Radiation literature survey

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This was a meta-analysis of 6 case-control studies that examined the relationship between solar ultraviolet radiation (UVR) exposure and breast cancer. Three of these case-control studies were also used to assess a possible dose-response relationship between solar UVR exposure and breast cancer. The study reported a statistically significant reduced risk of breast cancer with UVR exposure (relative risk, RR: 0.7, 95% confidence interval (CI): 0.65, 0.75). The study also reported a statically significant decrease in breast cancer risk as UVR exposure increased in women aged 20 to 30 years (RR: 0.92; 95% CI: 0.90, 0.95). In women over 40, the authors reported a linear dose-response relationship that for every 1000 mW/m2 hours of sunlight there is a 10% reduction in breast cancer risk. Overall, the authors report that solar UVR reduces the risk of breast cancer in women.

Exposure to solar ultraviolet radiation and breast cancer risk: A dose-response meta-analysis

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Despite the overall conclusion of the authors, when specific breast cancer subtypes were examined there was no reduced risk for estrogen receptor-negative and progesterone receptor-negative breast cancers (RR: 0.87, 95% CI:  0.67, 1.11). The study included relatively few studies (6), which limits any conclusions that can be made on the reported reduced risk of breast cancer with UVR exposure.

While this study suggests that solar UVR exposure may reduce the risk of breast cancer in women, UVR exposure remains one of the major risk factors for development of skin cancers. Skin cancer accounts for the largest number of cancers diagnosed in Australia each year (Australian Institute of Health and Welfare, 2016). In 1992 the International Agency for Research on Cancer (IARC) classified solar UVR as a Group 1 carcinogen (IARC, 1992). ARPANSA recommends that all Australians limit their UVR radiation exposure, however, if you are in the sun, it is recommended that a combination of sun protection measures is used including clothing and sunglasses, shade and sunscreen. For more information see the ARPANSA factsheet, Sun exposure and health. 

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This was a meta-analysis that examined the possible association between mobile phone use and tinnitus. The meta-analysis included eight studies that examined mobile phone use and tinnitus (two cohort, one case–control, and five cross‐sectional studies). The studies included self-reported cases of tinnitus. The authors grouped studies based on mobile phone exposure assessment (self-reported or network operator data) and study design. They reported no statistically significant increased risk of tinnitus for any of the grouped results. The authors concluded that overall their results do not support that mobile phone use is associated with tinnitus. 

The Impact of Mobile Phone Use on Tinnitus: A Systematic Review and Meta-Analysis

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This study is in agreement with the conclusion of previous high quality reviews that have not supported a possible association between mobile phone use and tinnitus such as the ARPANSA Technical Report 164 and SCENIHR 2015. While studies such as Hutter et al (2010) have previously reported an association between tinnitus and mobile phone use, a review by the Independent Advisory Group on Non-ionising Radiation commented that these studies often had not controlled for environmental exposures, including direct exposure to sound in the auditory range.

There remains no substantiated scientific evidence that the use of mobile phones causes any health effects. However, for those that are concerned about their exposure, ARPANSA does provide advice on how to minimise your exposure in the Mobile phones and health factsheet. 

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This case-control study examined the effects of extremely low frequency (ELF) magnetic field (MF) exposure on the incidence of B-cell acute lymphoblastic leukaemia (B-ALL). The study included 290 cases and 407 controls who were under 16 years of age and recruited from public hospitals in Mexico City. Participants exposure was assessed by measuring the ELF MF in their bedrooms over a 24-hour period. The study reported statistically significant associations between B-ALL and ELF MF at ≥ 0.4 µT (odds ratio (OR) 1.87 95% confidence interval (CI) 1.04–3.35) and ELF MF at ≥ 0.6 µT (OR 2.32 95% CI 1.10–4.93). The authors concluded that exposure to ELF‐MF ≥ 0.4 μT may be associated with the risk of B‐ALL.

Extremely Low-Frequency Magnetic Fields and the Risk of Childhood B-Lineage Acute Lymphoblastic Leukemia in a City With High Incidence of Leukemia and Elevated Exposure to ELF Magnetic Fields

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The results in this study are limited by the small number of subjects classified as exposed; only 29 cases and 27 controls and 19 cases and 15 controls at ELF MF ≥ 0.4 µT and ≥ 0.6 µT, respectively. A recent meta-analysis by Crespi et al (2019) reported that exposure to ELF MF above 0.4 µT was not associated with childhood leukaemia. Further, there are a number of factors that could be influencing the observed association between childhood leukaemia and magnetic fields including, selection bias, misclassification and other confounding factors (WHO, 2007). There is also no substantiated mechanism that has been identified from experimental studies that could explain a possible association between ELF MF and childhood leukaemia (SCENIHR, 2015). This, together with shortcomings of the epidemiological studies, limits any conclusions being made on reported associations between ELF MF and childhood leukaemia.

