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CONTENTS
EXECUTIVE SUMMARY 1
INTRODUCTION 4
1.4 Selection criteria and analysis methods in recent reports and documents
concerning mobile telephones and health 11
2.1 Introduction 14
BIBLIOGRAPHY 191
ANNEXES 230
MCL would like to thank Emilie Henein, who transcribed this translation.
Executive Summary
"Do the conclusions of recent reports summarising our current knowledge of the health
hazards related to the use of mobile telephones and their accessories justify the adaptation
of the risk management regulations recently adopted by the French and European
authorities?". This is, in effect, the crux of the question submitted to the expert group brought
together by the Direction Générale de la Santé (Health General Directorate).
The frequency range used for mobile telephony varies according to companies and their
technologies, ranging from 850 to 1900 MHz. The range will be extended to 2200 MHz with
the new UMTS technology, and to the 400 MHz waveband with the TETRA system, currently
under development. These are part of the much wider range of radio frequencies present
everywhere in our environment, at home (microwave cooking, etc.), at work (industrial
heating systems, etc.), or in public places (radio and television transmitters, burglar alarm
systems and remote-control devices, etc.), especially in urban areas.
The development of telecommunications has been followed by research into the effects of
radio-frequency electromagnetic fields (RF) on biological systems. Work first started in this
field after the Second World War. This research focused particularly on mechanisms that
could link exposure of human cells to the development of cancers. It is still too soon,
however, to assess any long-term effects. The highly-complex physical and biological
phenomena necessitated the development of new experimental, measurement and
observation procedures that were not always completely controlled in the early research
projects. This is why it is still difficult to draw clear conclusions, in spite of the enormous
volume of scientific work on the subject. Some research evidenced short-term modifications
in certain physiological or biochemical parameters, or even fine neuro-sensory functions,
while other work contradicted these results. The significance of these observations in
predicting the occurrence of long-term effects is debatable.
The public are naturally concerned by this difficulty in drawing conclusions. The issue of
potential health hazards resulting from exposure to RF takes on a very special importance
when it is considered that 30 million people are users of mobile telephones in France and
that the expected market is 44 million within 4 years. Even if the individual risk were very
small, the very number of people involved would produce a considerable impact in terms of
public health.
On the other hand, mobile telephones also contribute to health and safety. The speed with
which the alert can be given in case of accident, fire, or other dangerous situations, and the
effectiveness of emergency services have been considerably improved by the widespread
availability of this technology, which has already saved many lives worldwide. An evaluation
of the trade-off between risks, if there are any, and potential advantages, was not part of the
expert group's brief, which focused solely on risk assessment, based on the analysis of
scientific data alone.
The first chapter of this report describes, in detail, the critical synthesis approach used to
develop the expert group's opinion and recommendations. The second chapter presents the
sources and characteristics of the electromagnetic fields associated with mobile telephony,
and the known or investigated mechanisms by which they interact with living matter. The
third chapter gives the threshold limit values for public exposure to RF associated with
mobile telephony and explains the scientific basis for the figures.
The fourth chapter is the longest. It summarises the expert group's analysis of the current
state of scientific knowledge. Several scientific bodies have recently produced reports
containing comprehensive analyses of the biological and medical effects of RF. These
bodies, consisting of top-level experts in the various scientific fields involved, have analysed
1
all the scientific data available at the time. The expert group used five summary documents,
covering several hundreds of articles published in the scientific literature, to carry out their
mission. In addition to these ‘basic reports’, seven 'additional documents' were taken into
consideration: symposium proceedings and summary articles providing interesting
information. The expert group also made sure to take the most recent published work into
consideration, right up to the day this report was completed. Finally, the group interviewed
about twenty people from scientific organisations, administrations, industry, associations,
and politics, both to obtain further information and identify society's concerns on this issue
more fully.
The expert group had two main objectives in carrying out this assessment of scientific
knowledge:
To define the areas in which there were convincing scientific data proving the existence or, a
contrario, the absence of biological and medical consequences following exposure to RF
related to the use of mobile telephones and the operation of base stations (i.e. ‘what we
know’),
To highlight the areas in which currently-available scientific data does not exclude the
possibility of biological and medical effects, without necessarily confirming their existence
(i.e. ‘what is uncertain’).
The expert group's conclusions and recommendations are presented in the fifth chapter.
They are based on the following considerations:
There is considerably less personal exposure in the vicinity of base stations – with the
exception of exclusion areas – than there is when making a call with a mobile phone.
Scientific data indicate, with comparative certainty, that, during exposure to RF from a
mobile phone, a variety of biological effects occur (eg. electroencephalogram profile,
reaction time, etc.) at energy levels that do not cause any local increase in temperature.
However, in the current state of knowledge of these non-thermal effects, it is not yet possible
to determine whether they represent a health hazard.
Although this assertion is backed up by little scientific argument, the hypothesis that certain
medical effects are caused by the low-level RF fields associated with mobile telephones
cannot be completely excluded, in the current state of knowledge. Experimental and
epidemiological research into a range of health problems, including brain cancers and
headaches, is currently in progress; the role of exposure to RF in these symptoms or
diseases has not yet been clarified. However, in view of the exposure levels observed, the
expert group does not back the hypothesis that there is a health risk for populations living in
the vicinity of base stations.
If future research were to validate this hypothesis, i.e. demonstrate the existence of health
hazards, the risk, at an individual level, would probably be very low. Indeed, it is reassuring
to note that it has not yet been demonstrated, in spite of the considerable amount of work
done over the past several years. However, if mobile phone radiofrequency fields were
hazardous, the very high number of mobile telephone users could mean that, even if the
individual risk were very low, the impact on public health could be considerable.
The risk of accident and fatality associated with the use of mobile telephones when driving
has definitely been established. In the current state of knowledge, this is the only known
health risk, albeit a very serious one.
2
For all of these reasons, and in view of the brief they were given, the expert group
recommend a risk management approach based on the precautionary principle, aimed at
reducing public exposure to RF associated with mobile telephony to the lowest possible level
compatible with service quality and justified by current scientific data. The various measures
recommended are described in the full report. The objective is also to ensure that users and
the public have access to comprehensive information on their exposure. The expert group
consider that these recommendations would make it possible to apply the precautionary
principle in an enlightened way, i.e. on the basis of a rational approach.
The sixth and last chapter is devoted to recommendations for advanced research to
elucidate the remaining uncertainties in priority areas. Proposals are made concerning ways
of funding research that would guarantee the scientists' independence from the various
interests involved.
The expert group would like to emphasise that they have been able to work completely
independently, both from industry and public authorities. The Direction Générale de la Santé
(Health General Directorate) provided them with the effective, discreet support necessary to
complete their task.
3
“All scientific work is incomplete – whether it be observational or experimental. All scientific
work is liable to be upset or modified by advancing knowledge. That does not confer upon
us a freedom to ignore the knowledge we already have, or to postpone the action that it
appears to demand at a given time.”
Introduction
"Do the conclusions of recent reports summarising our current knowledge of the health
hazards related to the use of mobile telephones and their accessories justify the adaptation
of the risk management regulations recently adopted by the French and European
authorities?". This is, in effect, the crux of the question submitted to the expert group
brought together by the Direction Générale de la Santé (French Health General Directorate).
The electromagnetic fields associated with mobile telephones occur in an environment which
already contains a wide range of electromagnetic frequencies (radiofrequencies, RF, from
30 kHz to 300 GHz), particularly in urban areas. This is true of the domestic environment
(microwave cookers, radio and television signals), the work environment (industrial heating
systems, medical diathermy equipment) as well as in public places (radio and television
transmitters, radars, emergency services and taxi communication systems, burglar alarms,
and remote controls). The frequencies used by mobile telephones, depending on the
operator and the technology used, range from 850 to 1900 MHz, and will reach 2200 MHz
with the development of the new UMTS technology, and 400 MHz with the projected TETRA
system. Mobile telephone systems have two specific features which have aroused
legitimate concern among the public: for handsets it is the immediate proximity of the
telephone antenna to the head during conversations, and for base stations it is the
proliferation of antennas in the immediate environment. The huge number of users requires
an increasing number of cells to ensure optimal coverage, especially in built-up urban areas
where there are many physical obstacles. These antennas are visible for all to see: 'macro
cells' on roofs or towers, and 'micro' or 'pico cells' on the façades of buildings or even inside
public premises. As of 28 December 2000, 29,416 base stations had been installed in
France (macro cell, micro or pico cell antennas). In the course of the last three months of the
year 2000, more than 1,664 new base stations were installed and 589 modified, while 403
were abandoned.
The development of telecommunications has been followed by research into the effects of
radiofrequency electromagnetic fields on biological systems. Work started in this field after
the Second World War and a considerable body of scientific literature has been published.
Research was given a new impetus in the United States and then all over the world following
legal proceedings taken in 1992 by a citizen who accused RF of being responsible for the
death of his wife from brain cancer. Work has focused on this type of pathology, exploring
the biological mechanisms which may link the RF exposure of human cells to the
development of carcinogenic processes. Results of experiments on animals or isolated cells
have been published in a variety of scientific journals. However, the timescale of these
experiments is, by necessity, to short to allow the identification of any possible long-term
effects. Some authors have reported a possible link between certain forms of brain cancer
and the use of mobile telephones, whereas other recent publications have demonstrated the
opposite. All experts recommend continuing this research before drawing any conclusions
as to the consequences, which, similar to those of chemical substances and ionising
radiation, may appear only after many years of exposure. The highly-complex physical and
biological phenomena necessitated the development of new experimental, measurement
and observation procedures that were not always completely defined in the early research
projects. The necessary replication of results, particularly replication under identical
4
experimental conditions, is then very difficult. This is why it is still not easy to draw clear
conclusions, in spite of the enormous volume of scientific work on the subject. Some
research has indicated short-term modifications in certain physiological or biochemical
parameters, or even fine neuro-sensory functions, while other work has contradicted these
results. The significance of these observations in predicting the occurrence of long-term
effects is debatable.
That there is scientific debate comes as no surprise to specialists familiar with studies of
environmental risks, who know just how difficult it is to demonstrate the harmful effects of a
chemical substance or a physical or microbiological agent under everyday exposure
conditions. The public are naturally concerned by this difficulty in drawing conclusions. Is it
not precisely in such situations where the risk of serious consequences are uncertain that
the ‘Precautionary Principle’ applies? The answer is certainly yes, if the scientific indications
of possible “serious and irreversible” effects are sufficient to establish “reasonable doubt”,
but if this is the case, how far should the precautions go? Which aspects of exposure to RF
should they cover? Public and media pressure is focused on base station antennas, but the
exposure level is much less than that during a conversation on a mobile telephone.
The issue of potential health hazards resulting from exposure to RF takes on a very special
importance when it is considered that 30 million people (29,681,300 subscribers on 31
December 2000) are mobile telephone users in France and that the expected market is 44
million within 4 years. This is a worldwide phenomenon with more than 27 million users in
Great Britain and around 80 million in the United States, for example. Even if the individual
risk were very small, the number of people involved could produce a considerable impact in
terms of public health. The search for an answer to this question is thus an urgent one.
However, the number of people concerned is not enough to establish the existence of a
hazard, if RF is not dangerous, under current exposure conditions. A rapid response may be
required, but it will necessarily be dependent on the current state of knowledge.
Furthermore, mobile telephones also contribute to health and safety. The speed with which
the alert can be given in case of accident, fire, or other dangerous situations, and the
effectiveness of emergency services have been considerably improved by the widespread
availability of this technology, which has already saved many lives world-wide.
The brief of the expert group convened by the Direction Générale de la Santé did not cover
other aspects of the development of this communication technology in business, or the fact
that it facilitates exchanges between people, although competent national and international
authorities will certainly consider these factors. The management of proven or strongly
suspected risks is thus a part of a balance of costs and benefits, as no technology likely to
induce a risk, however small, could be justified if it did not also provide substantial
advantages.
Consideration of such a risk-benefit analysis was not part of the expert group's brief, which
focused solely on assessing the risks associated with using mobile telephones and their
accessories. The group did not take into account scientific work relating to low or extremely
low frequency fields; other technologies using RF – radio, television, and radar – will only be
mentioned in the context of health impact studies which provide indications for future
research.
In recent years, several health bodies have produced reports summarising the state of our
current knowledge of the biological and health effects of RF. Several groups of top-level
experts from the various scientific disciplines involved have worked for months to collect and
summarise all the literature available at the time. Examples include the commission led by
Professor W. Stewart in Great Britain (May 2000) or the Royal Society of Canada report
(March 1999). In preparing their report, the French expert group examined these documents
and many others (see full list in Appendix). They also updated the corpus of knowledge,
5
taking into consideration several works published after the completion of the work of these
commissions. Finally, the group interviewed a number of well-known people from scientific
organisations, administrations, industry, associations, and politics, both to obtain further
information and identify society's concerns on this issue more fully.
The expert group had two main objectives in carrying out this assessment of scientific
knowledge:
To define the areas in which there were convincing scientific data proving the existence or, a
contrario, the absence of biological and medical consequences following exposure to RF
related to the use of mobile telephones and the operation of base stations (i.e. ‘what we
know’),
To highlight the areas in which currently-available scientific evidence does not exclude the
possibility of biological and medical effects, without necessarily confirming their existence
(i.e. ‘uncertainty factors’).
Recommendations were made for research into priority areas, with the objective of
eliminating the remaining uncertainties. Guidelines were also defined to ensure that users
and the public benefit from the highest level of health protection justified by current scientific
data, as well as to encourage manufacturers and operators, as well as users, to take every
possible measure to reduce exposure to a minimum.
The expert group would like to emphasise that they have been able to work completely
independently, both from industry and public authorities. The Direction Générale de la Santé
(Health General Directorate) provided them with the effective, discreet support necessary to
complete their task.
6
1 The Expert Group's Approach
In such a context, it is a delicate matter to summarise knowledge with the aim of bringing out
the general meaning and formulating recommendations for managing any risks that may
have been identified. This is generally referred to as “assessment”, i.e. the art of translating
current scientific data into guidelines for action or information. This work can only be
collective. It must satisfy quality and reliability criteria, as must the scientific work on which it
is based. Readers who are keen to understand the scientific approach will see the difficulty
of discerning a clear message from a limited number of inconsistent results by looking at two
examples presented in the appendices. Both are taken from epidemiological studies of the
risk of brain cancer after exposure to RF. Brain cancer is a morbidity which particularly
focuses research and public emotions. The appendices describe two large-scale studies that
have been interpreted or presented in recently published articles by individuals or groups of
experts in a highly contrasting or even contradictory manner, as illustrated by quotations and
comments relating to their work. Although it is now widely recognised in the scientific
community – not yet the case in every field – that an isolated study can never be held up as
a demonstration or definite confirmation of a complex physical or biological phenomenon,
these examples also show how strict an approach must be used to analyse and interpret the
results of scientific work, even in the framework of a joint assessment. Epidemiological
literature is particularly subject to this interpretation bias, due to the multi-factor nature of the
biological and health phenomena observed. We would be mistaken, though, in thinking that
the experimental approach does not face the same difficulties, particularly as results are
highly sensitive to measurement conditions. This state of affairs is certainly regrettable, but it
is also real and generally applicable. Everyone can thus understand the importance of the
collective and explicit character of this process of critical reading and reviewing of all the
scientific literature available at a given moment on a scientific subject which is not yet
stabilised.
1
See, for example, the report of the Royal Society of Canada of March 1999 (p15) or the
introductory document to the EMF program of the WHO (can be viewed on the internet site
www.who.int/peh-emf)
7
this stimulation. A ‘health effect’ is a biological effect which may endanger the normal
working of an organism in that it goes beyond the framework of the ‘physiological’ responses
to the action of the external agent. This distinction is important and easy to understand.
Nobody could confuse the hearing of a sound (the enchanting song of a nightingale or the
disturbing noise of a dust-cart early in the morning), which is a biological effect (resulting
from a complex chain of elementary biological effects: mechanical, biochemical and
electrical), on the one hand, and the gradual (or sometimes sudden) loss of hearing after
prolonged exposure to noises of great intensity, such as that suffered by youngsters who go
to concerts with powerful amplifiers or in a metalworker after years of hammering without ear
protection: this loss is a serious adverse health effect.
Likewise, many people appreciate the biological effects induced by moderate exposure to
the sun, leading to the tanning of the skin via an increase in pigment production (melanin) by
the specialised cells in the skin, but they make a clear distinction between this effect and the
painful burns that come after excessively fast exposure to UV radiation without skin
protection, as well as the induction of a melanoma, both health effects which pose a serious
threat to the health of those who enjoy prolonged, intense sunbathing.
The duration or intensity of exposure to the agent causing the biological effect, and the
nature of the cell, tissue, or organism in which the effect is manifest, as well as other aspects
that have not all been elucidated, have a considerable impact on the link (or absence of one)
with a possible health effect. A wide range of biological or functional measurements are
undertaken when studying the effects of exposure to RF; some showing biological effects
according to the definition given above. Those which may be predictive of a health effect
remain to be determined. These 'hazardous biological effects' are causes for concern and, if
established, should be subject to preventive measures. Proving their existence is not an
easy task. First of all, they must regularly precede the occurrence of the suspected health
disorders or be associated with them. They may also constitute a stage in the chain of
biological effects leading to these disorders, in the human species in general or only in some
of its representatives (susceptible individuals) or, failing that, in several other species of
laboratory animals. An example which illustrates this, with regard to the non-thermal effects
of RF, is the increase which has frequently been described in the biochemical activity of
ornithine decarboxylase, an enzyme which may play a role in the development of cancerous
cells. This will be discussed later.
The Precautionary Principle is a policy tool for the prudent management of unproven risks. It
can be applied whenever plausible mechanisms or experimental or epidemiological
observations provide a minimal scientific foundation. It is essentially a matter of risk
8
management and not of evaluation; evaluation must try to keep to the area of facts or
scientifically-founded hypotheses provable by experimentation, or strict epidemiological
protocols.
This separation between 'objective science' and 'political management' can, however, turn
out to be rather theoretical in practice. In cases where facts have not been proven by
scientific means, the mere act of summarising knowledge leads the scientific community to
form judgement criteria on the existence or absence of links between exposure to the agent
studied and the biological or health effect under consideration. These criteria, however
objective they may be, are not always totally free of extra-scientific considerations. What
constitutes scientific ‘proof'? What is the degree of proof required to accept (or refute) the
hypothesis of causality? In their desire to protect health, scientists include elements of
caution in these criteria. But it is understandable that when they come to examine this
‘evidence’, they do their utmost to take into consideration the actual nature (serious and
irreversible, or benign and short-lived) of the health effect under consideration, otherwise
their judgement may be biased. The fact that the exercise is a collective one is invaluable,
but it does not provide an absolute guarantee.
In contrast, ‘decision-makers’ must take into account the nature of the potential health
effects, as well as the number of people exposed in the population (today and in the
foreseeable future). It is also their responsibility to consider the availability and cost of
solutions available to reduce exposure of the population. In a context where millions of
people in France already use mobile telephones and the number is constantly increasing,
and families see them as a means of staying in close contact with their children, the dilemma
of 'the lesser evil' is particularly acute. It is necessary to assess the balance between the
risks linked with developing a technology that may one day be found to have dangerous
health effects, on the one hand, and the damage (including health considerations, as we are
reminded by the European Union Council recommendation dated 12 July 1999) that could
result from unjustified restrictions obstructing its development, on the other hand. One of the
World Health Organisation's working documents2 thus warns the health authorities against
taking measures which, although inspired by a legitimate desire to reassure public opinion
and prevent hypothetical health hazards, would have no scientific foundation. Indeed, there
is a great risk that varying levels of pressure from public opinion could lead governments to
enact disparate ‘safety standards’ which could ruin all efforts to achieve international
harmonisation. The confusion and fears of the public would then be artificially exaggerated,
and there would certainly be conflicts about ‘arbitrary rulings and unfair competition or
constraints on commercial transactions'.
The Precautionary Principle cannot therefore justify measures without any rational
foundation. The demonstration of hazardous biological effects, if there are any, would
certainly require action to prevent the possible consequences, but that would not suffice to
provide a rational basis for an efficient approach if the physical parameters requiring action
were not yet fully understood. Exposure to RF, and the resulting energy absorbed by the
body, depends on many factors, such as intensity of the field (which depends on the position
of the device in relation to the base stations and on the position and type of antenna), field
modulation – which makes it possible to transmit information – exposure duration (long when
one is near a base station, but at very low intensity, intermittent yet more intense with the
telephone itself and variable over time in both cases). For example, a precaution which
appears to be ‘common sense’ (such as installing a physical protection around the antenna
of the mobile telephone to ‘protect’ the head) is in fact counter-productive, for it causes the
automatic power control of the telephone to increase field intensity to compensate for
weaker reception. There are, in fact, many ways of reducing exposure to RF, but if the
2
Draft Fact Sheet for Final Review. Electromagnetic fields and public health cautionary
policies. (6 July 2000); the document can be viewed on the site http://www.who.int/peh-emf/
9
health risks were clearly established or strongly suspected, we would need to act specifically
on the physical parameters responsible for the deterioration of the working of cells or
tissues, which are not necessarily the same as those which enable communication between
people.
In its text on the Precautionary Principle3, the European Commission proposed certain
guidelines with the aim of “finding an adequate balance that makes it possible to make
proportionate, non-discriminatory, transparent and coherent decisions – (through) – a
decision-making process which is structured, based on detailed scientific data and other
objective information”. It reminds us that “the Precautionary Principle which decision-makers
use essentially in the context of risk management must not be confused with the element of
caution applied by scientists to the evaluation of scientific data”. One of these guidelines
which is particularly relevant in this case is the desire to ensure that the measures
implemented in accordance with the Precautionary Principle are:
· proportionate to the desired level of protection (and therefore to the level of risk to be
avoided);
The expert group was consulted about the existence of biological effects or health hazards
resulting from exposure to RF associated with mobile telephones. This scientific body has no
brief to decide on the size of the safety margin that would be required, if such effects were
proved to exist today or were only seriously suspected, in the light of the current data, to
achieve a level of risk which could be defined as ‘acceptable’. This is a matter for political
judgement legitimised by public debate on these issues. In contrast, the expert group will
determine whether the current state of our knowledge justifies a reduction in the exposure of
mobile telephone users or people who frequent places within the field of base stations. In
this case, they may make scientifically-founded recommendations concerning ways of
reducing exposure. Their report will indicate whether, despite any remaining uncertainties,
the facts appear to be sufficiently well-founded and serious, in health terms, to adopt a
precautionary approach. It will present the main lines of research required to eliminate these
uncertainties. It can be seen that ‘experts’ and ‘decision-makers’ have distinct, yet closely
related ambits.
Although the Precautionary Principle, used by public authorities for the prudent management
of potential hazards as part of a wide range of more-or-less restrictive measures – e.g.
regulatory, administrative, informative, etc. – is a public policy tool, various exposure-
reduction measures can be taken by industry or even individual users. The “prudent
avoidance” concept can be defined as the full set of voluntary measures which can be taken
by private individuals to minimise any unnecessary and/or easily avoidable exposure. For
example, telephoning under poor radiocommunication conditions (e.g. in certain closed
spaces) leads to a substantial increase in the radiation received. If we are aware of this and
have means available for acting on the information, it is then up to each individual to behave
appropriately, in an enlightened, responsible manner. The expert group thus considered a
set of measures – compulsory, recommended, or voluntary – which would contribute to
reducing personal exposure. Once they have explained their recommendations, they will
3
Communication from the Commission about recourse to the Precautionary Principle, 2
February 2000
10
indicate the measures they consider the most appropriate in the light of current knowledge of
the risks.
The criteria governing the selection of the scientific materials to be reviewed must be
explicit. The expert group thus selected 5 summary reports written by committees of experts
that met the following criteria:
· the expert committees included scientists from several disciplines connected with RF,
sometimes along with specialists from disciplines not directly involved with RF, and
produced their reports for national or international health authorities,
· the review of scientific evidence carried out by the committees of experts was based on
publications in scientific journals with a reading committee ('peer-reviewed' cf. below),
and was intended to be exhaustive at the date of review,
· these reports have been published since 1996 (date of the McKinlay report for the
European Union), as it was considered that a sufficient amount of scientific data had
been published on the biological and health effects of RF by that date.
The expert group chose to accept only summary reports based on articles published or
accepted for publication in scientific reviews with a peer-review committee; this rule ensures
that the work in question has been scrutinised by specialists in the same subject, who were
not a part of the project itself. Although this does not provide an absolute guarantee of
quality, and even less so of truth, this rule is widely accepted in various international
assessment bodies and makes it possible to base the synopsis on information which meets
minimum quality conditions, thus avoiding fanciful or purely anecdotal documents and
limiting the amount of non-validated work. In our opinion, work refused for publication in the
(many) scientific journals available could have any claim to being superior, and this view
must also be accepted by those authors who consider it unnecessary to submit themselves
to external scrutiny. Despite the delays which these ‘peer review’ procedures cause
(sometimes as long as 1 year), the vast majority of topics considered in this report have
4
See for example “Evaluation and use of epidemiological evidence for environmental health
risk assessment”, WHO-Euro, Copenhagen, 2000
5
All the members of the group of experts filled out an information sheet on which, following
the example of the experts assigned by other health safety agencies such as the AFSSAPS,
they declared the scientific works carried out in conjunction with or financed by companies
involved in the development of mobile telephony, as well as any business interests they
might have in such companies.
11
been studied for long enough for the group of experts to obtain sufficient publications related
to each subject. Except for recently published works, the expert group considered that it was
neither useful nor feasible, in the time it had to give its opinion, to go back over each of the
hundreds of articles which had been analysed in detail in the summary reports it was
studying. Some particularly innovative recent works may, however, be exempted from this
rule. They were analysed on a case-by-case basis and their inclusion in this report was
clearly explained. Each of the ‘basic’ summary reports was subject to detailed critical
analysis by the expert group, who then gave an opinion on the scientific relevance of each
set of conclusions.
This report presents the critique of all the basic reports, following a single plan. In order to
make it easier to read this synopsis, this plan systematically follows the various morbidities
studied in the most recent summary report directed by William Stewart (May 2000).
Whenever possible, the reader will find, successively, studies concerning the nervous
system and behaviour; those concerning cancer, reproduction and development; the
cardiovascular system; the immune and blood systems; other miscellaneous disorders that
may have been studied; interference with biomedical implants and, finally, the risks linked
with driving a car when using a mobile telephone, with or without a hands-free system. For
each theme, the conclusions of the authors of the summary report are cited in the
introduction, in an identifiable manner, followed by a short presentation of the main work
justifying these conclusions. The judgement expressed by the expert group is mentioned at
the end of each theme. A summary of the opinion of the expert group is presented at the end
of each chapter devoted to a given report.
Besides the ‘basic reports’, a certain number of ‘additional documents’ were also taken into
consideration. They do not satisfy the criteria mentioned above but do provide other
interesting information (cf. list in the appendix). The points included in these documents
which were inadequately or differently covered in the ‘basic reports’ have been highlighted.
The expert group also collected all the scientific literature published after the most recent
summary report. Besides the usual exercise of bibliographical monitoring via computerised
databases, the group also contacted the main scientific publishers who were likely to receive
articles on the subject (about forty journals were identified on the basis of the articles
published in recent years), asking them to inform them of any article accepted for publication
(and therefore positively reviewed by peers) and intended for publication by the end of the
year 2000. Many editors responded (see list in the appendix of journals contacted and those
which responded). These recent original articles were added to the list of additional
documents studied with the ultimate aim of enabling the expert group to give a global
judgement of all the scientific material available.
Finally, the group interviewed a number of well-known people from scientific organisations,
public bodies, industry, associations, and the political sphere, both to obtain further
information on aspects not covered in scientific literature and identify society's concerns on
this issue more fully.
The principle of transparency also applies to the criteria used by the group in forming their
judgement on the state of knowledge, so that third parties would have an opportunity to
criticise their choices and tools. The criteria chosen by the expert group should be
understood in light of the main question they were asked: "Do the recently published
summary reports provide comprehensive, reliable information which the French health
authorities can use as a basis for updating their principles and rules for managing the risks
associated with the use of mobile telephones and base stations?” The expert group
considered that any response to this question would necessitate answering three logically
connected questions:
12
· What are the demonstrated biological effects of RF?
· Among these biological effects, which can be considered reasonably predictive of a
health effect, in the light of our current knowledge?
· Given what we know today, can we determine RF exposure levels and/or conditions
which would reduce or eliminate these possible hazardous biological effects?
The guidelines adopted for preparing this “expert judgement” were those stipulated more
than 30 years ago by the famous British epidemiologist Bradford Hill: “Is there any other way
of explaining the set of facts before us, is there any other answer equally likely, or more
likely, than cause and effect?”6.
The main criteria selected by the expert group for assessing the quality of the knowledge
summaries were as follows: the exhaustive nature of the literature review (at the date of
publication), the relevance of the critique of the articles upon which the opinion was based,
the degree of consistency of the different results observed in the literature – which implies
waiting for the replication of observations before pronouncing on their reality – and their
coherence (these results must be part of a logical sequence covering a chain of
mechanisms and/or be found in different animal species, including man). It should be noted
that criteria relating to the intrinsic quality of the studies published (experimental or
observation protocol, data analysis, and account taken of interfering factors, comparison
with pre-existing scientific data) are not on this list, as they have already been taken into
account, usually explicitly, in the summary reports on the literature that the expert group
analysed. These criteria were nonetheless applied to articles published too recently to be
included in the summary reports.
6
Hill, AB. The environment and disease: association or causation. Proceedings of the Royal
Society of Medicine, 1965, 58: 295-300
13
2 Radio Frequency Electromagnetic Fields and Health:
Elements of Physics and Biology
2.1 Introduction
Mobile telephony has developed into a major component of modern society in the last few
years. It uses electromagnetic fields in a well-defined frequency range, referred to as the
radiofrequency (RF) range. Radiofrequency electromagnetic fields are also used in other
applications, including :
X and gamma rays can break molecular bonds and cause ionisation, which can lead to
carcinogenisis. Ultraviolet, visible and infrared radiation can change the energy levels of
bonds within molecules. Radio frequencies do not have sufficient energy to disrupt
molecular bonds.
14
Frequency Range Application
examples
0 Hz Static fields Static electricity
50 Hz Extremely low Electric power
frequencies (ELF) transmission and
domestic power supply
· the electric field is expressed in the unit volt per metre (V/m)
· the magnetic field is expressed in the unit ampere per metre (A/m) or the tesla (T), 1 A/m
= 1.27 µT
· the electromagnetic field strength can also be expressed as an equivalent power density
(PD, in W/m2 ). The PD is proportional to the product of the electric and magnetic field
strengths:
· The total power contained in an electromagnetic field can also be expressed in watts
(W).
15
Other properties:
· Polarisation: orientation of the electric field vector in the electromagnetic wave
· Modulation:
amplitude (AM),
frequency (FM),
pulsed wave (PW),
no-modulation = continuous wave (CW)
When the emission is modulated, one must differentiate between the peak power
(maximal power) and the average power. For example, in a pulsed radar emission
with a 1 ms pulse every second, the average power is one thousand time less than
the peak power.
· Field uniformity
3 Environmental factors
· temperature
· humidity
16
Other factors that affect the resulting biological effects
2 Experimental variables
· acclimatisation procedures
· animal – researcher relationship
· condition and confinement of animals (anaesthesia, stress,…)
· exposure interval during the day
· duration of exposure
· number of exposures
· time elapsed between exposure and measurement
In tissues, the electric field can displace free charges like ions, or orient polar molecules like
amino acids. This induces reaction forces in the exposed medium that are proportional to
the viscosity of the medium. Part of the electromagnetic energy is therefore transformed into
heat (thermal effect).
The field that penetrates the tissues can be calculated using electromagnetic models. The
validity of calculations can be confirmed by field measurements in “phantoms” containing a
tissue-equivalent material. The dose of energy absorbed by transformation into heat is
quantified by the power absorbed per unit mass of exposed biological material. It is termed
the specific absorption rate (SAR) and is expressed in W/Kg (cf. dosimetry annex). The field
level corresponding to a given SAR can be calculated when a well-characterised body is
exposed in the “far field”, a long distance from the source. This method is pertinent to the
characterisation of the exposure of the public to fields from base stations but not easy to
apply when the biological system is exposed close to the source (“near field” exposure),
which is the case when using a mobile telephone. The estimation of the absorbed power
necessitates the use of complex modelling methods.
17
preceded by a moderate effort, the same exposure provokes increased bloodflow to the skin
with sweating [Adair 2000]. The effects of a given exposure thus depend on the metabolic
state of the individual.
Animal experiments: cataract. Animal studies have shown that a cataract can be
provoked by an exposure of one hour at a surface power density of 100 to 150 mW/cm2
[Williams et al., 1955. Carpentier, 1960; Zaret et al., 1975]. Such high intensities are never
observed in the environment, of the general public and rarely in occupational exposure.
Even during an overexposure, not one case of cataract has been noted in humans.
Remark on thermostatation7 in vitro. In some studies, the heating of the exposed sample
is prevented by a cooling system. There is therefore no measurable increase in
temperature. Nevertheless, the energy absorbed in the exposed medium may be
considerable and it cannot be said that the exposure in these studies was “of weak intensity”
[Maes et al, 1993].
Other non-thermal effects. Other non-thermal effects have been reported [Thuery, 1989;
de Seze & Veyret, 1996]. They are at the heart of the debate on health effects of RF. The
analysis of scientific reviews, reports and recent literature in this field, in Chapter IV of this
18
report, is mainly concerned with these biological effects, which are only mentioned here for
the record.
In the GSM 900 system, the carrier frequency is in the 900 MHz range. It extends from 872
to 960 MHz. In the GSM 1800 system, the carrier frequency is in the 1800 MHz range. It
extends from 1710 to 1875 MHz.
Within these ranges, the base station assigns to each user a narrow band of 0.2 MHz for
each conversation (frequency division). This allocation is not fixed and can change when
the user is moving as the call is relayed from one cell to another. Within each 0.2 MHz user
band, there is a time division whereby the information is transmitted in pulses, at the rate of
one 576 µs pulse every 4.6 ms (pulse repetition frequency of 217 Hz; duty cycle of 1/8).
This allows each narrow frequency band to be utilised by 8 different users simultaneously.
The conversation is then “reconstituted”, after decoding, all in sufficiently short time for it to
appear as continuous.
Handsets
Commercial mobile telephone handsets operate as GSM 900, GSM 1800, or both (dual
band telephones). Some are even compatible with the North American system (tri-band).
The various models differ in performance, size and weight. The use of the weakest possible
signal for communication gives the best possible performance and makes possible a
smaller, lighter battery; this leads to minimum emissions from the telephone.
The highest possible power output from handsets is 2 W for GSM 900 and 1 W for the GSM
1800 system. The pulsed emission means that the average power is 8 times less, i.e. 0.25
W for the GSM 900 and 0.125 W for the GSM 1800 system. The power output is further
regulated in relation to the proximity to the base station; it is inversely proportional to the
quality of the link (250 mW several kilometres from the base station antenna, 10 mW in
close proximity).
The field emitted by a handset operating at maximum power is of the order of 400 V/m at a
distance of 2-3 cm. It decreases very rapidly with distance.
Interaction between handset and user.
The power absorbed in the head is about 40% of the total power output of the handset
(100mW maximum for the GSM 900). For 3 kg head, the corresponding average SAR is of
the order of 30 mW/Kg. However, since the power absorbed decreases exponentially as
function of depth, the local SAR is the more important factor as it is calculated in a small
volume. For a 10 g mass it ranges from 0.4 to 1 W/kg.
19
Two technical constraints tend to reduce the SAR in the head of users:
· good communication requires that most of the radiation emitted by the handset be in the
direction of the base station, which implies that the part absorbed by the head of the user
be minimal;
The purpose of power control is to reduce interference between users in the same cell, and
to allow the reduction of the volume of the battery due to reduced power consumption.
When a mobile user is first connected to the network, the power emitted is set to a high level
for optimal immediate communication, and then the power control reduces the level in steps
of 2 dB in a few seconds, until it stabilises at the minimum level compatible with a good
quality of communication. Therefore the field to which the user is exposed varies at any
location, as a function of time (on a scale from 20 to 30 seconds). The displacement of the
user (while walking or in a moving vehicle for example) instigates the pick-up of the relay by
several successive base stations, each of them starting its communication at a higher level,
than lowering the power. Therefore, the exposure profile is a series of different exposure
levels varying from a few hundredths to the order of 0.5 to 1 W/kg. It is therefore during the
use of a mobile while moving that the exposure is the highest, or during a conversation in a
location with mediocre reception, which compels the base station and the handset to
maintain high power levels.
Base Stations
Different types of relay antennas or base stations are in use, depending on the area covered
and the number of calls made:
· macrocell installations: the most common of this type can emit a maximum power of 20
to 30 watts per frequency band. In rural settings the power will be elevated to cover
extended areas (10 - 30 km) with a limited number of user frequency bands, whereas in
urban areas the power will be distributed among several user bands within a smaller
area (500 m).
· microcells have less power and are used to cover limited areas with high user density
such as train stations or shopping centres, for example.
· Behind the antenna, a metallic plate reflects completely the fields emitted in this
direction. A 50 cm distance is however recommended in order to ensure compliance
with the recommended levels.
· Away from the axis of the antenna, either above or below (antennas are usually mounted
at a height of about 20 m) the field is of the order of 1 to 2 V/m at most. The beam is
directional, slightly tilted downwards, with a large horizontal span of the order of 120°
20
and a narrow vertical range of a few degrees. It reaches ground level some 20 to 200
metres away from the base station depending on the height and tilt of the antenna (see
the figure below).
Antenna
Beam
GSM
The GSM protocol was introduced in 1992; it is a TDMA signal (time division multiple
access). The repetition frequency is 217 Hz. The duty factor is 1/8 for the mobile phone
and varies from 1/8 to 8/8 for the base station (except for the control channel (BCCH) where
the duty factor is always 8/8).
HSCSD (High Speed Circuit Switched Data), allowing data rates of 38.4 kbps (email, fax,
etc.) and GPRS (General Packed Radio Service) allowing data rates of 115 kbps result
from improvements to the second-generation protocol.
Two complementary protocols are used: W-CDMA and TD-CDMA (Wide-band or Time
Division Code Division Multiple Access), in the frequency bands 1900-1920 MHz and 2010-
21
2025 MHz respectively. The power used is up to 50 W for the base station and 2 W
maximum for the mobile phone (in practice much less due to power control).
Other RF applications
Several protocols for the transfer of numerical data at short distances are under
development:
Bluetooth
Bluetooth (from the name of a 10th century Viking king) is a short-range communication
system. The idea came from within a group founded by the companies Ericsson, IBM, Intel,
Nokia and Toshiba. The frequency used is in the band 2400-2483.5 MHz, the power is
typically 1 mW and the range is 10 m only (communications between appliances in the
house or between mobile phone and ear piece). The data rate can reach 1 Mbps.
22
broadcasting), whose power will not decrease significantly even for digital transmission.
(20 kW).
However, different organisations in other European countries have carried out surveys and
published data in scientific papers or reports. Data from these sources are summarised in
this section.
For a 900 MHz macrocell antenna (Kathrein K736863) producing a beam with a vertical
width of 8° and a horizontal width of 90°, the safety distance corresponding to an exposure
limit of 41 V/m is 2 m in front of the antenna, 20 cm behind the antenna as well as above
and underneath, and 1 m at the side of the antenna. The simulation of the antenna on a 23
m mast gives the following results: 15 V/m at 10 m in front of the antenna, 7 V/m at 20 m in
front of the antenna, 3 V/m at 50 m in front of the antenna, 2.25 V/m at 5 m under the
antenna at a horizontal distance of 20 m from the foot of the mast and 1 V/m at 10 m under
the antenna at a horizontal distance of 20 m from the mast.
For an antenna 1 m from the edge of a roof covered with cement, simulations show a
maximum value of 0.5 V/m at 2 m below the antenna (in the storey below). For a wall-
mounted antenna, the field strength is 15 V/m at 1 m from the sides of the antenna and
1.5 V/m at 1 m behind the antenna, taking into consideration a 10 dB absorption by the wall.
For wall mounted microcell antennas (Kathrein K736350), the safety distance corresponding
to the limit of 41 V/m is 10 cm around the antenna as well as above and below. The field
values of 3 V/m at a distance of 1 m behind the antenna, 10 V/m at 1m on the side of the
23
antenna and 1.5V/m at 15m in front of the antenna. For picocellular sites, the safety
distance defined by the same conditions is 10 cm around the antenna and 5 cm above and
below the antenna.
Measurements have been made on-site by France Telecom; the results are dependent on
the measurement instrumentation (sensitivity, isotropy, frequency range). Using an isotropic
frequency selective probe from Melop Thomson, measurements were made in 9 busy public
places in Paris. The maximum value of power density measured ranges from 0.72 to 0.0056
mW/m2 in the GSM 900 band and from 0.13 to 0.018 mW/m2 in the DCS 1800 band. The
sampling was repeated with the inclusion of power densities in the frequency range 85 to
1900 MHz covering, in addition to the base stations, FM radio and television broadcasting;
the power densities range from 19 to 1.2 mW/m2; the highest value, obtained close to the
Eiffel Tower, corresponded to a field strength of 2.7 V/m. On the basis of these data, mobile
base stations contribute only a very small part of the total power density from all radio
frequency sources. In fact the ratio between the maximum power density in the GSM 900
band and the power density in the band 85 to 1900 MHz ranges from a maximum 0.142 at
Notre Dame to a minimum of 0.001 at Montmartre (14% to 0.1%). In the DCS 1800 band
the ratio is less variable it extends from 0.032 at Place de la Concorde to 0.0086 at
Montmartre (from 3.2% to 0.86%).
France Telecom Mobiles provided 3 reports on the field measurements made by technical
control bodies on rooftops or in apartments. These measurements were made with isotropic
probe of low sensitivity and very wide frequency range (Wandel Golterman or Chauvin
Arnoux); these cannot be considered typical of base stations only but of the whole radio
frequency spectrum.
Field survey in Parisian schools that in the neighbourhood of a base station (data
submitted by Bouygues Telecom).
At the instigation of Bouygues Telecom, the ETDE (a technical control body) carried out a
survey of electric field strength in Parisian schools near Bouygues Telecom base stations.
The results of this study have not yet been published, but were presented at a congress in
December 2000. They are intended for the information of the Directorate of Scholastic
Affairs, Paris and the Directorate General of Health.
1/Methodology
A list of 100 nurseries and elementary schools, near a Bouygues telecom base station was
established from the 338 nurseries and 335 elementary schools in inner Paris, of which 69
were visited in the month of August 2000. For each school, 3 measurement locations were
identified: the centre of the playground, a classroom in the middle of the building and the
entrance hall. In the absence of a harmonised measurement standard at the national or
European level, the operators made use of the latest drafts of standards under development.
The electric field was measured in narrow bands in the FM, TV, GSM-900 and GSM-1800
bands, using a spectrum analyser and antennas specific for each frequency band. The
results were given in V/m and as percentages of the reference level specified in the
European recommendation of July 12, 1999.
2/Results
The distance between the nearest GSM 1800 base station and the school ranged from 30 to
372 m; the distance to the nearest GSM 900 base station and to other RF sources was not
reported in this study. The maximum call traffic in the GSM 900 and GSM 1800 bands was
obtained by extrapolation from data in the service channel, taking into consideration the
number of channels per antenna (usually 4 in Paris). Signals from FM sources and
television broadcast were combined to determine the total signal level in these two bands.
24
The results were expressed as a percentage of the reference field strength: in the FM band,
the values were between 1/100,000 and a few percent of the reference level; for the TV
band and the GSM 900 band the values were between 1/100,000 and 1/1000 of the
reference level; for the GSM 1800 band, the values were between 1/1,000,000 and 1/10,000
of the reference level (see the figure below). The reference level of 58 V/m for the GSM
1800 band is higher than the 41 V/m in the GSM 900 band: this could explain in part the
observed differences as the result is expressed in percentage of the reference level. The
scatter of points in each band makes it difficult to differentiate between the field strength in
the classrooms, the playgrounds or in the entrance halls, except in the FM band where the
values appear systematically higher in the playgrounds. This observation warrants a closer
statistical analysis. The relationship between the distance of the nearest base station and
the field strength was studied for each site in the playgrounds, the halls and the classrooms.
In the playgrounds, the results agrees with the theoretical model: between 30 and 100
metres, the field is weak and steady, on average between 0.005 V/m, with the exception of
one point situated 70 m from a base station, where the field strength was 0.003 V/m,
probably due to the presence of a side lobe. Then between 100 and 150 m, the average
field strength increased, reaching 0.002 V/m; also observed is a large scatter in the data
points probably due to the presence of obstacles and reflectors. Thereafter, the field
decreases and reaches a low value of 0.0005 V/m at around 200m. In the classrooms, the
distribution of field is a little different: irrespective of the distance to the nearest base station
the field strength is below 0.0005 V/m. As previously observed at 70m there were a few
high values of 0.004 V m-1, and between 70 and 175 metres there were a few points above
0.001 V/m. In the halls the measured values were low because of absorption by the walls
and more-or-less constant, on the order of 0.0002 V/m irrespective of the distance, with a
few points (6) between 0.0006 and 0.001V/m at distances between 70 and 120 metres.
25
Electric field strength (% of reference level)
Total FM field playground (%) Total TV field playground (%) Total 900 field playground (%) Total 1800 field playground (%)
Total FM field hall (%) Total TV field hall (%) Total 900 field hall (%) Total 1800 field hall (%)
Total FM field classroom (%) Total TV field classroom (%) Total 900 field classroom (%) Total 1800 field classroom (%)
26
3/ Conclusions
This study was carried out over a relatively large number of sites; at each site three data
points were taken in places were different types of activity take place and the measurement
procedure was correct. It can be concluded from the data available that the exposure level
in Parisian schools is higher in the FM band than in the GSM bands and that the exposure in
the TV band is of the same order of magnitude as in the GSM bands. The relationship
between the distance and the average field strength in the playground agrees with
established models, it is weak and fairly constant at short distance, it increases with distance
from about 100 metres and decreases again from about 150 metres. Measured field
strength from the nearest base stations appeared weak in the schools, the average value is
below 0.001 V/m at the classrooms as well as in the playgrounds; it is below 0.0005 V/m in
the halls.
Analysis of NRPB report: Exposure to radio waves near mobile phone base stations
NRPB-R 321.
In the UK, the NRPB, National Radiological Protection Board, is a public body in charge of
radiation protection, including non-ionising radiation. The Stewart report, published in May
2000, made recommendations with respect to base stations, in particular the need for
independent audit of sites in order to ensure that the exposure limits are not exceeded in
the proximity of base stations outside the designated safety (exclusion) zone. It is within this
framework that the NRPB undertook a programme of measurements at 118 base station
sites in neighbourhoods where the level of emission had been questioned. This study was
the subject of the report NRPB R321, published in June 2000.
1/ Summary of methodology
a/ Technical aspects
There is a description in the report of the basic concepts of cellular telephony in which base
stations, at the centre of cells, with uplinks from the mobile handset to the base station and
downlinks from the base station to the mobile. The cells have variable sizes depending on
the geographic characteristics of the terrain, ranging from tens of kilometres in rural areas to
one kilometre or less in towns. For macrocells, coverage is provided by antennas located
on rooftops or on a mast. Short distances of the order of 100 metres or less are covered by
means of microcells, or picocells for the very short range. The report specifies the technical
characteristics of antennas and in particular the directional characteristics of the beam. The
horizontal beamwidth is large, on the order of 120°, and the vertical beam width is just a
few degrees. The beam is slightly tilted with respect to the horizontal; it reaches ground
level at between 50 and 300 m depending on the height of the installation and its tilt with
respect to the horizontal. Each sector of the antenna emits a maximum power on the order
of 10 watts. The study reports only on macrocells were the maximum emitted power in the
United Kingdom ranges from 25 to 70 Watts depending on the number of sectors. According
to the authors of the report, microcell antennas emit maximum powers on the order of 1 W
while in the case of picocells the power level is on the order of 0.1 or 0.2 W. The gain of
microcell or picocell antennas is low which means that the beam is less directive and of
lower intensity. The corresponding safety zone does not exceed a few tens of centimetres.
