Radiation literature survey

Article review date

Oct 2024

Summary

This systematic review examined the awareness and use of the ultraviolet radiation (UV) index according to the World Health Organisation definition. The authors identified 40 publications with an outcome related to either awareness of the UV index (UVI), sun exposure or protective behaviours in association with UVI, and the impact of UVI interventions. The review also assessed the risk of bias within the included studies using the working group guidelines of Joanna Briggs Institute (Munn et al. 2015).  The review identified variation in public awareness of the UV index between countries.  The highest level of awareness was noted in Australia with over 90% of study participants reporting to have UV index awareness. Notably, the awareness in other countries was reported to be much lower (Europeans 50%, New Zealanders 43%, North Americans 34%). Despite being the high awareness of the UV index in Australia, only less than 10% of Australians use the UV index to inform their sun protection behaviour. There was a high risk of bias for all the outcomes that examined the use of the UV index for sun protective behaviours in Australia. The review recommended that further information needs to be disseminated on the advantages on using the UV index to better inform sun protection behaviours globally. 

Published in:

Kaiser et al. Photochemistry and Photobiology, 2024

 Link to study

A systematic review has examined the awareness of UV index and how it is used to inform sun protection messaging globally, and in Australia 

ARPANSA commentary

The study shows that awareness of UV index considerably varied globally with Australians having the highest awareness of the UV index. This finding demonstrates the success of the Australian sun protection messaging to spread awareness of the UV index. However, the UV index has not always been considered by the Australian public while considering how to protect themselves from UV exposure. In Australia, there are policies and recommendations in place to protect people from harmful UV exposure. For example, in Victoria, 97% of early childhood services and 90% of primary schools have policies to use the UV index to inform sun protection (SunSmart 2024) in their settings. Similar data for other Australian state and territory are lacking. The use of media and app to enhance the dissemination awareness of the UV index has been highlighted in the study. One of the limitations of the review is that it is difficult to draw qualitative evidence on how UV index is used to inform sun protection behaviours. Therefore, more research is needed to understand how Australians use the UV index. 

Despite the high awareness of the UV index in Australia and the Slip, Slop, Slap, Seek and Slide messaging, Australia has some of the highest rates of melanoma and skin cancer in the world and two-thirds of Australians will receive a skin cancer diagnosis of some type in their lifetime. As such, skin cancers, including melanoma, continue to constitute a large public health burden. This indicates that further work is needed to improve Australians’ sun protection behaviours and improve awareness on how to use the UV index to inform those behaviours. The UV index helps Australians know when UV exposure is high, and they should avoid sun exposure or practice other sun protection measures. More information on UV protection can be found on the ARPANSA Sun Protection factsheet. The UV index must be disseminated with greater efficacy via the media and apps. Currently, a free SunSmart Global UV app is available to know live UV index of global cities in view of boosting public awareness of the UV index globally. 

Article review date

November 2024

Article publication date

September 2024

Summary

This systematic review and meta-analysis assessed the association between radon exposure and health effects other than lung cancer in human populations. A total of 129 studies, published during 1990-2023, were included in the review and 40 studies were used in the meta-analysis. Risk estimates such as risk ratio (RR) per 100 units (Bq/m³ or Working level Month) of increased radon exposure level were calculated with a 95% confidence interval (CI). A range of health outcomes, including cancers (except lung cancer) and non-cancerous diseases were considered in the evaluation. The quality of the included studies were jointly evaluated using the New-castle Ottawa Scale (NOS) and the UNSCEAR’s approach of assessing quality of studies (including ecological studies) (UNSCEAR, 2017, p 48, table 3).The meta-analyses generally showed no statistically significant positive association for any health outcomes. Some of the estimated risk ratios were positive with the significance level near the threshold  for statistical significance including lympho-hematological cancer incidence in children (RR = 1.01; 95% CI: 1.00-1.03; p = 0.08); malignant melanoma mortality in adults in the general population (RR = 1.10; 95% CI: 0.99-1.21; p = 0.07); liver cancer mortality (RR = 1.04; 95% CI: 1.00-1.10; p = 0.06), and intestine and rectal cancer mortality combined among mine workers (RR = 1.02; 95% CI: 1.00-1.04; p = 0.06). The included studies had moderate to high quality scores. In conclusion, this review showed an absence of statistically significant associations between radon exposure and potential health outcomes other than lung cancer however, these effects cannot be ruled out. 

