Statement of Ronald B. Herberman, MD Chairman of Board ...

Statement of Ronald B. Herberman, MD
Chairman of Board, Environmental Health Trust
Founding Diiector Emeritus. University of Pittsburgh Cancer Institute
Chief Medical Officer, Intrexon Corporation
I want to thank this committee for inviting me to taIk with you today about the important
concerns that have been raised about cell phones and our health, and what might be done now to
reduce risk. 1 am a physician and cancer researcher and served as the founding director of the
University of Pittsburgh Cancer Institute [UPCI] from 1985 to 2009.
For two decades before coming to Pittsburgh, I worked fortheNationa1 Cancer Institntc,
performing innovative research and provid~ng leadership for avariety of major national
programs. I have published inore than 700 peel-reviewed articles and currently serve as Chief
Medical Officer of lntrexon Corporation, and Chairman of the Board of Environmental Health
Trust (EHT)--a nonprofit research and public educational organization devoted to identi&ing
and reducing risks from avoidable mvironmcntal health hazards. Wc at EHT believe that cell
phone radiation constitutes one of the greatest unrecognized potential global public health threats
in the world today.
111 mid-2008, I became sufficiently concerned about the potential for health effects from cell
phones to develop a simple precautionary message to the 3,000 members of my staff in the cancer
institute, urging that people take simple steps to reduce exposure now while we develop new
research to better measure the possible health impacts of cell phone and cordless phone use.
As history tells us, there are examples where delays in teducing exposure to eanmr-causing
substances have led to large increases in cancer. Continued tobacco useand asbestos use, after
evidence of health risks, are two striking examples that havc resultcd in millions of unncccssary
and preventable deaths and cases of disease.
Mindful of the lessons leatned from these other environmental causes of cancer, under my
leadership, the UPCI Center for Environinental Oncology carried out a year-long process of
reviewing evidence on the possible association of brain cancer with the long-term use of cell
phones. During this process, I became aware of a growing body of sc~etlt-fic evidence indicating
that Long-term frequent use of cell phones, which ~eceive and emit radiofrequency [RF] s~gnals,
may be associated with an increased risk of brain tumors, including malignant gliomas, the type
of tumor that Senator Edward Kennedy recently developed as well by Ellen Marks' husband,
Alan.
This particularly concerned me since in the United States use of cell phones was rising very
rapidly. In fact, more than 9 out of every 10 adults use a cell phone today, a remarkable number
that has doubled in just the past 5 years. Worldwide, there are now about 5 billion regular cell
phone users, including a growing number of children.
Generally speaking, it is important to stress that children are notjust little adults. They often are
much more vulnerabte to the harmful effects of environmental exposures. For cell phones, this
matters because the skull of children is thinner than the skull of adulrs and modeling research has
shown that ccll phone RF signals are absorbed much deeper into the hfains of children.
In contrast to the rather recent explosive rise in cell phone use in the United States, in the
Scandinavian countries, widespread cell phone use has been prevalent for more than two decades.
Dr. Lennart Hardell, a distinguished oncologist, found that peopIe who have used cell phones the

most, for more than 10 years, have double the chance of developing malignant bmin tumors and
also tumors on the hearing nerve, called acoustic neurwoas.
Since my precautionary advisory in 2008, published peer-reviewed articles have provided
mounting support for the concern about increased tumor risks. and other health risks, from longtenn,
regular use of cell phones held against the head. Dr. Hardell found that when cell phone or
cordless phone use began as a teenager or younger they had a 680% and 690% increased risk of
brain cancer on the side of the head where they held their phones, respectively. Theanalogous
increased fisks when cell or cordless phone use began between 20 and 49 year of age were I 10%
and 60%, respectively. Last year, the 13 country Interphone shmdy, sponsored by the World
Health organization, finally published its findings, which also clearly indicated that frequent cell
phone use for more than 10 years was associated with a significant, 118% increase in risk for
developing brain tumors. In addition, an Israeli study indicated an increased risk fordevelopment
of salivam gland tumors on the same side ofthe head as cell phone use. Row might this happen?
Although RF radiation is considerably weaker than x-rays and we still don't understand well the
molecular mechanisms, it has been shown that is ha3 dear biologic effects, including breakage of
DNA. A recent study by Dr. Volkow, Scientific Director of the Naiional institute of Drug Abuse,
reported in JAMA that even expcsure of tho brain to RF for a few minutes changed brain
metabolism, and several studies have indicated that males who cany their ccll phone in their
pants pocket had significant decreases in sperm counts. Also, quite disconcerting are findings
from Prof. Nesrin Seyhan, the NATO-supported founding chairman of the Biophysics
Department at Gazi University in Ankara, Turkey, who reported that prenatally RF-exposed
rats and rabbits have fewer braln cells
Very recently, the Wortd Health Organization bmughttogether a group of 30 experts &om 14
nations who reviewed all known experimental and human studies regarding cell phones and
cancer. Based largely on a detailed; careful review of human popul~ion-based studies, including
some released just prior to the meeting, there was anear unanimous consensus (29-1) that regular
use of cell phones is apossible cancer-causing exposure [see attachment 1 by Baan et all.
Despite the mounting evidence for health risks from cell phone use, there certainly ale some
studies that conclude no such health risks. It is understandable that the public remains confused
about the science ou this issue. A very recent lepolt by Aydin et a1 that appeared in the Journal
of the National Cancer Institute is a case In point, That study reported no increased risk of brarn
cancer from 2004 to 2008 in children ages 7 to 19 who used cell phones. Industry-affiliated
scientists who were ~nvited to provide a commentary on this study concluded that this study
provided definitive and clear evidence that children face no increased risk at all fmm cell phone
radiation Similarly, a recent report in Forfzme magazine reassured its readers that there is an
absence of evidence for a current brain cancer epidemic.
Hold your horses! Maybe you can trust Fortune with your money, but certainly this is not the
besf source to rely on for predicting brain cancer risk. In my view, nothing could be further from
the truth. There seem to be at least three likely explanations forthe reassuring negative
conclusions in some reports: First, most such reports were supported at feast in part by the cell

phone industry, Secondly, in these negative reports, the studies were limited to cell phone usage
for only a few years, considerably less than the ten years ormore that have beenassociated with
increased risk for brain cancers. And thirdly, in some reports with negative conclusions, there are
clear data that refute the reassurances. For example, data in Table 5 of theJNCI report by Aydin
et a1 shows that those who had subscribed to a cell phone for more than four years, or had made
more than 2,63 8 calls in their lifetime, had three times the rate of brain cancer [see attachment 2
by Morgan ef all. Brain tumors are known to have very long latency periods. Analyses of tbse
sane 90,000 who survived the atomic bombs dropped on Japan in 1945 only detected four
decades later derected an increased incidence of meniagiomas.
Based on my carefUl analysis of the issue in2008, coupled with the knowledge that experts in
several other countries had issued precautionary advisories, I issued an advisory to our
physicians, scientists and staff. The advice was straightforward; to keep the cell phone away from
the body and to use wired headsets or speaker phone mode. Also, don't keep them turned on and
on your body all the time. After my inlernal advisory was distributed, it got picked up by news
outtets around the world.
Within a week, the lsraeli Health Ministry endorsed my recommendations, andsr~bsequentiy this
warning has also been translated into German, Pomguese and Spanish. Some public health
officials have made the statement to the people that if one is worried, take these precautions.
However, I feel strongly that such advice avoids the responsib~lity for experts and governments
such as the Commonwealth of Pennsylvanlato provide helpful information that citizens have a
Right-To-Know and not depend on worries of an ill-informed or confused populace. At the very
least, 1 believe if is important for city, state, and federal governments to ensure that the public is
informed clearly and visibly about what is actually contained in the fine print of the manuals that
are sold with every cell phone in the country. Over the last three years, I have been pleased that
mounting evidence supports this position and that there 16 a growing number of American cancer
experts who provide similar precautionary advice. I arn pleased ta ele ease to th~s oornmittee today
an analysis of the literature jut published by one of the nation's top brain cancer specialists,
Santosh Kesari, MD, PhD, chairman of neuro-oncology of the University of Californ~a at San
Diego. Tn an extensive and deta~led analys~s of epidemiological studies, Dr. Kesari and his
colleagues conclude that cwrent evidence justifies taking precautionary polic~es, especially for
children and adolescents [attachment 3 by Corle et all.
Based on the cunent body of evidence as a physician-scientist who has devoted my professional
life to preventingor treating cancer and saving lives, I cannot tell this oommittee they are
definitely dangerous hut I certainly cannot telf you that they are safe.
And, in closing, I would just say that it is vely apt for this situation to follow the old adage, to be
better safe than sony.

~
1 News ?
Carcinogenicity of radiofrequency electromagnetic fields
In May, 2011, 30 scientrsts from
14 coumries met atthe Internattonal
Agency for Research on Cancer
(IARC) In Lyon, France, to assess the
carcinogenicity of radiofrequency
electromagnettc fields (RF-EMF)
These assessmentsw~ll bepubllshed as
Volume 102 ofthe IARC Monographs'
Human exposures to RF-EMF
(frequency range 30 kHz300 GHz) can
occur from use of personal devices (eg,
mobile telephones, cordless phones,
Bluetooth, and amateur radios).
from occupational sources (eg, hlgh.
frequency d~elearic and lnduct~on
heaters, and high-powered pulsed
radars), and from envimnmental
sources such as mobile-phone base
statlow, broadcast antennas, and
med~cdl applications. For workers,
most emosure to RF-EMF comes from
near-fierd sources, whereas thegeneral
populat~on receives the h~ghest
exposure from transmitters dose to
the bodv, such as handheld devices like
.
mobile telephones. Exposure to high.
power sources at work might involve
highercumulative RF energy deposited
into the body than exposure to mobile
phones, butthe local energydeposited
in the brain is generally less. Typical
exposures to the brain from rooftop
or tower-mounted mobilephone base
stationsandfmmNandradibstations
are several orders of magnitude
lower than those from global system
for mobile communications (GSM)
handsets. The average exposure
from use af digital enhanced cordless
telecommunications (DECT) phones
is around five times lower than that
measured for GSM phones, and
third-generation (3G) phones em
it, on average, about 100 times less
RF energy than GSM phones, when
signals are strong. Similarly, the
average output power of Btuetooth
wireless hands-free krts is estimatedto
be around 100 times lowerthan that
of mobilephones.
EMF5 genkrated by RF sources
couple with the body, resulting in
Induced electric and magnetic fields
andassociated currents lns~de tissues.
The most ~mportant factors that
determ~ne the Induced fields are
the distance of the source from the
body and the output power level.
Additionally, the efficiency of coupling
and resulting field distribution inside
the body strongly depend on the
frequency, polarisation, and direction
of wave incidence on the body, and
anatomical features of the exposed
person, including height, hodymass
index, posture, and dielectric
properties of the tissues. Induced
fields within the body are highly nonun~form,
varytng over several orders of
masn~tude, with local hotseotr
Holding a mobile phone to the ear
to makea voice call can result in high
specific RF energy absorption-rate
(SAR) values in the brain, depending
on the design and position of the
phone and its antenna in relation to
the head, how the phone is held, the
anatomy ofthe head, andthe quality
of the link between the base station
and phone. When used by children,
the average RF energy deposition
is two times higher in the brain and
up to ten times higher in the bone
marrow of the skull, compared with
mobile phone use by adults? Use
of hands-free kits lowers exposure
to the brain to below 10% of the
exposure from use at the ear, but it
might increase exposure to other
partsofthe body?
Epidemiological evidence for an
association between RF-EMF and
cancer comes from cohort, cash
control, and time-trend studies. The
populations in these studies were
exposed to RF-EMF in occupational
settings. from sources in the general
environment, and fromuseofwireless
(mobile and cordless) telephones.
which is the most extensively studied
exposure source. One cohort study'
and five case-control studiesrg were
judged by the Working Group to
offer potentially useful information
@
regarding associations between use of
wireless phones andglioma.
The cohort study' inciuded2V cases
of glioma among 420095 subscribers
t~twoDanishmobilephonecompanies
between 1982 and 1995. Glioma
incidencewas nearthenationalaverage
for the subscribers. In this study,
reliance on subscription to a mobile P&II,~~O~I~~~
phone ~rovider, as a surrogate for J""*ZI.~OI~
mobile phone use, could have resulted ~~$'~~~~~~
in considerable mivlassification in fama,eanthclrRC
ewsure asses5ment Three early M ~ ~ ~ ~ ~ ~ ~ , . .
case-control studies*' encompassed hwiimo~os.phria.~~vh~iar~~r~
a period when mobile phone use was Upcominpmtt~tingr
low, userstypically had low cumulative oal~-~a.mn
erposurer, tlme since first use of a ~ ~ ~ ; ~ ; ~ t ~ ~ - ~ ~ ~
moblle phone was short, and effect
estimates were generally imprecise; P.bl.142iu
the Working Group considered these ~o~wm~uiiua~[wqo,auc.ard
studies less informative. Tme.trend ~~~~~mllvi~~~~liiundmal~riri
analyses did not show an increased JU"S-u.zml
rateof brain tumoursafterthe increase ~ ~ / ~ ~ ~
in mobiie phone use. However, these MonaJnph
roup
studies have rubstantial limitations ~ t ~ b ~ ~
because mostoftheanalysesexamined I Sam~-CM~lUSA):
trends until the early 2000s only. Such ~ ~ ~ , ~ ~ ~ ~ o ~ ' ~ u
analyses are uninformative If excess Pva~uraonri,r~.rrth..ve
risk only manifests more than a decade 18elsiuml:l Siemia~Xi.
after phone use beg~ns, or if phone ~ ~ ~ ~ " s ~ " , ~ ~ ~ , , m
use only affects a small proportion of (finland) R ~ E S . 1 ~ iaore
cases-eq.the mostheavllyemosed, . . or (Fiance) M Btettnw

