OBJECTIVE: During the last decade, mobile phone use increased to almost 100% prevalence in many countries of the world. Evidence for potential health hazards accumulated in parallel by epidemiologic investigations has raised controversies about the appropriate interpretation and the degree of bias and confounding responsible for reduced or increased risk estimates. DATA SOURCES: Overall, I identified 33 epidemiologic studies in the peer-reviewed literature, most of which (25) were about brain tumors. Two groups have collected data for >/= 10 years of mobile phone use: Hardell and colleagues from Sweden and the Interphone group, an international consortium from 13 countries coordinated by the International Agency for Research on Cancer. DATA SYNTHESIS: Combined odds ratios (95% confidence intervals) from these studies for glioma, acoustic neuroma, and meningioma were 1.5 (1.2-1.8); 1.3 (0.95-1.9); and 1.1 (0.8-1.4), respectively. CONCLUSIONS: METHODOLOGIC CONSIDERATIONS REVEALED THAT THREE IMPORTANT CONDITIONS FOR EPIDEMIOLOGIC STUDIES TO DETECT AN INCREASED RISK ARE NOT MET: a ) no evidence-based exposure metric is available; b) the observed duration of mobile phone use is generally still too low; c) no evidence-based selection of end points among the grossly different types of neoplasias is possible because of lack of etiologic hypotheses. Concerning risk estimates, selection bias, misclassification bias, and effects of the disease on mobile phone use could have reduced estimates, and recall bias may have led to spuriously increased risks. The overall evidence speaks in favor of an increased risk, but its magnitude cannot be assessed at present because of insufficient information on long-term use.

Electromagnetic hypersensitivity (EHS) is used for a variety of subjective symptoms related to exposure to electromagnetic fields (EMF). The aim of this pilot study was to analyze the concentrations of certain persistent organic pollutants (POPs) in subjects with self-reported EHS. In total, 13 EHS subjects and 21 controls were included, all female. The concentration of several POPs was higher in EHS subjects than in controls. Lower concentrations were found for hexachlorobenzene and two types of chlordanes. The only significantly increased odds ratios (ORs) were found for polybrominated diphenyl ether (PBDE)#47 yielding OR=11.7, 95% confidence interval (CI)=1.45-94.7 and the chlordane metabolite MC6 with OR=11.2, 95% CI=1.18-106. The results were based on low numbers and must be interpreted with caution. This hypothesis generating study indicates the necessity of a larger investigation on this issue.

ABSTRACT: BACKGROUND: Recent years have seen a rapid increase in the use of mobile phones and other sources of microwave radiation, raising concerns about possible adverse health effects. As children have longer expected lifetime exposures to microwaves from these devices than adults, who started to use them later in life, they are a group of special interest. METHODS: We performed a population-based study to assess ownership and use of mobile phones and cordless phones among children aged 7-14 years. A questionnaire comprising 24 questions was sent to 2000 persons selected from the Swedish population registry using a stratified sampling scheme. RESULTS: The response rate was 71.2%. Overall, 79.1% of the respondents reported mobile phone access, and 26.7% of them talked for 2 minutes or more per day. Of those who reported mobile phone access, only 5.9% reported use of hands-free equipment. Use of cordless phones was reported by 83.8% of the respondents and 38.5% of them talked for 5 minutes or more per day. Girls generally reported more frequent use than boys. CONCLUSIONS: This study showed that most children had access to and used mobile and cordless phones early in life and that there was a rapid increase in use with age. It also showed very low use of hands-free equipment among children with mobile phone access, and finally that girls talked significantly more minutes per day using mobile and cordless phones than boys did.