Published in

Frontiers in Public Health

Link to study

A recent review assessed evidence on links between radon exposure and health outcomes apart from lung cancer

ARPANSA commentary:

The overall conclusion of the review indicates no significant association between radon exposure and a range of health outcomes other than lung cancer in children and adult populations. Importantly, this review contributes to the body of knowledge on the potential health effects (both malignant and non-malignant diseases) of radon exposure in occupational and residential settings. Comparison of the findings of this review with other studies was not possible due to a lack of similar published reviews. Of the epidemiological studies included (except those on miners related to occupational radon) in this review, a majority of them related to children and adults were ecological studies, which may lead to ecological fallacy. There were several methodological limitations of the included studies, such as assessment of radon exposure and health outcomes as well as accounting for potential confounders which may alter the risk estimation. Therefore, further well-designed epidemiological research using robust radon exposure assessment tools and methods are needed to evaluate the potential risk of radon exposure for a range of population health outcomes. Some limitations of the study were: the inclusion of few studies in the meta-analysis of the exposure-risk relationships may have resulted in a lack of statistical power, significant heterogeneity was estimated in studies on occupational exposure to radon which limits the interpretation of the risk estimates and meta-regressions/in-depth sensitivity analyses was not done to evaluate the sources of heterogeneity due to the limited number of included studies. The review also did not conduct a certainty in evidence assessment which is another limitation.

According to the Australian Radiation Protection and Nuclear Safety Agency’s (ARPANSA) nationwide survey of Australian homes, the average radon exposure level in Australian homes is much lower than the global average. Consequently, residential radon exposure is not expected to be a significant contributor to any health risk other than lung cancer in Australia. ARPANSA has a fact sheet on ionising radiation exposure doses, including natural sources such as radon, and health. The International Commission on Radiological Protection has published guidance on radiological protection against radon exposure.

Article review date

October 2024

Article publication date

September 2024

Summary

This study compares the radiofrequency electric and magnetic field (RF-EMF) exposures estimated for the INTEROCC RF-EMF job-exposure matrix (JEM) and the measured personal exposure data to assess whether it can be used as a surrogate measure for occupational RF-EMF exposure in epidemiological studies. First, some occupations relevant to RF-EMF exposures were selected based on exposure prevalence and levels indicated in the preliminary INTEROCC-JEM. Personal RF-EMF exposure measurements were then undertaken for some selected occupational group of workers. The workplace exposure (i.e. high-intensity RF-EMF) levels over full work shifts (8 hours) were measured with a personal exposure meter (RadMan 2XT) worn outside the participant's clothing at the left chest level. Total RF-EMF exposure measured was estimated. The level of agreement between the exposure measure (exposure intensity or level and prevalence) of the INTEROCC-JEM and that of the measured personal exposure was estimated. A total of 333 workers representing 22 occupations provided their personal exposure data.  The study found a poor agreement for both intensity and exposure prevalence between the measurements and the INTEROCC-JEM estimates. On average, the INTEROCC-JEM tended to overestimate the measured RF-EMF exposure levels by >194%. The study also found that the exposure prevalence was higher in the measurements compared to the JEM.