obrewliT sideoftheheadasthetumour)andfor associated with ipsilateral mobile total number of malipant tumours
Ifldg'lMnb'kM~"fa"u'*~' turnours in the temporal lobe, where phoneuse.
war found in RF-EMF-exposed animais
F.uro);cMarn*(L4anBbad
cPnsc Fm.aortia NutulI RF expowe is highest. Associations For meningioma, parotid-gland, in one of the seven chronic bioassays.
~c,ndian~anreirodetrcs betweengiiomaandcumuiativespecific turnours, leukaemia, iymphoma, and Mcreased cancer incidence in exposed
Ca~&):IRo.ri*y(GSM energyabsorbedatthetumourlocation other tumour types, the Working animalswasnoted intwoofl2studies
Arswiaion. Ui0;MSGmrd
rcmWi,~l~~A,~d3,bn,UrA, were examined in a subset of553 cases Group found the available evidence with tumour-prone animals'"" and
that had estimated RF doses."The OR Insufficient to reach a condusion on in one of 18 studies,using initiation-
~~.~~,~s..s.h~~.~~li.,, for giiuma increased with increasing the potential association with mobile promotion pr~tocols?~ Four of six
VBauvadLl.6~~merRC=L RF dose for exposures 7 yeas or more phone use. Epidemioiogicai studies of co-carcinogenesis studies showed
iDe1rouyFE1chir5rra~ before diagnosis, whereas there was individualswithpotentialoccuparional increased cancar incidence after
LG~l'cheiY Ororre, NGuha.
A,ia,~wo~lm,ii~ml, no as~ciation with estimated dose exposureto RF-EMF have investigated exposure to RF-EMF in combination
AWsminien+Ehub~-Slcr~*m, for expusures less than 7 years before brain tumoum, leukaemia, lymphoma, witha known carcinogen: however,the
M Mok$onnt~r, RSarlrrl,I iihU2, diagnosis,
and other types of maiignanq pradictivevatue ofthistypeofstudy for
xwraif.~vin Oeuenrer
A Swedirh reswch group did a including uveal melanoma, and human cancer is unknown. Overall, the
co",lkt,@,"tat,t
M~srpaureawnrrha~r pooled analysis of two vety similar cancers of the testis, breast, lung, Working Group concluded that there
lwonh€l3iO)inAkba.a studiesofassociationsbewen mobile and skin. The Working Group noted is "limited evidence" in experimental
tek~m~~n~tionrcomPa~~
and cordless phone use and gRoma, that the studies had methodological animais Fot the carcinogenicity of
h+!wlii(.BA hag re.m.
8.1 r-,rnz1-.*,m.~e~mc~
IS p0rr:o.e A s'm'iar

News 1
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body frommaiile phones u,.dwi&
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bsnzopyrcne-in6ured rkinranrerin mim
hanb-free ktr. PhysMdBiol2009; brdn turnours andtheuse of mobileznd ~ M e 102450-MHtrmmrawaueisdiatlon.
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545493-508. iordlerr phomrinduding living and 81otlecti~m0g0~Ii~11982;3:I79-91.
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publirl~edonllnejune 9.DOI:10.1136/
bralncanierinMd 2000;284: 300147.
oened.2011-100155.

The JNCI Study by Aydin et a1 on
Risk of Childhood Brain Cancer fi-om Cellphone Use
Reveals Serious Health Problems
L. Lloyd Morgan, Sr. Research FeUow Environmental Health Trust,
Devra Davis, PhD, MPH, President Environmental Health Trust
Dr. Ronald B. Herberman, Chairman of the Board Environmental Health Trust
4 August 2011
Introduction
Contrary to the accompanying Guest Editorial, the widely circulated 'hedia s pw and a Journal
of the National Cancer Institute Press Release the just released study in the JNCI' by Aydin et
al[l] raises major concerns about cellphone safety despite the authors interpretarion as showing
no increased risk of brain cancer in children and adolescents fmm cellphone use.
The Conclusion and the Results of the abstract, 'The absence of an exposure-response
relationship either in terms of the amount of mobile phone use or by localization of the brain
tumor argues against a causal association" is contradicted by the data within the paper.
Further the study's introduction states, "The lack of genotoxicity of mobile phone radiation has
been confirmed by experimental animal and laboratory studies [citing 2 papers from 1999 and
20011." The authors are, or should be, well aware of a multiplicity of papers showing
genotoxicity published in the last decade [e.g. 2-41,
Results
Contradicting the abstract's conclusion, TabIe 4 found a statistically significant greater than
doubled risk of brain cancer, 2.8 years after the first subscription for a cellphone began
(OR=2.15, 95% CI=1.07 to 4.29) along with a 99.9% confidence of a trend that the longer the
subscription the higher the risk. Thus, this report found a classic example of what is termed an
"exposure-response relationship," with longer time since exposure signaling a greater risk of
disease.
Contradicting the abstract, Table 5 showed that when the duration of cellphone subscription was
more than 4 years (the highest exposure) from ipsilateral use greater than a 3-fold iisk of brain
cancer (OR=3.74,95% CI=1.19 to 6.71), and close to a 3-fold risk when the number of cellphone
calls was greater than 2,638, the highest exposure (OR=2.91,95% CI=1.09 to 7-76),
While the Results section discussed the lack of consistent results at substantial length, it never
discussed the fact that the study design had limited statistical power to find consistent results due
to the relative small number of cases in each category.
' "Children and adrjlescents who use mobile phones are not at a statistically significant increased risk of brain cancer
compared to their peers who do not use mobile phones, aceordmg to a study published July 27 in the Journal of The
National Cancer Institute "

IpsilateraI/Contralateral Data (tumor same sidelopposite from where cellphone was held, Table
5)
Many other studies have found a clear association between side of head on which phone use was
generally reported and location of brain tumor, referred to as ipsilateral association.
Analysis of the reported data in this study found an increased ipsilateral or contralateral risk of
brain tumors in most cases and nearly half (46%) of these results that were statisticaIly
significant or borderline statistically significant. Eight data trends were reported, and seven of
these showed increasing risk with increasing exposure and were either statistically significant or
borderline significant. With a five-fold increased risk of brain cancer in children contained
within these trends, it is hard to imagine how this did not grab the attention of the authors and the
edito~% of the JNCI.
At first glance, because the ipsilateral risks found in this study are smaller than the ccntralated
risks, there appears to be something wrong. The most likely explanation is that the reported
laterality was not consistent with the use. Nevertheless these results indicating increased risk for
brain cancer are of major concern.
Among the possible expladations for Why holding a phone on the opposite side of the head from
the tumor, where very little cellphone radiation was absorbed results in a greater iisk compared
to holding the cellphone on the same side of the head where almost a11 of the cellphone radiation
was absorbed, are:
1, There are more brain tumor cases (215in the "Central or unknown location" than in either
the ipsilateral (208) or contralateral (190) results. The lack of tumor location data is a
major flaw in this report, and such key data should have been available from hospital
records.
2. Ipsilateral use is defined in the study as "predominately on same side of head, or both
sides of head." StFangely a footnote implies all of these data should have been e~cluded.~
3. Contralateral use is defined in the study as "mostly on side opposite the tumor."'
4. Ipsilateral, contralateral and central or unknown locations are mutually exclusive
categories, yet when the cases in each category are summed, the total is substantially
larger than the number of cases (613 compared to 352). No explanation is provided.
The study's definitions of ipsilateral and contralateral use differ from dictionary definition^,^ and
from those employed in all previous cellphone studies.
' "All matched sets in whtch the case patient andior the control subject was a regular conmlateral user were
excluded fiom the ipsilateral analyses; similarly, sets in which the case patient andlor the control subject was a
re@laripsilateral user were excluded from the contralateral analyses." [Emphasis added]
Ipsilateral. ''s~tuated or appearing on or affecting the same side of the body;" Contralateral: "occurring on oractAhg
in conjnnction with a pa^ on the oppositesldeofthe body." /5]

This suggests that this anomaly may be the combined result of unknow locations, and the
unprecedented and overlapping definitions of laterality in this study. It also suggests that
children and adolescents may in fact have a shorter latency time for the development of brain
cancer than adults. Given the large significant increases in brain cancer in children found from
both reported ipsilateral and contralareral use, and the inconsistent definitions of these terms in
this study, such data should be taken seriously.
Dafa Discrepancies
In examining the detaiIed data within the text in comparison to the summary data we find the
following discrepancies:
1. The study reports 423 eligible cases and 909 eligible controls, with participation by 352
cases (83.2%) and 646 controls (71.0%) resulting in exclusion of 71 cases and 263
controls. Yet when the reasons for exclusion are summed, the number of cases excIuded
were 121 (50 more than stated), and the number of controls excluded were 280 (17 more
than stated). This would result in case participation of 60% and control participation of
69%, which in turn would likely increase various biases.
2. The text reports that 35% of cases and 34% of controls had operator data for length of
time since prescriptions began. Calculating the number of cases and controls this would
mean that there would be 123 cases and 200 controls with this information. Yet, Table 4
reports 196 cases and 360 controls. The reason for this discrepancy is unclear, but it
would likely make a large difference in the associated risks as there would be 37% fewer
cases and 39% fewercontrols,
3. As noted above, the number of cases in Table 5 sums to 613, when the total number of
cases were 352.
Missing data
Table 6 reports the risk from cordless phone use. However, for 33% of the cases, the data are
"missing," as well as for 35% of the controls. This major data gap for cordless phones, which
also generate radiofrequency emissions, is striking in conpast to the detailed data for cellphones.
Yet other than reporting the missing data in Table 6, there is no mention of such a glaring
problem.
Table 6 reports two identical P-trend values (0.20 or 80% confidence that there is a ?rend for
increasing iisk with increasing exposure). CertainIy, removing the missing data from the trend
analysis would result in a lower P-trend, and it might have resulted in a statistically sigtnficant
knd.
Choice of Cutoffs Used in Exwsure Ranza
In the Statistical Analysis section the choice of cutoffs used for exposure ranges is stated, ". ..
the 50th and 75th percentiles were chosen as cutoffs to allow for the skewed data distribution."
Also in Table 6 where cordless phone data is presented a footnote stated, "The 75th and 90th
percentiles served as cutoffs because of broad categories." Nothing is said about what these
"broad categories" are, or how using different cutoffs would affect the reported results.

Journal of the National Cancer Institute's Invited Editorial
The JNCI invited Editorial, written by two principals of the International Epidemiology Institute
(IEI), John Boice and Robert Tarone, who are former NCI employees, ignores these numerous
methodological problems. The editorial describe the "Implications" of this study as, "The
authors found little or no evidence that mobile phofies increase brain tumor risk, and the single
positive association could be explained by bias or chance?
Numerous data discrepancies and other problems can be found with this paper that makes its
publication in a peer-reviewed journaI Iie the JNCI quite surprising. In fact there are multiple
positive association in Tables 4 and 5 as indicated above. It appears that this paper was ntshed
to publication in order to offset the impact of the World Health Organization's declaration that
cellphones are "possible human carcinogen." baxd on an expert review for the Imemational
Agency for Research on Cancer, by 30 experts fiom 14 nations 161.
According to David Michaels who heads the Federal Occupational Safety and Health Agency
(OSHA), IEI is one of many "product protection firms" [personal communication] hired by
corporations to create doubt about products that may cause harm. For more information see:
http:,,'~~~w.cspinet.~r~linteorits.'nonritsintcmational cvidcmiolo~v insti~urcm.
111 iJirconilect--rhe rrurlt ahotrt cellpl~one radiation, Davis reports that IEl ellgaged in this work
with the Danish Cancer Society as part of a business development strategy [73.
IEI designed the Danish cellphone cohort study. This study was 100% finded by industry and
by IEI, and examined the risk of cancers and neurological diseases from over 400,000
subscribers (85% were men, and over 200,000 corporate usws were excluded).
Three Danish cellphone cohort studies have been published (2 by NCI) over a period of 8 years
[S-101. They found being a cellphone subscriber protects cellphone subscribers from the
following cancer^:^ All cancers, cancer of the buccal cavityipharynx, esophageal cancer,
stomach cancer, liver cancer, all smoking related cancers, lung cancer, cancer of the larynx,
kidney cancer, pancreatic cancer, brain cancer of the parietal lobe (men & women), brain cancer
of the cerebellum (men & women), and brain cancer with ?lo year cellphone subscription (men
&women). Additionally, for neurological diseases they found statistically si&icant protedzon
for men & women for: Alzheimer's disease, vascular dementia, other dementia, Parkinson's
disease, and male epilepsy.
These statistically significant protective effects in adult cellphone users were reported by the
authors as finding "no risk" fiom being a cellphone subscriber. In fact, epidemiologists
understand that cohorts cannot be studied to determine the risks of rare diseases such as brain
cancer. With an expected rate of about 6 per 100,000 in persons of all ages, in order to detect a
change in brain tumors risk in a cohort, one would have to study a cohort that would be several
million in size, Since being a cellphone subscriber cannot conceivably protect the subscriber
' Men, unless otherwi~e noted
4

