Radiation literature survey

Review date

June 2023

Article publication date

April 2023

Summary

This cross-sectional study investigated associations between short-term mobile phone use and the subsequent radiofrequency electromagnetic energy (RF EME) exposure with cognitive performance, stress and sleep quality. This study recruited 121 adults (aged 18 – 70) from Basel, Switzerland and Besancon, France who regularly used a smartphone and had a laptop/computer with internet access. Participants were required to complete 10 daily assessments over a 2-week period (no assessments on weekends). Exposure was assessed in these daily assessments via a questionnaire which gathered data on participants mobile phone call time and their total mobile phone screen time which served as a proxy for RF EME exposure. Cognitive performance was also assessed daily by a cognitive test battery available via laptop or computer, while sleep quality was assessed using a Fitbit Inspire activity tracker and stress via the questionnaire. The study found no consistent association with mobile phone use and cognitive function despite some sporadic results which were likely chance findings. Sleep quality was also not associated with mobile phone use, however, there was a significant association between stress and mobile phone screen time with stress increasing in relation to a 10-min increase in mobile phone screen time. The authors suggest that due to the low amount of RF EME exposure caused during mobile phone screen time that is unlikely that the increase in stress is due to RF EME exposure but instead due to a non-biophysical mechanism.

Link to

The association between real-life markers of phone use and cognitive performance, health-related quality of life and sleep

Published in

Environmental Research

ARPANSA commentary

The results for cognitive performance and sleep are consistent with other studies (Cabre’-Riera et al. Verrender et al. Eggert et al.) which found no association with RF EME exposure. The association found between stress and mobile phone screen time is likely due to behavioural factors associated with increased mobile phone use as suggested by the authors. The results of this study provide further evidence that the limits set within the ARPANSA RF Safety Standard (RPS S-1) are appropriate for protecting people from the known harmful effects of exposure to RF EME. It is the assessment of ARPANSA and other health authorities, including the World Health Organization and International Commission on Non-Ionizing Radiation Protection, that there is no substantiated scientific evidence that mobile phones cause any adverse health effect.

Review date

April 2023

Article publication date

March 2023

Summary

This nested case–control study evaluated risk of skin melanoma associated with occupational exposure to cosmic (ionising) radiation and solar ultraviolet (UV) radiation among military pilots. The study included 199 male cases (10 of which had ever worked as a pilot) of skin melanoma diagnosed between 1990 and 2003, and 1,126 male cancer-free controls identified from a large Danish military population. The Danish National Cancer Registry provided data on the male cases for skin melanoma; whilst data on all participants’ work history in military service and other jobs, socioeconomic and lifestyle characteristics (e.g., leisure-time sun exposure habits) were obtained from a self-reported questionnaire. The study found a positive association between work onboard aircraft and skin melanoma (Odds Ratio (OR)=2.30, 95% Confidence Intervals (CI): 1.06–4.97) and the risk was indicated only to be increased in pilots (OR=7.08, 95% CI: 2.51–19.93). Similarly, a positive association between longer duration of employment as a pilot and skin melanoma was also found (OR _{per year} =1.07, 95% CI:1.01–1.14).

Link to

Incident skin melanoma in Danish male military pilots: a nested case-control study

Published in

Occupational Environmental Medicine

Commentary by ARPANSA

The overall conclusion of the study indicates that occupational exposure to cosmic and solar UV radiation among male pilots increases risk of skin melanoma, and the risk increases with longer duration of the employment. These findings are consistent with the findings of previous systematic reviews and meta-analyses  ( Sanlorenzo et al., 2015; Miura et al., 2019). A cohort study (Olsen et al., 2019) conducted among Australian-licensed commercial pilots showed a modestly raised risk of in situ melanoma, but no increased risk of invasive melanoma compared with the general population. Limitations of this study include likely inaccuracies in the assessment of cosmic and UV exposure levels, and recall bias in the exposure reporting. Further, a modest participation rate of male cases and controls may have also instigated selection bias, which partly could be a reason for relatively high risk estimates for skin melanoma among pilots compared with previous findings. The Australian Radiation Protection and Nuclear Safety Agency’s (ARPANSA) Guide for Radiation Protection in Existing Exposure Situations Radiation Protection Series G-2 provides framework for managing existing exposure situations, including exposure of aircrew due to cosmic radiation. Similarly, ARPANSA’s Radiation Protection Standard for Occupational Exposure to Ultraviolet Radiation (2006) sets fundamental requirements for safety in relation to occupational UV radiation exposure. Though an elevated risk of skin melanoma among commercial pilots has been indicated by recent epidemiological studies, generally, there is no increase in health risk from exposure to cosmic or UV radiation for casual flyers. However, some of the frequent flyers (critical population groups e.g., pregnant women and children) may exceed reference levels of cosmic radiation (Tate et al., 2021), and hence additional awareness or protection may be considered.

