Mobile phones, brain tumors, and the interphone study: where are we now?

Use of multimedia devices in pediatric age: risks or advantages? A survey in an Italian center

BACKGROUND

Nowadays children live in a digital world, exposed to relevant risks for their health and safety. The aim of this study is to investigate the use of multimedia devices in a sample of children and adolescents.

METHODS

The study was performed between November 2018 and June 2019 in a third-level University Hospital, recruiting children and adolescents during general or specialistic follow-up visits. Anonymous, age-specific, questionnaires were distributed to 500 children and adolescents and 370 parents.

RESULTS

Among children, 25 (17.1%) had their own mobile device, of which 84% Italian. The 54.1% of them uses multimedia devices half an hour/an hour per day and many of them (37.5% of Italian and 40% of foreign) use it without their parents' control. Most of adolescents had a mobile phone since the age of 10-12 years old. WhatsApp (Meta Inc., Cambridge, MA, USA) is the most used social network, followed by Instagram and Facebook. The use of multimedia devices was widespread between teenagers during classroom hours, meals and before sleeping and they are an important mean for cyberbullying. In addition, in the 29.9% of cases there is no correspondence between information given by parents and respective sons/daughters.

CONCLUSIONS

This study shows more risks than advantages derived from the use of multimedia devices in children and adolescents. Therefore, it is essential to educate them about their correct and responsible use.

Health Scares: Tracing Their Nature, Growth and Spread

Background

Health scares are highly publicised threats to health that increase public concern and protective behaviours but are later shown to be unfounded. Although health scares have become more common in recent times, they have received very little research attention. This is despite the fact that health scares often have negative outcomes for individuals and community by affecting health behaviours and causing high levels of often unnecessary anxiety.

Method

In this paper we undertook a review and analysis of the major types of health scares as well as the background factors associated with health scares and their spread.

Results

We found most health scares fell into seven main categories; environmental contaminants, food, malicious incidents, medical treatments, public health interventions, radiation from technology and exotic diseases. For most health scares there are important background factors and incident characteristics that affect how they develop. Background factors include conspiracy theories, trust in governmental agencies, anxiety, modern health worries and wariness of chemicals. Incident characteristic include being newly developed, not understood or unseen, man-made rather than natural and whether the incident is out of personal control. We also identified the aspects of traditional and social media that exacerbate the rapid spread of health scares.

Conclusion

More research is needed to identify the characteristics of media stories that intensify the levels of public concern. Guidelines around the media's reporting of health incidents and potential health threats may be necessary in order to reduce levels of public anxiety and the negative public health impact of health scares.

Challenges on the effect of cell phone radiation on mammalian embryos and fetuses: a review of the literature

Cell phones operate with a wide range of frequency bands and emit radiofrequency-electromagnetic radiation (RF-EMR). Concern on the possible health hazards of RF-EMR has been growing in many countries because these RF-EMR pulses may be absorbed into the body cells, directly affecting them. There are some in vitro and in vivo animal studies related to the consequences of RF-EMR exposure from cell phones on embryo development and offspring. In addition, some studies have revealed that RF-EMR from cellular phone may lead to decrease in the rates of fertilization and embryo development, as well as the risk of the developmental anomalies, other studies have reported that it does not interfere with in vitro fertilization or intracytoplasmic sperm injection success rates, or the chromosomal aberration rate. Of course, it is unethical to study the effect of waves generated from cell phones on the forming human embryos. Conversely, other mammals have many similarities to humans in terms of anatomy, physiology and genetics. Therefore, in this review we focused on the existing literature evaluating the potential effects of RF-EMR on mammalian embryonic and fetal development.

Risk factors for childhood and adult primary brain tumors

Primary brain tumors account for ~1% of new cancer cases and ~2% of cancer deaths in the United States; however, they are the most commonly occurring solid tumors in children. These tumors are very heterogeneous and can be broadly classified into malignant and benign (or non-malignant), and specific histologies vary in frequency by age, sex, and race/ethnicity. Epidemiological studies have explored numerous potential risk factors, and thus far the only validated associations for brain tumors are ionizing radiation (which increases risk in both adults and children) and history of allergies (which decreases risk in adults). Studies of genetic risk factors have identified 32 germline variants associated with increased risk for these tumors in adults (25 in glioma, 2 in meningioma, 3 in pituitary adenoma, and 2 in primary CNS lymphoma), and further studies are currently under way for other histologic subtypes, as well as for various childhood brain tumors. While identifying risk factors for these tumors is difficult due to their rarity, many existing datasets can be leveraged for future discoveries in multi-institutional collaborations. Many institutions are continuing to develop large clinical databases including pre-diagnostic risk factor data, and developments in molecular characterization of tumor subtypes continue to allow for investigation of more refined phenotypes. Key Point 1. Brain tumors are a heterogeneous group of tumors that vary significantly in incidence by age, sex, and race/ethnicity.2. The only well-validated risk factors for brain tumors are ionizing radiation (which increases risk in adults and children) and history of allergies (which decreases risk).3. Genome-wide association studies have identified 32 histology-specific inherited genetic variants associated with increased risk of these tumors.

Supervised Machine Learning Algorithms for Bioelectromagnetics: Prediction Models and Feature Selection Techniques Using Data from Weak Radiofrequency Radiation Effect on Human and Animals Cells

The emergence of new technologies to incorporate and analyze data with high-performance computing has expanded our capability to accurately predict any incident. Supervised Machine learning (ML) can be utilized for a fast and consistent prediction, and to obtain the underlying pattern of the data better. We develop a prediction strategy, for the first time, using supervised ML to observe the possible impact of weak radiofrequency electromagnetic field (RF-EMF) on human and animal cells without performing in-vitro laboratory experiments. We extracted laboratory experimental data from 300 peer-reviewed scientific publications (1990-2015) describing 1127 experimental case studies of human and animal cells response to RF-EMF. We used domain knowledge, Principal Component Analysis (PCA), and the Chi-squared feature selection techniques to select six optimal features for computation and cost-efficiency. We then develop grouping or clustering strategies to allocate these selected features into five different laboratory experiment scenarios. The dataset has been tested with ten different classifiers, and the outputs are estimated using the k-fold cross-validation method. The assessment of a classifier's prediction performance is critical for assessing its suitability. Hence, a detailed comparison of the percentage of the model accuracy (PCC), Root Mean Squared Error (RMSE), precision, sensitivity (recall), 1 - specificity, Area under the ROC Curve (AUC), and precision-recall (PRC Area) for each classification method were observed. Our findings suggest that the Random Forest algorithm exceeds in all groups in terms of all performance measures and shows AUC = 0.903 where k-fold = 60. A robust correlation was observed in the specific absorption rate (SAR) with frequency and cumulative effect or exposure time with SAR×time (impact of accumulated SAR within the exposure time) of RF-EMF. In contrast, the relationship between frequency and exposure time was not significant. In future, with more experimental data, the sample size can be increased, leading to more accurate work.