ABSTRACT: BACKGROUND: The use of cellular and cordless telephones has increased dramatically during the last decade. There is concern of health problems such as malignant diseases due to microwave exposure during the use of these devices. The brain is the main target organ. METHODS: Since the second part of the 1990s we have performed six case-control studies on this topic encompassing use of both cellular and cordless phones as well as other exposures. Three of the studies concerned brain tumours, one salivary gland tumours, one non-Hodgkin lymphoma (NHL) and one testicular cancer. Exposure was assessed by self-administered questionnaires. RESULTS: Regarding acoustic neuroma analogue cellular phones yielded odds ratio (OR)= 2.9, 95 % confidence interval (CI)= 2.0-4.3, digital cellular phones OR = 1.5, 95 % CI = 1.1-2.1 and cordless phones OR = 1.5, 95 % CI = 1.04-2.0. The corresponding results were for astrocytoma grade III-IV OR = 1.7, 95 % CI =1.3-2.3; OR = 1.5, 95 % CI = 1.2-1.9 and OR = 1.5, 95 % CI = 1.1-1.9, respectively. The ORs increased with latency period with highest estimates using > 10 years time period from first use of these phone types. Lower ORs were calculated for astrocytoma grade I-II. No association was found with salivary gland tumours, NHL or testicular cancer although an association with NHL of T-cell type could not be ruled out. CONCLUSION: We found for all studied phone types an increased risk for brain tumours, mainly acoustic neuroma and malignant brain tumours. OR increased with latency period, especially for astrocytoma grade III-IV. No consistent pattern of an increased risk was found for salivary gland tumours, NHL, or testicular cancer.

The Hardell-group conducted during 1997-2003 two case control studies on brain tumours including assessment of use of mobile phones and cordless phones. The questionnaire was answered by 905 (90%) cases with malignant brain tumours, 1,254 (88%) cases with benign tumours and 2,162 (89%) population-based controls. Cases were reported from the Swedish Cancer Registries. Anatomical area in the brain for the tumour was assessed and related to side of the head used for both types of wireless phones. In the current analysis we defined ipsilateral use (same side as the tumour) as >/=50% of the use and contralateral use (opposite side) as <50% of the calling time. We report now further results for use of mobile and cordless phones. Regarding astrocytoma we found highest risk for ipsilateral mobile phone use in the >10 year latency group, OR=3.3, 95% CI=2.0-5.4 and for cordless phone use OR=5.0, 95% CI=2.3-11. In total, the risk was highest for cases with first use <20 years age, for mobile phone OR=5.2, 95% CI=2.2-12 and for cordless phone OR=4.4, 95% CI=1.9-10. For acoustic neuroma, the highest OR was found for ipsilateral use and >10 year latency, for mobile phone OR=3.0, 95% CI=1.4-6.2 and cordless phone OR=2.3, 95% CI=0.6-8.8. Overall highest OR for mobile phone use was found in subjects with first use at age <20 years, OR=5.0, 95% CI 1.5-16 whereas no association was found for cordless phone in that group, but based on only one exposed case. The annual age-adjusted incidence of astrocytoma for the age group >19 years increased significantly by +2.16%, 95% CI +0.25 to +4.10 during 2000-2007 in Sweden in spite of seemingly underreporting of cases to the Swedish Cancer Registry. A decreasing incidence was found for acoustic neuroma during the same period. However, the medical diagnosis and treatment of this tumour type has changed during recent years and underreporting from a single center would have a large impact for such a rare tumour.

Whether low-intensity non-thermal microwave radiation alters the integrity of the blood-brain barrier has been debated since the late 1970s, yet no experimental study has been carried out on humans. The aim of this study was to test, using peripheral markers, whether exposure to a mobile phone-like signal alters the integrity of the human blood-brain and blood-cerebrospinal fluid barriers. A provocation study was carried out that exposed 41 volunteers to a 30minute GSM 890MHz signal with an average specific energy absorption rate distribution of 1.0W/kg in the temporal area of the head as measured over any 1 gram of contiguous tissue. The outcome was assessed by changes in serum concentrations of two putative markers of brain barrier integrity, S100B and transthyretin. Repeated blood sampling before and after the provocation showed no statistically significant increase in the serum levels of S100B, while for transthyretin a statistically significant increase was seen in the final blood sample 60min after the end of the provocation as compared to the prior sample taken immediately after provocation (p=0.02). The clinical significance of this finding, if any, is unknown. Further randomized studies with use of additional more brain specific markers are needed.

