Emerging risks: mobile phones/EMFs
BLM Emerging Risks Team Report on Mobile Phones/EMFs
November 2014
Malcolm Keen
Solicitor, BLM London
T 020 7865 3381
E [email protected]
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Emerging risks: mobile phones/EMFs
Introduction
Use of mobile phones has of course increased dramatically in recent years. According to Ofcom
there were 83.1 million mobile phone subscriptions in the UK in Q4 2013. The same data stated
that in Q1 2014 93% of adults in the UK own/use a mobile phone. With such ubiquity, and with
increasing frequency and duration of use, concerns have increased about whether exposure to
electromagnetic fields from mobile phones may cause adverse health effects.
There has been a plethora of scientific research concerning the possible adverse health effects of
mobile phones. Whilst the balance of scientific evidence does not prove a clear health risk there is
uncertainty. Because mobile phone use is comparatively recent, current studies do not take
account of the effect of exposure over very long periods of time. Many conditions (cancer or
noise-induced hearing loss for example) have very long latency periods (the time between
exposure to the harmful agent and onset of symptoms). Lack of long-term evidence is of course a
typical feature of emerging risks. Uncertainty also results from gaps in scientific knowledge,
continual developments in mobile phones themselves, and changes in patterns of use.
Electromagnetic fields
Electromagnetic fields (EMFs) are naturally occurring (such as the earth’s magnetic field). EMFs
also arise as a result of the use of electric power. The electromagnetic spectrum includes radio
waves (as used in mobile phones), microwaves, ultraviolet light and x-rays.
Extremely low frequency fields
Extremely low frequency fields (ELFs) are generated by the transmission of electric power. Such
exposure can occur within the home and workplace as a result of electrical appliances.
Radio frequency
Radio frequency (RFs) are frequencies between 3 KHz and 300 GHz. They are widely used for
telecommunications such as radio, television and mobile phones. Mobile phone frequencies are
within the ranges 872–960 MHz and 1,710–1,875 MHz.
Microwaves
These are at frequencies within the RF range. They have a wide variety of uses such as radar and
satellite communications, and cooking.
Light
Light is at higher frequencies and includes infrared and ultraviolet light.
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Emerging risks: mobile phones/EMFs
Ionising Radiation
This is found at the higher frequencies of the spectrum and include x-rays and gamma rays.
AGNIR
In April 2012, the Advisory Group on Non-ionising Radiation (AGNIR - which reports to the Health
Protection Agency – HPA) published its report on the health effects of radio frequency
electromagnetic fields (EMFs). The study (Health Effects from Radiofrequency Electromagnetic
Fields, Independent Advisory Group on Non-ionising Radiation, HPA, April 2012) noted that
exposure to the general public to low level radio frequency (RF) fields from mobile phones,
wireless networking, TV and radio broadcasting, and other communications technologies is now
almost universal and continuous. The study noted that there are now over 80 million mobile
phones in the UK, supported by nearly 53,000 base stations. The AGNIR noted the expansion in
the number of peer-reviewed scientific papers relevant to this area. In undertaking this study, the
AGNIR considered that:
“Careful scientific review is needed to draw sound conclusions from this mass of evidence …”.
For the purposes of its review, the AGNIR defined RF fields as that part of the electromagnetic
spectrum between 100 kHz and 300 GHz. These frequencies are used for a great variety of
applications including mobile phones. The AGNIR addressed the scientific research related to the
potential health effects from exposures to RF fields, concentrating on new evidence since 2003.
The AGNIR considered “many hundreds of scientific studies.”
The AGNIR noted that current exposure guidelines are based on the thermal effects of RF fields.
No consistently replicable effects have been found from RF field exposure at levels below those
that produce detectable heating. In particular, there has been no convincing evidence that RF
fields cause genetic damage or increase the likelihood of cells becoming malignant.
The evidence suggested that RF field exposure below guideline levels does not cause adverse
health effects in humans. Short-term exposure to RF fields at levels well above guideline limits can
cause thermal injury to tissues. Although some positive findings have been reported in a few
studies, overall epidemiological research does not suggest that use of mobile phones causes brain
tumours or any other type of cancer. The data, however, is essentially restricted to periods of less
than 15 years from first exposure.