Review date

April 2023

Article publication date

February 2023

Summary

This cross-sectional study evaluated the association between sunlight exposure, changes in vitamin D levels and sleep quality. The study included 1,709 people from Brazil and was conducted between October and December 2020 during the Covid-19 pandemic. The study assessed sunlight exposure over one week and sleep quality using a questionnaire. Vitamin D levels were measured with a blood test. The authors reported that vitamin D levels were not associated with poor sleep quality (odds ratio (OR) 0.85; 95% confidence interval (CI) 0.43–1.72) among the people who received adequate sunlight exposure. However, vitamin D deficiency was associated with poor sleep quality (OR 2.02; 95% CI 1.10–3.71) among individuals with insufficient sunlight. They further reported that each 1-ng/mL increase in vitamin D levels reduced the chance of poor sleep quality by 4.2% (OR, 0.96; 95% CI 0.92–0.99). The study concluded that deficiency in vitamin D resulted in poor sleep quality among those who had insufficient exposure to sunlight.

Link to

Influence of sunlight on the association between 25-hydroxyvitamin D levels and sleep quality in Brazilian adults: A population-based study

Published in

Nutrition

Commentary by ARPANSA

The study has limitations that should be acknowledged, including the subjective nature of self-reported sleep quality and sun exposure, which may result in overestimation or underestimation of the findings. Previous studies have also concluded that sunlight and vitamin D can impact sleep quality. Studies by Boubekri et al (2014) and Mirzaei-Azandaryani et al (2022) reported that sunlight exposure and vitamin D supplementation could improve sleep quality in office workers. However, the relationship between sunlight, vitamin D, and sleep is complex and may be influenced by factors such as time of day, environment, and behaviour (Choi et al, 2020). Further research is needed to better understand this relationship.

The Cancer Council Australia mentions that most  people reach adequate vitamin D levels through incidental sun exposure. When the UV index is above 3, adequate vitamin D levels can be maintained just by spending a few minutes outdoors. When the UV index is below 3, the Cancer Council Australia suggests adequate vitamin D levels can be still be reached by incidental exposure during outdoor physical activity or gardening. Despite Australia’s high solar UV, one in four Australians are estimated to be vitamin D deficient (Cancer Council Australia). The Cancer Council and the Endocrine Society of Australia recommend that people who may be at risk of vitamin D deficiency discuss their vitamin D requirements with their medical practitioner rather than seeking sun exposure.

Date:
March 2023

Article publication date:
December 2022

Authored by:
Ishai et al
 
Summary

This narrative review provides an overview of the potential harm caused by radiofrequency electromagnetic energy (RF EME) based on a variety of studies, including epidemiological, in vivo, in vitro, and mechanistic. The authors claim that there is a causal relationship between RF EME and various health outcomes such as cancer, developmental issues, and reduced fertility. They attribute these negative health outcomes to the build-up of reactive oxygen species (ROS) and the activation of voltage gated calcium channels (VGCC) in cells. The review also discusses the findings of large studies, such as the 2018 U.S. National Toxicology Program (NTP) study and the 2018 Ramazzini Institute study, which both exposed rats and mice to high levels of RF EME and reported on cancer outcomes . The authors conclude that there is an established link between RF EME and adverse health outcomes and call for increased funding and research on RF EME and health, as well as an immediate moratorium on 5G mobile telecommunications.

Link to

Problems in evaluating the health impacts of radio frequency radiation

Published in

Environmental Research

Commentary by ARPANSA

This review claims many health outcomes and relies on criticized research to draw its conclusions, particularly the NTP study, the Ramazzini Institute study, and the epidemiological studies and reviews conducted by the Hardell group.