&om all these cancers and neurological disorder;, these studies appear to be designed to create
doubt that cellphones are a health hazard.
Conclusions
Both the Results and Conclusion of the abstract are contradicted by the reported results. Contrary
to the commentary, this paper presents evidence for a shorter latency of brain cancer tied with
cellphone use in children-a finding that is consistent with studies of other environmental
carcinogens in children.
The inconsistent results reported for ipsilateral and contralateral use of cellphone and location of
brain tumor are likely to reflect the failure to use standardized def~tions for these terms and/or
the far greater number of cases in Table 5 than the actual cases in the study. Whatever the
problem, the ipsilateraVcontraiatera1 risks should be taken as a serious indication of potential
risk.
The statement in the Guest as JNCI Editorial in JNC, "Cldldrenand adolescents who use mobiIe
phones are not at a statistically significant increased risk of brain cancer compared to their
peers," is a gross misrepresentation of what this paper actually reports.
The contradictory data between the table and the text or within the text itself speaks of a rushed
effort to publish andtor a poor peer-review process.
Lastly, several cellphone companies provided funding for thii study. The problem of financial
bias has been well documented [ll]. Conspicuously missing fiom the Funding and Notes
section are individual conflicts of interests among the authors (e.g., consulting, stock ownership,
director status, etc.).
Commonly science journals report the funding sources for the research paper. Less frequently
they report funding provided to individual authors. For individual authors they rarely report
such conflicts-of-interest as consulting anangements, stock ownership (for authors and spouses),
directorships, etc. The recent dismissal from the IARC Monograph meeting of Professor Anders
Ahlbom of the Karolinska Institute because of his individual conflicts of interest, speaks of the
essential need for this to be standard practice in all journals and, in particular, the JNCI, both for
original articles and for invited commentaxies.
References
1. Aydin et al. Mobile Phone Use and Brain Tumors in Children and Adolescents: A
Multicenter Case-Control Study. Journal of the National Cancer Institute. 201 1;103:1-13.
2. D'Ambrosio et al. Cytogenetic damage in human lymphocytes following GMSK phase
modulated mictowave exposure. Bioelectroma~netics. 2002 Jan;23(1):7-13 Bioelectromagnetics.
2MI2 Jan;23(1):7-13.
3. Schwan C, Kratoclivil E, Pilger A, Kuster N, AdIkofer F, Riidiger HW 2008.
Radiofiequency electromagnetic fields WMTS, 1,950 MHz) induce genotoxic effects in vitro

in human fibroblasts but not in lymphocytes. Int Arch Occup Environ Health
May;81(6):755-67.
4. Yadav & Sharma. Increased frequency of micronucleated exfoliated cells among humans
exposed in viva to mobile telephone radiations. Mutat Res. 2008 Feb 29;650(2):175-80.
Epub 2007 Nov 29.
5. Mirriam Webster's Collegiate Dictionary, Tenth Edition. Merriam-Webstef, Inc. Springfield,
MA. U.S.A 1993.
6. Baan et al. Carcinogenicity of radiofrequency electromagnetic fields. Lancet Oncology
Published online June 22,2011 DOI:lO.l016/S1470-2045(11)70147-4.
7. Devra Davis, Disconnect, The Truth About Cellphone Radiation, What the Industry Has
Done to Hide It, and How to Protect Your Family, Dutton, New York, NY USA, p, 200.
8. Johansen et al. Cellular Telephones and Cancer-a Nationwide Cohort Study in Denmark.
Journal of the National Cancer Institute, Vol. 93, No. 3, February 7, 2001.
9. Schuz et al. Cellular Telephone Use and Cancer Risk Update of a Nationwide Danish
Cohort. Journal of the National Cancer Institute, Vol. 98, No. 23, December 6,2006.
10. Schiiz et al. Risks for Central N~NOUS System Diseases among Mobile Phone Subscribers:
A Danish Retrospective Cohort Study. PLoS ONE, 1 February 2009, Volume 4, Issue 2.
11, Morgan LL. Estimating the risk of brain tumors from cellphone use: Published case-control
studies. Pathophysiology. 2009 Aug; 16(2-3): 137-47. Epub 2009 Apr 7.

2 Cell phones and glioma risk: a review of the evidence
3 Courtney Corle Milan Makale - Santosh Kesarl
4 Il:cc~*eJ 27 S.p:einner.20.0l,\;ccp:ej: I July ? Ill
j :2 Spri4igr.r Sctenc~~Ru~icess \Icdla. !.LC 2C I
Introdaction
Recently cell phones have become the target of much controversy
because they are increasingly betng viewed as
potential carcinogenic agents with a causal role m brain
tumor development The overall inc~dennee of malignant
brain tumors in the UtutedStates from 1992 to 2007 declined
slightly from 6 8 to 6.2 per 100.000, while the Incidence in
chlldren has riren sliglitly over the pesr three decadec [I, 21
According to the Central Brain Tumor Registry (CBTRUS)
[3] m 199S1heincideuceofboth benign and malignant brain
tumors was 13.4 per 100,000 and in 2004 it was 18 2 per
100.000. The causc of the clear increase m benign tumor
tncidence 1s unknown, but there is concern that cell phones
can trigger biological effects and that several decades of cell
phone usein an individual may signifiuntly increase the nsk
of a malignant brain tumor The potenual public heaith
problem 1s sizeable as the most colnmon malignant brain
tumors are hlghly lethal and cell phoneuse in the U.S. alone
haq e5calated dramat~cally, with approximately 70 mlllion
new cell phone rub~cnptions between 2006 and 2010, and
250 million subscriptions overall rn 2007 [4,51.
The concem relating to cell phone use and braincancer is
underscored by the fact that teens andchildren are beginning
to use cell phones at younger ages C61. Moreover, greater
than 4 of 5 childredteens 12 years and older sleep wlth a
cell phone next to them, often underthe pillow [71 Children
Counney Corle and Mihn Makek are co-flrrr auihor$
and young adultsaremore suscepnble to the harmful effects
of carcinogen~c agents such as rad~ation [a]. Therefore, a
shift in inc~dence of brain tumors lnyoungernge groups may
emerge as therr exposure to cell phones reaches long-term
status and attains the 10-yearor greater mark. Arecent study
revealed that children exposed to 1,800 MHi cell phone
eiectromagnetic fields (EMF) can experience signlfioantl$
higher exposures to corr~cal regions, hippocampus, hypothalainus
and the eye than adults, and that this difference can
be greater thaR one order of lnagnrthde [61.
The most feared brain tumors in adults and chrldren are
the gliomas, whlch include the astrocytomns and nligodendrogliomas
These tumors are graded on a progressive
scale of mal1gnancy-and4ornor-bhxd~fl, and astrocytomas
that have progressed to the Grade IV Wotld Health Organization
(WHO) clarsification level ale also !mown as
glioblastomas [91. Ghoblostomas are common bra~n tumors
and most frequently manse de novo os pnmary cancer$. The
gliomas as a whole compnse approximately 33% of all
brain tumors and 7945 of malignant brain tumors 131.. Cum
is not vp~cal and the therapy of even low grade ghoms
can be challenging The glioblastomas are highly lethal and
despite &&6 treatment efforts patients are dead at a
medlan of 14 months after diagnosis [lo]. Five ycar swvlval
is dismal, less than 5% This review will focus specifically
oh glioma nsk from ell phone use, and will begin
with a brief overvmw af the state of the relevant cell
phone-brain tumor r~sk likwature.
The two significant, comprehendve databases conceming
cell phone use and brain cancer risk are tlie often cited
Hardell (Sweden) and the multicenter Eworrenn Intemhone
A2 C. Corle . M. Makale . S. Knari (a) studies [ll, 121. These two groups each ~nclude multiple 63
A3 DepertmenL oFNeurorcreoces, UC S m &ego, hboies UCSD
A4 C~ncer Center, 3855 Healrh Sciences Dnve, MC
studles, and they eompnse the major focus of the cutient
0819. LaJolia,
64
~5 CA 92093-0819, USA review. Olioma risk data denved from Hardell and inter- 65
A6 e-mall sksan@ucsd edu phone, as well as h some smaller studies, is pmitioned 66
Imnd. Lnrgc 11060 UlWdl. 21.74051 hp 13
o LE n rv~~sfr
MIC&
d cr d DISK
9 Springer

Efg. 1 a Electric cutre~lr
Rowing in a canducror, cirhu an
atlrenna or n circuit hsidc the
cell ohono. . .- -neratcs bath
milgnctic and electric fields.
Tttere fieids consist of
oscillatingrnagnetic and electric
waves which combine to Eorm
the EMF. b Thz magnetic and
electric waves which make up
the EMF oscillate pcrpcndicular
to each ather and also
pcrpmdidiculur to the direction of
propagation of thc EMF. Eilch
pertad of oseillntion is I cycle,
of which a certain number occllr
per unit time. This is known as
;hc frequency. Cell phones emit
electromagnerie waves rhac
oscillate at a frequency of
800-2.2W MHz, or up to
2200.0W.000 rimes per second.
E Cell phones emit EMF wheh
lhcy nceine, pncess a~id
amplify a signal, and also when
they generate a signal from the
built-in onrennn. l'he EMF is
strongest at the source and
weakens exponentially
according to the distance from
the source. This iswhy it is best
to kaep the cell phone away
from the bndy and the head
(a)
Magneticend electric waver produce8 by rvrrenl flowingthrough a conductor combine to
createan el~tromaenelicfield IEMFI.
ElCCfdC
FlCI

function [16-201 Whether these effects can tngger the
development of cancer and whether they are pertlnent to
human cell phone use, i~ not known. Nonetheless, the
available information while st111 early and limited in nature,
polnts to rhe possibility that cell phones have the
potentla1 to cause biological changes, and that these elfects
should be Further cllaracterized [211
Ove~ew of epidemiological studies
Mylmg et a1, [22] performed a meta-analysis on 22 relevant
case-control cell-phone risk studies to compw the results
and derive an o~*erall estunation of the risk of brain tumors
from cell -phone use. The authors determined that overall,
there was a slight increase in therisk of brain tumors for
regular celt phone users and this risk is most pronounced for
an induction period of 10 years or greater [22]. When the
results were analyzed in greater dctail, the pooieddata from
eight studies showed a positive association between cell
phones and brain tumors, seven of which were the Hardell
group studies, These studies were considered by the Mynng
study [22] to have higher methodological quality because
they oscd blinding as to whetherthe participant was a case or
control. Fifteen other studies found an overall negative
association between cell phone useand tumors, nineof these
studies wete Interphone related studies that were criticited
for lack of subject versus conrml blinding [22]. Blinding in
casexonuol studies, signifies that the interviewer does not
know ivhether the subject being interviewed has the disease
of inietesf (be.: brain cancer) ot not. In this sense, [hey are
less likely to be biased when directing questions to alt
interviewee, Therefore, blinding as to whether the subject is
a case or control, is less likely to introduce bias into the
study. For example, ns Schulz and Grimes [50] state, the
interviewer might ask more leading questions of look more
in depth at a cares exposure status or background (i.c.: cell
phone use and exposure) than hdshe would for a mtrol
subject, which can in turnlead to skewed results.
Other observers have either determined that there is or is
not a significant risk associated with cell phone use and the
development of gliomas. Christenscn et al. [23], Ahlbom
et al. [24]. Schnemaker et al. [XI, Takchayashi ct al. [45],
Klaeboe et al. 1461, and Johansen et al. [47] stated that the
available evidence does not suggest an association. Kundi
[26] however indicates that the Interphone studies ore
flawed and that the Hardell data reveals a definite association
between cell phones and brain cancer. A review by
Khurana and colleaycs [S] states that the evidence sup
ports an association between cell phone use and brain
tumor risk, especially for those who have been exposed ta
cell phones for longer periods of time. Khurana's [S] paper
fepresentsa comprehensive effort at synthesizing data from
different sources, as if incorporates the full weight of the
evidence, includmg in vivo and m vitro studies, as well a%
evolvutg epidemiologio evfdence. With the evidenee
pointing in both direct~ons, il is clear that a comprehensive
standard~zatlon of study design needs to be implemented
before a clear detem~nation can be made. Most authors
agree that more evldence is needed, especially wrrh regard
to exposure in children, and that the effects of long latency
periods and high intensity of cell phone use need to be
systemacmlly exarmnmd.
Glioma risk and duration of cell phone use (latency)
Short tmn exposure risk
Therc is considerable variation in tho l~teraiule as to the
definition of a short term versus a long term nsk. For the
purposes of this review, we will define short term use as
less than 10 years of cell phone use and long term use as
10 years or greater. Table 1 sum~nnnzes the results of
several papers addressing glioma risk for different latency
periods, 4.e.. durat~on of use. Focusing on latency is an
important factor of epidemiologic studies since the time
from exposure to cancer development is often thought to be
around 10 years [271. Exposure tune ir alw a relevant
factor since some ~ubjec~ mlght be u$mg cell phones for
longer call times, increasing the11 cumulat~ve exposure
times The perunent studies had d~fferent designs, wd th~s
should be borne in m~nd with the recognition that Table 1
is a summary of somewhat diverse mformat~on.
Ovemll shorl Perm wsk flssessment-Herdell
and inrerphone
The Hardell studies identified an association between short
rerm cell phone use and an Increased ri~k of glioma
(Table I) [28-311. The 20% study deteimmed that astrocytoma
patients with a 1-5 year latency period and a
cumulnt~ve call time of greatcr than 64 h of digital cell
phone use experienced a 2 0 (1 1-3 6) lncreaced odds of
astrocytoma than non-regulor cell phone lisers Similarly.
patients with a 5-10 year latency period and cumulati\~e
call time of >64 h of digltal cell phone ttse had a 2.7
(1 5-5-01 increased odds of cancer compared to non regular
users. For leps exposure time 4 4 h. there was no sigmficant
assoclatlon between eel1 phone use and astrocytoma.
Pooled Interphone data reveal no nsrociatlon bctween cell
phones and gliomas w~th use of less than 10 years, with the
exception of >1,640 cumulative hours ofcell phone use and
a latency of I 4 years (Table 1; odds ratlo = 3.77
[1.25-I 1.41) [12, 32, 331. However some of the Interphone
data polnt to significam stady design Raws,as several of the
interphonerelated studies indicated a protective effect of cell