Published in

Annals of Work Exposures and Health

Link to study

Comparison of a radiofrequency electric and magnetic field source-based job-exposure matrix with personal radiofrequency exposure measurements

Commentary by ARPANSA

Overall, the data of personal exposure-based JEM and source-based (INTEROCC) JEM showed little agreement as the former seemed to overestimate the workplace RF-EMF exposure. Therefore, the findings of the previous epidemiological research using the INTEROCC-JEM should be interpreted accordingly in view of the overestimation by this particular JEM. Importantly, the findings also indicate the need for considering new metrics for occupational RF-EMF exposure and collecting additional personal exposure data. This will help improve job exposure matrix applicable in future epidemiological studies. The main strength of this study is that it compared the measured RF-EMF exposures from a large number of workers (Migault et al., 2019). The study limitations were: i) the high detection threshold and low sensitivity of the measurement device limited the measurements to detect low level RF-EMF exposures such as those from Wi-Fi and mobile phone telecommunication sources which generally co-exist in occupational environments; ii) the exposure measurements did not characterise source (frequency band) specific exposures. The INTEROCC group has published (Vila et al., 2016; Migault et al., 2019) an occupational RF-EMF exposure measurement database to provide some evidence for epidemiological studies.

Occupational RF-EMF exposures in Australia are generally far below the limits given in the Australian Safety Standard (e.g. RPS-S1), s. The Australian Safety Standard, developed by ARPANSA, is consistent with the 2020 ICNIRP guidelines and is based on validated international scientific evidence.

Article review date

November 2024

Article publication date

August 2024

Summary

This study reports on the results of two birth cohort studies that were constructed to study the effects of Iodine-131 that was released due to a fire at Windscale nuclear reactors at Sellafield in Cumbria, England in 1957. The study aimed to examine the incidence of thyroid cancer in young children in Cumbria. Iodine-131 concentrates in the Thyroid, hence thyroid cancer was the key outcome of the studies. The two cohorts included 56,086 births in Cumbria between 1950-1959 and 137,444 more births in Cumbria from 1959-1980, respectively. These cohorts were broken up into three groups based on regions that were modelled to have high to low levels of Iodine-131. Area 1 being the highest, Area 2 with intermediate exposure level and Area 3 having the lowest. For the combined results from Areas 1 (highest) and 2 (intermediate) there was no increased risk of thyroid cancer with an Incidence rate ratio (IRR) of 0.68 (95% confidence interval (CI): 0.24-1.56). There were no cases of thyroid cancer for those in the highest exposure group. The authors conclude that a substantially raised thyroid cancer risk, even in the highest exposure groups, can be excluded. The authors said follow-up studies should continue to monitor the exposed groups for thyroid cancer. However, noted that these studies are unlikely to result in any changes to these conclusions. 

Published in

Radiation and Environmental Biophysics

Link to study

Thyroid cancer incidence in cohorts exposed in childhood to ¹³¹I released during the Windscale nuclear reactor accident at Sellafield, England, in 1957

Commentary by ARPANSA

The study examined the impact of Iodine-131 released due to an accident at a nuclear power plant. It provides strong evidence that the preventative measures instituted after the emergency, such as a restriction on the distribution of contaminated milk, were correct and may have prevented an increased risk of thyroid cancer occurring in the area. This is illustrated by the events in Chernobyl where consuming heavily contaminated milk led to tens of thousands of children receiving thyroid doses > 1 Gy and thousands of additional thyroid cancer cases (UNSCEAR 2018). This study also provides confidence in the conclusions of UNSCEAR 2022 about the impact of the Fukushima Dai-ichi nuclear reactor accident in Japan during in March 2011. UNSCEAR 2022 concluded that increased thyroid cancer risks will be small and unlikely to be detectable. This is because of the protective measures put in place after the accident that limited Iodine-131 exposure.  No adverse health effects have been reported for the residents of Fukushima that could be directly attributed to radiation exposure (UNSCEAR 2022).