27
c/ Instrumentation
The authors report that hand held isotropic probes designed for measuring exposure level
comparable to the recommended limits are not appropriate for this type of measurement
because of their lack of sensitivity. The measurement were therefore made with a spectrum
analyser and antennas specific for each frequency range, allowing a detection threshold of
less than 1 µW/m2 and a good resolution. The measurements uncertainties were evaluated
and tend to be quite significant, on the order of 3 dB, even with this methodology.
2/ Modelling
In order to verify the validity of their measurements the authors compared their data with
predictions from well-established mathematical models. They used two models to calculate
the distance corresponding the limit of exposure in front of an 80 watt, 12 element antenna.
Using the inverse square law as the basis of calculation, the limit of exposure in the
European recommendation of July 12, 1999 is met at 8 metres in front of a 900 MHz
antenna or 6 metres in front of an 1800 MHz antenna. According to a more realistic model
for near field calculation, the exposure limit is met at 2.5 metres in front of a 900 MHz
antenna and at 5.5 metres at 1800 MHz. There were great discrepancies between actual
measurements and predicted values. The difference is more significant near the antenna as
the model can overestimate the actual value of power density by up to 4 orders of magnitude
where the measurement point is not directly within the main beam or when an obstacle, such
as a wall, act as a screen. Models for power density at ground level for a 15 metre high
antenna predict a very low power density under the mast and up to 10 m around. It
increases gradually between 10 and 100 m (the increase is not linear but shows peaks and
trough in view of the presence of side lobes). The maximum power density, taking into
consideration reflections, is reached around 180 m from the mast, beyond which power
decreases according to the inverse square law, and at 300 m it is slightly higher than the
value estimated at 70 m. The lower edge of the main beam reaches ground level in this
model configuration at a distance of about 100 m
3/ Measurements
Measurements were made at each site in the frequency range 30 MHz to 2.9 GHz in order
to cover the whole spectrum of emissions from FM radio and television broadcast and also
telecommunications. It was possible to identify, at each measurement point, the signal
emitted by the nearest base station, other base stations and radio signals in the frequency
range under consideration. Measurements were made inside and outside buildings.
The power density corresponding to the nearest base station varies considerably,
particularly at very short distances. The values obtained outside the buildings are on the
order of 10 µW/m2 to 1 mW/m2, which is about one thousandth or one millionth of the values
of the European recommendation. The power densities measured inside buildings are
generally lower and more variable than the values obtained outside: they range from 0.1
µW/m2 to 1 mW/m2. The average power density tends to increase between 0 and 100
metres from the antenna and then to remain relatively constant at about 0.1 mW/m2. The
reason is that, as one gets further from the antenna, one gets progressively nearer to the
main beam and then enters it completely. At short distances, the scatter in the measured
data is consistent with the presence of obstacles between the beam and the measurement
point and that the measurement points vary with respect to the position of the main beam.
The range of power densities corresponding to all radiofrequency sources is less than that
for the main base station alone. If the power density from the nearest base station alone is
higher than 0.1 mW/m2 the addition of all other sources has very little effect on the total
value, while if the power density from the base station is less than 0.01 mW/m2 the
contribution of the base station to the total power density is insignificant. On the basis of
geometric averages, the power density from nearest base stations is little different from the
power density from all other sources: 33 µW/m2 against 21 µW/m2.
28
The report shows that the total power density at a measurement point is between one
thousandth and one ten millionth of the allowed levels in the European recommendation.
As predicted, there is a large scatter in the data near the antenna and a more or less steady
value of the order of 1/10,000 from 100m onwards, which probably means that the power
density from the base station cannot be distinguished from the background power density at
this distance. The ratio of the signal from the nearest base station to the signal from all
other sources is quite variable at short distances; it ranges from 0.001 to 100. From 100m
onwards it steadies to a value on the order of 0.1.
4/Conclusions
The power density from the antenna may exceed the reference level at a short distance in
front of the antenna in the direction of the main beam. Because of the directionality of the
antennas, and as by predicted mathematical models, the exposure limits are not exceeded
beyond at distances greater than a few metres in the direction of the main beam. In general,
the measurements do not show a decrease in the power density with distance. In the sites
considered in the study, the power density from all sources (other than the nearest base
station) is of the same order of magnitude as that from the nearest base station. The
geometric mean of power density, from all sources, at distances of 5 to 230 m, are of the
order of 18 millionth of the values recommended by ICNIRP. Excluding the power density
from the nearest base station, the geometric mean of power density from all other sources is
less than 5.5 millionths of the values recommended by ICNIRP; in both cases there is
scatter in the measured data.
1/Polish regulations
The Polish regulations specify different levels of exposure for the general public and
workers. For the public, in the frequency range 300 MHz to 300 GHz the maximum
permissible power density is 0.1 W/m2 (6.14 V/m). For workers there are three classes of
risk, necessitating 3 different levels of protection: > 100 W/ m2, 20 to 100 W/m2 and 0.1 to
20 W/m2. The last two categories correspond to exposure levels observed in the work place.
29
characteristic of these antennas in the vertical plane; it also demonstrates the necessity to
place them near the edge of the rooftops, which is not common practice in Poland.
Measurements were carried out at 20 sites near base stations by public authorities. For
base stations on the roof of residential buildings, on masts with heights between 1.65 m and
8.5 m and panel tilts of 0° to 9°, the reference level is exceeded at any point on the rooftop
only in 20% of cases. The measured values range from 0.025 to 2 W/m2. The power
densities in the upper floors of the building were below the measurement threshold. In
neighbouring buildings, the measured power densities were of the order of a quarter of the
Polish reference level. For antennas on towers or factory chimneys, the power density in the
immediate surroundings was below the measurement threshold. On towers or chimneys in
regions accessible only to maintenance personnel, power densities on the order of 0.66 to
1.7 W/m2 were observed in the vicinity of antennas. These values are higher than the Polish
reference levels but significantly lower than the reference level of the European
recommendation of July 12, 1999.
4/ Conclusions
The power density reference levels in Poland are 45 to 95 times lower than those in the
European recommendation. The Polish reference levels are exceeded on rooftops with
base station antennas in only 20% of cases, and in 5% of the locations where
measurements were made on masts and very close to chimney-mounted antennas. The
Polish reference levels were not exceeded in any public place in neighbouring residential
buildings or in buildings with base stations. Maintenance personnel may be exposed to
levels above the reference level. Moreover, in order that the Polish reference levels are not
exceeded on rooftops, the microwave data links between base stations must be installed at
a minimum height of 2 metres for a 23 GHz link and at a minimum height of 3 metres for a
7 GHz link.
This is a study carried out by ARCS; the results have been presented at a conference but
have not yet been published in the scientific literature. The study was conducted as part of a
European project under the umbrella of COST 244 bis. The aim of this project is to assess
the extent of compliance with the reference levels at various sites near base stations in
Austria, Belgium, Hungary and Sweden. The results will be published in a COST 244 bis
report.
1/ Methodology
In 1999, there were about 8500 base stations in Austria, operating at 900 and 1800 MHz.
Narrow-band field strength measurements were carried out by technical control bodies at
202 sites close to base stations, of which 100 were in urban areas and 102 in rural areas.
The measurements were made with a spectrum analyser and antennas specific to each
frequency band; broadband measurements were also made. Distance and area plans are
not reported in the presentation.
2/ Results
The results, expressed as power density, show a maximum value, measured in the narrow
frequency band of the nearest base station, of 13.4 mW/m2 (2.24 V/m) or 0.28% of the
power density reference level in the European recommendation. The maximum broadband
power density is 66.3 mW/m2 (5 V/m); in this case the measured power density is mostly due
to other sources than the nearest base station.
Overall, 8 out of 202 measured narrow-band power densities were equal to or greater than
1 mW/m2 (0.6 V/m), 40 were between 0.1 and 1 mW/m2, 43 were between 0.01 and
30
0.1 mW/m2, 61 were between 0.01 and 0.001 mW/m2 (0.02 V/m) and 50 were below
0.001 mW/m2.
3/ Conclusions
These results are in agreement with similar studies involving narrow-band measurements
centred on the frequency of the nearest base station. Expressed as percentage of the
reference levels for power density, the measured values are of the order of one thousandth
to less than one millionth. Generally, the power density from sources other than the nearest
base station is of its same order of magnitude or even larger than that from the base station
itself.
Opinion of the expert group on these measurement surveys and their results.
Measurement methodology
The results of the different studies are in general agreement: measurements were made
using similar but not identical protocols, which can explain some of the differences in the
results. It is clear that it is necessary to develop, as a matter of urgency, harmonised
European measurement standards based on a well-established methodology. All the base
station measurements (published in scientific articles) were narrow-band measurements
made with dedicated antennas. This methodology is quite appropriate in the absence of
isotropic probes that are also frequency selective and highly sensitive, because of the very
low field strengths measured in areas accessible to the public and in view of the fact that
other sources of radio frequencies can produce field strengths greater than those from the
nearest base station. This is understandable when we recall, for example, that a 1 megawatt
television transmitter is, in terms of radiated power, about twice as powerful as all the mobile
telephone base stations in France. Measurement using broadband isotropic probes is not
recommended, as such measurements are not representative of the base station alone but
of the totality of the radio frequency spectrum. Also, measurements of small field strengths
made with such probes have high uncertainties. These measurement methods could be
used in an anechoic chamber for the certification of base stations.
31
Field strengths in areas accessible to the public, and effect of distance to the antenna
In places where people spend time (residential buildings, offices or educational
establishments) measured field strengths are very much lower than - on the order of one
thousandth or one millionth of - the reference levels given in the European recommendation.
Because of the shape of the beam, the field strength is very small directly below the antenna
and increases gradually as a function of distance from the antenna, reaching a maximum
value at a distance that depends on height of the antenna with respect of the measurement
point, on a tilt angle and on the presence of any buildings that may act as screens. The
measurements carried out by the Scientific and Technical Centre for Building show that a
sheet of reinforced concrete attenuates the beam by a factor of approximately 30 and that a
plaster partition attenuates by a factor of 5. It can be seen that buildings constitute a good
protection against radiation from antennas, particularly when the antenna is on top of the
building, or very close by, such that the building is not in the main beam. Therefore the idea
of siting antennas away from certain buildings (particularly schools) cannot be supported by
rational argument; the best protection for a building is to be directly underneath the antenna.
By contrast, the expert group sees an advantage in ensuring that the main beam of the
antenna is not oriented directly towards places, within 100 m of the antenna, where people
spend a considerable amount of time even if the field strengths are very low and cannot be
distinguished from the RF background, particularly in the radio and FM band. This is for two
reasons: firstly, to avoid directing the beam unnecessarily toward people nearby, and to help
achieve the least possible exposure of the whole population; and secondly for a common
sense reason: directing the beam toward buildings reduces the range of the antenna by
absorption or partial reflection. This proposal is perfectly compatible with the possibility of
the beam passing above these buildings even if the antenna is nearby.
Like any wave, RF electromagnetic fields can be reflected from certain surfaces. The
phenomenon of reflection applies also to optical and acoustic waves. The extent of reflection
of an RF field depends on the material and is strongest with metals. This effect can be
advantageous, for example when used to increase the local field strength where it is needed
in certain applications. This is the principal of operation of a parabolic antenna where the
radiation received over a large surface is directed to its focal point. There is conservation of
energy and no amplification of the signal. All parabolic surfaces can focus, to a greater or
lesser extent, a radiofrequency beam but for an optimum result the beam must be directed
toward a large surface of uniform curvature. Convex surfaces lead, by contrast, to a
divergence of the beam, a plain surface to a direct reflection with no effect on the
beamwidth. In practice, reflection phenomena lead to spatial inhomogeneities of the power
density that can be modelled, and so taken into consideration in the calculation of antenna
patterns. This was considered in the NRPB report on base stations and the conclusion was
that reflections could increase or decrease the local field strength by a factor of two at most.
These models are only valid in the main bean and at a distance of more than 10 metres from
the antenna: under other conditions they could significantly overestimate the phenomenon.
An amplification mechanism is quite different. When amplification occurs, the energy
emitted is more than the energy received. A theory by which metallic structures are capable
of amplifying radio frequency fields is not compatible with the basic principles in physics.
32
2.7 The question of co-location of base stations7
The question is whether, with respect of the exposure of people to radiation from base
stations (BS), it is preferable to have all the antennas of different operators on the same
mast or if, on the other hand, there is an advantage in not doing so.
The answer depends on the criteria chosen to define the exposure. Assuming, for the sake
of argument, a population that is uniformly distributed over an area. The exposure is higher
near the base station and decreases gradually with distance according to the laws of
electromagnetic propagation, although the power density distribution can be quite complex
in an urban site.
Irrespective of the directionality of emission, if the population is uniformly distributed then the
average exposure is the average of all signals emitted by the different operators (when all
the signals are not correlated, which is the case) irrespective of the location of antennas.
Under these conditions, the co-location of antenna or a more random distribution makes no
difference.
If, by contrast, the maximum exposure is used as exposure metric, there is an advantage in
a more random distribution.
There were no instances were the SAR in head was increased with the hands-free kit. The
SAR with the hands-free kit ranged from 0.39 to 0.007 W/Kg depending on the mobile phone
and hands-free kit and the configuration in which it was used. The average SAR reduction is
of the order of a factor of 50 under normal conditions, the lowest reduction, or worst case
scenario, was a factor of 2 only. The efficiency of 2 hands-free kits, used on the same
mobile and under normal use conditions varied by a factor of 1 to 10.
Whilst these results are limited and the measurements need to be extended, the outcome is
consistent with that from in international trials under standard conditions (unlike the results of
other studies which were made public).
7
M. Bach-Andersen’s contribution at the request of the group of experts (University of Aalborg
Denmark).
33
The first draft of a harmonised basic technical standard for measurement of specific
absorption rate resulting from the exposure of people to fields emitted by mobile phones has
been issued for consultation by CENELEC TC 211 in the last few months. The preliminary
inquiry for this standard ended in 5 October 2000, and it will not be published before early
2001. Publication was expected earlier but it was delayed to accommodate dialogue with
the IEEE group developing a similar American standard. Harmonisation would result in a
truly international standard so that results can be obtained using the same measurement
protocols and direct comparison becomes possible. Another standard, a product standard
for the compliance of mobile phones, was placed in circulation by the UTE in France, on 17
March 2000. It was also submitted for preliminary inquiry until 5 Oct 2000. This product
standard is expected to appear in the first part of 2001 together with the basic technical
standard, and to be adopted as a French standard.
The standard for assessing compliance of base stations (in the laboratory) is circulating
within the technical committees of CENELEC and it is soon to be issued for consultation.
Publication is not expected before the end of 2001.
The standard for testing the compliance of base station in situ is under development; it is not
yet available because of the technical complexity of such measurements. At the same time,
the National Agency of Frequencies (Agence Nationale de Fréquences) is considering a
measurement protocol based on the requirement of the European recommendation of 12
July 1999, using a spectrum analyser and a narrowband antenna. Measurements made
with a broadband isotropic probe are not sufficiently accurate and are not representative of
the base station under consideration because they are sensitive to the totality of the radio
frequency spectrum, including sources producing fields that may be bigger than those from
of the base station under test. Prior to the publication a harmonised European standard, the
measurement procedure developed by the ANFR, which is much needed by those in the
field, could be used as a reference procedure in France. Such a reference procedure is
needed now. In the absence of a standard procedure, measurements have been made
using ill-defined protocols and, occasionally, inadequate equipment. Results, some of which
have been inaccurate, have been published in the press. Some private technical control
bodies have been active in this field because of the demand for measurements created by
public concern; the results obtained are uncertain or at least difficult to compare or verify.
For the future, it will be necessary to have reference procedures from a national control
organisation, which could be the ANFR, and which would be in a position to certify technical
control organisations carrying out measurement in accordance with standard procedures.
34
3 Limits on the Exposure of People to Radiofrequency Fields:
Basic Principles of Risk Management
The exposure limits adopted in the 1999 European Council Recommendation are based on
the outcome of a long process of deliberation by groups of experts. The recommendations
were established by committees of scientists and engineers with academic, industrial and
government backgrounds. The most widely quoted are the 1991 IEEE and the 1998 ICNIRP
recommendations.
The risks associated with exposure to electromagnetic fields in general and radiofrequencies
in particular have been evaluated after an exhaustive review of the scientific literature on
their biological effects. Following this scientific review, the establishment of limits of
exposure is based on consideration of the most sensitive biological effects reported to date
(that is those that appear at the lowest level of exposure tested and have undesirable health
consequences). Extra factors are then applied to these values to account for uncertainties
and to provide a certain "safety margin". The scientific state-of-knowledge is constantly
reviewed, as are the limit values which are derived from it; the scientific database held by
WHO comprises more than 40 to 100 articles describing recent or ongoing studies.
The consensus of opinion from these committees concerning undesirable effects observed
in exposed animals is that changes in behaviour, as observed in rhesus monkeys and
rodents, have the lowest exposure threshold. The change in behaviour most commonly
observed is an increased difficulty in, or a complete inhibition of, the performance a complex
learned task when exposed to RF energy above a certain threshold. The experimental
results show that this is a thermal effect; it occurs when the power absorbed by the body,
under whole body exposure conditions, reaches or exceeds a specific absorption rate of 4
W/kg averaged over the whole body. With the inclusion of a safety factor of 10, the value of
0.4 W/kg was proposed as exposure limit for workers under conditions of whole body
exposure. This parameter, derived from the study of a biological effect with an undesirable
health consequence, is termed a “basic restriction”. An additional safety factor of 5 was
introduced for the general population, in order to take into consideration the fact that people
have no control or knowledge of their exposure and their environment, and to account for the
variation in response due to the physiological or pathological state of individuals. The public
limit for whole body exposure is thus 0.08 W/kg.
Dosimetric analyses have indicated that, during whole-body exposure, certain parts of the
body could absorb up to 25 times the average. It was thus decided that the localised
specific absorption rate should not exceed 2 W/kg for the head and the trunk (since they
hold vital organs such as the heart, lungs, intestine) and 4 W/kg for the extremities. The
"local" exposure limits are not therefore directly derived from biological considerations, but
are indirectly obtained from dosimetric observations and extrapolated from whole body
exposure conditions.
SAR is not a quantity that is easily measured; it was therefore necessary to establish by
means of "transfer equations" electric and magnetic field strengths that are capable of
producing, under worst-case exposure conditions, SARs corresponding to the basic
restriction. These fields values can be measured; they are termed “reference levels”.
Because the absorption of RF energy in the body is frequency-dependent, the reference
levels are also frequency-dependent. The electric field strengths capable of producing a
SAR of 0.08 W/kg during whole-body exposure are 41 and 58 V/m respectively for the
mobile telephony frequencies of 900 and 1800 MHz10. These field strengths correspond to
35
power densities of 4.5 and 9 W/m2 . The derivation of the reference levels incorporates an
additional safety margin with respect to the basic restriction: they were derived under worst-
case exposure conditions so that the basic restrictions will always be met when the field
strength is less than or equal to the reference level.
WHO has based its recommendations on those of ICNIRP; similarly the Council of the
European Union incorporated them into its 1999 Recommendation8.
In summary, the current standard includes 3 "safety factors": (1) the fact that the basis of
the assessment is the lowest threshold for a biological effect; (2) the additional safety
margins applied to these thresholds; (3) the way in which reference levels are derived from
basic restrictions.
It should however be noted that the safety margins incorporated are more (sic) restrictive
than those usually used for chemical substances. In this case, starting from the lowest dose
establishing an undesirable effect in animals (LOAEL) the first reduction factor (2 to 10
depending on the type of effect) leads to an estimate of a dose that has no undesirable
effect (NOAEL). A factor of extrapolation from animal to man (often 10) is then applied
followed by another coefficient (often 10) to take into account the sensitivity and different
responses between people. In total, a reduction factor of up to 1000 is then applied from the
LOAEL in the animal to the limit value for the exposure of the population while the sum of all
reduction coefficients is only 50 in the case of electromagnetic fields. This is because the
scientific uncertainty is judged to be less than that associated with toxic chemicals because
of the procedures leading to the establishment of exposure recommendations for fields.
8 th
EU Official Journal L1999/59 of 30 July 1999
36
4 State of Scientific Knowledge: Analysis of Reports and
Recent Documents on Mobile Phones and Health
a-Animal studies
Summary of conclusions: Degenerative effects on the eye and changes in EEG after
exposure to modulated fields have been observed, but the results are inconsistent and the
studies must be replicated.
EEG: Three studies, on rats, cats and frogs, were considered. The last of these used very
high exposure levels, outside typical human exposure levels (peak SAR close to 100 - 3000
W/kg). EEG appears to be modified by a 950 MHz pulsed field with a power density of 15
W/m2 but not for 3 W/m2 .
A variety of effects were reported in eight studies, five researchers did not find any EEG
changes under a range of experimental conditions (analogue or digital mobile phone; rest or
waking EEG, with or without visual or acoustical stimulation, continuous or intermittent
exposure; power densities ranging from 0.2 at 50 W/m2).
In one study, for a local SAR in the head of 1 W/kg, effects on sleep were observed,
including changes in sleeping patterns, shortening of waking time whether conscious or
unconscious, together with changes in the intensity of the EEG in the dream phase.
9
The report does not specify if it is localised or whole body SAR
37
The performance of cognitive tasks and the shortening of reaction times have been reported
in two studies; the reduction in the execution times of tasks requiring vigilance were only
modest and these results could be explained by a mild thermal effect. In two other studies
there were no significant differences related to exposure.
Comment of the expert group on effect on the central nervous system and behavioural
studies: The first lesson to be learned is that the experimental protocols followed in the
studies were very different; it was therefore not possible to make comparisons, and this is
true of human volunteer studies as well as animal studies. The occurrence of physiological
and behavioural effects cannot be confirmed from these studies because of a lack of
replication under identical experimental conditions. The hazardous implication of these
effects has not in any case been established. Investigation of effects on the eye should be
extended to include exposure conditions that are commensurate with the use of mobile
phone. Despite the reported limitations, these conclusions are based on the findings of a
large number of studies.
Genotoxicity has been studied in vivo and in vitro. Although the majority of studies were
negative, an increase in DNA breaks in rat brain cells, following exposure to RF EMF at
2450 MHz in the form of short intense pulses, has been described, but this result has not
been independently reproduced. Breaks in DNA have also been observed in radio-sensitive
cell lines exposed to modulated fields around 813 MHz, but not at 836 MHz, with a SAR
between 2.4 and 26 W/Kg, suggesting that a DNA repair mechanism, that has not been
sufficiently studied to date, could play a role. Chromosome aberrations have been reported
in human lymphocytes exposed to fields from a GSM base station, but the same author
could not replicate this result. By contrast, micronuclei analysis has shown RF-induced
changes in plant tissue (exposure to a 10 to 21 MHz field) and in human lymphocytes (9
GHz); these frequencies are quite different from those used in mobile telephony, so these
results must be reproduced under more realistic exposure conditions.
The activity of the intracellular enzyme ODC (ornithine decarboxylase) was increased in
several experiments with amplitude-modulated fields, but not in the case of frequency
modulation or no modulation at all. In view of the possible role of ODC in the promotion or
progression of cancer, this could point to the possibility of some epigenetic mechanism of
carcinogenesis but this work needs to be replicated.
38
Studies on the initiation and the promotion of tumours have been described in nine studies.
These include the study of Repacholi et al (1997), which showed an increase in the number
of lymphoma in a genetically-sensitive strain of mice after exposure for 18 months to 900
MHz EMF of modulated at 217 Hz. The results of this study have been discussed, with the
aim of eliminating interpretation problems arising from the heterogeneous exposure
conditions of the mice; replication studies are in progress, with a better-controlled
experimental protocol. The other studies reported were negative, including those dealing
with the joint effect of fields and known cancer initiating agents (diethylnitrosamine) and
promoting agents (aromatic polycyclic benzo-a-pyrene).
b-Epidemiological studies
Summary of conclusions: The majority of studies, all with different protocols, did not
characterise properly the exposure to RF EMF; some studies were not sufficiently large or
lacked information on potential co-founders. The studies were not consistent in the types of
cancers that they considered might be related to EMF. In view of these limitations, it is not
possible at present to conclude on the existence of a cancer risk to general population
related to exposure to RF EMF.
The ARCS report first reviews, in this very important chapter, the well established quality
criteria for epidemiological studies. These are the criteria that are always considered by the
epidemiological community. Eight studies are presented, of which four relate to
occupational exposure to RF EMF. Of these, one relates to the exposure of personnel in the
Polish army exposed to high frequencies (150 to 3500 MHz)1 - a study whose results are not
in agreement with other work on military personnel, particularly that on American Navy
personnel; another discusses Canadian policemen exposed to fields from radar, while a third
reports on Norwegian Merchant Navy radio and telegraph operators (405 to 25 000 MHz
fields)10. The results of these three studies, for which the exposures were very varied,
mostly characterised by job description and only in a few rare occasions by some
measurements, cannot not be extrapolated to the mobile phone situation; it is important to
note that the cancers linked to these exposures are very diverse (leukaemia, lymphoma,
malignant melanoma, prostate and testicular cancer, breast and uterus cancer).
Three studies were initiated specifically to investigate clusters of cancer cases. It is well
known that a cluster of cancer cases does not necessarily mean that there is a common
cause; if so, epidemiological studies cannot lead to a definitive conclusion. One cluster
occurred in Great Britain in the neighbourhood of a radio and television broadcast station,
where there was an apparent increase in adult leukaemia. The study showed an increased
incidence of lymphoma, skin melanoma and bladder cancer in the population within 10 km of
the station, but not for all cancers or for childhood leukaemia. Another study of cancers
around 20 broadcast stations in Great Britain was made by the same team, following the first
study; the results do not show any increase in cancer of the bladder, adult leukaemia or
melanoma, and thus it does not confirm the findings of the initial study. A similar study was
carried out around three masts in New South Wales, in Australia. When six municipalities
within 12 km were considered, an excess of childhood leukaemia was observed in regions
within 4 km, but there was no increase in adult or child brain cancer. When other nearby
municipalities were included in the analysis, the results were not changed except that in one
of the extra municipalities there was an excess of childhood leukaemia.
10
Additional data taken from Elwood, Environ Health Perspect, 1999 (referred to in the ARCS report)
39
mobile phone if the analysis did not take into consideration the side of the head on which the
cancer occurred. These results are based on small numbers and need to be confirmed, as
stated by the authors of the study (see the annex for the different ways in which these data
can be interpreted [Hardell et al 1999], in different articles and reviews).
One study compared the causes of death between mobile phone users and users of hands-
free car phones, were the antenna is distant from the head No difference in mortality was
observed, after one year of mobile phone use - which is a very short time – while the
mortality among mobile phone users was less than the population as a whole, probably for
social and demographic reasons.
Comments of the expert group on cancer-related effects: The history of mobile phone use is
not long, and this limits considerably the scope of epidemiological studies, as the latency
period for cancers can exceed 10 years (it could be shorter for leukaemia or thyroid cancer,
although the latter is not under consideration here; the latency could also be shorter if an
already-initiated cancer is promoted or progressed, which is the hypothesis currently under
consideration by the international IARC project). When the risk is low (practicably, a relative
risk less than 2), characterisation of exposure, to allow discrimination between different
groups, assumes great importance . The studies presented were somewhat lacking in this
respect, as observed in the Austrian report. Although the review of epidemiological studies
is not exhaustive, the studies not considered do not convey a different message.
The review of experimental data from in vitro and in vivo studies and from epidemiological
studies does not add up to conclusive evidence with respect to cancer, as reported in the
Austrian document. The case for pursuing further research is however justified because
even though the risk of cancer is not supported by genetic mechanisms, as suggested by
current data on the genotoxicity of RF EMF, epigenetic mechanisms cannot be excluded at
present.
Comments of the expert group relating to cardiovascular system: the studies are very
limited in number; the data do not allow for firm conclusions to be made.
40
4. Studies on reproduction and development
Only two studies on rodents are described, suggesting a reduction in the weight at birth, but
the relevance of the results is limited by the quality of the exposure protocol. The authors do
not report teratogenic effects.
Comments of the expert group on reproduction and development; the studies are very
limited in number; these data do not allow for any conclusions to be made. This is a
sensitive biological end point necessitating further experimental studies.
Comments of the expert group concerning immune response: The studies are very limited
in number but do not support an effect of RF EMF on the immune system.
Cardiac defibrillators and pacemakers. The latest mobile phone technologies are more
likely to cause interference because the low frequency components associated with them
are close to cardiac electrical frequencies. In vitro studies (active implants not worn by
people) showed that signals from digital phones were more likely than analogue signals to
influence the functions of some of the pacemakers tested, at short distance. Cardiac
defibrillators implanted in people suffering from tachycardia and fibrillation showed similar
tendencies. Beyond 20 cm, none of the devices were perturbed. Similar results were
observed in a study of a human volunteers wearing pacemakers, with a distance of less
than 15 cm between the antenna and the implant.
Consequently, it is recommended that people wearing a pacemaker carry their mobile phone
15 cm away and that while making a telephone call they place the device on the opposite
side to the pace-maker. With these measures, the use of mobile phones should be without
risk. Care must be taken while going through electronic security installations at the exit of
some stores. People with cardiac defibrillators should not dawdle within the bounds of the
equipment; instead they should move rapidly through the installation without coming into
close contact with the antennas.
Neurostimulators. These implants are used to alleviate tremors of people suffering from
Parkinson's disease. Tests using signals from different 900 MHz mobiles showed no effect
on their function, probably because (unlike pacemakers) these implants are not designed to
react to physiological signals.
Comments of the expert group on electromagnetic interference with medical implants: The
Austrian report highlights the great need to develop research on electromagnetic
compatibility in view of the significant increase in the number of sources and the number of
implants in the population in general. The immunity of implants must be improved, and the
41
information given to the people concerned must ensure that they know what precautions to
take to limit their exposure.
7. Other effects
Summary of conclusions: these are studies on people regarded a priori as more sensitive
(older people or people who report being unwell). The significance to health of the reported
endocrine effects is not clear.
A variety of subjective symptoms were reported by some users of mobile phones (headache,
local sensation of heat, fatigue…). One study was conducted in Sweden and Norway
among users of analogue GSM devices. This epidemiological study showed a higher
incidence of problems with analogue devices, which could be correlated with higher fields
emitted and to a thermal effect due to the high battery current.
Another cohort study was undertaken in the vicinity of a short wave source in Switzerland.
Complaints were more frequent in the immediate vicinity of the source (restlessness,
insomnia, fatigue…); the authors of the study recognised that it is difficult to conclude that
these manifestations are due to electromagnetic fields rather than to public concern.
Comments of the expert group on other effects: RF EMF could have effects on certain
hormonal functions. At present it is not possible to say whether these are physiological
adjustments in response to the exposure or an indication of possible health risk. These
studies should be conducted primarily on people described a priori as highly sensitive, for
example, people taking medication for psychoses, or people on anti epileptic or and
migraines drugs
General conclusion of the group of expert on the ARCS report: Although recent, this report
is limited in content by comparison with the Canadian and British documents. The actual
report of which this is the summary has not been consulted. The literature cited does not
appear to be exhaustive, and the criteria used for selecting papers for review are not always
given. The conclusions of the authors are however similar to those of the more
comprehensive reports just mentioned. This report is however interesting in as much as it
reports in greater details on the risk related to interference of electromagnetic fields with
implanted electronic prosthesis and gives recommendations to their users.
11
Mobile Phones and Health. Report from the Independent Expert Group on Mobile Phones, May
2000
42
Electronics Industry. The committee also relied on information from the press and 5
regional public meetings in order to be to be fully aware of the reaction and sensitivity of a
large percentage of the population. Invitations to public meetings appeared in the national
press: individuals and organisations were encouraged to present their views. Written
evidence was also received from a large number of people. Certain number people and
organisations (28) were invited to present their evidence in closed meetings with the
committee. The establishment of a health risk from exposure to RF fields depends on the
outcome of well conducted reproducible scientific studies. This is particularly important
when studying the effects of mobile telecommunications equipment, as they are very weak.
Such studies are mostly published in peer-reviewed journals; in addition, the committee of
experts considered information from all other sources of available to it.
Comment of the expert group: emissions from mobile phones may or may not be in
pulses but the mean power is not very significantly lower than the peak: in the GSM system,
it is 8 times lower; in radars, this ratio is usually around 1000.
Changes in calcium efflux were observed together with other different phenomena:
a decrease in the rate of formation of ion channels specific to calcium,
a decrease in the frequency of channel opening,
an increase in the occurrence of spontaneous action potentials.
Calcium is associated with the activity of a certain neurotransmitter receptor: (the NMDA-
receptor). More specifically, in the cortex and hippocampus it is associated with long-term
potentiation, which is thought to be associated with mechanisms of memory. In an in vitro
study, it was shown that phase transition in lipid membranes was facilitated by low level RF
EMF. However, occurrence of this phenomenon, which was observed at temperatures
between 17.7 and 25°C, is not thought to be possible in man at physiological temperatures.
Many other studies did not show any modification in transmembrane action potential, or in
calcium and potassium currents (36 articles and 2 reviews).
43
Several studies show effects on neurotransmitters and their metabolism; the work of Lai is
cited in this context, and the Stewart report suggests that changes in acetylcholine
metabolism could be related to thermal sensitivity of the hypothalamus 12 (7 articles).
Several studies showed changes in EEG, but the conditions under which these changes
take place are ill defined (7 articles). Learned task performance and memory can be
affected in rodents at whole body SAR levels of 2.5 to 8 W/Kg, due to heating of
approximately 1°C; these effects are correlated with an increase in the expression of c-fos: a
proto-oncogene implicated in neuronal plasticity. The sensitivity to such effects depends on
the frequency and on environmental factors such as external temperature and humidity. The
threshold of exposure leading to an effect, under the most adverse conditions, can be as
low as 1 W/kg The study by Lai stands out from the others by showing effects at 0.6 W/Kg.
Wood has even shown, in an in vitro study on hippocampus slices, a change in the long term
potentiation at 0.001 W/Kg! The statistical approach of Lai has been contested ( 5.88) (9
articles, 1 review).
Effects on the permeability of the blood-brain barrier have not been independently
confirmed (7 articles, 1 review).
Thermoregulation comes into action when the SAR is comparable to or greater than the
rate of production of metabolic energy, that is of the order of 1 W/Kg. RF EMF at
frequencies below 10 GHz is less effective in inducing thermoregulation because of the
smaller percentage of energy reaching subcutaneous receptors involved in the
thermoregulatory response (2 articles, 1 review). The level of physical activity is reduced to
lower endogenous heat production, this happens above 1 W/Kg at 2.45 GHz, and 3 W/Kg at
915 MHz. One study reported that activity levels were reduced after 6 weeks continuous
exposure at 0.4 W/kg before stabilising (1 review: UNEP/WHO/IRPA, 1993).
Eye
Effects on the eye, which could not be confirmed, could only be observed at very high peak
powers (9 articles, 1 review).
Melatonin
An inhibition in the secretion of melatonin is frequently reported at low frequencies, but has
not been demonstrated at radio frequencies and specifically not in the frequency range 3 to
30 MHz or at 900 MHz in the rat, or at 900 MHz or 1800 MHz in man (5 articles, 2 reviews).
12
Comment of the group of experts: this remark is surprising since the SAR used is 0.6 W/kg usually
considered non thermal, including by Lai himself
44
While it is true that the reported effects on memory have not been confirmed, they constitute
nevertheless the coherent set of studies that have not been refuted. However these effects
cannot be extrapolated to mobile telephony exposures because of the very short pulses and
high peak power that were used, and the possibility that the auditory effect might be
implicated.
Comments of the expert group: The authors conclude that there is an increase in the
concentration of ODC, in our opinion this has yet to be confirmed. Moreover the authors
indicated that the observed changes are of the same order of magnitude as those required
to cause promotion, they then qualify the finding as a relatively weak effect on the activity of
ODC. The authors estimate that it is very unlikely that the increase in ODC has a promoting
effect. We agree with their appraisal. However it is difficult to reach this conclusion without
the support of more detailed arguments. They refute the idea of a synergy with other
environmental factors without presenting a rationale for their hypothesis (9 articles, 1
review).
With respect to gene expression, table 5.8 qualifies two studies as being positive: Goswani
et al (1999) have shown a slight elevation in c-fos but not in c-jun or c-myc at 0.6 W/Kg, and
Ivaschuk et al (1997) have shown an increase in c-jun but not in c-fos “at higher intensities”
(5 mW/kg). These results are described as “contradictory” while, in fact, they relate to
different models and different intensities; if there were a specific mechanism at radio
frequencies, could it not have a thermal threshold at 0.6 W/Kg on the c-fos gene and a
specific effect at 5 mW/kg on the c-jun gene ? (10 articles).
Changes in cell growth of the order of 10 to 20% were reported for yeast cells by Grundler
(1992) with 41-42 GHz fields, but these effects were not replicated by Gos (1997). A low-
level effect was reported by Stagg who observed an increase in DNA synthesis in an
intensity window of 6 mW/Kg, while Kwee and Raskmark found a decrease in their
proliferation. The authors of the Stewart report recommend further studies to compliment
those of Stagg (8 articles).
No mutagenic effect and no damage to DNA were observed in vitro. Some fragmentation
of DNA was reported in vivo by Lai using the comet essay after exposure to a signal very
different from that used in mobile telephony, this result is one of many by the same author
and his group showing similar effects. Other research groups were not, however, able to
confirm these findings. Two in vitro studies and one in vivo study showed an increase in
chromosomal aberration. The result of studies of sister chromatid exchange were
inconsistent, increased micronucleus formation has been refuted in in vitro studies but has
sometimes been reported after exposure in vivo. The health consequences of these
observations are not clear.
Studies on the incidence of tumours after long-term exposure are not numerous and mostly
negative (Chou et al., 1992), even on animal models with a high incidence of spontaneous
45
tumour formation such as C3H/HeJ mice. A co-promoting (“epigenetic”) effect was reported
by some research groups but not by others: it should be studied further. Finally, studies on
the proliferation of grafted tumours were negative. Out of 38 articles reviewed, only 4
showed increased tumour incidence. Of these, 3 pertain to high SAR levels while the 4th,
that of Repacholi (1997) is currently being repeated in 2 different laboratories (4 reviews).
Cardiovascular system
There are no reports of low-level RF fields on the cardiovascular system (4 articles).
Comments of the expert group on animal and cellular studies: some reports of cancer
co-promotion need verification. The authors of the Stewart report reported damage to the
ocular tissues, however these effects were due to very high intensity pulses. Also reported
are effects on the nervous system of the rat. These effects were minor and difficult to
interpret in terms of biology or health; they do not appear to lead to altered cellular function
or to have an impact on health.
Koivisto studied 48 volunteers with tests exploring the same functions with a 902 MHz signal
modulated at 217 Hz, with a power output of 0.25 W. He did not confirm Preece's finding of
an effect on choice reaction time at 0.125 W, but he found a significant effect on what its
termed “vigilance” reaction time. In another study on working memory, currently in press, he
found a decrease in the reaction time of the visualisation of a target letter in a sequence of
letters. Paradoxically this visualisation time is increased for the reaction to a target letter
presented after just one or two previous trials.
46
These results imply that future experimental conditions should reflect a more elaborate
hypothesis, in order to narrow the range of circumstances under which an effect occurs to
include a more limited number of psychophysiological variables. Moreover these
investigations deal with short-term effects, and it is therefore not possible to make any
deductions, on the basis of these findings, about long-term consequences of exposure.
Krause et al (2000), found a change in the frequency content of the EEG between 4 and
12 Hz when hearing a word matched to four target words given at the beginning of the test.
This difference was considered by the authors as possibly correlated to behavioural
modification as described by Koivisto et al (2000, in press). Unfortunately, Krause et al
(2000) did not report the performance scores of the subjects, and so there is no way of
knowing if the exposure improved performance of memory-related tasks or if modifications in
EEG are really correlated to this effect.
Three other studies on evoked potential gave the following results: one study on visual
potential by Urban et al (1998) was negative, one by Freude et al (1998) showed a decrease
in amplitude of the response, and finally that by Eulitz et al (1998) on cortical auditory
potential associated with a vigilance task showed a decrease in the spectral power at high
frequencies (18-30 Hz).
Conclusion of the expert group on studies concerning brain function: The results of
Preece and Koivisto suggest that acute exposure to fields from mobile phones at levels
below the recommended limits produce effects of sufficient magnitude to modify behaviour.
The causal mechanism remains unclear, but may well be due to a small localised thermal
effect. It appears clear that exposure to mobile phones modifies certain brain functions, it is
not however possible to establish any clinical significance for such effects or to demonstrate
a possible health effect. Long-term exposure studies among groups of new mobile phone
users could be designed to identify changes in brain function associated with cumulative
exposure. Such studies should be a priority for future research.
The expert group concludes that there is no reason to suspect an effect on the heart and the
circulation but they advise that Braune’s study should be repeated with an appropriate
protocol.
47
telephone call is more important than simply listening to the radio or even performing an
automatic task such as repeating words; the effect on driving is evident during a simple
conversation, increasing with the cognitive load of the discussion, and is more significant in
older drivers.
3- Epidemiological studies
Studies pertaining to the general population (6 articles)
The cohort study carried out by Rothman et al (1996) was prematurely interrupted. The
absence of difference of mortality between users of hands-free and handheld phones after
three years is not sufficient to draw conclusions. In fact if there were a cancer risk it would
need a longer period to manifest itself.
The case control study of Hardell et al (1999) in Sweden did not show any increased risk of
tumour formation related to the use of a mobile phone, either analogue or digital. A fuller
critique of this article is presented in the annex.
Cancer: Szmigielski (1996) reported a 6-fold increase of the risk of lymphoma and
haematopoietic cancer among Polish military personnel exposed to RF while at work.
However, this study is deficient in many ways that limit or even nullify its conclusions; firstly
the exposure of cancer cases was not evaluated in the same way as for the general
population, and secondly the statistical analysis is not well described, with important data
missing from the report. With this exception of this study, out of 9 other publications only
that of Tynes et al (1992) shows a significantly increased risk - of leukaemia in Norwegian
electrical personnel. Similarly in the case of brain cancer, apart from Szmigielski's study, 2
out of 7 studies, both case-controlled studies, showed a significantly elevated risk; that of
Thomas et al (1987) who evaluated the exposure from job title, and that of Grayson (1996)
which indicated a modest increase in risk even for the highest exposure (RR = 1.39; 95%
confidence interval = 1.01 - 1.90).
In summary, taken as a whole these studies do not show an increased risk of cancer from
occupational exposure to RF. However, the exposure parameters vary between the studies
and are not comparable to mobile phone exposures. Many of the studies have low statistical
power and some have deficient methodologies. This is why the absence of consistently
positive findings does not necessarily mean that RF radiation from mobile phones does not
constitute a risk of cancer.
Health aspects other than cancer (5 articles, 1 review): Several cohort studies of
occupational groups exposed to RF radiation have examined non-cancer mortality, and in
some cases morbidity; while these studies did not provide any evidence of health risk, it is
nevertheless reasonable to suggest that workers exposed to high intensity RF fields should
48
be monitored in the long-term. The experts recommend the setting up of register of
exposure of workers and the assessment of cancer risk and mortality to determine whether
there are any harmful effects.
The general conclusion of the Stewart Report is given in its prologue: “The balance of
evidence to date does not suggest that exposure to RF radiation from mobile
telecommunication technologies is hazardous to the general population in the UK. There is
some preliminary evidence that exposure to the fields from these technologies can produce
subtle biological effects, but it is important to note that these effects do not necessarily
constitute a health hazard”.
The general conclusions of the expert group on the Stewart report: This report
presents a clear and accurate description of mobile phone systems and of the fields they
emit, in air and in the tissues of the head. The physical characteristics of electromagnetic
fields and the mechanisms of interaction, well established or hypothetical, are described
well13. The reference section is quite extensive but not exhaustive.
The expert group notes that the analysis of biological and health effects in the Stewart report
takes into consideration high- and low-level effects, which could be misleading. Exposure
levels are often not sufficiently precise, and often qualified (“very weak, weak, average or
high intensity”). This can be misleading, and allow errors in interpretation of the actual
values corresponding to these terms. For example a SAR level of 55 W/m2 appears to be
considered as “weak” (§5.138), while a few pages previously, 100 W/m2 is identified as “very
high intensity” (§ 5.128): the interpretation of biological effects occurring under such
exposure conditions can vary, constituting a non-negligible source of errors of judgement.
Similarly, the magnitude of the effects observed is not always indicated, which makes it
difficult to interpret them in term of health consequences.
13
There were however a few errors that slipped into the report, for example, the mass density of
3 3
biological tissues is 1000 kg/m and not 0.001 kg/m (§ 4.37 p.38), an electron is attracted by a
positive not a negative charge (§ 4.39 p.39), and some arguments are not clear or not sufficiently
precise (the dividing line between ionising and non ionising radiation corresponds, in fact, to the
ionisation energy of the hydrogen atom in the water molecule: 12.4 eV), as this is the most abundant
element in the body.
49
Some results have been considered in the report as not relevant to mobile telephony: for
example, health effects of radiofrequency fields modulated at 16 Hz are not considered; the
reason given is that this modulation is not used in mobile telephony. The expert group has
reservations on this point because it is perfectly conceivable, in terms of mechanism, that
effects occurring at 16 Hz could also occur at 217 Hz (frequency actually used in mobile
telephony) it is also possible that future developments in technology may one day justify the
use of such a modulation frequency. Similar reservations are directed to their interpretation
of phase transitions in the lipid membrane, and on effects on EEG. If the mechanism
underpinning these effects, and the repercussions on cell or body function, are not known
they cannot be considered as without any health consequences just because the exposure
or biological conditions under which there were observed do not correspond to exposures
from mobile phones.
The expert group agrees with the statement in the Stewart report that there is clear evidence
that exposures to radiation from mobile phones, at intensities below the ICNIRP
recommendations, have short term direct effects on the electrical activity of the brain and on
cognitive functions. It is important to study the consequences of such effects on health,
because, even if only one health effect is present, the recommendations should be changed
accordingly. It is also agreed that it is important to determine if these effects are due to a
slight localised elevation in temperature or, as is also possible, a non-thermal effect. The
group of French experts agrees with the conclusion of the Stewart report that the
experimental studies carried out do not suggest harmful effects on the heart, the blood, or
the immune system but they considered that the data on reproduction and development are
poorer.
Some people report symptoms such as headaches, fatigue and the perception of heat
behind the ear while using, or shortly after the use of, a mobile phone. It is not clear if these
symptoms are actually due to RF fields. They call for new studies. The epidemiological
evidence to date does not suggest that exposure to RF causes cancer, this is in line with the
absence of mutagenic effects, whether initiator or promoter, from exposure to RF below the
recommended levels. However, the use of mobile phones is too recent to allow for a
decisive epidemiological evaluation, consequently the possibility of an association between
the mobile telephony technology and cancer cannot not be excluded at this stage.