The NTP and Ramazzini Institute studies have been criticized by many researchers, including both ARPANSA and the International Commission on Non-Ionizing Radiation (ICNIRP), the peak international organization providing science-based advice on limiting exposure to non-ionizing radiation. Both organizations reported that neither study provides consistent, reliable evidence that RF EME at levels below the ARPANSA RF health standard can cause health effects in humans. This conclusion was based on methodological and statistical failures in both studies, such as high levels of exposure, failure to use appropriate statistical analysis, and inconsistencies in the health outcomes of the animals. For more information, please see the ARPANSA analysis of the NTP study and the analysis of both studies by ICNIRP.

When the authors reviewed the evidence of the association between RF EME from mobile phones and glioma, they relied heavily on the conclusions previously made by the Hardell group. The authors did not examine evidence from recent major studies, such as Karipidis et al. (2018), Villeneuve et al. 2021, Elwood et al. 2022, Little et al. 2012, Deltour et al. 2022 and Choi et al 2021, which reported no change in brain cancer incidence since the introduction of mobile phones in Australia, Canada, New Zealand, America, Denmark, Finland, Norway, Sweden and Korea.

The review reports that there are two mechanisms by which RF EME could cause various health issues: production of ROS and activation of VGCC. However, the review's discussion of how RF EME could cause ROS production is limited and fails to address any evidence from experimental studies that actually measured ROS production from RF EME exposure. It relies on evidence from the criticized NTP study (Smith-roe et al 2020), which again did not actually measure ROS production and previous review articles. For more information on the Smith-roe et al (2020) paper see the analysis by Vijayalaxmi et al, (2020). The authors also miss evidence provided by Wood and Karipidis (2020) that reviewed the literature from the last 50 years of how RF EME could activate VGCC, and the authors report that the experimental studies have not validated that RF affects calcium transport into or out of cells.

The review claims to use the Bradford Hill criteria to establish causation for RF EME and cancer, but the authors do not apply the criteria themselves and only report on opinions presented in a previous review by Carlberg and Hardell (2017).

Overall, this review appears to be strongly influenced by confirmation bias with the authors relying heavily on other reviews that supported their conclusions rather than assessing the evidence themselves. There are higher quality reviews of RF EME and health available that have reviewed the evidence, such as the reviews by Karipidis et al (2021) and Wood et al (2021), and reviews by large organizations such as Public Health England and The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR). The World Health Organization is also currently conducting systematic reviews on many different topics related to RF EME and health (link to report).

Article publication date

January 2023

Authored by

Yamazaki et al.

Summary

This measurement study aimed to assess personal radiofrequency (RF) electromagnetic field (EMF) exposure in Japanese children living in the Hokkaido Prefecture and compare the exposure levels to European countries. The study also investigated a possible association between RF EMF exposure and behavioural issues, such as attention deficit hyperactivity disorder (ADHD) symptoms, and internet addiction. There were 107 children and their parents agreeing to participate. In the study, personal exposure to RF EMF was measured in 101 children over three days and the children also completed a questionnaire which gathered information on mobile phone, wireless communication device and internet use. The parents completed the Strengths and Difficulties Questionnaire, which assessed behaviour and mental health problems among the children. The RF EMF exposure from mobile phone base stations was found to be the most significant contributor to total exposure, while those who lived in an urban setting had consistently higher exposure. Overall, the exposure to Japanese children was found to be lower than similar studies conducted in Europe. The study did not find an association between RF EMF exposure and internet addiction or most of the behavioural outcomes. However, an association was found between Wi-Fi exposure at night and inattention/hyperactivity. The authors concluded that this may be due to children who could not limit their use of wireless electronic devices (mobile phones, gaming devices, etc.) at night-time.

Link to

Measurement of personal radio frequency exposure in Japan: The Hokkaido Study on the Environment and Children's health

Published in

Environmental Research

Commentary by ARPANSA

Although this study found children living in urban environments were exposed to consistently higher levels of RF EMF exposure, these levels were still well below the exposure limits set in the International Commission for Non-Ionising Radiation Protection (ICNIRP). Further, the reported RF-EMF exposures in Japan are comparable to those measured in Australia. The exposure limits in the ARPANSA safety Standard are based on current scientific knowledge and are closely aligned with international guidelines prepared by ICNIRP. The ARPANSA safety Standard is designed to provide protection to people of all ages and health statuses against the known short- and long-term effects of exposure to RF EMF. The association found between Wi-Fi exposure at night and inattention/hyperactivity is likely due to confounding from behavioural factors such as hyperactivity/inattention as the authors concluded.