ARPANSA also undertook protective measures during and after the Fukushima Dai-ichi nuclear reactor accident to ensure the safety of Australians. This included investigating the levels of radioactivity in foods imported into Australia from Japan and testing the levels of radioactivity in the ocean water, seafood and the atmosphere. Other products coming into Australia from Japan were also tested such as cars, and cargo vessels. ARPANSA can use the lessons learnt from these accidents to improve how it responds to nuclear accidents in the future and to ensure the safety of Australians. 

Article review date

October 2024

Article publication date

August 2024

Summary

This systematic review and meta-analyses examined the scientific evidence of the effect of radiofrequency electromagnetic fields (RF-EMF) on biomarkers for oxidative stress as reported in experimental animal (in vivo) and cell (in vitro) studies. A literature search found 12409 studies and of these, 56 met the inclusion criteria for further analysis. Results were analysed by individual biomarkers for oxidative stress and were further subdivided by the biological system the marker was recorded from. Results were reported as the standardised mean difference (SMD) with a 95% confidence interval (CI). Certainty of evidence and risk of bias for each result was assessed according to OHAT-GRADE. 

For many outcomes, calculating a pooled effect size was not possible as the results of the included studies were too inconsistent to make a meaningful synthesis, ranging from large decreases to large increases compared to a control. Where a pooled effect size was calculated, most outcomes reported a statistically non-significant result however, some of the analyses showed significant effects ranging from small to large. These effects were reported for oxidised DNA bases in rodent cells (SMD 2.49; 95% CI [1.30, 3.67]), plasma (SMD 2.25; 95% CI [1.27, 3.24]) and testis (SMD 1.60; 95% CI [0.62, 2.59]) as well as modified proteins in the thymus (SMD 6.16; 95% CI [3.55, 8.76]) and liver (SMD 0.55; 95% CI [0.06, 1.05]) of rodents. However, all outcomes, regardless of whether they showed an effect or not, were assessed as very-low certainty evidence. This was primarily due to high risk of bias ratings across the included studies and the large degree of inconsistency and imprecision in the measured effects. In some cases, the analysis was based on results from single studies with very small sample sizes. Although a full dose response analysis was not possible, the authors identify several counter-intuitive trends across the studies where the study with the lowest RF-EMF exposure level reported the largest effect or the study with middling exposure reported the largest effect. 

The study concludes that, due to the very low certainty in the evidence, the current scientific literature does not have any implications for policy related to RF-EMF but does highlight the need for drastic improvements in future studies.

Published in

Environmental International

Link to study

The effects of radiofrequency electromagnetic field exposure on biomarkers of oxidative stress in vivo and in vitro: A systematic review of experimental studies

Commentary by ARPANSA

The present study represents the most comprehensive and latest review of the scientific literature related to the effect of RF-EMF exposure on oxidative stress. The review also identifies several challenges in this field of assessment. Evaluating the generation of reactive oxygen species or biomarkers of oxidative stress is challenging because these umbrella terms represent a broad class of molecules that participate in an extremely wide range of chemical transformations, both positive and negative. One of the challenges for biomarkers of oxidative stress is that they can also be formed through other mechanisms, giving results that may lack enough specificity. As such, it is recommended that multiple biomarkers are used to assess oxidative stress (Frijhoff et al., 2015; Murphy et al., 2022). However, singular biomarkers are overwhelmingly over-represented in many of the meta-analyses in this review, reflecting the low overall quality of the scientific evidence. Further to the challenges of measurement, the connection between oxidative stress and various diseases is also complex. While oxidative stress is frequently associated with the pathology of certain diseases, it is comparatively infrequently identified as a part of the cause and onset of a disease (Forman & Zhang, 2021). 

The counter-intuitive negative correlation between effect size and RF-EMF level has also been shown in a previous analysis conducted by ARPANSA of in vivo and in vitro studies investigating the bioeffects of RF fields used by 5G telecommunications (Wood et al, 2021). The ARPANSA review also reported a negative correlation between effect size and study quality, meaning that poor quality studies showed RF bioeffects whereas good quality studies did not.