Table 1 Summaw of ovemll sltoma nsk In eoidcmzolo8ical ~rudies to date
-
Paper
Hlsfalogy Cell plmne HOUR of Latency Number of OR 4546 CI
exposure (ye~~rr) c~ses/coui~ols
Harden (2006)
Ashocytoma
Asrmcyto~na
Artmcytoma
A~tracymma
Astrocytama
Artiocytama
Ahrucytomrt
A~trocytomn
Astrocytoma
Aamoytana
Asfrocytoma
Olieodendroglioma
Otherlmixed glioma
.2stmcyramil
oligodcndmgliuma
Othsdmixed glidma
Gnomas
Gliolnas
Gliomar
Gliomas
Gliomar
Gliomas
Gliomas
Gliomxs
GIiomas
Glimar
Gliomov
Gliomqs
Gliomas
Glioma~
Gliamaz
Gliomas
Gbiomnar
Gliomas
Gliomas
Dliomss
Glimes
Gliomas
Gliomas
Glinmas
Glioma8
Glionlas
Gliomar
Gliom,
Gtiornas
Giiomas
Gliornas
Digiml
Digital
Digital
Digital
Analag
Analag
Digital
Digit++
Analog
Andog
Both
Both
Borh
Both
Borh
Bath
Borh
Both
Both
Boll!
Both
Buth
Bob
Buth
Both
Digital
Digital
Analog
Analog
Analog
Both
Both
60th
Analog
Analog
Anulog
Digital
Digital
Digital
Bolh
60th
Bo~h
Digital
Digital
Digital
Analog
Analog
564
>a
564
7 64
580
>80
- EO
-
-
-
-
-
-
-
-
-
34 5
Regula u%?'
Regular us
Regular use
Regular u\c
Ryular use
Regular u\e
Regular use
Regalar ux
Rep11ar nae
- c75
375
Regular use
Regulw uic
Regular UK
Regulx nsr-
Rcgulm u s
Regolar use
Ragulxr use
RFSIW U6C
Regular use
Regular use
Regolar use
Regulw use
Regular use
Regular use
a Springer
~018rnvi i~rgr z~vm D~spach 25.1.1011 PAS" 13
O LE
4 IYPESET
c/ cr d ots~

Table 1 connnued
Paper Birroloay Cell phone Hours of btency Number of OR 95% CI
type crpo*urc (years) caseslconnnls
Schua (2006)
hhansen [471
lnskip murarian-XU-20101
HepworPh (~kew&LL2006)
Hanikka (2009)
Interphone (multiple nudies)
Glioms
Gliomas
Glinmas
Fliomas
Gliomas
Gliomas
Gliamas
Gliomas
Ciiomas
Gliomns
Gliomas
Gliomas
Gliomas
Gliomas
GB,
Glianas
-
Glioqas
Gliomes
olio mil^
Glinmas
Gliomas
Glinmas
Gliomas
Gliomas
Gliornos
Gliomar
Giiomas
Gllomns
Gliumirs
Gliomas
Gtlomn
Both
Both
Bock
Bath
Both
Both
Both
BOffi
Both
60th
Both
Diital
Analog
Analog
Analog
Bo1h
60th
Bolh
Both
Both
Both
Both
Botll
Bod$
Both
Bolh
Both
Both
Both
Bath
Regular use
Regular use
Regulwnie
Reenlac rise
Regular use
Regular use
Regular use
1.5-4
5-9
?I0
SIR
CO 5
0 5 ta
?3 0
-15
€10
210
210
" Regular use is defined VI ilt 1e%st one lncomiog or uulzuing call per *eek frn ur leust 6 month%
(-7 Dash denoms value not indtcdted in onglnal report
Numbers in bold me sr&uustlcally bignrAc;~ic
phone use with lespect roglionu,~,e ,tho~e vubjects that used
cell phones were less likely to develop glioma [23]. An
lnterphone study by Lakhola and colleagues [33], whleh
encompassed data from five Notthem European counms,
foundthat cell phone non-regular users were248 more l~kely
lo have glioma than subjects who ustd cell phones for
1-10 years (OR G 0 76 10 65-0 881). When this association
was further annlptul based on the cell phone type, il s~gnlficant
protective effect emerged for d~gital cell phones but not
for analog cell phones [33]. Moreover a pooled analysls
showed that other Interphone studies also uncovered a pmiective
effcct. Th~s analyyis suggested that subJects who used
cell phones for 1-1 14 9 h, for a latency period (duattolr) of
14 years, were less likely to develop glromas compared YO
~mbjetcts that did not regularly use cell phones Moreover the
pooled analysis also indicated that those subjetts who used
cell phones for 115-16399 h for a latency period of
5-9 years were less likely to dcvelog gliomas compared to
subjects Who used cell phone on m inconsistent bas15
Additiofral studies-overall
short renn risk nswsynzent
There were few other studles conducted that were not
associated with e~rherhe Hardell gi'ollp or the Interphone
Imwl hmrs 11044 Dnprkch L1-1.2011 Fdgtr 13
e
D LE 2 TYPESR
MS cde: d ce n' nnr
Q Spmger

study. Two studies, one by Hepworth and colleagues I341
~nd the second by Inskip et al. [351, did not uncover a
s~gnificant association between cell photie use and gliomas
for a latency penod of less lhan 10 years.
Shon term cell phone use risk according to grade
of glioma
Tumor grade n an index of malignmcy and low grade gliomas
are capable of transforming into the very lethal highgrade
gliomas. When sublects were d~vided based on whether
they were diagnosed with a low or hrgh-grade glioma,
significant drfferei~ces were observed (Tablts 2, 3). There
was no incleased risk for low grade gliomas and cell phone
use at short or Long latency penods or for short and long
cumulative call time5. Although only six studies looked at
low grade glioknas specifically, the resnlts are all consistent.
tow grade gltnn~ar sharf fer~n risk Hai'dell
and InterpJlone
Two Hardell analyses from 2006 examined short term
exposure to cell phones and the nsk of low grade gtiomas
Neither study found d slgnrficant associatton [28, 521.
Only two studies associated wttli the Interphone study
group examined thls association. Shuz and colleague$ [36]
looked at the association between sholt term exposure and
low grade gltoma~ in 2006, but did not lind a significant
association. Lonn alid colleagues [373 also found no association
between cell phones and low grade gltomas for short
term use. Another study associated with Interphone by
Christensen and colleagites [23] found a proteqtivc etfect of
cell phone use and the risk of glioma for those who used cell
phones forgreatertltait 5 years compamd to nonregular users
Htgh grade glimrms short renn risk Hardell
and Itlrerphone
Two Hardell analyses from 20M, d~d find a significant
association between cell phone use and h~gh-grade anrocytomas
[28, 521. Those who uSed cell phones for
1-5 years and fur greatel than 64 h Were 2 I (I 054.1)
times Inore likely to have astrocytorna than non-regular cell
phone users. Digital cell phone users who had a cumulative
call timeof less than 64 hand a 5-10 year latency were 2 4
(1.2-4.8) lrrnes more likely to have astrocytokna than non
regular users, white those with a cumulative call Ume of
greater than 64 h had 3.3 (1.7-6.4) tlmer greater odds of
having astrocytoma than non-regular users. Por analog cell
phone uqers, Hardell found that those with 5-10 years of
cell phone use and a curnulat~ve cail ttme of greater than
80 h were 3 9 (1.2-12) hmes more likely to have astrocytoma
than non-regular users
Four Interphone stud~es examined the association
between cell phones and high-grade ghomas. As can be
seen in Table 2, only one of these snidles, by Shuz and
colleagues [36], found a positive association between cell
phones and ghomas. This study looked specifically at the
association for men and women separately 8nd found that
women who were regular cell phone users had a 196
(1.1&3.50) increased odds of glioma, compared to nonregular
cell phone users. This was not observed for men.
Long term exposure tisk
Ouerall ldng term ~isk assessment Hardell
o~zd Interphone
HardellsNdiesdrd findasignifioantly ihcreased~isk of hi~hgradegllorna
with exposure to cell phone, with agreaterrisk
for longer latency penods and higher cumulative call times.
Ha~dell arid colleagues 1381 dtd find an increased risk of
aqtrocyroma of 5 4 (26-11) for a Latency period of over
10 yean and acumulative call timeofgreaterthan SO h, for
analog phones. Similarly, digital cell phone users wtth a
latency penodofgrealerthanorequal to 10 years and greater
than 64 h of cell phone use were 3 6 (1.6-7 8) tlmes more
likely to have astrocy toma than non regular users. A s~milar
Imding was Found tor artrocyroma cases In another Hardell
study from 2006 (Table 1).
Several Interphone studles looked at the wsociation
betweencell phones andgliomas,although onlyafew looked
at the association for greater than 10 years of latency. Of
those thai did, m e found nsignificant associnhon between
cell phom use and gliomss, even at long term exposure
One stsdy by Hepworth and colleagues [34] looked at the
assotimon between cell phones a d gliomas at greater than
10 years of latency, and did not hnd a significant asrociation
benveen cell phones and gliomas An Interesting
Swedish study by Navas-Acien et a1 (391, found that
subjects with long-term exposure to solvents, lead, and
pesticrdeslherbicidet only exhibited increased glioma
incidence when they were also exposed to moderate or high
levels of low frequency magnetic fields.
Long term cell phone use dsk according to grade
of glioma
Loiv grade gliomas tong term risk Hwdell
and lnlerphone
There are 5 studies that specifically examined long term
exposure (latency) and low-grade glioma risk, including 2

Table 2 Summary of h~gh
grade glioma nsk in
eprdern~ologxcal studier i(, date
" Regular use is defined as at
lens1 one incornin:: or ourgoilrg
cbll per wek for at leesr
6 months
(.I Dash &ores value nor
iildicatod in original report
Numbers in bald nrc ~mdstically
significant
Vwbble
H~Iology
Hardell 12006) Aslrocytoma
Astmcymma
Asnacyroma
Astrooytoma
A?trncytama
Asuocytarna
Amcyroms
Asrrocyroma
Aslmcyloma
Astmcytoma
H~dell(2006b) Asmytom4
A~tmcytoma
Asrmcytomv
Artmcyroma
Astmcycoma
AItroryroma
Asr5cyiums
Asmcytama
i\rmcytorna
A5aocyroma
hsrmeymma
Arirodytama
Shuz (2006) Gliomaz (males)
Gliomus (tomakr)
Lonn (2005)' Gl~oma 111-lV
Glioma Ill-IV
Ollomo TII-IV
Gliablnloma
Gl~oblsstoma
Gllobhstoma
Lakhdla (2007) Gltoblasroma
Ghobla~toma
Glroblnstorna
Chnstbnsen (2003) Gliomas
Gl~omns
Gl~oma\
Glromrs
Cell Houis of Latency Number OR 95% CI
phone exposure (ycnm) of onsed
[YPe
cunlrair
Digit.al 564 1-5
Olglrai %4 1 -5
Dlgnal 564 5-10
D~grtal 3-64 5-10
Analog 580 5-10
Pindog >80 5-18
D~gltal 264 210
Digtral >M - 10
Analog 580 ?ID
Aoalog >I30 210
Dlgltd 564 1-5
D~gtcal >64 1-5
Analog 585 1-5
Analog >a5 1-5
D~girai 564 5-10
D!g,rai >64 5-1 0
Andlog 585 5-10
Analog >85 5-10
Drg~td 564 210
D181ml 264 ?I0
Andog 585 r10
Analog 285 210
Both Regular wsp. -
Both Rcgulnr uc -
Both Regular use