The AGNIR study concluded that:
“There are still limitations to the published research that preclude a definitive judgment, but the
evidence considered overall has not demonstrated any adverse health effects of RF field exposure
below internationally accepted guideline levels.” In addition: “The accumulating evidence on cancer
risks, notably in relation to mobile phone use, is not definitive, but overall is increasingly in the
direction of no material effect of exposure.”
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Emerging risks: mobile phones/EMFs
The AGNIR noted that the weakness in reaching a firm conclusion about cancer risk and RF
exposure included the lack of information on brain tumour and acoustic neuroma (an acoustic
neuroma is a non-cancerous brain tumour on the vestibulocochlear nerve which helps control
hearing and balance) after 15 or more years of mobile phone use, as well as the risks of brain
tumour after childhood exposures. In relation to this, the AGNIR considered the importance of
further research, noting that studies of highly exposed occupational groups would be of
considerable interest.
HPA’s response
In May 2012, the HPA responded to the AGNIR’s report. The HPA noted that AGNIR’s main
conclusion is that, although a substantial amount of research has been conducted in this area,
there is no convincing evidence that RF field exposures below guideline levels cause health effects
in adults or children. These guideline levels are those of the International Commission on NonIonizing Radiation Protection (ICNIRP), which form the basis of public health protection in the UK
and in many other countries.
The HPA’s view was that the continuing possibility of: (a) biological effects, although not
apparently harmful, occurring at exposure levels within the ICNIRP guidelines, and (b) the limited
information regarding cancer effects in the long term, support continuation of the UK’s
precautionary approach to mobile phones.
The HPA stated that:
“Excessive use of mobile phones by children should be discouraged, while adults should make their
own choices as to whether they wish to reduce their exposures, but be enabled to do this from an
informed position.” The HPA stated that it “will undertake another comprehensive review of the
scientific evidence and its advice when sufficient new evidence has accumulated.”
The HPA became part of Public Health England in April 2013.
Public Health England
Public Health England (PHE) stated in December 2013 that its advice is the same as that issued by
the HPA: there is no clear evidence that the health of the general public is being affected
adversely by the use of mobile phone technologies. Nevertheless PHE stated that uncertainties
remain and a continued precautionary approach to their use is recommended.
PHE noted that “mobile phones are a new technology that many people have become exposed to
over the last 10 years or so, so there are bound to be gaps in scientific knowledge.” The PHE
recommends that “a precautionary approach should be adopted for mobile phone technology, in
particular the use of handsets by children. Handsets give the highest exposures to radio signals
because they are normally held close to the head. These exposures are far higher than those from
phone masts. PHE recommends that excessive use of mobile phone handsets by children should
be discouraged.”
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Emerging risks: mobile phones/EMFs
Interphone
The results of the Interphone study, set up in 2000, were published in June 2010. 1 No causal link
between mobile phone use and cancer was made. The Interphone study was reviewed in the same
publication 2. The review concluded that Interphone’s findings indicated that the question as to
whether mobile phone use increases the risk of brain cancer remained open. The director of the
International Agency for Research on Cancer (IARC) said that:
“An increased risk of brain cancer is not established from the data from Interphone.” However, he
said that further investigation was merited. 3
The AGNIR considered that:
“As with all epidemiological studies, and particularly case-control investigations that rely on recall of
complex past exposures from memory, there are uncertainties in interpretation. Nevertheless, within
the limits of those uncertainties, which are discussed at some length in the report, the study provides
no clear, or even strongly suggestive, evidence of a hazard.” 4
The International Commission on Non-Ionizing Radiation Protection (ICNIRP) concluded that
existing evidence did not support an increased risk of brain tumours in mobile phone users within
the duration of use investigated so far. 5
IARC
The IARC classifies radiofrequency electromagnetic fields as 2B, possibly carcinogenic to humans.
In its press release, the IARC stated that this decision was “based on an increased risk for glioma, a
malignant type of brain cancer, associated with wireless phone use.” 6 The HPA stated that it
supported the call for additional research into the long-term, heavy use of mobile phones. The
HPA considered that the IARC classification was consistent with previous reviews of the science.