ARPANSA has conducted RF measurement studies and published the results on the ARPANSA website. Additionally in 2017, ARPANSA published a study assessing the RF exposure level due to Wi-Fi in Australian schools. Exposure levels in these measurement studies from RF sources were found to be much lower than the public exposure limits in the Australian safety Standard. There remains no substantiated scientific evidence that exposure to RF EMF below the limits in the Australian Standard causes any adverse health effects.

Article publication date

February 2023

Authored by

Freudenstein et al.

Summary

This study assessed the effects of generalisation descriptions on risk perception of radiofrequency electromagnetic field (RF EMF) sources. The study tested 629 participants, who were randomly allocated into three groups. Group G1 received an excerpt of an original press release from the International Agency for Research on Cancer (IARC) implying that all RF EMF sources are possibly carcinogenic to humans (i.e., strong generalization); Group G2 received the original press release and an additional explanatory text module informing that the IARC risk assessment refers only to mobile phones (i.e., weak generalization); and Group G3 received rewritten text using the phrase ‘RF EMF from mobile phones’ whenever ‘RF EMF’ was mentioned in the IARC press release (i.e., weak generalisation). Participants’ risk perceptions regarding mobile phones and other sources of EMF were measured before and after the reading of the text. Further, the degree to which the participants generalised mobile phone-related EMF to other RF EMF exposures was evaluated to determine whether this was predictive of their post-text risk perceptions.

The study found that all three groups showed an increased risk perception for EMF sources after reading the presented texts. Respondents reporting a strong risk generalisation belief showed significantly higher risk perceptions for all tested EMF sources (except mobile phones) than subjects with a weak risk generalisation belief. The higher the general risk perception, the more people are inclined to generalise the cancer risk across all EMF sources.

Link to

Effects of generalization descriptions on risk perception

Published in

Environmental Research

Commentary by ARPANSA

This study demonstrates that risk generalisation belief affects the risk perception of RF EMF exposure sources, which is consistent with what has been previously reported (Pradhan et al., 2022). The overall conclusion of the study is that a weak risk generalisation belief (i.e., that the IARC’s RF EMF exposure risk specifically relates to mobile phones) reduces risk perception overall. Consistent with the findings of this study, a previous study conducted in Australia (Zeleke et al., 2019) showed that risk perception for RF EMF exposure was not different among three groups of people who received different levels of information about RF EMF exposure. (Zeleke et al., 2019) also showed that the people who received their personal RF EMF exposure data indicating very low level of exposure (compared to the limits set by the ARPANSA Safety Standard) were more confident about protecting themselves from RF EMF exposure.

Based on the current scientific evidence, it is the assessment of ARPANSA that there is no substantiated evidence that RF EMF exposures at levels below the limits set in the ARPANSA Safety Standard cause any adverse health effects, including cancers in human populations. The World Health Organization is also currently conducting an overall health risk assessment for exposures to RF EMFs in the general and working populations.

Article publication date

January 2023

Authored by

Zhivagui et al

Summary

This in-vitro study examined the DNA damage in cells exposed to ultraviolet radiation (UVR) from nail polish dryers. The study exposed 10 mouse and 13 human cell cultures to UVR for 20 minutes either twice in one day or once a day for three days. Eight human and five mouse cells cultures that were unexposed and used as controls. The authors reported statistically significant DNA damage in both the exposed human and mouse cells. The study also reported that for all cell types a single 20-minute exposure resulted in 20–30% cell death, while three consecutive 20-minute exposures caused cell death in the range of 65-70%. The authors concluded that UVR emitted by UV-nail polish dryers may increase the risk of skin cancers of the hand.

Link to

DNA damage and somatic mutations in mammalian cells after irradiation with a nail polish dryer

Published in

Nature Communications

Commentary by ARPANSA

The study exposed the cells to UVR for over 20 minutes which is much longer than would be required to dry nail polish (e.g. usually 2-3 minutes). This is also longer that than the U.S. Food and Drug Administration recommendation of no more than 10 minutes per hand. Therefore, given the UVR exposure durations used in the study and that used in drying nail polish, there should not be any health concern for the later. However, if people are still concerned about the potential health risks and prefer to minimise their UVR exposure, they can wear fingerless gloves and/or apply sunscreen to protect their hands from the UVR during the drying process.

