Telecommunications Health & Safety James C. Lin University of Illinois at Chicago 851 S. Morgan Street, M/C 154 Chicago, IL 60607-7053 USA +1 (312) 413-1052 (direct) +1 (312) 413 1052 (office) +1 (312) 413-6465 (Fax) lin@ece.uic.edu (e-mail) Brain-Tumor Risk and Cell-Phone Use James C. Lin University of Illinois-Chicago 851 South Morgan Street, M/C 154, Chicago, IL 60607-7053 USA Tel: +1 (312) 413-1052 (direct); +1 (312) 996-3423 (main office); Fax: +1 (312) 996-6465; E-mail: lin@ece.uic.edu Abstract Epidemiological studies on the use of a cell phone for less than ten years showed no overall association between cell-phone use and increased risk of malignant brain tumors, according to the recently published summary report of a large international study: the INTERPHONE project. This was so with duration of use, years since first use, cumulative number of calls, or cumulative hours of use. However, brain tumors are known to have latencies longer than 10 years, and maybe as long as 30 years. Keywords: Land mobile radio cellular systems; cellular mobile telephones; biological effects of electromagnetic radiation; human health and safety; electromagnetic radiation effects; brain tumor The here is a general consensus among researchers that people who use a cell phone for ten years or less are no more likely to develop a brain tumor than those who do not regularly use a cell phone. This has been the emerging trend for several years. It recently has been confirmed by publication of the summary report of a large international epidemiological study: the INTERPHONE project [1]. However, the challenge is what happens after ten or more years of regular use, since brain tumors are known to have latencies longer than 10 years, and maybe as long as 30 years. The finding that cell-phone radio-frequency (RF) exposure for less than ten years showed no overall association between cell phones and increased risk of malignant brain tumors with duration of use, years since first use, cumulative number of calls, or cumu- lative hours of use, is comforting. Even so, the report is not as reassuring for long-term use. The same study showed odds ratios of 2.18, 1.82, or 1.49 for developing a glioma associated with 10 years or more of regular use, 1640 or more hours of cumulative call time, or 128,000 or greater cumulative number of calls, respectively, when the analyses were performed using the lowest category of users (ever regular user) as the reference category for 166 risk estimates in higher categories and excluding the use of hands- free devices (from Appendix 2 of [1], available online). An odds ratio of 1.0 corresponds to normal incidence. The increased risk is statistically significant for all three measures of RF exposure. The INTERPHONE project was scheduled to be completed in 2005, at a cost of approximately $30 million. It was coordinated by the International Agency for Research on Cancer (IARC) in Lyon, France, a specialized research agency of the World Health Organization (WHO). It was a complex study, not only because of the large number of investigators from 13 different countries and the enormous effort of data collection (through 2004), but also because of the methodologies involved. For example, the study observed an overall reduction in risk of glioma with any regular use of a cell phone. This apparent but suspect downward shift in the risk estimate for cell-phone use sug- gested possible methodological weaknesses in the study's design, resulting from a participation (or selection) bias: the reliability of the subject's recall over time, variations in the subject's motivation and willingness to participate in the study. Likewise, possible IEEE Antennas and Propagation Magazine, Vol. 52, No. 4, August 2010 methodological limitations may have contributed to investigators' disagreement over how to analyze or interpret the findings of an increased incidence of tumors among long-term users (10 years or more regular and heavy user) of cell phones. Observations of an increased odds ratio of glioma among long-term and heavy users of cell phones, and of gliomas in the temporal lobe on the same side of the user's head under direct RF exposure, are causes for concern. Nevertheless, it is important to note that contrary to some popular notions, however desirable, no scientific investigation is complete or perfect. The suggestion from the INTERPHONE summary paper's authors that "The possible effects of long-term heavy use of mobile phones require further investigation," is thus as appropriate and relevant today as it was before the launch of the INTERPHONE project, from a public- health perspective. In fact, there are two ongoing research projects investigating risks associated with cellular mobile telephones: COSMOS and CEFALO. Both of these projects were originated from Europe and are being conducted in Europe, well ahead of the recent call to action of the INTERPHONE summary paper. COSMOS is an international cohort study, examining the possible long-term health effects of cellular mobile telephone use (http://www.ukcosmos.org/faqs_1.html#1). The study is in its very early stages. The cohort study will follow the health of approxi- mately 250,000 European cell-phone users (18 or more years of age) in Denmark, Finland, Sweden, Netherlands, and the United Kingdom for 20 to 30 years. Its aim is to follow changes in the fre- quency of diseases and symptoms over an extended period of time, especially cancers, benign tumors, neurological and cerebrovascu- lar diseases, as well as headaches and sleep disorders. CEFALO is an international case-control epidemiological study on brain tumors in children and adolescents (http://www.kinderkrebsregister.ch/index.php?id=2010). Cases are identified through a combination of cancer registry and informa- tion obtained from pediatric patient wards through December 2008. All incident cases of brain tumor in the age group of 7-19 year olds, diagnosed between 2004 and 2008, are invited to par- ticipate. The CEFALO project is expected to include a total of 550 cases of brain tumors from four participating countries: Denmark, Norway, Sweden, and Switzerland. For each case, two control per- sons are randomly selected from the general population, matched by age, sex, and geographic regions of residence of cases. The objective of CEFALO is to investigate whether use of cellular mobile telephones by children or adolescents increases the risk of developing brain tumors. In addition, the study aims to pro- vide a comprehensive data base to help investigate other potential risk factors for childhood brain tumor, specifically, potential gene- environment interactions. Accordingly, DNA from saliva samples are extracted and analyzed for DNA stability and repair. Polymor- phisms in genes that affect oxidative metabolism, detoxification of carcinogens or immune responses are examined as candidates that might reveal genetic susceptibility to brain tumors. A very important aspect of this and all epidemiological stud- ies is RF-exposure assessment. Objective information on the fre- quency and duration of cell-phone use are obtained from cell- phone operators and from the information stored in the cell phone currently in use, as surrogates. Information on the extent of expo- sure to RF fields from cell phones, and on other known and sus- pected risk factors for childhood brain tumors, is obtained by means of computer-assisted personal interviews. Specifically, trained interviewers conduct the interviews, either in the hospital or in the participant's residence. As of the date of this article, the project, under the leadership of Martin Röösli from the Institute of Social and Preventive Medi- cine, University of Basel, Switzerland, is near completion. Reference 1. E. Cardis and the INTERPHONE Study Group, "Brain Tumour Risk in Relation to Mobile Telephone Use: Results of the INTERPHONE International Case-Control Study," International Journal of Epidemiology, 39, 3, 2010, pp. 675-694. IEEE Antennas and Propagation Magazine, Vol. 52, No. 4, August 2010 167/nSUMMARY in 250-300 words in 3 paragraphs

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Telecommunications Health & Safety James C. Lin University of Illinois at Chicago 851 S. Morgan Street, M/C 154 Chicago, IL 60607-7053 USA +1 (312) 413-1052 (direct) +1 (312) 413 1052 (office) +1 (312) 413-6465 (Fax) lin@ece.uic.edu (e-mail) Brain-Tumor Risk and Cell-Phone Use James C. Lin University of Illinois-Chica