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This was a cross-sectional study that examined the possible association between exposure of radiofrequency electromagnetic fields (RF EMF) to the brain of preadolescents (ages 9-11) and adolescents (ages 17-18) and cognitive function. The study included 2952 preadolescents and 261 adolescents that were originally recruited for separate Dutch and Spanish birth cohort studies. The study used self-reported questionnaires to estimate exposure to the brain based on the use of mobile phones and other near field RF EMF exposure sources. The study also estimated exposure to RF EMF in the far field based on exposure to mobile phone towers and TV and radio broadcast towers. The near field exposures were the largest contributor for both preadolescents (70.3%) and adolescents (96%). The study reported lower non-verbal intelligence but did not find any associations with other cognitive outcomes. The authors concluded that the one positive result could be due to reverse causality or may have occurred due to chance.

Association between estimated whole-brain radiofrequency electromagnetic fields dose and cognitive function in preadolescents and adolescents

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There have been several studies conducted on the possible effects of RF EMF on the cognitive function of children and adolescents and the evidence reported by these studies has been conflicting; however, the majority of studies report no evidence of an effect (Ishihara et al, 2020). A study by Mireku et al (2018) indicated that self-reported mobile phone use in adolescents can only differentiate between high and low users of mobile phones. This study by Cabr´e-Riera et al used questionnaires to evaluate mobile phone use and this self-reported data could have introduced inaccuracies leading to exposure misclassification. The use of speakerphone mode was also not controlled for in this study and this may have been a further source of exposure misclassification. This is because, the study estimated RF EMF exposure to the head based on call time and the use of speakerphone mode would substantially reduce RF EMF exposure from calls. There remains no substantiated scientific evidence that exposure to RF EMF causes any health effects. 

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There have been two separate reviews published by the same study group which have examined the literature on solarium use and the risk of melanoma. These reviews were conducted as a supplement to a meta-analysis of the same body of evidence published by Burgard et al in 2018. ARPANSA had previously reviewed this meta-analysis and provided comment. Briefly, in the 2018 meta-analysis, the authors included 2 cohort and 29 case-control studies and reported overall risk factors supporting an association between varying degrees of solarium exposure ranging from moderate to heavy use and a risk of malignant melanoma. Further, the risk of melanoma increased with higher use of solariums suggesting a dose-response relationship with ultraviolet radiation (UVR) exposure. Despite these results, the authors pointed to weaknesses in the included studies being a major cause of bias and thus concluded that there was no substantiated evidence of moderate solarium use being a causal factor for the development of malignant melanoma.

The current 2020 reviews provide further critique regarding the quality of the studies that form the basis of solarium use as a risk factor for melanoma. Specifically, they focus on “moderate” sunbed use being used as the criteria to question the scientific basis of current mainstream advice that the use of solaria is carcinogenic from exposure to artificial UVR, which is classified as a Group 1 carcinogen by the International Agency for Research on Cancer. The reviews discuss the impact of confounders including solar UVR exposure, age of exposure and smoking status and argue that the risk of bias presented by these factors would most likely lead to an overestimation of the risk. In relation to the criteria of “moderate” sunbed use, the authors argue that there is no strong evidence for melanoma development at UVR exposures below levels sufficient to cause erythema (sunburn).

Solarium Use and Risk for Malignant Melanoma: Many Open Questions, Not the Time to Close the Debate

Sunbeds and Melanoma Risk: Many Open Questions, Not Yet Time to Close the Debate

https://pubmed.ncbi.nlm.nih.gov/32918218/

Despite the critiques of the studies reporting an increased risk between solarium use and melanoma provided within the reviews, the included studies revealed a consistent relationship despite some of their weaknesses.

The authors’ assertions about the safety of moderate solarium use present the question about how ‘moderate’ is defined and, further, how use can be monitored and enforced. Before the total ban of commercial solaria in Australia by 2016, the solarium industry was guided by a voluntary code of practice which focussed on limiting use of sunbeds by factors such as age and skin type of the client. A 2011 study by Makin et al. demonstrated poor adherence by solarium operators to the requirements of this code when accepting clients.