There is high quality epidemiological evidence for the increased risk of skin cancer from the use of tanning beds (Gordon et al, 2008, 2020). However, this level of evidence is not present for the risk of using UVR nail polish drying devices, and therefore, the findings of this in-vitro study may not be directly transferable to humans. Epidemiological research is therefore needed to better understand the potential health risks of these devices.

Skin cancer accounts for the largest number of cancers diagnosed in Australia each year (Australian Institute of Health and Welfare, 2016). The major cause of skin cancer is due to the UVR exposure from the sun. However, UVR induced skin cancer is almost entirely preventable. The Australian Radiation Protection and Nuclear Safety Agency recommends that sun protection measures (e.g., clothing and sunglasses, shade and sunscreen) should be used, wherever applicable. For more information see the ARPANSA factsheet, Sun exposure and health. The SunSmart app is also a great tool that can be used to inform people of the UV level outside a recommend the appropriate sun protective measures.

Article publication date

23 January 2023

Authored by

ABC News

Summary

The ABC published a news article on a potential cluster of nine non-Hodgkin’s lymphoma (NHL) cases identified in military officers who were stationed at the Malstrom Air Force Base, which is a nuclear missile base in Montana. The officers all served as missileers decades ago and their duties included being deep underground in a small operations bunker on standby to turn the missile launch keys if ordered. They were diagnosed with NHL between 1997 and 2007. The Malstrom Air Force Base had previously been investigated in 2001 when a suspected cancer cluster of 14 various types of cancer were reported amongst missileers. Two of these cases were NHL and it is unclear if these are also included in the group of nine NHL cases. However, the site was found to be environmentally safe following the investigation in 2001. In a statement to the Associated Press, an Air Force spokeswoman said “senior leaders are aware of the concerns raised about the possible association of cancer related to missile combat crew members at Malmstrom AFB. The information in this briefing has been shared with the Department of the Air Force Surgeon-General and our medical professionals are working to gather data and understand more.

Link to

Investigation underway after nine nuclear missileers develop non-Hodgkin's lymphoma

Commentary by ARPANSA

The incidence of NHL has been increasing worldwide in recent decades (Cai et al, 2021). In Australia NHL has increased from an incidence rate of 11.3 (per 100,000 persons) in 1982 to 20.4 in 2022, ranking the disease as the sixth most common cancer (AIHW, 2022). The causes of the rise in incidence are not clear and exposure to ionising radiation has been suggested as a possible factor.

As the suspected cluster reported by the ABC article occurred in the USA, we do not have specific information on the kinds of exposures occurring at the Malstrom Air Force Base. However, considering the suspected cluster occurred in a nuclear missile base, it is possible that personnel were occupationally exposed to ionising radiation. There have been a number of previous epidemiological studies that have investigated occupational exposure to ionising radiation and the risk of NHL including studies on individuals working in the nuclear industry, nuclear weapons testing programs, medical imaging or those working as airline crew; these have recently been reviewed by Harbron and Pasqual (2020). Results from the studies have generally been mixed and there are various methodological limitations that weaken the results including potential confounding and other biases. Another limitation in epidemiological studies is the uncertainty in the dose assessment. As described by Hasbron and Pasqual (2020), while most lymphomas are formed of mature lymphocytes, these cells do not necessarily represent the origin of the disease which means the appropriate organ for dose response analysis is unclear.

In Australia, ARPANSA has previously collaborated  with various universities to investigate occupational exposure to ionising radiation and NHL in a population-based case control study (Karipidis et al. 2007). The study used overseas estimates of ionising radiation exposure and found no association with NHL. In an update to the study, Karipidis et al 2009, used occupational radiation estimates from ARPANSA’s Personal Radiation Monitoring Service and again found no association with NHL.

It is ARPANSA’s goal to ensure that the highest standard of protection is made available through the implementation of the relevant Codes and Safety Guides. The Code for Radiation Protection in Planned Exposure Situations (2020), RPS C-1 (Rev.1), sets out the requirements in Australia for the protection of occupationally exposed persons, the public and the environment in planned exposure situations. All Australian jurisdictions have uniform annual limits for public and occupational exposure to ionising radiation: 1 mSv for the public and 20 mSv for workers who are occupationally exposed. Compliance with the occupational dose limit protects occupationally exposed workers from the harmful effects of ionising radiation.