Thble 3 Summnry of low grade
glmma 6sk I" cpidemtotoglcal
srudtes to dnro
Re~uIn usc is dcfincd as at
lelsr one incoming or outgoing
call per weck for ar lea?
6 months
(-> Daslr dcrm64 1-5 9175 2.3 0.7-7.9
Astrocyroma Digital 564 5-10 1144 0.4 0.W.6
Astrocyroma Digital >64 3-10 7/67 1.1 0.3-4.6
Astrocytomo Analog 580 5-10 U24 1.8 0.3-13
Asmytoma Analog zB0 5-10 1112 1.3 0.1-15
Anmytoma Digital 564 210 010 - -
Astrocytoma Digital >64 %I0 1/18 1.5 0.1-15.0
Astmcytana Anillog 580 510 0113 - -
Aarrocyrnma Analog >80 %I0 2/27 1.8 0.3-12
Hardell (2006b1 AsuocyMma Digital 564 1-5 901349 1.4 1.01-1.9
Astwcymrna Digiral >64 1-5 531232 1.2 0.8-1.7
Rstmcyroma Annlog 9 5 1-5 13167 IS 0.5-1.9
Astmcytoma Analog >85 1-5 8119 1.9 0.83.7
Astrncytomq Digital 564 5-10 3~70 1.2 0.34.3
Astrocytornn Digital >6$ 5-10 111107 1.7 0.74.1
Astrocytma Analog 585 >- I0 4/63 1.4 0.4-4.2
Astrocytoma Andog >85 5-10 3/64 0.8 0.2-2.8
Astrooytoma Digicd 564 210 010 - -
Astracytoma Digital >&1 - >I0 1118 1.3 0.2-1 1
Actrncytoma Analog 585 710 OD6 - -
Astrocyturr~a Analog >85 510 6/58 2.2 0.8-5.9
Nardell (2MP) - - - - A
- -
Shuz (2006) Gliornas Borh Reylar ilw: - 21147 0.89 0.38-2.08
(males)
Gliomas Both RcgUlar us" - 1 1/28 0.77 0.32-1.84
(femlrst
Loon (2005)" Glioma 1-11 Both Regular use d 221213 0.6 0.3-1.1
Glirnna 1-11 Bofh Regulilr me 5-9 161139 0.6 0.3-1.2
Oiiornv I-il Both Reaular uc 2 ID 6138 1.0 0.4-2.8
Chinensen (20051 Glioinas Barh - 1-4 I9139 0.86 0.43-1.75
Ye*
Gliomas Both - - >5 22/46 0.87 0.41-1.85
Gliomas Both - 5-9 16137 0.79 (1.36-1.71
Gliomss Both - 210 619 1.64 0.44-6.T?
33 1 Shdy designs and potential pitfall9
Although the different group stud~es conststently find confl~cong
results, they all usea s~milar case-control apptonch.
Case-contrnl studies begin with indiv~duals with disease,
cases, and those w~thootdisease, controls. These two groups
are then quesuoned about thetr exposure stahis, in this case
might have a hard time i-emembetioghow oftet? and for how
long they used cell phones 122, 231. A recently published
paper took a different approach to studying this topic by
looking at he cornelatton between cell phone subschptions
and brain tumors [40] The authors found that there was a
'significant associat~on between the number Of cell phone
subsctiptions and brain tumors. Using multiple linear
cell phoneuse. Inall of theccillphones~die~,aquem~onnaiie regression analys~s, the effect of cell phone subscriptions
was used to determine the durattonand treqoency of phone was significant and independent of the effect of mean
calls, and ultimately the cumulative amount of cell phone income, population and mean age [40].
exposure [22,41] One problem with this method is the hlgh One smdy from the Interphone group developed a caseprobabiitty
of recall btas, where both cases and controls control study of Illntted scope to determide how much bias
t" An:,cNG
~oumul ~nrge tlrm osprrcn X.T.ZO~ prsn 13
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there might be m cell plione recall smdies [22. 231. For 27
patients and 46 controls, they obtained cell phone records
m order to compare them to self-reported call frequency
and duratiod. The authors found that both cases and controls
recalled the number of calls accurately, but tecalled
the duration of phone calls imprecisely [23]. This is always
apotential pitfall with case control studies and is especially
relevant in these sudies since total amount of cell phone
call time is being used to determine total erposure tlme
Inaccurate recall of total call time might cause an over OF
under estimation oi true risk, depending on the magnin~de
of the error.
Laterality 1s another important issue in the cell phone
brain cancer debare 114, 421. Laterality refers to the locannn
of the piimary tumor and the side of the head that 1s
rouuncly und for cell phone conversations. If a subject
used their cell phone on the same side of the head as the
tumor appeared, th~s 1s defined as ipsilateral exposure.
Conversely, when the cell phone wks routineSy used on the
oppodtc side of tho head as the tumor appeared, this is
defined as contralarcral exposure. Lateralit)' mlghl be an
imponant predictor of tumor nsk, and a srronger assodiation
would be observed between glioma rrsk and ipS11ateral
versos conwalareral use. But, the resdts m this context
have been extremely vnriabfe (Table 4) [14, 421. Some
studies reported an mcreased risk for the s psi lateral scenarro
while others find a decreased risk. Moreover there are
reports of decreased nsk for the contralateral scenario
whilc others found an increased risk,and still others found
no arsoc~ation with lateral~ty [S, 9, 23, 33, 421, This perplexing
data may have an as of yet undetermined biological
basis, or may in pan stem from errors in self reportrng cell
phone use. For example, subjects might try to mnonalize the
causeof their tumor nnd report ipsilateral cell plione use.
Hardell study design
The Hadell grmp has peifomed several epidemiologic
studie~ examining theroie of cell phone use in brain tumor
devclopment [I I, 28-3 1, 38, 521. Smdy parucipants were
cho.ren fmm a cancer reglstry in Sweden and controls were
chosen from the national Swedish population registry The
srudy population ranged from 20 to 80 years old and was
given a Self-adminiqtered questionnarc If the guestionnaire
was ~ncomplete or additional clarificat~on was needed
subjects were later interviewed over the telephone Farticipanon
rates range from 85 to 91% for cases and controls
in all published sludies by the Hardell group. The Hardell
group has cons~stently reported a significant association
between brain tumors and cell phone and cordless phone
use. They have found an association when analyzing all
ages combined, for latency penods from 1 to 10 years and
greater than 10 years with ipsllateral cell phone use. Many
Hardell studla include participant ovetlap, as several of
the published papers am extensions of previous studies or
include adjusted age categories to match otherstudies. Also
noteworthy is the fact that the highest risk values are
obtained in Hardell studies where exposures began when
the subjects were teenagers
Interphone study design
The IdErphbne study is a lirrge case control study involving
13 countries It is coordinated by the Union for International
Cancer Control (UICC) and is Cmrdlnated by an
lntemattonal Interphone study group that conststs of 21
scientists who are in charge of the progress of the study,
analyses and mterpretanon of the study results I411
Fundlng for the Interphone study comes frorri the Mobile
Manutacturers' Fomm. he GSM Association whlch rep
resents the world wide interests of the mobile commnntcations
lndushy and from other mobile phone operators
and manufacturers. Approximately 6 m~llion out of a total
of 20 millionEur6s came from pnvate funding. The bulk of
Intcrphone fund~ng came from publm sources such as the
European Commission. The U.S did nor participate in the
Interphone study. Overall scientific coordination of Interphone
was provided by the International Agency for
Research on Cancer (IARC), nther than by UICC-whrch
provided qoie funding, but no technical overs~ght.
Ia the description of the Interphone study funding
&calfs, the UICC did state that there was a tirewall
meehanlsm pmvided by thc UICC for somc of the funding
to guarantee tho independence of thesclentlsts [12.32,41].
Controls for the study were frequency or individually
matched by age, sex and region of residence to control fw
these factors in analysis. A common core protocol and
questionnaire were used for all study sites involved in the
interphone study. Study participants rangcd from 30 to
59 ycars old and partic~pation rates for the multiple Inter-
phone stndy groups were 64% forgliomas and for 5% for
controls.
Overall, most of the results in the multiple Interphonc
studies found no significant asocration beiweencell phone
use and brain cancer, except at exposure t~mes greater than
1,640 h of total cell phone use. In a recent publication on
p~oled Intcrphone srudy rwults, the only slgn~ficant association
the authors found between cell phones and Grain
rumon wat for glioma? and nienlnglomas and psil lateral
cell phone use at greater than 1,6&0 h of cumulative call
time 1321. In many msances, the Interphone study results
showed a protecuve effect of cell phones, meaning that
tho% who use cell phones are less llkely to have brain
cancer. This suggests that a significant study design Aaw
corrupted the statisocal analy%is, and may have also prevomed
the detection of an asociation between brain cancer
: I - - 7
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TnMe 4 Sunlmary of larernl~ty and glsoma risk in eptdemlolog!cnl mfies to date
Variable Htstology Cell phone Cuenl ipiildterul Cnsesl Contralaten1
typc/latoncy contro1s ~o~ltrols
Paper
klanlell 2006
Takcbayashl [15]
Lonn (2005)
Low grade ajrrncytoma
Low gnde vvtrooytoma
High grade axrocytoma
Hggh grade asrrocymms
Lou* gmdc astrocytoma
Low grade astrowoma
High grad=abtmcyram
Hlgh grade ssrmcyroma
Astmcytama Grade i-IV
Astwytoma Gcrde I-IV
Gliomv
Ol~oma
Gbema
Trll~fia
Glrornn
Glzomil
GI~oma
Oliomu
Gltoms
Ol~oma
Glioma
Glroma
Glloma
Any glcoma
A~mcytlc glivmd
Glroma
Olioma
(-1 Dash deooies Yalue not indicated in original repon
Numbers in bold alt swtistieaily sipificnnr
Analog
Digltal
Analoe
Digmsl
Andlog
Dtglral
Analog
Digital
Both (cl yetrlatencyl
Bah (clO yenfs la~acy)
Both
Both (c5 years)
Both [S-9 ysasJ
Both (>I 0 years)
Both (4 yeas)
Both (54 yearn)
Bo'h (>I0 pars)
Both (d yeam)
Bolh (2-5 year;)
Barh (z6 years)
Bath lc5 yean)
Both (5-9 yess)
Both (>I0 yeas)
Both
Both
Both
Both
sfid cell phones The authors of various Interphone sNdles
generally admtt that aprotective effect is not plaustble and
do mentian that partrcipat~on rate dtffercd betwcen ca%s
and conuols. They also pomt to sampltng hias, prodromal
synrproms, eonfoundlng vanables (a third vanable elated
to both cell phone use and hra~n cancer can affect the
association between the tvio vanables), and ill-ttmed
interviews, as potenttal reasons why this effect occurred
The Interphone Studtes did tnvolve some personal interviews
\nth patients while they were tn the hoSpiwl [29,41.
511. Hence blinding as to whether thesubject was a case or
control dld not occur, and mtght have led t6 interviewer
btas and skewed tlie resulrs [22].
Another Lrmttauon of the Interphone study was the fact
that use of cordless phones was not systeniarioally taken
into account, Thts represents a potential source of bzas as
exposure to RF radiation from cordless phones may not
have been uniformly shared between cases and eontmls If
cordless phone use was not imiver~ally sbared between
cases and controls then this falure turther hampered the
abllity to find tmportnnt assoclarions
Future studies
Generating dec~sive evidence of an association between
cell phones and bratn cancer is challenging because cell
phone technology, energy levels, and usage are evolving,
and bratn cancers are relattvely rare and may rake decades
to develop. 'The scenano is further complicated by the
likelthood of differing genetlc suscept~brllty of indivrdual
subjects to brain cancer [43]. Genetically pred~sposed
~ndvtduala may have a higher bram tumor risk wtth cell
phone use, while other members OF the population may

havemuch reduced risk. Hence the studies have a selection
bias because susceptible indiv~duals may be very rare in the
entire population, yet participants in [he large scale studies
with brain tumors typically outiiuniber controls. Finally, it
is hard to detect short term changes in ban physiology or
StNCtUre that may result from a cell phone call and are
associated with, or fad to, a long-tern process resulting in
the development 6f a tumor.
A key problem wrth the large scale population studies
evaluating cell phone use and brain tumor risk is the variability
of study design. Although the Interphone study
groups all use a similar design, o w gmups such as the
Hardell have used different deslgns. This makes it difficult
to d~recdy cross reference and pool data originaung from
different studies. For example design differences are evident
in the wide varianon in the sgecific time epochs
defined within sholi and long term latency periods, so that
latency data cannot be readily compared among the different
studtes (Tables 1, 2, 3).
Lack of standardization m study design reduces the
effecttve sample stee which is a disadvantage when
attempting to define a care effect. Woreover, a lack of
coordinatign and cooperation between researchers has
allowed potentially flawed des~gns, like the Interphone
group studies, to be implemented. Conseqiiently rvsdence
is effectively limrted and it is difficuIt to determine whether
there is an actual association between cell phones und brain
cancer. The potential for recall bias, intervrewer bias,
participation bias and other potentla1 pit falls associated
with cae-control studies make it difficult to understand
how much of the information from these studle.. 15 a rNe
association or a true lack of associat~on. The best way to
remedy this, is to conduct prospecnve studies, to follow
those exposed to and not exposed to cell phones and
determine if there is a difference in the ~ncidence rates of
brain tumors comparing the two gmups. This type of snidy
mlnimrdes the recall bias present in case-control stuhes
and also allows for collection of relevant exposure and
disease information, ratber than relying on data collected in
the past. A prospective snidy was launched in Eumpe in
March 2005, called the COSMOS study which wilt follow
250,000 participants for 20-30 years.
Prospectrve studies like COSMOS are an important step
in studying the association between cell phones and bra~n
rumors, but it will also be a long rime before there wilt be
results from such studies. While in an ideal world a nested
prospective study would be of great value, this is a iuxury
that socie~ cannot afford at this hme, given the very
rap~dly rrslng use of cell phones in persons of all age
groups. The potential for dama5.e to the population is tw
great so research pursued over a shotter tinla scale is
needed and must be standardized Casecotitrol studies
should follow a similar study design and be controlled for
potenhl bias in evely way possible. Moreover a recent
report stemming from a nationwide lsraeli study on the
sharp increase in parotid gland tumors associafed phone
use indicates that potemiaiiy a brorld specwm of pathologies
will need to be considered [48J. Standiirdization of
studies will allow for valid comparisons between study
groups and will enable more sensitive and valid statistical
analyses of pooled data. Realizing this goal will most
probably require a multidisciplinnry intematbn;il body
comprised of leading contributors to define an array of
standard criteria to which srudies must c'onfom~. This
would be analogous to how neoplastic diseases are eurrently
staged and evaluated in clinical trials. Several
guidelines may be discussed and adopted for study design
standardization and these could include:
(I) Cell phone energy levels necd Lo be tabulated and
matched between studies.
(2) The study population needs to be subdivided in a
predictable manner according to age, sex, ethnicrty,
general health status, etc.
(3) The range of pathologtes, e g., brain turnof$, paroud
tumors, oral cancers, needs to be defined.
(4) The questionnaire should be the seme for all shidies,
with reasons given for deviations, and appropriate
blinding needs to be iin~formly appl~ed.
(5) If at all possible actual cell phone usage records
ahoufd be used in place of subject recall, as recommended
by Han et al. 1491. This should be mandated
(6) The latei~cy periods (duration of use) should he
defined uniformly.
(7) The overall statistical approach shuuld be optimied
and well-defined for prospectwe nseardr~rs,
Moreover, how the intenhi3 of use is defined can he
expanded to rnclude an additional d~menaron. Length of
phone use isonemeasure of exposure, but another imponant
measure is average length of call over time Cu~mlative
integrated doseunder the curve incorporates both duration of
time of use along with average intensity. Thug, persons who
nsea phone for several hours a day have much more iniense
exposureeven over less than 10 years, than those who use a
phone for a few honrs d month. Consideration of thiq additional
measurehighlights the need for researchers to be abie
to access cell phone provider call history data
Contemplatmg the in vitro and in vrvo experimental
data
&though a comprehensive analysis of the cuirenl body of
in vitro and in vim experimental studles is beyond the
scope of the present renew, the authors do recognize that
some tuture expenmental studies may be designed to
DVpnb *%1.1011 Pkger I3 I
a Springer