A meta-analysis of in vitro exposures to weak radiofrequency radiation exposure from mobile phones (1990-2015)

To function, mobile phone systems require transmitters that emit and receive radiofrequency signals over an extended geographical area exposing humans in all stages of development ranging from in-utero, early childhood, adolescents and adults. This study evaluates the question of the impact of radiofrequency radiation on living organisms in vitro studies. In this study, we abstract data from 300 peer-reviewed scientific publications (1990-2015) describing 1127 experimental observations in cell-based in vitro models. Our first analysis of these data found that out of 746 human cell experiments, 45.3% indicated cell changes, whereas 54.7% indicated no changes (p = 0.001). Realizing that there are profound distinctions between cell types in terms of age, rate of proliferation and apoptosis, and other characteristics and that RF signals can be characterized in terms of polarity, information content, frequency, Specific Absorption Rate (SAR) and power, we further refined our analysis to determine if there were some distinct properties of negative and positive findings associated with these specific characteristics. We further analyzed the data taking into account the cumulative effect (SAR × exposure time) to acquire the cumulative energy absorption of experiments due to radiofrequency exposure, which we believe, has not been fully considered previously. When the frequency of signals, length and type of exposure, and maturity, rate of growth (doubling time), apoptosis and other properties of individual cell types are considered, our results identify a number of potential non-thermal effects of radiofrequency fields that are restricted to a subset of specific faster-growing less differentiated cell types such as human spermatozoa (based on 19 reported experiments, p-value = 0.002) and human epithelial cells (based on 89 reported experiments, p-value < 0.0001). In contrast, for mature, differentiated adult cells of Glia (p = 0.001) and Glioblastoma (p < 0.0001) and adult human blood lymphocytes (p < 0.0001) there are no statistically significant differences for these more slowly reproducing cell lines. Thus, we show that RF induces significant changes in human cells (45.3%), and in faster-growing rat/mouse cell dataset (47.3%). In parallel with this finding, further analysis of faster-growing cells from other species (chicken, rabbit, pig, frog, snail) indicates that most undergo significant changes (74.4%) when exposed to RF. This study confirms observations from the REFLEX project, Belyaev and others that cellular response varies with signal properties. We concur that differentiation of cell type thus constitutes a critical piece of information and should be useful as a reference for many researchers planning additional studies. Sponsorship bias is also a factor that we did not take into account in this analysis.

Possible Effects of Radiofrequency Electromagnetic Field Exposure on Central Nerve System

Technological advances of mankind, through the development of electrical and communication technologies, have resulted in the exposure to artificial electromagnetic fields (EMF). Technological growth is expected to continue; as such, the amount of EMF exposure will continue to increase steadily. In particular, the use-time of smart phones, that have become a necessity for modern people, is steadily increasing. Social concerns and interest in the impact on the cranial nervous system are increased when considering the area where the mobile phone is used. However, before discussing possible effects of radiofrequency-electromagnetic field (RF-EMF) on the human body, several factors must be investigated about the influence of EMFs at the level of research using in vitro or animal models. Scientific studies on the mechanism of biological effects are also required. It has been found that RF-EMF can induce changes in central nervous system nerve cells, including neuronal cell apoptosis, changes in the function of the nerve myelin and ion channels; furthermore, RF-EMF act as a stress source in living creatures. The possible biological effects of RF-EMF exposure have not yet been proven, and there are insufficient data on biological hazards to provide a clear answer to possible health risks. Therefore, it is necessary to study the biological response to RF-EMF in consideration of the comprehensive exposure with regard to the use of various devices by individuals. In this review, we summarize the possible biological effects of RF-EMF exposure.

Epidemiology and Molecular Epidemiology

Incidence, prevalence, and survival for diffuse low-grade gliomas and diffuse anaplastic gliomas (including grade II and grade III astrocytomas and oligodendrogliomas) varies by histologic type, age at diagnosis, sex, and race/ethnicity. Significant progress has been made in identifying potential risk factors for glioma, although more research is warranted. The strongest risk factors that have been identified thus far include allergies/atopic disease, ionizing radiation, and heritable genetic factors. Further analysis of large, multicenter epidemiologic studies, and well-annotated "omic" datasets, can potentially lead to further understanding of the relationship between gene and environment in the process of brain tumor development.

Trends and patterns of incidence of diffuse glioma in adults in the United States, 1973-2014

INTRODUCTION

The objective of the study was to identify trends in incidence of adult diffuse gliomas in the United States and evaluate the contribution of age, period, and cohort effects to the trends.

METHODS

Using the Surveillance, Epidemiology, and End Results 9 database, primary diffuse glioma patients (≥20 years old) diagnosed from 1973 to 2014 were identified. Incidence trends were analyzed using joinpoint regression and age-period-cohort modeling.

RESULTS

Overall, the incidence for adult glioma decreased slowly from 1985 to 2014 (annual percent change [APC] = 0.5%, 95% confidence intervals [CI], 0.3%-0.6%). In histology subtype-stratified analysis, glioblastoma and nonglioblastoma exhibited opposite trends. The incidence for glioblastoma increased from 1978 to 2014 (APC for year 1978-1992 = 2.7%, 95% CI, 1.8%-3.6%; APC for 1992-2014 = 0.3%, 95% CI, 0%-0.6%), while the incidence for nonglioblastoma decreased significantly from 1982 to 2014 (APC = 2.2%, 95% CI, 2.0%-2.5%). Age-period-cohort modeling revealed significant period and cohort effects, with the patterns for glioblastoma and nonglioblastoma distinctive from each other. Compared with adults born 1890s, those born 1920s had approximately 4-fold the risk of glioblastoma after adjustment of age and period effects, while the risk of nonglioblastoma was reduced by half in individuals in the 1939 cohort as compared with those in the 1909 cohort.