These challenges are reflected in the current body of evidence and consequently the very low certainty ratings given to all meta-analyses in this review. The most important outcomes from the review are the flaws identified in the body of evidence and the recommendations made for improvements. Further experimental studies that follow these recommendations are required before more robust conclusions about the relationship between RF-EMF and biomarkers of oxidative stress can be made.

This review is part of the World Health Organisation’s ongoing project assessing the health effects of RF-EMF (SR9 – Effect of exposure to RF on biomarkers of oxidative stress). ARPANSA is supporting this WHO review process. 

Literature review date

September 2024

Article publication date

July 2024

Summary

This systematic review and meta-analysis examined the effect of radiofrequency electromagnetic energy (RF EME) on cognitive performance in human experimental studies. The review included 50 studies in the meta-analysis (2,433 participants) from 15 countries that were conducted between 2001 and 2021. It assessed cognitive performance of five (of the 7) cognitive domains (Orientation and attention, Perception, Memory, Construction and motor performance, and Concept formation and reasoning), including 19 (of 35) cognitive domain subclasses as defined by Lezak et al (2004). Each subclass was assessed based on the speed and accuracy of the participant performing tasks associated with that particular subclass (attentional capacity, concentration, etc). Most of the included studies used 2G-era mobile phone RF EME as the exposure source. Certainty of evidence and risk of bias were also evaluated according to OHAT-GRADE approach. 

The authors reported no statistically significant results, indicating that RF-EME exposure has not impact on cognitive performance on human in experimental studies for all of the 19 subclasses tested. However, the certainty in these results ranged from high to low. Three of the 19 subclasses were not able to be tested for both speed and accuracy. Of 35 meta-analyses performed on the subclasses, a majority (20) of them provided high certainty of evidence that RF EME exposure results in little to no difference in cognitive outcome. The evidence on the effect of RF EME on the remaining 16 subclasses of the cognitive domains was uncertain. This uncertainty was due to limitations in the study quality, inconsistency in the results or imprecision of the combined effect size estimate. Overall, the review reported no evidence that RF EME exposure impacts cognitive performance. 

Link to

The effect of exposure to radiofrequency electromagnetic fields on cognitive performance in human experimental studies: Systematic review and meta-analyses

Published in

Environment International 

ARPANSA commentary

The overall conclusion of the review was that RF EME exposure does not impact cognitive performance in human experimental studies. This systematic review is the most comprehensive that has been published on this topic as it considered all cognitive domains and people of all ages. Other recent reviews and meta-analyses have had similar outcomes (Valentini et al, 2010; Barth et al ,2011; Zubko et al, 2017) reporting no impact of mobile phone frequencies on short term cognitive performance. However, these studies only examined a few cognitive domains including, attention, processing speed and working memory. Further, these reviews did not assess the quality or risk of bias of their included studies in the same manner as this systematic review. For example, Barth et al (2011) performed no quality assessment; Valentini et al (2010) used a simple assessment that assessed the blinding, participant selection, exposure assessment and statistics used. Zubko et al (2017) did use the risk of bias tool developed by OHAT, however, it did not assess the certainty of the evidence according to the GRADE approach. 

This review is part of the World Health Organization’s (WHO) ongoing project assessing the health effects of RF-EMF. ARPANSA is supporting this WHO review process. One of the WHO systematic reviews has examined the long-term impacts on cognition of RF EME exposure (Benke et al 2024). This review was conducted in Australia and was co-led by ARPANSA scientists. This systematic review also reported that RF EME had no consistent impact on cognition.

Overall, the results from this systematic review are consistent with previous research and ARPANSA’s scientific understanding that exposure to RF EME below the limits in the ARPANSA RF safety standard do not cause health impacts, including cognitive outcomes.