Despite the conclusions of these reviews, the positive associations consistently demonstrating an increased risk between solarium use and melanoma in epidemiological studies continue to support Australia’s nation-wide policy to ban all commercial solaria as a strong health protection measure.

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The ‘Moscow signal’ incident occurred during the Cold War between 1953 and 1976. The former USSR reportedly irradiated the US embassy with a 2.5 – 4 GHz microwave beam with a maximum reported exposure of 15 μW/cm2 for 18 hours a day (Lilienfeld et al., 1978). This paper reviewed the evidence of adverse health effects to staff working in the US embassy. Based on medical records and a Health History Questionnaire, there were no observed differences to total mortality or in ‘mortality from cancer’ between the Moscow group and the comparison group (staff who served in other eastern European embassies). Likewise, the results for morbidity found no differences in health status between the Moscow exposure group and the comparison group except for an increased rate of protozoal infections in males, and a slightly increased frequency of common health conditions. However, hundreds of morbidity comparisons were made, and these are likely chance findings. The paper concludes that no adverse health effects related to increased exposure to radiofrequency electromagnetic energy (RF EME) from the ‘Moscow signal’ incident were found. This supports the findings of the original report by Lilienfeld et al. commissioned by the US Department of State.

Microwaves in the cold war: the Moscow embassy study and its interpretation. Review of a retrospective cohort study

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The exposure experienced by staff in the US embassy in Moscow is low compared to the current ARPANSA RF exposure standard. Further, there is no substantiated scientific evidence of adverse health effects from exposure to RF EME below the limits set by the ARPANSA RF Standard. The exposure limits are underpinned by several reviews of the body of scientific literature including: the ICNIRP review of RF EME and health, and The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR)’s opinion ‘Potential health effects of exposure to electromagnetic fields (EMF)’. The results of this study contribute further to the growing body of evidence supporting no adverse health effects from RF EME below the set exposure limits.

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This in vivo study examined the effects of radiofrequency electromagnetic energy (RF EME) on the reaction of rats to auditory stimulus. The study exposed rats to RF EME or sham for 2 hours 5 days a week over either a 1 or 10 week period. The RF exposure had a specific absorption rate (SAR) of 0.66 W/kg to the head and 0.005 W/kg to the body. After the exposure period, each animal’s hearing function was tested by measuring its auditory brainstem response (ABR). The authors reported no difference in the ABR threshold values between any of the groups. They did report a statistically significant increase in the latencies of the ABR in the one week exposure group and a decrease in the 10 week exposure group. The study also reported statistically significant changes in the concentration of some biomarkers in the brains of the exposed mice that could indicate changes in the concentration of reactive oxygen species (ROS) and imply oxidative stress.

The effects of acute and chronic exposure to 900 MHz radiofrequency radiation on auditory brainstem response in adult rats

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While there were some changes in biological indicators this did not result in any physiological effects. The effect of RF on ABR has previously been examined in newly born mice Kim et al, 2019. Kim et al also found that RF exposure for 5 days had no significant effects on ABR.

While there were changes in the concentration of biological indicators of ROS, a link between RF EME exposure and altered ROS production has not been substantiated. When the total body of available research on ROS production is considered there are no consistently demonstrated health risks to humans (SCENIHR, 2015).

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This study is a retrospective case series of staff from the US government embassy in Havana, Cuba, who reported experiencing an auditory stimulus that was associated with the onset of various health effects. The stimulus reported by the staff had differing physical characteristics such as high (n=18) or low (n=2) pitch and pressure (n=9) or vibrations (n=3). Of the 24 individuals with suspected exposure, 21 were evaluated 203 days after the reported exposure. The persistent symptoms reported by these individuals were highly variable and included cognitive (n=17), balance (n=15) and visual (n=18) effects, and auditory dysfunction (n=15), sleep impairment (n=18) and headaches (n=15). Different individuals reported various combinations of these health effects. MRI neuroimaging was conducted for the 21 individuals and only three showed changes outside of the normal range. Of these three cases, the authors mention that the changes observed could possibly be attributed to other pre-existing conditions or risk factors.