CONCLUSIONS

The results support the hypothesis of etiological heterogeneity of diffuse gliomas by histology subtypes. The established risk factors cannot fully explain the distinct patterns by histology subtypes, which necessitate further epidemiological studies.

Epidemiology of Brain Tumors

Incidence, prevalence, and survival for brain tumors varies by histologic type, age at diagnosis, sex, and race/ethnicity. Significant progress has been made in identifying potential risk factors for brain tumors, although more research is warranted. The strongest risk factors that have been identified thus far include allergies/atopic disease, ionizing radiation, and heritable genetic factors. Further analysis of large, multicenter, epidemiologic studies, as well as well annotated omic datasets (including genomic, epigenomic, transcriptomic, proteomic, or metabolomics data) can potentially lead to further understanding of the relationship between gene and environment in the process of brain tumor development.

Estimates of Environmental Exposure to Radiofrequency Electromagnetic Fields and Risk of Lymphoma Subtypes

We investigated the association between environmental exposure to radiofrequency electromagnetic fields (RF-EMF) and risk of lymphoma subtypes in a case-control study comprised of 322 patients and 444 individuals serving as controls in Sardinia, Italy in 1998-2004. Questionnaire information included the self-reported distance of the three longest held residential addresses from fixed radio-television transmitters and mobile phone base stations. We georeferenced the residential addresses of all study subjects and obtained the spatial coordinates of mobile phone base stations. For each address within a 500-meter radius from a mobile phone base station, we estimated the RF-EMF intensity using predictions from spatial models, and we performed RF-EMF measurements at the door in the subset of the longest held addresses within a 250-meter radius. We calculated risk of lymphoma and its major subtypes associated with the RF-EMF exposure metrics with unconditional logistic regression, adjusting by age, gender and years of education. In the analysis of self-reported data, risk associated with residence in proximity (within 50 meters) to fixed radio-television transmitters was likewise elevated for lymphoma overall [odds ratio = 2.7, 95% confidence interval = 1.5-4.6], and for the major lymphoma subtypes. With reference to mobile phone base stations, we did not observe an association with either the self-reported, or the geocoded distance from mobile phone base stations. RF-EMF measurements did not vary by case-control status. By comparing the self-reports to the geocoded data, we discovered that the cases tended to underestimate the distance from mobile phone base stations differentially from the controls ( P = 0.073). The interpretation of our findings is compromised by the limited study size, particularly in the analysis of the individual lymphoma subtypes, and the unavailability of the spatial coordinates of radio-television transmitters. Nonetheless, our results do not support the hypothesis of a link between environmental exposure to RF-EMF from mobile phone base stations and risk of lymphoma subtypes.

An international prospective cohort study of mobile phone users and health (COSMOS): Factors affecting validity of self-reported mobile phone use

This study investigates validity of self-reported mobile phone use in a subset of 75 993 adults from the COSMOS cohort study. Agreement between self-reported and operator-derived mobile call frequency and duration for a 3-month period was assessed using Cohen's weighted Kappa (κ). Sensitivity and specificity of both self-reported high (≥10 calls/day or ≥4h/week) and low (≤6 calls/week or <30min/week) mobile phone use were calculated, as compared to operator data. For users of one mobile phone, agreement was fair for call frequency (κ=0.35, 95% CI: 0.35, 0.36) and moderate for call duration (κ=0.50, 95% CI: 0.49, 0.50). Self-reported low call frequency and duration demonstrated high sensitivity (87% and 76% respectively), but for high call frequency and duration sensitivity was lower (38% and 56% respectively), reflecting a tendency for greater underestimation than overestimation. Validity of self-reported mobile phone use was lower in women, younger age groups and those reporting symptoms during/shortly after using a mobile phone. This study highlights the ongoing value of using self-report data to measure mobile phone use. Furthermore, compared to continuous scale estimates used by previous studies, categorical response options used in COSMOS appear to improve validity considerably, most likely by preventing unrealistically high estimates from being reported.

Maternal cell phone use in early pregnancy and child's language, communication and motor skills at 3 and 5 years: the Norwegian mother and child cohort study (MoBa)

Background

Cell phone use during pregnancy is a public health concern. We investigated the association between maternal cell phone use in pregnancy and child’s language, communication and motor skills at 3 and 5 years.

Methods

This prospective study includes 45,389 mother-child pairs, participants of the MoBa, recruited at mid-pregnancy from 1999 to 2008. Maternal frequency of cell phone use in early pregnancy and child language, communication and motor skills at 3 and 5 years, were assessed by questionnaires. Logistic regression was used to estimate the associations.

Results

No cell phone use in early pregnancy was reported by 9.8% of women, while 39%, 46.9% and 4.3% of the women were categorized as low, medium and high cell phone users. Children of cell phone user mothers had 17% (OR = 0.83, 95% CI: 0.77, 0.89) lower adjusted risk of having low sentence complexity at 3 years, compared to children of non-users. The risk was 13%, 22% and 29% lower by low, medium and high maternal cell phone use. Additionally, children of cell phone users had lower risk of low motor skills score at 3 years, compared to children of non-users, but this association was not found at 5 years. We found no association between maternal cell phone use and low communication skills.

Conclusions

We reported a decreased risk of low language and motor skills at three years in relation to prenatal cell phone use, which might be explained by enhanced maternal-child interaction among cell phone users. No evidence of adverse neurodevelopmental effects of prenatal cell phone use was reported.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4672-2) contains supplementary material, which is available to authorized users.

Effect of Cell Phone Radiations on Orofacial Structures: A Systematic Review

INTRODUCTION

The widespread use of cell phone in recent years has raised many questions whether their use is safe to operator who is exposed to Electromagnetic Waves (EMV).

AIM

To find out the effect of cell phone emitted radiations on the orofacial structures.

MATERIALS AND METHODS

To identify suitable literature, an electronic search was performed using Medline, Pubmed and EBSCO host database in December 2016. The search was focused on effect of cell phone on orofacial structures. Among the literature available in English, the screening of the related titles and abstracts was done, and only those articles were selected for full text reading that fulfilled the inclusion criteria.