Hardell et al
In December 2012, Hardell et al published a meta-analysis (ie. a statistical way of reviewing,
summarising and quantifying previous research) of evidence concerning the association between
use of mobile phones and brain tumours. 7 Hardell et al note the IARC’s decision in May 2011 to
1
E. Cardis et al, ‘Brain tumour risk in relation to mobile telephone use: results of the INTERPHONE international
case-control study’, International Journal of Epidemiology, 39, 3, 675-694, June 2010
2
R. Saracci & J. Samet, ‘Commentary: Call me on my mobile phone … or better not? – a look at the INTERPHONE
study results’ International Journal of Epidemiology, 39, 3, 695-698, June 2010
3
Dr. Christopher Wild, IARC, Press release No. 200
4
Brain tumour risk in relation to mobile telephone use: results of the interphone international case-control study - A
statement from the Advisory Group on Non-Ionising Radiation (AGNIR), May 2010).
5
Note from the International Commission on Non-Ioniozing Radiation (ICNIRP) on the Interphone Publication, May
2010
6
IARC classifies radiofrequency electromagnetic fields as possibly carcinogenic to humans, WHO press release No.
208, 31 May 2011
7
Hardell et al, ‘Use of mobile and cordless phones is associated with increased risk for glioma and acoustic neuroma’,
Pathophysiology (2012)
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Emerging risks: mobile phones/EMFs
categorise radiofrequency electromagnetic fields (RF-EMF) from mobile phones, and from other
devices that emit similar non-ionising electromagnetic fields, as a Group 2B - a “possible” human
carcinogen. Hardell et al considered that “there is reasonable basis to conclude that RF-EMFs are
bioactive and have a potential to cause health impacts.” In addition, Hardell et al concluded “that
there is a consistent pattern of increased risk for glioma and acoustic neuroma associated with
use of wireless phones (mobile phones and cordless phones) mainly based on results from casecontrol studies from the Hardell group and Interphone Final Study results” and that “the current
safety limits and reference levels are not adequate to protect public health.” Hardell et al also
cited a decision of the Supreme Court of Italy which considered the association between mobile
phone use and brain tumours.
In July 2014 a letter by Hardell et al, ‘Mobile Phones and Cancer’, was published in Epidemiology.
Hardell et al stated that we have discussed elsewhere the increasing incidence of brain tumours in
several countries including Denmark. They state that there was a sharp increase in the incidence of
brain tumors during 2003–2012 (41% in men and 46% in women). The authors conclude that in
considering the most up-to-date publications, we find increasing evidence of an association
between the use of mobile or cordless phones and glioma and acoustic neuroma.
Marcolini
In October 2012, the Italian Supreme Court handed down judgment in a case in which the
claimant, Innocente Marcolini, sought workers’ compensation in respect of a brain tumour. It has
been reported that the claimant used mobile and cordless phones for 5-6 hours per day for 12
years. The Italian Supreme Court reportedly found in favour of the claimant in respect of
causation. 8 It can also be noted that an earlier judgment in the case in a lower court in which the
claimant was also successful received criticism.
In a paper in 2011, Lagorio et al stated that an Italian Court has recently recognized the
occupational origin of a trigeminal neuroma in a mobile telephone user, and ordered the Italian
Workers' Compensation Authority (INAIL) to award the applicant compensation for a high degree
(80%) of permanent disability. In the abstract to the paper it states that: “… it appears that the
judge relied on seriously flawed expert testimonies. The ‘experts’ who served in this particular trial
were clearly inexperienced in forensic epidemiology in general, as well as in the topic at hand.
Selective overviews of scientific evidence concerning cancer risks from mobile phone use were
provided, along with misleading interpretations of findings from relevant epidemiologic studies
(including the dismissal of the Interphone study results on the grounds of purported bias resulting
from industry funding). The necessary requirements to proceed to causal inferences at individual
level were not taken into account and inappropriate methods to derive estimates of personal risk
were used.” Lagorio et al concluded that a comprehensive strategy to improve the quality of
expert witness testimonies in legal proceedings and promote just and equitable verdicts is
urgently needed in Italy.
