels of A, amyloid precursor protein and BACE1. Rats exposed to pulsed EMFs every day are reported to develop universal or near universal very very very early onset neurodegeneration including AD; these findings are superficially similar to humans with digital dementia. EMFs producing modest increases in [Ca2+]i can also produce protective, therapeutic effects. The therapeutic pathway and peroxynitrite pathway inhibit each other. A summary of 18 different findings is provided, which collectively provide powerful evidence for EMF causation of AD. The author is concerned that smarter, more highly pulsed "smart" wireless communication may cause widespread very, very early onset AD in human populations.

Histopathological and epigenetic alterations in the spinal cord due to prenatal electromagnetic field exposure: An H3K27me3-related mechanism

Neural system development is one of the most important stages of embryogenesis. Perturbations in this crucial process due to genetic and environmental risk factors cause neural tube defects and other central nervous system diseases. We investigated the effects of prenatal exposure to 900-MHz electromagnetic field (EMF) on the spinal cord. Pregnant rats were exposed to 900-MHz EMF for 1 h/day from E13.5 until birth. Six pups from the control and EMF groups were sacrificed at postnatal day 32, and the upper thoracic region of the spine was removed and processed for histological procedures. For histopathological analyses, hematoxylin&eosin staining and, for stereological analyses and the quantitation of motor neurons, cresyl violet staining was performed. H3K27me3 levels were determined via immunofluorescence staining. Histopathological analysis identified structural alterations of ependymal cells, enlarged central canals, as well as degenerated and shrunken motor neurons in the EMF group, while the control group tissues had normal appearances. We also observed enrichment of H3K27me3 in the ependymal cells and the motor neurons in the spinal cord of the control group rats, while the EMF group had low levels of H3K27me3 staining. Our results suggest that the loss of H3K27me3 signals might correlate with reduced neuronal stem cell potential in the EMF group and result in anatomical and structural differences in the spinal cord. This study provided a comprehensive histopathological analysis of the spinal cord after prenatal EMF exposure and offered an H3K27me3-dependent molecular explanation for the detrimental effects of EMF exposure on the spine.

The role of magnetic fields in neurodegenerative diseases

The term neurodegenerative diseases include a long list of diseases affecting the nervous system that are characterized by the degeneration of different neurological structures. Among them, Alzheimer disease (AD), Parkinson disease (PD), and amyotrophic lateral sclerosis (ALS) are the most representative ones. The vast majority of cases are sporadic and results from the interaction of genes and environmental factors in genetically predisposed individuals. Among environmental conditions, electromagnetic field exposure has begun to be assessed as a potential risk factor for neurodegeneration. In this review, we discuss the existing literature regarding electromagnetic fields and neurodegenerative diseases. Epidemiological studies in AD, PD, and ALS have shown discordant results; thus, a clear correlation between electromagnetic exposure and neurodegeneration has not been demonstrated. In addition, we discuss the role of electromagnetic radiation as a potential non-invasive therapeutic strategy for some neurodegenerative diseases, particularly for PD and AD.

Thermal and non-thermal health effects of low intensity non-ionizing radiation: An international perspective

Exposure to low frequency and radiofrequency electromagnetic fields at low intensities poses a significant health hazard that has not been adequately addressed by national and international organizations such as the World Health Organization. There is strong evidence that excessive exposure to mobile phone-frequencies over long periods of time increases the risk of brain cancer both in humans and animals. The mechanism(s) responsible include induction of reactive oxygen species, gene expression alteration and DNA damage through both epigenetic and genetic processes. In vivo and in vitro studies demonstrate adverse effects on male and female reproduction, almost certainly due to generation of reactive oxygen species. There is increasing evidence the exposures can result in neurobehavioral decrements and that some individuals develop a syndrome of "electro-hypersensitivity" or "microwave illness", which is one of several syndromes commonly categorized as "idiopathic environmental intolerance". While the symptoms are non-specific, new biochemical indicators and imaging techniques allow diagnosis that excludes the symptoms as being only psychosomatic. Unfortunately standards set by most national and international bodies are not protective of human health. This is a particular concern in children, given the rapid expansion of use of wireless technologies, the greater susceptibility of the developing nervous system, the hyperconductivity of their brain tissue, the greater penetration of radiofrequency radiation relative to head size and their potential for a longer lifetime exposure.

Generation and propagation of yeast prion [URE3] are elevated under electromagnetic field

In this study, we studied the effect of 2.0 GHz radio frequency electromagnetic field (RF-EMF) and 50 Hz extremely low frequency electromagnetic field (ELF-EMF) exposure on prion generation and propagation using two budding yeast strains, NT64C and SB34, as model organisms. Under exposure to RF-EMF or ELF-EMF, the de novo generation and propagation of yeast prions [URE3] were elevated in both strains. The elevation increased over time, and the effects of ELF-EMF occurred in a dose-dependent manner. The transcription and expression levels of the molecular chaperones Hsp104, Hsp70-Ssa1/2, and Hsp40-Ydj1 were not statistically significantly changed after exposure. Furthermore, the levels of ROS, as well as the activities of superoxide dismutase (SOD) and catalase (CAT), were significantly elevated after short-term, but not long-term exposure. This work demonstrated for the first time that EMF exposure could elevate the de novo generation and propagation of yeast prions and supports the hypothesis that ROS may play a role in the effects of EMF on protein misfolding. The effects of EMF on protein folding and ROS levels may mediate the broad effects of EMF on cell function.

miRNA expression profile is altered differentially in the rat brain compared to blood after experimental exposure to 50 Hz and 1 mT electromagnetic field