One important health risk of mobile telephony has been clearly established: an increased
risk of road accidents for drivers using a mobile phone. The risk is the same for hand-held
or hands-free phones as it is due to the distraction caused by the telephone conversation
rather than to an impediment to driving the car or to a direct field effect on the brain.
In general the group of (French) experts considers the information in the Stewart report to be
quite considerable and relevant, and agrees with its main conclusions.
14
Directorate General in charge of telecommunications
50
safeguard the general public and the management of this research (including financial
management and the setting up of a "fire wall").
In 1998, DG XIII requested the members of COST “244 bis” to update the review and
recommendations of the McKinlay report. This report, referred to hereafter as the COST
244 report was submitted to DG XIII in June 1999, following a workshop entitled "Future
European Research on Mobile Communications and Health", that was held in Bordeaux in
April 1999. Researchers from academia and from industry worked together towards the
realisation of this task. There follows a critique of the two reports.
1. Studies on the nervous system and behaviour (47 studies in 1996; 18 supplementary in
1999)
Previously reported studies on calcium efflux from brain tissue preparations exposed to
microwaves are also not conclusive as the exposure conditions were not well defined and
replication studies proved negative.
Calcium: Several studies reporting calcium ion efflux from cellular membranes were carried
out on chick brain. The effect was only observed at modulation frequencies between 6 and
20 Hz. Some studies reported that the effect could only be observed for exposure to signals
within a certain power range, this is referred to as “window” effect. Some replications
studies proved negative.
Long term potentiation: Scott and Tattersall (1999) studied the effect of exposure to 700,
900 and 1800 MHz (continuous and GSM) for 10 minutes on rat brain slices. They reported
a change in their long-term potentiation (a memory related mechanism) which occurs
irrespective of the nature of the signal.
Gene expression: Ivaschuk et al (1997) exposed PC12 nerve cells previously treated by
NGF15 to an 836.55 MHz (signal TDMA16, SAR of 0.41 - 41 mW/kg) for 20, 40 and 60
minutes. There were no modifications to the expression of the oncogene c-fos while that of
c-jun was increased at the highest SAR level, but only after 20 minutes of exposure.
Neurotransmitters and hormones: The available data appear to indicate that the effects
observed are thermal in nature. Recent studies on the level of neurotransmitters in the rat
(dopamine, noradrenaline) proved negatives.
Blood brain barrier: Numerous studies have been performed on the possible effects of
microwaves on the permeability of the blood brain barrier (BBB). Most of the older studies
15
nerve growth factor
16
pulsed signal: time division multiple access
51
were carried out at exposure levels that illicit thermal responses, but the more recent studies
with mobile telephony signals are more difficult to evaluate. The effects are inconsistent
except at high exposure levels. It is therefore conceivable that the effects are due to an
increase in the arterial pressure caused by the stress of confinement in exposure systems.
Fritze et al (1997) showed that microwaves from mobile phones do not cause protein
leakage at SAR levels below 7.5 W/kg in rats with their heads exposed inside a “carousel”.
The group of Salford and Persson carried out a long series of studies in rats with whole body
exposures to different signals. They reported a 50% increase of permeability at SAR levels
of less than 0.3 W/kg (GSM 900 and 1800; Persson et al., 1999). Beyond this threshold, the
permeability increased rapidly with power.
Recently, Tsurita et al (1999) exposed rats in a carousel at 1.439 GHz and did not detect
any increase in the permeability of the BBB for SAR values up to 10 W/kg
Memory: One study, from 1994, showed deleterious effects on the learning of rats exposed
to pulsed microwaves (work memory). Since then, only one replication study has been
attempted with a weak signal at 900 MHz and this proved negative.
In 1999, Sienkiewicz et al tried to repeat the work of Lai on mice exposed for 45 minutes
(GSM 900, SAR of 0.05 W/kg). The animals were then placed in an eight arm maze, no
effect of learning was observed at this low power level.
Gene expression and stress studies: Several studies have been carried out on heat shock
proteins (ARNm). Only exposure to high intensity pulsed or continuous radiation resulted in
an increase in gene expression. In the brain, the expression of the c-fos gene corresponds
to stress of thermal or other origin. The level of c-fos was used as a metric in two studies
that showed effects only at thermal levels.
Fritze et al (1997) studied stress, papooses and cell proliferation in rat brains exposed to
mobile telephony signals. Morrissey et al (1999) carried out similar studies on mice. In both
cases, increases in the expression of c-fos and other genes were only observed at the
highest SAR level (about 7 W/kg).
Summary of findings: Studies on EEG and sleep showed minor changes. Such studies
should be repeated under more rigorous conditions to confirm these results and enable a
clear interpretation.
Comments of the expert group on effects relating to nervous system and behaviour:
The two reports are very comprehensive and show the significance of this field of study in
the context of health effects of mobile phones. None of the studies carried out in vitro
showed evidence of any effect at non-thermal levels; nevertheless, some of these studies
should be duplicated. For animal studies, it is agreed that the effects on the permeability of
the blood brain barrier should be studied in a consistent manner and that stress markers are
a useful measure of effect on brain function. In human volunteer work, it is reasonable to
recommend sleep studies with diurnal exposure, this has not yet been carried out.
52
2. Studies on cancer
Experimental studies
Summary of conclusions:
Genotoxicity studies in vitro (11 studies reported in 1996, 9 others in 1999, 2 ongoing
or expected).
Most of the results obtained prior to 1996 were negative for non-thermal exposures. Recent
studies on DNA damage, sister chromatid exchanges, micronuclei and cellular cycle were
equally negative. Some results indicate a possible synergy between microwaves and other
mutagenic factors.
Low-level effects were reported by Maes et al (1996, 1997), showing a possible synergy
between RF fields and a mutagenic agent (mitomycine C) on human lymphocytes (935.2
MHz CW and GSM, 2 hours exposure at 0.3 - 0.4 W/kg.)
Most studies were carried out at high SAR levels corresponding to thermal effects. However
one series of studies on fragmentation of DNA in rat cells exposed to pulsed microwaves,
produced positive results that have not been replicated since.
In 1996, Lai and Singh published the results of DNA fragmentation in rat cells. The
exposure was whole body, for 2 hours, to pulsed or continuous microwaves (2450 MHz,
SAR of 1.2 W/kg). The test method known as “comet assay” was used and the number of
breaks of DNA was increased significantly. In 1997, the same group reported an inhibition
of the effect by antioxidants.
Malayapa et al (1998) could not replicate the effect using the same protocol or the same
exposure system (continuous microwaves). Since then, the same group failed to replicate
the experiments of Lai and Singh with pulsed microwaves (Lagroye et al 1999). Similarly,
the experiment by Hook (1999) on the same biological model but with signals similar to
those of mobile telephony was negative.
The group of Cleary described effects on the proliferation of CHO cells (Cao et al, 1995) and
of lymphocytes (Cleary et al, 1996), exposed to high intensity microwaves (2450 MHz, 25
W/kg) under isothermal conditions. Subsequently, Shi et al (1999) were unable to observe
the same effect using a similar exposure system with better temperature control.
Recently, Stagg et al (1997), exposed C6 glioma cells to 836.55 MHz (pulsed mobile phone
signal) for two weeks at a low level (mW/kg). A slight increase in the incorporation of
53
tritiated thymidine was observed in some of the trials; however, the proliferation, measured
by counting cells, was not affected.
Cellular transformation
Following the 1991 study of the Balcer-Kubiczek group, showing a positive effect of
modulated microwaves together with other tumour promoters on the transformation of
C3H10T1/2 cells, two other cellular transformation studies carried out with mobile telephone
signals reported negative results (Cain et al, 1997; Malyapa et al 1997).
Enzymatic activity
A series of studies carried out on low-level microwaves modulated at low frequency showed
changes to the activity of intracellular enzymes implicated in cancer promotion, without any
significant effect on DNA synthesis. This applies particularly to the work of Litovitz's group
(Krause et al, 1997; Litovitz et al, 1993, 1997) on the activity of the enzyme ornithine
decarboxylase (ODC). When such effects are observed, their magnitudes are much lower
than the magnitudes of effects produced by other cancer promoters.
In vivo cancer studies (10 studies reported in 1996, 14 supplementary studies in 1999,
1 ongoing or expected).
Different animal cancer models were used to determine the possible effects of microwaves
on the three phases of the development of cancer (initiation, promotion and progression).
Other models were also used, such as tumours induced chemically or by means of ionising
radiation and transgenic animals that are more susceptible to the development of tumours.
Taken as a whole, the results of studies on different animal models do not show a significant
effect of microwaves on the formation of cancer and in particular on the promotional phase
that was most studied.
In 1997, the Australian group led by Repacholi published positive results on transgenic mice
carrying lymphoma exposed for a period of 18 months to GSM signals (whole-body SAR of
0.008 to 4.2 W/kg). A significant increase in the incidence of lymphomas was observed.
Toler et al, 1997 and Frei et al, 1998 exposed mice that are susceptible to develop brain
tumours to 2450 MHz (up to 1 W/kg) for the lifetime of the mice. No difference was
observed in the frequency or the stage at which the tumour appeared, and no change was
observed in the longevity of the animals.
The results by the group of Adey (1999) on brain tumours induced in rats were all negative,
irrespective of the mobile telephone signal used for long term exposure of the animals.
Wu et al (1994) did not observe any change in the development of colon tumour in mice.
Imaida et al (1998) did not report any effects of microwaves on liver cancer in the rat.
The group of Bartsch and Anane, studying rats with DMBA-induced tumours subjected to
low-level GSM signals, reported reductions in the incidence of tumours or a delay in their
appearance.
54
Epidemiological studies related to exposure from base stations are not recommended. Also
not recommended is the study of other non-cancerous diseases and subjective ailments,
given the current state of knowledge (pending the results of studies carried out in Sweden
and Norway).
Comments of the expert group on effects related to cancer: The data presented are
exhaustive and take into consideration the studies ongoing in 1999. In the light of
information acquired in 1999, it is possible to concur with the authors' conclusion that
exposure to microwaves does not, in general, induce lymphoma and other tumours.
However, the question of promotion remains open. It is therefore important to settle the
issue as the results to date are inconsistent.
The recommendations of the report concerning epidemiological studies were incorporated in
the protocol of the international study led by IARC. The conclusions of the (French) expert
group agree with those in the report under consideration with respect to studies related to
base stations.
In 1999, Braune et al published results showing a 10% increase in arterial blood pressure of
volunteers exposed to GSM signals for 35 minutes. Unfortunately, the interpretation of these
results is made difficult by the lack of randomisation in the sequences of real and sham
exposures.
Comments of the expert group concerning the cardiovascular system: the effects
observed after exposure to high-intensity microwaves are probably due to heating. Studies
related to exposure from mobile telephony are very limited in number; it is therefore not
possible to give firm conclusions in this respect.
Most of the recent results from in vitro studies of immune responses were classified in the
chapter on genotoxicity and cancer. In these experiments no effects were reported on the
immune system (for example, Antonopoulos, 1997; Eberle, 1997).
In vivo studies of the immune systems (11 acute studies reported in 1996, 5 chronic
and 2 more in 1999).
Most of the immune systems studies to date have been on animals. Most were coupled with
studies of cancer promotion. Few studies related specifically to exposures to mobile
telephony signals. The conclusion of the report was that only high exposure levels, causing
55
thermal effects, could have a permanent effect on immunity. The role of stress should be
studied in detail and so should immune response in the skin.
In 1999 Chagnaud et al published some negative results from the study of certain immune
system parameters of rats exposed to GSM signals (activation and under-population of
lymphocytes)
Comments of the expert group concerning immunity: Given that only very few results
were relevant to the issue of immunity, it is not possible to conclude that mobile telephone
signals have an effect on the immune system. Nevertheless, there is a need for a better
understanding of thermally-induced stress (even in the absence of an increase in body
temperature). There is also a need to study possible effects on skin in its capacity as an
organ of the immune system.
Several studies have shown that that there is no interference with pacemakers when there is
sufficient distance between the device and the mobile phone (Barbaro et al, 1995; Carillo et
al, 1995; Hayes et al, 1995; Meckelburg et al, 1996).
In 1999, the subject was not discussed further, to some extent because the problem was
considered to be resolved.
Comments of the expert group on implants: It is agreed that the question of interference
with pacemakers does not arise with modern devices and the advice to keep mobile phones
at least 15 cm away. However, the issue of cochlea implants has not been resolved.
General conclusions of the expert group on the McKinlay/COST 244 bis reports: These two
reports constitute a coherent and comprehensive view of the state of knowledge. The
participation of a very large number of experts in the drafting of these reports meant that a
large spectrum of opinions was obtained. It should also be pointed out that these reports,
and in particular that of 1996, served as a basis for the call for proposals by the European
commission within framework V.
Tables summarising the results of studies are sufficiently comprehensive. The tabulation of
all ongoing studies and details of the research groups concerned is a useful and original
aspect of these reports. The recommendations for research are carefully drawn.
The weaknesses of these two reports relates to the chapter on cardiovascular system and
that on reproduction and development, which is non-existent.
The expert group concurred with the general conclusions of these reports with respect to the
absence of confirmed health effect from mobile phone technology and on the direction of the
research program required to fill the gaps in knowledge and to provide for a rigorous risk
analysis.
56
4.1.4 Analysis of the Report Of The Royal Society Of Canada
This report, submitted to the Minister of Health of Canada in March 1999, is entitled: "A
Review of the Potential Health Risks of Radiofrequency Fields from Wireless
Telecommunication Devices"
A group of eight North American experts led by Professor D. Krewski of Ottawa, prepared a
report on the potential health risks of RF fields from mobile telecommunication systems. It
is intended to inform the government on the validity of the scientific basis of the Canadian
"Safety Code 6" health standard, developed by Health Canada, the organisation in charge of
setting limits on the exposure of workers to various environmental factors.
The criteria for selecting members of the group were set up by a Canadian committee on the
selection of experts; successive versions of the report were submitted to the committee who
arranged for another independent expert group to peer-review them. The final report was
then published without any modifications by the mandating organisation, the Royal Society
of Canada.
It is recognised, at the beginning of the report, that the field levels measured near base
stations are significantly lower than the limit in Safety Code 6 while those from mobile
phones could be of a similar order of magnitude.
Do current safety limits protect both the workers and the general population from the
thermal effects associated with exposure to RF fields?
No harmful effect is known to occur below the limits for whole body exposure. On the other
hand, the limits for partial body exposure are clearly higher and allow longer exposure times.
Consequently, the committee cannot confirm that these levels of exposure fully protect
workers from thermal effects on all parts of the body. Further research is required to
ascertain the maximum duration for safe exposure.
There is at present no scientific basis for concerns over cancer. Clinical studies have
investigated cancer, problems with reproduction or development, epilepsy and headaches
Taken as a whole these studies were not conclusive but more research is needed.
Is there evidence that non-thermal effects, if they exist, are more important for
children or other sub-populations?
Certain sub-populations such as children, pregnant women and the elderly are generally
more sensitive to certain environmental health effects. Very few studies have been carried
out on these groups in relation to exposure to RF fields. The committee has not found
evidence in support of a microwave health effect syndrome. However, it seems that some
people are able to detect that they are exposed to RF fields.
What are the conclusions of the committee with respect to exposure levels, in
particular, should non-thermal effects be considered in Safety Code 6?
Safety Code 6 protects workers and the public from thermal effects; the committee has
however pointed out that, under the partial body exposure conditions, some parts of the
body of the workers such as the head, the neck, the trunk and the extremities can
57
experience some heating. The committee recommends the revision of partial body
exposure levels and exposure time for workers.
Current knowledge of non-thermal effects does not provide sufficient evidence of health
effects that can be incorporated in a revision of Safety Code 6. Partial body exposure limits
should be applied to the eye.
In the following critique of the Canadian document the deliberations and conclusions of the
Canadian group are reported in the order in which they appear in the document.
Blood brain barrier (BBB): increases in the permeability of the blood brain barrier have
been observed under exposure to microwaves. These are effects that could have important
health consequences.
Brain metabolism: A series of studies, from the same research group, have shown
changes in neurotransmitter receptors and imply a role for endogenous opiates in
microwave effects.
Behaviour: Some studies have described a memory effect on rats exposed to pulsed
microwaves.
Most of the effects observed in animal studies occurred at high (thermal) exposure levels,
except for those on calcium ion efflux. Behavioural studies are generally positive but the
extrapolation of their results to man is difficult.
An increase in calcium ion efflux from cellular membranes of brain tissue was reported by
Blackman et al (1979, 1980). The exposure was to low-level RF (147 MHz, 0.5 mW/cm2)
modulated at 16 Hz.
D’Andrea's group exposed rats for 90 days (7 hours/day) to microwaves (2450 MHz,
0.5 mW/cm2) and observed changes in their performance of repetitive tasks (DeWitt,
D’Andrea et al, 1997)
Lai, Horita et al (1994) studied the role of endogenous opiates on memory deficit induced by
exposure to RF in rats using a radial arm maze. The retarded learning could be blocked by
pre-treatment with either a cholinergic agonist or an opiate antagonist.
58
The group of Salford and Persson (1992, 1994) demonstrated that pulsed or continuous
microwaves (915 MHz, SAR of 0.016-5 W/kg, modulated at 8; 16; 50 or 200 Hz) increased
significantly the permeability of the BBB to albumen in exposed rats. The increase was quite
evident at the highest SAR, but still perceptible below 0.1 W/kg (that is below the values
recommended in Safety Code 6)
Sleep disturbance: Results of studies on human volunteers exposed during their sleep
showed alterations in sleep pattern with exposure to mobile phone signals or signals from
lower frequency therapeutic devices. However, these results do not appear compatible with
those from animal studies.
Depression, suicide and behaviour: A microwave syndrome has been described but
never quantified. The most common symptoms are: irritability, fatigue, loss of appetite,
torpor, loss of memory, loss of concentration, emotional instability, depression and
headache. Experimental data do not confirm the existence of a link between exposure to
microwave and headaches. This is, though, the subject of numerous complaints.
Epidemiological studies on suicide have been carried out only for exposure to ELF.
The eye: The potential effects of microwaves on the eye, and in particular the production of
cataracts, have been studied for 40 years. The studies have numerous experimental
difficulties and it is not always possible to determine the mechanism by which microwaves
cause damage to eye tissues, except at high power where thermal effects are evident.
In conclusion, with the current state of knowledge it is not possible to identify a neurological
effect or an effect on brain function that can be directly attributed to microwaves at non-
thermal levels. Headaches are a common complaint in relation to exposure to RF, however
this symptom is ill-defined and difficult to relate to neurochemical changes. It is important to
carry out studies on this subject. Similarly, the unique properties of the eye call for special
attention.
In a study by Reiser in 1995, a commercial mobile phone operating at 900 MHz was used
40 cm from a person. An increase in the amplitude of the EEG spectrum was observed in
the alpha and beta bands after 15 minutes of exposure.
Sobel and Davanipour (1996) have suggested that electromagnetic fields contributed to the
process of neurodegeneration while Feychting et al (1998) have suggested that alteration in
brain tissue by electromagnetic fields predisposes to Alzheimer's disease.
In a study on sleep by Mann and Röschke in 1996, volunteers were exposed for 8 hours at
night-time, showed no change in total amount of sleep and no change in total amount of
slow wave sleep. However, there was a reduction in the period of REM sleep. In 1998, the
same group failed to reproduce theses results at lower exposure level.
59
A recent study by Hansson-Mild in Sweden and Norway in 1998, seemed to confirm that
headaches are a subjective symptom often reported by users of mobile phones.
In 1997, Kues et al studied vascular permeability in monkeys exposed to 2450 MHz
microwaves at for 3 days. A dose related effect was found between the microwave-induced
vascular permeability and corneal lesions that developed subsequently.
Comments of the expert group on nervous system and behaviour: The conclusions of
the Canadian report identify gaps in knowledge, particularly in relation to headaches and the
eye. They reviewed and took into consideration most of the published studies but their
analysis of animal and in vitro studies is not very rigorous, and there are some errors in
interpretation. There are data supporting an effect of RF on animal behaviour, but the
interpretation of these results in terms of relevance to human exposure cannot be done on
the basis of current knowledge.
When the Canadian report was being drafted, some recent results on sleep and cognitive
tasks were not yet known. Consequently, some of their conclusions are not up-to-date.
2-Cancer Studies
Cellular proliferation: The effect of microwave exposure on cellular proliferation has been
studied under a number of different conditions. Where the exposure conditions, and in
particular temperature, are rigorously maintained, the results were almost always negative.
ODC: Ornithine decarboxylase, a catalytic enzyme involved in the formation of polyamines
in cells, plays an important role in the promotional phase of the process of carcinogenesis.
An increase in ODC activity has been observed with exposure to low frequency modulated
microwaves; this could be a type of “window effect”, as the increase in ODC activity is
reported by certain authors at very specific modulation frequencies (5 studies reported
positive results with exposure to modulated microwaves).
Melatonin: Some studies carried out at ELF reported changes in the night-time level of the
hormone melatonin in rodents. In view of these results, some studies were later carried out
with exposure to microwaves. No effects were observed on people exposed during the
night. In the case of exposed rats, there were also no effects on night-time melatonin level.
One positive result has been reported on the induction of sister chromatid exchange in
human lymphocytes exposed to 167 MHz (Khalil et al, 1993). It is possible that, in this
experiment, the effect was due to RF heating.
60
Lai and Singh (1995), used the test procedure known as comet assay to observe an
increase in the fragmentation of DNA in rat brain cells exposed at 2450 MHz. These results
have not been independently replicated despite several attempts by other laboratories.
The results of Balcer-Kubiczek and Harrison (1985; 1989; 1991) on the transformation of
C3H/10 T1/2 cells showed that the transformation did not occur with microwave exposure
alone. However, microwaves could act in synergy with other mutagens or promoting agents.
C6 cells and stem cells of rats were exposed by Stagg et al (1997) to mobile telephone
signals (TDMA) for 24 hours at low SAR levels. An augmentation in DNA synthesis was
observed at 5.9 mW/kg but not at 0.59 or 59 mW/kg; these are very low SAR levels.
Litovitz's group, among others, have reported an increase in ODC activity in cells exposed
for several hours to RF (835-915 MHz, 2.5 W/kg). The increases were observed only when
the signal was modulated at 16 and 60 Hz. The increase in ODC activity was only
temporary.
In a study on the rate of production of melatonin, Vollrath et al, (1997) did not find an effect
in rats exposed for 6 hours to low level microwaves (900 MHz, 0.06 to 0.6 W/kg).
In 1997, Repacholi et al published results on transgenic mice exposed to GSM 900 signals.
The exposure increased the incidence of lymphoma (x 2.4) at the end of 19 months of
exposure. The average SAR ranged from 0.008 to 4.2 W/kg. It is expected that these
experiments will be repeated in other laboratories.
In a cohort study carried out in Poland in 1996 by Szmigielski, the dosimetry was carried out
on volunteers under well-defined conditions. An increased incidence of cancers of the
haematopoietic system, lymphatic organs and nervous system was observed. The
methodology of this study has been the subject of severe criticism. In the UK, following the
detection of a cluster of adult leukaemias in the neighbourhood of a radio and television
mast, two studies were conducted, one in the vicinity of the original mast, and the other
covering the whole of the country (Dolk et al., 1997). A non-significant increase of 3% in the
incidence of cancer was observed in the vicinity of the mast irrespective of the distance.
The only significant increase was for leukaemia (OR: 1.83 [1.22-2.74]). By contrast, in the
study carried out all over the country no association was observed. The problems with
such studies are in the difficulty of assessing the exposure of people as a function of
distance from the mast and in determining the population movement during long observation
periods.
Rothman et al, (1996) measured the overall mortality of 255,868 users of mobile phones
(high power) and cordless phones (low power). No difference was observed between the
two populations. This study was criticised because of the short follow-up period and the lack
of exposure details provided by the operators.
Comments of the group of experts on the effects related to cancer: A very large
number of references are quoted but the information is not very well organised: different
aspects of the process of carcinogenesis and health consequences are in different non-
61
consecutive chapters. The authors of the report have paid particular attention to the risk of
cancer. They discuss at length, and may have over-interpreted, experimental studies on
ODC. This is presented as a possible “missing link” in a carcinogenic mechanism. The
available data are confused, and a hypothesis alone is not a proof. Given the current state
of knowledge more experimental data are needed. In fact, the inconsistency in the results is
pointed out as is the fact that most of the studies were negative. More specifically, on the
basis of current knowledge, it is possible to conclude that microwaves do not have a
genotoxic effect. A promoting effect cannot be excluded, in fact this is the hypothesis at the
basis of the international study by IARC. It is a matter for regret that the possible synergy
between RF and mutagens, or other agents, was not sufficiently considered.
In a recent study (Bortkiewicz et al, 1997) reported that some electrocardiogram anomalies
were more frequent in exposed volunteers than unexposed volunteers, (71 employees were
included in the study).
One study, carried out in Lithuania, was instigated by an observation of a decrease in male
births in the neighbourhood of a radar station emitting 154-162 MHz fields, pulsed at 24.4
Hz. A number of psychometric and neurological tests were carried out showing differences
as a function of proximity to the station, but the mobility of children aged 9 to 18 years was
not taken into consideration: this dilutes the relevance of any conclusions drawn from this
study.
Comments of the group of experts on the immune system: It is not possible to reach a
conclusion on the basis of existing data.
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6. Studies on interference with medical implants: summary of conclusions
The subject was not treated in this report.
Microwave syndrome:
This syndrome, previously described, has not been objectively confirmed. However, it
would be desirable to undertake a double-blind study of the possible sensitivity of some
people to RF fields.
Comments of the group of experts on effects on the eye: The importance given to the
eye in this report is in part because the standard is primarily developed for workers who
under certain circumstances can be exposed to relatively high-power microwaves.
However, it is not reasonable to give so much importance to this subject for the following
reasons:
· They were obtained at high (in comparison to the power levels of mobile telephones and
walkie-talkies) power levels, and they are largely contested.
· The exposure levels proposed are lower than those for other, less vulnerable, organs or
the extremities but quite compatible with the use of mobile phones. In fact, because of
its position, the eye is not directly exposed to the fields from mobile phones.
63
This report dwells at length on biological effects resulting from exposures to RF at levels
well-below those known to give rise to thermal effects. Nevertheless, the report is prudent in
its interpretation of these observations in terms of adverse effects and health risks. The
possibility of differentiating between biological effects on the basis of RF modulation
characteristics is reported, and deserves further exploration. Certain mechanisms are well
developed but remain hypothetical, indicating that further research is needed to reduce
uncertainties related to localised exposures and long-term effects.
Introduction
The aim of the symposium was to consider, as exhaustively as possible, all issues related to
biological effects from exposure to mobile communications signals. It was organised in six
sessions:
Session 1, dealing with dosimetry, was the responsibility of Joe Wiart of France Telecom
Research and Development. It was chaired by Pierre Aigrain of the Academy of Science
and of the CADAS.
Session 2 was dedicated to human studies; Jean-Louis Coatrieux and Alain Bardou of
LTSI-INSERM at the University of Rennes were responsible for this session. It was chaired
by Claude-Henri Chouard of the National Academy of Medicine.
Session 3, dedicated to in vitro animal studies, was the responsibility of Bernard Veyret of
PIOM, Bordeaux and was chaired by Charles Pilet of the National Academy of Medicine, the
Academy of Sciences and the CADAS.
Session 5, dedicated to technical, economic and regulatory affairs, was the responsibility
of Luis Miro of the Faculty of Medicine at Nimes and was chaired by Jacques Joussot-
Dubien of the Academy of Science.
In line with the aims of the group of experts, the review of this document will be confined to
reported work on biological and health effects of RF. This does not, of course, mean that the
other contributions are less valuable. However, they are more concerned with risk
management, and an interested reader can refer to the full report published by the Academy
of Science. The references cited in this review are given in the annex.
64
1/Dosimetry
The first chapter in this section related to the principles of electromagnetism as they apply to
dosimetry and the interaction of RF with people. Joe Wiart states in the introduction that
dosimetry, or the quantification of fields and power induced in biological tissue, is an
important aspect of the study of the interaction of electromagnetic fields with people. As
previously reported by the World Health Organisation EMF project [917], any analysis of
possible biological effects of electromagnetic waves must refer to the levels of electric and
magnetic field strength and power induced in tissues. Many of the earlier studies of
biological effects of electromagnetic fields did not incorporate rigorous dosimetric analyses,
which makes their interpretation difficult. The experts of DGXIII [576] recommended in their
report that dosimetric analysis should be a requirement for all in vivo and in vitro studies.
Dosimetric studies are also essential for the testing of compliance to international guidelines
and standards of exposures from mobile phones and associated systems. The European
Commission has issued a Recommendation in relation to the limitation of exposure of
people to electromagnetic fields (1999/519/CE)[224]. This document is based on the
scientific recommendations [386] of the International Commission on Non-Ionizing Radiation
Protection (ICNIRP). This document defines basic restrictions, limits on power absorbed by
tissues that guarantee the protection of people from known health effects. It also defines
electric and magnetic field strengths that ensure that the power absorbed is less than the
corresponding basic restriction. For the general public, according to these
recommendations, the power absorbed by the whole body should not exceed 0.08 W/Kg.
Locally, the average power absorbed in any 10 grams of tissue should not exceed 2 W/kg.
In the frequency range of radio telephony, the electric field strength reference level for the
general public is 41.1 V/m at 900 MHz and 58 V/m at 1800 MHz.
After presenting the requirements for electromagnetic dosimetry, the author discusses the
basic aspects of numerical and experimental dosimetry, recalling the characteristics of
electromagnetic fields and the coupling between electric and magnetic fields via Maxwell’s
equations. These are the principles for the numerical and experimental quantification of
electromagnetic fields and energy absorption in tissue and, in particular, the specific
absorption rate (SAR).
The second part of this document relates to the role of dosimetric analysis in the
assessment of possible biological effects from radiofrequency fields. The physical principles
of temporal multiplexing (TDMA), power control and discontinuous transmission are
described because they collectively determine the actual power emitted from mobile phones.
The evaluation of induced fields from exposure to base stations is also considered. The
interaction of fields from base stations with people can be analysed either in terms of
incident field or in terms of fields induced in tissues. The latter approach, based on SAR, is
the only approach that is valid when the person is very close to the antenna (“near field”). In
this case, an experimental or a numerical model is developed to allow quantification of the
65
interaction. The former approach, of using incident fields, allows for a comparison to be
made with the reference levels in the exposure guidelines. This approach demonstrates that
the surface power density decreases rapidly as a function of distance from the source.
Beyond a few metres, the induced fields and the associated power densities are significantly
lower than international recommendations. Base station antennas, often designed as an
array of dipoles, focus the energy in one direction, this beam is emitted principally in a
direction normal to the antenna. The metrological problems of on-site measurement
originates from the multifrequency and multipolar nature of the summed emissions from all
the systems that may be present in one location. The use of probes with an integrating
diode detector is not appropriate in this situation. Methodologies based on the use of
selective isotropic antennas covering a wide frequency band, and associated signal
analysis, are being developed.
This article also describes a portable dosimetric system [506] that enables the evaluation of
the electromagnetic coupling between base stations and the human body in less than one
minute. The precision of this technique is 5 to 10% compared to a numerical evaluation
using a full FDTD (Finite Difference Time Domain) simulation with a mesh size of 3 cm at
835 MHz and 1.5 cm at 1900 MHz. The numerical evaluation would require a one hour
computational time. Such a portable dosimetric system can be used to identify rapidly the
spatial region close to base stations where the SAR is in excess of that given in international
recommendations.
The third and final contribution in this section on dosimetry is from Niels Kuster and Nicolas
Chavannes who report the latest progress in experimental dosimetry for the evaluation of
human exposure and for the characterisation and optimisation of exposure systems used in
biological experiments. According to the authors, the evidence for biological and health
effects from exposure to electromagnetic fields is often questionable because of poor or
incomplete dosimetry. This is the case for both in vitro and in vivo experiments. Another
important consideration is the validity of available tools for the analysis and optimisation of
the daily exposure of people [53]. The purpose of this article is to review the state-of-the-art
in experimental dosimetry, bringing out its strengths and weaknesses with respect to the
assessment of fields within the body and in exposure systems used in biological
experiments.
66
In the last few years, numerous systems based on high performance “diode-loaded” field
probes have been described. These are highly specialised probes designed for the
measurement of fields in vivo and in vitro [705], and the determination of field polarisations
[706], etc. Major advances have been realised in terms of spherical isotropy, spatial
resolution, sensitivity, bandwidth, linearity, secondary mode rejection, and precision of
calibration, etc. [704]. The strength of experimental dosimetry resides in its ability to validate
numerical data as it can precisely determine the distribution of fields under realistic
conditions without simplifications or modifications. Weaknesses are, essentially, that it is
restricted to homogeneous or liquid media, its spatial resolution is limited (bigger than 1
mm3), its applicability is limited when dealing with small structures.
In contrast, the strengths of the most viable numerical methods (Finite Difference Time
Domain technique or FDTD) are principally its applicability to non-homogeneous structures,
its ability to produce high spatial resolutions in 3D, and its ability to evaluate the sensitivity of
the results to a number of different parameters (anatomy, posture, tissue parameters, etc.).
Under these conditions, FDTD is perfectly appropriate for the tasks of optimisation of
antenna design. Its primary weaknesses are that electromagnetic simulations require initial
simplifications compared to actual exposure conditions, and also that the FDTD method
does not allow for an assessment of uncertainty in the distribution of internal field [117].
2/ Human Studies
The introduction to this chapter was given by Alain Bardou and Jean-Louis Coatrieux
who provided a general summary of the state-of-knowledge on biological effects from
telecommunication equipment, as described in a report from the Commission of Consumer
Safety to the President of the Republic and the Parliament in 1997 [60]:
· the possibility of induction of brain tumours. Most of the studies gave negative results
(Persson and Salford [762, 764], Adey [11], Juutilainen [426]); the only study with a
different result was that of the group of Michael Repacholi (Royal Academic Hospital,
Adelaide, Centenary Institute of Cancer Medicine, Sydney, Australia), who is currently at
a WHO. The group carried out experiments on transgenic mice, genetically modified to
be predisposed to the development of lymphoma; they showed that “the risk of
developing lymphoma is significantly higher in irradiated mice in comparison with the
control group”, [734].
· modifications in the permeability of the blood-brain barrier, where the results remain
controversial (Prato [10], Salford and Presson [763, 695], Fritze et al[278]).
· effects on pituitary hormones. René de Sèze, having shown that there is a “slight
modification in the level of TSH during a period of a mobile telephone call”; another
possibility is the change in the level of melatonin [211, 212]
· the metabolism of acetylcholine. Lai [480] suggests a possible decrease in the sodium-
dependent uptake of choline and an augmentation in cholinergic receptors. Hossmann
67
[373] reports effects on the neurotransmitter system at the level of variations in the
activity of acetylcholine-esterase.
The contribution of René de Sèze on human studies is mostly concerned with the effects of
mobile phones on hearing, sleep and the nervous system. With respect to sleep, Röschke
and Mann in a study of 12 sleeping volunteers, have shown a slight decrease in sleep
latency (9.5 min. instead of 12.3 min.; p <0.005) and also a decrease in the total period of
REM sleep from 17.1 to 13.9% (p<0.05) [554]. Borbely has also shown a reduction in
waking time during sleep from 18 to 12 min (p<0.05), and an increase in the spectral content
(of ECGs) during REM sleep [40]. The exposure was alternating with stop-go intervals of 15
minutes, with a modulation at 217 Hz as well as 2, 8, 17 and 36 Hz; these frequencies are
found to a small extent in emissions from actual telecommunication systems. The calculated
peak SAR in tissue, averaged over 10 g, was 1 W/kg.
With respect to the nervous system in general, an unpublished epidemiological study [610]
has shown an association between the use of cellular radiotelephones and benign
symptoms that nevertheless affected quality of life (headaches, heating, skin irritation etc). If
such effects are caused by radiotelephones, they must be preceded by a primary
physiological interaction leading to the manifestation of the symptoms, or a pathology, which
could possibly be detected by quantitative electroencephalography (Q-EEG). The results
are variable, but Reiser in 1995 [729] have reported an increase in the spectral content in
several EEG bands. Thuroczy has found contrary results, first in the rat (1995), than in man
[862], while Hietanen found no effect after 30 minutes' exposure [30], as did Röschke's
group after 3.5 minutes [748].
With respect to cognitive tests (memory, attention, vigilance) Preece [715, 714] showed that
choice reaction time was significantly modified, while there was no change in simple reaction
time, vigilance reaction time and the immediate memory of words, numbers or images, or
spatial memory.
Koivisto has found no significant modification in any visual reaction test [446]. Krause has
shown [452] that an exposure to a GSM mobile phone signal during a task requiring the
recall of pronounced words, involving auditory working memory, increased the relative
contributions to ECG in the frequency range 6-12 Hz, with a predominance in the 10-12 Hz
range.
Ulf Berqvist's contribution to this topic addressed mainly the possibility of hormonal and
cardiovascular effects of mobile communication signals, and the possibility of perception of
such signals by hypersensitive subjects.
Concerning hormonal effects, the author referred mostly to melatonin as it has different
modes of action and is implicated in the inhibition of tumour growth as well as in the
nycthemeral cycle. Some studies have looked at variations in the level of melatonin, using
different frequency sources [216, 555], without relating observed differences to exposure.
Other studies have investigated levels of cortisol and other hormones, reporting some weak
effects due to exposure [555, 213]. It should also be noted that there are some rather
contradictory results relating to cortisol which, Berqvist thinks, can be considered as being
without biological significance.
Braune [106] has investigated changes in circulatory parameters. Diastolic arterial pressure
in man increased by 5 mm Hg with GSM exposure and systolic pressure increased by
68
10 mm Hg. No change was observed in cardiac rhythm or in capillary perfusion. It should
however be noted that this study has been criticised for its lack of randomisation (the
exposure always taking place after the placebo) and also for the fact that it was conducted
with a simple, not double blind, design. However, these results have been discussed at
length in view of their possible relevance to the headaches reported by some people (see
the work of Hansson Mild in the epidemiology section of this report) and also
cerebrovascular events. Another study has not however found any changes in the
circulation in the brain after exposure to GSM signals [862].
The ability to detect radiofrequency signals emitted from mobile phones or their base
stations has been studied in certain subjects who presented themselves as suffering from
electromagnetic hypersensitivity. Definitive recent studies carried out in Finland have shown
that these individuals were not able to detect GSM signals from mobile phones.
The author concludes on this point, saying that these studies are still ongoing and that some
aspects must be followed. This would include study of subjects from different age groups,
and people suffering from variety of symptoms from using a mobile phone, as well as people
suffering from electromagnetic hypersensitivity.
Genetic expression
Several studies, for example those of de Pomerai et al [208], show a possible increase in the
heat shock protein c-fos suggesting the possibility of a very localised rise in temperature.
According to the author, this line of research deserves further attention and an independent
replication.
An effect on neurotranmitters has been reported in several isolated studies from different
laboratories. Acetylcholine is an important neurotransmitter associated with learning and
memory in different parts of the brain. Exposure to electromagnetic fields appears to alter
69
cholinergic activity in the hippocampus and the frontal cortex [473, 447]. A prolonged
exposure appears to bring about an autoregulating increase in cholinergic receptors [480];
these effects are correlated with effects on behaviour. It has been remarked [476] that
similar modifications can be induced by stress factors such as noise or confinement.
Current thoughts lean towards the possible mediation of corticotrophine “releasing factor”
and the intervention of endogenous opiates [479, 482, 490]. Different modifications in
behaviour and learning function can be observed under different types of irradiation [485,
912, 810, 715, 445]. The author mentions, without specific reference, that recent studies
suggest that microwaves can have specific effects on cognitive performance in man; he also
thinks that complementary studies should be made on the subject, particularly on primates.
Effects on carcinogenesis
One important concern is the lack of replication [775] of the experiments of Lai [549] on
damage to DNA after exposure to microwaves. Supplementary studies carried out in vitro
[548, 547] confirmed that the effect could not be replicated. It is also important to note, that
other studies using different indicators of DNA damage [73, 778, 893, 895] tended to
absolve the mobile phone from any genotoxic effects.
The great majority of studies of the incidence of spontaneous tumours have provided
negative results [160, 870, 272, 271, 842]. According to the author, the results of the study
of Repacholi [734], carried out on transgenic mice cannot easily be extended to non-
transgenic animals, including man.
Studies from about twenty years ago have reported effects on promotion and progression of
tumours induced in the skin of mice using benzopyrene. The promotion effect has been
studied very specifically in some recent studies on chemically-induced tumours in the colon
of mice [485] and in the liver of the rat [391, 392]. There was no effect on the incidence,
number and size of tumours. The conclusion was the same for exposures of brain and
medulla tumours in the rat, whether these tumours are spontaneous or chemically-induced
using ethylnitrosourea (ENU) [15, 942].
Few studies have looked into the progression of tumours induced by injection of cancer cells
in healthy animals. Whilst most of the studies show that exposure has very little effect on
the growth of this type of tumour [765, 660], one study did describe an increase in growth
due to exposure to microwaves [900].
Possible effects on melatonin have also been studied. Because this hormone acts as
oncostatic agent, a reduction may lead to some increased risk of cancer. Two studies
reviewed by the author do not show any effect on the level of melatonin after exposure; two
studies even showed a slight increase in saliva melatonin [39, 392]. It should be noted that
in this same work are two references to papers by René de Sèze showing a possible
variation of melatonin level following use of a mobile phone [211, 212].
The author concludes that, taken as a whole, the data on carcinogenesis leave little room for
the hypothesis of an increased risk of cancer due to exposure to radiation emitted by mobile
phones. However, the few studies reporting a positive effect prevent us from indemnifying
completely mobile communications (even if it is possible to criticise the poor experimental
methodology or the difficulty of extrapolating to man); this residual scientific uncertainty
justifies the need for further, high quality, research.
Effects on reproduction
The teratogenic and testicular effects of hyperthermia are well known, as is the fact that heat
from exposure to microwaves can induce a higher level of intrauterine mortality and foetal
defects, as well as a more-or-less temporary sterility [415. 665]. Because the thermal effects
from mobile phones are extremely weak, one should expect an absence of effects at the
70
level to which the public are exposed. However, a study carried out on mice exposed in a
commercial antenna park showed a rapid decrease in fertility as well as decrease in the size
of the embryos [545]. The absence of a control group, and the fact that this type of result
can occur in a stressful situation, calls into question the validity of these results. This type of
study should be carried out in laboratory under well-defined experimental conditions.
The contribution of Jukka Juutilainen deals with in vitro studies on possible carcinogenic
effects of radiofrequencies. In its introduction, the author points to the importance of the
determination of the SAR in this type of study, in order to distinguish thermal from non-
thermal effects. Genotoxicity is related essentially to DNA damage. Physical agents that
can cause damage to DNA are often carcinogenic: in vitro genotoxicity is often used as a
pre-screening process for the identification of potentially cancer-initiating substances. Some
non-genotoxic substances can also have carcinogenic effects (promoters), either by
preventing the repair mechanism of DNA, or by suppressing the protective responses
towards oxidative stress, affecting apoptosis or by stimulating cellular proliferation.
Most of the studies in the literature suggest that radiofrequencies have no direct genotoxic
effect [113]. However, two studies provide positive results: that of Maes et al, at relatively
low levels of SAR [542] and that of Phillips et al that suggests a specific effect due to
modulation (TDMA and iDEN) at low exposure levels.[160]. Whilst the experiment of Maes
can be criticised for the lack of control over exposure conditions, the results obtained by
Phillips appear interesting. The author of this presentation thinks that effects at low
exposure levels should be confirmed by independent studies before they can be considered
further.
Several studies have not shown any increase in DNA damage from a combination of a
known genotoxic agent and exposure to radiofrequencies; no effect has been observed on
DNA repair mechanisms also [701]. Some positive results have been obtained [544, 543,
781]. It is interesting to note that positive results have been obtained only if the exposure to
radiofrequencies precedes the action of the mutagen and not if it is simultaneous or
afterwards [544, 543]. Scarfi et al [781] have also shown effects from pre-exposure to
radiofrequencies, but at high SAR levels so that the possibility of thermal effects cannot be
excluded. Nevertheless, according to the author, the combined effect of radiofrequencies
and genotoxic substances must be the subject of further research.
Two studies suggest that genetic expression could be modified by an exposure to low level
radiofrequencies [323, 402]. These two studies giving positive but different results, one
showing an effect on the fos proto-oncogene , the other on the jun proto-oncogene, and they
cannot be directly compared because of the different cell types used as well as the
differences in the level of exposure. Although these two studies show a possible positive
effect, the author considers that, in practice, their significance is not very clear.
Three models for in vitro transformation show a heightening of a chemical promoter (TPA)
[49, 50, 51], but these three studies, originating from the same research group, have not
71
been replicated independently. A study by Cain et al, shows no effect at a low SAR level
[125]. However, as previously noted, the differences in exposure parameters and
methodologies make direct comparison between the different results impossible.
· Available data do not suggest direct genotoxic effects, but studies on indirect effects and
other effects must be pursued.
· The reported studies used different biological models and exposure parameters, making
it difficult to carry out a comparison.
· There is no evidence in the studies carried out to date to prove an effect of amplitude
modulation, however, it is not possible to exclude this either.
4/Epidemiology
In her introduction to the subject, Elisabeth Cardis recalled that, before mobile telephones,
the two main sources of exposure to radiofrequencies were occupational and domestic and
that the information on health hazards at that time were limited. Such information is
considered today to be totally inadequate to determine the presence or absence of an
association between exposure to radiofrequencies and effects on health. The author
concludes her introduction by citing two epidemiological studies dedicated to exposure of
mobile phones, one by Kjell Hansson Mild on symptoms associated with the use of a mobile
phone and the other by Joshua Muscat et al more specifically targeted to brain tumours.
The presentation of Kjell Hansson Mild described two epidemiological studies: one dealing
with subjective symptoms and brain tumours, the other addressing the possible induction of
brain tumours. The author underlines that since 1995 many people have reported suffering
from a variety of subjective symptoms such as migraine, discomfort, heating of the ear and
difficulties of concentration while using a mobile phone [667, 365, 611].
A large epidemiological study, including 12,000 users in Sweden and 5,000 in Norway, was
set up to evaluate the incidence of this type of symptom. A comparison between users of
GSM and NMT shows that the latter complain much more of a sensation of heat behind the
ear than do GSM users. The same conclusions apply to users in Sweden with respect to
headaches and fatigue [610].
The author described the work carried out by Hardell et al [346] on possible induction of
cerebral brain tumours, in which he himself participated. This was a case-control study of
233 people suffering from brain tumours and living in Uppsala and Stockholm. An increase
in the risk of brain tumour as a function of mobile phone use was observed between tumours
in the temporal and occipital lobes of the brain of subjects who use the phone on the same
side of the head. This increase in the risk was observed only for the NMT system, the
observation time being too short to include effects from GSM. These results, not statistically
significant, are based on a small number of observations (13 cases, 10 with malignant
tumours, 3 benign of which 9 were exposed to NMT, and 3 to both NMT and GSM and only
72
one to GSM) The conclusion of the author is that an increase in the risk of brain tumour in
the anatomical regions where the mobile phone is used must be examined in the future.
This is taken into consideration in the various exposure regulations by an additional safety
factor of 5 compared to the exposure limit recommended for workers and in controlled areas.
The risks to health are under control.
However, if we consider this situation, we can see that it refers only to mobile phones. Their
integration in the totality of telecommunication developments going on around is not
considered. In fact, in the medium term, the mobile phone will be integrated in a
constellation of networks of wireless devices including “Wireless Local Area Networks”
(WLANs) such as office networks, networks for the control of the domestic environment and
even body-mounted WLANs installed on the person itself. This development is likely to lead
to a significant increase in the number of emitting devices and in particular in the number of
low power devices, some of which may be placed in direct contact with the body. However,
the intercommunication between networks will probably take place at higher frequencies, of
the order of tens of GHz: that is in the millimetric wave region.