Article publication date

January 2023

Authored by

Pinto et al.

Summary

This systematic review evaluated the evidence on exposures to radiofrequency electromagnetic field (RF-EMF) and increased risk of tumour (malignant and benign) incidence in laboratory animals (rodents). A total of 294 research papers were screened and 46 were included in the systematic review. This included 27 in vivo eligible studies to evaluate cancer incidence, with 23 studies used in the subsequent meta-analysis to assess the possible risk of tumours. The findings of the study demonstrated that there was no statistically significant association between exposure to RF-EMF and the risk of cancer in most of the considered animal tissues or organs; while significant associations were found for tumours in the heart, central nervous system (brain), and intestine. The quality of evidence for the significant associations were either low or very low. The study showed that there is little or inadequate evidence of an association between RF-EMF exposure and incidence of tumours.

Link to

In Vivo Studies on Radiofrequency (100 kHz–300 GHz) Electromagnetic Field Exposure and Cancer: A Systematic Review

Published in 

International Journal of Environmental Research and Public Health

Commentary by ARPANSA

The review provides a robust evaluation of whether RF-EMF exposure is related to the incidence of tumours in laboratory animals. The studies suggesting significant associations for the heart, intestine and brain tumours (e.g., The NTP study and Falcioni et al., 2018) have a number of limitations. For example, these studies were prone to multiple testing and the reported significant associations could have occurred due to chance. An evaluation  of these studies has also been published by the International Commission on Non-Ionizing Radiation (ICNIRP) and has been commented by the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA).

The overall findings of this review study are consistent with a recent review conducted by the US Food and Drug Administration on RF-EMF and Cancer. The World Health Organization is also currently conducting a systematic review on the same topic to understand whether exposure to RF-EMF is related to cancer in laboratory animals. Based on the current scientific evidence, and consistent with the findings of this review, it is the assessment of ARPANSA that there is no substantiated evidence that RF-EMF exposures at levels below the limits set in the ARPANSA Safety Standard cause any adverse health effects, including cancers in human populations.

Article publication date

January 2023

Authored by

Zagar et al.

Summary

This retrospective cohort study, conducted in Slovenia, investigated whether increased exposure to extremely low frequency (ELF) magnetic fields (MF) due to living in close proximity to high voltage powerlines was associated with an increased risk of childhood leukaemia, brain tumours and all childhood cancers. This study applied a new exposure modelling methodology, which used data from the high voltage powerlines registry to estimate ELF MF levels for the whole of Slovenia. These exposure estimates were then validated by a subset of measurements. The Slovenian cancer registry data was used to gather data on cases of leukaemia (aged 0–19), brain tumours (age 0–29), and all cancers (age 0–14) between 2005 and 2016. The distance of the permanent address of residence of the cancer cases to high voltage powerlines was used as the proxy indicator for ELF MF exposure. The exposure modelling found that 0.5% of children and adolescents in Slovenia were exposed to 0.1 µT or greater and only 0.09% were exposed to 0.4 µT or greater. The results of the study found no increased risk of leukaemia, brain tumours, or all cancers in children and adolescents with exposure of 0.1 µT or greater. The authors concluded that the risk of cancer for children and adolescents living near high voltage powerlines does not differ from the average risk in the general population.

Link to

Estimating exposure to extremely low frequency magnetic fields near high-voltage power lines and assessment of possible increased cancer risk among Slovenian children and adolescents

Published in

Radiology and Oncology 

Commentary by APRANSA

Although this study found no association, some epidemiological studies observing outcomes from exposure to ELF MF greater than 0.3 or 0.4 µT have shown an association with childhood leukaemia (SCENIHR 2015). However, this association has not been established by consistent scientific evidence. The epidemiological evidence for this association is weakened by various methodological problems such as potential selection bias, misclassification and confounding. Furthermore, it is not supported by laboratory or animal studies and no credible theoretical mechanism has been proposed on how ELF MF could cause cancer.  This study used enhanced exposure assessment methods supported by residential magnetic field measurements and the results are supported by a recent meta-analysis by Crespi et al (2019), which found ELF MF above 0.4 µT was not associated with childhood leukaemia. Overall, the scientific evidence does not establish that exposure to ELF EMF from powerlines is a hazard to human health.