Common complex diseases are a result of host and environment interactions. One such putative environmental factor is the electromagnetic field exposure, especially the occupational extremely low frequency (ELF) magnetic field, 50 Hz, 1 mT, whose neurobiological relevance remains elusive. We evaluated the effects of long-term (60 days) ELF-MF exposure on miRNAs previously related to brain and human diseases (miR-26b-5p, miR-9-5p, miR-29a-3p, miR-106b-5p, miR-107, miR-125a-3p). A total of 64 young (3 weeks-old) and mature (10 weeks-old) male/female Wistar-Albino rats were divided into sham and ELF-MF exposed groups. After sacrifice of the animals, blood samples from rat's tail vein and brain tissues were collected. The expression levels of miRNAs were investigated with Real-Time PCR technique and TaqMan probe Technology. All miRNA expression levels of the young female rats show a significant decrease in blood according to brain samples (p < 0.05), but fewer miRNAs displayed a similar significant decrease in the blood. In conclusion, these new observations might inform future clinical biological psychiatry studies of long-term electromagnetic field exposure, and the ways in which host-environment interactions contribute to brain diseases.

Inhibition of STAT3- and MAPK-dependent PGE2 synthesis ameliorates phagocytosis of fibrillar β-amyloid peptide (1-42) via EP2 receptor in EMF-stimulated N9 microglial cells

Background

Prostaglandin E₂ (PGE₂)-involved neuroinflammatory processes are prevalent in several neurological conditions and diseases. Amyloid burden is correlated with the activation of E-prostanoid (EP) 2 receptors by PGE₂ in Alzheimer’s disease. We previously demonstrated that electromagnetic field (EMF) exposure can induce pro-inflammatory responses and the depression of phagocytosis in microglial cells, but the signaling pathways involved in phagocytosis of fibrillar β-amyloid (fAβ) in microglial cells exposed to EMF are poorly understood. Given the important role of PGE₂ in neural physiopathological processes, we investigated the PGE₂-related signaling mechanism in the immunomodulatory phagocytosis of EMF-stimulated N9 microglial cells (N9 cells).

Methods

N9 cells were exposed to EMF with or without pretreatment with the selective inhibitors of cyclooxygenase-2 (COX-2), Janus kinase 2 (JAK2), signal transducer and activator of transcription 3 (STAT3), and mitogen-activated protein kinases (MAPKs) and antagonists of PG receptors EP1-4. The production of endogenous PGE₂ was quantified by enzyme immunoassays. The phagocytic ability of N9 cells was evaluated based on the fluorescence intensity of the engulfed fluorescent-labeled fibrillar β-amyloid peptide (1-42) (fAβ₄₂) measured using a flow cytometer and a fluorescence microscope. The effects of pharmacological agents on EMF-activated microglia were investigated based on the expressions of JAK2, STAT3, p38/ERK/JNK MAPKs, COX-2, microsomal prostaglandin E synthase-1 (mPGES-1), and EP2 using real-time PCR and/or western blotting.

Results

EMF exposure significantly increased the production of PGE₂ and decreased the phagocytosis of fluorescent-labeled fAβ₄₂ by N9 cells. The selective inhibitors of COX-2, JAK2, STAT3, and MAPKs clearly depressed PGE₂ release and ameliorated microglial phagocytosis after EMF exposure. Pharmacological agents suppressed the phosphorylation of JAK2-STAT3 and MAPKs, leading to the amelioration of the phagocytic ability of EMF-stimulated N9 cells. Antagonist studies of EP1-4 receptors showed that EMF depressed the phagocytosis of fAβ₄₂ through the PGE₂ system, which is linked to EP2 receptors.

Conclusions

This study indicates that EMF exposure could induce phagocytic depression via JAK2-STAT3- and MAPK-dependent PGE₂-EP2 receptor signaling pathways in microglia. Therefore, pharmacological inhibition of PGE₂ synthesis and EP2 receptors may be a potential therapeutic strategy to combat the neurobiological deterioration that follows EMF exposure.

Electronic supplementary material

The online version of this article (doi:10.1186/s12974-016-0762-9) contains supplementary material, which is available to authorized users.

A review on Electromagnetic fields (EMFs) and the reproductive system

Environmental factors, such as electromagnetic waves, induce biological and genetic effects. One of the most important physiological systems involved with electromagnetic fields (EMFs) is the genital system. This paper reviews the effects of EMFs on human reproductive organs, female animals, fetus development and the importance of two types of natural antioxidants, i.e., vitamin E and fennel. The studies presented in this review referred to the effects of different exposures to EMFs on the reproductive system, and we tried to show the role of natural antioxidants in reducing the effects of the exposures. Many studies have been done on the effects of ionizing and non-ionizing electromagnetic waves on the cell line of spermatogenesis, sexual hormones, and the structure of the testes. Also, about the hormonal cycle, folliculogenesis and female infertility related to EMF have been given more consideration. In particular, attention is directed to pregnant women due to the importance of their fetuses. However, in addition to the studies conducted on animals, further epidemiological research should be conducted.

Effect of 50 Hz Extremely Low-Frequency Electromagnetic Fields on the DNA Methylation and DNA Methyltransferases in Mouse Spermatocyte-Derived Cell Line GC-2

Previous studies have shown that the male reproductive system is one of the most sensitive organs to electromagnetic radiation. However, the biological effects and molecular mechanism are largely unclear. Our study was designed to elucidate the epigenetic effects of 50 Hz ELF-EMF in vitro. Mouse spermatocyte-derived GC-2 cell line was exposed to 50 Hz ELF-EMF (5 min on and 10 min off) at magnetic field intensity of 1 mT, 2 mT, and 3 mT with an intermittent exposure for 72 h. We found that 50 Hz ELF-EMF exposure decreased genome-wide methylation at 1 mT, but global methylation was higher at 3 mT compared with the controls. The expression of DNMT1 and DNMT3b was decreased at 1 mT, and 50 Hz ELF-EMF can increase the expression of DNMT1 and DNMT3b of GC-2 cells at 3 mT. However, 50 Hz ELF-EMF had little influence on the expression of DNMT3a. Then, we established DNA methylation and gene expression profiling and validated some genes with aberrant DNA methylation and expression at different intensity of 50 Hz ELF-EMF. These results suggest that the alterations of genome-wide methylation and DNMTs expression may play an important role in the biological effects of 50 Hz ELF-EMF exposure.