· the placing on certain parts of the body of low power devices that may be capable of
direct coupling to reactive components in the skin.
73
· studies of field distribution inside the body show that penetration decreases with
increasing frequency, correspondingly increasing absorption in the superficial areas of
the skin
· several biochemical, cellular, physiological and therapeutic studies have shown an effect
from such waves. The conclusions from these studies are not self-consistent but,
collectively, these studies seems to imply that such effects exist even if for now we do
not know the relevant parameters.
· a certain number of studies have shown the possibility of resonance effects at certain
frequencies, although these results are considered controversial and are the subject of
discussion.
In conclusion, the author considers that it is important to initiate biological and medical
studies to evaluate closely the real, and possibly physiopathological, effects on man from
millimetric waves and from the increase of the “electromagnetic environment” in which man
is destined to live. The author thinks that this should take place simultaneously with the
development of the technology.
In his contribution, Jörgen Bach Andersen treats the impact of technological evolution on
the biological effects of mobile phones. The author considers the relationship between the
continuous evolution of microelectronics, the popularity of mobile phones and the “global
internet” to mean that the growth in the number of mobile phones will continue. One of the
major changes to be expected is the increase in the amount of data transmission (images,
electronic commerce, news, commercials, publicity, etc) compared to the transmission of
speech. The main requirement for this change of utilisation is the ability to transmit data at
high rates: specifically the transmission rate should increase from 9.6 kb/s to several
hundreds of kb/s, reaching 2 Mb/s for UMTS or IMT-2000 terminals. This evolution has
already begun with GPRS or EDGE, an incremental modification of the GSM family. This
means that the TDMA (Time Division Multiple Access) system will persist. New spectrum
has just been allocated in the 2 GHz frequency band for UMTS, but this UMTS system will
be a new departure in that it will be a code division system (W-CDMA): the signal will be
transmitted at constant power and will not have the repetitive nature of the TDMA signal.
The mode of use of UMTS terminals will have implications for biology and health. The
terminals, which will be video-enabled, will be used at a reasonable distance from the head
thus reducing the direct coupling with the brain that occurs with current handsets. However,
the voice communication mode will remain an important component of the new UMTS
phone.
At high data rates, transmission will be almost permanently at the maximum available power
of 2 Watts, which is not the case for current mobile phones. The specification of maximum
transmission power will have to take into consideration possible biological interactions. An
interesting new area in wireless communication is the increasing use of small low power
transmission devices (of the order of milliwatts).
Many devices will be built into every-day objects to achieve connectivity without cables to,
for example, a printer or a digital camera. These will be low-power devices operating in the
ISM band at a frequency of the order of 2.45 GHz. The use of hand-held mobile phones
close to the ear, at low power, will be reduced. The main mode of use will be at high power
but at a reasonable distance from the body.
74
Opinion of the group of experts on the report to the Academy of Sciences: this
document provides a snapshot view of the state-of-scientific-knowledge available in April
200017. The different areas of research relating to possible relationships between mobile
phones and health are clearly presented and comprise in particular:
In general these studies provide evidence for numerous biological modifications without
allowing any health consequences to be attributed to them. With respect to the hypothesis
of a carcinogenic risk, the review of all studies leas to the conclusion that it is very unlikely
that radio frequencies have a direct genotoxic effect. However, several points need to be
further clarified, in particular:
· a co-carcinogenic effect suggested by the results of several studies (Maes et al., Scarfi
et al.)
· changes observed in the levels of oncostatic agents (where a deficit can lead to an
increased risk of cancer), such as melatonin (de Seze et al.)
· changes observed in the level of proliferation agents such as thymide (increase in the
synthesis of DNA (Stagg et al.)) or ornithine decarboxylase (ODC) (Stagg et al, Litovitz et
al., Penafiel et al.), which are key enzymes in the synthesis of polyamines. The group of
experts agrees with the conclusions of Jukka Juutilainen who, in reporting these studies,
qualifies them as potentially important, and consider that this field of study should be
actively pursued
The group of experts observed that the issue of base stations, despite it being the subject of
media attention, has been considered only superficially in this work.
The general conclusion is that, while the results of the studies presented do not provide
evidence of an actual health risk, it remains necessary to evaluate possible implications of
the biological effects observed. Several international research projects, cited in the report to
the academy, are actually pursuing this aim.
This report was initially mandated by STOA18 of the European Parliament. It deals with the
whole of the non-ionising electromagnetic spectrum and in particular the low frequencies
(ELF) that are relevant to power distribution and the radiofrequencies that are relevant to
mobile telephony.
17
the document was published in January 2001 but it reports on work presented to the Academy on
th th
the 19 and 20 of April 2000
18
Scientific and Technical Options Assessment
75
The information for the report was obtained from different sources: analysis of information
available on the internet, sending a questionnaire to 45 experts, analysis of international
reports and interviews with 25 people; the final revision of the report was undertaken by 3
international experts (U. Bergqvist, M. Repacholi and B. Veyret).
The report deals equally with research and risk management. The following points are
considered specifically:
Special attention must be given to “co-factors” that can increase the sensitivity of a biological
system to electromagnetic fields. Three categories of co-factors are considered:
The question of the possible vulnerability of children is also considered. If no specific effect
has been observed in relation to mobile phones and base stations it is, according to the
report, in part due to the very small number of specific studies that have been carried out.
The question is complex because of the lack of objective data. However, it appears that the
additional factor of five reduction in the limits compared to occupational exposure is
adequate for the protection of children. To tackle this problem more fully, more objective
data are needed.
76
· The scientific data available do not justify a revision of the recent European
Recommendation. It would even be desirable that this recommendation becomes a
directive.
· Several research areas must be given priority: possible effects of low-level, long-term
exposures; possible effects on populations that are considered a priori vulnerable
(children, the elderly, sick people); clinical studies of symptoms; studies on mechanisms
of interaction.
Conclusions of the group of experts on the Essor-Europe report: This report covers most of
the electromagnetic spectrum and provides, in a tabular form, a summary of the main
scientific data. It is not a comprehensive compilation, and its approach is different from that
of the other reports considered. The objective of this report was to extract the main thrust of
the interpretation of scientific data and to provide recommendations and options. Its main
feature of interest is that it was written after consultation with a very large number of players
in this field, from academia and from industry.
The conclusions relating to the need to pay further attention to the exposure of children are
reasonable, despite the lack of an explicit scientific basis.
This report has not been disseminated very widely because of strong political reaction to its
conclusions. This is regrettable, because it complements, in a useful manner, the other
recent international reports.
The Committee on Man and Radiation of the Institute of Electrical and Electronic Engineers
has produced two reports on the impact on human health of mobile phones and their base
stations.
Field measurements have shown that the exposure of people from mobile phones and other
wireless systems is, in general, within the recommended limits. Some of these systems may
perturb the function of active medical implants, such as cardiac pacemakers, when they are
placed at very close contact. Wearers of such implants must seek advice from their doctor
with respect to the risks of using telecommunication devices.
77
The licensed frequencies used in the United States are described. The power emitted and
the distance at which the equipment is used should be defined: hand-held equipment is low-
power and used near the body, while other mobile equipment operating at high powers is
used at greater distances.
The scientific basis for the determination of limit values is presented in chapter III “exposure
limits”. A non-verified hypothesis is that the perturbation of learning in primates, occurring at
an SAR of 4 W/Kg, can be extrapolated to man. Despite numerous scientific speculations,
no mechanism has yet been established through which electromagnetic fields at levels
below the recommended values could cause biological insults with pathological
consequences.
Conclusions: The SARs produced by cellular mobile phones and other radio
communication equipment do not exceed the recommended limits set by standardisation
bodies. The scientific evidence to date does not show any risk to health from these devices.
There is a possibility of interference when they are used close to active implants.
Comments of the group of experts: the follow-up period is in fact too short in the
Rothman study as well as that of Hardell, it is expected that the latter will be extended to
1000 volunteers.
II Health effects associated with base stations used for radio communications
In most cases, public exposure to RF fields from base stations is clearly lower than the
recommended limits. In some cases, when antennas placed on rooftops are mounted such
that they are easily accessible, the exposure levels could be exceeded. Access to such
sites should be prevented or at least there should be a warning sign. Personnel who are
likely to be exposed in the close vicinity of the antenna must follow operating procedures,
including where appropriate the use of dosimeters or alarmed devices. Alternatively, if
maintenance personnel absolutely need to get close to the operating antenna, they should
wear protective clothing to reduce their exposure. Moreover, exposure to the main beam
may result in interference with active implants such as cardiac stimulators. People fitted with
such implants must seek the advice of their doctor prior to working close to antennas.
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There are two criteria for the siting of base stations: providing coverage within a cell and
producing the necessary traffic capacity. When a system is being extended, base stations
are sited in smaller and smaller cells to increase the capacity of the network, however they
will operate at lower power in order to limit possible interference between base stations. The
height of the antenna is critical: it is typically between 10 and 100 m.
In the United States, the Federal Communications Commission (FCC) regulates base station
power levels. The effective radiated power is limited to 500 watts per channel; a base
station may use 21 channels or more per sector (sometimes 96). In towns, many base
stations would use only 16 watts per channel. Inside certain buildings, micro-cells operate at
less than one watt per channel.
The beam radiating from a base station antenna is narrow in the vertical plane and wide in
the horizontal (typically 6º in height and 120º horizontal aperture). Outside the main beam,
as in the case immediately beneath the antenna, the intensity of RF fields is weak. The
maximum field to which an individual would normally be exposed is at the point where the
main beam reaches ground level, usually between 50 and 200 m from the base of the tower.
This maximum level is already far below the recommended limit. Inside buildings, the field
intensity is less than outside, whether the building is directly below the antenna or in its
neighbourhood.
Conclusions: the levels to which the public are exposed in the neighbourhood of base
stations are significantly below the recommended values. Base stations do not constitute a
health risk for the population in general, including the elderly, pregnant women and children.
The group of experts is in agreement with the conclusions of COMAR on base stations
The methodology is similar to that adopted by the group of French experts. The great
diversity of research protocols is pointed out, and it is recommended that in order to reach a
conclusion it is necessary to take into consideration all studies based on the same
hypothesis and not only the result of a single experiment.
Considering firstly occupational exposures to RF (other than mobile phones), the authors of
the report observed that many effects are associated with temperature rises of 1 to 2º C
(effects on behaviour, on the neuromuscular system, performance deficits, etc….).
19
” Eloverkanslighet och halsorisker av elektriskaoch magnetiska falt. Forskningsoversikt och
uivardering”. Slutrapport fran arbetsgruppen vid. Radet for arbetslivforskning.
Ulf Bergqvist, Lena Hillert and Elisabeth Birke, November 2000
79
By contrast, with respect to exposures below the reference levels, that is exposure without
thermal consequences, there is no evidence to date of an increased risk of cancer either
from experimental animal studies or from epidemiological studies. Even under worst case
communication conditions, the exposures of mobile phone users are always below the
reference levels. Some studies have reported biological effects, but the scientific evidence
does not support health consequences from the use of mobile phones.
Part of the review is dedicated to the problem of RF hypersensitivity. The report concludes
that it has not been possible to associate any particular RF parameter with the reported
problems. The idea is not dismissed that a combination of internal factors (related to the
autonomous nervous system) or external factors (physical, chemical and/or psychosocial)
can, for some people, produce these unexplained effects. The fact that this can lead to
public health problems, and deserves special attention, is underlined.
In conclusion, the report points to some studies whose aim is to verify that these
conclusions, based on work carried out at RF frequencies in current use, can be
extrapolated to other RF frequencies associated with new radio communication
technologies.
Contribution of R. Santini
R Santini, a university lecturer from INSA in Lyon, holds the view that current standards are
inadequate and that long-term health effects should be considered. He has recently carried
out a survey of low statistical significance on students in his institute. The purpose was to
determine whether users of mobile phones were more likely than non-user to have
symptoms such as headaches, fatigue, etc. The results of the study, which are essentially
negative, have been submitted for publication.
Contribution of G. J. Hyland
The presentation of G J Hyland focused on a theoretical mechanism to explain possible
health effects of RF: biocompatibility by electromagnetic compensation. Since the
colloquium, G J Hyland has published this theoretical perspective in a prestigious
international medical journal (G J Hyland, Physics and biology of mobile telephony. The
Lancet 2000; 356:1833-35); this article is discussed elsewhere in this report (cf. reviews of
recent articles).
Contribution Of G. Carlo
G Carlo was the president of Wireless Technology Research (WTR) which was a private
organisation charged with developing for the US a large, industry-financed, programme of
research. In the colloquium, he summarised the main results obtained within the framework
of the WTR programme. These results, (some were still provisional at the time) extended
over several fields of studies including genotoxicity, particularly in vivo, and epidemiological
studies. These results will not be reviewed at this stage, as they are mostly published and
80
are discussed elsewhere in this report. However, it is important to point out that G Carlo's
main conclusion, taking into consideration the scientific results he reported, is that mobile
phones present an actual health hazard and that a public health approach to the issue must
be taken. This would require research and observations based on the systematic gathering
of data (such as complaints from users, cohort studies of users, studies on children and
pregnant women), studies on the adequacy of SAR, on effects on the brain, and on the
behaviour of mobile phone users. Finally, G Carlo proposes recommendations regarding
the use of mobile phones that fall within the concept of “prudent avoidance” even though this
term is not used explicitly.
Contribution of B. Veyret
The main purpose of this contribution was to present the French "COMOBIO" research
programme; this programme is detailed elsewhere, see chapter V-1..
Contribution of M. Bastide
M. Bastide (Laboratory of Immunology and Parasitology of the Faculty of Pharmacy at
Montpellier) presented the results of research on effects on embryonic mortality and the
hormonal system in animals from exposure to electromagnetic fields from mobile phones.
These results show very significant effects on the embryonic mortality of chicks and on
stress hormones in young mice; these results are novel and without parallel in the
international scientific literature. For this reason, they arouse a great deal of interest, and
require independent replication before they can be taken into consideration, moreover the
experimental protocols used in the study are described very briefly and do not correspond to
realistic exposure conditions.
In the first part of the report, Cindy Sage, a private consultant, presents to the Transport and
Environment Committee of the Scottish Parliament her views on what information the
committee should consider in formulating advice “based on the present state of knowledge”.
In the second part of the report, she reviews the scientific articles that she considers
important and which should be taken into consideration.
Comments
The development of radiocommunications has resulted in a long-term cumulative exposure
of people without precedent in human history. There is evidence that biological effects occur
from exposure to radiofrequency radiation (RF). There is no conclusive scientific evidence of
the safety of such exposures, and some studies suggest that serious health effects can
occur due to cumulative or chronic exposure. The committee should advise “public health
precaution” and urge that the exposure of people all over the world be kept to a minimum
until further research can clarify risks. The committee should also advice that cumulative
81
exposure of the public to radiofrequency fields can eventually be dangerous on the basis of
existing scientific results.
The Precautionary Principle is frequently promoted by public health advocates given the
massive public health risk that is possible if exposure is carcinogenic or has other adverse
bioeffects. Even if the risk to individuals is slight, the sheer number of people around the
globe who may be at risk makes this choice of policy of utmost importance. The virtual
revolution in science that is taking place now is based on the growing recognition that non-
thermal and low intensity RF exposure can be detected in living tissues and results in well-
defined biological effects. The biological effects that are reported to result from RF exposure
include changes in cell membrane function, metabolism, cellular signal communication,
activation of proto-oncogenes, and cell death. Resulting effects reported in the scientific
literature include DNA breaks and chromosomal aberration, increased production of free
radical, cell stress and premature ageing, changes in brain function including memory loss,
learning impairment, headaches and fatigue, sleep disorders, neurodegenerative conditions,
reduction in melatonin secretion and cancer.
According to Cindy Sage, the committee for transport and environment should require the
wireless industry to provide complete, honest and factual information to consumers, to
independently monitor any health effects of mobile phone use, and to strongly urge public
participation in policy-making and regulatory processes for RF exposures and technology.
The United States has a policy of “post-sales surveillance” for cell phones: that means that
cell phones can be sold to the public, and only after years of use will there be studies to
characterise what health consequences have arisen as a result. In short, “we are the
experiment” for health effects. The committee should reject post-sales surveillance as
inadequate to protect existing users.
While the scientific community continues to study and understand the physical bases for
electromagnetic effects on living systems there is little to protect or inform the public about
consequences of blind belief in these new technologies. For all the potential good that such
technologies bring to us we must be vigilant about possible undesirable consequences.
Comments of the group of experts: numerous studies have failed to demonstrate any risk
to health. It appears that, for this author, whilst a serious effect has not been demonstrated,
the studies are not conclusive. It is already possible to confirm that if a risk exists, it must be
weak, because of the many studies demonstrating negative results. A non-thermal
exposure can be detected in living tissues, but it is rather presumptuous to say that the
biological effect that results from it is well defined. Effects on membrane function are not
explicit, which makes it difficult to guess what other results the author refers to. Cellular
death has not been reported except at very high thermal levels.
As will become clear from the comments on the studies cited in reference, the effects
referred to are either far from being confirmed, or due to an exposure with characteristics
very different from those of radio telephones: radar pulses of high peak power or emissions
of high average power.
Many studies have been carried out in the United States in the last few years; the results of
epidemiological studies published to date are rather reassuring.
82
that occur in living systems in response to RF is increasingly understood by the scientific
community as a mature multidiscipline. Disease is not the only end point of this research,
there are potential medical implications that offer an unparalleled opportunity for healing and
well being.
Comments of the group of experts: effects can be observed in all biological systems,
some weak effects are reproducible but the majority are not, nor are strong effects in
particular. Effects in the extremely low frequency range (ELF) are more consistent than
those reported in the RF range.
Effects on DNA
The author has reviewed the work of Lai on DNA breaks evaluated by comet essay after
exposure to RF fields at 2450 MHz, and those of Jerry Phillips. Phillips suggests that the
rate of DNA repair could be altered by RF. He found an identical effect at extremely low
frequencies (ELF) of 100 mT at 60 Hz. He postulates that ELF magnetic field exposure can
affect both augment DNA damage and inhibit repair mechanisms, and lead to cell death
(apoptosis).
Conventional wisdom has traditionally held that microwaves are not genotoxic unless high
temperatures are produced.
Blank and Goodman (1997) postulate that the mechanism of EM signal transduction in the
cell membrane may be explained by direct interaction of electric and magnetic fields with
mobile charges within enzymes. Recent studies on DNA show that large electron flows are
possible within the stacked base pairs of the double helix of DNA molecules. Therefore
gene activation by magnetic fields could be due to a direct interaction with moving electrons
within DNA. Electric fields as well as magnetic fields stimulate gene transcription and both
fields could interact with DNA directly. Previous work on a heat shock protein by Goodman
and Blank, cited in the 1997 article, show that one cellular response to EM fields is activation
of the same stress response system seen in heating, but at very much lower energy than the
response to heat shock. (see § “gene transcription and induction”).
Comments of the group of experts: The hypotheses of Phillips on apoptosis have not
been confirmed experimentally. Moreover, they relate mostly to ELF as do the hypotheses
of Blank and Goodman on the interaction with free charges either in enzymes or with DNA
molecules.
Maes et al (1995) reported that whole-blood exposed to the radiation from a GSM base
station showed increased chromosomal aberrations when placed within a distance of 5 cm
or less with 2 hours exposure. Combined effects of 954 MHz radiation and the chemical
mutagen mitomycin C (MMC) were studied by the same authors using human lymphocytes
(reference not cited: Maes et al, 1996). Samples exposed to an estimated SAR of 1.5 W/kg
and to MMC showed a significant increase of one form of chromosomal aberration;
translocation (sister chromatid exchange) by comparison to MMC only. Single strand DNA
breaks were also reported.
83
Comments of the group of experts: the study of Maes et al, 1993 was carried out at
75 W/kg, an SAR that cannot be qualified as non-thermal, even with a continuous thermal
control to maintain a temperature of exactly 36.1ºC. The agreement with other studies not
cited by Sage is not entirely evident in the summary of articles published by Information
Ventures in their EMF bibliographic database: Leonard indicates that most of the studies on
mutagenicity were negative except at thermal levels, but that exposure at non-thermal level
could activate other mutagenic agents such as UV or chemical substances. Similarly, the
study of Ambrioso showed a mutagenic effect, at a clearly thermal level of 100 W/kg with an
increase in temperature of 5º C.
In his study of 1995, Maes states clearly that the observed differences are not significant. In
the 1996 study that combines exposure to RF and that to a mutagen: mytomycine C, the
results indicate a significant effect of MMC compared to microwaves only, but it has not
been shown that it is significant the other way round as well, that is MMC plus microwaves
compared to MMC only.
Comments of the group of experts: the magnitude of the effect observed is a factor of 2;
the increase in ODC activity in tumour cells (considered a promoting effect) is of the order of
a factor of 400 to 500.
Comments of the group of experts: the resulting SAR is not given in this report. One can
assume that Fos is used instead of c-fos.
Stress response
Daniells et al (1999) found that some worms responded to microwaves as they would
respond to heating or to the presence of a toxic chemical substance. The model used
shows that lower intensities induced the highest responses (the opposite of simple heating).
Microwave radiation caused measurable stress and protein damage within cells (induction of
heat shock protein) comparable to damage from metal ions, which are known to be toxic.
Comments of the group of experts: it is important to specify the SAR obtained and the
amplitude of the corresponding response. Similarly, in the comparison with toxic metallic
ions, it is important to specify the equivalent concentration of the magnitude of the toxic
effect produced.
84
Adey (1993) has given a summary of explicit effects of microwaves at the cellular level that
support the concept of an athermal effect. He has discussed the importance of free radicals
in a number of pathological phenomena such as neurological diseases, cardiovascular
diseases or cancer. Microwave exposure at athermal levels may act as a cancer promoter.
He recommends that the biological effects of low-level microwaves require further
investigation particularly in the light of non-linear non-equilibrium co-operative processes.
Comments of the group of experts: calcium ion equilibrium is very important, but its exact
concentration is not very critical compared to the intra- and extra-cellular concentrations of
sodium and potassium, for example. Only very large changes in concentration, of the order
of 100 to 1000, are associated with cellular functions such as secretion, contraction, the
generation of action potentials, division or differentiation. When the variation produced by
microwaves are of the order of 50 to 100% (a factor of 1.5 to 2), it is not possible to speak of
“changes to cellular functions”, as a response induced by the exposure. There are only very
weak fluctuations in magnitude compared to spontaneous variations that can be observed in
these systems.
It is actually very doubtful that Adey would have written that “the exposure to microwaves at
athermal levels can have the same effect as cancer promoters”. Even if that was the case,
which is not been verified, this statement was not supported by any evidence.
Veyret et al (1991) found a significant change to the immune system from exposure to
amplitude modulated microwaves with an SAR of 0.015 W/kg.
Elekes (1996) found a slight increase in the production of antibodies in male mice (but not in
female!) with exposure to amplitude-modulated RF. The authors postulate that the very
weak effects observed may be due to the very short exposure time.
Comments of the group of experts: the magnitude of the biological effects produced is
not given in the Sage report. In the study of Veyret et al (1991), the variations observed
were on the concentration of antibodies produced by immunisation and are at most 50%
either way. Compared to variations by a factor of 1000 to 10 000 that take place during
slight inflammation of the throat this effect is not biologically significant, and has no health
consequence even if it is statistically significant and the mechanisms are of fundamental
interest. The same argument might be applicable to the work of Lyle and Elekes, but this has
not been verified. The comment by Sage relating the magnitude of the biological effect and
the duration of exposure seems to suggest a cumulative effect that has never been
demonstrated. By contrast, in certain studies such as those by Lai for example, the effects
appear to be rather “cyclic”, positive at one time than negative a few minutes later, without a
continuous increase as a function of exposure time ever having been observed.
85
Salford has shown a leakage through the blood-brain barrier produced by RF at 915 MHz,
either pulsed or continuous. Further research is needed to demonstrate whether or not this
constitutes a risk to health. At least 10 references cited in his article report effects on the
blood-brain barrier by RF.
Comments of the group of experts: the work of Salford is contradicted by the results of a
large number of other studies (Hossmann, …), but also supported by some others (Albert,
1977), although that was at higher power. Most of the studies carried out at that time did not
include an evaluation of the SAR. Some of the references relates to high-power exposure.
The molecules identified in the leakage are molecules that are normally present in the brain
but usually at lower concentrations.
Cancer
It has been demonstrated that the electromagnetic fields produce biological effects, at all
levels of the organism, that can have deleterious health consequences. The basic functions
that control proper cell growth, proliferation, immune surveillance and toxin protection are
shown to be adversely affected in many cases at environmental levels of exposure. In
human and animal studies it has been shown that there is a relationship between exposure
and certain cancer conditions. The major concern with mobile telephony is its rapid growth
around the world, and the increasing evidence of brain tumour.
Guy et al (1984) made a long term study of rats exposed throughout their lifetime to
450 MHz RF at a low power density (1 mW/cm2; SAR of 0.15 to 0.4 W/kg). Numerous
previous studies did not address the question of risk to human health from low-level
exposure. He reported that the number of primary malignant tumours was (significantly)
elevated: four times higher in a group of exposed animals compared to the control group.
Repacholi et al (1997) found 2.4 times more lymphomas in mice exposed for 8 months to
fields similar to mobile telephony compared to the control group.
Hardell (1999) reported an increased risk of malignant tumours of the brain in analogue
mobile phone users, on the side of the head where the telephone is usually used.
Adey (1996) found a protective effect on brain tumour in rats, however this result was not
statistically significant.
Comments of the group of experts: the mice in the Repacholi study were transgenic, that
is genetically modified to produce lymphoma. If the results of this study were confirmed, it
would be important to study more carefully the possibilities of extrapolating these results to
man: two replication studies are ongoing. In the studies by Hardell and Adey a non-
significant modification does not mean a risk, or a protective effect, but rather the practical
impossibility of reaching a conclusion. In contrast to the interpretation by Sage, Hardell
himself describes his study as not showing a risk. The work of Adey was published in 2000.
Hocking (1998) has also studied the occurrence of symptoms in man, reported to be more
common with GSM phones than analogue phones.
Comments of the group of experts: given that there is an appreciable heating from
telephones, probably more significant with analogue phones operating at 600 mW compared
to GSM phones operating at 125 or 250 mW, the sensation of heat or even headaches may
86
be expected. Fatigue should be studied further. The results of Hocking are rather
surprising, showing a predominance of symptoms with GSM phones.
Lai (1994) has written a review of the normal function of the nervous system and of the way
in which it could be influenced by RF. Changes in behaviour could be the most sensitive of
the effects of RF exposure.
The movement of calcium ions in brain tissue is altered by RF. Calcium ions control
numerous functions in the brain and the body, including the secretion of neurotransmitters
and their action at the level of receptors, and all such modifications could have implications
for health.
Comments of the group of experts: only changes above the “physiological noise level”,
that is the spontaneous variation of the parameter under consideration, are capable of
having any repercussion on health.
Psychoactive drugs
Changes in neurotransmitter function may occur under the influence of psychoactive drugs.
Lai has given some examples and concludes that endogenous opiates are activated by RF
(Lai, 1992, 1994b).
Comments of the group of experts: The hypothesis of Lai is that the action of RF on
endogenous opiates is an initial step that triggers an avalanche of other biological reactions
Serotonin
Serotonin activity is reported to be affected by RF hyperthermia (Lai et al 1984 and
Panksepp, 1973 cited by Lai, 1984). Man can suffer from a number of symptoms, known
collectively as serotonin irritation syndrome, that includes anxiety, headaches, blushing and
hyperperistaltism. There have not been any other studies on RF effects on serotonin.
Comments of the group of experts: This work relates to high power exposures. There is
a strange resemblance between the symptoms described and those often reported to occur
at low power levels and collectively known as “microwave syndrome”.
Ocular damage
Drugs can enhance the adverse effect of RF on the eye (Kues et al, 1992)
Comments of the group of experts: the pulses used in this study are similar to those used
for radar, with a pulse of 10 µs width every 10 ms, which means that the peak power used in
the study is 1000 times higher than the average reported. Therefore, the threshold of 0.05
W/kg for the observation of an effect is in reality obtained with a peak SAR of 50 W/kg. It is
surprising to find this study reported in an identical manner in the Stewart report which leads
us to think that some contributions from outside the group were taken by the committee of
experts without verification of the information obtained.
Behavioural changes
The performance disruption paradigm which is the basis for the acceptable level of RF
(below the limit for thermal effects) does include the effect of microwaves on cognitive
87
processes. Such effects will not necessarily completely alter behaviour but they could
modify it. (d’Andrea, 1999; Silverman, 1973; Raslear et al, 1993).
Comments of the group of experts: Again, the RF used by Lai was emitted in the form of
very short-duration pulses (2 µs every 2 ms), which means that the peak power is 1000
times higher than the average power of 0.6 W/kg: 600 W/kg peak. One could certainly
conceive of effects under such conditions.
Cognitive function
Preece (1999) showed an acceleration in human choice reaction time. This acceleration in
reaction was a function of the power level used.
Comments of the group of experts: The reference cited by Sage does not correspond to
the study described. In fact, there was a significant effect only with analogue telephones
that are effectively more powerful than the GSM type. This is more indicative of a threshold
than of a dose-effect relationship as suggested by Sage.
Sleep
A decrease in the period of REM sleep (dream period) was reported by Mann et al (1996).
Comments of the group of experts: these effects were not confirmed by the same
research group in two further studies: Wagner et al (1998) and Röschke et al (2000), or
reproduced in an identical manner by other groups (Borbely, 2000).
This article was submitted to the journal Environmental Health Perspectives in 1998; it
reviews critically those epidemiological studies published between 1988 and 1998 on the
risk of cancer associated with exposure to RF.
The range of RF exposures considered covers radar, radio and television signals in areas
close to transmitters or occupational exposure in the electronics and telecommunications
sectors. The first publications related to mobile telephones are concomitant. What is of
interest about this article, therefore, is that it encompasses other occupational or
environmental exposure to RF than that related to mobile phones.
The author is from a university cancer research centre in New Zealand and carried out this
literature review at the request of Telecom New Zealand. The EHP journal is one of the
most prestigious in the field of environment and health sciences. It is a publication of the
National Institute of Environmental Health Sciences (NIEHS) and reports on experimental or
epidemiological scientific works.
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The authors divided the work analysed into four categories: investigations into clusters - 4
original publications; studies of the general population exposed to radio and television
transmissions and other similar fields (5); cohort studies concerning occupational exposure
(5); and case-control studies (6). The articles considered were identified by researching the
Medline database and also from published reviews. After a description of each study,
including the way in which exposure had been assessed, the main results are tabulated by
category of work to facilitate comparison. Finally, Elwood takes all this information and
applies an interpretation grid inspired by B. Hill’s causality criteria.
A case-control study was initiated when 12 children living near a radio transmitter in Hawaii
were found to be suffering from acute leukaemia. Among children living less than 4.2 km
away, a (non-significant) excess of cancers was suggested, but the small number of cases
led the authors to conclude that the cluster had doubtless arisen by chance. 340 American
policemen equipped with radar speed guns was investigated: the 6 cases of testicular
cancer that occurred could not be linked to exposure. Another cluster occurred around a
radio and television transmitter near Birmingham in Great Britain. The investigation covered
all cancer cases occurring over 12 years within a radius of 10 kilometres around the
suspected source. An excess of adult leukaemia was suggested in the inner circle, within a
radius of 2 kilometres. This apparent trend was due to the lower-than-expected number of
cases in the second circle, compared with the population as a whole. The authors concluded
that it was not possible to attribute the cancers to the transmitter, but they did undertake a
wider-ranging study covering 21 RF transmitters across the country.
Another incidence study was conducted near three television transmitters (60 to 500 MHz) to
the North of Sydney, Australia. The maximum power density estimated at a distance of 1 km
was 80 mW/m2, with 2 mW/m2 at 4 km. The comparison covered cases of child and adult
cancer in the period 1972-1990, in relation to the distance from the transmitters (less than 4
km and from 4 to 15 km). An excess risk of leukaemia, but not brain cancer, was observed in
adults (RR = 1.18 [0.98- 1.42]) and children (RR = 1.58 [1.1-2.3]). These results therefore
contrast with the British observations, despite the distinctly weaker exposure levels. They
show no gradient effect and the possibility of differences linked to socio-demographic
structures of the populations cannot be excluded. This work was continued by another
author who extended the area covered by the study to other nearby areas. Field
89
measurements were taken, showing power densities varying from less than 2.5 W/m2 to
1,000 W/m2 at the foot of the transmitter. Although one of the three most-exposed zones
showed, as in the initial study, an excess of child leukaemia compared with more distant
zones, two others did not, thus suggesting the possible role of factors other than EM fields.
The incidence of leukaemia and lymphatic and brain cancer among subjects below the age
of 21, between 1973 and 1988, in the San Francisco area was analysed in relation to
distance from a television transmitter tower: no excess risk was revealed within an inner
circle of 3.5 km (RR = 0.73). Another study drawn attention to by Elwood is reported in a
review of studies carried out on the subject, but was not the subject of a referenced
publication.
An earlier study compared 20,000 radar operators in the American Navy with 20,000 other
sailors (who had undergone lesser exposure) between 1950 and 1954; several exposure
classes were defined in accordance with job descriptions. Cancer mortality was evaluated in
1974. It did not vary between the groups, nor between the particular categories of cancers of
the digestive organs, leukaemia or lymphoma. However, lung cancer mortality was higher,
with a gradient that followed the intensity of exposure.
The incidence of various cancers was studied in a cohort of male radio amateurs from the
states of California and Washington 1979 and 1984. For all types of cancers, mortality was
lower than expected, but it was higher for one of the 9 forms of leukaemia studied: acute
myeloid leukaemia, as well as for the ‘other lymphatic cancers’ category. Unfortunately, too
little information was available about the exposure of the subjects who, in their activities or in
their jobs (often connected with electronics) could be subjected to other chemical or physical
exposure. A valid interpretation of this study is therefore impossible.
A cohort of 2,600 radio and telegraph operators in the Norwegian Merchant Navy, active
between 1920 and 1980, was studied for the incidence of cancers. A slight excess risk was
observed for all types of cancer (RR = 1.2 [1.0-1.4]), as well as for malignant tumours of the
breast (1.5 [1.1-2.0]) and uterus (1.9 [1.0-3.2]). Leukaemia, lymphoma and brain cancer
were no more common than in the reference population (not specified in the Elwood review).
A case-control study was nested within this cohort study. The similarity of excess of cancers
in the breast and uterus, in the absence of excess of other forms of cancer whose link with
RF has sometimes been shown, suggests the role of reproductive factors. This excess
remained after the age of the women when their first child was born had been taken into
account. Some EM field measurements carried out on vessels still equipped with old radio
equipment showed magnetic field levels (> 8 MHz) above occupational exposure limits.
The last cohort study, considered by the author to be the most methodologically valid, was
of Canadian and French electricity company employees. In total, 2,679 cases of cancer of all
types were recorded, thus making it possible to carry out a case-control analysis within the
cohort. Exposure was characterised using job-exposure matrices and by measuring the
electric field over a week at the work location of 1,300 workers in 1991 and 1992.
90
The high-exposure classes corresponded to electric field strengths of more than 200 V/m in
the 5-20 MHz band, but could also include fields of 150-300 MHz and RF (radio
transmissions). An ‘all cancers’ excess risk was observed (RR = 1.39 [1.05-1.85]), as well as
for bronchial cancer (after adjustment for tobacco use and a wide range of other risk
factors). However, no link was demonstrated with cancers reported elsewhere to be linked to
EM fields (leukaemia, lymphoma, brain cancer and melanoma). Elwood notes that the EM
fields considered in this cohort study are, for the most part, a long way from the RF band.
4- Case-control studies
Specific mention of RF was found in 6 case-control studies. US Airforce personnel employed
from 1970 to 1989 who developed brain cancer were each compared with 4 controls (same
force, age, and ethnic category). Occupational exposure was characterised using job-
exposure matrices defined by a group. As well as a strong, unexplained association with
rank, a modest relation to RF exposure was observed (RR = 1.39 [1.01-1.90]). One of the
weaknesses of this study is the fact that personnel who had left the army were not included,
making selection bias a possibility.
In three regions of the United States, fatal cases of brain cancer (white men over 30 years
old) were compared with control groups (same age and area of residence) who had died
from causes other than cancer, epilepsy, cerebrovascular accident, or violent death. A close
friend or relation was asked about occupational exposure (difference in response rate
between the cases and the controls: 74% vs 63%). The jobs were classified by potential
exposure to RF. The risk of cancer was linked with the ‘exposed’ jobs (RR=1.6) only among
the employees in the electrical and electronics industries, but not among those with other
occupations (RR=1.0). This suggests that the risk factor could be due more to other aspects
of the jobs than to RF (solvents, vapours etc.).
Testicular cancer risk was investigated in 271 cases aged from 18 to 42 and in 259 controls,
in three hospitals (including two military establishments). Job categories and subjects'
statements were used to classify exposure to microwaves and other radio waves. The
results were inconsistent, with excess risk when the subjects declared that they were subject
to exposure, but not in relation to the job title - the jobs considered as being the most highly
exposed to RF were associated with a low risk (RR = 0.8).
Risk factors in the incidence of breast cancer in men, a very rare disorder, were studied in
227 cases and 300 controls in 10 regions of the United States. The fact of having worked in
a job involving RF defined exposure. Although the a higher risk was observed among
electricians, telephone line installation, and power station staff, it was not significantly higher
among workers in the radio and telecommunications sectors (OR = 2.9 [0.8-10.0]; for 7
cases). The participation rates in the study were described as low by Elwood, who
considered this work a preliminary study.
Risk factors in female mortality from breast cancer were the subject of a case-control study
covering a total of 33,000 cases and 117,000 controls in 24 States of the United States
between 1984 and 1989. The only exposure data available were derived from death
certificates, which were used to classify the women by a job-exposure matrix. Alongside
various potential exposures to chemical substances (styrene, chlorine-containing solvents
etc.), the probability of exposure to RF was estimated and categorised in four groups
according to a gradient. Although exposure classes 1 and 3 suggested the existence of an
effect compared to the non-exposed group (average OR = 1.14 and 1.15 respectively), the
intermediate class showed no excess risk (OR = 0.95). The authors concluded that ‘the
investigations showed no association with ionising or non-ionising radiation'.
91
The effect of RF on the risk of intraocular melanoma was studied in 221 white men in a San
Francisco hospital and 447 controls from the same geographical area. Many occupational
exposure factors were explored by job category. Only those that turned out to be associated
with cancer were reported, thereby preventing any evaluation of the possibility of fortuitous
associations. An association was demonstrated with exposure to microwaves and radar
signals (OR = 2.1 [1.1-4.0] out of 21 exposed cases). This result is not featured in the
summary written by the authors, who also point out the possibility of recall bias in this type of
survey.
At the end of his review, the author recaps the observations and submits them to Hill’s
causality criteria. This leads him to conclude that individual studies are weak in terms of
methodology, particularly when it come to the characterisation of exposure, thus making it
impossible to interpret them clearly in terms of a cause and effect relationship. “The major
impression is that these studies are inconsistent. No type of cancer is linked consistently
with exposure to RF”.
Opinion of the group of experts on this article: The studies considered in this review do
not directly concern exposure to RF from mobile phones and base stations. The frequency
ranges and exposure conditions are distinctly different. However, these studies are relevant
because they may highlight categories of cancers that deserve particular attention in specific
epidemiological studies on mobile telephones.
The information provided by Elwood on the quality of the original studies is very variable.
There is sometimes a certain confusion between presentation and criticism of the studies,
which does not facilitate ‘objective’ reading. Despite this, we can only agree that the
message from this series of studies is far from convincing.
A short article has recently been published in the prestigious journal Nature, describing the
results obtained by British and Canadian teams on small earthworms called nematodes, of
the species Caenorhabditis elegans. These animals were exposed to low-level microwaves.
The aim of the study was to detect indirectly the expression of heat shock proteins (HSP)
caused by exposure. These proteins are produced when an organism is submitted to an
92
insult such as heat or a toxic substance. Cellular proteins can become damaged, and HSPs
act as guides for these proteins to maintain or re-establish their three-dimensional structure.
Overnight, the worms were exposed to CW microwaves at 750 MHz in a TEM20 cell, one of
the most commonly used exposure systems for cells in culture. During the course of several
experiments carried out at increasing temperatures in a standard incubator, it was observed
that the exposed worms reacted very differently than did the control worms: the activity of
the ß-galactosidase enzyme increased rapidly with the temperature of the incubator, as if
they were heated by the microwaves. There was a difference of 3°C between the two
batches (cf. appendix 3). The SAR was estimated at 1 mW/kg, which corresponds to a very
small rise in temperature.
1) microwaves act on the bonds which maintain proteins in their folded structures
2) production of reactive oxygen species
3) the signal21 has an effect on transduction processes.
The Grundler and Kielman group have published results of work on the effects of millimetric
waves on yeast22. The Gos group in Bern have unsuccessfully attempted to replicate these
experiments23. More recently, a study financed by the FGF and Swiscom was carried out by
the same group. The aim was to determine any possible effect on the same biological model
of GSM-900 type microwaves. Cultures of Saccharomyces cerevisiae were therefore
exposed at 900 MHz under far-field conditions.
20
transverse electromagnetic
21
propagation of messages from outside the cell to the cytoplasm and the nucleus
(23°C, SAR of 0.13 and 13 W/kg). The tests carried out were those of reverse and direct mutation in
response to canavanine. No effect was detected
22
Grundler W, Keilman F, Putterlik V, Strube D (1982): Resonant-like dependence of yeast growth
rate on microwave frequencies. Br J Cancer 45:206-208.
23
Gos P, Eicher B, Kohli J, Heyer W-D (1997): Extremely high frequency electromagnetic fields at low
power density do not affect the division of exponential phase Saccharomyces cerevisiae cells.
Bioelectromagnetics 18:142-155
93
This article concerns the possible effects on brain development of radiofrequency
electromagnetic fields used in mobile telephone technology. Gravid female Wistar rats were
continually exposed to 900 MHz radiation, modulated at 217 Hz, during gestation. This
exposure is representative of typical public exposure to mobile telephony signals. The total
SAR (whole body) corresponding to this exposure was between 17.5 and 75 mW/Kg. The
animals which, as embryos, were subjected to these conditions were then tested to assess
their cognitive faculties in terms of learning abilities (obtaining food). These tests are
described as being particularly discriminatory for two parameters: the frequency of lever
activation and the inter-response interval. The results obtained with these different tests,
particularly the two parameters described, showed that in-utero exposure produced no
measurable effect on cognition in the exposed animals compared to controls.
Laurence et al, in Australia, studied the effects of pulsed microwaves on the induction of
heat shock proteins. Induction of HSP-70 was observed in mouse cells after exposure to
bursts of microwaves at 2450 GHz, each lasting 6 minutes.
The amplitude of the effect increased with the dose (SAR from 12 to 58 W/kg). The authors
claim to have shown that the 6 minute averaging time recommended by ICNIRP is
inadequate. They also carried out simulations of the underlying mechanism for this effect.
The main hypothesis was that the synthesis of heat shock proteins is triggered by the
transitory warming of proteins without a macroscopic temperature rise. They estimate that
the time required for a protein with a diameter of 10 nm to reach thermal equilibrium with its
environment after absorbing microwaves is 1 nanosecond, whereas the time required for the
unfolding of a protein is 50 nanoseconds.
Comments of the group of experts: several of the hypotheses put forward in this article
are somewhat unreasonable, notably that the temperature of the water bonded with the
proteins is high after absorption of the microwaves without there being a change in the
temperature of the bath. In fact, the equilibrium between the two forms of water (free and
bonded) is established almost instantaneously. Likewise, the explanation of the existence of
power “windows” is not supported by the experimental observations nor by theoretical
considerations (incomplete triggering of the response to the heat shock). It is probable that a
defective dosimeter is the source of the observations made in this article and that the effects
are in fact likely to be thermal in nature.
Volunteers were exposed to a mobile telephone field emitted by a planar antenna on one
side of the head or the other. After a short night limited to just 4 hours of sleep, the
volunteers were exposed for half an hour early in the morning, in a seated position, before
going back to sleep. A GSM signal was emitted, with modulation at the various frequencies
encountered in actual telephones: 2, 8, 217 and 1736 Hz, with a pulse duty factor of 87.5%.
The maximum local SAR in 10 g was calculated as being 1 W/kg, corresponding to an
average SAR on the hemisphere of the exposed side of 0.28 W/kg. The sleep parameters
(latencies, duration, efficacy etc.) were not significantly different. A significant difference of
10 to 12% in EEG spectral power density in the frequency bands 9.75-11.25 Hz and 12.25-
13.25 Hz was observed in the first 30 minutes of non-REM sleep. This effect was not
predominantly on the exposed side.
94
Comments of the group of experts: the exposure conditions are not at all physiologically
realistic. An effect under these conditions has no significance that can be related to a real
situation. The authors justify their protocol among other things by arguing that daytime sleep
was favoured because the subjects had been previously deprived of night-time sleep.
Generally, it takes just a few nights for volunteers to get used to an unusual environment
and to sleep correctly. The main interest in this study is that it shows a delayed effect after
exposure, thus suggesting the possibility of a cumulative effect. This hypothesis remains to
be demonstrated in more physiologically-realistic conditions, e.g. exposure in the evening
before going to sleep.
This editorial in the journal Neuroreport was triggered by the article by Huber et al,
published in the same issue (cf. the critique of this article presented above). It places this
study in perspective by referring to 6 other articles published since 1998 of brief exposure to
RF on the physiology of the brain and cognitive function.
The mechanisms for these effects remain uncertain, but it has been proposed that that a
microthermal effect on synaptic transmission could play a facilitating role in cognitive
function. The editorial underlines the fact that the effects shown by Huber et al are no longer
visible after a 3-hour period of sleep and thus draws the conclusion that, in the light of our
current knowledge, it is not possible for these short-term manifestations to be predictive of
long-term consequences after repeated exposure. New work is required to answer this
question.
The conditions under which this effect was demonstrated were unusual and caution is called
for when it comes to interpreting these data.
The mobile telephony signals studied have a carrier frequency of about 837 MHz (analogue,
CDMA and TDMA) or 1900 MHz (PCS) and are either voice-modulated or otherwise.
Cultures of circulating human lymphocytes (2 donors) were exposed to SARs of 1, 2.5, 5
and 10 W/kg for 3 and 24 hours.
(i) induction of DNA damage (single-strand breaks, alkali-sensitive sites) assessed by the
comet test: this test identifies damage to individual cells after electrophoresis. An affected
cell takes the shape of a “comet” with the intact DNA forming the head, while the fragmented
DNA which has migrated makes up the tail.
(ii) micronuclei induction (MN, chromosome fragments or whole chromosomes which do not
migrate correctly on division of the cell) assessed by the cytokinesis-blocked micronucleus
assay. Only those cells which underwent cell division after treatment (binuclear cells) were
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considered, which increased the sensitivity of the test (M. Fenech, The in vitro micronucleus
test, Mutation Research, 2000).
In this study, the comet test revealed no induction of DNA damage whatever the exposure
conditions. The MN test was negative for all the signals after 3 hours of exposure. It is worth
noting that only 2 experiments were carried out in most cases. The signals tested at 5 W/kg
and 24 hours (TDMA and analogue) inducted MN in the lymphocytes (p<0.001, only one
experiment). Finally, all the signals (modulated or not) showed an ability to induce MN after
24 hours' exposure (p<0.001, two experiments per condition).