Article review date

August 2024

Article publication date

July 2024

Summary

This meta-analysis of cohort studiesevaluated the current evidence on the association between occupational exposure to ionising radiation and risk of thyroid cancer. A total of six studies published between 2006 and 2021, which had a total of 420,543 participants, 6,322 cases and a mean follow-up period of 23 years, were included in the analysis. Data on radiation exposure levels (in Gray (Gy) or mSv) were available for almost all studies; whereas the information on thyroid cancer was largely based on clinical (i.e., histopathological) diagnosis except two studies which had self-reported diagnosis. The associations between ionising radiation exposure (i.e., personal or estimated thyroid doses)  and thyroid cancer were examined in terms of risk ratio (RR) with 95% confidence interval (CI). Quality assessment of the included studies was also conducted according to the Newcastle-Ottawa Scale (NOS). The results showed that the five included studies had reported the occupational radiation exposure doses (individual doses or estimated thyroid doses), which ranged from 10.4 to 500 mGy or <0.20 to 7.2 mSv. Occupational radiation exposure was associated with the risk of thyroid cancer (RR=1.61, 95% CI: 1.27‑2.04). Sex-wise sensitivity analysis further showed that males with the history of occupational radiation exposure (compared to females) tend to be at a slightly higher risk of developing thyroid cancer (RR=1.74, 95% CI: 1.61‑1.87 vs. RR=1.30, 95% CI: 1.15‑1.48). Overall, the evidence from the meta-analysis indicates that occupational exposure to ionising radiation was associated with the risk of thyroid cancer. 

Published in

Oncology Letters

Link to study

Occupational radiation exposure and risk of thyroid cancer: A meta‑analysis of cohort studies 

Commentary by ARPANSA

The meta-analysis provides the latest risk estimate of thyroid cancer risk among occupationally exposed human populations to ionising radiation. These findings are consistent with those of a previous pooled analysis of seven studies (Ron et al, 1995); however, contrary to those reported in a previous case-control study (Fincham et al, 2000). Similarly, the findings that males tend to have higher risk of developing thyroid cancer is contrary to the findings of a latest study (Khoramian et al., 2024) reporting higher thyroid cancer risk among females (compared to males) undergoing head CT imaging. No similar data are available to compare these findings in the Australian context. A key limitation of the current meta-analysis is that the available data in the included studies did not allow a detailed subgroup analysis of the occupation type, dose‑effect and time‑effect relationship. Further, the meta-analysis doesn't provide any information on the exposure contrast, so it is difficult to determine whether the exposure metrics that were used in the meta-analysis from the different studies were appropriate. Though quality of a majority of the included studies in the meta-analysis was high, they had a considerable heterogeneity (I²=84%) resulting in between-study variance.

In Australia, The Code for Radiation Protection in Planned Exposure Situations  sets out the requirements for the protection of occupationally exposed persons in all planned exposure situations. All Australian jurisdictions have uniform annual limits (20 mSv) for occupational exposure to ionising radiation. In addition to the dose limits, optimisation of radiation protection and safety involves practising ‘as low as reasonably achievable (ALARA) considering economic and societal factors.

Article review date

August 2024

Article publication date

July 2024

ARPANSA summary

This study aimed to investigate the efficacy of public health messaging in relation to sun protection when using appearance-based or health-based messages. The study recruited 95 participants (aged 17-24 years) who first completed a questionnaire on their sun protection behaviour and knowledge. The participants were then shown one of six possible text messages and their sun protection intentions were evaluated. Each of the six text messages tried a different strategy to appeal to the study participants. The messages either contained information on melanoma health risk, methods of sun protection, the cosmetic consequences of surgical melanoma removal or a combination thereof. The results showed that none of the messages affected the sun protection intentions of the participants compared to a control message indicating no significant difference between any of the interventions. Outside of the intervention evaluations, the survey found a gender-gap in sunbathing behaviour where 26% of male participants sunbathed compared to 60% of female participants. 