Exposure to some pesticides and persistent organic pollutants (POPs) has been indicated to be a risk factor for non-Hodgkin's lymphoma (NHL). Epstein-Barr virus (EBV) has been associated with some subgroups of NHL. In a previous study we found an interaction between high concentrations of some POPs and titres of antibodies to EBV early antigen (EA IgG) in relation to NHL. In the present study we measured lipid adjusted plasma concentrations of 35 congeners of polychlorinated biphenyls (PCB), p,p'-dichlorodiphenyldichloroethyelene (p,p'-DDE), hexachlorobenzene (HCB), seven subgroups of chlordanes (cis-heptachlorepoxide, cis-chlordane, trans-chlordane, oxychlordane, MC6, trans-nonachlordane, cis-nonachlordane) and one polybrominated diphenylether (PBDE) congener (no. 47) in 99 cases with NHL and 99 population based controls. Odds ratios (OR) for NHL were estimated. Sum of PCBs > median in the controls gave odds ratio (OR) 2.0, 95% confidence interval (CI) 0.99-3.9. High sum of chlordanes yielded OR 2.3, 95% CI 1.2-4.5. An interaction with EBV EA IgG was found. High sum of PCB gave OR 5.2, 95% CI 1.9-14 in the group with EA IgG > 40. Similarly HCB yielded OR 5.3, 95% CI 1.9-15, pp'-DDE gave OR 3.3, 95% CI 1.4-7.7 and sum of chlordanes yielded OR 6.8, 95% CI 2.3-20, whereas no association was found with PBDE. In summary, this study confirmed an association between certain POPs and NHL with an interaction with titre of IgG antibody to EBV EA.

BACKGROUND: Whether low-intensity radiofrequency radiation damages the blood-brain barrier has long been debated, but little or no consideration has been given to the blood-cerebrospinal fluid barrier. In this cross-sectional study we tested whether long-term and/or short-term use of wireless telephones was associated with changes in the serum transthyretin level, indicating altered transthyretin concentration in the cerebrospinal fluid, possibly reflecting an effect of radiation. METHODS: One thousand subjects, 500 of each sex aged 18-65 years, were randomly recruited using the population registry. Data on wireless telephone use were assessed by a postal questionnaire and blood samples were analyzed for serum transthyretin concentrations determined by standard immunonephelometric techniques on a BN Prospec instrument. RESULTS: The response rate was 31.4%. Logistic regression of dichotomized TTR serum levels with a cut-point of 0.31 g/l on wireless telephone use yielded increased odds ratios that were statistically not significant. Linear regression of time since first use overall and on the day that blood was withdrawn gave different results for males and females: for men significantly higher serum concentrations of TTR were seen the longer an analogue telephone or a mobile and cordless desktop telephone combined had been used, and in contrast, significantly lower serum levels were seen the longer an UMTS telephone had been used. Adjustment for fractions of use of the different telephone types did not modify the effect for cumulative use or years since first use for mobile telephone and DECT, combined. For women, linear regression gave a significant association for short-term use of mobile and cordless telephones combined, indicating that the sooner blood was withdrawn after the most recent telephone call, the higher the expected transthyretin concentration. CONCLUSION: In this hypothesis-generating descriptive study time since first use of mobile telephones and DECT combined was significantly associated with higher TTR levels regardless of how much each telephone type had been used. Regarding short-term use, significantly higher TTR concentrations were seen in women the sooner blood was withdrawn after the most recent telephone call on that day.