The amelioration of phagocytic ability in microglial cells by curcumin through the inhibition of EMF-induced pro-inflammatory responses

Background

Insufficient clearance by microglial cells, prevalent in several neurological conditions and diseases, is intricately intertwined with MFG-E8 expression and inflammatory responses. Electromagnetic field (EMF) exposure can elicit the pro-inflammatory activation and may also trigger an alteration of the clearance function in microglial cells. Curcumin has important roles in the anti-inflammatory and phagocytic process. Here, we evaluated the ability of curcumin to ameliorate the phagocytic ability of EMF-exposed microglial cells (N9 cells) and documented relative pathways.

Methods

N9 cells were pretreated with or without recombinant murine MFG-E8 (rmMFG-E8), curcumin and an antibody of toll-like receptor 4 (anti-TLR4), and subsequently treated with EMF or a sham exposure. Their phagocytic ability was evaluated using phosphatidylserine-containing fluorescent bioparticles. The pro-inflammatory activation of microglia was assessed via CD11b immunoreactivity and the production of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β) and nitric oxide (NO) via the enzyme-linked immunosorbent assay or the Griess test. We evaluated the ability of curcumin to ameliorate the phagocytic ability of EMF-exposed N9 cells, including checking the expression of MFG-E8, α_vβ₃ integrin, TLR4, nuclear factor-κB (NF-κB) and signal transducer and activator of transcription 3 (STAT3) using Western blotting.

Results

EMF exposure dramatically enhanced the expression of CD11b and depressed the phagocytic ability of N9 cells. rmMFG-E8 could clearly ameliorate the phagocytic ability of N9 cells after EMF exposure. We also found that EMF exposure significantly increased the secretion of pro-inflammatory cytokines (TNF-α, IL-6 and IL-1β) and the production of NO; however, these increases were efficiently chilled by the addition of curcumin to the culture medium. This reduction led to the amelioration of the phagocytic ability of EMF-exposed N9 cells. Western blot analysis revealed that curcumin and naloxone restored the expression of MFG-E8 but had no effect on TLR4 and cytosolic STAT3. Moreover, curcumin significantly reduced the expression of NF-κB p65 in nuclei and phospho-STAT3 (p-STAT3) in cytosols and nuclei.

Conclusions

This study indicates that curcumin ameliorates the depressed MFG-E8 expression and the attenuated phagocytic ability of EMF-exposed N9 cells, which is attributable to the inhibition of the pro-inflammatory response through the NF-κB and STAT3 pathways.

Severe Cognitive Dysfunction and Occupational Extremely Low Frequency Magnetic Field Exposure among Elderly Mexican Americans

Aims

This report is the first study of the possible relationship between extremely low frequency (50–60 Hz, ELF) magnetic field (MF) exposure and severe cognitive dysfunction. Earlier studies investigated the relationships between MF occupational exposure and Alzheimer’s disease (AD) or dementia. These studies had mixed results, depending upon whether the diagnosis of AD or dementia was performed by experts and upon the methodology used to classify MF exposure.

Study Design

Population-based case-control.

Place and Duration of Study

Neurology and Preventive Medicine, Keck School of Medicine, University of Southern California, 2 years.

Methodology

The study population consisted of 3050 Mexican Americans, aged 65+, enrolled in Phase 1 of the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE) study. Mini-Mental State Exam (MMSE) results, primary occupational history, and other data were collected. Severe cognitive dysfunction was defined as an MMSE score below 10. The MF exposure methodology developed and used in earlier studies was used.

Results

Univariate odds ratios (OR) were 3.4 (P< .03; 95% CI: 1.3–8.9) for high and 1.7 (P=.27; 95% CI: 0.7–4.1) for medium or high (M/H) MF occupations. In multivariate main effects models, the results were similar. When interaction terms were allowed in the models, the interactions between M/H or high occupational MF exposure and smoking history or age group were statistically significant, depending upon whether two (65–74, 75+) or three (65–74, 75–84, 85+) age groups were considered, respectively. When the analyses were limited to subjects aged 75+, the interactions between M/H or high MF occupations and a positive smoking history were statistically significant.

Conclusion

The results of this study indicate that working in an occupation with high or M/H MF exposure may increase the risk of severe cognitive dysfunction. Smoking and older age may increase the deleterious effect of MF exposure.

Extremely low-frequency magnetic exposure appears to have no effect on pathogenesis of Alzheimer's disease in aluminum-overloaded rat

Objective

Extremely low-frequency magnetic field (ELF-MF) has been reported to be of potential pathogenetic relevance to Alzheimer's disease (AD) for years. However, evidence confirming this function remains inconclusive. Chronic Al treatment has been identified as a contributing factor to cognitive function impairment in AD. This study aims to examine whether or not ELF-MF and Al have synergistic effects toward AD pathogenesis by investigating the effects of ELF-MF with or without chronic Al treatment on SD rats.

Methods

Sprague-Dawley (SD) rats were subjected one of the following treatments: sham (control group), oral Al (Al group), ELF-MF (100 µT at 50 Hz) with oral Al (MF+Al group), or ELF-MF (100 µT at 50 Hz) without oral Al (MF group).