8
See for example Mobile Manufacturers Forum, Viewpoint, Italian Supreme Court and Mobile Phones,
http://www.mmfai.org/public/
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Emerging risks: mobile phones/EMFs
Ahlbom et al
In June 2012 the Swedish Council for Working Life and Social Research (FAS) published their
report reviewing research since 2003 on the state of knowledge in respect of the risk of disease
and ill health as a result of exposure to RF EMFs. The report, by Ahlbom et al, found that “… the
data on brain tumor and mobile telephony do not support an effect of mobile phone use on
tumor risk, in particular when taken together with national cancer trend statistics throughout the
world.” Ahlbom et al also concluded that: “Research on mobile telephony and health started
without a biologically or epidemiologically based hypothesis about possible health risks. Instead
the inducement was an unspecific concern related to a new and rapidly spreading technology.
Extensive research for more than a decade has not detected anything new regarding interaction
mechanisms between radiofrequency fields and the human body and has found no evidence for
health risks below current exposure guidelines. While absolute certainty can never be achieved,
nothing has appeared to suggest that the since long established interaction mechanism of
heating would not suffice as basis for health protection.”
Despite Hardell et al, and the Italian Supreme Court decision, as noted above the weight of
evidence, and particularly authoritative guidance, does not support causal attribution.
Nonetheless, given the HPA’s view above, and the uncertainty of long-term health effects, it is
arguable that a precautionary approach remains appropriate.
Other research
Pettersson et al 2014, 9 investigated the possible association between mobile phone use and
acoustic neuroma. The investigation was a population-based, case-control study. Eligible cases
were persons aged 20 to 69 years, diagnosed between 2002 and 2007. Controls were randomly
selected from the population registry, matched on age, sex, and residential area. Postal
questionnaires were completed by 451 cases and 710 controls. The study concluded that its
findings did not support the hypothesis that long-term mobile phone use increases the risk of
acoustic neuroma.
Coureau et al, 2014, 10 analysed the association between mobile phone exposure and primary
central nervous system tumours (gliomas and meningiomas) in adults. Data about mobile phone
use was collected through a questionnaire. A total of 253 gliomas, 194 meningiomas and 892
matched controls selected from the local electoral rolls were analysed. The study concluded that
there was a possible association between heavy mobile phone use and brain tumours.
COSMOS study
The COSMOS study is an ongoing international cohort study investigating possible health effects
from long term use of mobile phones and other wireless technologies. The study involves
approximately 290,000 participants across 5 countries in Europe. The UK cohort, with nearly
105,000 participants, is the largest part of this international cohort. Recruitment to the study has
9
Pettersson et al, ‘Long-term mobile phone use and acoustic neuroma risk’, Epidemiology (2014) 25, 2, 233
Coureau et al, ‘Mobile phone use and brain tumours in the Cerenat case-control study’, Occ Env Med, (2014)
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Emerging risks: mobile phones/EMFs
now been completed. The study is looking at changes in the frequency of specific symptoms over
time, such as headaches and sleep disorders, and also the risks of cancers, benign tumours,
neurological and cerebrovascular diseases. The research in the UK is being conducted by Imperial
College London. The study in the UK is jointly funded by industry and government. The research is
likely to be ongoing in 2015.
Other bodies
The National Institute of Environmental Health Sciences in the US states that current scientific
evidence has not conclusively linked mobile phone (or cell phone) use with any adverse health
problems, but more research is needed.
The American Cancer Society states that the IARC classification (2B) means that there could be
some risk associated with cancer, but the evidence is not strong enough to be considered causal
and needs to be investigated further. It adds that individuals who are concerned about
radiofrequency exposure can limit their exposure, including using an ear piece and limiting cell
phone use, particularly among children.
The U.S. Food and Drug Administration, responsible for regulating the safety of machines and
devices that emit radiation (including mobile phones), notes that studies reporting biological
changes associated with radiofrequency energy have failed to be replicated and that the majority
of human epidemiologic studies have failed to show a relationship between exposure to
radiofrequency energy from cell phones and health problems.
The U.S. Centers for Disease Control and Prevention (CDC) states that, although some studies
have raised concerns about the possible risks of cell phone use, scientific research as a whole does
not support a statistically significant association between cell phone use and health effects.