BACKGROUND: The debate regarding the health effects of low-intensity electromagnetic radiation from sources such as power lines, base stations, and cell phones has recently been reignited. In the present review, the authors attempt to address the following question: is there epidemiologic evidence for an association between long-term cell phone usage and the risk of developing a brain tumor? Included with this meta-analysis of the long-term epidemiologic data are a brief overview of cell phone technology and discussion of laboratory data, biological mechanisms, and brain tumor incidence. METHODS: In order to be included in the present meta-analysis, studies were required to have met all of the following criteria:(i) publication in a peer-reviewed journal;(ii) inclusion of participants using cell phones for >/=10 years (ie, minimum 10-year "latency"); and (iii) incorporation of a "laterality" analysis of long-term users (ie, analysis of the side of the brain tumor relative to the side of the head preferred for cell phone usage). This is a meta-analysis incorporating all 11 long-term epidemiologic studies in this field. RESULTS: The results indicate that using a cell phone for >/=10 years approximately doubles the risk of being diagnosed with a brain tumor on the same ("ipsilateral") side of the head as that preferred for cell phone use. The data achieve statistical significance for glioma and acoustic neuroma but not for meningioma. CONCLUSION: The authors conclude that there is adequate epidemiologic evidence to suggest a link between prolonged cell phone usage and the development of an ipsilateral brain tumor.

During recent years there has been increasing public concern on potential cancer risks from microwave emissions from wireless phones. We evaluated the scientific evidence for long-term mobile phone use and the association with certain tumors in case-control studies, mostly from the Hardell group in Sweden and the Interphone study group. Regarding brain tumors the meta-analysis yielded for glioma odds ratio (OR)=1.0, 95% confidence interval (CI)=0.9-1.1. OR increased to 1.3, 95% CI=1.1-1.6 with 10 year latency period, with highest risk for ipsilateral exposure (same side as the tumor localisation), OR=1.9, 95% CI=1.4-2.4, lower for contralateral exposure (opposite side) OR=1.2, 95% CI=0.9-1.7. Regarding acoustic neuroma OR=1.0, 95% CI=0.8-1.1 was calculated increasing to OR=1.3, 95% CI=0.97-1.9 with 10 year latency period. For ipsilateral exposure OR=1.6, 95% CI=1.1-2.4, and for contralateral exposure OR=1.2, 95% CI=0.8-1.9 were found. Regarding meningioma no consistent pattern of an increased risk was found. Concerning age, highest risk was found in the age group <20 years at time of first use of wireless phones in the studies from the Hardell group. For salivary gland tumors, non-Hodgkin lymphoma and testicular cancer no consistent pattern of an association with use of wireless phones was found. One study on uveal melanoma yielded for probable/certain mobile phone use OR=4.2, 95% CI=1.2-14.5. One study on intratemporal facial nerve tumor was not possible to evaluate due to methodological shortcomings. In summary our review yielded a consistent pattern of an increased risk for glioma and acoustic neuroma after >10 year mobile phone use. We conclude that current standard for exposure to microwaves during mobile phone use is not safe for long-term exposure and needs to be revised.

BACKGROUND: Since the late 1970s, experimental animal studies have been carried out on the possible effects of low-intensive radiofrequency fields on the blood-brain barrier (BBB), but no epidemiological study has been published to date. OBJECTIVE: Using serum S100B as a putative marker of BBB dysfunction we performed a descriptive cross-sectional study to investigate whether protein levels were higher among frequent than non-frequent users of mobile and cordless desktop phones. METHOD: One thousand subjects, 500 of each sex aged 18-65 years, were randomly recruited using the population registry. Data on wireless phone use were assessed by a postal questionnaire and blood samples were analyzed for S100B. RESULTS: The response rate was 31.4%. The results from logistic and linear regression analyses were statistically insignificant, with one exception: the linear regression analysis of latency for UMTS use, which after stratifying on gender remained significant only for men (p = 0.01; n = 31). A low p-value (0.052) was obtained for use of cordless phone (n = 98) prior to giving the blood samples indicating a weak negative association. Total use of mobile and cordless phones over time yielded odds ratio (OR) 0.8 and 95% confidence interval (CI) 0.3-2.0 and use on the same day as giving blood yielded OR=1.1, CI=0.4-2.8. CONCLUSIONS: This study failed to show that long- or short-term use of wireless telephones was associated with elevated levels of serum S100B as a marker of BBB integrity. The finding regarding latency of UMTS use may be interesting but it is based on small numbers. Generally, S100B levels were low and to determine whether this association - if causal - is clinically relevant, larger studies with sufficient follow-up are needed.