Results

After 12 wk of treatment, oral Al treatment groups (Al and MF+Al groups) showed learning and memory impairment as well as morphological hallmarks, including neuronal cell loss and high density of amyloid-β (Aβ) in the hippocampus and cerebral cortex. ELF-MF without Al treatment showed no significant effect on AD pathogenesis. ELF-MF+Al treatment induced no more damage than Al treatment did.

Conclusions

Our results showed no evidence of any association between ELF-MF exposure (100 µT at 50 Hz) and AD, and ELF-MF exposure does not influence the pathogenesis of AD induced by Al overload.

The effects of extremely low-frequency magnetic fields on melatonin and cortisol, two marker rhythms of the circadian system

In the past 30 years the concern that daily exposure to extremely low-frequency magnetic fields (ELF-EMF) (1 to 300 Hz) might be harmful to human health (cancer, neurobehavioral disturbances, etc) has been the object of debate, and has become a public health concern. This has resulted in the classification of ELF-EMF into category 2B, ie, agents that are “possibly carcinogenic to humans” by the International Agency for Research on Cancer. Since melatonin, a neurohormone secreted by the pineal gland, has been shown to possess oncostatic properties, a “melatonin hypothesis” has been raised, stating that exposure to EMF might decrease melatonin production and therefore might promote the development of breast cancer in humans. Data from the literature reviewed here are contradictory. In addition, we have demonstrated a lack of effect of ELF-EMF on melatonin secretion in humans exposed to EMF (up to 20 years' exposure) which rebuts the melatonin hypothesis. Currently, the debate concerns the effects of ELF-EMF on the risk of childhood leukemia in children chronically exposed to more than 0.4 μT. Further research is thus needed to obtain more definite answers regarding the potential deleterious effects of ELF-EMF.

Effect of electromagnetic field exposure on the reproductive system

The safety of human exposure to an ever-increasing number and diversity of electromagnetic field (EMF) sources both at work and at home has become a public health issue. To date, many in vivo and in vitro studies have revealed that EMF exposure can alter cellular homeostasis, endocrine function, reproductive function, and fetal development in animal systems. Reproductive parameters reported to be altered by EMF exposure include male germ cell death, the estrous cycle, reproductive endocrine hormones, reproductive organ weights, sperm motility, early embryonic development, and pregnancy success. At the cellular level, an increase in free radicals and [Ca²⁺]i may mediate the effect of EMFs and lead to cell growth inhibition, protein misfolding, and DNA breaks. The effect of EMF exposure on reproductive function differs according to frequency and wave, strength (energy), and duration of exposure. In the present review, the effects of EMFs on reproductive function are summarized according to the types of EMF, wave type, strength, and duration of exposure at cellular and organism levels.

The role of the JAK2-STAT3 pathway in pro-inflammatory responses of EMF-stimulated N9 microglial cells

Background

In several neuropathological conditions, microglia can become overactivated and cause neurotoxicity by initiating neuronal damage in response to pro-inflammatory stimuli. Our previous studies have shown that exposure to electromagnetic fields (EMF) activates cultured microglia to produce tumor necrosis factor (TNF)-α and nitric oxide (NO) through signal transduction involving the activator of transcription STAT3. Here, we investigated the role of STAT3 signaling in EMF-induced microglial activation and pro-inflammatory responses in more detail than the previous study.

Methods

N9 microglial cells were treated with EMF exposure or a sham treatment, with or without pretreatment with an inhibitor (Pyridone 6, P6) of the Janus family of tyrosine kinases (JAK). The activation state of microglia was assessed via immunoreaction using the microglial marker CD11b. Levels of inducible nitric oxide synthase (iNOS), TNF-α and NO were measured using real-time reverse transcription-polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA) and the nitrate reductase method. Activation of JAKs and STAT3 proteins was evaluated by western blotting for specific tyrosine phosphorylation. The ability of STAT3 to bind to DNA was detected with an electrophoresis mobility shift assay (EMSA).

Results

EMF was found to significantly induce phosphorylation of JAK2 and STAT3, and DNA-binding ability of STAT3 in N9 microglia. In addition, EMF dramatically increased the expression of CD11b, TNF-α and iNOS, and the production of NO. P6 strongly suppressed the phosphorylation of JAK2 and STAT3 and diminished STAT3 activity in EMF-stimulated microglia. Interestingly, expression of CD11b as well as gene expression and production of TNF-α and iNOS were suppressed by P6 at 12 h, but not at 3 h, after EMF exposure.

Conclusions

EMF exposure directly triggers initial activation of microglia and produces a significant pro-inflammatory response. Our findings confirm that the JAK2-STAT3 pathway may not mediate this initial microglial activation but does promote pro-inflammatory responses in EMF-stimulated microglial cells. Thus, the JAK2-STAT3 pathway might be a therapeutic target for reducing pro-inflammatory responses in EMF-activated microglia.

Work-related exposure to extremely low-frequency magnetic fields and dementia: results from the population-based study of dementia in Swedish twins

BACKGROUND

We examined the association between extremely low-frequency magnetic fields (EMF) and the risk of dementia and Alzheimer's disease using all 9,508 individuals from the Study of Dementia in Swedish Twins (HARMONY) with valid occupational and diagnostic data.

METHODS

Dementia diagnoses were based on telephone screening followed by in-person clinical workup. Main lifetime occupation was coded according to an established EMF exposure matrix. Covariates were age, gender, education, vascular risk factors, and complexity of work. Based on previous research, data were also analyzed separately for cases with disease onset by age 75 years versus later, men versus women, and those with manual versus nonmanual main occupation. We used generalized estimating equations with the entire sample (to adjust for the inclusion of complete twin pairs) and conditional logistic regression with complete twin pairs only.