WHO
The World Health Organisation (WHO) reviewed its Fact Sheet on EMFs and mobile phones in
October 2014. 11 The WHO noted that there are an estimated 6.9 billion subscriptions globally,
studies on potential long-term effects of mobile phone use are ongoing, and that the WHO will
conduct a formal risk assessment of all studied health outcomes from radiofrequency fields
exposure by 2016.
The WHO noted:
“A large number of studies have been performed over the last two decades to assess whether mobile
phones pose a potential health risk. To date, no adverse health effects have been established as
being caused by mobile phone use.”
11
Electromagnetic fields and public health: mobile phones, Fact sheet N°193, Reviewed October 2014, WHO
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Emerging risks: mobile phones/EMFs
In respect of short term effects, the WHO noted that tissue heating is the principal mechanism of
interaction between radiofrequency energy and the human body. At the frequencies used by
mobile phones, most of the energy is absorbed by the skin and other superficial tissues, resulting
in negligible temperature rise in the brain or any other organs of the body. A number of studies
have investigated the effects of RF fields on brain electrical activity, cognitive function, sleep, heart
rate and blood pressure. To date, research does not suggest any consistent evidence of adverse
health effects from exposure to RF fields at levels below those which can cause tissue heating.
In respect of long-term effects, the WHO noted that epidemiological research examining potential
long-term risks from RF exposure has mostly looked for an association between brain tumours
and mobile phone use. The WHO considered that because many cancers are not detectable until
many years after exposure, and since mobile phones were not widely used until the early 1990s,
epidemiological studies at present can only assess those cancers that become evident within
shorter time periods. However, results of animal studies consistently show no increased cancer
risk for long-term exposure to radiofrequency fields.
The WHO stated that it will conduct a formal risk assessment of all studied health outcomes from
radiofrequency fields exposure by 2016.
Conclusion
As the US Food and Drug Administration has noted, over the past 15 years, scientists have
conducted hundreds of studies looking at the biological effects of the radiofrequency energy
emitted by mobile phones. While some researchers have reported biological changes associated
with RFs, the majority of studies do not show an association between exposure to RFs from
mobile phones and adverse health effects.
Case law in the UK and USA suggests that where a claimant is unable to show exposure above
official guidance (see Appendix below), and because of the lack of evidence in respect of the
possible non-thermal effects of RFs (see Appendix below), causation is likely to be difficult to
prove.
However, given the uncertainty of long-term health effects, the possibility for future claims
remains open. Whilst scientific evidence does not show a causal relationship between mobile
phone use and adverse health effects, it is arguable that a precautionary approach remains
appropriate.
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Emerging risks: mobile phones/EMFs
Appendix – causes of adverse health effects and guidance on acceptable exposure levels
There are broadly two routes by which mobile phones could potentially cause adverse health
effects: (i) Thermal effects - RF waves can penetrate the body and can potentially interact with
biological tissues and cause damage through a direct thermal or heating effect. Biological tissues
absorb the energy produced by electric fields resulting in heat production. The rate at which RF
energy is absorbed by biological tissues is known as the Specific Energy Absorption Rate (SAR).
SAR is measured in watts per kilogram (W/kg). (ii) Non-thermal effects. Can the non-thermal or
indirect effects of RF exposure on biological tissues cause adverse health effects such as cancer?
Guidelines
The International Commission on Non-Ionizing Radiation Protection (ICNIRP) developed
guidelines on exposures to EMFs. The guidelines are designed to provide protection against all
known health effects from EMFs. The Guidelines relevant to mobile phones were published in
1998. The ICNIRP limits on occupational exposure are set out in the table below (with the general
public exposure limits in brackets)
ICNIRP Exposure Guidelines for EMF exposure (frequency range 10 MHz–10 GHz)
Tissue region
SAR limit (W/kg)
Whole body
0.4 (0.08)
Head, trunk
10 (2)
Limbs
20 (4)
According to its website, the ICNIRP is currently revising the guidelines on limiting exposure to
high and radiofrequency fields in the range (100 kHz - 300 GHz).
European Commission EMF Directive
The EMF Directive on the minimum health and safety requirements regarding exposure of workers
to the risks arising from EMFs, originally published in April 2004, has not yet been implemented in
the UK. Member States have been given 3 years, up to 1st July 2016, to transpose the Directive.
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