RESULTS

The initial literature search resulted in 360 articles out of which only 24 articles fulfilled the inclusion criteria and were included in this systematic review.

CONCLUSION

Cell phone emitted radiations had their adverse effect on salivary glands and facial nerves. Studies showed that cell phone emitted radiations had effects on oral mucosal cells and causes changes in salivary flow rate. It was still unclear that cell phone radiations cause tumours of the salivary glands.

ELF exposure from mobile and cordless phones for the epidemiological MOBI-Kids study

This paper describes measurements and computational modelling carried out in the MOBI-Kids case-control study to assess the extremely low frequency (ELF) exposure of the brain from use of mobile and cordless phones. Four different communication systems were investigated: Global System for Mobile (GSM), Universal Mobile Telecommunications System (UMTS), Digital Enhanced Cordless Telecommunications (DECT) and Wi-Fi Voice over Internet Protocol (VoIP). The magnetic fields produced by the phones during transmission were measured under controlled laboratory conditions, and an equivalent loop was fitted to the data to produce three-dimensional extrapolations of the field. Computational modelling was then used to calculate the induced current density and electric field strength in the brain resulting from exposure to these magnetic fields. Human voxel phantoms of four different ages were used: 8, 11, 14 and adult. The results indicate that the current densities induced in the brain during DECT calls are likely to be an order of magnitude lower than those generated during GSM calls but over twice that during UMTS calls. The average current density during Wi-Fi VoIP calls was found to be lower than for UMTS by 30%, but the variability across the samples investigated was high. Spectral contributions were important to consider in relation to current density, particularly for DECT phones. This study suggests that the spatial distribution of the ELF induced current densities in brain tissues is determined by the physical characteristics of the phone (in particular battery position) while the amplitude is mainly dependent on communication system, thus providing a feasible basis for assessing ELF exposure in the epidemiological study. The number of phantoms was not large enough to provide definitive evidence of an increase of induced current density with age, but the data that are available suggest that, if present, the effect is likely to be very small.

Evaluation of Mobile Phone and Cordless Phone Use and Glioma Risk Using the Bradford Hill Viewpoints from 1965 on Association or Causation

Objective. Bradford Hill's viewpoints from 1965 on association or causation were used on glioma risk and use of mobile or cordless phones. Methods. All nine viewpoints were evaluated based on epidemiology and laboratory studies. Results. Strength: meta-analysis of case-control studies gave odds ratio (OR) = 1.90, 95% confidence interval (CI) = 1.31-2.76 with highest cumulative exposure. Consistency: the risk increased with latency, meta-analysis gave in the 10+ years' latency group OR = 1.62, 95% CI = 1.20-2.19. Specificity: increased risk for glioma was in the temporal lobe. Using meningioma cases as comparison group still increased the risk. Temporality: highest risk was in the 20+ years' latency group, OR = 2.01, 95% CI =1.41-2.88, for wireless phones. Biological gradient: cumulative use of wireless phones increased the risk. Plausibility: animal studies showed an increased incidence of glioma and malignant schwannoma in rats exposed to radiofrequency (RF) radiation. There is increased production of reactive oxygen species (ROS) from RF radiation. Coherence: there is a change in the natural history of glioma and increasing incidence. Experiment: antioxidants reduced ROS production from RF radiation. Analogy: there is an increased risk in subjects exposed to extremely low-frequency electromagnetic fields. Conclusion. RF radiation should be regarded as a human carcinogen causing glioma.

The Intracranial Distribution of Gliomas in Relation to Exposure From Mobile Phones: Analyses From the INTERPHONE Study

When investigating the association between brain tumors and use of mobile telephones, accurate data on tumor position are essential, due to the highly localized absorption of energy in the human brain from the radio-frequency fields emitted. We used a point process model to investigate this association using information that included tumor localization data from the INTERPHONE Study (Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and the United Kingdom). Our main analysis included 792 regular mobile phone users diagnosed with a glioma between 2000 and 2004. Similar to earlier results, we found a statistically significant association between the intracranial distribution of gliomas and the self-reported location of the phone. When we accounted for the preferred side of the head not being exclusively used for all mobile phone calls, the results were similar. The association was independent of the cumulative call time and cumulative number of calls. However, our model used reported side of mobile phone use, which is potentially influenced by recall bias. The point process method provides an alternative to previously used epidemiologic research designs when one is including localization in the investigation of brain tumors and mobile phone use.

GSM 900 MHz Microwave Radiation-Induced Alterations of Insulin Level and Histopathological Changes of Liver and Pancreas in Rat

BACKGROUND

The rapidly increasing use of mobile phones has led to public concerns about possible health effects of these popular communication devices. This study is an attempt to investigate the effects of radiofrequency (RF) radiation produced by GSM mobile phones on the insulin release in rats.

METHODS

Forty two female adult Sprague Dawley rats were randomly divided into 4 groups. Group1 were exposed to RF radiation 6 hours per day for 7 days. Group 2 received sham exposure (6 hours per day for 7 days). Groups 3 and 4 received RF radiation 3 hours per day for 7 days and sham exposure (3 hours per day), respectively. The specific absorption rate (SAR) of RF was 2.0 W/kg.

RESULTS

Our results showed that RF radiations emitted from mobile phone could not alter insulin release in rats. However, mild to severe inflammatory changes in the portal spaces of the liver of rats as well as damage in the cells of islet of Langerhans were observed. These changes were linked with the duration of the exposures.

CONCLUSION

RF exposure can induce inflammatory changes in the liver as well causing damage in the cells of islet of Langerhans.

Review: Weak radiofrequency radiation exposure from mobile phone radiation on plants

AIM

The aim of this article was to explore the hypothesis that non-thermal, weak, radiofrequency electromagnetic fields (RF-EMF) have an effect on living plants.

SUBJECT AND METHODS

In this study, we performed an analysis of the data extracted from the 45 peer-reviewed scientific publications (1996-2016) describing 169 experimental observations to detect the physiological and morphological changes in plants due to the non-thermal RF-EMF effects from mobile phone radiation. Twenty-nine different species of plants were considered in this work.