RESULTS

Level of EMF exposure was not significantly associated with dementia or Alzheimer's disease. However, in stratified analyses, medium and high levels of EMF exposure were associated with increased dementia risk compared with low level in cases with onset by age 75 years (odds ratio: 1.94, 95% confidence interval: 1.07-3.65 for medium, odds ratio: 2.01, 95% confidence interval: 1.10-3.65 for high) and in participants with manual occupations (odds ratio: 1.81, 95% confidence interval: 1.06-3.09 for medium, odds ratio: 1.75, 95% confidence interval: 1.00-3.05 for high). Results with 42 twin pairs discordant for dementia did not reach statistical significance.

CONCLUSIONS

Occupational EMF exposure appears relevant primarily to dementia with an earlier onset and among former manual workers.

Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention

More than 25 million people in the world today are affected by dementia, most suffering from Alzheimer's disease. In both developed and developing nations, Alzheimer's disease has had tremendous impact on the affected individuals, caregivers, and society. The etiological factors, other than older age and genetic susceptibility, remain to be determined. Nevertheless, increasing evidence strongly points to the potential risk roles of vascular risk factors and disorders (eg, cigarette smoking, midlife high blood pressure and obesity, diabetes, and cerebrovascular lesions) and the possible beneficial roles of psychosocial factors (eg, high education, active social engagement, physical exercise, and mentally stimulating activity) in the pathogenetic process and clinical manifestation of the dementing disorders. The long-term multidomain interventions toward the optimal control of multiple vascular risk factors and the maintenance of socially integrated lifestyles and mentally stimulating activities are expected to reduce the risk or postpone the clinical onset of dementia, including Alzheimer's disease.

Fielding a current idea: exploring the public health impact of electromagnetic radiation

Several publications in the scientific literature have raised concern about the individual and public health impact of adverse non-ionizing radiation (a-NIR) from electromagnetic field (EMF) exposure emanating from certain power, electrical and wireless devices commonly found in the home, workplace, school and community. Despite the many challenges in establishing irrefutable scientific proof of harm and the various gaps in elucidating the precise mechanisms of harm, epidemiological analyses continue to suggest considerable potential for injury and affliction as a result of a-NIR exposure. As environmental health has not been emphasized in medical education, some clinicians are not fully aware of possible EMF-related health problems and, as a result, manifestations of a-NIR may remain misdiagnosed and ineffectually managed. It is important for physicians and public health officials to be aware of the fundamental science and clinical implications of EMF exposure. A review of the scientific literature relating to the link between electromagnetic radiation and human health, several public health recommendations, and four case histories are presented for consideration.

Occupational risk factors in Alzheimer's disease: a review assessing the quality of published epidemiological studies

Epidemiological evidence of an association between Alzheimer's disease (AD) and the most frequently studied occupational exposures--pesticides, solvents, electromagnetic fields (EMF), lead and aluminium--is inconsistent. Epidemiological studies published up to June of 2003 were systematically searched through PubMed and Toxline. Twenty-four studies (21 case-control and 3 cohort studies) were included. Median GQI was 36.6% (range 19.5-62.9%). Most of the case-control studies had a GQI of <50%. The study with the highest score was a cohort study. Likelihood of exposure misclassification bias affected 18 of the 24 studies. Opportunity for bias arising from the use of surrogate informants affected 17 studies, followed by disease misclassification (11 studies) and selection bias (10 studies). Eleven studies explored the relationship of AD with solvents, seven with EMF, six with pesticides, six with lead and three with aluminium. For pesticides, studies of greater quality and prospective design found increased and statistically significant associations. For the remaining occupational agents, the evidence of association is less consistent (for solvents and EMF) or absent (for lead and aluminium).

Mortality from Alzheimer's, motor neuron and Parkinson's disease in relation to magnetic field exposure: findings from the study of UK electricity generation and transmission workers, 1973-2004

BACKGROUND

There are a number of reports linking magnetic field exposure to increased risks of Alzheimer's disease and motor neuron disease.

METHODS

The mortality experienced by a cohort of 83 997 employees of the former Central Electricity Generating Board of England and Wales was investigated for the period 1973-2004. All employees were employed for at least six months with some employment in the period 1973-82. Computerised work histories were available for 79 972 study subjects for the period 1971-93. Information on job and facility (location) were used to estimate exposures to magnetic fields. Two analytical approaches were used to evaluate risks, indirect standardisation (n = 83 997) and Poisson regression (n = 79 972).

RESULTS

Based on serial mortality rates for England and Wales, deaths from Alzheimer's disease and motor neuron disease were unexceptional. There was an excess of deaths from Parkinson's disease of borderline significance. No statistically significant trends were shown for risks of any of these diseases to increase with lifetime cumulative exposure to magnetic fields (RR per 10 μT-y: Alzheimer's disease 1.10 (95% CI 0.90 to 1.33); motor neuron disease 1.06 (95% CI 0.86 to 1.32); Parkinson's disease 0.88 (95% CI 0.74 to 1.05))

CONCLUSIONS

There is no convincing evidence that UK electricity generation and transmission workers have suffered increased risks from neurodegenerative diseases as a consequence of exposure to magnetic fields.

A case-control study of occupational magnetic field exposure and Alzheimer's disease: results from the California Alzheimer's Disease Diagnosis and Treatment Centers

BACKGROUND

A few studies have investigated a possible relationship between Alzheimer's disease (AD) and occupations with extremely low frequency magnetic field (MF) exposure. The purpose of this study was to further evaluate this possible association in a large patient population with expert diagnoses.