According to the authors, this effect could be due to the cells heating, as the SAR range of
the samples was very wide (7 to 31 W/kg - Guy et al, 1999, Bioelectromagnetics, 20, 21-39).
However, no hypothesis was formulated by the authors to explain the fact that the comet test
was negative under certain conditions although a significant increase in MN had been
detected.
This is an investigation of the induction of micronuclei (MN) in C3H 10T1/2 cells (mouse
fibroblast cell lines) exposed to radiofrequency signals used in mobile telephony in the USA.
Cells were exposed to the FDMA signal (carrier frequency: 835,62 MHz) at SARs of 3.2 and
5.1 W/kg or to the CDMA signal (carrier frequency: 847.74 MHz) at SARs of 3.2 and 4.8
W/kg. The exposure was isothermal (37 ± 0.3°C) and exposure times were 3, 8, 16 and 24
hours for the cells in the exponential growth phase or in the plateau phase (G0 phase of the
cell cycle). Ionising radiation (137Cs gamma rays) was used as a positive control. The test
used was the so-called “cytokinesis-blocked micronucleus test” in which only the binuclear
cells, whose division is chemically blocked, are considered.
Under the experimental conditions of this study, the test proved to be capable of detecting
the inducted MN from 0.6 Gy gamma photons.
The results showed that there was no increase in micronuclei when the cells were exposed
to the FDMA signal, whatever the exposure conditions. Exposure of less than 24 hours to
the CDMA signal was also without effect whatever the exposure level and the cell growth
phase.
In contrast, an increase was noted in the number of MN (binuclear cells with micronuclei and
number of MN for 100 binuclear cells) in the C3H cells in the plateau phase exposed at the
highest level (5.1 W/kg) for 24 hours. The increase was around 20% and was significant
(p<0.05, Student t with n=6). It should be noted that in cells in the plateau phase, the 50%
increase in MN observed after a dose of 0.3 Gy of 137Cs gamma rays was not found to be
significant (n=3).
Professor Hyland of Warwick University puts forward, in this article, a theory concerning the
non-thermal effects of mobile telephones. It gives a brief reminder of basic information about
mobile telephony and its thermal effects. He then touches on the non-thermal effects,
presenting his basic hypothesis, which is that the organism reacts to modulated waves as
the latter can interfere with the oscillations of certain biological processes. A comparison is
96
made with the interference phenomena encountered in electromagnetic compatibility. There
then follows a list of examples of observed effects, such as:
· epileptic activity in rat brain sections, observed by Tattersall (however, the effect was
observed at 700 MHz GSM as well as with non-modulated RF….).
In all the results selected, except those of Repacholi, the amplitude of the biological effects
was low and did not correspond to foreseeable health effects.
Comments of the group of experts: The argument is undermined by the selective choice
of articles from the literature, since the negative experiments, in particular in replication, are
not quoted and the examples are taken from the ELF, RF and millimetric bands without this
being explicit. Furthermore, certain quoted references relate to unpublished works. Thus, in
the second table, the work of the group of M. Bastide is quoted although it has not been
published and concerns ELF.
Faced with the impossibility of reproducing certain results, the author invokes the “non-
linear” character of the phenomena (chaos, “butterfly effect”) to explain that the results
depend so strongly on the initial conditions that it is not possible to reproduce them! This is
a scientifically unacceptable argument. The citations of epidemiological data are also biased
and the conclusion on the famous episode of the irradiation of the American Embassy in
Moscow is quite irrelevant to RF exposures from mobile telephony. In conclusion, it is most
surprising that such a scientific journal as The Lancet should have published this article
which fails to comply with the elementary rules of scientific communication in terms of
content and form.
Criticism of the health assessment in the ICNIRP guidelines for radiofrequency and
microwave radiation (100 kHz–300 GHz)
Cherry N, 2000. http://www.emfguru.com/ CellPhone/cherry2/ICNIRP-2.htm
Neil Cherry is a professor of climatology in New Zealand. For several years, he has been
actively fighting for low RF exposure limits to be applied. N Cherry has just published a
severe critique of the ICNIRP recommendations24 on the internet. The author’s main
argument is that ICNIRP maintains, despite all the evidence, that the only established and
conceivable biological effects are thermal in nature, whereas non-thermal effects should also
be taken into account when assessing health risks.
Despite the impressive length of this contribution (143 pages), which claims to cover all
biological and health aspects of the non-ionising electromagnetic spectrum, the presentation
which follows is short, as it is for the other recent works reviewed by the group of experts. A
few examples drawn from the report by N Cherry highlight the methodological and
theoretical weaknesses of his arguments:
N Cherry explains that the amplitude of biological effects increases with the frequency over
the whole of the electromagnetic spectrum (‘EMR Spectrum Principle'). This hypothesis is
not backed up either by knowledge of the mechanisms, which depend on the frequency, or
by the biological results obtained in the various frequency bands.
24
International Commission on Non-Ionizing Radiation Protection
97
Disparate studies are bundled together by the author without discrimination (thus, ELF and
RF fields are all considered together)
The results of experiments are not always taken into account (negative and positive).
This thesis is a good illustration of the fragility of an isolated critical approach in a scientific
field characterised by its great complexity. In its intermediate report, the group of experts
insisted on the necessity, in such a context, of mobilising skills in different disciplines, as well
as different points of view on the subject. This need for contradictory scientific critique is
clearly highlighted here.
First of all, the article examines cancer. The studies relating to RF from radio and television
antennas, and also in certain occupational environments (radar, the electronics sector) – 11
articles discussed – are instructive but have little value as far as mobile telephony is
concerned. Exposure near base stations poses, for K Rothman, “formidable problems” of
method and he expects little in the way of conclusive results from such studies, given the
25
“The studies cited by ICNIRP contain sufficient evidence to conclude cause and effect between
RF/MW and cancer across many body organs, especially leukaemia and brain tumours, and at
chronic lifetime exposures showing dose-response relationships pointing to a Level of No Observed
2
Adverse Effects threshold of about 20 nW/cm .”
98
influence of so many possible factors. Three studies concerning mobiles are presented –
including one by the author of the article – and are considered inconclusive (doubts are
expressed about the interpretation of the results of the Hardell study). The results of 3 other
studies are expected, two in the near future (completed case-control studies) and the last
one in several years time (the IARC Interphone project).
The effect which is the most clearly established by epidemiology (3 articles presented) is the
risk of accident when driving a vehicle, with an excess risk of over 100 %.
The conclusion of the author is that it is too early to pronounce a verdict on the risks
associated with mobile telephones, notably with regard to cancer. But K Rothman, on the
basis of the risk factors envisaged (for brain cancer) or demonstrated (for accidents),
estimates that even if mobile telephones were proven to represent a health hazard, the
number of cases expected would be much lower than those due to accident.
A detailed analysis of the work history of these employees, using company records, allowed
them to be categorised by level of exposure (nil – that is to say equal to the general
population – weak, moderate, and strong) and duration: a study was carried out to validate
the job-exposure matrix developed for the study, comparing the classification obtained in this
way with on-site measurements. Two mortality comparison systems were adopted: external,
with the population at large of the 4 American states in which most of the plants studied
were located (calculation of SMR), and internal, the most valid system, by comparing the
exposure categories within the cohort itself. The very elaborate statistical analysis made it
possible to take into account different factors of latency and length of service in the
company.
Overall, neither the external comparisons (a strong ‘healthy worker effect’ was observed,
with an SMR ‘all deaths' of 0.66 [IC95%=0.64-0.67)], nor the internal comparisons (by level,
duration, mode – usual, maximum or accumulated value – seniority, or latency of exposure)
suggested that RF exposure played a role, notably in the three causes of death which
initiated the study.
Although this study provides no argument in favour of the existence of a risk linked with
occupational exposure to RF in this population, the authors underline the modest proportion
of people classed as being “moderately or strongly” exposed (about 9%), the small number
of subjects who died (3.2 %), and the relative youth of Motorola staff and point out that, in
their opinion, the possibility of long-term effects cannot be excluded.
99
In an Editorial in the same journal26, RD Owen, the head of the Radiation Branch of the
United States FDA, expressed his satisfaction with this study which he qualified as a
‘beginning’, pointing out that it is not possible, as things stand today, to extrapolate data from
one RF band to another or to predict the existence or absence of long-term effects. He
insisted on the need for further research, with focusing particularly on the conditions for
estimating exposure, both in experiments and epidemiological studies.
This was a population case-control study carried out in Sweden and concerning various risk
factors for brain tumours. 209 subjects (men and women) with brain tumours (malignant or
benign) and 425 controls were included in the analysis.
The cases, selected from the National Cancer Register, came from 2 different regions of
Sweden between 1994 and 1996 (benign tumours were only considered in 1996) and the
patients were alive at the time of their inclusion in the study. Anatomopathology reports were
available for 197 cases (136 malignant tumours and 62 benign tumours). The controls were
matched by sex, age and region and were drawn at random from the National Population
Register.
Exposure to risk was evaluated using a self-report questionnaire sent to the homes of the
subjects (completed by a telephone interview if necessary). The collection and coding of the
questionnaires and the additional telephone interviews were carried out blind with regard to
case or control status. The risks considered were: occupational factors (profession,
exposure to ionising radiation for health workers, chemical exposure), radiological
examinations, use of cellular phones.
The results show some significant associations with certain professions and with X-ray
examinations of the head and neck (we will not comment on the results concerning these
factors). As far as cellular-phone use was concerned, a significant association was observed
(OR = 2.62 ; CI : 1.02 - 671), and confirmed after adjustment for all the risk factors, with the
occurrence of tumours in the temporal or occipital zones and the temporoparietal lobe on the
side where the user habitually held the telephone (most exposed area of the brain). In
contrast, no association was observed for tumours on the opposite side to the ear usually
used or tumours in general, whatever their location. These results are based on 13 exposed
cases (10 malignant tumours and 3 benign); 9 cases were exposed only to analogue
telephones and 3 to analogue and GSM telephones.
Comments of the group of experts: This high-quality study is extremely sound in various
aspects: case and control recruitment in a population register, blind, standardised collection
of data, inclusion of the main known or suspected risk factors in the brain.
The main arguments in favour of causality are a clear association, the fact that the main
confounding factors were taken into account, the overall quality of the study and, above all,
the fact that the excess corresponds to the location at the greatest risk, in principle, and was
not detected at locations further from the exposure, thus making the observed positive result
biologically likely.
The principal limitations are the small number of exposed cases on which the results are
based (although the study as a whole is of a good size). For this reason, it was impossible to
26
Possible health risks of radiofrequency exposure from mobile telephones. Owen RD. Epidemiology,
2000, 11 : 99-100
100
take into account the analysis of exposure-effect relationships, nor the temporal aspects of
exposure, nor the histological form of the tumours. The homolateral location of the cancer in
relation to the declared use of the telephone is striking, but it is quite possible, given the
conditions of the study, that this could be a recall artefact.
In conclusion, this study provides arguments in favour of the causality hypothesis, but
remains too limited to go any further. In particular, it is not possible to exclude a potential
bias in the statement of the usual side on which the telephone was used. The study is
continuing and it will obviously be interesting to have more results and to compare them with
the other studies published on the subject.
This keenly-awaited article (it was presented in July 2000, by G Carlo – who had contributed
to its financing by the WTR - as “suggesting that there is a risk of brain cancer”, in particular
on the side on which the mobile is used27, as the work of Hardell tended to show in 1999),
was published in mid-December. It presents the results of a case-control study conducted
between 1994 and 1998 in 5 university hospitals on the east coast of the United States,
covering 469 subjects (aged from 18 to 80) suffering from brain cancer and 422 matched
controls. Exposure to the fields associated with mobiles was characterised by a
questionnaire and measured by the number of hours of monthly use and the number of
years of use.
Compared to non-users, and after adjustment for confounding factors, the 'Odds Ratio' (OR:
standard measurement for "excess risk") for cellular telephone use was 0.85 (95% CI: 0.6 -
1.2). The average length of use was 2.8 years for cancer sufferers, as compared to 2.7
years for controls. The ipso- or contra-lateral position of the cancer depended on the area of
the brain that was affected. All histological types of cancer had an OR less than 1, except for
one rare form: neuroepithelioma (OR = 2.1 [0.9-4.7]).
The authors concluded from this work that there was no excess risk of brain cancer
associated with the use of mobile telephones, but considered that further research was
required, particularly to take longer periods of use into account.
This case-control study, carried out between 1994 and 1998, involved 782 patients with
intracranial tumours (cancers of the brain, meningioma, and neurinoma of the acoustic
nerve) and 799 matched controls (residence, age, and sex) with non-cancer diseases, in
three cities in the United States. This is the largest-scale study to date.
The cumulative use of a mobile telephone for at least 100 hours was not associated with the
presence of a tumour (OR = 1.0 [95% CI = 0.6-1.5] when all forms of cancer were
considered. This result varied depending on the type of cancer, but the relationship was
never statistically significant, once the various confounding factors had been taken into
account. The authors did not find any link between the presence of cancer and the intensity
27
Scientific Progress - Wireless Phones and Brain Cancer: Current State of the Science. George L.
Carlo, PhD, MS, JD, and Rebecca Steffens Jenrow, MPH, Wireless Technology Research, LLC
Washington, DC, MedGenMed, July 31, 2000, Medscape.
101
of use (over 60 minutes per day or over 5 years), or between mobile telephone use and the
side that the tumour was located.
As in the previous article, the authors concluded that, while their research did not show any
link between mobile telephone use and brain tumours, it was not possible to come to a final
conclusion concerning the consequences of long-term exposure (only 8 % of the patients
had started using a mobile telephone before 1993).
In an editorial in the same journal, two leading specialists in cancer epidemiology expressed
the opinion that this research should be considered reassuring as it confirmed other
publications on the same topic, and was consistent with the weakness of empirical
observations and the lack of a theoretical basis for carcinogenic effects unrelated to heat.
The study population, consisting of 808 men and women between 12 and 70 years old,
made very frequent use of mobile telephones (44.5 %). Special attention was paid to
controlling bias in the selection and declaration of symptoms. Headaches were the only
symptom significantly associated with the use of MT (OR = 1.31 [95% CI: 1.00-1.70]), with
increasing prevalence in relation to the declared length of use (up to 1 hour per day). It was
quite remarkable that MT users equipped with hands-free systems reported fewer
headaches (41.7% if they used them all the time, 54.4 % for irregular users, and 65.4 for
non-users). The authors envisage two etiological hypotheses: the effects of RF waves on the
blood-brain barrier and on the dopamine-opioid system. In spite of the limitations of cross-
sectional studies, particularly the difficulty of establishing the time sequence of the factors
studied, this research indicates that RF may play a role in headaches in the general
population. It remains to be determined whether, in view of the environment under study
(electromagnetic radiation density, noise, atmospheric pollution, etc.), these results can be
extrapolated to other situations. It should be noted that there is a high frequency of
headaches in this population. For example, in the French GAZEL cohort (40-60 years old),
the rate (prevalence over the previous 12 months) was on the order of 15-20 % in men and
33-38 % in women.
A very recent article published in the journal "Epidemiology", presenting the findings of a
case-control study carried out by a German team, examined the relationship between
professional exposure to various sources of EMC, including RF, and the occurrence of uveal
melanoma, which affects eye tissue between the cornea and the crystalline lens. In a series
of 118 cases and 475 controls, an excess risk associated with RF from mobile telephones
was identified (OR = 4.2, IC95% = 1.2-14.5).
Although this scientific journal has a good reputation, the group of experts could not assess
this work as they had access only to the abstract, and not the full text of the article.
102
General conclusions of the group of experts on recent research: Recent literature does
not make any clear departure from previously available information. Publications describing
experimental work give further details concerning the effect of exposure on certain cognitive
functions in both animals and man. Is this a ‘microthermal’ effect? Does it involve hormonal
phenomena? It is difficult to say in the current state of knowledge, just as it is impossible as
yet to conclude that prolonged and/or frequent exposure to these phenomena represents a
real risk to human health. However, these results will certainly be considered in light of the
epidemiological study in Singapore, which suggests quite convincingly that intensive use of
mobile telephones may lead to headaches. As the protocol of this study was relatively
unsophisticated, the findings should be confirmed and validated using other approaches,
under different circumstances, before they are considered as hard evidence.
The various epidemiological studies investigating the risk of brain tumours are in agreement
and do not conclude that RF plays any role in the development of these forms of cancer,
under present observation conditions, i.e. after relatively short induction periods (maximum:
5 to 6 years). While these results are reassuring, they do not exclude the possibility of long-
term effects. They do not, however, give any indication that such effects exist.
· the exposure of a young child's brain is considered to be higher than that of an adult, if
the cellular telephone is emitting the same power
No facts have yet been clearly established concerning the greater dose absorbed by
children's heads due to their smaller size. Research by Gandhi's team (1996) at the
University of Utah concluded that the SAR received by the brain of a 5 year-old child at a
frequency of 835 MHz was 3.3 times higher than that received by an adult, while the ratio
was 2.2 for a 10 year-old child; there was no age-related difference at 1900 MHz. In 1998,
28
Particularly: Adey et al (1999): Spontaneous and nitrosourea-induced primary tumors of the central
nervous system in Fischer 344 rats chronically exposed to 836 MHz modulated microwaves. Radiat
Res.152(3):293-302; and: (2000) Spontaneous and nitrosourea-induced primary tumors of the central
nervous system in Fischer 344 rats exposed to frequency-modulated microwave fields. Cancer Res.
1;60(7):1857-63.
103
Schönborn et al carried out a new modelling and simulation study at the same frequencies,
but using head phantoms that were more representative of children (3 and 7 years old,
respectively). The findings contradicted those of Gandhi et al. Among their criticisms of the
earlier research, these authors indicated that the models used were merely proportional
reductions of adult heads, which do not really correspond to children's. Other authors
(Kuster and Balzano [1992], Hombach et al [1996], and Meier et al [1997]) agreed with
Schönborn et al. Another experiment that Stewart seems to have considered was carried
out on rats of different ages (Peyman et al 2000)29. It showed differences between the
dielectric properties of the brain, salivary glands, and muscle mass of rats 10 and 20 days
old, but there was no further reduction in conductivity in rats over 20 days old. It is very
difficult to extrapolate these (not yet published) findings in animals to age-related
differences in humans.
The other arguments presented by Stewart et al are discussed and explained below. The
age at the time of initial exposure can certainly affect the risk of developing a delayed
pathology in the long term. The major risk is cancer, but any delayed effect may present the
same characteristics. Cancer epidemiology offers arguments that the age at the time of
initial exposure may affect the risk level for various reasons.
Greater sensitivity: children may be more sensitive than adults to the carcinogenic effects of
exposure for reasons related to development (developing tissue, etc.) and physiology
(greater activity is accompanied by higher absorption, although the relevance of this
parameter for RF radiation is not obvious). Perhaps the best-established example is that of
tobacco: the younger a person starts smoking, the higher the risk of lung cancer, all other
exposure conditions being equal (average quantity, cumulative dose, etc.). There are,
however, also some counter-examples. In the case of asbestos, all the available findings
show that age at the time of exposure probably has no effect, so the risk is the same
whether the first exposure occurs during childhood or adulthood.
"Mechanical" effects of time: whether or not there is any greater sensitivity during childhood,
the "lifelong" risk of developing a cancer caused by exposure is increased if exposure takes
place early in life. This is due to a combination of two phenomena that have a cumulative
effect: (i) in general, the earlier the exposure, the higher the cumulative lifelong exposure will
be (if exposure is continuous: this is obviously not true if exposure stops or decreases over
time): the relevant parameter for quantifying cancer risk is generally cumulative exposure
levels; (ii) the earlier the exposure the more time is "available" to develop an effect related to
this exposure. This is all the truer if there is a long latency period between exposure and the
occurrence of the effect. For example, there is almost no risk of developing a mesothelioma
of the pleura if even very intense exposure to asbestos occurs after the age of 80, as the
average latency period is approximately 35 years and the person will probably have died
before a mesothelioma has had time to develop. Conversely, if exposure occurs very early,
the risk will be much higher, even though children do not seem to have any intrinsically
increased sensitivity, as mentioned above.
These arguments should be tempered by the fact that the hypothesis on which they are
based is that exposure will be continuous over time. It is, however, clear that, as
radiocommunication technologies develop, exposures from devices tend to decrease. In
particular mobile telephones will soon cease to be in close proximity to users' heads (see
paragraph on technological developments in chapter II), although the increasing number of
radiation sources in our everyday surroundings may offset this positive trend.
29
Peyman, Rezazadeh and Gabriel, poster presented at the annual meeting of the BEMS
(BioElectromagnetics Society), in Munich, 9-14 June 2000. "Changes in the dielectric properties of
aging rat tissues".
104
These data led the group of experts to recommend a "precautionary approach", although
they did not consider that currently available scientific data justified any restrictive legislation.
Three hearings took a different format: George Carlo, who was the director of the WTR in
the US, responded to the group of experts in a telephone conference on the 23rd of
November in the evening; Marc Séguinot, from DG SANCO of the EU met with the group of
experts on the 14th of December 2000. On these two occasions, the meetings could not be
retranscribed, so they have been reported more briefly. Philippe Quenel, in charge of the
Department of Health & Environment of the InVS responded by mail to the question of
monitoring possible health effects associated with mobile telephony. For consistency, this
contribution, with which the group of experts agrees, is reported in the chapter dealing with
recommendations for research (Chapter VI). Finally, Mr Roger Santini of INSA of Lyon was
asked for his opinion; he responded by mail on the 5th of September 2000: he did not think it
was necessary for him to meet face-to-face with the group of experts to express his opinion.
This section also contains the response given by Laurent Bantoux, of the Directorate
General of Research of the European Commission, to the questions addressed to him by
mail on the direction of research on RF and health.
· following up the work of WHO and of ICNIRP, of scientific symposia and of all meetings
related to these issues;
30
The GSM Association represents the interests of 490 members from European countries and
elsewhere in the world (third generation GSM operators, administrative establishments,
networks.manufacturers)
105
· ensuring a liaison between government, industry, and consumers.
IV-What are the new technologies available in France or at the international level that could
lead, in years to come, to a change in the level or in the conditions of exposure of the public
to RF EMF from mobile telephony?
e. The impact of UMTS and Bluetooth: evolution in the use of mobiles and
technological evolution
Major evolution will be driven by UMTS and Bluetooth. New modes of use of radio
telephones will take place - reading from and watching the screen - new frequencies will be
used and new technical characteristics will be developed.
The increase in the number of users and the density of cells will lead to a decrease in the
level of emissions from handsets and base stations. In fact, power-control is an important
determinant of the emission from a radiotelephone; the nearer the user is to a base station,
the lower the signal level needed to make a call. One of the technical constraints on mobile
telephony in general, originating from the need to reuse frequencies in non-adjacent cells, is
to limit as much as possible the possibility of interference. Therefore, in order to reuse a
given frequency within a few kilometres, emissions from mobile should be minimised.
Bluetooth used close to the ear will be limited to class 3 emitters (1 mW), in the frequency
range 2.4 GHz.
106
V- What are the measures taken by French operators to reduce the exposure of the
public to RF EMF from telephones and base stations to "as low as reasonably achievable"
(ALARA) ?
Q: Do base stations operate at or near maximum levels or do they often reduce the power
emitted?
A: A GSM base station has several signal sources:
Q: In an urban site (saturated or nearly), do all the emitters operate at full power?
A: No. The site density is necessary to deal with traffic peaks. A given station does not
always emit at its maximum. The intensity of emission varies as a function of time with
periods of saturation and of scarcity of calls. The power input to the antenna depends on
the configuration, whether the cell is urban or rural and on the cell size. The fields emitted
by the antenna depend on the antenna's characteristics and its gain (concentration of the
107
energy into a beam). The fields around a base station antenna decrease rapidly: for
antennas sited on rooftops, beyond a few meters the field strength is below the reference
levels.
Q: In fact, a saturated base station means that all the channels are utilised and not that they
emit at full power. On average, what are the emissions of a saturated base station with
respect to its maximal power (40%, 60%, ..)?
A: This depends on the power-control implemented by the operator. There are no studies
on this subject at the moment. I know the effect of power-control on exposures from
radiotelephones. An article, accepted for publication in IEEE Transactions on EMC, deals
with the subject. The fields emitted are, on average, less than the maximum field because
of power-control and that is before taking into consideration DTX (that minimises emissions
when no-one is speaking). These are statistical studies.
Q: What is the distance at which the SAR values correspond to the Recommendation ? Is it
a few metres?
A: The distance that I mentioned for base stations corresponds to the reference levels. The
basic restrictions given by ICNIRP and the European Recommendation are defined in W/kg
(in SAR). Instead of SAR, it is possible to use reference levels that ensure that the basic
restrictions are adhered to. While it is possible to use reference levels with respect to base
stations, is it not possible to use them for radiotelephones because the exposure is in the
near field.
Q: What are the possible consequences of operation at high frequencies with UMTS and
Bluetooth? Has there been any epidemiological or experimental work?
A: The answer to this question lies with biologists, not the GSM Association. Actually
international recommendations cover all frequencies. UMTS devices should also give rise
to fields and SAR levels that meet the recommendations. The power emitted by UMTS
devices is of the order of 125 mW. Power control is more effective with UMTS (every 0.66
milliseconds) compared to GSM (a minimum of 60 milliseconds, but often several seconds).
Q: Are GSM operators within the Association involved in new protocols other than UMTS:
TETRA, DECT, local wireless loops, and are they going to deal with the effects of these
systems?
A: At present, local wireless loops are not strictly speaking a part of mobile telephony. The
organisations dealing with this technology will address the conformity of these systems with
international standards. At present, when we site a base station antenna we take into
consideration all existing wireless systems.
108
standards, regulations and in the dissemination of information with respect to health in
relation to mobile telephony. More precisely, it sets itself the following objectives:
k. Regulatory policy
to co-ordinate at a global level the development and presentation of the views of the mobile
telephone industry.
to provide assistance to national employees' organisations (in France, the FIEEC and the
GITEP) by providing them with information.
Some employees' unions within the FIEEC decided to draft a leaflet entitled "Facts on
electromagnetic fields" - which covered radio telephony - for the benefit of its members and
interested official organisations. I submit this booklet to you along with that of the MMF. I
invite you to refer to the MMF booklet to get acquainted with the research financed by the
MMF, and its views on the health issues, aspects that there is no time to present to you now.
The SAR level (specific absorption rate) of second-generation mobile phones should not
change significantly. Only a change in the network could affect appreciably this parameter.
109
The cell size (geographic zone covered by a base station) depends on three parameters:
· the frequency band used (the higher the frequency the smaller the cell);
Hence, GSM base stations are 0.2 to 0.5 km apart in town and from 2 to 5 km in the
countryside. The capacity or limit in the number of calls of base stations is an important
element in changing the exposure conditions. In fact, the increase in the number of users
will require an increase in the number of cells and hence it will decrease their size. The
smaller the size of a cell, the lower the power level emitted by the base station in order to
avoid interference effects with neighbouring cells. Moreover, in order to reduce the
consumption of the battery, each mobile phone, during the conversation adjusts its power
level to the minimum necessary for the base station to receive a signal (Adaptive Power
Control, APACE). Similarly, the base station regulates itself continuously to emit at the
lowest acceptable level. Hence, the shorter the distance between the phone and base
station the lower the emission levels from the phone (and hence the actual value of SAR).
Consequently, the increase in the density of the network translates itself for the user of
mobile phone into an actual reduction in exposure and not, as one would have thought, an
increase.
2. UMTS TDD (Time Division Duplex) which is a combination of a CDMA technology and a
time division multiple access (TDMA).
The UMTS specifications give no indication as yet on the maximum power from base
stations. There are different power classes – as there are for GSM – that will be defined in
March 2001. Base station manufacturers have already announced that the power input to
the antenna of their base stations would be of the order of 20 W. This value is the result of a
compromise between two elements:
110
1. the capabilities of current wide band power amplifier technology
2. the operators' desire to use existing GSM/DCS radio sites to locate UMTS base stations.
UMTS will initially operate in the frequency range 1920 to 2200 MHz, with a view to a new
allocation in the band 2.5 GHz in a few years time. The transition from the second to the
third generation will take place gradually.
Bluetooth technology will eventually replace wire and infrared connections between devices
such as between the mobile phone and the ear piece, and also between the phone and
computers, cameras etc. It will operate in the frequency range 2.4 GHz, at very low power
levels (probably less than 2.5 mW for mobile phones); its data output may reach 1 Bit/s
within a 10 metre range.
All these technologies will be deployed to meet existing standards based on the conclusions
of scientific studies. This will enable the development of applications within well-established
safety standards.
In conclusion, changes in exposure conditions may well take place in the future due to
technological change and/or changes in usage, and not for health reasons (which do not
justify any changes). In fact, after the detailed analysis of scientific studies carried out over
many years, international experts have concluded that, based on current knowledge, mobile
telecommunications has no negative effect on public health.
VII- What measures are in force, or planned for the future by French mobile phone
equipment manufacturers, that will lead to a reduction in the exposure of the public to RF
EMF to "as low as reasonably achievable" (ALARA) for mobile phones and base stations?
In line with the position taken by the World Health Organisation, the MMF considers that
neither the Precautionary Principle nor the ALARA principle apply to electromagnetic fields
(EMF). Neither should, therefore, become a basis for the formulation of public health policy
on exposure to electromagnetic fields. Standardisation bodies, government agencies and
health authorities periodically evaluate the data from scientific studies on health effects. The
conclusions of their most recent evaluation are summarised in the document submitted
during the interview31. In general, international experts conclude that on the basis of
established scientific fact, there is no evidence of negative health effects. In agreement with
the conclusions of the experts, WHO states that "ALARA does not apply to the formulation of
public health policy in relation to exposure to electromagnetic fields. In fact, the policy does
not apply to electromagnetic fields (whether generated by transmission lines or at
31
The document that Mr. Carballes presented during the interview, refers to the ICNIRP report, that
of the European Commission (European Commission Expert Group, Possible Health Effects Related
to the Use of Radiotelephones. Proposals for a Research Programme by a European Commission
Expert Group [1996]), the report of the Royal Society of Canada (A Review of the Potential Health
Risks of Radio Frequency Fields from Wireless Telecommunication Devices [March 1999]), the
Stewart report (Independent Expert Group on Mobile Phones and Health, Chairman Sir William
Stewart [May 2000]) and the report of the WHO (Repacholi MH. Low-level exposure to radio
frequency electromagnetic fields: Health effects and research needs. Bioelectromagnetics 19:1-19
[1998]). These documents are also presented in this report.
111
radiofrequencies) in view of the absence of risk at low exposure levels and in view of the
widespread nature of exposure"32.
Q: Do you think that audio from the mobile will be delivered by Bluetooth rather than by
direct contact with the ear?
A: Yes, in Bluetooth-enabled devices, all information, including audio, will go via Bluetooth.
Bluetooth technology will enable the easy use of an earpiece, avoiding existing problems
with this type of accessory.
Q: The public is concerned by the multiplicity of sources: mobile telephony, TETRA, DECT,
BLR… Are the manufacturing members of MMF concerned by the biological effects of
mobile telephony (GSM then UMTS) of other sources?
A: The majority of other sources, in particular DECT, emit very low power. Licenses for the
installation of local wireless loops were given recently by ART to new operators in order to
facilitate direct access. The frequencies used are in the range 3 to 40 GHz. Two
frequencies bands are used in France: 3.5 GHz and 26 GHz. The levels emitted are lower
than from conventional base stations. However, I do not have any precise information about
biological effects at 26 GHz.
Q: Is it possible to indicate the SAR values on the display of the user's phone, and to
establish technical specifications such that SARs are verifiable and consistent for all
manufacturers?
A: SAR is a very complex technical parameter; it is difficult albeit necessary to explain it
simply to users. To simply indicate a value on the screen is not enough. Moreover, SAR is
directly proportional to emitted power. As previously observed, power is not constant with
time: it varies when the user moves, and even if the user is not moving it changes with time
during a call. There is also a "hand over" protocol which ensures that the user is connected
to a good cell. This is characterised by an increase to maximum power and a decrease to
minimum power. The exposure level varies during this time.
32
http://www.who.int/peh-emf/publications/facts_press/EMF-Precaution.htm
112
Technical remark: The greatest technical difficulty is that the SAR depends on the position of the
telephone with respect to the ear, and the way in which it is held in the hand. Therefore the SAR is
not necessarily the same as the value indicated. It is therefore possible to indicate the SAR,
calculated from the power necessary to reach the base station, only if it is possible to standardise the
way in which the telephone is held during the call. The coupling between the hand and the telephone
modifies the power emitted from the phone by anything up to a factor 10.
A: The standard procedure for measuring SAR uses a phantom with a specified shape, a
test liquid whose properties depend on the operating frequency, and predefined positions of
the phone with respect to the head with the device operating maximum power.
Q: A possible solution would be to indicate on the screen the SAR corresponding to that
measured for example, three seconds previously, not the instantaneous SAR.
A: This sounds very complicated and the results will not be very meaningful. Actually, the
standards specify threshold values that take into consideration safety factors. As long as the
values of SAR are below the threshold value, there is no difference in terms of safety for
users exposed to SAR of, for example, 0.1 or 2 W/Kg. The industries that I represent are
not against the publication of SAR values on condition that they are indicated clearly and
understood by the public, and only after harmonisation between the American and European
standards which would enable the provision of viable and consistent data. As for indicating
instantaneous values of SAR permanently on the mobile, this sounds to me as very difficult.
Technical remark: Notwithstanding the above, on-screen indication of SAR is technically possible but
the values indicated will be no more precise than, for example, the number of bars indicating the level
of reception on the screen. People often hold their fingers close to the antenna whilst using the
phone, and this causes SAR variations. What really matters is the SAR measured in the laboratory
and the average power emitted by the mobile phone during a call.
Q: The indication of SAR on the screen of the mobile phone is a useful piece of information
for the users because it would enable them to change the way in which they make a call in
practice if they know that their level of exposure depends on the condition of use.
A: The user is already given different types of information and recommendations for
example not to hold the mobile phone by the antenna. To measure SAR under all possible
conditions sounds technically impossible to me. What may be possible is to give some form
of dosimetric information by indicating the average power emitted, in the knowledge that the
SAR is related to this value.
Q: For some telephones the maximum SAR is 1.5 W/Kg, for others it is 0.2 W/Kg. It
appears that the lowest SARs are obtained for telephones that have higher technical
specifications, price and performance. Is it possible to standardise all telephones to a
comparable emission level ?
A: From the technical perspective, it is possible to conceive a “quality factor” that takes into
consideration both the efficiency of emission from mobile phone and the maximum SAR. A
very low efficiency phone (which, technically, is not good quality) would probably produce
very low values of maximum SAR (the values specified in the standard). It is therefore not
quite right to say that very low maximum SAR values are systematically obtained from the
best performing telephones. It is right to say that an important parameter is the efficiency of
the phone and this is somewhat related to the maximum SAR. Personally I think there are
three important elements:
1. the technology must aim to minimise SAR (the design of the telephone is an important
parameter in this respect, as the antenna can be made to orient away from the head: a
favourable design element);
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3. the technical specifications of the network (currently the network operates on the basis of
33 dBm , if it where to function at 30 dBm, the SAR would be halved.)
The group of experts had been informed that Mrs Segala will be accompanied by Mr Le Ruz,
Adviser to the ADECEM, who was not able to attend.
2. What effects have been brought to your attention by people reporting symptoms from
exposure to electromagnetic fields, and more specifically mobile phones?
We have distributed a petition on electromagnetic fields and can report the following:
· thermal effects;
· specific effects on the nervous and endocrine systems;
· an increase in the number of people hypersensitive to electromagnetic fields in Europe.
However, this petition was not specific to mobile phones and the Association has no answer
to this question yet despite the fact that it received many complaints from mobile phone
users.
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3 What action do you recommend on the use of mobile phones and the siting of their base
stations? What are the reasons behind these demands?
· The implementation of the limits of exposure to electromagnetic fields for the general
public proposed to the European commission and the Parliament, which is 1 V/m, at 400
kHz to 300 GHz;
· Taking into consideration the residents equipped with active and passive implants as
well as the residents who are hypersensitive to electricity.
These demands are made because of the very large number of court cases and by the
revelations in the media.
Q: There are actually thousands of base stations in our environment, so that all the
population is exposed. Are you indicating to us that some people as more exposed than
others, or that some people can suffer more than others ?
A: This probably depends on the exposure, or the distance of the exposure, or the degree of
sensitivity of the persons.
Q: How often do you receive complaints and how serious are they? How many people have
complained about power lines and computers?
A: The number of complaints varies from week to week, I do not have the number of people
presenting common symptoms.
Q: On what basic principles do you base your replies and advise to the complainants (how
do you attribute a cause to a symptom)?
33
Technical note: The correspondence of the DGS (Directorate General of health) was brought to the
attention of DGUHC (Directorate General for Urban Housing and Construction) on the siting of base
station antennas on the balconies of some residential buildings in places that are directly accessible
to the public, in particular those fitted with pacemakers, this at a time when the European Commission
was preparing a recommendation limiting exposure of the general public. The DGUHC circular has
adopted the terms of this correspondence to communicate to HLM Organizations.
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A: First we rely on the opinion of medical doctors and scientists. Secondly, the
complainants themselves try to understand the origin of their symptoms by reflecting on their
various activities (contact with electrical equipment, daily work on the computer etc.) or by
discovering if there is a base station antenna close to their homes.
Technical remark: R. de Seze has indicated that he receives similar queries through a professional
network of consultant pathologists at the INRS and that he redirects the complainants to the ADECEM
to determine a cause for their symptoms.
Q: A powerful 6 MW antenna is sited on top of the Eiffel Tower: this is the equivalent to 10
times all the base stations in France. Have you received complaints from residents in that
area that may be related to this antenna? Furthermore, there are about 40 FM radio
transmitters in Paris. The electromagnetic field strength due to the FM transmitters is
highest in Paris; it was there before television and GSM who contribute approximately
similar levels. Have you had more complaints in the vicinity of these FM stations?
A: We have some cases, but our Association is not the only one receiving complaints.
Q: In view of the lack of credible information, what type of organisation should, according to
you, provide trustworthy information (district, local council, DDASS)?
A: The District and Local Councils should ensure that base station antennas are sited in
locations that do not cause problems for residents.
Q: Base stations are, however, designed to be installed in the proximity of their users.
A: Of course, but they should not be sited near schools for example.
Q: However, according to the Stewart report published in the UK in May 2000, the siting of a
base station on the rooftop of a school reduces the level of exposure in the school.
A: I am not a scientist, I am not sufficiently qualified to answer this type of question. I am
sorry that Mr Le Ruz could not join me today, he would have given you a learned opinion on
this matter.
Q: How do you identify the independent expert that you need within the Association?
A: We contact the ABPE, for example. We also make inquiries at the European
Commission and we are in contact with foreign associations, in particular the Swedish. All
the associations have scientific councils.
Q: While not everyone has technical qualifications; it is necessary to provide the general
population with credible, well-founded information. This is why we would like to know what
type of organisation, or what course of action, you think would allow the provision of such
credible information?
A: There are laws and regulations on health matters.
Q: Do you therefore consider that the publication by the Ministry of Health of regulations to
form a solid and sufficient base ? According to you would the public trust such information?
A: I would like experts, independent of the Ministry, to provide an opinion in order to
exchange ideas.
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4.5.4 Elisabeth CARDIS
International Agency for Research on Cancer (IARC) (World Health Organisation)
The study of Szmigielski (1995) in Poland shows a systematic increase in the risk of cancer
but it is very difficult to interpret because its methodology is not clear.
The Grayson study (1996) is a case-control study within a cohort in the United States; the
participants responded to a questionnaire. There were 230 cases and 920 controls from
within the US Airforce. The study shows a relative risk of brain cancer of 1.4 for those
exposed to radiofrequencies, but no dose-response relationship with respect to exposure.
The Thomas study (1987) is also a case-control study: it has 435 cases and 386 controls, it
used job titles to classify exposure. The relative risk of brain cancer was 1.6. A more
detailed analysis shows that this increased risk is only present in workers who, in addition to
exposure to microwaves, work in the electric and electronics industry and that the risk of
brain cancer is higher for workers in this industry even if they have not been exposed to
microwaves.
On the basis of case-control and cohort studies it is difficult to conclude that there is an
increased risk of brain tumour or leukaemia among workers. However, most of these
studies suffer from poor methodology and in particular none of the studies has really
characterised the individual level of exposure.
The study of Hardell et al. (1999) on brain cancer risk is based on 233 brain tumours. The
results show two elements:
· no risk of cancer in mobile phone users (relative risk of 0.98) compared to controls;
· a non significant increased risk of 2.5 on the basis of 13 tumour cases, three benign,
localised in the brain lobe near the antenna on the side of the head that the user places
the phone
However, it is difficult to draw firm conclusions on the basis of this study because of
methodological problems: it is based on a small number of cases and only on those cases
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alive six month after that diagnoses, such that a very large number of eligible tumours were
not included in the study.
The study of Muscat et al (not yet published, but reported in the recent document from the
Academy of Science)34 on risk of brain cancer is based on 450 cases of brain tumours in the
United States. It reached two conclusions:
In contrast to the conclusions of the Hardell study, this study does not show any increase in
the tumour on the side of the head near the antenna.
Nevertheless, this study has limitations of its own. It has too few cases, and relatively fewer
people use mobile phones in the United States than in Europe. Finally, the study was
carried out too early considering that the cases were recruited between 1994 and 1998, a
period were the number of mobile phone users all over the world was relatively small. The
fact that this study does not show an increase does not therefore mean that none exists.
The study of Dreyer et al (1999) on cancer risk had a cohort of 285,000 users in the United
States from among analogue phone users and car phone users. Two cases of death by
brain tumour and 4 cases of death from leukaemia were revealed, which corresponds to a
very small standardised mortality rate. It is difficult however to come to a conclusion
because the follow-up period is too short (only one year) and the number of cases too small.
The study of Morgan et al (2000) on Motorola workers deals with exposures from all
communication equipment, not only handheld devices. It has a cohort of 196,000 Motorola
employees followed up from 1976 to 1996. It defines three levels of exposure related to
different types of job description of the people involved, but it does not include any individual
assessment of exposure. Overall, it shows a decrease in the number of deaths compared to
the population as a whole. The same result is found for all cancers as well as for leukaemia
and brain tumours. No dose-response relationship was established.
A more detailed analysis showed that among those 196,000 subjects, few were exposed
(17,000 people exposed to high and moderate levels), with only 17 brain tumours (of which
three were among the highly exposed group) and 21 leukaemia cases (of which 5 were
among the highly exposed group).
The only conclusion is that it is too soon to reach a firm conclusion of any kind for RF
exposures with telecommunication equipment.
34
This study was since published in JAMA in December 2000 and it is reviewed among the recent
articles (see Chapter IV-E).
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II. Discussion with the members of the group of experts:
Q: Is there a scientific basis for the reclassification of benign and malignant tumours in the
case control study of Hardell? Moreover, it is true that the follow-up period is too short to
show effects. However, according to Muscat, the hypothesis for carcinogenesis veers more
toward the role of promotion rather than initiation; under such conditions the time period
leading up to the appearance of cancer is shorter than if it was an initiating effect. Is this a
relevant parameter?
A: The two questions are related. It is thought that if RF has an effect, this effect will be
seen in the promotion or progression of the tumour, that is an increase in cell division etc.
which can occur with benign as well as malignant tumours. This is why it is important to
look into the two types of tumour. I think however that in the IARC study we will derive
conclusions for the two types of tumours separately. The study of Hardell has few cases, so
it is necessary to combine the two types of tumours.
Q: Reporting on the study of Hardell, Hansson-Mild points out that out of 13 cases of
tumour, 9 were exposed to NMT, 3 to NMT and GSM and 1 exposed to GSM only. Do you
see any grounds for discriminating between the effects of the different type of phones?
A: NMT phones are analogue telephones that monopolised the market up to 1992 when
digital telephony was developed. Consequently, the result reflects the follow-up period
between exposure and the appearance of tumours. In the United States, unlike in France,
the number of people in the whole population who have used NMT is higher than those who
have used GSM.
Q: Are the scientific data relating to the risk of cancer associated with RF EMF the
justification for the important IARC study? What is the time frame?
A: On the basis of the studies carried out on occupational exposure we cannot conclude
that there is no effect. However, if such effects exist, they would be very weak indeed at the
level of exposure of mobile phone users. Nevertheless, even a very small risk at the
individual level could mean a very large number of cancers all over the world in view of the
exponential growth in the use of mobile phones.
Q: In your criteria for the evaluation of the carcinogenic effects of RF, have you taken into
consideration experimental work that supports your hypothesis that effects could occur ?
What are the studies that support your hypothesis?
A: It is equally difficult to draw conclusions on the basis of experimental studies. The only
risk is probably the risk of promotion or progression. If this is the case, the latency period
could be short, of the order of five years, so we should have sufficient follow-up for the cases
to develop within the time frame of the epidemiological studies that are just starting.
Q: IARC has initiated an important international study; the results should be available in
three or four years.
A: We have not yet secured funding for the whole project. We have partial funding from the
European Commission and national bodies, and we are still looking for additional funds from
industry. The latter entered into discussion with the International Union Against Cancer
(Union Internationale Contre le Cancer (UICC)) about a year ago. The UICC could deal with
appropriate funds from industry but we had not yet received a contract that is acceptable to
us in as much as it guaranties the independence of our work. If we manage to secure the
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funds required within the next few months, we should be able to produce the first results
from the national study in 2003 then the final international results in 2004.
Q: Our group of experts will be making recommendations on the means of providing funds
for research in electromagnetics; why have you met with difficulties in establishing clear
basis for securing funds from industry?
A: The contracts proposed by industry contain a number of conditions, such as the
possibility of stopping funding the study if the work is not carried out correctly, the
nomination of members of the scientific committee in charge of monitoring the progress, the
review of papers 60 days prior to their publication etc. However, according to our
international protocol the results must remain confidential until their publication. Only one
copy of the paper can be sent to the funding agency under confidential cover – with the
agreement of the journal –not more than one week before publication.
Q: The IARC evaluation of RF and cancer will be based on all the available data. How will
that fit with the schedule for the publication of results from this study?
A: The date of the evaluation of the individual studies is 2003. However, in one or two
years we will review the state of current knowledge and decide if it is too soon to carry out
such an evaluation. The Interphone study is independent of the individual studies. The
latter are the responsibility of another unit within IARC.
We wanted to include leukaemia in the Interphone study but we did not have the funds to do
so. Independent studies on leukaemia may be therefore carried out elsewhere. Now that
ionising radiation and even extremely low frequencies are considered factors in the
development of leukaemia, some researchers thought that, by analogy that radiofrequencies
could also be responsible for leukaemia because the bone marrow of the skull is exposed to
RF while using mobile phones.
Q: How did you deal with combining data from questionnaires and the results of actual
dosimetry?
A: In a feasibility study, we tried to identify factors that determine the level of exposure
(number of calls, duration of calls, use of power control etc). We have started a process of
quantification and we will be developing some sort of index of exposure.
Q: Are there any ongoing studies dealing with pathologies other than cancer in relation to
mobile phones (headaches for example)?
A: This is a field with which I am not familiar, I don’t know.
Q: Pending the results of this study, does the state of knowledge justify the adoption of
measures to reduce electromagnetic field exposures to below the levels recommended by
ICNIRP and the EU?