RESULTS

Our analysis demonstrates that the data from a substantial amount of the studies on RF-EMFs from mobile phones show physiological and/or morphological effects (89.9%, p < 0.001). Additionally, our analysis of the results from these reported studies demonstrates that the maize, roselle, pea, fenugreek, duckweeds, tomato, onions and mungbean plants seem to be very sensitive to RF-EMFs. Our findings also suggest that plants seem to be more responsive to certain frequencies, especially the frequencies between (i) 800 and 1500 MHz (p < 0.0001), (ii) 1500 and 2400 MHz (p < 0.0001) and (iii) 3500 and 8000 MHz (p = 0.0161).

CONCLUSION

The available literature on the effect of RF-EMFs on plants to date observed the significant trend of radiofrequency radiation influence on plants. Hence, this study provides new evidence supporting our hypothesis. Nonetheless, this endorses the need for more experiments to observe the effects of RF-EMFs, especially for the longer exposure durations, using the whole organisms. The above observation agrees with our earlier study, in that it supported that it is not a well-grounded method to characterize biological effects without considering the exposure duration. Nevertheless, none of these findings can be directly associated with human; however, on the other hand, this cannot be excluded, as it can impact the human welfare and health, either directly or indirectly, due to their complexity and varied effects (calcium metabolism, stress proteins, etc.). This study should be useful as a reference for researchers conducting epidemiological studies and the long-term experiments, using whole organisms, to observe the effects of RF-EMFs.

Light and the City: Breast Cancer Risk Factors Differ Between Urban and Rural Women in Israel

Women are exposed to indoor and outdoor artificial light at night (ALAN) in urban and rural environments. Excessive exposure to hazardous ALAN containing short wavelength light may suppress pineal melatonin production and lead to an increased breast cancer (BC) risk. Our objective was to address the differences in BC risks related to light exposure in urban and rural communities. We examined indoor and outdoor light habits of BC patients and controls that had lived in urban and rural areas in a 5-year period, 10 to 15 years before the time of the study. Individual data, night time sleeping habits and individual exposure to ALAN habits were collected using a questionnaire. A total of 252 women (110 BC patients and 142 controls) participated in this study. The sample was divided to subgroups according to dwelling area and disease status. Age matching was completed between all subgroups. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated for urban and rural women separately, using binary logistic regression. OR results of urban population (92 BC patients and 72 control) revealed that BC risk increases with daily use of cellphone (OR = 2.13, 95% CI = 1.01-4.49, P < .05) and residence near strong ALAN sources (OR = 1.51, 95% CI = 0.99-2.30, P < .06). Nevertheless, BC risk decreases if a woman was born in Israel (OR = 0.44, 95% CI = 0.21-0.93, P < .03), longer sleep duration (OR = 0.75, 95% CI = 0.53-1.05, P < .1), and reading with bed light illumination before retiring to sleep (OR = 0.77, 95% CI = 0.61-0.96, P < .02). Furthermore, in the rural population (18 BC patients and 66 control) BC risk increases with the number of years past since the last menstruation (OR = 1.12, 95% CI = 1.03-1.22, P < .01). However, BC risk decreases with longer sleep duration (OR = 0.53, 95% CI = 0.24-1.14, P < .1), reading with room light illumination before retiring to sleep (OR = 0.55, 95% CI = 0.29-1.06, P < .07), and sleeping with closed shutters during the night (OR = 0.66, 95% CI = 0.41-1.04, P < .08). These data support the idea that indoor and outdoor nighttime light exposures differ between urban and rural women. Therefore, we suggest that women can influence BC risk and incidence by applying protective personal lighting habits. Further studies with larger sample sizes are needed to strengthen the results.

Review of the Evidence that Transcranial Electromagnetic Treatment will be a Safe and Effective Therapeutic Against Alzheimer's Disease

We have demonstrated in multiple studies that daily, long-term electromagnetic field (EMF) treatment in the ultra-high frequency range not only protects Alzheimer's disease (AD) transgenic mice from cognitive impairment, but also reverses such impairment in aged AD mice. Moreover, these beneficial cognitive effects appear to be through direct actions on the AD process. Based on a large array of pre-clinical data, we have initiated a pilot clinical trial to determine the safety and efficacy of EMF treatment to mild-moderate AD subjects. Since it is important to establish the safety of this new neuromodulatory approach, the main purpose of this review is to provide a comprehensive assessment of evidence supporting the safety of EMFs, particularly through transcranial electromagnetic treatment (TEMT). In addition to our own pre-clinical studies, a rich variety of both animal and cell culture studies performed by others have underscored the anticipated safety of TEMT in clinical AD trials. Moreover, numerous clinical studies have determined that short- or long-term human exposure to EMFs similar to those to be provided clinically by TEMT do not have deleterious effects on general health, cognitive function, or a variety of physiologic measures-to the contrary, beneficial effects on brain function/activity have been reported. Importantly, such EMF exposure has not been shown to increase the risk of any type of cancer in human epidemiologic studies, as well as animal and cell culture studies. In view of all the above, clinical trials of safety/efficacy with TEMT to AD subjects are clearly warranted and now in progress.

Long-term exposure to electromagnetic radiation from mobile phones and Wi-Fi devices decreases plasma prolactin, progesterone, and estrogen levels but increases uterine oxidative stress in pregnant rats and their offspring

We investigated the effects of mobile phone (900 and 1800 MHz)- and Wi-Fi (2450 MHz)-induced electromagnetic radiation (EMR) exposure on uterine oxidative stress and plasma hormone levels in pregnant rats and their offspring. Thirty-two rats and their forty newborn offspring were divided into the following four groups according to the type of EMR exposure they were subjected to: the control, 900, 1800, and 2450 MHz groups. Each experimental group was exposed to EMR for 60 min/day during the pregnancy and growth periods. The pregnant rats were allowed to stand for four generations (total 52 weeks) before, plasma and uterine samples were obtained. During the 4th, 5th, and 6th weeks of the experiment, plasma and uterine samples were also obtained from the developing rats. Although uterine lipid peroxidation increased in the EMR groups, uterine glutathione peroxidase activity (4th and 5th weeks) and plasma prolactin levels (6th week) in developing rats decreased in these groups. In the maternal rats, the plasma prolactin, estrogen, and progesterone levels decreased in the EMR groups, while the plasma total oxidant status, and body temperatures increased. There were no changes in the levels of reduced glutathione, total antioxidants, or vitamins A, C, and E in the uterine and plasma samples of maternal rats. In conclusion, although EMR exposure decreased the prolactin, estrogen, and progesterone levels in the plasma of maternal rats and their offspring, EMR-induced oxidative stress in the uteri of maternal rats increased during the development of offspring. Mobile phone- and Wi-Fi-induced EMR may be one cause of increased oxidative uterine injury in growing rats and decreased hormone levels in maternal rats.