complement epidetniological studies so that data f~om
these two sources can be cross-referenced m reveal
important assouattons. For example short term epidemiological
data that tncludes intense exposures might be
related to in vitro and in viva experiments that screen for
the cell and tisue effects of short term, Intense exposures
Moreover, studies involving humans, head phantoms, cell
cultures and antmal models may be integrated to provide a
mechanistic understanding of events associated w~th ipsilateral
and convalateral exposures and nsks, as this is
currently poorly understood and problemdtic.
Published repons suggest that mammalian brain tissue
may be sensittve to cell phone levels of EMF and exhibit
measurable changes in structutE md function [5, 17-21 1.
For example there u evidence whlch sllows that certain
enLymus and DNA can be directly damaged by lowintensity
EMFs, although mote canfirtnatory work needs to
be done and the precise mechanism(s) of damage has to be
elucidated [5, 17, IS, 211. The work of Volkow el al. [lq
w~th human subjects shows that cell phone use at lower
than typtcal energy levels can cause psil lateral Increases in
bran glucose metaboltsm This acute physiolagicai finding
Indicates chat biological effects can be caused by exposure
to cell photle EMF, and it is reasonable to conclude that
further tn vltro and in vivo studies to elucidate potential
mecltanistns of lrrological damage are warranted [211
Conclusions
Edwards BK (ads) SEER Cancer Sta~ixtics Review, 1975-2002,
National Cancer Instirure. Bcrhesda. MD, htrp:/!scc~.caacer.gov!
cudi975_20M/, based on November 2W6 S m darn submission,
posted m the SEER Web site, 2007
2. Pwes J (2010) One canclusion emerges from Interphone smdy:
conrmversy will continue, I Natl Cancer lmt 102(13):928-931
3. (2010) CBTRUS statistical repon: primary brain .and centrzl
nervous system tumors diagnosed in the United States in
2004-2006. Central Brain Tomor Registry of the United States.
Hirisdale
4. Bonnin JM, Rubinstein LI 11989) A8rrubTastomasa pathologicat
study of 23 tomors, with a post-operative foliaw-op in 13
patients. Neurosurgery 25(1):6-13
5. Khurvila VG, Teo C, Kundi M. Hardell L, Cilrkrg M (2009)
Cell phones and bnin tumors! u review including the long-term
epidemiologic dam. Surg New1 72(3):205-214 (discussion
214215)
6. Christ A, Gosselin MC, Christopoulou M, Kuhn S, Kuster N
(2010) Age.dependeut tissue-specific exposure of ceil phonc
usen. Phys Med Bioi 55(7):L767-1783
7. Lenhae A, Ling R, Catnpbcli SW, Furcell K [ZOIO, Apiil) Teens
and mobile phones. A project of the Pew Ramirrch Center and the
University of Michipn. Aveilable at http:i/www.pewintcrneior&'
Repom!201O~ems-;md-M(1biie~Phones.~spx
8. Knamtsch P. SpixC, lung I, BiettoorM (2008) Childhoodl=ukcmia
In the vicinity of nuclear power planrs in Germany. Dlsch Arztchl
lnt 105:725-732
9. Gladson Ch Pr;lyson RA, Li'u WM (2010) TheparhobioTogy of
~lioma tumors. Annu Rev Pathgl Mech Dia 533-50
10. Dierrich J. Diamond EL. Kes& S S2OlOl . . Olioma stem ccn sienaling:
therapeutic opportunities and challenges. Expee Rev
Allticancer nler 10(5):709-722
1 I . Hnrdell L, Mild KH. Cariberg M. Haliqtiisr A (2004) Cellnlarnnd
cordless telephone use and the a~sociition with brain tumorr in
different age gmups. Arch Environ Health 59(3): 132-137
12, Cardis E (2010) Bnin turnour risk in relation to mobile telephrme
use: resulk of the INTERPHONE incemarinnal case-control
study. lnt J Epidemiol 39(3):675-695
Despire results pointing to an association in one 13. Curdis E, Dellour I, cl (20081 Distributio,I of RF
direction or another, it is clear thS there is no definite rnrrgy emitted by mobile phoncs in anatomical structures of tho
answer to rhe question of whether cell phone use is asso- brain. Phys Med Biol53(1 1):2771-2783
ciated increased brain risk. ~ ~ ~ * i ~ 14. h Schuz ~ l(20091 ~ ~ Lost ~ in d lilternlity: i ~ interpreting ~ 'preferred side OF
the hezd during mabile phone use and risk of brain rumour"
the inconsisttncies in !he epiderniologicai studies, a few of ,,Sociarions, Publie Meiilrh 31(61:664467
the human studies do suggest tlrr associatiin between cell IS. Hubor R. Trcyer V. Schudorel- I ct a1 (2005) Exposure to pulse-
phone UTE- and brain tumors for a 10 year or greater
~nduction period andlor a h~gh nomber of cwmulattve call
hours. However, given the tncooclusive nature of even the
long terrn data, the best eourse of action is to putsue further
stttcttes and to execute thebe acco~ding to a standardtzed
design. Moreover, in view OF the confltoring epidemiological
data, same researchers including the present authors
ruggesr that cell phone use certainly conrinue, but that
users mtght wish to consider using headsets if feasible to
reduce EMF exposun, and that heavy cell phone use in
chtldren and young teens be avoided ~ iat all possiblc [44].
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120:1769-1775
34. Hepworth $1. Schoemuter MI. Muir KR, SWerdl?5w Al. van
Tongcren MIA, ~McKinney PA (2006) Mobile phone uue and risk
of glioma in ildulis: case-control study. Br Med J 332(7546):
883-886
35. Inskin PD. Hoover RN. DeverhSS (2010) Brain cancer incidence
. .
trends in relation to callular telephone use in ihe United States.
Neurooncaiogy lZ(l1); l t47-1151
36. Shuz 1. Iacubuen R. Olsm IF1 Boice JD, McLaughlin JK, Johdnsen
C (20061 Cellui~relevhone use and emcee rhk uodate of
a nationwide Danislr cohon, i ~atl Cancer Inst 98123):1767-1713
37. Lonn S, Ahibom A. MI P, Feychting M (2W5) Long-term
mobile phone ~lso and brain tumor risk. Am I Epidcmiol
3 61(6):52&535
3K, H%dell L. Cvrlberg M. Soderqvist F, Milti KH, Morgan LL
(2007) Longtern use of cellulac phones and brain rumoun
~ncreased nsk assoctabd wtth use for >=I0 year$ Oceup Em
ion h1ed 64!9) 626-632
39. Nuvas-Acien A. Pollan M. Gustnvsron P. Roderub 6. Plaio N.
Dowmic~ \I (2W2 lc~:cr.:i::s: eS~L~: rlx r.,~ :li.,-
mrr so? mcnlng am?; in Srrrd!%l, men. C!l#cer El,id:lr~id Bidmdrk
Prev 11 1678-1683
80. Lehrer S. Green S StockRGl2D10) . . 4rsoctattonbctween number
~f CCI: >11011t ;3ot:?cr~ 2% brxn rJmor in~ldcn:c n n~~.ctc:n
U.3. 5r3t:i. J Seurau?cu. .0113; 505. ,Ti
.I1 Cnrdts E. Ri;karJ;on I., I)r.':our I et al (L1137) Thr Ih'ThR-
PHONE ~tudv deslgh eilldem~oloErcz1 ,methods, and descn~lion
of the rludy popu)aGon.'~ur J ~~iiemiol 22(9):647-464
42. Hanikka H, Heieinaunam S, Mantyla R, Kahnra V, Kuntio P.
Auvinen A (2009) Mobile phone use and location af glioma: a
caseivse analysis. Bioelecnomagned~s 30(31: I 76-182
43. Knudson AG (2WI) Tvia pnetic hhs (more or less) to cancer.
Not Rev Cancer 1(2):157-162
44. Habash RW. Elwood JM, Krewski D, Lon WG, McNarnee JP.
Praro FS (20091 Recent advances in reseach on radiofrequency
Relds md health: 200b2007. J Toxicol Environ Health R Crir
Rcu 12(4):250-288
45. Takebnyashi T, Vaisier N, Kihciii Y, Wake K, Taki M. Watonabe
S. Akiba S, Yomaguchi N (2008) Mobile phone me,
. . .
in Noway and risk of intracraniill turnours. Eur J Cancer Pnv
16:158-I64
47. Johanson C, Boice I Jr. McLaughlin J. Olren 1 (2001) Cellulw
telephones and cancer-a nationwide fohorl Study in Denmurk.
J Nntl Cnnccr Inst. 7 93(3):203-207
48. Sadetzki S, Chetrit A. Jarur-H&ak A. Cardis E. Dciircl, Y. buvdewdni
S. Zulten A. Novikor I. Freedman L, Wolf M ,(M08)
Cellulur phone use and risk of benign and malignanr parotid
gland tumors-a nationwide care-control study. Am I Epidcmiol
167:457467
49. Hno YY, Kano H, Davis DL Niiar,jm A, Lunstord LD (2009)
Cell phnnc use end aconstic newoma: theneed for rrundardizcd
questionnaires and aceoss to induSq dam. Surg Neural
72(3):216-222
50. Schulz KF. Grimes WA (2002) Case-control sru6ies: march in
reverzc. Lancet 3M:431434
51. Kundi M (2009) The cmtrovcrsy about pnssible telationships
between mobiie phone use andcanccr. Environ Health Perspect
117:316-324
52. Hilrdcll L. Curlberg M (2006) Pooicd analysir d two ease-te-cbntml
studies on use of celluleraod cordlcsr tclephnncs and the risk for
malignant brain lumours diagnosed in 1997-2003. Ini Arch
Occup Environ Health 79:63&639
8 Springer

Worldwide Cell Phone Safety
Recommendations and Policies
September 2011
On May 31,2011 the World Health Organization/International Agency for Research on
Cancer classified the electromagnetic radiation from cell phones as possibly carcinogenic to
humans based on an increased risk for glioma, a malignant type of brain cancer, associated
with use of mobile phones.
ACTIONS IN THE UNITED STATES
U.S. FEDERAL COJ1RIUUIC,\l'fOUS CO\lMISSION
Kegulato~y powers oi,lcvelopi~lg safcc) jlrndards or'ccll ~lar phones was given hy rhc FDA to thc FCC.
The FCC and FDA have not updated thew consumer information subsequent to the WHO class~fication in
May 201 I. Unbeknownst to most consumers, the FCC requires thatevery celluiarphonc manual mclude a
safe d~staiice warning because when the phone is held to the body the user may he exposed to microwave
radiat~on that couldexcced the federal safety limit for cxposure. Thisreqmrement isdue to the way in
whlch the FCChas the devices tested Unfortunately, this information is h~dden iu fine print in cellular
phone manuals most users never read.
I
SAN FRANCISCO. CALTFORNlA was the first city and county in the nation to pass cell phone
safety legislation in July 2011. The "Right to Know" ordinance passed the Board of Supervisors
unanimously and was signed by Mayor Lee on August 2,201 1. The ordinancerequires cell phone
retailers to distribute an educational sheet created by thc San Fmnclsco Department of Enviro~lmenthat
explains mdiorrequency emlssioiis from cell phones and how consumas can min~mizc thclr exposure,
This mfonnahonal sheetwill be given to purchaseis at the point of salc. Each retailer must also display a
poster (also crcated by the SFDOE) that statcs that cell phones emit radiofrequeticy energythat is
absorbed by the head and body
htcn.//%ww s~os.o1~lftu~~inlondcdfiI~/bdh~h~~1siboee1daslnatenlbaO72G
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BURLINGAME. CALIFORNIA: On August 15,201 1, Burlingame dty touncil voted to indudeeel1
phoneguidelines as part of their Healthy Living in Burlingame initiative. The guidelines w11 be
distnbutcd to residents and wll include the WHO classification and precautions a consumer can take if
concerned. The CTIA-Wireless Assoc~at~on presented to Burlingame City Counc~l in September 20 10.
The Council then determined to include guidelmes in their initiative.