Neurological Manifestations Among US Government Personnel Reporting Directional Audible and Sensory Phenomena in Havana, Cuba

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It is not known how an auditory stimulus or any other exposure, including radio waves, could cause the health symptoms that US government personnel reported. Neither sound in the auditory range or exposure to radio waves is associated with any of the reported symptoms. Further, ARPANSA is not aware of how any other type of radiation exposure could cause the reported symptoms. As discussed by Swanson et al. (2018) the symptoms could possibly be due to a collective delusional disorder, such as a type of mass psychogenic illness. However, Swanson et al. (2018) states there is little evidence for this, and other occurrences of mass psychogenic illness don’t usually result in persistent symptoms. However, a report by Bartholomew et al. (2018) suggests a mass psychogenic illness is the most likely cause and that such occurrences have been reported before. Bartholomew et al. (2018) further suggests that the sound that was perceived was likely just the normal sounds of the city and was conflated with the reported symptoms.

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This review examined the scientific evidence of a connection between exposure to radiofrequency electromagnetic fields (RF EMF) and non-specific symptoms by individuals who identify as suffering from electromagnetic hypersensitivity (EHS). EHS individuals reported a wide range of non-specific health problems, which they attributed to RF EMF exposure. This study reported that short-term symptoms have been commonly examined using double-blinded provocation studies. These studies have used either typical environmental exposures (e.g. mobiles phones and wi-fi) or sham exposures on both non-EHS individuals and those that report to have EHS. The studies reported no difference in reported symptoms between real or sham exposure. These results suggest that it is the perception of exposure to RF EMF and not the exposure itself that triggers the symptoms reported by EHS individuals. The review also reported on the outcome of cohort studies and meta-analyses of cross-sectional studies that examined the long-term symptoms from RF EMF exposure. When examining the meta-analyses this review reported that lower quality studies or studies where participates were aware of their exposure more commonly reported positive associations between RF EMF exposure and EHS symptoms. In contrast, high quality cohort studies that measured exposures objectively, and compared this to the occurrences of symptoms in EHS individuals, did not demonstrate associations between RF EMF exposure and EHS symptoms. Overall, this review concluded that the symptoms experienced by EHS individuals are closely associated with perception of RF EMF exposure. This suggests that the symptoms experienced by those who report to be EHS are likely because of a nocebo response. 

Is there a syndrome caused by radiofrequency electromagnetic fields?

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This review contributes to our understanding of the evidence surrounding RF EMF exposure and the occurrence of EHS symptoms. ARPANSA has previously reviewed the evidence of an association between RF EMF exposure and EHS in technical report 164 and continues to review research on EHS to stay up to date on this topic. The symptoms experienced by people who report to have EHS are real and can have disabling effect for the affected individual. However, the scientific evidence suggests that exposure to RF EMF is not the cause of these symptoms. In 2017, ARPANSA published technical report 178 on the research needs for RF EMF and health. This report outlined a number of research aims for scientific investigation that will further elucidate the connection between EHS symptoms and RF exposure.

More information on EHS is available in a factsheet by ARPANSA as well as the World Health Organization.

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This human experimental study examined whether all-night exposure to radiofrequency electromagnetic energy (RF EME) from Wi-Fi affected sleep-dependent memory consolidation and its biological indicators. Thirty males were recruited to spend 5 nights sleeping in the laboratory where they were exposed to the RF EME from Wi-Fi and sham exposure on the 3rd and 5th nights. Memory performance was evaluated with various cognitive tasks while learning-associated brain activity was collected via an electroencephalogram (EEG). The study found exposure to Wi-Fi had no effect on emotional or procedural memory, but there was improvement in the declarative memory task. However, there was no effect on the sleep-specific brain activity parameters recorded by the EEG for any of the assessed memory parameters. Therefore, the authors concluded that the beneficial effect of Wi-Fi exposure on declarative memory was likely a chance finding, and that Wi-Fi does not affect sleep-dependent memory consolidation.

Effects of 2.45 GHz Wi-Fi exposure on sleep-dependent memory consolidation

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Despite the small sample size of males for this study, the findings add to the growing scientific body of evidence that RF EME exposure from Wi-Fi sources does not adversely affect sleep. A replication study with a larger sample size is required before concluding that the beneficial effect on declarative memory is more than a chance finding. The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR)’s review on ‘Potential health effects of exposure to electromagnetic fields (EMF)’ also found a lack of evidence that RF affects cognitive functions in humans. This is in line with ARPANSA’s view that there is currently no substantiated scientific evidence that exposure to RF EME at levels below the limits set in the ARPANSA Standard (RPS S-1) cause any adverse health effects.