Link to study

Sun safety in young Queensland adults: behaviours, knowledge, and responses to health-based and appearance-based text messages

Published in

Australian Psychologist

ARPANSA commentary

Ongoing sun protection campaigns in Australia like SunSmart continue to seek to improve the efficacy of their messaging, ultimately with the goal of reducing adverse health outcomes related to sun overexposure. Recent studies (Persson, S. et al., 2018; Mahler, H. 2015; Cheng, J. et al. 2018) have indicated that appealing to concerns about appearance may be more effective than appealing to concerns about health risk and this direction has been partially adopted by some newer sun protection campaigns. 

The present study did not add significantly to this discussion as neither the health-based nor appearance-based messages had an effect compared to the control. The use of a single intra-survey text message to deliver the intervention and the absence of follow-up behaviour evaluations were highlighted as major limitations that contributed to the ineffectiveness shown. The authors also identified several other limitations with their study including low statistical power for the number of conditions that were tested and a gender imbalance among the study participants. It should also be noted that the appearance-based messaging in the study focused on surgical scarring from melanoma excisions, whereas other studies have focused primarily on skin photo-aging. This difference, although subtle, is significant as photo-aging is a much more deterministic outcome compared to melanoma and related treatments.

Whenever the UV-index is over three, ARPANSA recommends protecting yourself from the sun by following the five sun protection principles. More information about the risks of sun exposure and methods of sun protection can be found from: The World Health Organization, The Cancer Council of Australia and SunSmart websites. 

Article review date

August 2024

Article publication date

August 2024

ARPANSA summary

This prospective cohort study examined the association between exposure to radiofrequency electromagnetic energy (RF-EME) from the use of Wi-Fi, cordless and mobile phones, and behavioural problems among children. The study included 2,465 children (aged 8-17 years) from the Hokkaido Study on Environment and Children's Health. Data on the use of Wi-Fi, cordless and mobile phones was collected from parent-child dyads at baseline (October 2020-January 2021). Data on the children’s behavioural problems were collected at baseline and follow-up (September 2021-March 2022) via a Strength and Difficulties Questionnaire (SDQ). The children were categorized into four groups of composite measure of behaviour stability: normal (i.e., no difficulty at baseline and follow-up), persistent (borderline/clinical at baseline and follow-up), improved (borderline/clinical at baseline and normal follow-up), and concurrent (normal at baseline and borderline/clinical at follow-up). The association between RF-EME and different behavioural problems in children were estimated in terms of odds ratio (OR) with 95% confidence interval (CI).

No overall statistically significant association was found between RF-EMF exposure from Wi-Fi, cordless or mobile phone calls via mobile networks, and behavioural problems.  Conducting phone calls via the internet for over 40 minutes weekly had an increased risk (OR 2.01; 95% CI:1.14–3.57) for concurrent total difficulty scores. Mobile phone audio-streaming between 60 to 120 minutes weekly had a reduced risk (OR 0.53; 95% CI:0.30–0.93) for persistent total difficulty score. Cordless phone use was associated with higher odds (OR 1.88; 95% CI:1.24–2.85) of improved total difficulty scores. 

Link to study

Link between Wi-Fi, cordless devices, mobile phone usage patterns, and behavioral problems among Japanese children: A prospective cohort study

Published in

Environmental Research

ARPANSA commentary

The study largely showed that no association was found between Wi-Fi, mobile phone calls via mobile networks, and behavioural problems. However, there were a few sporadic findings showing both positive and negative effects. It is likely that these may have been affected by confounding or chance findings. A major limitation of the study is that the data on the uses of Wi-Fi and mobile and cordless phones were self-reported or reported by a parent on behalf of their child, which results in recall bias and an inaccurate estimation of the effect. Another major limitation is that any effects arising from RF-EME exposure could not be distinguished from effects that result from the activities themselves (e.g., texting, gaming/streaming and social media use). 