The exposure levels from mobile phones and base stations are actually well below the
recommendations in the standards. Most of the time, mobile phones emit less than 5% of
their maximum power: the emissions are therefore below the levels in the standard. While
35
This study by Inskip et al has also just been published in the New England Journal of Medicine and
is reported elsewhere (see recent articles)
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there is some uncertainty relating to possible effects, one should adopt some form of
precautionary approach but it is difficult to know on what to base it. For example, it has
been recommended to limit the use of mobile phone by more vulnerable populations such as
children. This precautionary approach is based on analogy with the risk to children from
other agents, such as chemicals, ionising radiation etc.
Q: Industry and its representatives rely on the advice of WHO with respect to the
Precautionary Principle; they interpret it to mean: "provided that we respect
recommendations based on established science, it is not necessary for us to modify our
position". Has the WHO said that only well-established scientific data should form the basis
for regulations and that there is no reason to adopt a Precautionary Principle?
One part considers biomedical phenomena related to the interaction of people with the
electromagnetic environment. A comparative analysis and a summary of results as a
function of frequency are presented.
Another part of the report gives opinions that were gathered on the validity and scientific
soundness of the data that were considered. Particular attention was given to the sources of
information and to the criteria used in the presentation of the results. A distinction was made
between the results that were validated and those still under discussion or where
replications had not yet been completed. Results that had not been discussed by the
international scientific community were discarded. The report has two main parts: the first
gives the main subjects considered and the main conclusions and recommendations for the
benefit of Members of the European Parliament. The second part presents the arguments
in support of the first part. The last part of the report is a summary dealing with the basic
principles of electromagnetism and biology.
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· pay particular attention to vulnerable populations, particularly children, the elderly and
people undergoing medical treatment;
· look for possible physiological or psychological reasons for the hypersensitivity of certain
people to electromagnetic fields;
· address the lack of basic knowledge on interaction mechanisms for people in the
electromagnetic environment;
XII- What are the regulations adopted by the Member States of the European Union and
their neighbours with respect of the exposure of the public to RF EMF?
Notwithstanding the Recommendation adopted by the European Council in July 1999, the
exposure standards relating to electromagnetic field are not harmonised between different
European countries. The report details the special cases that apply in Italy and Switzerland.
The countries can be divided into six categories:
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· Countries following the ICNIRP standard and the Council Recommendation. This
category includes Austria, Germany, France, Ireland, Norway, the Netherlands, Portugal
and Sweden.
· Countries following ICNIRP but which are in the process of developing more stringent
new regulations. The Walloon region in Belgium is preparing a standard on the basis of
3 V/m.
· Countries not following ICNIRP but having more stringent regulations. Italy with 6 V/m
(but 20 V/m in places where people do not stay longer than 4 hours per day). In
Switzerland, limits of 4 V/m for base stations at 900 MHz, 6 V/m at 1800 MHz and above;
5 V/m for base stations emitting in the two bands, are expected.
· Countries not following ICNIRP but having less stringent regulations. This is the case of
the United Kingdom with an SAR of 0.4 W/kg, which correspond to a power density of
26-33 W/m 2 for 800 – 1000 MHz and 100 W/m2 for 1800 – 1900 MHz.
· Countries which are not following ICNIRP and do not have regulations. This is the case
of Greece.
· Countries who have not yet taken any position. This category includes Denmark, Spain,
Finland and Luxembourg.
Q: How can we better understand the advice of people in authority on the biological and
health effects of mobile phones on children?
A: To the question “do you think that the children are more vulnerable than adults to
possible risk?”, the responses of the experts consulted were as follows:
a) People within the industry do not consider themselves qualified to reply to such a
question and do not consider that the question should be asked while there is no
evidence of any effect. One however has said that it is not possible to say no.
Another gave an absolute positive response to the question. Another opinion was
that the response to the question depends on the hypothesis set out at the onset,
either we think that the effects are too weak to observe, or we think that there are
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compensation mechanisms coming into action. In the latter case, the response is
certainly positive.
b) With two exceptions the scientists were in favour of the potential vulnerability of
children. One of the positive responses indicated that other people might also be
vulnerable if the effects reported on protein expression were true.
c) One scientist was of the opinion that current knowledge of the specific way in
which children interact with electromagnetic fields is largely inadequate
Taking into consideration the various arguments, often contradictory, reported in the
literature, the report concludes that it is necessary to deal very specifically with the case of
children. It was not possible to make very specific recommendations except to create the
conditions in which "educated and responsible awareness" becomes a means of active
prevention.
Q: Does your report recommend studies of children to see if they are particularly sensitive
from a neurophysiological or other perspective? Why should the energy absorbed by the
skull of a child be weaker than that of an adult under similar exposure conditions?
Technical remark: This question relates to coupling: the head-handset impedance is lower, which
means that more radiation is reflected outward than toward the head given the morphology of the
head of a child.
Q: Have you debated the principle of optimisation, bearing in mind the possibility that the
European Recommendation of 1999 might become a Directive? Have you discarded the
ALARA principle? According to the people who gave evidence this morning, the
technological objectives lead to optimisation and thus to the reduction of doses: they
therefore adopted the ALARA principles without health justification.
A: Our report holds the principle of ERA ("educated and responsible awareness"). It implies
optimisation of the electromagnetic environment. We have gathered different opinions on
the ALARA principle: according to some it would not be applicable to the field of mobile
telephony.
Q: In view of the lack of basic knowledge that you have referred to in your report, do you
recommend fundamental research on the growing animal?
A: Such studies would be useful. Those carried out to date have not shown a difference in
the results depending on the phase of development, but there have not been many studies
on the subject. In general, an improvement in our knowledge of mechanisms of interaction of
living organisms with electromagnetic fields would provide generally useful information.
Q: We always meet an ethical problem with research on children. Consequently how would
you direct the research (on a growing animal, on growing cells or on the gonads)?
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A: The solution of this ethical question must come from the competency and responsibility
of the researchers themselves. One approach would be to start from basic knowledge of the
development of children and the interaction with electromagnetic fields, to develop a better
ability to analyse specific effects a priori, and determine whether such effects are possible or
not and at various stages of development.
Q: This means taking into consideration growth and risk cofactors simultaneously.
A: One issue needs to be clarified; the hypothesis referred to earlier of compensating
mechanisms that ensure a sort of homeostasis in the organism with respect to sensitivity to
the environmental electromagnetic field. This would explain some of the results obtained, in
particular from epidemiological studies, as due to a deficiency in such mechanisms in a
small percentage of the population. Moreover, in dealing with cofactors of risk, it can be
noted that the hypersensitivity of certain people to EMF is not related to EMF so much as to
these people's fear of EMF. It would be desirable to study people who are known to be
hypersensitive because one may find among them symptomatic cases that would make
possible the study of a number of parameters and would increase our knowledge of specific
issues.
Technical remark: It is important to distinguish the epidemiological and psychological aspects and
hence to differentiate between people who think they are hypersensitive to electricity but who
objectively are not and people who are sensitive to electricity because the field constitute, in their
case, a co-factor to their symptoms. Some people are also sensitive without knowing it.
We have followed very specific experimental conditions: for financial reasons we have
worked in call- rather than communication-mode with a telephone fitted with a mobicard, that
is, without subscription. The Faculty provided us with a silent line and a code number
allowing a repeat call every three minutes. We were therefore in an extreme exposure
situation system: our telephone will dial a number with a ringing phone for one minute then
rest for two minutes in total three minutes, then repeats the cycle over again etc.
Prior to the tests with the telephone, we carried out an experiment with computers. We
noticed a change in the ratio CD5/CD20 (immature B lymphocytes/mature B lymphocytes).
We used chick models that we had in the laboratory. Within three weeks of incubation, we
realised a 40% mortality rate in the eggs. We placed the survivors in a cage in front of the
screen of a computer, having covered the screen with a black cloth. We then proceeded to
measure antibodies, corticosterone and melatonin. We realised a very significant decrease
in melatonin and a decrease of corticosterone and specific antibodies.
Pleased with this experiment, we kept the same model for the experiments with mobile
phones and, as an end point the evaluation of the mortality of embryos.
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2- How do you extrapolate from chick embryo to man? What risk to man would your results
predict? In your opinion, does your work relate to the problem of low frequency emissions
from mobile phones?
First of all, we have adopted a high intensity toxicological approach by using a call mode,
which is not the usual condition since the telephone is mostly used for communication.
However, before the establishment of communication, the users are also in call-mode albeit
for a shorter duration than we have used in our test.
We have carried out mutagenic test on bacteria (AMES’ test), which proved negative. A
positive mutagenic test on bacteria would suggest potential mutagenesis in man. The
mortality of embryos observed in our experiment originates from changes in the sequence of
development of the embryo. It is important to note that the chick embryo goes through the
same sequence of development as the human embryo, so extrapolation is more
straightforward than for bacteria. The group of Jocelyne Leal in Madrid have worked with
other electromagnetic fields (low frequency pulsed fields) applied over 48 hours. They
detected development anomalies and malformations in the first two days. In our work on
chick embryos, we did not analyse development anomalies for financial reasons, however
because we fixed and kept a series of embryos at the time of death in order to look for
anomalies, this work could still be carried out. We have therefore just carried out a
phenomenological study by counting the dead embryos. I think that their death is due to
developmental anomalies and structural modifications. The toxicological approach that we
have taken is similar to pharmacological studies carried out to predict possible toxicological
effects of drugs. Mobile phones could, in my opinion, be classified as teratogenic because
of the effect on the normal development of an embryo. If, on the basis of our results, the
mobile phone is classified as a teratogenic "drug" – a very special drug, used by a large
portion of the population - the advice should be not to give it to people at risk or to children.
Q: Your experimental model consists of a multiplicity of sequences of calls that are not
representative of the normal operations of a telephone. How is it possible to extrapolate
from this situation toward the general problem of the telephone?
A: It is necessary to carry out complementary studies. Our model can be used in a variety
of different configurations. With respect to our operational modalities, we have repeated our
experiment several times and always obtained the same results. We have always carried
out the experiment in parallel with an incubator containing the same eggs as those under
consideration and we have always obtained the same rate of mortality of exposed embryos
compared to controls.
The increase in temperature due to the operation of the telephone cannot constitute an
experimental bias because the experimental container used was thermally-regulated and the
temperature was monitored with 4 probes in the middle and around the tray of eggs and
there were practically no difference in temperature (38 ± 0.5°C).
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Mr. Bouillet of Bouygues-Telecom has agreed to help us replicate this work with the
collaboration of Supélee and two different research groups, the Bioelectromagnetic
Laboratory of Jocelyne Leal in Madrid and that of INRA in Tours, both specializing in birds.
Q: You seem to be attributing the effects observed to the low frequency magnetic fields
from the telephones. Could you please explain that in more detail?
A: Because of our experiment in front of the screens of computers we knew that the effect
was not due to high frequencies (microwave effect). We have blocked the transmission of
high frequencies from the telephone using a 350 mm diameter copper mesh: we earthed the
mesh and placed it on top of the eggs without touching them before placing the telephone on
top of the grid. We observed the same mortality rate with and without the grid. We have
carried out similar experiments with mice and observed the same decrease in corticosterone
and ACTH as previously observed without the grid.
Q: Do you conclude from your experiments that there is a possible teratogenic risk?
A: I would conclude that our experimental results are repeatable and demonstrate an
important effect on the viability of chick embryos. We cannot say that the mobile phone is
safe. Computers appear to be more dangerous however, because their users spend several
hours in front of the screen and at proximity of between 50 and 80 cm as in the case of
exposed eggs. If the user spend several hours in front of the computer whilst using a mobile
phone, it synergic effects and enhancement might be possible.
The inner ear is a highly differentiated structure, a specific micro-organ relatively isolated
from the rest of the body. It has a very high sensitivity to external acoustic stimulation, with
a threshold of detection of vibration of nanometre amplitudes. Reception of acoustic
vibration occurs through the intermediary of contractile proteins (prestine) that amplify the
vibration by 40 to 50 dB. The sensory epithelium is very heterogeneous and includes an
extracellular compartment for liquids of high potassium content (endolymph, in which the
filaments of the sensory cells bathe). There is a difference in potential of about 160 mV at
the interface between the filaments of the sensory cells and the liquid in which they bathe.
The electrical phenomena associated with mechanosensory transduction are of the order of
a few nanovolts. This is why, other than the biological effects common to all tissues, one
might expect possible perturbation of the electro-biochemical phenomena that are delicately
balanced and specific to the function of the ear
Finally, the ear is submitted simultaneously to microwaves from the mobile phone and to the
sound produced by it. It is possible that some synergy between microwaves and sound
could take place in sensory cells, and it is also possible that this synergy may prove
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deleterious even if the two agents separately are harmless. The sensitivity of sensory cells
to microwaves may be different during their functional depolarisation.
2. What do we expect to see from the exposure of the ear to GSM microwaves?
If the energy absorbed at the level of the inner ear is sufficiently high, one would expect an
auditory sensation associated with electromagnetic stimulation, which is apparently not the
case with mobile phones. So, if the mobile phone induces an acoustic wave in the skull, this
would be below the intensity threshold for hearing. It would also be below ambient noise
and therefore without any risk to the ear. Electromagnetic waves could also stimulate
directly - in the same manner as an electrical stimulation - the sensory and nervous
structures of the inner ear that are highly sensitive to acoustic and electrical phenomena,
and result in an auditory sensation. This is evidently not the case.
Other possible effects are not necessarily specific to the ear but common to the effect of
GSM microwaves on biological tissues in general.
Q: Do you mean to say that in the absence of an auditory sensation there are no other
effects given that – according to you – the first manifestation is the development of an
auditory sensation?
A: The energy, not being sufficient to develop an auditory sensation, would also not be
sufficient to produce damage to the ear or to the retina for example. The same argument
can be made for equilibrium (dizziness).
Q: Some studies have shown that cortical auditory evoked potentials were modified only
when the people were carrying out an intellectual task. Can this have any consequences for
brain functions?
A: If sensory evoked potentials other than auditory (visual or somesthetic) are modified, we
can perhaps consider that we are dealing with central nervous system functional changes.
If only auditory potentials are modified, we should investigate further. In our experiments, we
do not exclude the possibility that a central effect occurs in addition to peripheral
phenomena. If a modification occurs in central responses via a chain of effects from the
periphery, we are in a position to carry out different types of tests (acoustical otoemission,
electrocochleography, cerebral evoked potential) that will enable us to localise the
disturbance and determine whether it is central or peripheral.
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verified. It would also be interesting to measure the first peak and the interval between the
first and the fifth in order to determine the peripheral or central location affected.
t Ongoing studies
Within the COMOBIO Project , we have studyed hearing at the peripheral level (ciliary cells
and the auditory nerve) and at the central level (brain stem) of hamsters exposed to different
SAR levels (1.2 and 4 W/kg) for one hour per day, five days a week for two months. We
used groups of eight animals. Permutations of the groups and of the animals within a group
were made in time and location in order to homogenise the exposure conditions. The
detection of otoacoustic emissions gives a measure of the function of ciliary cells outside the
cochlea, are involved in the first stage of the reception of sound. Detection of the action
potential of the auditory nerve gives a good measure of overall peripheral function (cochlea
and auditory nerve). The detection of evoked responses from the brain stem gives a central
measure of the auditory function. We are particularly interested in the threshold of
electrophysiological responses as a function of frequency and to the existence or absence of
acoustic distortion of otoacoustic emissions also as a function of frequency.
In the future, we intend to modify the experimental protocol because several animals lost the
cannula implanted in the brain to hold the bottom part of the detecting electrode. We will
implant permanent cannulas and, to detect the signal, we will insert needle electrodes under
the skin at the level of the vertex and the mastoids. With this arrangement we can detect the
evoked potential of the brain stem. By doing this, we will ensure that the detection of the
responses from the two ears are absolutely identical and that the animals that survive will be
available at all stages of the experiment. We have just validated this methodology in normal
animals.
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Technical remark: One should add that in vitro experiments are not in line with the current tendency
in research, and risk the creation of new questions without necessarily addressing the main issue of
health effects.
XIII- Could you summarise the main conclusions of the Academy of Sciences colloquium on
RF EMF ?
It appears to me that the there are three different aspects to the mobile phone problem. The
first is the measurement of physical quantities, the electric field in V/m, the power density in
W/m2 , the magnetic field strength in A/m or the magnetic flux density in µT. These
measures are related to an important element which is the power absorbed in the tissues of
the body, evaluated via the Specific Absorption Rate (SAR). This quantity is by far the most
difficult to assess because it cannot be obtained directly and requires measurement inside
tissue, which therefore must be modelled; it is generally expressed in W/kg of exposed
tissue either in the whole body or in 10 g or even 1g of tissue. These dosimetric evaluations
are essential as they give us an objective means of measuring the fraction of RF energy
from an external source that interacts with the body.
The second aspect derives from public concern and problems reported by users. Radiation,
even non-ionising radiation, has long been the object of concern about possible health
effects; the mobile phone has reactivated this somewhat dormant fear. With the exception
of a few cases of tumours, reported clinical symptoms are subjective: headaches, dizziness,
changes in sleep pattern etc. These symptoms led a number of European countries to carry
out research on animals and human volunteers. In France, the research was carried out
under the umbrella of the COMOBIO Programme, instigated at the initiative of the RNRT
and financed from public and private funds.
The third, sociological, aspect concerns deep-rooted "panic and risk". There are, for the use
of mobile phones as for many other activities that carry risk, human and social elements that
should not be forgotten.
The colloquium organised by the Academy of Sciences had three main themes. The report
of the proceedings reflects these three aspects. The first chapter is dedicated to dosimetry.
A second chapter reports on human studies other than epidemiology, and a third chapter
deals with animal and in vitro studies. The following chapter specifically deals with
epidemiology and almost exclusively that of cancer. The fifth part is more speculative,
dealing with future technological development. Finally, the last chapter is dedicated to the
management of hazards where four sociologists describe their visions of risk and hazard
management. What, in my opinion, can we be summarised from this colloquium? I will
report mostly on dosimetry and then on human and animal studies.
In the field of dosimetry, we had three presentations reporting good data. They
demonstrated to us that several aspects of SAR measurement (not easy to do) were very
well advanced, but that there is also a great deal still to be accomplished, including further
development of models. Experimental phantoms exist, and very accurate probes can be
used. However, some doubt remains as to what constitutes an acceptable measure of
specific absorption rate. The scientists base their assessment on the fact that the telephone
does not always function at full power. GSM produces a peak power of 2W at 900 MHz and
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1W at 1800 MHz. It is generally the case that that, particularly in urban areas, the power is
only about one tenth of these maximum values. These values are significantly below the
levels considered acceptable in recommendations from organisations such as ICNIRP
(international), CENELEC for the European Community, NRPB for the United Kingdom, and
IEEE-ANSI and the FCC for the United States. These studies are very important because
they point to the necessity of revising part of the early human and animal studies that often
suffered from poor dosimetry. It is important to add that these values remain below the
values eliciting thermal effects.
It should be noted that almost all of the report of the Academy is dedicated to the mobile
phone itself, that is to antennas placed next to the ear. The report does deal with base
stations, and these are considered low-risk. Having said that, it is right to recall public
concerns about the siting of these fixed antennas. We have here a complex fear syndrome
despite objective reassurances and discussions with significant contributions from
sociologists. The report also discusses what may constitute acceptable exposure levels; a
downward revision cannot be discounted, particularly in view of the initiative to lower the limit
values in Italy and Switzerland (to respectively 2 and 6 V/m as against 40 and 60 V/m that
prevail according to current European and international recommendations).
Other studies have reported epidemiological analysis of less serious effects. For example, a
Scandinavian study used a rather rigorous protocol to uncover a high incidence of
headaches from prolonged mobile phone use. This type of study must also be continued.
Some human volunteer studies have investigated effects on sleep. They showed a
shortening of the latency time for sleep or a reduction in the duration of REM sleep. Sleep
studies require careful planning to avoid confounding effects, such as the effect of stress,
but the results are most interesting. I will not dwell too much on electroencephalographic
analysis. It is quite possible to observe changes in the spectral power using signal analysis
but this is phenomenology, in my opinion; it has little explanatory value. Studies in
experimental psychology have shown a reduction in choice reaction time (simple reaction
time is not modified) during exposure to GSM signals. I do not know, however, how to
evaluate these observations. It is also important to note that no changes were observed in
human auditory evoked potential; a detailed analysis of such effects would have allowed the
study of latency and thus change in auditory function. Other observed effects are somewhat
doubtful, for example cardiovascular effects such as modification in arterial pressure
observed by one researcher but criticised because of their lack of accurate dosimetry.
Finally it should be observed that reported human effects such as headaches are currently
the subject of experimental animal research under the frame of project COMOBIO.
Q: The conclusion you reached on effects on man is that the work is not yet completed. Is
this opinion based on the legitimate and common professional concern of always pursuing
further research or does it signify fears that the researchers have?
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A: I think that both interpretations are valid. It is easy to criticise, but the research on man
and on experimental animals is very difficult for different reasons. In man, there is always
fear, even if we are dealing with an effect quite different from the direct effect of mobile
phones. The media does not necessarily differentiate between such effects. However, it is
quite impossible to neglect sociological phenomena, fear of risk, and to eliminate the stress
that this fear can eventually create. Clinicians are quite familiar with psychosomatic effects
of different kind. These should not be forgotten. There is also an element of stress when
dealing with animals. Having said that, I am rather surprised that most experimental studies
are carried out mainly on rodents. This species is very different from man. It is regrettable
that there are absolutely no studies on monkeys.
Technical remark: The main reason for that is that it is extremely difficult in view of a different shape
of the skull to reproduce the exposure to man in the rhesus monkey. Years of research have been
dedicated to the design of special antennas for rodents; a system has yet to be developed for the
rhesus monkey. Moreover, we have a lot of experimental data on rodents.
A: I acknowledge these reasons are often used in other fields of studies, in addition to
financial reasons and the difficulty of manipulating primates. It is clear that the use of rhesus
monkey or even baboons requires completely different logistics, a great deal of money and a
lot of effort but I still think it will be worth doing.
Q: We have the impression that this field of study is rather immature, as was the extremely
low frequencies about 8 years ago. Today, research at low frequencies leads to consistent
results from one group of researchers to the others.
A: I agree. It is necessary to standardise protocols in order to stabilise results and facilitate
interpretation. It is important to note that several of the chapters of the report of the
Academy of Sciences conclude with a ritual sentence; "further studies should be carried out
because the results are not conclusive". In other words "it has not been demonstrated that
RF is a risk to health, but the absence of risk has not been demonstrated either".
Q: It could be interesting to work on human and animal models that are subject to certain
pathologies. For instance, to investigate whether electroencephalograms that are slightly
abnormal are more affected than normal ones.
A: Absolutely. Slightly abnormal EEGs may be quite a sensitive indicator. We often lack
such sensitive indicators. I think one of the COMOBIO projects considered the use of
epileptic subjects.
Q: In a review article published in the summer, K Foster and J Moulder stated that if non
thermal effects actually existed, SAR would not be the most appropriate measure of the
exposure. What do you think of this proposition?
Technical remark: There is a widely held idea that SAR is a measure of a thermal effect: this is not
the case. SAR is representative of the square of the electric field. To determine it, one should
measure the electric field at a given point. By taking the square of the field, we loose information.
The SAR takes into consideration absorption in different types of tissue because it includes the
conductivity of the material as a factor.
A: To respond to the technical remark, it is true that SAR is not a measure for thermal
effects only, it is more generally a measure of absorbed power. But a measurement of
electric field strength only is not sufficient to evaluate absorbed power because, as in the
technical remark, the conductivity of the irradiated tissue is a multiplying factor and its mass
density r is a quotient (SAR = sE2/2r). We have yet to determine if SAR is the best
measure of RF exposure given that we are dealing with situations that are below the thermal
threshold. I certainly repeat myself here, but I would like to stress the necessity of dealing
with not just the physical effects of the irradiation, but to place it into a wider context in which
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psychological effects and the fear of risk are also included. Among all the messages
directed to the media this last one deserves special attention.
In conclusion, I would like to underline that the report of the Academy and the Colloquium on
which it is based represent a snapshot of the state of knowledge and that it has no
pretension of being anything more than a progress report of how things stood at the time.
I did not have time to report here the message of the sociologists with respect to risk
management, and what should and should not be done when facing a panic situation. I
have no doubt this would have been of interest.
I Introduction
Technical Note: Philippe Hubert has thought deeply about the incorporation of scientific uncertainty in
decision-making. He is part of a group that considers risk evaluation within the national committee for
health and safety. From an epistemological perspective, the situation of mobile telephony today is
similar to that of ionising radiation about ten years ago, hence the interest in this interview.
I look after risk evaluation and the development of risk management at IPSN, mostly in
relation to ionising radiation. The department has a unit for the evaluation of impact, another
unit to deal with the epidemiology of radiation and finally a unit on risk management that
deals with the principles of management from a philosophical as well as from a risk
perception perspective.
Technical note: The following text was submitted by Philippe Hubert, it is followed by the transcription
of the discussions with him.
The management of risks from radiation is a very large field. It relates to the exposure of the
general public and to that of workers. It bears on activities using nuclear energy such as
nuclear reactors, nuclear-propelled ships, nuclear military installation. It relates to the
properties of ionising radiation as used in diagnostic radiography, radiotherapy, material
control, sterilisation, surface treatment, baggage and parcel inspection, fire detection. Also
included within the domain are activities leading to an increase in "natural" exposure such as
mines, air travel, certain rare earth and ceramic materials, geothermal spas and bottling of
mineral water. The field encompasses also the reduction of natural risks from, for example,
radon in buildings. Finally, “radiological protection”, the control of radiation doses to patients
in cases of radiological examination or treatment is also covered. In addition to a few
hundred thousand workers (in France about 250,000 people are monitored), the whole
population is affected to a greater or lesser extent (diagnostic radiology, radon).
The hazards that must be controlled fall in two groups. The first group contains the
threshold effects associated with high doses, giving rise to acute effects such as burns and
the destruction of tissue, problems with spermatogenesis, cataracts, teratogenesis; these
are referred to as “deterministic effects”. Remaining below the exposure limit values
eliminates this type of effect. The second group contains different effects that do not
necessarily manifest themselves but the probability of their occurrence increases with the
dose (cancers, congenital malformations). These are called “stochastic effects”. The
Exposure Limit Values do not protect against this type of risk, its management relies on the
concept of acceptability.
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Since the identification of risks and the first warnings (1896 for burns) an elaborate system
of risk management has been developed and adopted at the international level. The
summary of this system and the way it functions are described below. The advantages and
disadvantages of this “model of risk management” will be discussed later and placed in the
perspective of the of management principle under discussion.
The Second World War saw the birth of the military nuclear industry (mines, nuclear
reactors, ammunitions, arms, recycling). After the war, the civil nuclear industry developed
in turn, followed by other applications of radiation (sterilisation, smoke detectors, thickness
gauges). Little by little, the problems related to the nuclear industry lead to different
developments in radiological protection.
ICRP, reconstituted after the hostilities, produced formal publications from 1955 onward.
Since then, the changes have been documented, argued on scientific grounds and in terms
of management objectives. The US National Council on Radiation Protection (NCRP),
formed in 1946, played a similar role in the American continent. The proposals of the two
institutions were always quite similar. However, the first limits of public exposure were
proposed outside this frame (tripartite conference on nuclear industry EU, RU, Canada).
The fifties were characterised by nuclear weapons tests. The increase in fall-out and the
Bravo” test of 1st March 1954 (contamination of the Japanese fishing boat ‘Lucky Dragon”
and tests at Bikini Atoll) lead to the creation by the United Nations of the United Nations
Scientific Committee on the Effects of Atomic Radiations (UNSCEAR). The main activity of
the committee is the gathering of information, including data on effects and on sources of
exposure whether natural, industrial, military or medical The Committee then proceeds to
produce complete, critical reviews that constitute an important source of information without
equivalence for other physical agents.
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standards are based on the ICRP recommendations) or by intergovernmental agencies
(IAEA).
The other deterministic effects (cataract, decrease in fertility or sterility, foetal malformations
due to in utero irradiation) were identified early. There was a great deal of research on the
subject because all these effects and their mechanisms are not completely understood and
the stakes are high in situations of accidental or therapeutic exposure. However, the
management of these effects is not a controversial subject as none of the research studies
so far has put in question the pertinence of the limits in force.
Leukaemias and other blood diseases, and bone cancer, were identified in the twenties in
workers operating X-rays machine and radium sources. The Congress of Stockholm
concluded that “known effects that must be prevented are: (a) damage to superficial tissue,
(b) problems with the internal organs and changes in the composition of blood” [Norstedt
1929]. The mechanisms involved were not really considered to be significantly different from
acute effects and the knowledge available at the time did not lead to changes in risk
management.
Before the Second World War, researchers identified hereditary effects (also known as
genetic effects). These are mutations that are capable of leading to malformation in the
offspring and descendants of exposed individuals. This had already been seen in animal
experiments (animal models: drosophila). This risk was known to researchers at the time of
the Manhattan Project . It was behind many of the research studies carried out in Hiroshima
and Nagasaki. Today, genetic effects are considered a lower risk than cancer (about 1/3 in
total in 1977 and 1/7 in 1990). There are still no epidemiological studies underpinning the
animal experiments. It is important to note that some genetic mutations can be recessive
and this has to be taken into consideration in the evaluation of risk at the societal level. The
unpredictable nature of genetic effects has introduced the notion of “stochastic” effects
(where the effect is not directly related to the irradiation in a deterministic manner);
stochastic effects are also characterised by the absence of threshold.
In the late fifties, ICRP stated that there were a number of identified effects that should be
avoided [ICRP 1958]:
It can be seen that all the effects had been identified even though their importance has
changed considerably since then, and so has the development and understanding of
mechanisms (damage to the genetic material inside the cells was not then considered as a
carcinogenic mechanism). Very few of these effects were supported by epidemiological
studies, a discipline that was not very informative and had little credibility among biologists.
For example, the epidemiological studies of A Stewart on the effects of in utero irradiation
were not well received. The effects that were most feared were those supported by
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experimental studies [Muirhead 1989]. In man, leukaemia and bone cancer were identified
from clinical rather than epidemiological observations.
In the sixties, advances in epidemiology changed the picture. Several kind of cancers were
observed (skin, thyroid, breast, lung, liver, stomach etc) placing cancer at the top of the list
of hazards, well ahead of reduction in life span and, to a lesser extent, genetic effects that
have not been supported by the epidemiological evidence. Another important change is that
the discussion focuses on the quantification of risk. The linear dose-response relationship
without threshold value has been postulated as a tool for risk management. Questions now
relate to the estimation of risk parameters and to the principles involved in obtaining them,
for example, are the risk parameters the same for low and high dose rates? Can we
transport findings from one population to another? Scientists now make full use of
epidemiological studies, without neglecting animal and in vitro studies that are used in
discussions of dose level and equivalence between irradiation times. Studies on survivors of
Hiroshima and Nagasaki played an important role in the construction of a dose-response
relationship but they are not its only determinants. ICRP, for example, did not use this study
in its evaluation of cancer of the skin, thyroid, liver and bone (ICRP 1991). The BEIR
committee has used a large number of other sources in parallel with that of Hiroshima and
Nagasaki, in particular for breast cancer and cancer of the thyroid [BEIR 1990].
To appreciate the extent of the extrapolations needed, we can plot the actual exposure
conditions and the epidemiological study in a dose/duration plot (Figure 1).
136
Durée d'exposition (années)Radiographies in utero
Expositions usuelles
Radiodiagnostic
Etudes H&N
permettant Thymus
Seconde
la quantification Teignes
0,0000001
plus faibles groupes significatifs Mastites
Fluoroscopies
Etudes mettant en Minute
évidence un effet 0,00001 Spondylarthrites
Fractionné
Heure
0,001
Expositions professionnelles Thyroides
Tchernobyl
Iles Marshall
Semaine
0,1
Naturel
Populations Tcheliabinsk
1
Trav. Mayak
10
Travailleurs, CIRC
The public is exposed to doses on the order of 2.5 to 5 mSv per year, depending on location.
The dose accumulates throughout a lifetime and may exceed 200 mSv. For diagnostic
radiography, the average makes little sense because the exposure is of short duration and
targets specific organs. While generally low, the doses to specific organs may be high, for
example in angiography and body scanning. The exposure of workers is of the order of 2
mSv per year in the nuclear industry but the regulations allow up to 50 mSv per year, and
this is the case for some people.
The idea of “extrapolation to weak doses” may not be entirely correct. The dose levels in
epidemiological studies do not require significant extrapolation to relate to actual exposure.
For example, the average dose to a survivor from Hiroshima and Nagasaki is about 130
mGy (230 in the 35 000 people exposed), exposure in excess of 50 mSv are considered
significant [Pierce 1996], even though 100 mSv is considered a more plausible value. For
thyroid irradiation in children, the risk is significant at fairly low doses for example of the
order of 100 mGy for Israeli children treated for tinea or in the range of 0-300 for those
treated for thymus hypertrophy [Shore 1992], [Shore 1993]. These levels have reduced
significantly in the last two decades because of the statistical power accumulated throughout
an increased lifespan. In the seventies, no increased risk could be observed below 1 Gy. At
the time of the 1990 ICRP recommendation, that level was 0.2 Gy.
In contrast, dose rates are very different (except for diagnostic radiography); the extent of
extrapolation is no longer one order of magnitude, but rather 4 or 5. The relevance of the
first results relating to workers in the nuclear industry, residents and workers from the river
Techa, or even the cases of cancer of the thyroid around Chernobyl are no longer very clear.
Even if the results are not sufficient to estimate a risk coefficient, they show that the
induction of cancer occurs in these circumstances. The extrapolation is not more precise
but it does have a better foundation.
137
The same exercise can be carried out for exposures to radon; most studies on miners were
collectively reviewed [NCI 1994]. Smaller differences were observed for both rate and level
of exposure. For example, in his working life, a miner in the French study received the same
dose as a resident of the two or three most exposed regions would over his whole life. To
validate in the general population the estimation of risk deduced from the study of miners,
case-control studies were carried out in different countries. The first results did not lead to
the determination of a clear effect related to radon at the doses currently found in the
general population. Some studies were positive, others did not lead to any significant
results. A recent meta-analysis of the best eight studies in this field produced a risk factor
closed to that of miners [Lubin 1997].
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Table I: Evolution of risk coefficients
1990 : ICRP 60 5
The concept of dose is not self-evident and its current status often leads to errors. Today,
“effective dose”, the quantity used to express the main exposure limit, is not a physical
quantity but rather an indicator of different exposures (to different organs, from different
types of radiation), as a function of their alleged effects and their weighting (one death by
radiation-induced cancer is equivalent, for example, to a serious anomaly in offspring). It is
more a management tool than a physical quantity.
The limits therefore apply to different doses and have had different objectives. The first
limits intended to eliminate risks. The first measure of “quantity of X-rays” was adopted in
1928 on the basis of ionisation in air, it was termed Röntgen (r then R). Other researchers
attempted to define a Skin Erythema Dose (SED) in the twenties. As can be seen, right from
the beginning, it was necessary to put together physical as well as biological concepts of
dose. It was possible to estimate that SED corresponds to 600 r (later this dose was
estimated to be 500 rad or 500 rem for X- and gamma rays and finally 5 Gy or 5 Sv). The
first value from ICRP (Zurich, 1934), was 0.2 Röntgen per day corresponding to about 500
mSv. That was considered “tolerable dose”.
In 1941, the concept of “maximum admissible dose” was proposed in the United States to
incorporate the concept that the limit is not an absolute guarantee. This value was reduced
to 0.05 r per day by the National Council on Radiation Protection and Measurement (NCRP)
around 1946, followed by ICRP in 1950), corresponding to around 125 mSv per year. These
values were established particularly to avoid hereditary effects. The concept of “limiting the
dose of the public” was proposed in 1949 (EU Conference, RU, Canada) for the first time
and was fixed at Harriman in 1953 (1.5 Röntgen per year: about 15 mSv, or about 1/10 of
the dose to the workers).
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The first concepts of dose did not allow for the regulation of radium intake (a limit of 0.1 µg
was proposed in 1941). The concept of cumulative exposure was not explicit and the doses
were expressed on weekly or monthly bases.
In 1958, at the time of the first ICRP recommendations, the current concepts were
discussed. The “physical” dose was the rad, corresponding to the ionisation produced in
tissue rather than air (1 rad = 0.01 Gy = 0.01 J Kg-1). The primary biological equivalent was
the rem (it was noted that neutrons and alpha particles were more “biologically” active) and
the concept of cumulative exposure was introduced with limits over a lifetime. The concept
of collective dose was also developed on the basis of genetic effects. It became possible to
calculate dose from the concentration of radionuclei in the body and hence it became
possible to convert rems into admissible concentration. The concept of “whole-body-dose”
was outlined but was not valid except in cases where “the organs received a fairly similar
dose”.
The concerns over “genetic effects” or “hereditary effects” led to two new concepts that were
formulated by ICRP in its 1958 recommendations. The limit value for reproductive organs is
a “ceiling” value deriving from a balance between cost and benefit. The concept of
“collective dose” was introduced indirectly. A limit of 5 rems (50 mSv to organs) applied to
the average dose to the population. The system is based on a linear relationship without
threshold. The concept of acceptability (health-socio-economic) was introduced and related
to the limit. ICRP was of the opinion that these values imposed a “heavy burden on society”
in view of hereditary damage but it was tolerable in view of the benefit to be expected from
nuclear energy. The need to keep the doses as low as possible was stressed.
For all other risks, the “permissible dose” had to restrict the risk to a “negligible” level that
could not be detected at the level of the population by “statistical methods applied to a large
group” and remained “probably hidden within normal biological variation”. We have here a
second concept of acceptability, different from the previous one related to “non detectability”
([ICRP 1958]§31). At the same time, the absence of threshold and the absence of “repair”
of organs tissue long after the exposure were postulated as prudent hypotheses. The limits
were more stringent for gonads, haematopoietic organs and the cornea (0.1 rem per week,
about 50 mSv per year). For the population (because of children) the limit for the organs
was fixed at 0.5 rem per year (5mSv).
Later, the linear relationship without threshold took on an increasing importance and “risk” of
radiation-induced cancer was judged as more important than hereditary effects. The
publication 26 of ICRP of 1977 [ICRP 1977] formalised the system with weighting
coefficients per organ and per type of radiation. The concept of central dose became “whole
body effective dose”. It did not apply for the estimation of acute effect for which the doses to
organ remained the only pertinent measure. It allowed the assessment in a uniform manner
of all exposure situations but requires some important assumptions (for example, that the
rate of exposure has no effect on carcinogenesis) that one tends to forget when using this
metric.
Recommendation 26 confirmed a limit of 50 mSv (on the idea of “whole body equivalent
dose”). For the first time it associated a risk to this limit (about 10-3 per year of exposure). It
was therefore a limit based on responsibility, defined by comparison to the risk of workers in
established industries (on the basis of the hypothesis that the average dose of the worker is
1/10 of the limit), and the risk was calculated using a dose effect relationship that is
considered as “reasonably prudent”. Except for acute effects, the protective character of the
limit was definitely rejected and the word "acceptable" was used instead.
The principle of optimisation –“all doses must be maintained as low as reasonably possible”-
was integrated in the recommendation and constitutes one of its main elements.
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The new 1990 recommendation (publication 60 of ICRP [ICRP 1991]), in addition to lowering
the limits (20 and 1 mSv per year averaged over 5 years), did not qualify the limit values as
“acceptable” but as “the limits of what is unacceptable”. The exposures were now only
acceptable if they were below the limit and had been reduced to the minimum possible.
Acceptability and optimisation are therefore related and the acceptability no longer judged in
terms of risk level but on the quality of risk management. The text contains long
deliberations on how to judge optimisation and a framework of how to achieve it in practice.
The notion of genetically-significant dose had disappeared. It is only rarely that the
hypothesis is described as prudent. The need to re-evaluate the risk coefficient made ICRP
more prudent and less likely to make such an affirmation.
Limit values, concepts of dose and acceptability were modified with time and have resulted
in the current system of “risk management of acceptable risk” the outline of which is given
below.
The only explicit extrapolation rule (apart from that on the nature of the radiation) is that of
dose and dose rate effectiveness factor (DDREF). The epidemiological data are from
populations exposed to relatively high doses, delivered in a very short time (cf. Figure 1).
ICRP postulates that for X- and gamma rays the effect per unit dose is less important at low
doses and low dose rates. ICRP has used a DDREF of 2 since 1977. It should be noted that
higher values were suggested (3 to 10). The DDREF must be applied to doses less than 0.2
Gy or at dose rates less than 0.1 Gy h-1 .
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The risk coefficients for of death from cancer after whole-body irradiation are evaluated in
terms of probability of death from radio induced cancers:
These coefficients equate to quite high levels of risk: 12,000 deaths by cancer can be
attributed to natural and medical irradiation in France. The coefficients of genetic risk for
future generations:
A metric has been developed to include the risk of non-fatal cancer (essentially skin and
thyroid cancer) by weighting the probability of occurrence by an index of loss of quality of
life. This weighting factor is added to the risk factors for mortality and hereditary effects.
Hence, the measure of risk depends on management as well as on end-point. Loss of life
expectancy might perhaps have been chosen. Analysis of data from Hiroshima and
Nagasaki would have had very little influence on this metric, and the lowering in the
exposure limit values would have been minimal, which demonstrates the importance of “non-
scientific” choices.
The absorbed dose is the basic dosimetric quantity. It is a physical quantity (DT for dose in
tissue), defined as the energy deposited per unit mass, expressed in the unit joule per
kilogramme ( or Gray, Gy).
Many biological effects depend on the nature of the radiation. ICRP defines weighting-
factors for the quality of the radiation, to calculate a weighted dose called organ dose
equivalent (HT = S RWTW RDT.R where DT.R is the dose absorbed in organ T from radiation
type R as described in Figure 2). The name given to this unit is the Sievert (Sv). The
weighting factors are derived from data obtained from animal and in vitro studies. As the
weighting factors are dimensionless, the unit is still equivalent to the joule per kilogramme,
but this is no longer an actual physical quantity (cf. Table II). Among the changes that could
have important practical implications, one should note the change in the weighting factors for
neutrons from 10 to 20 for a large part of the energy spectrum. Finally, the effective dose
allows for the summation of exposure to different organs. It is equal to the sum of the dose
equivalent to organs weighted by the weighting factor for organs:
E = å WT WR DT .R
R.T
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On the basis of risk factors per organ, from epidemiological data, ICRP established relative
contributions of different organs (Table III).
Nature – energy WR
Photons (all energies) 1
electrons, muons (all energies)
Neutrons < 10keV 5
10 keV – 100 keV 10
100 keV – 2 MeV 20
2 MeV – 20 MeV 10
> 20 MeV 5
Protons > 20 MeV 5
Particles (a, fission fragments, heavy nuclei) 20
Dose équivalente
à un organe =S Wr Dr
Dose efficace =S Wt Dt Dneutron
D thyroide Dalpha
D Poumon
D gamma
D estomac
D béta
D gonades
D peau
The collective effective dose is calculated by integrating the effective dose for all exposed
people over the whole exposure time. As with equivalent dose, it assumes linearity of the
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dose-response relationship. It is an indicator of collective risk, measured in the unit Man-
Sievert (M.Sv).
An important characteristic of radiological protection becomes evident: the basis for practical
evaluation, the dose, has its origins in risk evaluation
- activities that lead to an increase in exposure from the use of existing sources, from new
sources (by definition controllable), from new exposure situations or exposure of previously
unexposed individuals. These activities are termed “applications”. The nuclear industry,
medical radiography, industrial gamma radiography are typical examples.
- activities that decrease the exposure of people by acting on sources, modifying the
exposures they produce or decreasing the number of people exposed. These activities are
termed “interventions”. The term applies to the management of accidents and also to the
reduction of exposure to natural radiation (for example, the case of radon in residential
areas) and also to the management of situations inherited from the past (for example sites
polluted by historical radium usage).
It is difficult to classify activities that do not themselves use any radiation, but lead to an
increase in natural irradiation: crewing of aircraft, mining, work in caves with radon are
examples of this. The European Directive requires that member states make note of the
situation but it allows them the freedom to apply part or all of the radiological protection
system.
Control of acute effects is achieved by keeping doses below the relevant threshold. Control
of the risk of carcinogenisis is more complex. The protection system is based on three
principles first formulated in 1997:
· Justification: requires the exposure to result in a net benefit when balanced against the
radiological detriment.
· Optimisation: means that the doses form any source must be as low as reasonably
possible bearing in mind economic and social considerations.
· Limitation of doses (and risks): the exposure of people to sources that can be
controlled must be subjected to dose limits.
The text stresses that it is not good practice for the levels to be near the limits. The limits
are clearly defined as “bordering the unacceptable”. Exceeding the limits is not
acceptable. Below the limit, the level of exposure is only acceptable if all efforts have been
made to reduce the exposure and the principle of optimisation has been correctly applied.
ICRP suggests that very low doses may be ignored. It does not define what can be
neglected, but the European directive provides levels of exemption based on activity.
Three population categories are considered: workers, the general public and medical
patients. For “applications” the three principles apply to all categories except medical
exposures. For interventions the limits are not applicable: an intervention must be justified
and optimised. Levels are given for guidance but do not have the status of limits. In the
case of radon, ICRP 65 [ICRP 1994] suggests that action may be appropriate above an
"action level" of between 3 and 10 mSv per year (200 to 600 Bq m-3). There is guidance for
accidental exposures (levels at which counter-measures are appropriate) in ICRP 63 [ICRP
1995]. Experience has shown that a value 1 mSv is very appropriate in post-accident
situations. In the case of “situations inherited from history”, the outcome is unclear.
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This system makes it possible to treat very different problems within the same conceptual
framework. It was developed progressively to give coherence to many situations that would
otherwise have had to be treated on a case-by-case basis. The introduction of intervention
should enable the future development of a unified analysis of situations of increased natural
irradiation. The three principles have now been around for nearly 20 years. ICRP subjects
them to critical analysis periodically, and a new revision is under consideration.
Limit values
For workers, ICRP bases its limit on an evaluation of risk and proposes an average annual
dose of 20 mSv for a period of 5 years with, no more than 50 mSv in any one year. To
derive this value, ICRP calculated the consequences, in terms of several end points, of a
working-life exposure (18 to 65 years) to annual doses of 10, 20, 30 and 50 mSv. It should
be noted that the risk for one year of exposure to 20 mSv is about 10-3 (death by radiation-
induced cancer or equivalent detriment following non-lethal cancer or hereditary disease).
This value is quite high, effectively “bordering the unacceptable” which accounts for the
insistence of ICRP on increased optimisation. Notwithstanding subtle changes in the
decision-making process, the lowering of the values is essentially a repercussion of an
increase in risk coefficients. The Exposure Limit Value (ELV) (that is “effective dose”)
ensures against acute defects but an additional limit of 500 mSv (equivalent dose) is
necessary for the “skin surface”. The same approach was used to set limits for the general
public. This led to the proposal of a limit of 1 mSv per year (which in terms of risk to life from
one exposure is 7x10-5, which is quite high) and, in very exceptional circumstances, 5 mSv
in one year on condition that the average of 1 mSv/year is met over 5 years.
Implementation
ICRP attaches great importance to the practical implementation of its recommendations.
For example, it identifies obligations on authorities and on operators, and defines
procedures for evaluating doses. It identifies the need for justification, and for the availability
of valid and efficient radiological protection protocols.