GRAPHICAL ABSTRACT

TRPV1 cation channels are the possible molecular pathways responsible for changes in the hormone, oxidative stress, and body temperature levels in the uterus of maternal rats following a year-long exposure to electromagnetic radiation exposure from mobile phones and Wi-Fi devices. It is likely that TRPV1-mediated Ca(2+) entry in the uterus of pregnant rats involves accumulation of oxidative stress and opening of mitochondrial membrane pores that consequently leads to mitochondrial dysfunction, substantial swelling of the mitochondria with rupture of the outer membrane and release of oxidants such as superoxide (O2 (-)) and hydrogen peroxide (H2O2). The superoxide radical is converted to H2O2 by superoxide dismutase (SOD) enzyme. Glutathione peroxidase (GSH-Px) is an important antioxidant enzyme for removing lipid hydroperoxides and hydrogen peroxide and it catalyzes the reduction of H2O2 to water.

Effect of cell phone-like electromagnetic radiation on primary human thyroid cells

PURPOSE

To evaluate the potential carcinogenic effects of radiofrequency energy (RFE) emitted by cell phones on human thyroid primary cells.

MATERIALS AND METHODS

Primary thyroid cell culture was prepared from normal thyroid tissue obtained from patients who underwent surgery at our department. Subconfluent thyroid cells were irradiated under different conditions inside a cell incubator using a device that simulates cell phone-RFE. Proliferation of control and irradiated cells was assessed by the immunohistochemical staining of antigen Kiel clone-67 (Ki-67) and tumor suppressor p53 (p53) expression. DNA ploidy and the stress biomarkers heat shock protein 70 (HSP70) and reactive oxygen species (ROS) was evaluated by fluorescence-activated cell sorting (FACS).

RESULTS

Our cells highly expressed thyroglobulin (Tg) and sodium-iodide symporter (NIS) confirming the origin of the tissue. None of the irradiation conditions evaluated here had an effect neither on the proliferation marker Ki-67 nor on p53 expression. DNA ploidy was also not affected by RFE, as well as the expression of the biomarkers HSP70 and ROS.

CONCLUSION

Our conditions of RFE exposure seem to have no potential carcinogenic effect on human thyroid cells. Moreover, common biomarkers usually associated to environmental stress also remained unchanged. We failed to find an association between cell phone-RFE and thyroid cancer. Additional studies are recommended.

Pituitary tumor risk in relation to mobile phone use: A case-control study

BACKGROUND

The number of mobile phone users has grown rapidly, which has generated mounting public concern regarding possible health hazards. This study aims to assess pituitary tumor risk, as it has rarely been investigated.

MATERIAL AND METHODS

A case-control study was conducted with 80 eligible cases identified from all five university hospitals in Finland and frequency-matched 240 controls from the national population register. Controls were matched to cases by age, sex, region of residence and date of interview. A detailed history of mobile phone use was obtained using a structured interview. Several indicators of mobile phone use were assessed using conditional logistic regression.

RESULTS

A reduced odds ratio was seen among regular mobile phone users [OR 0.39, 95% confidence interval (CI) 0.21, 0.72] relative to never/non-regular users, possibly reflecting methodological limitations. Pituitary tumor risk was not increased after 10 or more years since first use (OR 0.69, 95% CI 0.25, 1.89). The risk was not increased in relation to duration, cumulative hours of use, or cumulative number of calls. The results were similar for analog and digital phones.

CONCLUSIONS

We found no excess risk associated with self-reported short- or medium-term use of mobile phones. This is consistent with most of the published studies. However, uncertainties remained for longer duration of use, as a very small proportion of study participants reported use beyond 10 years.

Epidemiology of gliomas

Gliomas are the most common type of primary intracranial tumors. Some glioma subtypes cause significant mortality and morbidity that are disproportionate to their relatively rare incidence. A very small proportion of glioma cases can be attributed to inherited genetic disorders. Many potential risk factors for glioma have been studied to date, but few provide explanation for the number of brain tumors identified. The most significant of these factors includes increased risk due to exposure to ionizing radiation, and decreased risk with history of allergy or atopic disease. The potential effect of exposure to cellular phones has been studied extensively, but the results remain inconclusive. Recent genomic analyses, using the genome-wide association study (GWAS) design, have identified several inherited risk variants that are associated with increased glioma risk. The following chapter provides an overview of the current state of research in the epidemiology of intracranial glioma.

Validation of self-reported start year of mobile phone use in a Swedish case-control study on radiofrequency fields and acoustic neuroma risk

The possible effect of radiofrequency exposure from mobile phones on tumor risk has been studied since the late 1990s. Yet, empirical information about recall of the start of mobile phone use among adult cases and controls has never been reported. Limited knowledge about recall errors hampers interpretations of the epidemiological evidence. We used network operator data to validate the self-reported start year of mobile phone use in a case-control study of mobile phone use and acoustic neuroma risk. The answers of 96 (29%) cases and 111 (22%) controls could be included in the validation. The larger proportion of cases reflects a more complete and detailed reporting of subscription history. Misclassification was substantial, with large random errors, small systematic errors, and no significant differences between cases and controls. The average difference between self-reported and operator start year was -0.62 (95% confidence interval: -1.42, 0.17) years for cases and -0.71 (-1.50, 0.07) years for controls, standard deviations were 3.92 and 4.17 years, respectively. Agreement between self-reported and operator-recorded data categorized into short, intermediate and long-term use was moderate (kappa statistic: 0.42). Should an association exist, dilution of risk estimates and distortion of exposure-response patterns for time since first mobile phone use could result from the large random errors in self-reported start year. Retrospective collection of operator data likely leads to a selection of "good reporters", with a higher proportion of cases. Thus, differential recall cannot be entirely excluded.