Aims To investigate the relationship between adolescents' alcohol use and physical health. Design A total population, cross-sectional survey of adolescents, aged 13-19 years, attending secondary or high school in Nord-Trøndelag County, Norway. 8,983 youths (91%) answered the Young-Hunt questionnaire in the 1995-1997 HUNT-survey. Method Self-reported data mainly analyzed by logistic regression models. Findings 80% of the respondents had tried alcohol, and 29% reported more than 10 intoxications. Ill health perception was associated with frequent alcohol intoxications. Tension symptoms had the closest relationship to frequency of intoxications in both genders. Girls that frequently used health services had frequent alcohol intoxications. Funding Central Norway Regional Health and the County Council of Nord-Trøndelag. Conclusions There is a close association of physical health complaints and alcohol intoxication frequency in Norwegian teenagers. The study's limitations were noted.

OBJECTIVES: As more children use mobile (cellular) telephones, public anxiety grows about possible adverse health effects of radiofrequency (RF) exposure upon developing nervous systems. Most epidemiological studies investigating health effects of mobile telephones have relied on self reports from questionnaires. Whilst there are some validation studies investigating the accuracy of self-reported mobile phone use in adults and adolescents, self-reported laterality of use has not been validated at any age. Although this study mainly sought to validate accuracy of self reported laterality of mobile telephone use in adolescents, investigation also covered number and duration of calls. METHODS: We monitored 455 calls in 30 students, Mean age (Standard deviation)= 14 (0.4) years. For 1 week, participants used Hardware Modified Phones (HMPs) which logged dosimetric parameters such as laterality (side of head), date, number and duration of calls. These "gold standard" measurements were compared with questionnaire self-reported laterality and estimated typical weekly phone use. RESULTS: Agreement between HMP and self-reported laterality was modest, kappa (95% confidence interval)= 0.3 (0.0, 0.6). Concordance between HMP and self-reported number of calls was fair, intraclass correlation coefficient ICC = 0.38 (0.07, 0.69) but poor for duration, ICC = 0.01 (0.00, 0.37) with wide limits of agreement for both. CONCLUSIONS: These results suggest that adolescent self-reported laterality was of limited validity. Adolescent self-reported phone use by number and duration of calls was generally inaccurate but comparable to recent adult studies. Epidemiological studies of mobile phone use based on self-reported information may underestimate true associations with health effects.

In this study, the radiation emission from mobile phones when used with wireless and wired hands-free kits (HFK) was evaluated to determine the necessity for a dedicated compliance procedure and the extent to which the use of wired and wireless HFK can reduce human exposure. The specific absorption rates (SAR) from wireless HFK were determined experimentally. Wired HFK were evaluated dosimetrically while connected to mobile phones (GSM900/1800, UMTS1950) under maximized current coupling onto the HFK cable and various wire routing configurations. In addition, experimentally validated simulations of a wired HFK and a mobile phone operating on anatomical whole-body models were performed. The maximum spatial peak SAR in the head when using wired HFK was more than five times lower than ICNIRP limits. The SAR in the head depends on the output power of the mobile phone, the coupling between the antenna and cable, external attenuation and potential cable specific attenuation. In general, a wired HFK considerably reduces the exposure of the entire head region compared to mobile phones operated at the head, even under unlikely worst-case coupling scenarios. However, wired HFK may cause a localized increase of the exposure in the region of the ear inside the head under worst-case conditions. Wireless HFK exhibit a low but constant exposure.

Objective. To assess the effect of wireless telephone substitution in a survey of health care reform opinions. Data Source. Survey of New Jersey adults conducted by landline and wireless telephones from June 1 to July 9, 2007. Study Design. Eighty-one survey measures are compared by wireless status. Logistic regression is used to confirm landline-wireless gaps in support for coverage reforms, controlling for population differences. Weights adjust for selection probability, complex sample design, and demographic distributions. Principal Findings. Significant differences by wireless status were found in many survey measures. Wireless users were significantly more likely to favor coverage reforms. Higher support for government-sponsored universal coverage, income-related state coverage subsidies, and an individual mandate remain after adjustment for demographic variables. Conclusions. Opinion polls excluding wireless users are likely to understate support for coverage reforms.