The final definition of "dose constraints" is left to the authorities. These are values, below
the limits, which authorities can use to ensure that optimisation will not lead to undesirable
individual doses. The constraint must ensure that optimisation will not lead to individual
doses that much higher than average (certain individuals will be exposed near the maximum
allowed, others not at all), must reflect the number of sources (people exposed
simultaneously to several sources could receive high doses), and should represent the
state-of the-art in radiological protection (the operators must be encouraged to implement
“good practice”). ICRP expects that, in the majority of cases, the real level of protection will
largely depend on the implementation of constraints. Operators have obligations with
respect to procedures. Some of these obligations are quite general, such as the
development of a safety culture and the creation of an organisation into which radiological
protection fits naturally. Other obligations are more specific. For example, there is are
obligation to appoint a trained "radiological protection advisor” and to classify occupational
environments.
145
One important change is the placing of a greater emphasis on the practical aspects of
radiological protection, with more rigour in the execution and evaluation of specific actions.
There are recommendations relating to the role and responsibilities of employers, users of
sources and Member States and their agencies. The text identifies a duty of care, which
makes effective optimisation imperative.
Although average doses have always been clearly lower than the ELV, the development of
optimisation has been slow. The formulation of the principle in 1976 was the result of
deliberation over a long period. It was not immediately applied practically. The early work in
this field considered “the financial value of the man-Sievert”: the question of the value of
human life. It was only after a number of case studies, retrospective rather than prospective,
that the approach was applied to exposures within Electricité de France (EdF) and other
companies in the electrical sector in the late 80s. Changing the way in which steam was
generated was considered a key step in the generalisation of the ALARA principle.
It should be noted that “good practices” were not widely used and, where used, they took
about a decade to be applied [Hubert 1994]. Management of the exposure of patients
during diagnostic radiography differs significantly between European countries, with doses
ranging from 1.65 mSv (France) to 0.3 mSv (Netherlands) [UNSCEAR 1994]. There is room
146
for a reduction of dose of about 99000 Man-Sv, and half of this would be possible at very
low cost. In medical centres, provisions are being made for the management of exposure
from very specific sources (surgical intervention under radiation for example). Outside the
nuclear industry very few steps have been taken towards optimisation. On the other hand,
the practical implications of the approach may not be well understood by all the interested
parties or by the authorities. The statutory basis of the principle of optimisation is not well-
established and there are few precedents and references to rely on [Hubert 1993].
Progress has still to be made on the improvement radiological protection via dosimetric
considerations. It is more important to reduce doses to exposed workers (100 Man-Sv) and
to the public around installations (the order of 60 Man-Sv) than exposures from radon (about
70000 Man-Sv) or diagnostic radiography (about 100000 Man-Sv). Operational radiological
protection has taught us that changes happen slowly. It has shown us that a management
regulation that is well accepted in principle cannot be placed in operation immediately. The
complete system of risk management, the exchange of information, the operational rules
and the procedures for implementation must be adopted and assimilated by all the players in
the field before it can be applied.
Novel approaches
Having realised that a no-risk situation was not possible (because of zero-threshold
carcinogenesis, and the presence of a certain level of natural exposure), the next step was
the abandonment of the idea that an acceptable or negligible dose level could be defined.
ICRP did not just define a level above which the risk would be “unacceptable” (about 1 in
1000 for one year for one worker, which corresponds to the ELV), it indicated that an
exposure above any level is unacceptable if the dose could be reduced easily. The
acceptable dose therefore is a dose that is below the limit and has been reduced to “as low
as reasonably possible”. Acceptability is therefore no longer judged by level of risk (which
may exclude but cannot prove acceptability), but on the implementation of management
practices. This approach, that can be described as “risk management of acceptable risk “
was developed very gradually and is now quite mature. It must be noted that it can be used
in other fields some of which may be far from the concept of zero-threshold carcinogenesis
(for example major industrial risk in the UK [HSE 1989] in the Netherlands [Kuijen 1988] or in
Switzerland [CFS 1991]).
These principles of management are not absolutely novel and they could have remained
principles of action without practical implications. In the case of radiological risk, the
principles could be implemented because the operators and authorities had at their disposal
conceptual and technical tools for their evaluation and management:
· the concept of effective dose, and more generally the concept of dose,
· the dose-response relationship,
· the definition of a standard man (weight of organs, rate of respiration etc),
· the publication of coefficients that allow the transformation of exposure to doses,
· standardisation of dosimetry,
· the means to carry out dosimetric investigations,
· the follow-up in real time of dosimetric evaluation,
· learning from experience,
· ALARA committees (As Low As Reasonably Achievable, an expression of the principle
of optimisation) within organisations.
Finally one should mention expert institutions that support public authorities, themselves
supported by the development of international expertise. In fact, a very well developed
national and international infrastructure has made available tools for the evaluation of
exposure as well as means for sharing information. The analysis of local practices was not
147
neglected in the development of recommendations. The most original aspect of radiological
protection is the balance between a principle of management, the management of an
acceptable risk and the practice of optimisation as well as the various tools made available
for its practical implementation [Hubert 1990]
The principle of optimisation has an inherent inertia. For example, comparison with limits
can be made using brief but relevant calculations. Optimisation however requires
estimation of doses and risks with the highest possible precision: this requires great
expertise from operators and authorities. This investment in evaluation is the inevitable price
of greater efficacy, but the procedures should be simplified as soon as possible. In fact, the
theory of optimisation itself provides means for such regulation because the cost of obtaining
information must be taken into consideration.
From a scientific perspective (for example assessment for an epidemiological study, analysis
of mammography) an evaluation necessitates relying on basic data and not on effective
dose or global risk coefficient. Similarly, decisions that do not rely on daily management
problems (distribution of iodine, criteria for the return to normal of polluted sites etc) there is
a separation between the analysis of risk and decision-making.
Finally, another originality of the system is the important role played by a non-governmental
organisation, ICRP, whose members are elected and which is not subject to any external
control. Some people consider this status to guarantee independence, others voice doubts
148
about the legitimacy of ICRP when it introduces public health regulation. However, there are
very few alternatives: intergovernmental organisations (European Commission), professional
associations, international bodies (UNSCEAR). It is not possible to say which is the ideal
situation but a certain equilibrium is achieved when different types of organisations actually
interact in the definition of modes of risk management.
Conclusion
The radiological protection system developed gradually over a period of more than a
century. Advancement in scientific knowledge went hand-in-hand with the development of
concepts and management regulations. Ionising radiation is treated as a ubiquitous zero-
threshold (or “inaccessible threshold”) carcinogenic agent. As usual in such cases,
Exposure Limit Values do not correspond to zero risk. In the case of ionising radiation, an
original idea was the definition of the ELV as a bordering the unacceptable, and the
insistence on the requirement that doses should be “as low as reasonably possible”. The
strength of the radiological protection system is that the means of carrying out such an
optimisation have been made available. This was achieved through co-operation, and by
the work of international organisations which became the focus of the main scientific
reviews.
We can consider this system as a typical example of the “management of acceptable risk”,
however this is not a solution adaptable to all situations. The options selected may be
contested in themselves or because they cannot be adapted to other situations. In particular,
a full dosimetric survey is a very specific requirement and its equivalent is not always
available in all circumstances. Finally, the operation of this system has a very long history
from which we learned that a significant and sustained effort is needed to implement the
principles of risk management.
The dose-response relationship between radiation and cancer was established on the basis
of human data obtained in the seventies. It allows for the quantification of risk. In terms of
management, the concepts of acceptability of risk and non-attainable limits were being
discussed in the seventies. Management started with deterministic limits: sufficiently low
doses to avoid deterministic effects. In the sixties, the exposure standard was still one tenth
of the dose at which skin erythema can be observed. In the fifties, other phenomena were
taken into consideration. It became evident that the standard did not ensure zero risk but
instead considered acceptability. ICRP developed all these concepts in 1958. Assessment
of population exposure, and the concept of collective dose was based on genetic effects,
that is effects on the descendants. It was considered immaterial whether there were few
people highly exposed (that is with very damaged genetic material) or more people less
exposed, hence the description of exposure in terms of collective dose. The limits were
determined such that the burden of exposure was acceptable to society. Later, the same
reasoning was applied to cancer. At the individual level, the probability of developing cancer
is never zero. An acceptable level had to be defined in the full knowledge that it does not
guarantee zero risk. The dose-response relationship was the basis of the determination of
acceptable risk. In 1972, the International Commission for Radiological Protection produced
the risk management system that we know today. This system is based on three principles.
Firstly, the limits are set in order to eliminate acute defects and maintain an acceptable level
of genetic effects and cancer. The second principle is that complying with the limit does not
guarantee acceptability in the case of zero-threshold effects. It is therefore necessary to
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keep exposure as low as reasonably possible. The third principle is the principle of
justification, which states that one must balance the risks of exposure to the benefits deriving
from it. For example, it is not justified to dope jewels with neutrons so that they look more
brilliant.
Q: How does this last principle apply to people living in the neighbourhood of a nuclear
installation?
A: The question of justification applies to nuclear energy. Is it justified to have such a
practice, that is to have a human activity that creates exposure? The answer is eminently
political.
Q: Can the statement that all levels of exposure carry a risk of genetic effect, and the
principle that the exposure must be as low as possible (ALARA) be dissociated? Is the
ALARA principle intrinsically linked to the consensus on the existence of a zero-threshold
effect? This point is important if one is to extrapolate this logic to the situation of mobile
phones.
A: I think that the definition of the word risk is ambiguous. In the case of ionising radiation,
researchers have absolutely no doubt that there is a risk. The concept of dose was invented
and introduced gradually in the case of ionising radiation. There is a physical quantity
expressed in J/kg corresponding to the energy deposited by ionising radiation. This quantity
is not used either in the evaluation or in the management. Another completely artificial
quantity, the effective dose, was invented. This takes into consideration the dose-response
relationship. It incorporates observations that neutrons are more efficient than gamma rays
which themselves are a little less efficient than X-rays. The system for evaluation of the
different types of radiation was developed from data from in vitro and animal studies. The
concept of dose equivalent for the whole body was introduced in order to be able to compare
exposure of the lungs, the thyroid or elsewhere in the body. The response of each of these
organs is different; the dose to each organ is weighted accordingly. The dose currently used
for ionising radiation is called the Sievert. It incorporates equivalence in risk of exposure to
different organs from different types of radiation.
The system has been stretched to the limit in the case of radon. In this situation, a
calculation of a dose is no longer the first step. Instead, scientists use a direct relationship
between the time-integrated concentration to which people are exposed and risk.
Consequently, the parameter "concentration-time" forms the basis of a dose that has
equivalence in risk. The unit of exposure to radon is the Bq/m3 which, in conjunction with
exposure time, gives the risk. The dose-response relationship from Hiroshima makes it
possible to express a risk in terms of milliSieverts equivalent. An actual physical dose does
not contribute to this process.
With respect to the dose-response relationship, I think we should distinguish between two
things. In fact, there are two different relationships. The first is obtained from modelling
epidemiological data and the second is used for prediction. These two relationships are
ultimately the same in terms of value but have very different status.
In the field of ionising radiation, there are three types of studies. Some of these studies
enable quantification when the doses and effects are well understood. The confidence
intervals on the risk coefficients are relatively small. It is therefore possible to quantify a
primary risk coefficient. Other studies say nothing at all. The third type of study is
somewhere in between. The best known studies in this category are those where it is not
possible to achieve quantification of the dose-response relationship because the doses are
not well-defined or because the confidence intervals are too high. The studies on thyroid
cancer after the Chernobyl accident fall within this category. Without any doubt, there has
been an increase in this type of cancer. However, scientists have not been able to quantify
the risk because the doses were not well defined. Some studies on workers in the nuclear
150
industry also fall within this category. The confidence intervals are so high that it is not
possible to progress the discussion on the dose-response relationship. There are therefore
a series of studies with an in-between status. They supply qualitative information but
nevertheless are very important.
Document 2 (p.7) [cf annexes] shows how the dose-response relationship has been
developed by different organisations. Institutions such as the Science Academy of the
United States, UNSCEAR, or ICRP developed a dose-response relationship on the basis of
epidemiological evidence, animal studies or theoretical predictions. The Academy of
Science of the United States indicates which hypotheses were discarded and points to the
mix of data from animal and human studies, and describes its decision-making process.
The strategies followed by the other institutions are not very different. ICRP and UNSCEAR
draw on data from Hiroshima and Nagasaki for the determination of coefficients. Other
studies are taken into consideration; the coefficients are modified on the basis of animal
studies and applied to a mixed population. The institutions could then conclude that there is
a 5% mortality associated with an exposure of 1 Sievert.
4.5.10 J P VAUTRIN
National Research and Safety Institute (Institut National de Recherche et de Securite
(INRS))
XIV- Are there any surveys carried out in professional circles in order to characterise the
exposure of workers from mobile phones and related equipment particularly base stations?
XV- Did the results of these surveys lead to the formulation of preventive regulations
intended to improve the safety of workers?
XVI- What are the technical and normative grounds on which your Institute bases its
preventive regulations, do you think these grounds are satisfactory?
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auspices of the National Salaried Workers Health Insurance Fund (CNAMGS). It is an
essential link in the French system for the prevention of occupational risk. The headquarters
are in Paris but the Centre for Research is in Lorraine. The remit of this organisation
encompasses research, studies and information. It is also responsible for a general social
security regime run for the benefit of salaried workers and businesses. It is important to note
that the competence of INRS is unique.
152
The frequencies most often used in high frequency presses, for welding or PVC processing,
are mostly 27.12 MHz and 13.6 MHz. Five to six MHz is used for the polymerisation of
rubber and the drying of wood. In electrolysis, the electric field strength is low and the
magnetic field strength relatively high because high currents and low voltages (on the order
of 3 V) are used.
II Discussion with the Group of Experts
Q: Do you receive many queries from workers who use the mobile phones extensively?
A: We have received many queries about delivery personnel who use the telephone more
than average in their lorries or vans. There is perhaps a small problem to solve. The
solution is often to keep a distance.
Q: Has it been suggested to the delivery personnel to keep the antenna outside their
vehicle?
A: No, we are in the process of putting together typical responses to frequently asked
questions. This question will be included.
Q: Are you aware of what the ANFR has done in this field?
A: Absolutely. The ANFR is perfectly aware of the possible effects of electromagnetic fields
on man. It shows its interest by participating in various meetings and having internal
discussions and deliberations on the subject.
There are other organisations working in this field. We cannot overlook the
Recommendation of 12 July 1999 of the Council of the European Union, this document is a
starting point even thought it was not designed for implementation in occupational situations
where the standards must be less stringent. For occupational exposure, one of the
references that we have used right from the very beginning is that of ICNIRP. At the
European level, the CENELEC standards 50166/1 and 2 were published and adopted in
France by the Standards committee C 18-600/C 18-610. We follow these two references.
The Council Recommendation stipulates 41.25 V/m for 900 MHz and 58 V/m for 1800 MHz.
For occupational exposure, the application of the limit values obtained from standard C 18-
610 gives, respectively, 92.1 and 130 V/m for the same frequencies.
153
Q: What are the rules of good practice aimed at limiting exposure during the installation and
maintenance of base stations?
A: We base our practices on ICNIRP. The first solution is distance. We do not allow people
to move freely on a site unless it is absolutely necessary. The second solution is signage of
two or three zones:
Q: Can you confirm that most maintenance personnel ask for shutdown of the antenna
during servicing?
A: I do not have sufficient information to respond.
Q: At present, there is no official regulation about this. Would you recommend the shutting-
down of the base station during maintenance depending on the power level?
A: It is difficult to respond to this type of question. A worker may be assessing the
radiation pattern of an antenna and hence be in the vicinity of the source, and the source
must be functional. Therefore one must consider the nature of the work. Together with
René de Sèze we will be thinking about this problem and analysing a range of likely
scenarios. I cannot elaborate further today.
Q: One should also take into consideration the fact that maintenance personnel may work
on a number of base stations in one day.
A: Of course. We would recommend to limit the exposure time, and to adhere to the six
minute average. I could also add that personal protection is a possible solution but I do not
think that it is appropriate for base stations. However, it is a solution I favour for high power
sources. It is not recommended for mobile telephony as it may end up generating
unnecessary concern.
Finally, I would like to draw attention to two points: firstly the problem of people with
implants. This problem is not so important today but one has to be careful about workers
with cardiac pacemakers. Secondly, we have realised that different operators do not follow
the same safety regulations. This creates a problem of unfair competition between
companies. The establishment of national or European regulation would resolve the
situation as well as ensure better safety for maintenance workers.
36
the comments of Michèle Rivasi on the re-transcription of the interview had not been received by
the group of experts at the date of the publication of this report.
154
2. Do you consider that the scientific data available today on the biological and health
effects of RF EMF justify the strategy for siting base stations and the use of mobile
telephones?
We receive a lot of queries from citizens about mobile phones and their associated base
stations. I receive a considerable amount of mail from people who ponder on the dangers
and ask themselves if they should accept the siting of a base station antenna on their
rooftop. I have even received a delegation of co-proprietors [owner-occupiers of buildings in
multiple occupancy] and would like to refer to an article that appeared this week in the
Journal du Dimanche reporting that in Paris a rooftop can be rented out for between 20,000
and 110,000 francs. The operators use teams to identify available rooftops.
When we organised a colloquium at the National Assembly, I called the Directorate General
of Health and I was surprised to find that there were no regulations. I think that regulation
must cover a number of points.
There are many sources. I think that it is important to carry out measurements on these
sources. One must therefore decide on who will carry out the measurements and who will
monitor them. It could be government organisations if they are competent, identifiable and if
they publish their results. It is important to make a decision on the question of
measurements. Moreover, it would be desirable if the measurement procedures were the
same from one organisation to the other. In fact, there is actually a disparity in the units in
which they are expressed.
A study group has come up with a proposal for a law that covers several issues. I do not
want to enter into the specifics of it. My personal position is to say that fields have biological
effects and we do not have enough information to determine whether they also have an
effect on health. The biological research may well find genes that are radiosensitive, or
sensitive to magnetic fields. In my opinion concepts of threshold will develop in the next few
years. In the field of radioactivity a radiosensitive gene is practically identified. A threshold
of a few milliSieverts does not mean much to people who are radiosensitive. With respect to
antennas, in my opinion one should adopt an attitude of prudence as did the English, the
Austrians and others; the installation of sources in the proximity of public buildings should be
avoided. The proposed law will try to prevent the installation of base station antennas close
to public buildings and, a fortiori, schools.
There are two positions among the Deputies regarding doses. The first is to say that field
strengths must not exceed a certain limit value set by decree. The second position is to fix a
maximum field strength of 1 V/m for a base station antenna. One must also be aware of the
possibility of resonance in metallic infrastructures that may deflect beams.
A third problem is that of public information. When the sources are in large open spaces I
think that the minimum required is to inform the public that they are going through an
electromagnetic field.
The last issue relates to the protection of workers. When workers have to pass close to
antennas, the minimum requirement is that some means of assessment should be available.
It is possible to establish controlled areas defined in relation to a standard source. It is also
possible to equip workers with means of making measurements so that they themselves can
evaluate the danger in the place where they work. In case of danger, the worker can then
ask for the source to be shut down. It is also possible to combine the two solutions.
I would also like to inform the General Directorate of Health that there is an urgent need for
regulations. When there are no regulations, the law of money prevails.
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II. Discussion with the group of experts
Q: You have concentrated in your discussion on base stations and their environment.
However, the field to which a person is exposed fairly close to a base station is lower than
that received by a user of a mobile phone. Have you extrapolated your argument to the
telephone itself?
A: With respect to mobile phones, I would wish to pass responsibility to parents, and to
provide information on the purchase of telephones for children. Advertising campaigns
urging parents to buy mobile phones for their children of 4 or 5 years old to keep them in
touch with their homes and their parents are quite absurd. I do not wish to forbid this type of
practice but it seems to me that we should say to parents that the purchase of mobile
phones for their children could carry risks. Ultimately the parent must have a choice. We
must at least provide information. Of course I am quite aware that the risk is not higher
close to sources (base stations). However there should be some controls on emissions
when a source is being installed.
Q: Effectively, we must avoid directing the beams towards public buildings. What do you
recommend with respect to radiofrequency sources other than mobile telephony? The Eiffel
tower has the equivalent of 30,0000 base stations. Here (ed: in the building of the State
Health Secretariat), we are exposed to fields of the order of 3 V/m from sources on the Eiffel
tower. You mentioned a value of 1 V/m for base stations. Could you explain the criteria that
determine this value? Does it depend on the frequency of the waves?
A: I have studied the existing foreign legislation, and proposals from scientific bodies. This
value emerged from that study. The Swiss government for example is close to 3 V/m (ed:
the Federal Ordinance has fixed a value of 4 V/m at 900 MHz and 6 V/m at 1800 MHz). I
made this proposal because I do not trust decrees. When you are elected, you make a law
on the basis of certain logic. If thereafter the values are fixed by order or decree it may fall
outside the logic of the elected members. We should avoid having an imposed decree or
order that allows high values when we wish to apply the Precautionary Principle.
Q: If, tomorrow, new scientific facts indicate that this value should be divided by two would
you ask the Parliament to reconsider?
A: It would be possible to have a new vote. There is a system that allows certain
modification of articles of law by vote.
Q: A standard is always related to the state of knowledge at the time it was developed. Do
you think that the Parliament can fix limit values for all the regulations that protect health and
can follow them up regularly?
A: I agree with you in principle. But even if certain levels are fixed by law, the levels can be
decreased by regulation. In radiological protection, there is a need to set a limit value of 1
mSv. Actually there is a discussion going on as to whether this value should be set in law
or in a decree. We would prefer this value to be set in the general law on radiological
protection. In fact decrees are not subject to discussion.
Q: You have invoked the Precautionary Principle with respect to base stations and the
definition of a limit value. Do you really think that the Precautionary Principle, in the strict
sense of the words, as defined in national and international interpretations, applies to the
situation where there is no knowledge of serious risk?
A: The level of 1 V/m came from different countries: there were also strong variations
between countries. However, studies show that some effects may occur in sensitive
populations. Adopting this value is therefore a compromise. If it is found later that effects
persist even at this level, we would be in a situation of acceptable risk.
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Q: The idea of an acceptable risk requires that the risk be quantifiable. However at the
moment, in this field of interest, the risk is not quantified. We cannot state that we will save
lives by reducing the level from 40 V/m to 1 V/m as you suggest. We do not even know if it
will save any life at all.
A: No, but it can eliminate public concern. Studies on workers close to base station
antennas have taught us something. This is a precautionary approach.
Q: We are going to say to people that it is not good to be in a field in excess of 1 V/m.
However when we are passengers in a train or a bus and sitting right next to a person
constantly on the telephone, I could say that this person is exposing me to a field in excess
of 1 V/m during a call and ask the person to leave the vehicle to make the call. The law
must be consistent.
A: The argument would be the same for 5V or 10 V, etc.
Technical note: No, because when we are near a person on a mobile phone we can be subjected
easily to 1 V/m. However, under the same conditions we would probably not be submitted to fields of
5 or 10 V/m and certainly not to 40 V/m corresponding to the European recommendations.
A: What do you know at 40 V/m? You know very well that there have been many criticisms.
We found out that most of the studies were commissioned by mobile telephone operators.
You know that there are questions being asked nevertheless you adhere completely to this
logic.
Q: I would like to come back to the development of the standard of 41 V/m. There have
been numerous studies at radiofrequencies since the sixties and seventies. First, scientists
looked at high-intensity acute harmful effects. Then they looked at the possibility of long-
term effects on the development of cancer. No effect on cancer was found. The most
sensitive indicator is a change in behaviour. Researchers have also found some evidence
of effects on attention and learning in primates and baboons. These effects are induced at
levels ten times higher than 40 V/m. A safety factor has therefore been incorporated in
order to avoid the possibility of producing even changes in behaviour.
One has to be consistent in regulation. Look at the problem of glycol ethers today. The use
of certain ethers is forbidden in cosmetic and household products even though they were
only present in very small quantities in these products. However, we tolerate the exposure
of workers to higher levels. This is not consistent. Irrespective of the agreed value we must
take into consideration regulations for different exposure situations. A value of 1 V/m, given
the current state of affairs, would mean that mobile phones and other sources of radiation
may cause problems.
A: One can discuss levels. As you know a standard has scientific, economic and social
perspectives. There is now an urgency to act. I favour regulation of these antennas. We
must not let things happen anywhere anyhow. The British report is very interesting and
raises many questions. Some people are more sensitive than others. One must therefore
adopt an attitude of prudence. The British thought this way. We must inform the public and
identify areas where an electromagnetic field is present. This phenomenon must not be
trivialised. If we are not sufficiently rigorous at this stage, there is a risk that electromagnetic
pollution will get out of control.
Q: Have you any suggestions on how to conduct truly independent scientific research in
France? This is a general question. The National Assembly must make available means for
independent research in areas where the interest of the economy and the interest of health
may not coincide. One solution, recommended by the English, would be for industry not to
give funding directly to the laboratory but to an intermediate authority. The Parliament has a
very significant role to play in this matter. I think that Parliament should work on such
matters rather than on what limit value to adopt for electromagnetic fields.
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A: This is a very difficult question. There is a need for financial independence. The
contracts given to university laboratories are often financed by the operators. I would favour
the solution you mentioned, as long as the money is subsequently given to several
laboratories.
XVIII What are your recommendations about the use of mobile telephones and the siting of
base stations, and what is their basis?
The main sources of information at our disposal on the possible risks to health from mobile
telephony are the publications of WHO, peer-reviewed scientific papers, publications
intended for the general public and studies carried out by consumers associations in other
European countries. We are linked to these associations via the framework of ICRT, a
group of consumer associations that carry out tests in common. In this context, an English
association has carried out tests on hands-free kits. [Note: the French original does not
distinguish clearly between "hands-free" vehicle-mounted sets, and "pedestrian" hands-free kits in this
context.] The results of these tests were published on the Internet site of this association.
We were very interested in this study because it shows that there are problems with these
kits.
Technical note: The protocol used in this test is probably not good. The hands-free kit is 99%
effective in decreasing exposure. The authors of the English study should be challenged by
international experts in the measurement of fields from mobile phones. The scientific consensus
today is that these kits decrease significantly the level absorbed in the head, but there are sometime
significant differences in their efficacies: some are defective in their design.
UFC-Que choisir? will carry out tests on mobile phones in the near future. These tests will
include measurements of radiation. You asked us if we have confidence in the authors of
international reports. It appears to us that these reports are rather contradictory. It is
difficult to determine whether there is a hazard or not. An Australian study showing that
there was a hazard was reported in the press. We have also detected some conflict
between willingness to carry out serious studies and the fact that research groups were
financed by operators and manufacturers. This seems to us to be dangerous. Moreover,
the studies lack universality at present: there are sources other than radiation from mobile
phones. It would be interesting to carry out studies that take into consideration the overall
exposure of consumers. Finally we are eagerly waiting the results of the epidemiological
study just started by WHO.
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A: Articles in the press place individual studies and international reports at the same level.
But the scientists in our organisation are perfectly aware that we cannot equate these two
sources of information. Nevertheless there remains the problem of consumer information.
This is a task for public authorities: information is received similarly by the consumer
whether the source is an international report or an individual study. People's perception of
hazard probably overestimates the actual hazard. If the consumer uses a telephone he will
accept a certain measure of risk. By contrast, he will accept any risk from a base station
antenna installed in his neighbourhood.
Q: You wish to see information on the state of scientific knowledge and on uncertainties.
What other forms of information should we place at the disposal of the public and
consumers?
A: We stress the need for manufacturers and operators of mobile phones to inform
consumers about the level of radiation from the mobile phones by clearly marking them, as
well as providing the information within the documentation (user's manual, contract, etc).
More information would lead to a better understanding of the risks by the consumer. I think
that manufacturers have already taken an initiative in this respect37. I think we must also
consider preventive measures. In particular, we should avoid siting antennas close to
establishments for children.
Q: Should it not be the case that schools must not be in the main beam, because surveys
show that the greater the proximity the weaker the radiation at ground level and in the
building under the beam? Do you think that it is possible to explain that the exposure is
practically nil for people in the building on which the antenna is sited and that the exposure
is somewhat higher for people in the beam at 200 to 300 metres distant from the source?
For example, for schools in Paris the radiation from FM broadcasts is higher than that from
the mobile telephone base stations.
A: Absolutely. It is only a question of information. I think that the public should receive full
and clear information about electromagnetic fields so that they are in a position to evaluate
the risks. I think that a legal proposal to limit the use of mobile phones and the installation of
antennas must be drawn up.
I would also like to comment on the use of phones by children. It appears to me that nothing
has been done about this. The operators have phone contract targeted at children. A study
in Sofres, carried out in 1999, showed that 4% of children aged 8-10 and 14% of children
aged 11-13 possess a mobile phone. Since then, the numbers have probably increased.
Actually the operators are no longer actively recruiting more subscribers. If these phones
are potentially more dangerous for children, something has to be done to make the operator
refrain from these types of contracts.
Q: You mentioned in the document that you submitted to us the problem of using a mobile
phone while driving. Hands-free [vehicle-mounted] kits create a real problem in this respect.
In fact, currently, the Highway Code does not penalise the users of these devices. However,
scientific studies have shown that the risk of serious accident is 4 to 6 times higher when the
driver is using a hands-free kit. This risk is comparable to that of a driver with a 0.8g/l of
blood alcohol. Do you have any proposal about this?
A: Yes, we would like to see information for consumers about this issue, with leaflets
discouraging their use and also the putting in place of effective controls on this activity. I
would like to say that, so far, we have not received any complaints from consumers about
symptoms that could be linked to mobile phones. The last point that I would like to
emphasise is that the contract system encourages people to use the phone for the whole of
the prepaid period and therefore at times to use the telephone more than necessary.
37
Technical note: this action was instigated independently by industry in response to
recommendations by public bodies in different countries. A protocol is currently being finalised.
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From a technical viewpoint, we would like to see a decrease in the level of radiation. This
level must be determined by an independent organisation, measured by a credible
procedure and indicated on the device. For base stations, France applies European
standards. Other countries are much more restrictive. This raises questions. Following the
Precautionary Principle, it seems consistent to adopt a standard as low as possible in order
to prevent possible risks.
Q: What do you think is the best way to inform the consumer about the device that he
purchases? Is it better to express the level of radiation as a value or as a percentage of the
recommended standard? In fact the actual value may be difficult to comprehend because
the unit of measure is totally incomprehensible to the lay person.
A: We have not yet taken a position on this subject.
Q: To my knowledge, you have not published in your magazine a long article on the
possible effects of mobile phones on health. Is there an article in preparation?
A: There will probably be an article dedicated to this subject when we report on the
forthcoming tests of mobile phones. A draft will probably be ready in the next few months. I
would like to state that the legal section of our association is concerned about publicity for
protective devices, but we are not thinking at this time of dedicating any space to these
devices.
Technical remark: These devices are either inefficient or counterproductive. When they actually
decrease the radiated power of the telephone, the telephone will automatically increase its power to
the maximum possible hence neutralising the benefit to the user. The net result of the development
of these devices will be the necessity of increasing the number of base stations in order to maintain
the function of networks.
Q: Does biomedical research about the risk to health from the use of mobile phone
generate specific constraints, and what are these constraints?
A: The government has organised biomedical research in France in accordance with the
Huriet-Sérusclat law of 20 December 1988.
The following text reports, in the light of these regulations, on the operation and decision-
taking criteria of one CCPPRB, reached through practice and experience.
In this respect, there can be no prospective scientific research without a previously thought
out protocol. It should incorporate the following:
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· a statement of the problem;
· the current state of knowledge;
· justification of the study in terms of scientific advances and/or returns in terms of health;
· clearly defined objectives and methodologies.
The practical feasibility of the protocol must also be demonstrated. It should include the
possibility of recruiting subjects for the study by the investigator. This should be realistic and
comparable to the number of subjects expected to be included within a certain period of
time.
· that the risk from the proposed research remains proportional to the predicted benefit
(the law defines more precisely “out of proportion”). These risks are not necessarily
zero, but they must not be higher than those normally taken in the same pathological
situation; the additional risk must be compensated by the potential benefit expected from
the agent being tested and by closer observation. Therefore when research has an a
priori potential benefit for the subject, a relatively high risk can be acceptable in the case
of a serious pathology that has not known cure. Similarly we can refuse an even modest
risk for a benign pathology that can be cured with existing means.
· the competence of investigators in the subject (hence the need for a Curriculum Vitae);
· the acceptable demonstration of a requirement for the research, on the basis of pre-
clinical trials (experimental animal, tissue tests, toxicological studies etc…) taking into
account the development of research capability.
The rules for testing a device are not fundamentally different from those applicable to a drug
whether the device is ultimately destined for biomedical research or for the general public. If
it is a device already in circulation, the standard to which it must ultimately adhere must be
well established (European standards for example). If the standard has not been developed,
the situation is that of a prototype, which is similar to that of a drug which has not been
licensed (AMM). In this case, guarantees must be given from the manufacturer of the device
or its various parts, for example, a certificate of conformity in relation to the protection from
electric power or from radiation. From their side the researchers must also endeavour to
use the device according to the recommendation of the manufacturer or to clearly indicate
that they intend to do otherwise (wavelength, power, duration of exposure etc) in the
framework of a non-conventional utilisation, which is a situation comparable to that of
research for a new usage licence for an established drug.
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1 The need to guarantee the ethics of the project
The rules that apply to clinical research are not fundamentally different from “good clinical
practice” or the “quality care” that apply generally to all medical practice; research
constitutes a specific case but not a new medical practice.
The information must be part of a written text that is sufficiently explicit and does not exclude
the right of the subjects to solicit further questions in order that they receive appropriate
responses. Finally the subjects must be given sufficient time to reflect before they are asked
to give their consent in writing.
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· agreement of the Director of the health establishment who may also deal with the
allocation of resources. This agreement is a de facto requirement of the contract
between the promoter and the medical centre;
· submission by the promoter of the protocol to the Ministry of Health. The file must
include the advice of the CCPPRB.
Responsibility rests with the investigator, not the promoter, and can be questioned by the
CCPPRB. In fact, this should not impede good collaboration between the three parties.
In fact, monitoring of the execution of the protocol is not within the power of the CCPPRB
unless it had voiced reservations at the onset and reserved the right to follow up the
research. Of course, the investigator must communicate to the CCPPRB any undesirable
effect during the course of the research and to propose an amendment to the protocol. The
Ministry, who must be alerted by the promoter, may at any time exercise its power to stop
the research.
· there is an obligation to carry out a study in a place agreed by the Ministry of Health; this
agreement is given to a certain person carrying out a certain type of research (physiological,
pharmacological, etc..) there may be some difficulty in realising “field” studies;
· submission of the volunteers to an initial medical examination; we are not dealing here
only with healthy volunteers, some studies without benefit may include sick volunteers who
may be happy to take part on condition that the study may potentially ultimately help other
similarly sick people;
· a special insurance on the basis of reversal of proof: the demonstration of the absence of
error is the responsibility of the investigator;
It is important to recall the special responsibility of the investigator given the absence of any
benefit to the subject, and therefore a necessarily disadvantageous benefit/risk ratio. This is
a situation that requires an absolute guarantee of safety (notwithstanding imponderables)
based on the hypothesis and the predictions of the protocol. An innocuous status requires
that the means of observation and any precautions implemented must be clearly indicated in
the protocol. It also requires that the investigator follow the protocol. The safety of the
subjects is also assessed from the pre-clinical file on the product to be tested. This file will
be examined exhaustively by the CCPPRB - hence the need for scientific expertise within
the committee.
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One can therefore imagine a piece of research being carried out in a number of steps to
ensure prudence. For example, in order to conduct research on the possible effects of
mobile phones on the brain it is important to first carry out research on a population without
known brain pathology before testing subjects having a defined brain pathology such as
epilepsy or migraine conditions.
For certain category of subjects, the law has additional constraints for studies without direct
benefit. These categories include people at particular risk (eg pregnant women) and
situations where it is not practical to obtain consent (emergency cases, minors, wards of
court). These studies can only be carried out with these subjects if they will ultimately benefit
people in the same category, as well as being impossible to carry out within a normal
population.
There are also misconceptions about the Huriet law even though it has now been in
existence for about ten years, such that some investigators may think, in good faith, that the
law does not apply to their research particularly when it deals with the evaluation of new
therapeutic responses of medicines that have previously been evaluated and licensed. The
absence of an industrial promoter aids such oversights.
There are however cases where the investigator has a good reason to hesitate before
submitting a research to the CCPPRB. Confusion is encouraged by the nature of the law
itself: it is not designed to encompass all research but rather to ensure protection of the
subjects of research. There is debate about an interpretation by the judiciary that research
that carries no risks (for example a non-invasive study) falls outside the Huriet law. The
Ministry itself leans toward this interpretation. It has a guide to investigators in which it gives
examples of biomedical research where the Huriet law does not apply. This indicates that in
ambiguous cases the choice (submission or not to the CCPPRB ) is definitely the
responsibility of the investigator, the courts being able to decide in a complex cases where
there is an appeal.
Borderline cases relating to devices include: tests relating to ECGs, ultrasound, MRI without
injection, hospital beds and wheelchairs. Certainly these devices are not invasive in the
strict sense of the term. One must not forget that hazards do not necessarily result from the
device being tested but also from the supplementary constraints required by the protocol
including collateral risks from, for example, the journey of the subject to be in a certain place
at a certain time. Not all biomedical research falls within the Huriet law but the distinction is
sometimes difficult and the problems of illegal research encourage researchers to be on the
safe side and not to operate outside the law.
We have encountered two phenomena. Sometimes investigators asked the CCPPRB to
determine whether their project falls within the Huriet law. Alternatively, some investigators
submit to the CCPPRB research projects that clearly do not fall within the Huriet law. While
the position of the different CCPPRBs are not unanimous on this point, our CCPPRB has
agreed that it is not within its remit to confirm or deny the requirement that a certain protocol
be submitted to it: this is the exclusive prerogative of the investigator who may be advised by
a member of the CCPPRB. Ultimately, the decision remains with the investigator and not the
CCPPRB.
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However, we think that the CCPPRB is not qualified to refuse to examine a protocol
submitted to it as long as it falls within the area of biomedical research, even if it appears
that a submission to the CCPPRB should not have been made; to do otherwise would be to
give the CCPPRB a great responsibility that does not fall within its legal remit.
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of hand-held mobile phones have a risk that is twice as higher as that of users of car
phones (this result was not statistically significant). The study of Muscat on acoustic
neuroma indicates that the user of a mobile phone has a cumulative risk of 50% (this
result was significant only when the duration of use was taken into consideration). In
three epidemiological studies (those of Muscat and Hardell), the risk of tumour was
increased in the region of the brain close to where the mobile is held; this is an argument
in favour of a dose-response relationship.
Therefore the results of all of these studies are consistent.
The pieces of the puzzle fit well together and draw a picture that researchers, the
administrators and users can see for themselves. The picture is not complete and some
pieces of the puzzles are still missing. Enough is in place to realise that there is
sufficient reason to be concerned for the health of users of mobile phones. The radiation
emitted by the antenna can cause cancer and other health problems. This risk affects
hundreds of millions of people all over the world. One should use this information to
derive means of protection, and in particular the protection of small children whose skulls
are developing and who may be more vulnerable to the risk from radiation.
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management of risks associated with mobile telecommunications. Based on this, the
Commission would be in a position to submit, by the end of 2001, a new legislative proposal
to the Council and the European Parliament. The Recommendation of 1999 was under
discussion by the Parliament in 1994; the initial timetable predicted for the revision of this
Recommendation represents an acceleration of the rhythm of the procedure of gathering
information and reaching decisions which is quite appropriate in view of the rapid
development of new technologies that increase public exposure to RF. The Commission
favours the setting-up by mobile telephone operators of procedures for consultation with
residents prior to the installation of base stations. The situation in New Zealand is cited as
an example of this. The whole situation is framed in public involvement in decision-making:
it relies on the following argument that involves everyone:
"Would you like to be able to use mobile phones for communications? If yes, than there is a
need for base stations.
· This is how a base station works;
· Here are the standards of emission formulated to avoid any risk to the health of
residents, and here are the results of surveys carried out in the neighbourhood of
existing base stations.
· It is up to you (operators and residents) to come to an agreement on the siting of base
stations in your neighbourhood."
Such approaches incorporate rationalisation of the perception of risk related to the use of
these systems via a cost-benefit analysis, as required by the Council Recommendation.
Sir,
Thank you for the information concerning the work of your group of experts. The points
made below do not represent the official position of the European Commission but give a
factual response to the precise questions that you asked.
During the preparatory work for Framework V, we became aware that the public has
legitimate concerns about the potential effects on health of mobile phones. The large
scientific uncertainty remaining in this field calls for new, more conclusive studies to be
done. This issue was therefore included in the work programme of the "Environment and
Health" Key Action under the umbrella of the "Quality of Life and Management of Human
Resources" Programme (1998-2002).
Initially, no priority was given to any specific area within the general theme of effects of
electromagnetic radiation on health. However, following the selection and funding of 5
projects after the 1999 call for proposals, this initial position was somewhat modified. In this
call, about 9M euros were allocated to projects aiming at elucidating potential carcinogenic
effects of RF. After consultation, in particular with the co-ordinators of our projects, we
decided not to include electromagnetic radiation in the research priorities of the 2000 call,
then to focus the 2001 call for proposals (currently open) on the potential for non-
carcinogenic effects of RF.
There is no a priori allocation of budget, in the 5th Framework, for the potential health risk of
RF specifically. The "Environment and Health" Key Action has a total budget of 160M
euros for the period 1998-2002. At the moment, following the calls of 1999 and 2000, 9M
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euros have been allocated to research projects on RF and 1.4M euros to research projects
on radiation in the range of 1 Hz. We do not yet know how much will be allocated to studies
on non-carcinogenic effects because that depends on the number of proposals received by
March and on their success after evaluation.
For the period 2002-2004, nothing can be said because that depends on decisions related to
the 6th Framework.
The first projects financed within the 5th Framework started at the beginning of the year 2000
and all have durations of between 3 and 4 years. The most important results will be known
before 2004.
The results of these research projects will be used in the development of policies and
European recommendations and will be included in the WHO general evaluation expected in
2004-2005. Their relevance is ensured by two mechanisms. On the one hand, the work
programme of DG RDT and their annual reviews were developed in co-ordination with the all
the DGs concerned, in order to ensure that the themes covered correspond to the main
political concerns. On the other hand, the evaluation of the proposals includes an item on
"relevance" and on "added value" with the intention of maximising the usefulness of the
results for the Commission.
I do hope that you find some of this information useful. Please do not hesitate to contact me
if you need further details.
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5 Conclusions of the Group Of Experts on Health Hazards and
Recommendations for Reducing Exposure of the Population to RF
Electromagnetic Fields
[Note: the translation of this section provided with the French text starts at Section 5.2. ]
The ARCS and COST reports do not give any recommendations on risk management. The
report of the Royal Society of Canada proposes that the exposure limit for workers be
reduced to 1.6 W/kg, the level used in Canada for public exposure38, because the limit of
8 W/kg for exposure of the head, neck and trunk is considered too great in view of the
possibility of risks to the eye. The 1998 WHO memorandum considered that, overall, any
health risk was unlikely. WHO does not make any recommendations for protection except
for common-sense measures (control of access to base station antennas, the avoidance of
EMC-related safety problems, the development of effective communication to "reduce
mistrust and anxiety"). The June 2000 WHO publication maintains a reassuring tone, but
does give some "active" recommendations: don't use a phone while driving; ask
manufacturers to reduce emission levels voluntarily; ask the public to limit the exposure of
themselves and their children; use a hands-free kit; consider visual impact and public
concern about the siting of base stations.
The Stewart Report is primarily concerned with giving recommendations. These are based
explicitly on a "precautionary approach" to the current state of scientific knowledge, except
for the risk of accident from using a phone whilst driving. Recommendations concerning
local authorities, industry and consumers are given.
These recommendations justify lower levels of exposure for the public than for workers for
various reasons: the existence of sensitive subgroups (old people, children, ill people);
differences in exposure duration; the possibility that children absorb more RF than do adults.
The Stewart Group also recommend the putting in place of a register of exposed workers
and a study of their mortality: this should be relatively easy in most circumstances (this is
done in France for all occupational risks).
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users. The Stewart Group particularly insisted that children's use of mobile phones should
be limited and that manufacturers and operators should stop all advertising aimed at
children.
Specific recommendations for the public and mobile phone users: provision of information
on potential health effects, creation of the post of Ombudsman for base station installations.
Salient points:
1. International regulations, inspired by the work of the International Commission on Non-
Ionizing Radiation Protection (ICNIRP), are based solely on scientifically demonstrated
biological effects corresponding to health hazards. In the RF range, these consist of
certain effects due to heating generated by dielectric absorption. ‘Reduction factors’
have been applied to the lowest exposure levels that cause the most significant effect in
animals to transpose these to the human species; occupational as well as general public
exposures are considered. Exposure levels are expressed in terms of the quantity
Specific Absorption Rate (SAR), which was used to define the ‘basic restrictions’ for
exposure of the public in the European Union Recommendation of July 12th 1999.
2. Current scientific data do, though, indicate that a variety of biological effects occur at
energy levels that do not cause any localised temperature rise. From the current state of
knowledge on these non-thermal effects, it is not yet possible to state whether they
represent a health hazard.
3. Is it possible to state that there are no health risks ? No: although few scientific
arguments are available to back up this hypothesis, it is not possible to eliminate the
possibility of non-thermal health hazards associated with low-level RF fields on the
basis of our current state of knowledge. Furthermore, some potentially-serious effects
(e.g. promotion of brain cancer) are currently the subject of large-scale, international
epidemiological research which will not produce results for several years. Research is
also continuing into other potential effects (e.g. effects on hearing or the nervous system,
and headaches).
4. If future research were to validate this hypothesis, i.e. demonstrate the existence of
health hazards related to the usage of mobile phones, the probability, at an individual
level, would certainly be very low. Indeed, it is reassuring to note that no risk has yet
been demonstrated, in spite of the considerable amount of work undertaken over several
years. However, if there were a risk, the very high number of mobile telephone users
could mean that, even if the individual risk were very low, the impact on public health
could be substantial. In view of this, would it not be prudent to set new exposure
‘standards’ at lower values immediately, without waiting for the results of ongoing
research ? The group of experts consider that measures of this type would be justified if
they were really effective in reducing potential risks. This implies, firstly, that medical
effects resulting from exposure to RF fields could be identified and, secondly, that new
values could be defined that would guarantee reduction, or even elimination, of this risk.
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This is not the case in the current state of knowledge. There is not, at present, any
reliable scientific information that could be used to optimise such measures. Therefore,
such exposure limits would be unscientific, arbitrary, misleading, and would probably
differ from one manufacturer or country to another, thus adding to public confusion and
concern.
5. It has been conclusively established that using a mobile telephone while driving, whether
with a hands-free kit or not, is a real accident risk factor. This risk is not associated
with electromagnetic fields, but is due to the loss of concentration resulting from the
telephone conversation. This is a major risk, in terms of both frequency of occurrence
and seriousness.
6. Mobile telephony has also been identified as a factor in security and medical safety (by
speeding up calls for help and, thus, the arrival of emergency services, etc), and there
are other advantages that were not covered by the group of experts' brief.
a More intensive research into the biological and medical effects of exposure to RF is
required, to reduce the uncertainties and gaps in knowledge. Research priorities and
organisational recommendations are presented in the following chapter.
b Users should adopt prudent avoidance measures - simple steps aimed at reducing
superfluous exposure (e.g. minimise the use of mobile telephones when reception is
poor, use an earpiece, and avoid carrying mobile phones close to potentially sensitive
tissue – i.e. a pregnant women's abdomen or an adolescent's gonads).
e Children are theoretically a sensitive population. From the current state of knowledge, it
does not appear that sensitive organs inside children's heads receive a higher dose of
40
The limit of the beam is reached when the field power has decreased by a factor of two. This beam
is defined in the horizontal axis and in the vertical axis.