Transcriptome analysis reveals the contribution of thermal and the specific effects in cellular response to millimeter wave exposure

Radiofrequency radiations constitute a new form of environmental pollution. Among them, millimeter waves (MMW) will be widely used in the near future for high speed communication systems. This study aimed therefore to evaluate the biocompatibility of MMW at 60 GHz. For this purpose, we used a whole gene expression approach to assess the effect of acute 60 GHz exposure on primary cultures of human keratinocytes. Controls were performed to dissociate the electromagnetic from the thermal effect of MMW. Microarray data were validated by RT-PCR, in order to ensure the reproducibility of the results. MMW exposure at 20 mW/cm², corresponding to the maximum incident power density authorized for public use (local exposure averaged over 1 cm²), led to an increase of temperature and to a strong modification of keratinocyte gene expression (665 genes differentially expressed). Nevertheless, when temperature is artificially maintained constant, no modification in gene expression was observed after MMW exposure. However, a heat shock control did not mimic exactly the MMW effect, suggesting a slight but specific electromagnetic effect under hyperthermia conditions (34 genes differentially expressed). By RT-PCR, we analyzed the time course of the transcriptomic response and 7 genes have been validated as differentially expressed: ADAMTS6, NOG, IL7R, FADD, JUNB, SNAI2 and HIST1H1A. Our data evidenced a specific electromagnetic effect of MMW, which is associated to the cellular response to hyperthermia. This study raises the question of co-exposures associating radiofrequencies and other environmental sources of cellular stress.

The MOBI-Kids Study Protocol: Challenges in Assessing Childhood and Adolescent Exposure to Electromagnetic Fields from Wireless Telecommunication Technologies and Possible Association with Brain Tumor Risk

The rapid increase in mobile phone use in young people has generated concern about possible health effects of exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF). MOBI-Kids, a multinational case-control study, investigates the potential effects of childhood and adolescent exposure to EMF from mobile communications technologies on brain tumor risk in 14 countries. The study, which aims to include approximately 1,000 brain tumor cases aged 10-24 years and two individually matched controls for each case, follows a common protocol and builds upon the methodological experience of the INTERPHONE study. The design and conduct of a study on EMF exposure and brain tumor risk in young people in a large number of countries is complex and poses methodological challenges. This manuscript discusses the design of MOBI-Kids and describes the challenges and approaches chosen to address them, including: (1) the choice of controls operated for suspected appendicitis, to reduce potential selection bias related to low response rates among population controls; (2) investigating a young study population spanning a relatively wide age range; (3) conducting a large, multinational epidemiological study, while adhering to increasingly stricter ethics requirements; (4) investigating a rare and potentially fatal disease; and (5) assessing exposure to EMF from communication technologies. Our experience in thus far developing and implementing the study protocol indicates that MOBI-Kids is feasible and will generate results that will contribute to the understanding of potential brain tumor risks associated with use of mobile phones and other wireless communications technologies among young people.

International and national expert group evaluations: biological/health effects of radiofrequency fields

The escalated use of various wireless communication devices, which emit non-ionizing radiofrequency (RF) fields, have raised concerns among the general public regarding the potential adverse effects on human health. During the last six decades, researchers have used different parameters to investigate the effects of in vitro and in vivo exposures of animals and humans or their cells to RF fields. Data reported in peer-reviewed scientific publications were contradictory: some indicated effects while others did not. International organizations have considered all of these data as well as the observations reported in human epidemiological investigations to set-up the guidelines or standards (based on the quality of published studies and the "weight of scientific evidence" approach) for RF exposures in occupationally exposed individuals and the general public. Scientists with relevant expertise in various countries have also considered the published data to provide the required scientific information for policy-makers to develop and disseminate authoritative health information to the general public regarding RF exposures. This paper is a compilation of the conclusions, on the biological effects of RF exposures, from various national and international expert groups, based on their analyses. In general, the expert groups suggested a reduction in exposure levels, precautionary approach, and further research.

An update on mobile phones interference with medical devices

Mobile phones' electromagnetic interference with medical devices is an important issue for the medical safety of patients who are using life-supporting medical devices. This review mainly focuses on mobile phones' interference with implanted medical devices and with medical equipment located in critical areas of hospitals. A close look at the findings reveals that mobile phones may adversely affect the functioning of medical devices, and the specific effect and the degree of interference depend on the applied technology and the separation distance. According to the studies' findings and the authors' recommendations, besides mitigating interference, using mobile phones at a reasonable distance from medical devices and developing technology standards can lead to their effective use in hospital communication systems.

Mobile phone use and risk of brain neoplasms and other cancers: prospective study

BACKGROUND

Results from some retrospective studies suggest a possible increased risk of glioma and acoustic neuroma in users of mobile phones.

METHODS

The relation between mobile phone use and incidence of intracranial central nervous system (CNS) tumours and other cancers was examined in 791,710 middle-aged women in a UK prospective cohort, the Million Women Study. Cox regression models were used to estimate adjusted relative risks (RRs) and 95% confidence intervals (CIs). Women reported mobile phone use in 1999 to 2005 and again in 2009.

RESULTS

During 7 years' follow-up, 51,680 incident invasive cancers and 1,261 incident intracranial CNS tumours occurred. Risk among ever vs never users of mobile phones was not increased for all intracranial CNS tumours (RR = 1.01, 95% CI = 0.90-1.14, P = 0.82), for specified CNS tumour types nor for cancer at 18 other specified sites. For long-term users compared with never users, there was no appreciable association for glioma (10+ years: RR = 0.78, 95% CI = 0.55-1.10, P = 0.16) or meningioma (10+ years: RR = 1.10, 95% CI = 0.66-1.84, P = 0.71). For acoustic neuroma, there was an increase in risk with long term use vs never use (10+ years: RR = 2.46, 95% CI = 1.07-5.64, P = 0.03), the risk increasing with duration of use (trend among users, P = 0.03).

CONCLUSIONS

In this large prospective study, mobile phone use was not associated with increased incidence of glioma, meningioma or non-CNS cancers.