METHODS

Subjects came from the 8 of the 9 California Alzheimer's Disease Diagnostic and Treatment Centers not previously used in an earlier study. Cases had probable or definite AD; controls primarily had a dementia-related problem other than vascular dementia (VaD) and some were not demented upon expert examination. Occupations were classified as having low, medium or high MF exposure, based upon previous research, replicating the exposure methodology used in our previous published studies.

RESULTS

Occupational information was available for 98.6% of the 1527 cases and 98.5% of the 404 controls with age-at-initial examination known to be at least 65. Among cases, 2.1% and 5.4% had high and medium occupational MF exposure, respectively, while among controls the percentages were 0.8% and 3.0%. In univariate analyses, the odds ratio (OR) for subjects with medium or high MF exposures combined was 2.1 (p < 0.01), while for high exposure alone the OR was 2.9 (p < 0.08). Two models were used in multivariate analyses, with gender, stroke, and either age-at-onset or age-at-initial examination as covariates. The ORs for MF exposure varied little between the two models: 2.2 (p < 0.02) and 1.9 (p < 0.03) for medium or high exposure; 2.7 (p < 0.11) and 3.2 (p < 0.12) for high exposure. OR estimates for females were higher than for males, but not significantly higher. There were no material differences between the ORs resulting from univariate and multivariate analyses.

CONCLUSION

Elevated occupational MF exposure was associated with an increased risk of AD. Based on previous published studies, the results likely pertain to the general population.

Fifty Hertz electromagnetic field exposure stimulates secretion of beta-amyloid peptide in cultured human neuroglioma

Recent epidemiological studies raise the possibility that individuals with occupational exposure to low frequency (50-60 Hz) electromagnetic fields (LF-EMF), are at increased risk of Alzheimer's disease (AD). However, the mechanisms through which LF-EMF may affect AD pathology are unknown. We here tested the hypothesis that the exposure to LF-EMF may affect amyloidogenic processes. We examined the effect of exposure to 3.1 mT 50 Hz LF-EMF on Abeta secretion in H4 neuroglioma cells stably overexpressing human mutant amyloid precursor protein. We found that overnight exposure to LF-EMF induces a significant increase of amyloid-beta peptide (Abeta) secretion, including the isoform Abeta 1-42, without affecting cell survival. These findings show for the first time that exposure to LF-EMF stimulates Abeta secretion in vitro, thus alluding to a potential link between LF-EMF exposure and APP processing in the brain.

Gene expression profiling of human endothelial cells exposed to 50-Hz magnetic fields fails to produce regulated candidate genes

To address the question of a possible effect of magnetic fields (MF) at 50 Hz on living systems, gene expression analyses were performed on human primary vascular endothelial cells exposed to MF of various intensities compared to control cells. Exposure protocols included continuous exposure at a single intensity (10 and 700 microT), intermittent exposure at a single intensity (700 microT), and continuous exposure to a variable-intensity field (10-30 microT). The transcriptional response of the cells was investigated using oligonucleotide microarrays containing up to 30 000 unique features. Although in individual experiments genes were identified where the expression appeared to be affected by exposure to MF, none of these genes were regulated in the same manner in subsequent repetition experiments. This is the first report of a transcriptome-wide analysis of the effects of MF exposure on human cells. The lack of a reproducible effect of MF on the expression of any genes in our investigation adds further weight to the evidence that 50-Hz MF are not capable of interacting with biological systems and thus do not represent an endothelial stress factor.

Occupational exposure to low frequency magnetic fields and dementia: a case-control study

BACKGROUND

Several studies point to a potential aetiological relevance to dementia of exposure to low-frequency magnetic fields, but the evidence is inconclusive.

OBJECTIVE

To further examine the relationship between low frequency magnetic fields and dementia.

METHODS

From 23 general practices, 195 patients with dementia were recruited. Of these, 108 had possible Alzheimer's disease, 59 had possible vascular dementia and 28 had secondary or unclassified dementia. A total of 229 controls were recruited: 122 population controls and 107 ambulatory patients free from dementia. Data were gathered in a structured personal interview; in cases, the interview was administered to the next of kin. Exposure to low-frequency electromagnetic fields was assessed by expert rating. To identify occupations suspected to be associated with dementia, major occupations were a priori formed. Odds ratios were calculated using logistic regression, to control for age, region, sex, dementia in parents and smoking.

RESULTS

Exposure to magnetic fields was not significantly associated with dementia; restriction of the analysis to cases with possible Alzheimer's disease or possible vascular dementia did not lead to statistically significant results. We found an increased risk of dementia in blue-collar occupations (electrical and electronics workers, metal workers, construction workers, food and beverage processors and labourers).

CONCLUSIONS

Our study does not support a strong association between occupational exposure to low-frequency magnetic fields and dementia. Further studies should consider the relationship between blue-collar work and the late development of dementia.

Extremely low-frequency electromagnetic field (ELF-EMF) does not affect the expression of α3, α5 and α7 nicotinic receptor subunit genes in SH-SY5Y neuroblastoma cell line

Neuronal nicotinic acetylcholine receptors (nAChRs) are involved in a number of functional processes, including cognition, learning and memory, and alterations in their expression and/or activity have been implicated in various neurological disorders such as Alzheimer's disease (AD), Parkinson's disease and schizophrenia. Epidemiological studies have shown that exposure to electromagnetic fields (EMF) may contribute to the pathogenesis of neurodegenerative diseases such as Alzheimer's disease. Given the role of nAChRs in physiological and pathological conditions, we wondered whether an extremely low-frequency electromagnetic field (ELF-EMF) may affect the expression of the molecules involved in neurodegenerative processes. In order to investigate this possibility, we studied the expression of alpha3, alpha5 and alpha7 nicotinic subunits upon exposure of the SH-SY5Y human neuroblastoma cell line to a 50 Hz power-line magnetic field in a "blind trial" system; various magnetic flux densities and exposure times were applied. Our studies show that the expression of some relevant components of the cholinergic nicotinic system, which is one of the most affected neurotransmission systems in AD, did not undergo any change at molecular level by environmental exposure to ELF-EMF.