171
microwaves during a phone call than those of adults. However, if mobile telephone use
starts at an early age, cumulative lifetime exposure will be higher than that of today's
adults (however, the constant, rapid changes in technology may lead us to reconsider
this). There are no scientific data establishing any risks from long-term exposure in
adults or children, but neither is it possible to eliminate that possibility based on the
current state of knowledge. For this reason, the group of experts suggest that parents
who feel it is necessary to equip their children with mobile phones should ensure that
they make reasonable use of this equipment. A recommendation to this effect should be
included in the instructions for use supplied with all mobile telephones.
f Exclusion zones in the immediate vicinity of base stations, where access is prohibited,
must be clearly marked, with a pan-European signage system.
g The group of experts do not support the proposal in the Stewart report concerning site
sharing. In keeping with the objective of reducing public exposure to the lowest possible
level, the group noted that calculations have shown that, while concentrating or
dispersing antennas does not affect average exposure, installing several in the same
place would tend to concentrate the electromagnetic fields in space, and, therefore,
lead to a more heterogeneous exposure for the population. The group is aware that this
point of view may be in contradiction with concerns for landscape preservation, but feel
that this problem can be solved by additional efforts to integrate (or hide) these antennas
in the landscape, at a relatively moderate cost to operators.
The group of experts felt that consideration of the proposal in the Stewart report
concerning mediation for the installation of base stations was not part of their brief.
They do not endorse the hypothesis that living close to base stations poses a health risk.
Furthermore, they felt that aesthetic or economic issues involving base stations were
outside their ambit.
The group of experts emphasises that the prudent attitude they recommend, given the
current state of knowledge and uncertainties, does not in any way constitute a validation
of the health hazard hypothesis. It is, rather, a matter of common sense advice justified
by the existence of a "reasonable doubt", pending further scientific investigation.
b Mobile telephone users should be able to find out the extent of their exposure41. This
requires two types of measures:
· Information on the power of mobile telephone emissions and on the local SAR in users'
heads, measured under standardised conditions, should be provided with every mobile
telephone purchased. This will facilitate a comparison between mobile telephones, taking
into account radiation efficiency, which affects local SAR.
· Telephone displays should inform users of the emission strength during conversations,
expressed in a simple way (e.g. % of maximum power, averaged over the duration of the
last telephone call). This would have an educational effect, showing users that making
41
It is recalled that exact exposure cannot be directly measured and must be estimated according to
some standardised parameters. True exposure varies considerably according to the environment and
the antenna position. Standardised assessment procedures are under development.
172
telephone calls under poor reception conditions increases the radiation they receive
quite significantly.
c The public should be able to find out the usual exposure in the vicinity of base stations.
Several measures would be required to implement this principle:
· The ‘Agence Nationale des Fréquences’ (ANFR – National Frequencies Agency) should
establish standardised rules for measuring electromagnetic fields in the vicinity of base
stations (prepared in the context of European protocols), as soon as possible. These
rules should be adopted by all technical monitoring organisations authorised to carry out
these measurements.
· The ANFR should set up a register of results per site for all their own measurements and
those carried out by authorised private organisations, in the form of a data base
accessible to the public via the internet. The ANFR should publish an annual report
summarising the field levels measured throughout the entire country.
· The ‘Groupe interministériel RF’ (Interdepartmental RF Group) should issue the set of
technical specifications for the installation of base stations as soon as possible. This is
currently in preparation at the CSTB and its application should be made compulsory.
These national specifications should soon be replaced by a standardised European
reference manual.
3 In view of the frequency and seriousness of accident risks, there should be more
driver information on the danger of using mobile telephones while driving, with or
without a hands-free kit, and traffic laws on this subject should be made stricter. A
national information campaign on this theme should be launched in 2001.
· The informative document currently being prepared by the ‘Groupe interministériel RF’
(Interdepartmental RF Group) to explain the physical and biological phenomena
associated with mobile telephony should be completed and circulated to the general
public as soon as possible. In particular, it is necessary to explain that exposure to the
electromagnetic field of base stations is insignificant compared to that associated with
mobile telephones themselves, even considering the exposure of the closest neighbours
of the base stations under the most unfavourable emission conditions.
42
It follows from this sampling approach that average population exposure will be much lower than
these values.
173
noted that technical research into electromagnetic compatibility is continuing, particularly
to deal with new technological developments in RF, which will use different ranges of
frequencies.
· The group of experts do not recommend that users equip themselves with "anti-radiation
protection" systems, which have by no means proved their effectiveness.
5 The group of experts were not asked to examine the issue of occupational
exposure to RF. However, they recommend that appropriate steps should be taken
and their implementation monitored by the labour inspection department and
CRAM specialists, to ensure that maintenance and repair operations at base
stations are carried out only when the installation is shut down. This
recommendation is consistent with the concern to reduce exposure of the
population – including workers – to the lowest possible level compatible with
service quality.
The Royal Society of Canada report recommended the reduction of local exposure limit
thresholds for workers to the same values as those applicable for the public. The group
of experts consider that this issue should be settled by ad hoc occupational risk
management committees in France and the European Union. They are in favour of the
recommendation in the British report that a register should be put in place for certain
categories of highly-exposed workers, for epidemiological monitoring purposes.
6 In compliance with the rules recently laid down by the European Union governing
the application of the Precautionary Principle, a report on all available scientific
data should be prepared regularly by an ad hoc scientific body recognised by the
Union, in order to examine whether there are grounds to modify legislation on the
exposure of the general public and workers to electromagnetic fields associated
with the radiofrequencies used by mobile telephones and base stations, and make
appropriate recommendations to the political bodies responsible for these
matters.
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6 Recommendations for Research
The table below shows the state of research, ongoing or recently published (published in
2000 or in press). We can see from this table that there is a balance between in vivo and in
vitro studies (in particular due to the contribution of the European Community), we can also
see that studies on cancer models prevail.
Cancer
Epidemiological studies 4 3 + 10 (CIRC) 7 + 10 (CIRC)
Long term genotoxic studies 4 7 11
Sensitivity models 8 8 16
Other in vivo studies 24 15 39
In vitro studies 28 22 50
Total cancer 68 55 123
Non-cancer
In vitro studies 36 19 55
Acute in vivo studies 14 17 31
Human studies 26 23 49
Total non-cancer 76 59 74
Total 144 124 268
43
Main source: database of the WHO EMF project .
Evaluation
The usual source of information on results of research is the totality of the articles published
in the peer-reviewed literature. This is true for research in all scientific fields but in the case
of biological effects of electromagnetic fields, the number of specialised reviews and quality
papers is still small. In view of the diversity of the studies at the biological and physical
levels it is difficult to make a global interpretation and a review of all the knowledge acquired.
To facilitate the work, evaluations are made by different national and international
organisations. For example WHO publishes exhaustive databases on a regular basis.
Other informed databases are available44 as well as reports by experts.
The main in vivo and in vitro research programmes that are ongoing worldwide are briefly
described below.
Three types of research funding were identified: (i) programmes partially funded by a
government or the European Union, (ii) programmes carried out entirely by industry, and (iii)
programmes financed by industry through a foundation that shields the research from the
source of funds.
43
http://www.who.int/peh-emf/database.htm
44
http://www.femu.rwth-aachen.de/
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National programmes
Germany
There is a great deal of research in Germany, all the fields are covered by a number of
research groups that are funded by industry, the FGF foundation (see later) or the
government. Some examples are given below:
· Influence of exposure to RF fields (383 MHz, 900 MHz and 1.8 GHz) on the synthesis of
melatonin and reproductive functions in the hamster. (A. Lerchl, Institute of
Reproductive Medicine, University of Muenster).
· Effects of pulsed RF fields on the physiological parameters of the rat. Study of the
effect of an additional intense and acute exposure during gestation. (Dr. Buschmann,
Fraunhofer Institute for Toxicology and Aerosol research (ITA), Hanover, Dr. Hansen,
Chair of Theoretical Electrical Engineering, Bergische Universitaet-Gesamthochshule
Wuppertal; Dr. Chaloupka, Chair of High Frequency Engineering, Bergische
Universitaet- Gesamthochshule Wuppertal).
· Membrane receptors of electromagnetic fields (Prof. Boheim, Department of Cell
Biology Ruhr-University of Bochum; Prof. Hansen, Chair of Theoretical Electrical
Engineer, Bergische Universitaet-Gesamthochshule Wuppertal; Dr. Grosse,
Umweltagentur, Ruhr-University of Bochum
· Study of chemically induced tumours by DMBA in the rat subjected to low power GSM
signals (Bartsch, Tübingen, Deutsche Telekom).
· The study by Jensh on teratogenic effects of GSM signals on rats.
An informative database of recent results has been formulated (Dr. Silny, Institute for
biomedical Technology, Technical University (RWTH) of Aachen, http://www.femu.rwth-
aachen.de/).
Australia
Funding for research comes from a special tax on transmission licenses. The funds
collected are administered by an inter-ministerial committee, and the National Health and
Medical Research Council evaluate, recommend and supervise the research projects.
· Replication of the experiment of Repacholi on transgenic mice (Vernon-Roberts,
Adelaïde)
Belgium
· L. Verschaeve is carrying out an in vitro study on the effect of GSM 900 signals on mice
with chemically induced tumours.
Denmark
· A national cohort epidemiological study, carried out by Johanson, is in its final phase
(incidence and mortality of cancer).
· The university of Aalborg is very active in dosimetry (J. Bach Andersen).
Finland
· The Finnish research programme on possible health effects of mobile phones comprises
seven projects (including an animal study on skin cancer and two studies on cellular
culture). The research institutes taking part are: the University of Kuopio, the Finnish
Institute of Occupational Medicine, the Finnish Radioprotection Centre, the Finnish
Cancer Research Centre, and the Technical Research Centre of Finland. The
programme is funded to at a level of 1.1M euros per year, approximately.
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· Juutilainen at Kuopio is studying the effect of exposure to GSM signals on transgenic
mice whose tumours were initiated by UV.
France
The COMOBIO Project (MObile COmmunications and BIOlogy) is currently underway within
the framework of the RNRT Programme (National Network of Research in
Telecommunications), financed by the Ministries of Research and Industry. It comprises
eight sub-projects of which two relate to the dosimetry of mobile phones and exposure
systems. The six sub-projects relating to biology are the following:
· Human studies on auditory evoked potentials, including studies on epileptic subjects
(J.L. Coatrieux, and G. Faucon, University of Rennes, University of Marseilles and of
Montpellier-Nîmes, ENST Paris)
· Hearing in the hamster (J.M. Aran, Inserm, University of Bordeaux)
· Brain metabolism (Bruno Bontempi, CNRS, University of Bordeaux)
· Memory and learning in the rat (J.M. Edeline, CNRS, University of Orsay)
· Neurotransmitters and receptors in the rat (R.de Sèze, University of Montpellier-Nîmes)
· Blood-brain barrier in the rat (P.Aubineau, CNRS, University of Bordeaux).
The total funding for the COMOBIO Project, involving about fifteen groups and the main
industrial players in mobile telephony in France, is about 12 MF over two years.
Other projects are ongoing, financed by the mobile telephone operators:
· Effects of GSM signals on the development of tumours chemically induced by DMBA (R.
Anane, CNRS, University of Bordeaux)
· Effects on the skin of GSM signals: study on cellular cultures, reconstituted skin and on
animals (B.Billaudel, CNRS, University of Bordeaux)
· Effects of GSM signals on cognitive tasks in man (R.de Sèze, University of Montpellier-
Nîmes)
Greece
The majority of the projects ongoing in Greece relate to dosimetry (evaluation of fields in the
vicinity of base stations and terminals).
· Evaluation of health effects of mobile phones (K.S.Nikita, Biomedical Simulations and
Medical Imaging Unit, Department of Electrical and Computer Engineering, National
Technical University of Athens).
· PERFORM-A: studies of carcinogenicity in rodents (J.N. Sahalos, Radio
Communications Laboratory, Department of Physics, Aristotle University of
Thessaloniki).
Hungary
· Thuroczy's group is very active in different fields of study such as the effects of GSM
signals on the offspring of mice exposed to GSM signals.
Italy
There is a great deal of research activity in Italy. A multicentre research network was
created to co-ordinate the efforts of a number of universities (ICEmB). The Italian Ministry of
Research (MURST) has spearheaded a recent programme of research entitled: "Protection
of man and the environment from electromagnetic emissions". This vast programme
involves 59 institutes of research and is co-ordinated by the National Research Council
(CNR) and the Agency for New Technologies, Energy and the Environment (ENEA).
177
Several research projects are ongoing, in which animal and cellular models are used to
study the effects and their mechanisms.
Most of the studies were carried out under the umbrella of Framework V.
· Studies of the mechanisms of interaction of microwaves with tissues (group of d’Inzeo).
· Effects of the exposure on 3T3 and L929 cells (gene expression and oxidative stress).
Changes in the function of the internal ear of rats exposed to GSM signals (group of
Marino).
Japan
· An epidemiological study on brain tumours in mobile phone users (PDC, 1.5 GHz) is
ongoing, led by Yamaguchi
· Sharai is pursuing a study on mammary tumours in mice (DNBA model, PDC at 1.5
GHz).
Poland
The great majority of Polish research is carried out by the military health service:
178
USA
Research activity in the USA has significantly decreased in the past few years. There are
only a few studies funded by Motorola (groups of Roti Roti at St. Louis and of Anderson at
Battelle). Long-term studies on animals are envisaged by the NTP45
· PERFORM A. The most important of the three projects proposed by the industrial
consortium was funded; it tests the effects of RF on biological end-points related to
cancer in animals. The results of these studies will be used in the evaluation, in 2003,
of the outcome of studies by IARC into the carcinogenicity of RF. Rats and mice will be
exposed to GSM 900 and 1800 for 2 years (RCC in Switzerland and Fraunhofer ITA in
Germany). A complete histopathological study will be carried out on all the animals.
The ARCS laboratory in Vienna (Austria) will study chemically induced tumours by
DMBA in order to replicate the experiments carried out in Bordeaux and Tübingen. A
replication study of the Australian experiment of Repacholi on transgenic mice will be
carried out in the RBM laboratory in Italy. The group of N.Kuster in Zurich will be
45
National Toxicology Program
179
responsible for the dosimetry and the exposure systems including the challenge of
designing an 1800 MHz exposure system providing a well-defined SAR distribution in
the animals.
Germany
The FGF foundation was founded in 1992 to carry out research on the biological and health
effect of electromagnetic fields and to disseminate information on these matters, while
providing a buffer between funding agencies and researchers. The FGF has funded about
60 research projects over the past seven years at the cost of 50M F of which several were
animal (exposure system, melatonin, etc.) and cellular studies (calcium, etc).
Italy
The Electra 2000 foundation was set up to provide information on possible health effects of
electromagnetic fields and to co-fund research. It receives funds from the three Italian
operators Tim, Omnitel and Wind and funds Italian research groups at the recommendation
of an international scientific committee. Electra 2000 is currently evaluating several animal
and cellular studies.
USA
The five-year WTR program (Wireless Technology Research) was funded by the CTIA
(Cellular Telecommunication Industry Association). Some resources were allocated to the
design and production of viable in vivo and in vitro exposure systems. Animal studies
investigated the fragmentation of the DNA in rat brain and on the formation of micronuclei in
lymphocytes exposed to high intensity fields. The program has now concluded and
publications are in press.
Further research is taking place within the framework of a co-operation between industry
and the FDA (Food and Drug Administration).
It is also clear that some experts analyse the experimental findings through an implicit filter,
assuming that the biological effects of GSM microwaves must be due solely to an increase
in temperature in tissue, whereas other analyses envisage the possibility that microwaves
may have non-thermal effects, even if the precise mechanisms involved cannot be explained
scientifically at present. Depending on the importance given to experiments aimed at
demonstrating non-thermal effects, the main lines of research envisaged by various groups
of experts are quite different.
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Following these prefatory remarks, the group of experts make three general
recommendations concerning research, to be started or completed, on the biological effects
of GSM microwaves:
· in view of the very slight heating of tissues observed with mobile telephones in normal
use, special effort should be devoted to investigating effects that cannot be directly
explained by the thermal activity of microwaves (in vitro and in vivo);
A review of all the available scientific literature shows that a number of research fields have
received little or no attention. This is particularly the case for:
· the effect of microwaves on certain tissues that are directly exposed to varying degrees
(meninges, blood vessels, skin, etc.) under prevalent conditions of use (telephone held
to one ear), or probable future conditions related to the implementation of new
technologies like Bluetooth (telephone attached to a belt or carried in a pocket, which
leads to exposure of the skin, peritoneum, viscera, and sexual organs). Particular
attention should be given to the potential impact of RF on certain resident immune cells
active in a number of pathologies affecting the skin, aponeuroses, meninges, and viscera
and involving inflammation and/or pain (mast cells), both in vitro and in vivo.
· the particular effect of GSM waves on growing organisms and tissues (embryos,
foetuses, children, and adolescents);
· the possible effect of base stations during "whole body" exposure at average or relatively
strong intensities (installation and maintenance staff).
The group of experts felt that the major topics described in detail below should be given the
highest priority. Some of them require preliminary dosimetric studies. It is also important to
keep up with new developments in this technology and start research now into the potential
effects of the new frequency ranges that will be used in the near future (UMTS, Bluetooth,
etc).
Finally, the lack of epidemiological studies other than those targeting mobile phones as a
possible cause of brain cancer indicates a need for different types of research aimed at
identifying the possible effects of GSM microwaves on other pathologies, particularly
headaches, either in "ordinary" users or those with physiological conditions likely to make
them more sensitive to such effects.
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6.2.1 Studies of biophysical interactions
The COST 244b report recommended that large-scale work modelling these interactions
should be carried out prior to research in this field. It is obviously necessary to make a
precise determination of the type of field on a molecular level in order to predict its
macroscopic effects, which are based on the microscopic ion-ligand and membrane protein
interaction models.
This research may lead to an investigation into cellular mechanisms for detecting RF fields
(this work should initially concentrate on cells in the nervous systems of certain vertebrates
that are sensitive to magnetic fields).
By definition, in vitro studies observe isolated systems that do not take even the most
elementary interactions between the organic element studied and the rest of the system into
account. However, in vitro research is useful for studying the action of microwaves on
single-cell models (bacteria) and some cells isolated from animal and human organisms
(starting with immune and germ cells). These are justified in three specific cases:
1) replication of earlier positive experiments, 2) observing organisms that are difficult to
study in any other way, and 3) studying mechanisms that have not yet been investigated at
all.
· studies of the genotoxicity of microwaves (there are too few publications to form a
definite opinion). Among the experiments that should be replicated, for example, is the
"micro-nuclei" test which provides an evaluation of the extent chromosome of damage.
Another is the "comet" test, where fluorescence microscopy is used to identify
fragmented DNA (although a recent replication of this test in a French laboratory
produced negative results),
· the effect of microwaves on apoptosis or " programmed cell death" (no published work),
· gene expression (C-fos and C-jun) and nucleic acid synthesis. It is also important to
replicate recent experiments on worms showing that radiofrequencies modify the
expression of "heat shock" proteins without any increase in temperature using cultured
human cells. In fact, these proteins react to all types of cell "stress",
All of the above experiments should be repeated in the presence of chemical and physical
(ionising radiation) mutagens to identify any interaction between these agents and RF.
In vitro studies of the effect of microwaves on the functional characteristics of inner ear hair
cells are justified due to the difficulty in carrying out in vivo research (relative appreciation of
the possible influence of microwaves on the various stages in the nervous system, from
182
these cells to the primary auditory cortex, and effects of prolonged exposure on their
survival).
It is also true that several particularly important fields have received little or no attention,
although some are currently under investigation, e.g. in the French COMOBIO programme.
Among the data requiring confirmation, the group of experts give priority to the
following topics:
· effect on induced tumours (at SAR levels corresponding to GSM). Some controversial,
isolated experiments have shown that RF may reinforce the effects of certain
carcinogens or promote growth in transplanted tumours (cf. ICNIRP 1996, Repacholi
1998, Moulder et al 1999, Royal Society of Canada 1999); effect on DNA. Lai and
Singh's work (1995), showing DNA damage in animals exposed to radar signals,
requires validation;
· effect on the inner ear. Intense radiofrequency fields produce an auditory perception
("click") that is interpreted as being due to a temporary increase in temperature that
produces a shock wave in the inner ear. No other effect has been shown to date and, to
our knowledge, none of the published work investigated the effects of transmissions at
power levels compatible with mobile telephones, although there is one ongoing study in
France. In particular, it would be advisable to study the potential effects of these
transmissions in conjunction with the "normal" acoustic stimulation involved in using a
telephone, taking into account the increase in temperature due to holding it against one
ear (independently of any thermal effect due to microwaves as such).
183
Fields that have received little or no attention to date:
· synergy with other types of radiation (UV, ionising radiations, etc) or chemicals with
known teratogenic, carcinogenic, or immunosupressor effects;
· effect on skin, paying special attention to melanocytes and resident immune cells, i.e.
mast cells;
· effect on the meninges (especially the dura mater, described as the site of migraine
diseases, also considered to be the lymphoid organ that protects the brain);
· long-term effect on the structure and functions of blood vessels in the skin, meninges,
and brain (paying special attention to the endothelium);
· effect on digestive tissues, gonads, and germ cells, in view of the likelihood that GSM's
will increasingly be worn on belts. For the same reason, research should be extended to
include the effect on embryos and foetuses (exposure of pregnant women). It is
particularly important to replicate the study by Magras and Xenos (1997) that
demonstrated a decrease in female fertility following exposure to low-intensity signals;
· general application of these research fields to immature animals (more suitable for
representing the susceptibility of children or adolescents).
The proposed research should be carried out using both healthy volunteers and patients
with a diagnosed pathology suspected of affecting the impact of GSM microwaves and other
frequency ranges under development on health. In most cases, these experiments will be
designed to answer questions raised by animal research using non-traumatic techniques
available in laboratories or hospitals.
46
On this subject, we note that there have been no complaints from users suffering from chronic skin
diseases, such as eczema or psoriasis, that affect the immune and nerve cells primarily involved in
other inflammatory pathologies, such as migraine, where the occurrence of attacks can be
exacerbated by GSM microwaves. If GSM microwaves are capable of acting on these deep cell
systems (meninges), they should a fortiori have an even greater impact on these same cells located
on the surface, as they are exposed to a much greater degree. In the same way, to our knowledge,
there have been no particular complaints from patients with vascular facial pain or characteristic
neuralgia such as that caused by damage to the sensory nerves linked to the trigeminal gland.
184
· immune and humoral systems (blood test);
· sleep;
· memory and cognitive tasks or tasks involving targeted associative brain regions;
Part of this research should consist of non-invasive investigations, involving children and
adolescents, as well as patients with mild pathologies that may be aggravated (or attacks
may be caused) by the use of GSM, if this is ethically acceptable. These would focus
particularly on migraine, rheumatism of the joints, and inflammatory skin diseases, such as
eczema and psoriasis (which have not yet been studied, to the best of our knowledge). It is
also important to study the effects of mobile phone use on patients with more serious
pathologies: neurological syndromes (epilepsy, non-consolidated cerebral infarction, and
chronic or acute cerebral circulation disorders), cardiovascular problems (high blood
pressure), and ear or eye diseases (maculopathy, glaucoma, etc). In this field, we
emphasise that special attention should be given to the risk of epilepsy in children and
young adolescents. If the use of mobile telephones were shown to increase the risk of
epileptic seizure, the fact that the inhibiting mechanisms in young people's brains are not
completely developed should be taken into account, as it further aggravates this risk.
The same studies should also be carried out with a group of people who consider
themselves hypersensitive to RF, although no specific pathology has been identified, as well
as another group suffering from subjective symptoms (headaches, hot flushes, and attention
or memory disorders) associated with the use of mobile telephones (see study reports from
Scandinavia and Singapore). Double-blind studies could be carried out on these groups,
with or without exposure to GSM waves, under otherwise identical experimental conditions.
The group of experts also recommend that research should be carried out to identify a
possible nocebo effect, due to extensive media coverage of the potential dangers of mobile
telephones. The specific arrangements and protocol for such a study have not yet been
defined, but it could, for example, involve a group of healthy volunteers of the same sex and
age group, identified by a survey as being convinced that GSM phones are harmful or not.
These volunteers would be exposed to microwaves and subjected to the analyses described
above.
185
(headaches, migraines, sleep disorders, "radiofrequency syndrome", etc). There are
considerable differences between protocols for epidemiological studies, including methods,
feasibility, and cost, depending on the effects to be studied.
Cross-sectional studies are relatively easy to organise and may be completed in a short time
at low cost, but they have severe limitations in terms of causal interpretation. They may lead
to hypotheses, but never produce definite conclusions. Use data from operators for the
same subjects would strengthen the validity of these studies. A cross-sectional study based
on a sample where participants living close to base stations were clearly identified would be
useful for generating hypotheses, or disproving effects that are currently described without
any scientific basis.
Case-control studies are also difficult to interpret if they do not follow a particularly strict
protocol to avoid biased information, because the subjects under consideration are more
likely to attribute their disorders to the use of telephones at a time when the effects of
telephones are under close media scrutiny.
Prospective cohort studies (contemporary) are the best suited, as they study highly varied
effects, as well as the development over time of telephone technologies and methods of use
– if the monitoring period is long enough. The suspected benign effects are frequent and
short-term. Because of this, it is not necessary to set up very large cohort studies, and
reliable results can be obtained quite quickly, especially if data about the actual use of
mobile phones is available from operators. Existing prospective cohorts could be used, such
as SUVIMAX or GAZEL, with the addition on specific studies of the effects of mobile phones.
This would present several advantages (savings and speed), as they are already in place
and some of them have already had data collected on these effects for several years. This
methodological approach could easily and economically include studies on “well-being”, as
recommended by the Stewart report.
Susceptible or sensitive groups should be subject to specific studies, as should subjects who
are highly exposed in their working environment. Alongside general population studies, it
would therefore be wise to propose studies focusing on children, adolescents, and migraine
sufferers, as well as studies within suitably selected companies or professions.
Traffic accidents
Although the risk of accidents caused by the use of mobile phones while driving vehicles is
both clear and high, the group of experts recommends new epidemiological research in
France, for two reasons: (i) it would be useful to have epidemiological data comparing the
risks involved in the use of hands-free telephones with those of conversation with a
passenger, in order to confirm the results of experimental work on this point; and (ii) in terms
of prevention, the results obtained in the national context would obviously have a greater
impact on the public (and the public authorities), leading to a more effective implementation
of the necessary measures.
Cancer
As far as base stations are concerned, the available data give no indication of a real risk.
Nonetheless, owing to demand, the group of experts would recommend verifying this point, if
possible. However, none of the epidemiological methods available (ecological, case-control,
186
or cohort) are capable of producing valid information due to the infinitesimal nature of the
risk, if it indeed exists, and the large number of potential confusion factors.
Several types of study can be carried out on mobile phones: ecological studies, population
case-control studies, cohort studies, and registers of exposed subjects. Ecological studies
do not seem to be appropriate in the current state of knowledge.
Population case-control studies are clearly the preferred protocol at present in attempting to
provide rapid answers to questions about the carcinogenic effects of using mobile phones.
As hands-free kits have only relatively come into use and we do not have sufficient
hindsight, this retrospective approach can only concern tumours of the brain, acoustic nerve,
and salivary glands. As the results of the huge, ongoing IARC study (‘Interphone' project, a
case-control study on tumours of the brain, acoustic nerve, and – although not in France –
parotid gland) in 13 countries, with a number of cases guaranteeing excellent power, will be
available in 3 or 4 years, it is unreasonable to propose developing new studies of this type in
France, especially as a French team is taking part in this international IARC study. The
funding of the French part of this study should be carefully examined.
On the other hand, it is important to stress the importance of the large-scale occupational
mortality cohort studies being carried out in various countries. This type of study is relatively
easy to set up in France, thanks to the many measures available for monitoring mortality.
The context is also theoretically favourable: many large companies have computerised
personnel files including full work histories, and a number of technical and research teams
have good knowledge of exposure to RF and other potential carcinogens. However, it will be
necessary to implement measures to guarantee the methodological quality (no in-house
epidemiological teams exist) and independence of the research. Certain categories of ‘highly
exposed’ workers, as recommended in the Stewart report, could be recorded in parallel with
the setting-up of occupational cohorts to form the base of a study, even though it would be
wise to supplement them with other types of users. These registers should obviously be
coupled with monitoring of mortality by cause.
The idea of a population cohort proposed by the Stewart report would seem difficult to
implement in terms of the risks of cancer, owing to the enormous number of people that
would have to be monitored over many years. In any case, this sort of effort is only
conceivable on an international scale (it should be remembered that IARC, quite rightly, did
not choose this protocol, preferring a case-control approach).
With a view to long-term monitoring, questions should also be asked about current and
forthcoming technological developments, as well as changes in the methods of use of
mobile phones, which are leading to exposure of other parts of the body. At the moment,
although it is clearly premature to envisage case-control studies of cancer in other parts of
the body, occupational environment prospective cohort studies could be considered the best
answer to this concern.
This research could take several forms: individual dosimetry campaigns, and modelling
using data on base stations and the use of mobile phones.
187
Research in social sciences is necessary: quality studies of the psychological and
sociological aspects of mobile phone use would be of considerable importance if a “crisis
situation” were thought to be emerging.
Epidemiological monitoring
The group of experts' brief asked whether it would be advisable to set up a system for
monitoring the possible effects of exposure to RF. The group of experts consider that, like
future research in this area, priority should be given to the consequences of mobile
telephone use rather than the areas around base stations. The primary purpose of this
monitoring would be to produce information for decision-making purposes. Therefore, one of
the main criteria in considering the relevance of epidemiological monitoring programmes is
scientific evidence, which must be sufficiently sound to show that an increase in the
population's exposure to electric and magnetic fields resulting from the use of mobile
telephones is accompanied by an actual increase in associated health hazards.
Finally, when a potential hazard is an issue of widespread social concern and scientific
knowledge has failed to provide a satisfactory answer, epidemiological monitoring may also
be envisaged to collect further data on this social issue.
In the last two cases, the feasibility and cost-effectiveness of monitoring should be
compared with other approaches, including human or animal experimentation.
Does the issue of possible health effects associated with mobile phones fall into this
category?
· As far as the risk of cancer is concerned, some départements already have registers
covering brain cancer. Cancer-related mortality is also covered by exhaustive records
throughout France. Scientific evidence on the role of exposure to RF associated with
mobile phones is very limited, as mentioned above. It would thus seem preferable to wait
for the results of the multi-centre case-control study co-ordinated by IARC before
deciding on any systematic monitoring of these pathologies using the national registry.
The specific association between exposure to electromagnetic fields and the occurrence
of cancers (or the percentage attributable to this exposure in the occurrence of these
pathologies) takes on particular importance here, in that one of the main objectives of
monitoring will be to assess spatial and temporal trends. Low specificity combined with
rare morbidity (with an annual risk of 10 -5 ), would make the interpretation of these
trends all the more difficult.
· On the other hand, with regard to self-declared subjective disorders, which at present
remain ill-defined (headaches, attention or memory disorders, heat sensations, etc.),
epidemiological monitoring may be envisaged in order to:
188
In this context, the first stage could be to set up a descriptive survey based on the active
collection of self-declared events among mobile phone users via an active information
system developed in conjunction with the operators. The results of this survey would make it
possible to characterise the phenomenon more precisely and identify particular groups of
users to include in later analytical-type epidemiological studies (case-control), or groups for
targeted monitoring.
Whatever the measures chosen, they must always guarantee the absolute independence of
the programming and project-selection committees, as well as the research teams. For this
reason, it is crucial that contributions from the manufacturers and operators do not interfere
with the choice of research topics and follow-up. This implies that funding from
manufacturers and operators should either be channelled through the State or a structure or
“foundation” under state control.
For this reason, it seems important to form permanent “committees” of experts on a national
and European level. These experts should be chosen from various scientific disciplines and
governmental administrations concerned with the issue. In accordance with the rules already
applied in other research programs, the experts involved in projects submitted to these
authorities for funding should be excluded from discussions on those projects. On a national
level, this committee could be made up of members appointed by the major scientific bodies
(CNRS, INSERM) and the Public Health department. It would be responsible for several
activities:
This type of allocation should ensure complete transparency with regard to the
management, nature, operation, and progress of the research, as well as the content of the
resulting scientific publications.
189
On an international level, the national committee would also play a role in proposing and co-
ordinating research programs in liaison with any European committee(s) in this field.
The current level of funding for research in this field, which, including all public and private
contributions, comes to 7 million French Francs (excluding salaries), should be continued for
at least 5 years. Funding should be available not only for laboratory studies, but also for
epidemiological research in this field, which does not yet have any specific funding.
190
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Annexes
230
A.1 Group of experts' commissioning letter
The Directorate General of Health has become aware of a report on risks to health in
relation to the use of mobile phones and telecommunication equipment. The report in
question was produced at the request of the British authorities by a group of British experts
chaired by Sir William STEWART. It was published on 11 May 2000.
The report addresses the state-of-knowledge in this field and proposes a certain number of
recommendations in view of the current scientific uncertainties.
· obtain its scientific opinion on the British report and on other recent reports published on
this subject.
· emphasis the conclusions deriving from these reports with respect to protection of
health.
· make recommendations on surveys and research program on the possible risk to health
from the use of mobile telephones and their equipment
· propose recommendations for informing the public.
I urge you to agree to Chair this group of experts, made up of the following members:
· Mr. Bernard VEYRET (Director of research at CNRS, National School (Ecole Nationale)
of Physics and Chemistry in Bordeaux),
· Dr. René de SEZE (Member of the International Commission on Non-Ionizing
Radiation Protection),
· Mr. P. AUBINEAU (Director of research at CNRS, University of Bordeaux 2),
· Mr. Alain BARDOU (Director of research INSERM, University of Rennes I),
231
· Professor Marcel GOLDBERG (Professor of epidemiology, Director of unit 88 of
INSERM).
I hope that this group of experts will be able to present its report by the end of the year 2000
and present a preliminary report on the state of knowledge at the end of summer 2000.
232
A.2 Membership of the group
· Pierre P. AUBINEAU (Director of research at CNRS, University of Bordeaux 2),
· Alain BARDOU (Director of research, LTSI-INSERM, University of Rennes I),
· Marcel GOLDBERG (Professor of epidemiology, Director of unit 88 of INSERM,
University of Paris 5).
· René de SEZE (Member of the International Commission on Non-Ionizing Radiation
Protection, CHU of Nîmes),
· Bernard VEYRET (Director of research at CNRS, National School (Ecole Nationale) of
Physics and Chemistry of Bordeaux),
· Denis ZMIROU (Faculty of Medicine-University of Grenoble I, Honorary President of the
French Society of Public Health (Societé Française de Santé Publique)), Chairman of the
group of experts
· Gilles DIXAUT, Medical inspector of Public Health, has accepted the secretariat of the
group of expert, in the name of the Directorate General of Health.
233
A.3 Meetings of the expert group
234
A.4 People interviewed or invited for interview
ADECEM Association de Défense contre les Champs Electromagnétiques (Président : Yvette
Segala ; Scientific consultant : Mr. Le Ruz)
Prof. Pierre Buser, Coordinator of the Report of the French Academy of Science, Paris VI University
Pierre and Marie Curie, Institute of Neuroscience
Elisabeth Cardis, Responsible for the epidemiological study of the International Agency for
Research on Cancer, Lyon
Jean-Pierre Chevillot, Former director of research at the CNRS, consultant on the report ESSOR
Europe to the European Parliament
Philippe Hubert, (Institut de Protection et de Sûreté Nucléaire) Institute for the safety of and protection
from Ionising Radiation
Dr. Philippe Quénel, (Institut National de Veille Sanitaire) National Institute for Health Awareness
Roger Santini, Laboratory of de biochemical pharmacology, INSA of Lyon (invited, declined the
invitation)
Jean-Paul Vautrin, (Institut National de Recherche et de Sécurité) National Institute of Research and
of Safety
Joe Wiart, France Télécom R&D and IEBR Committee of the GSM association
235
A.5 Presentation and Interpretation of facts: a task of some
delicacy
The following two examples illustrate the difficulty of producing a consensus that reflects
scientific opinion. We report comments on 2 papers published in 1999 on the link between
brain cancer and exposure to RF EMF by 5 and by 3 authors, or group of experts,
respectively. The opinions expressed are significantly different. This emphasises the
importance of clearly stating the criteria for accepting or rejecting the results of scientific
work when providing an expert opinion. Overall analyses are particularly useful in this case.
1 Hardell L, Nasman A, Pahlson A, Hallquist A and Mild KH, 1999. Use of cellular
telephones and the risk of brain tumours: a case-control study. International Journal
of Oncology, 1999, 15, 113
236
Paper by KR Foster and JE Moulder (IEEE Spectrum online, August 2000, vol 37, n°8)
Other epidemiology studies have been mostly or entirely negative. In a study that received
extensive press coverage even before it was published, Lennart Hardell and his colleagues
at the Örebro Medical Centre in Örebro, Sweden, assessed mobile phone use by 209
Swedish brain tumour patients in comparison to 425 healthy controls. The study, funded by
the Swedish Medical Research Council, was negative in virtually all respects.
In reporting the study, the lay media focused on one finding: users of mobile phones who
had developed certain types of brain tumours were more likely to report having used the
phone on the side of the head with the tumour than on the other side. But the association
was weak. It was not statistically significant and might easily have been a result of recall
bias--a well-established tendency of subjects to remember exposures to something more
readily if they developed a disease. The brain cancer patients in Hardell's study knew their
diagnosis before they were asked about their use of mobile phones.
2 Dreyer NA, Loughlin JE, Rothman KJ. Cause-specific mortality in cellular telephone
users. JAMA, 1999, 282:1814
Paper by KR Foster and JE Moulder (IEEE Spectrum online, August 2000, vol 37, n°8)
In 1996, (…), the health records of more than 250,000 mobile phone users were reviewed by
Kenneth Rothman, a senior epidemiologist at Epidemiology Research Institute, in Newton
Lower Falls, Mass. This industry-sponsored WTR study reported no difference in mortality
between the users of hand-held portable phones, where the antenna is placed close to the
head, and mobile cellular phones, where the antenna is mounted on the vehicle, resulting in
lower RF exposure. In a later, follow-up study, the same investigators examined the causes
of death among nearly 300,000 mobile phone users (including some from the previous
237
study) in several U.S. cities. "The only category of cause of death for which there was an
indication of increasing risk with increasing minutes of use," the investigators reported in a
November 1999 letter in the Journal of the American Medical Association, "was motor
vehicle collisions”.
238
A.6 Documents used by the expert group
List of scientific publications approached to provide copies of the most recent
papers47
Adv Biol Med J Acoust Soc Am
Am J Epidemiol J Bioelectric
Bioelectromagnetics Lancet
Cancer J Nature
Carcinogenesis Neuropsychobiology
47
Responded (R) and provided papers (articles) (A)
239
Documents reviewed
A – Basic Reports
DGXIII Possible health effects related to the use of European Union e 1999 144
European Commission radiotelephones
COST 244bis
Mc KINLAY Report Possible health effects related to the use of European Union 1996 252
DGXII radiotelephones
European Commission
expert group
Royal Society of Canada A review of the potential health risks of Canada 1999 471
radiofrequency fields from wireless
telecommunication devices
Sir William STEWART Mobile phones and health Great Britain 2000 436
B – Additional documents
Origin Date N indexed references
* ND : not reviewed as only the summary was available in English, without references; SO : outside the scope because it is not a critical review
of research
A.7 Glossary, acronyms and abbreviations
243
Acronym Quantity Unit or value (in SI units)
B magnetic flux density, commonly known as T tesla
"magnetic field"
SAR Specific Absorption Rate W/kg watt per kilogramme
244
A.8 Internet sites covering RF
France
Europe
USA
245
International
Bioelectromagnetics Society :
http://bioelectromagnetics.org/
246
A.9 References for the contribution of P HUBERT
(Interview on 23 November)
[
BEIR 1990] BEIR Committee, Health Effects of Exposure to Low Levels of Ionizing Radiations. NRC
National Academy of Sciences. Washington 1990.
[CARDIS 1994] Cardis E., Gilbert E.S., Carpenter L., Howe G., Kato I., Armstrong B.K., Beral V.,
Cowper G., Douglas A., Fix J., Fry S.A., Kaldor J., Lavé C., Salmon L., Smith P.G., Voelz G.L., Wiggs
L.D. Effects of low doses and low dose rates of external ionizing radiation: cancer mortality among
nuclear industry workers in three countries. Radiat. Res. 1995;142:117-132.
[CE 1996] Commisssion Européenne. Conférence permanente sur la santé et la sécurité à l’ère
nucléaire. Troisième réunion. Informer le public sur les normes européennes de radioprotection.
Luxembourg 26-27 novembre 1996. Direction générale Environnement Sécurité, Nucléaire et
Protection Civile. Luxembourg 1996.
[CFS 1991] Conseil Fédéral Suisse. Ordonnance sur la protection contre les accidents majeurs
(OPAM°. Conseil Fédéral Suisse. 27 Février 1991
[CIPR 1958] International Commission on Radiological Protection. Recommendations of the ICRP.
Adopted September 9, 1958. Pergamon Press 1959.
[CIPR 1977] International Commission on Radiological Protection (ICRP)."1977 Recommendations".
(ICRP Publication 26) Ann. ICRP. 1 (1). Oxford : Pergamon Press. 1977.
[CIPR 1991] International Commission on Radiological Protection (ICRP)."1990 Recommendations".
(ICRP Publication 60) Ann. ICRP. 21 (1/3). Oxford : Pergamon Press. 1991.
[CIPR 1994] International Commission on Radiological Protection (ICRP). "Protection against Radon
222 at home and at work, ICRP Publication 65, Ann. ICRP 23/2, Oxford Pergamon Press, 1994.
[CIPR 1995] International Commission on Radiological Protection (ICRP) "Principles for Intervention
for Protection of the Public in a Radiological Emergency", ICRP Publication 63, Ann. ICRP 22/4,
Oxford Pergamon press, 1995.
[HOWE 1995] Howe G. R., Mac Laughlin J. Breast cancer mortality between 1950 and 1987 after
exposure to fractionated moderate dose-rate ionizing radiation in the Canadian fluoroscopy cohort
study and a comparison with lung cancer moratlity in the atomic bomb survivor study. Radiat. Res.
1995;142:295-304.
[
HOWE 1996] Howe G.R. Lung cancer mortality between 1950 and 1987 after exposure to
fractionated moderate dose-rate ionizing radiation in the Canadian fluoroscopy cohort study and a
comparison with breast cancer moratlity in the atomic bomb survivor study. Radiat. Res.
1996;145:694-707.
[HSE 1989] Health and Safety Executive. Qunatified Risk Assessment. Its input to decision making.
Her Majesty Stationary Office. Londres 1989
[HUBERT 1990] Hubert Ph. Comparison of the methodologies for risk management ; applied
comparison of optimisation to nuclear and non-nuclear activities. Final contrct report. EEC-DGXII B
16-020 F , CEPN report 171, Paris 1990.
[HUBERT 1993] .Hubert Ph.. The Regulatory Assessment of New Risk Management Practices,
.Proceedings from OECD NEA workshop. Radiation Protection towards the turn of the century. Paris
11-13 Janvier 1993. OECD Paris 1993
[HUBERT 1994] Hubert Ph. Mangement of Radiation Risks. Document introductif à la conférence
Comprehending Radiation Risks, AIEA-IPSN, Paris 1994.
[KUIJEN 1988] Van Kuijen C.J. Risk Managemnt in the Netherlands : a quantitative approach.
Proceedings two Safe technological systems meeting at IIASA May 11-12 1988. Laxenburg Austria.
Risques n°29, pp 89-100, Janvier mars 1997.
LUBIN 1997] Lubin J.H., Boice J.D. Lung cancer risk from residential radon: meta-analysis of height
epidemiologic studies. J Natl Cancer Inst. 1997;89(1):49-57.
[MASSUELLLE 1996] Comparaison des politiques radon au niveau international. Note IPSNDPHD
SEGR, 1996.
[
MUIRHEAD 1989] Muirhead C.R., G.W.Kneale. Prenatal irradiation irradiation and childhood cancer.
J. Radiol. Prot. 9:pp209 212, 1989
[
NCI 1994] National Cancer Institute. Radon and lung cancer risk. A joint analysis of 11 underground
miners studies. NIH publication 94-3644, 1994.
247
[NORSTEDT 1929] Second international recommendations for X Ray and Radium protection. P.A.
Norstedt & Söner. Stocholm 1929.
[
PIERCE 1996] Pierce D.A., Shimizu Y., Preston A.L., Vaeth M., Mabuchi K. Studies of the mortality
of atomic bomb survivors. Report 12, Part I. Cancer: 1950-1990. Radiat. Res. 1996;146:1-27.
[
SHORE 1992] Shore R.E. Issues and epidemiological evidences regarding radiation induced thyroid
cancer. Radiation Research, Vol 131, pp 98-11, 1992.
[
SHORE 1993] Shore R.E., N.Hildreth, Ph.Dvorestsky, E.Andresen, M.Moreson, B.Pastenack.
Thyroïd cancer among persons given X-Ray treatment for enlarged Thymus gland. Amer. J. of
Epidemiology, vol 137, n°10, 1993.
[UNSCEAR 1988] UNSCEAR Sources, effects and risks of ionizing radiations United Nations 1988
[UNSCEAR 1994] UNSCEAR Epidemiological studies of radiation carcinogenesis Unites Nations
1994
248
A.10 Biographies of the members of the group of experts
Pierre AUBINEAU is a Doctor of Neurophysiology and A Doctor of Science in Biology.
Director of Research at the National Centre of Scientific Research, he has worked
successively at the Paris VI University, the White Memorial Centre (Los Angeles) then at the
University of Bordeaux II on the physiopathology of blood circulation in the brain and on the
incidence of neuro-immune interactions. He is a member of the steering committee of the
COMOBIO national programme (MObile COMmunications and BIOlogy), in charge of animal
research, and has participated in this programme by studying with his team the influence of
GSM waves on intracranial blood vessels and migraine.
Alain BARDOU is Director of Research at INSERM, specialist in biology and medicine, more
specifically in cardiology. He has had two years of research in the United States at the
Downstate Medical Centre in New York and in the Cardio-Vascular Research Institute in San
Francisco. He is a member of New York Academy of Sciences, the IEEE/ Engineering in
Medicine and Biology, the American Heart Association, the French Society for Cardiac
Resuscitation, and the French Society for Theoretical Biology. He is the author of over 100
scientific publications and book chapters, his activities earned him promotion to the
International Order of Merit at Cambridge in 1994 for “Contribution to Cardiology and Public
Health”. Between 1994 and 2000 he was the statutory representative of INSERM at the
Consumer Safety Commission; during the last six years he has managed numerous cases
directly related to public health.
Gilles DIXSAUT is a Doctor in Medicine, with a diploma of study and research in human
biology. Chief Medical Inspector of Public Health, he is in charge of the Department of Non-
ionising Radiation at the General Directorate of Health. He is in charge of courses at the
University of North Paris and President of the commission of health biometrology of the
Council of Metrology.
249
biomagnetism at the Ecole Pratique des Hautes Etudes. He has carried out research on the
biological effects of electromagnetic fields since 1985. He is member of ICNIRP
(International Commission on Non-Ionizing Radiation Protection) and the Scientific
Committee of ELECTRA 2000. He is in charge of the scientific aspects of the French
COMOBIO project and the European PERFORM B programme on the possible health
effects of mobile phones.
250