ENVIRONMENTAL HEALTH TRUST
w\~w.cl?tntsr.org
PORTLAND. MAINE: Mayor Nicholas M, Mavodenes, Jr, declared October 2010 "Cell Phone
Awareness Month" and W 11 do so again In 201 I.
JACKSON, WYOMING: Mayor Baron dcclarod a"Ce1l Phone Awareness Month?
MAINE: Iiit0;i/www.ii~aincIcgi~laturc.o1-q4Lar~ MakcrWcbisumma~.aa1~~11)=280040439
"Our cell phone wamlng label b~ll passed the Malne House of Reprcscntativcs. Thc bill would have
requircd whatever warnings were in the tnanual to be placed on the package OR a label on the package
directing users to chcck thc manuaf for safe usage gu~dancc, and at what pages that appeared. In the
Senate all tlte Democrats present cxcept one, and tu75Republicans, voted in favorofthe b~ll. The Senate
Majo~lty Lcader worked aggress~vely.to defeat it, and succeeded The vote was 20-13, wlth two
Democrats excused. Clearly the choice was whether to protect the industry or the consumers bccause thc
wording m our proposed wamlng label leg~slatioii was cwefully chosen to use only the manufzdcturcrs'
own words." July 4, 201 1 Andrea Boland, Ma~ne state legislator.
SB 932: Senator Mark Leno mtroduced leg~slat~on whlch calls for posting language at the point of salc
advlsing consumers to read the safeusc ~nstructioirs in thexr cell phone user manual. This passed the
Senate Env~ronmental Quality committee May 9,201 1. The fill1 Senate vole has boen postponed unnl
next session.
BERKELEY, CALIFORMA: In December 2010, Berkeley city council passcd a resolution directing
thelr city managcr
-
to draft a cell pllone ordlnancc modcled on San Francisco's ordinance. The legislatton
is currently being draficd by the C~ty Manager w~th ass~stance from Envnonmental Health Trust. The
Bcrkclcy Health Commission has added precautions to tl~oil website
OREGON: http iiwwu-.lea.state.o~ .us11 I1c~/meas~df:~bO60O.dIr/sbOG79.i11~0 gdf
Senate B111 679 sponsoicd by Oregon Senator Sli~elds would prohtb~tetailets from selIing, leasing,
offering for sale or lease or othei wise distnbutrng cellular telephone unioss telephone and packaging bcar
spec~fic label. The proposed label reads:
"'WARNING: This rs a radio-fteqmncy [RF), radlat~on-emitt~ng dcvice that has nonthe~mal biological
effects for which no safety guidelmes have yet been establcshed. Controversy exists as to whether or not
these effects are harmful to humans Exposu~e to RF ~adiaiion may be reduced by limiting your use of fhis
dev~co and kecpmg it away from the hcad and body"
Th~s p"rposa1 will be brought to the Senate in 201 1,
NEW MEXICO:
htiu://w~~v iimlcgicg&Ics/ ~~ssI~~.osDx?C~X~~~~~,~~TYO~=M&LCP
State Rep. B~ian Ii'. Egolf (D-Santa Fe) sponsored HM 32, which d~rects the state goveniment to "study
ava~lable ilte~ature and reports on the effects of cell phone rad~ation on human hcalth." Also, by
Novcmhcr I 1, 201 I , the Departmmt of Health and the Departmolt of tlte Environment must prepare a
repnit with "reconmlendations on how to alleviate any dangerous effects that cell phone radiatron has on
human health."

ENVIRONMENTAL HEALTH TRUST
ww~v.ehtrust.ore
PENNSYLVAh?A
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1 $sind=O&bodv-I-l&W~e=B&b1~=l4
orr
Representative Vanessa Brown {D-190) and Former House Speaker Dcmiis O'Brien (R-169) introduced
HR 1408 'The Children's Wrreless Protection Act" in April 20 I I, Stores and tetaiIets would be required
to display paraphernalia bear~ng the waming as well If a ccllular telephone does not fall undertbse
provisions, the Attorney General may order its recall or order that it meet these requirements. The bill
orders that the Ofice of Attomcy General rssue a wamrng of the effects of wll phone usage to the public
on its website. This bill proposes to. "Requ~re manufacturers of cell phoncs in Pennsytvan~a to include
legrble, pfotmnent, non-hmovable waming labels on both ceilular teIephones and thcir packag~ng. The
proposed label would includc the following statement.
WARNING: This device emits electromagnetic rad~ation, cxposure to wl~ich may cause
brain cancn; Users, especially children and prcgnant women, should keep this dcvicc
away from the head and body "
Public Ilearings are planned September 1,2011; Environmental Wealth Trust's Chair of the Board, Ronald
E. Herbeman, MD, and Environmental Health Trust's Director of Government and Public Affa~rs, Ellen
Marks, will be testifjlng
PHILPIDELPHIA. PENNSYLVANIA
Ph~ladelph~a City Councilwoman-at-large Blondell Reynolds Brown developed and passed a strong City
Council resolut~on regardmg the Issue of cell phone radiation and authotlzing the Council's Publtc Health
and Wclfare Committee to hold heat~ngs on actions the C~ty call take to promote public ewarmcss of the
health nsk from ccll phone emissions to children and pregnant woman. The Resolution passed
unanimously m December 2010. The Councilwoman w~ll be workingto schedulc the hearing in early
Fail.

ENVIRONMENTAL HEALTH TRUST
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Page 4 oi' 12
I
INTERNATIONAL ADVISORIES
I
AUSTRALFA: hltv//rwlvw aroansa nov.auiniob~lenhoii~s~~ndcx cfm
An offic~al caution for chlJdren to text rather than talk on the~rcell phones was issucd in June 2010 by ihc
Australian Radiation Protection and Nuclear Safety Agency. The agency sa~d children must take
precautions to protea themselves from exposure to radlatlon because health nsks from thelr long-term
mob~le phoneusc arc unknown. "Ch~ldren should be encouraged to llinlt exposure from mobilephones to
then heads by reducing call tlme, by making calls where reception is good, by uslng hands-free dev~ces or
speaker options, or by texting."
BRAZIL: htt~:/l~v~vu~.~cems.~uldocsircsolutionsPo~ Alcprc Idf
-'We make an urgent call to all natronr; to convcnc apanel of experts, selected from candidates
recommended by civil soclcty groups (not only those prefcned by the affected industries) to discuss
precaut~onaty technology, laws and advlce in order to develop policies that reconcile public health
concerns w~th further development of wireless cornmunlcatlons technology such as mobilc phoncs as well
as electric power transmission and dlsirrbution systems." Porto Alcgre Resolution, May 2009
COUNCIL OF EUROPE:
htt~:~/assc~iiblv coe,~ntlMainf,a.;n?l~~~k~lDo~~im~~its:AdontedTextf~l
IiERFSI Xf5.htm
"Thc Assembly regrets that, desprte calls for the respect of the precautionary principle and dcspitcall the
recommmidations,declaiations and anumbm of statutory and Iegislativeadvances, there IS st111 a lack of
seaetion to known or emerging envilonmenlal and hcaIth risks and virtually systemartc delays iu adopt~ng
and ttnplementing cffectlve prevclrtive measures. Waiting for high levels of sc~entlfic and clinical proof
before taklng actron to prevent well-known nsks can lead to very high healtli and cconomlc costs, as was
the casc with asbestos, leadedpetrol and tobacco." Pailiamenta~y Assembly, CounciI of Europe, May
20 1 1, Rcsolutioii 1815 (excerpt):
"8 In llght of the above considerations, the Assembly recommends that the membcr statcs of the Coutzil
of Europc
8.1. in general terms:
8.1.1. take all reasonable measures to reduce exposure to clcctromagnctlc fields, especlaily to radio
frequenc~es from mobilc phones, and partioulaiiy the exposure to children and young people who seem to
hc most at risk fmm head tumours;
8.1 2 rccodsider the scientific basis for the prcsent standards on exposure to electromagnettc fields sct by
the T~~ltcmatlonal Commiss~on on Non-lon~sing Radiation Piotcct~on, which have serious limiialions, and
apply ALARA principles, covenng both thermal effects and the aihemc ot biological effects of
electromagnetic cmisslons of fadlation;
8 1 3. put 111 place infomation and awareness-raising campaigns on the risks of potent~ally harmful tongterm
blolog~cal effects on the environinent and on human health, especially targeting children, teenagers

ENVIRONMENTAL HEALTH TRUST
www.ch r r~&o~
and youilg peoplc ~Freproductive age;
8 1.4. pay particular attention to "&lectrosensitive" people who suffer from a symdrome ofiniolerance to
electromagnetic fields and introduce special measures to protect them, including the creation ofwave-i?ee
areas not covered by the wireless network:
8.1.5. in order to reduce costs, save energy, and protect tlie environment and human health, step up
research on new typcs of antenna, mobile phone and DECT-type device, and encourage research to
dcvciop tclecominun~cahon based on othet technologies whlch are just as efficient but whose cffects are
less negative on the environment and health,
8.2 concerning the private use of mobile phones, DECT wirelessphones, WBI, WLAN and WMAX for
computers and other wireless devlces such as baby mon~tors:
8.2 1 set prevcntlvc thresholds for levels of long-term exposure to microwaves in all indoor areas, in
accordance with tlleprecaut~onary pnncrple, not exceedmg 0 6 volts per metre, and in thc medium term to
reduce ir to 0.2 volts per metre;
8 2.2. undertake appropriate risk-assessmentpccdures for all new typcs of device ptior to limnsing;
8.2.3. rntraduce clear labeliing iild~catitlg the presence of microwaves or electromagtletic fields, the
trausmlttmgpower or tile specllic absorption rate (SAR) of the device and any hcallhnsks connected with
its use;
8 2.4, raise awareness on potentla1 health nsks of DECT w~ieless telephones, baby monitors and other
domestic appliance? wliieh em~t conbnuoas pulse wakes, if all elcctr~cal equipment 1s left permanently on
standby, and rccommcnd the use of wlred, fixed telephones at home or, falling that, models which do not
pcrmane~itly cmlt pulse waves;
8.3 conccming the protection of cl~ildren:
8,3.1 develop wiihrn differenr ministries [edducation, environlnent and health) targeted informatron
campaigns a~med at teachers, parents and ch~ld~en to alert Lhem tn the specific nsks of early, 111-
consrdered and prolonged use of mobiles and other devlces emitting microwaves;
8.3.2, for chlldren in general, and particularly in schools and classrooms, give preference to wired Intcrnet
connections, and sttictly regulate the use pfmobllc phones by schoolcluldren on school prcrnises;
8.4. conccming thc planning of electric powerlines and rclay antenna base ~mtions:
8.4.1. introduce tow1 pla~ming measures to keep high-voltage power Iinc8 and other eiech-IC ~nstallafions
at a safe disfa~tance fiom dwellings:
8.4 2 apply strict safety stai~dards for the healthimpact of electrical systems in new dwellings;
8.4 3.. reduce threshold values fur relay antennae in accordance with the ALARA piinclple and install
systems for comprehensive and continuous morntoring of all antennae;
8.4.4, dctcmiinc tl~c sites of any new GSM, UMTS, WlFi or WIMAX antennae not solely xcordlng to
tlie operators' interests but in consultation wltll local and regional government autl~orities, local realdents
and associat~ons of concerned cit~ze~is,
(continued next page)

ENVIRONMENTAL HEALTW TRUST
www elilrust.or~
8.5. concerning risk assessment and precantrons:
8.5.1 make risk assessment moreplevention onented;
8.5 2. impiove risk-assessmenr standards and qual~ty by creating a standard risk scale, making the
tndlcation of the risk level mandatory, commlsslonlng several risk hypotheses to be studied and
considering compatib~lity w~th real-life conditions;
8 5.3 pay heed to and protect "early waming"sc~entists,
8.5.4. formulate a human-rights-oriented definitioii of the precautionary and ALARA prmciples;
8.5.5. Increase public fundlng of indcpe~ident research, in particular through gm~its from industry and
taxation of products that are the subject of publlc rescarch studies to evaluate health risks;
8 5.6. create mdependent commissions for thc allocatio~l of pubi~c funds;
8.5.7. make the transparency of lobby groups mandatory;
8.5.8, promote pluralist and contradictory debates between all stakeholders, including civ~l society (Arhus
Convent~oii)."
IRELAND:
Mobile Phone Radiation Warn~ng Bili 20 1 1
htto://uww o~rcaohtas 1c!docurnenr~lb1l~i,2SibifIsi2011/2411~b241 is1 odf
"An Act to provide that a warning label shali be asxed to the extellor casing of mobile phone6 and 011
related packaglng, which shall state clearly that moblie phones emit efcctromagnetic radiatton, Be it
enacted by tlie O~reachtas as follows:
Every niobilephonc and its packaglng must have a clearly legible wmlngaffixed to if. Such wammg
must: (a) specify the mobile phone's non-ionwing radiation level, and
(b) the specific absorption (SAR), and
(c) contain a wammg as set out m the Scliedule of this Act"
"A new bill tabled by Kncsset member Yul~a Shmalov Berkovitz has received support of dozens of
Knesset. The most promlneiit demaiid ts to setid an SMS every day at I2 o'clock in which it will bc
witten: 'Warnzrzgg- tbrs mobriephone emits no~t-zonrz?~tg mdiafon. The WHO has dectdedfhnt if can
cawfie cmcer And caeh time tlie phone is turncd on, a simila~ waming will appear on the scrcen.
Anyone who purchases a ccil phone will have to sign that they understand tlie risks of use, cspccially in
children. Participation of children inadvcrtisements will be banned. An carpiece WIII have to begiven at
each purchase. At least i 5% of tlie company's rcvenucs will go to education to minimize the usc of cell
phones. Advertisements wiH include wamingswhas tho~c found on clgaredeS ads. The minister
Gilad Arden said tliat publtc aware~iess orcell phone use risk is needed. Although Ihedoes iiot supporr all
of tlie clauses of the bill, he considers most of them pos~tively. Over the next few weeks this b111 will be
brought to Knesset discussion." [Yediclf(newspaper) June 23,201 1 .]