Neurodegenerative diseases: an overview of environmental risk factors

The population of the United States is aging, and an ever-increasing number of Americans are afflicted with neurodegenerative diseases. Because the pathogenesis of many of these diseases remains unknown, we must consider that environmental factors may play a causal role. This review provides an overview of the epidemiologic evidence for environmental etiologies for neurodegenerative diseases such as Alzheimer disease, Parkinson disease, parkinsonian syndromes (multiple system atrophy and progressive supranuclear palsy), and amyotrophic lateral sclerosis. Epidemiologic evidence for an association between environmental agents' exposure and neurodegenerative diseases is not conclusive. However, there are indications that there may be causal links, and the need for more research is obvious.

Potential occupational risks for neurodegenerative diseases

BACKGROUND

Associations between occupations and neurodegenerative diseases (NDD) may be discernable in death certificate data.

METHODS

Hypotheses generated from 1982 to 1991 study were tested in data from 22 states for the years 1992-1998. Specific occupations and exposures to pesticides, solvents, oxidative stressors, magnetic fields, and welding fumes were evaluated.

RESULTS

About one third (26/87) of the occupations hypothesized with neurodegenerative associations had statistically significant elevated mortality odds ratios (MOR) for the same outcome. Occupations with the largest MORs were (a) for presenile dementia (PSD)-dentists, graders/sorters (non-agricultural), and clergy; (b) for Alzheimer's disease (AD)-bank tellers, clergy, aircraft mechanics, and hairdressers; (c) for Parkinson's disease (PD)-biological scientists, clergy, religious workers, and post-secondary teachers; and (d) for motor neuron disease (MND)-veterinarians, hairdressers, and graders and sorters (non-agricultural). Teachers had significantly elevated MORs for all four diseases, and hairdressers for three of the four. Non-horticultural farmers below age 65 had elevated PD (MOR = 2.23, 95% CI = 1.47-3.26), PSD (MOR = 2.22, 95% CI = 1.10-4.05), and AD (MOR = 1.76, 95% CI = 1.04-2.81). Sixty hertz magnetic fields exhibited significant exposure-response for AD and, below age 65, for PD (MOR = 1.87, 95% CI = 1.14-2.98) and MND (MOR = 1.63, 95% CI = 1.10-2.39). Welding had elevated PD mortality below age 65 (MOR = 1.77, 95% CI = 1.08-2.75).

CONCLUSIONS

Support was observed for hypothesized excess neurodegenerative disease associated with a variety of occupations, 60 Hz magnetic fields and welding.

The effects of electromagnetic fields from power lines on avian reproductive biology and physiology: a review

Electrical power lines are ubiquitous in the developed world and in urban areas of the developing world. All electrical currents, including those running through power lines, generate electric and magnetic fields (EMFs). Electrical power lines, towers,and distribution poles are used by birds for perching, hunting, and nesting. Therefore, many bird species, like humans, are exposed to EMFs throughout their lives. EMFs have been implicated in adversely affecting multiple facets of human health,including increasing the risks of life-threatening illnesses such as leukemia, brain cancer, amyotrophic lateral sclerosis, clinical depression, suicide, and Alzheimer's disease. A great deal of research and controversy exists as to whether or not exposure to EMFs affects the cellular, endocrine, immune, and reproductive systems of vertebrates. Laboratory work has used mice, rats, and chickens as models for this EMF research in an effort to understand better the possible implications of EMF exposure for humans. However, EMF exposure of wild birds may also provide insight into the impacts of EMFs on human health. This review focuses on research examining the effects of EMFs on birds; most studies indicate that EMF exposure of birds generally changes, but not always consistently in effect or in direction, their behavior, reproductive success, growth and development, physiology and endocrinology, and oxidative stress under EMF conditions. Some of this work has involved birds under aviary conditions, while other research has focused on free-ranging birds exposed to EMFs. Finally, a number of future research directions are discussed that may help to provide a better understanding of EMF effects on vertebrate health and conservation.

Occupational exposure to electromagnetic fields and risk of Alzheimer's disease

BACKGROUND

Extremely-low-frequency magnetic field (ELF-MF) exposure is suspected to increase the risk of Alzheimer's disease. Such fields are present in the vicinity of electrical motors and other electric appliances containing coils.

METHODS

We investigated lifetime occupational ELF-MF exposure in relation to Alzheimer's disease and dementia among a community dementia-free cohort (n = 931) age 75 years and older in Stockholm, Sweden. This cohort was followed from 1987-1989 until 1994-1996 to detect dementia cases (Diagnostic and Statistical Manual of Mental Disorders, revised 3rd edition criteria). Information on lifetime job history was obtained by interview, usually of next of kin. ELF-MF exposure was assessed using a job-exposure matrix, measurement on historical equipment, and expert estimation. We analyzed the data with Cox models controlling for potential confounders.

RESULTS

Dementia was diagnosed in 265 subjects, including 202 with Alzheimer's disease. Among men, ELF-MF exposure > or=0.2 microT in lifetime principal job was related to multivariate-adjusted relative risks of 2.3 (95% CI = 1.0-5.1) for Alzheimer's disease and 2.0 (1.1-3.7) for dementia. We found no association among women. A similar sex-specific pattern was seen for the associations with average ELF-MF exposure throughout the work life. A dose-response relation was suggested in men, with multivariate-adjusted relative risks of 2.4 (0.8-6.8) for Alzheimer's disease and 2.5 (1.1-5.6) for dementia for the upper tertile of lifetime average exposure.