The paper presents the results of studying the impact of using cellular phones and personal computers on the health status of 277 Saratov schoolchildren (mean age 13.2 +/- 2.3 years). About 80% of the adolescents have been ascertained to use cellular phones and computers mainly for game purposes. The active users of cellular phones and computers show a high aggressiveness, anxiety, hostility, and social stress, low stress resistance, and susceptibility to arterial hypotension. The negative influence of cellular phones and computers on the schoolchildren's health increases with the increased duration and frequency of their use.

ABSTRACT: BACKGROUND: In the last decade mobile telephone use has become more widespread among children. Concerns expressed about possible health risks have led to epidemiological studies investigating adverse health outcomes associated with mobile telephone use. Most epidemiological studies have relied on self reported questionnaire responses to determine individual exposure. We sought to validate the accuracy of self reported adolescent mobile telephone use. METHODS: Participants were recruited from year 7 secondary school students in Melbourne, Australia. Adolescent recall of mobile telephone use was assessed using a self administered questionnaire which asked about number and average duration of calls per week. Validation of self reports was undertaken using Software Modified Phones (SMPs) which logged exposure details such as number and duration of calls. RESULTS: A total of 59 adolescents participated (39% boys, 61% girls). Overall a modest but significant rank correlation was found between self and validated number of voice calls (rho = 0.3, P=0.04) with a sensitivity of 57% and specificity of 66%. Agreement between SMP measured and self reported duration of calls was poorer (rho= 0.1, P = 0.37). Participants whose parents belonged to the 4th socioeconomic strata recalled mobile phone use better than others (rho = 0.6, P=0.01). CONCLUSIONS: Adolescent recall of mobile telephone use was only modestly accurate. Caution is warranted in interpreting results of epidemiological studies investigating health effects of mobile phone use in this age group.

The Hardell-group conducted during 1997-2003 two case control studies on brain tumours including assessment of use of mobile phones and cordless phones. The questionnaire was answered by 905 (90%) cases with malignant brain tumours, 1,254 (88%) cases with benign tumours and 2,162 (89%) population-based controls. Cases were reported from the Swedish Cancer Registries. Anatomical area in the brain for the tumour was assessed and related to side of the head used for both types of wireless phones. In the current analysis we defined ipsilateral use (same side as the tumour) as >/=50% of the use and contralateral use (opposite side) as <50% of the calling time. We report now further results for use of mobile and cordless phones. Regarding astrocytoma we found highest risk for ipsilateral mobile phone use in the >10 year latency group, OR=3.3, 95% CI=2.0-5.4 and for cordless phone use OR=5.0, 95% CI=2.3-11. In total, the risk was highest for cases with first use <20 years age, for mobile phone OR=5.2, 95% CI=2.2-12 and for cordless phone OR=4.4, 95% CI=1.9-10. For acoustic neuroma, the highest OR was found for ipsilateral use and >10 year latency, for mobile phone OR=3.0, 95% CI=1.4-6.2 and cordless phone OR=2.3, 95% CI=0.6-8.8. Overall highest OR for mobile phone use was found in subjects with first use at age <20 years, OR=5.0, 95% CI 1.5-16 whereas no association was found for cordless phone in that group, but based on only one exposed case. The annual age-adjusted incidence of astrocytoma for the age group >19 years increased significantly by +2.16%, 95% CI +0.25 to +4.10 during 2000-2007 in Sweden in spite of seemingly underreporting of cases to the Swedish Cancer Registry. A decreasing incidence was found for acoustic neuroma during the same period. However, the medical diagnosis and treatment of this tumour type has changed during recent years and underreporting from a single center would have a large impact for such a rare tumour.