Overall the results of the study are consistent with the findings of the latest World Health Organization review and two Australian studies  (Bhatt et al., 2017; Thomas et al., 2011). The effect exposure to RF-EME sources on cognition has been reviewed by the International Commission on Non-Ionising Radiation Protection (ICNIRP) in their 2020 guidelines and they concluded that there is no substantiated experimental or epidemiological evidence that exposure to RF-EME affects cognition.  Overall, there remains no consistent scientific evidence that exposure to RF-EME below the limits set in ARPANSA safety standard, which is aligned with the ICNIRP guidelines, is a hazard to human health. 

Article review data

August 2024

Article publication date

February 2024

ARPANSA summary

This cohort study examined the association between ultraviolet radiation (UVR) and childhood acute lymphocytic leukaemia (ALL) and childhood non-Hodgkin lymphoma (NHL). The study included 30,349 cases of ALL and 8062 cases (aged <20 years old) of NHL collected from population-based cancer registries (SEER 2022) for the years 2000-2020. The study adjusted for sex, median rent, calendar year, age and racial/ethnic group. UVR exposure data were collected from the measurements of 239 UVR measurement stations, which provided exposure measures of average solar UVR (mW/cm²) and cumulative solar UVR exposure (MJ/cm²). The authors reported an association between ALL incidence and UVR (relative risk (RR) 1.2/mW/cm² (95% confidence interval (CI) 1.06-1.36)), but significant decreasing trends for NHL (RR 0.6/mW/cm2 (95% CI 0.51-0.82)). There was no increasing trend for cumulative UVR exposure for ALL (RR = 1.44/MJ/cm2 95% CI 0.95-2.2) but again there was a decreasing trend for NHL (RR = 0.28/MJ/cm2 95% CI 0.166-0.49). The study concluded that high UVR exposure could be associated with ALL, however, the evidence was not strong enough to make firm conclusions. 

Link to study

Solar ultraviolet radiation exposure, and incidence of childhood acute lymphocytic leukaemia and non-Hodgkin lymphoma in a US population-based dataset - PMC (nih.gov)

Published in

British Journal of Cancer

ARPANSA commentary

The authors reported an association between ALL incidence and UVR exposure. There is disagreement in the literature surrounding the association between ALL and UVR exposure. A French study reported that for children aged less than 5 years old there was an increasing trend of ALL for each 25 J/cm² of UVR exposure (standardized incidence ratio 1.18; 95% CI 1.10-1.27) (Coste et al 2015). However, a Californian study reported a reduction in the risk of ALL with UVR exposure of ≥5,111 W/h/m² (odds ratio 0.89, 95% CI: 0.81-0.99) for children under 5 years old (Lombardi et al 2013). Overall, it remains unclear if UVR exposure increases the risk of ALL. The study also reported a protective effect of solar UVR exposure on childhood NHL. This has been reported in previous studies and has been assessed in systematic reviews. The systematic reviews have reported contradictory results that UVR exposure reduced the risk of NHL in children and adults  (Kim and Kim 2021) and increased the risk of NHL in people aged 17 and above (Lu et al 2017). Overall, the evidence for an effect of UVR exposure on NHL is unclear. 

A major limitation of this study and those by Lombardi et al (2013) and Coste et al (2015) is that they do not examine UVR exposure at the individual level. The actual UVR a person is exposed to could deviate significantly from the average solar UVR depending on how much time they spend outside each day and their occupation. None of these factors were considered by the authors. This could result in misclassification bias where the people in the low exposure group could have high exposure and those in the high exposure group could have low exposure.

Given high UVR exposure in Australia compared to many parts of the world, ARPANSA recommends adoption of  the 5 sun protection principles (i.e. Slip, Slop, Slap, Seek, Slide) when the UV Index is 3 or more. ARPANSA administers and maintains UVR monitoring stations across Australia that can be used to measure the UV Index in real-time and provide sun protection recommendation to the general public on a daily basis.