CONCLUSIONS

Long-term occupational exposure to a higher ELF-MF level may increase the risk of Alzheimer's disease and dementia in men. Similar patterns were not seen in women, which may in part be the result of a greater exposure misclassification in women than in men.

Expression levels of heat shock protein 60 in human endothelial cells in vitro are unaffected by exposure to 50 Hz magnetic fields

Magnetic fields (MFs) from domestic power sources have been implicated as being a potential risk to human health. A number of epidemiological studies have found a significant link between exposure to MFs and increased rates of cancers. There have also been a number of in vivo and in vitro studies reporting effects of MFs in animal disease models and on the expression or activity of a range of proteins. In the past decade, our group proposed that atherosclerosis may have an autoimmune component, with heat shock protein 60 (Hsp60) expressed in endothelial cells as the dominant autoantigen. A number of stressors have been shown to induce the expression of Hsp60, including the classical risk factors for atherosclerosis. We were interested to see if the exposure of endothelial cells to an MF elicited increased expression of Hsp60, as has been reported previously for Hsp70. The present work describes the exposure of endothelial cells to domestic power supply (50 Hz) MFs at an intensity of 700 microT. The results from our system indicate that cultured endothelial cells exposed to a high intensity of MF either alone or in combination with classical heat stress show no effects on the expression of Hsp60 at either the messenger ribonucleic acid or the protein level. As such, there is no evidence that exposure to extremely low-frequency MF would be expected to increase the expression of Hsp60 and therefore the initiation or progression of atherosclerosis.

Alzheimer’s Disease and Vascular Dementia

This chapter explores the frequency with which dementing illnesses occur in populations, their distributions by personal characteristics, and what is known about their causes and potential protective factors. The primary focus is on the most common forms of dementia: Alzheimer's disease and vascular dementia. The chapter summarizes clinical and pathologic features of Alzheimer's disease and vascular dementia, and highlights recent theories of how risk factors affect brain reserve. With the evolution of the epidemiology of dementia from case-control studies to prospective cohort studies has come a new set of methodological challenges. These include identification of representative populations, enhancing subject participation and retention in studies, the need to include institutionalized as well as community-dwelling populations, the non-standardized use of cognitive tests to screen for dementia, and the complexities of the diagnostic process itself. Finally, the chapter summarizes risk and protective factors for disease expression, including cardiovascular risk factors, lifestyle factors, and factors that affect brain reserve.

Occupational magnetic field exposures of garment workers: results of personal and survey measurements

To explore the feasibility of performing an epidemiologic study of female breast cancer and magnetic field (MF) exposures, we chose to study garment workers, who reportedly have some of the highest MF exposures. We collected personal exposure (PE, n = 48) and survey measurements (n = 77) near commercial sewing machines at three garment facilities and conducted a pilot interview among 25 garment workers asking about exposure duration, activities, and machine characteristics. MF levels were higher for older machines with alternating current (AC) than newer machines with direct current (DC) motors. MF levels were comparable for both idling and sewing activities. Most interviewed workers could describe duration of exposure and machine type (automatic/manual), but not other machine characteristics. Measurements were lower than previously reported for garment workers but were higher than exposures to most women. A historical exposure assessment can be conducted by linking duration of exposure with reconstructed exposure measurements but may be limited by the accuracy of work history data.

Risk Factors for Alzheimer Disease: A Population-Based Case-Control Study in Istanbul, Turkey

The objective is to study risk factors for Alzheimer disease (AD) in Istanbul, Turkey. This is a population-based case-control study. We screened people over age 70 in the community for cognitive impairment. The screen positives and a proportion of screen negatives underwent neurologic examination in the second phase. Cases were 57 "probable" AD patients and controls were 127 cognitively normal individuals identified by neurologic examination. Odds ratios (OR) were calculated using multivariate logistic regression analysis. Having a university/college degree had a protective effect on AD risk (OR = 0.10, 95% confidence interval [CI] = 0.02-0.50). Exposure to occupational electromagnetic field had an OR of 4.02 (95% CI = 1.02-15.78). Use of electricity for residential heating also showed elevated risk (OR = 2.77, 95% CI = 1.12-6.85). Our results suggest that having a higher education is protective from AD and that electromagnetic field exposure at work or at home is a significant risk factor.

Neurodegenerative diseases in welders and other workers exposed to high levels of magnetic fields

BACKGROUND

Previous work has suggested an increase in risk of amyotrophic lateral sclerosis (ALS) and Alzheimer's disease among workers exposed to extremely low-frequency magnetic fields (ELF-MF). We evaluated the relation between ELF-MF from occupational exposures and mortality from neurodegenerative diseases.

METHODS

The study was based on a cohort of Swedish engineering industry workers, comprising 537,692 men and 180,529 women. The cohort was matched against the 3 most recent censuses and The Causes of Death Registry. Levels of ELF-MF exposure were obtained by linking occupation according to the censuses to a job exposure matrix. We used 4 levels of exposure and considered both the primary and contributing causes of death, 1985-96.

RESULTS

The risk of Alzheimer's disease as primary or contributing cause of death increased with increasing exposure to ELF-MF among both men and women, with a relative risk (RR) of 4.0 and a 95% confidence interval (95% CI) of 1.4-11.7 in the highest exposure group for both sexes combined. There was a RR of 2.2 (95% CI: 1.0-4.7) for ALS in the highest exposure group with the suggestion of an exposure-response relationship. No evidence of increased risk was seen for Parkinson's disease or multiple sclerosis.

CONCLUSIONS

The findings support previous observations of an increased risk of Alzheimer's disease and ALS among employees occupationally exposed to ELF-MF. Further studies based on morbidity data are warranted.