ENVIRONMENTAL HEALTH TRUST
wivw.ehtrust.org
In 2008, Tsrael's Mintsby of Health published a set of guidelines thatcalled for Itmlting children's use of
cell phones, avold~ng cellular oommun~cat~on in enclosed places such as elevators and trains, and using
wired, not wireless, eaqieces The Minlstry developed these gu~dellnes following a natlonal study that
detectzd an association between cell phone use and the nsk for developrng tumors of the salivary gland.
FINLAND:
Tn January 2009, thc Finuish government stated that children's celi phone use should be restricted, for
example, by sendlng tcxt messages Instead of talkmg, tnakittg shorter calls, using a hands-free device, and
avolding the use of cell phones when conuection is weak. According to theFiilnrs11 report, "althougli
research to date has not demonstrated health effects from ccll phone's redration, precautior> is
reconlmcndcd for children as all of the effecrsarenot known .. S~nce it takes years to develop acancer
and cell phones have been In common use only for about ten years, the poss~bility,tlrat a lillk between cell
phone use aud cancer might be found in later populatton studies, cannot be led out" [STUK (Finnish
Rad~ahon and Nuclear Safety Authority) 2009.1
FRANCE:
Tl~e new French cell phone statute, pad of a sweeping legtslatlve package called the "Natioil~ai
Engagement for the Envrronmcnt" was approved by French parl~ament July 12,2010 and is set to take
effect m April 20 I 1. France's law requires SAR postin&, headsets, and protects kids. It requircs French
electronrcs stores and other cell phone vendors to post cach devrce's Specific Absorption Rate (SAR)--
the standard masme of radiofrequency energy absorbed by the human body.
France's srattitc rcqulrcs merchants to display SAR numbers m leglblc French to glve consumers easy
access to radiation lnfonnation ror differcl~t models. It wlll allow cell phonc shopperslook~~rg for a low-
SAR modcl to make on-the-spot cornpansonu in stores Tl~e F~encllaw also requires that all ccll plrones
be sold with a headset, bans cell phoile ads aimed at cllildren and adoJcscc~lts younger than 14, and bars
the sale of phones specrfically made for kids younger than 6.
IJN17eD IUNCD OM:
'Therefore, as aprecautio~~. thc UK Chref Medical Ofticers advise that ch~ldl-en and youtig people under
16 should be encouraged lo use mobile phones for essential purposes only, and to keep calls short."
(Mobile Photles and Health Lextlet, 201 I.)

ENVIRDN MENTAL HEALTH TRUST
www.ehn-ttst.org
RUSSIA:
litm-~i~~ww.1~ho.int~1~:h-emf:oro1ec1a1trensSSl01o120205
ndf
The Russian Natronal Cominrttee on Non-Ionizing Radiation Protectron has expressed concern at thc
marketing of mobile phones to children and teenagers and has stated that it belleves that tlie risk to
chrldren from mobile phones is not much lower than the risk to children's health from tobacco or alcohot.
The Comn~itte explams thrs high potentla] rrsk as tbllows:
" "The absorbt~on of electro-magnetic encrgy 111 a chlld's head is cons~dcrable higher than that in
the head of an adult
* Chrldre~l are more sensitive to cle~?romagnetrc fields than adults
* Childrcns' bralns have h~gher scnslt~vity to the accumulatron of theadverse effects from chron~c
exposure to the electromagnetic fields
Today's children will spend a longer time using phoucs that1 today's adults.
Ofparticular concern is the morbidity increase among young people aged 15 to 19 years fit isvery hkely
that no st of them aremob~le phone users for along perrod of time). Compared to 2009, the number of
CNS disorders among IS to 17 year-old has grown by 85%, the number of tndividuats with epilepsy or
epileptic syndrome has grown by 36%, the number of "mcnlal retardatton" cases has grown by 1 I %, and
the number of blood dlsordcrs and ~nimune status disorders has grown by 82%. In group of children -qcd
less than 14 years there was a 61% growth in the number of blood disorders and immune status dlsotders,
and %%growth 111 nervous disorders rrsk assessmcnl for EMF exposure.
Taking into account the RNCNIRP position and the precaunonary mcasures suggested by WHO, the
Committee considers that urgent measures must bc taken because ofthe inability of children to recogriize
the harm from the mobilc phonc use and that a mob~le phone ltsclf can be considered as an uncontrolled
source of harmful exposure.
It is requited that the information that a mobile phonc is a source of RF EMF is clearly slrow~ on
the phone's body (or any other telecommnunication devlce).
Tt is rcquircd that thc "User's Guide" cantams infomatioli that a moblle phone (personal wireless
communication tool ustng electmlnagnetic communication method, etc.) is a source of harmful
RF EMF exposure. Usage of a mobile phone by ch~ldren and adolescents under 18 yearsold is
not recommcndcd .Mobile phone use by prcpdnt women 1s nor recommcndcd in order to
prevent risk for a fetus
The easiest way to reduce RF EMF exposure is to move themob~le phone away from one's head
dunng the phone call whlch may bc achieved by usmg the hands-free sets (protectron by
distance). Shortcnrng the call duration is another way to reduce the exposure (protecrion by
time).
(continued next page)

ENVIRONMENTAL HEALTH TRUST
www.el~wust,or~
The REC'NlRP considers it is reasonable to dcvrlop mobile phones with rcduccd EMF cxposure
(with hands-freesets, ~ncluded limitation functions, such as l~mrtation ofthe numberofdaily
phone calls, possibility of forced limitation of phonc call duration, etc.).
It is required to includecourses 011 mobile phomes use and issues coiiceming EMF exposure in the
educational program ~ II schools.
11 1s rcasonable to set Tim~ts on mobile telecommnnicatrons use by children and adolescents,
including ban on all types of advertisemenTof mohiio teleco~nmun~catior~s for children
(teenagers) and with theirparticipation.
The RNCNIRP is ready to as$~sl the mass-med~a in their awareness-ralwng work and educattonal
activities in the area of EMF and, rn particular, to prov~dc ~nformation about The neweStrcscarcli
of the impact of EMF on human health and the measures to curb the negative impact of this
phys~cal agent.
Better safety cr~teria for children and teenagers are requ~red in tile nearest term. Features of the
developing organisin should be taken into account, as well as the significance of bioeiectric
processes for human life and activ~t~es, prcscnr and Nure conditions of EMF, prospects of
teclmological and technical development should bc addressed in a document of legal status.
Development of a fundednalional program for studyingpossihle health effects froin chroulc
EMF Cxposure oftlx developing braln 1s ncccssary,

ENVIRONMENTAL HEALTH TRUST
wws-
JURISDICTIONS THAT ENCOURAGE LIMlTINGUSE OF PHONES BY CIBLDREN
UNITED STATES NOT TAKING ACTION
Be it noted that the United States' FCC's Kid's Zone (current but not n~dated since 2009) on the
FCC current wcbsite states:
'+Do cell phones cause brain cancer?
Thereis no sc~entific evidence to dare that proves that wlreless phone usage can lead to cnncer or a
vanery of other health efrccfs, including headaches, dizziness or memory lass Howevcr, studres are
ongorng and key government agencies, such as the Pood andDmg Admintstratron (FDA) contliiue to
monitor the results of the latest scientific research on this topro. In 1993," the FDA, whicl~ has prtmaly
jur~sdicZlon for mvestigating moblle phme safety, stated that it d~d not have enough lnformatron at tltat
trme to rulc out the possibihty of rlsk, but if such a risk cxiss, " ~t is probably small." Tbe FDA co~icluded
that there is no proof that cellular telephones can be harmful, but if rndividuals remain concerned sevaal
precauttorrary actrons could be taken, rncludmg llmiting convcrsat~ons on hand-11etd cellular telephones
and making grcateruse of telephones with veh~cle-mounted antennas wherc there is a greater separation
distance betwccn the user and the radiating antennas. Tlie Web srte for the FDA's Center for Dev~ces and
Radiological Hcalth provides further informatton on mobile phoue safety:
www .fda.govlcdrldplion~/~ndex.html "
No use in clitldren under 16 years of age htk~l/wwlv.aiehdeet com!2007/09!I3ikni'i1alska.mdi~hai1i1111p-
,mllpho~ics-for-kids-~tndcr- 161
Requests that manufacturers do not create ads with children and pregnant women.
Iittp if~hiilive 1n.co1nincws/no-k1db-r)rc~iani-~om~n-1r1-cdl1~h~n~~a~ls-ffo~~II67335-
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TSRAEL:
The Minis@ publrshed a siet of guidelines that called for limiting childrc~,'~ use of cell phones, avolding
ceilular communication in enclosed places such as elevalors and trains, and using wired, not wirclcqs,
earpieces (Azoulay 2008).
FINLAND:
In 2009, Finnish Radiation and Nuclear Safety Authority (STUK) advrsed that ohild~m's moblle phone
use should hc reqtncted. The Authority says that ~liildreo will havc more time to use a mobile plione for a
iongerperiod of time than adults, the long-term nsks frmn theuse of mohllephones cannot be assessed
bcforc thc phones have ben? in use for several decades, and chrldren's brains arc dwelop~ng up to the age
0020 years. "Wlth children, we have reason to be especially carefully, becausethere isnotei~ouglr
research on children's mobrle phone use. Unfortunately, it rwll not bc easy to obyain this information tn

ENVIRONMENTAL HEALTH TRUST
www.ehttust.org
the future either, because of ethical cbnslderanons, the use of children as research sub~ects must always be
lieavtly justified," according to STUKresearch director Slsko Salomaa.
The Authority suggests that children's mobliephone use could be restricted in the followmg ways:
favouring thc use of tcxt messages rather than calls,
parents limiting the number of calls and theirduratidn,
using hands-frec devices
avoid talking in an area with low conncct~vity or in a movlng car or. a train.
EUROPEAN UMON MEMEER STATES:
Euinpean Parliament (2008b, 2009) suggested tliat current limits arc obsolete and do not consider
developments in vulnel-able groups (e.g., pregnant women, newborns, ch~ldren). A wide-rang~ng
awareness campaign was suggested to familiar~ze young Europeans mth good moblle phone techniques
(e.g., llands-free kit, keep calls short, switch offpi~ones when not in use, usa phones tn good reception
areas).
EUROPEAN ENVIRONMENT AGENCY:
Dlrector J, McGlade made a policy statement in 2009, advising against regular use of cell phones by
children and proposing precautionaiy actions to ~cduce the general public's radiation cxposures
RUSSIA:
Tn 201 I. the Rusnan National Committee on Yon-Ton~zing Radiatton Protection advi~ed potential nsk for
children's health is very high. Current safety stalidards for exposure to microwaves from mobile phones
have been developed for adults anddo not conslder characteristtc fcatures of a child's body. RNCNJRP
stated ultimate urgcncy to defend chlldren's health rrom the influence of the EMF of the mob~le
cornmun~cat~ons syste~ns. Usage of a mobllephone by children and adolescents under 18 years old is not
recommended and mobile phone use rcquires lmplementat~on of precautionaiymeasures rn older to
PTeventliealih risks. Mobile phone use by pregnant women 1s not recommended in order to prevent risk
fol a fetus.
SWITZERLAND:
Tither keep your calls short or send a text message (SMS) ~nstead. This advice applies expeciatly to
cliildren and ndolescents." (Federal OEcc of Public Health)
GERMANY:
Federal Office for Radiatiou Protection (Bunesamt fur Strahlenschutz 2008d) recommends exposure
min~m~zatioii for children.
KO RE A:
Seoul Metropolltan Courrc1l(2009) bans thcusc of cell phonesat schools.

ENVIRONMENTAL HEALTH TRUST
~mv~~'..chtrust og
UNITED KINGDOM!
Chief Medical Oflicers in the Department of Hcalth strongly advise that where children and yonng people
usemobitc phones, encourage: use for essential purposes only and short oalls(2005).
FRANCE.
Under the new legrslat~on, "all publrc communication, whatwerthe means or suppori, that arm, drrectly
or indirectly to promote sale, availab~l~ty or use of cell phones by children younger than 14 years old
would be prohibited. Sale or frcc ddistribuiio~l of products containing radiofrequency devrces and a~mcd
specffically for use by children younger than 6 ymrs of agcmay bc forb~dden by orderof thc Healtli
Mmlster, in order to limit exceswvc exposwe of children "
General limitation under 18 years of age.
Tajikistan bans moblle phones from schools and universities to boost cciuoat~on. Anyone caught canying
or talking on a ccll phone wfll be fined.
TORONTO. CANADA:
h~~~:/!www.tor~nto.cn/hcalthih~h~!~df/b~h cllilcl~cn saf~ccll~~horr~.~dr
and
htrE/iwii~w.ioron1o.~d~~e;~~~~~~.ph~~~1~d~fd~cIshec1
~hi~ci~n,~.s:~~~~~lI~~~~on~~ndf
-. --
"Cllildr~, especially pre-adolescent childrco, use landlines whenever possible. keeping the use of cell
phones for essential purposes only, limrttng the length of cell phone calls and using headsets or hands-free
opbons, whenever poss~blc" (Toronto Public Health 2008a). "Parents who buy cell pllo~lcs for their
children~hould look for ones with the lowest cmissrons of RF waves. Pl7lle11 cell phoile receptron is low
(this happens when the base station antenna is far away) and when acell phone is hcmg used during h~gh
speed have1 (1.e. drivrng in 3 car) power being emicted from the cell phone must be increased in order to
maintarn reception, Cell phone use by chlldren ~hOuld be limited durrng these tfmes in order to reduce
exposure to RFs" (Tomnto Publ~c Health 2008b).
In collaboration with the California Brain Tumor Association and
Consumers for Safe Cell Phones