Use of mobile phones and cordless phones is associated with increased risk for glioma and acoustic neuroma

The International Agency for Research on Cancer (IARC) at WHO evaluation of the carcinogenic effect of RF-EMF on humans took place during a 24-31 May 2011 meeting at Lyon in France. The Working Group consisted of 30 scientists and categorised the radiofrequency electromagnetic fields from mobile phones, and from other devices that emit similar non-ionising electromagnetic fields (RF-EMF), as Group 2B, i.e., a 'possible', human carcinogen. The decision on mobile phones was based mainly on the Hardell group of studies from Sweden and the IARC Interphone study. We give an overview of current epidemiological evidence for an increased risk for brain tumours including a meta-analysis of the Hardell group and Interphone results for mobile phone use. Results for cordless phones are lacking in Interphone. The meta-analysis gave for glioma in the most exposed part of the brain, the temporal lobe, odds ratio (OR)=1.71, 95% confidence interval (CI)=1.04-2.81 in the ≥10 years (>10 years in the Hardell group) latency group. Ipsilateral mobile phone use ≥1640h in total gave OR=2.29, 95% CI=1.56-3.37. The results for meningioma were OR=1.25, 95% CI=0.31-4.98 and OR=1.35, 95% CI=0.81-2.23, respectively. Regarding acoustic neuroma ipsilateral mobile phone use in the latency group ≥10 years gave OR=1.81, 95% CI=0.73-4.45. For ipsilateral cumulative use ≥1640h OR=2.55, 95% CI=1.50-4.40 was obtained. Also use of cordless phones increased the risk for glioma and acoustic neuroma in the Hardell group studies. Survival of patients with glioma was analysed in the Hardell group studies yielding in the >10 years latency period hazard ratio (HR)=1.2, 95% CI=1.002-1.5 for use of wireless phones. This increased HR was based on results for astrocytoma WHO grade IV (glioblastoma multiforme). Decreased HR was found for low-grade astrocytoma, WHO grades I-II, which might be caused by RF-EMF exposure leading to tumour-associated symptoms and earlier detection and surgery with better prognosis. Some studies show increasing incidence of brain tumours whereas other studies do not. It is concluded that one should be careful using incidence data to dismiss results in analytical epidemiology. The IARC carcinogenic classification does not seem to have had any significant impact on governments' perceptions of their responsibilities to protect public health from this widespread source of radiation.

A systematic review of the etiopathogenesis of Kienböck's disease and a critical appraisal of its recognition as an occupational disease related to hand-arm vibration

BACKGROUND

We systematically reviewed etiological factors of Kienböck's disease (osteonecrosis of the lunate) discussed in the literature in order to examine the justification for including Kienböck's disease (KD) in the European Listing of Occupational Diseases.

METHODS

We searched the Ovid/Medline and the Cochrane Library for articles discussing the etiology of osteonecrosis of the lunate published since the first description of KD in 1910 and up until July 2012 in English, French or German. Literature was classified by the level of evidence presented, the etiopathological hypothesis discussed, and the author's conclusion about the role of the etiopathological hypothesis. The causal relationship between KD and hand-arm vibration was elucidated by the Bradford Hill criteria.

RESULTS

A total of 220 references was found. Of the included 152 articles, 140 (92%) reached the evidence level IV (case series). The four most frequently discussed factors were negative ulnar variance (n=72; 47%), primary arterial ischemia of the lunate (n=63; 41%), trauma (n=63; 41%) and hand-arm vibration (n=53; 35%). The quality of the cohort studies on hand-arm vibration did not permit a meta-analysis to evaluate the strength of an association to KD. Evidence for the lack of consistency, plausibility and coherence of the 4 most frequently discussed etiopathologies was found. No evidence was found to support any of the nine Bradford Hill criteria for a causal relationship between KD and hand-arm vibration.

CONCLUSIONS

A systematic review of 220 articles on the etiopathology of KD and the application of the Bradford Hill criteria does not provide sufficient scientific evidence to confirm or refute a causal relationship between KD and hand-arm vibration. This currently suggests that, KD does not comply with the criteria of the International Labour Organization determining occupational diseases. However, research with a higher level of evidence is required to further determine if hand-arm vibration is a risk factor for KD.

False positives in cancer epidemiology

BACKGROUND

A recent attempt to estimate the false-positive rate for cancer epidemiology studies is based on agents in International Agency for Research on Cancer (IARC) category 3 (agent not classifiable as to its carcinogenicity to humans) in the IARC Monographs Program.

METHODS

The estimation method is critiqued regarding biases caused by its reliance on the IARC classification criteria for assessing carcinogenic potential.

RESULTS

The privileged position given to epidemiologic studies by the IARC criteria ensures that the percentage of positive epidemiologic studies for an agent will depend strongly on the IARC category to which the agent is assigned. Because IARC category 3 is composed of agents with the lowest-assessed carcinogenic potential to which the estimation approach in question could be applied, a spuriously low estimated false-positive rate was necessarily the outcome of this approach.

CONCLUSIONS

Tendentious estimation approaches like that employed will by necessity produce spuriously low and misleading false positive rates.

IMPACT

The recently reported estimates of the false-positive rate in cancer epidemiology are seriously biased and contribute nothing substantive to the literature on the very real problems related to false-positive findings in epidemiology.

Cancer therapy and vaccination

Cancer remains one of the leading causes of death worldwide, both in developed and in developing nations. It may affect people at all ages, even fetuses, but the risk for most varieties increases with age. Current therapeutic approaches which include surgery, chemotherapy and radiotherapy are associated with adverse side effects arising from lack of specificity for tumors. The goal of any therapeutic strategy is to impact on the target tumor cells with limited detrimental effect to normal cell function. Immunotherapy is cancer specific and can target the disease with minimal impact on normal tissues. Cancer vaccines are capable of generating an active tumor-specific immune response and serve as an ideal treatment due to their specificity for tumor cells and long lasting immunological memory that may safeguard against recurrences. Cancer vaccines are designed to either prevent (prophylactic) or treat established cancer (therapeutic). Identification of tumor-associated antigens (TAAs) and tumor-specific antigens (TSAs) has led to increased efforts to develop vaccination strategies. Vaccines may be composed of whole cells or cell extracts, genetically modified tumor cells to express costimulatory molecules, dendritic cells (DCs) loaded with TAAs, immunization with soluble proteins or synthetic peptides, recombinant viruses or bacteria encoding tumor-associated antigens, and plasmid DNA encoding TSAs or TAAs in conjunction with appropriate immunomodulators. All of these antitumor vaccination approaches aim to induce specific immunological responses and localized to TAAs, destroying tumor cells alone and leaving the vast majority of other healthy cells of the body untouched.