EMR Literature Survey - February 2017
ICNIRP Statement on Diagnostic Devices Using Non‑Ionizing Radiation: Existing Regulations and Potential Health Risks
By: Green AC, Coggon D, de Sèze R, Gowland PA, Marino C, Peralta AP, Söderberg PG, Stam R, Ziskin MC, van Rongen E, Feychting M, Asmuss M, Croft R, D'Inzeo G, Hirata A, Miller S, Oftedal G, Okuno T, Röösli M, Sienkiewicz Z, Watanabe S
Published in: Health Phys 2017; 112 (3): 305-321
This is a statement issued by the International Commission on Non-Ionizing Radiation Protection which reviewed the evidence for health effects resulting from the use of non-ionising radiation (NIR) during diagnostic procedures. It also listed the regulations that are legally enforced internationally for the protection of patients as well as workers. The statement noted that the current balance of evidence on the clinical use of magnetic resonance imaging (MRI), ultrasound (in the absence of contrast agents), and optical radiation does not point to any adverse health effects. The statement also highlighted a knowledge gap in the health risks of foetal exposure to MRI and ultrasound in the first trimester of pregnancy, long-term exposure in MRI workers, and risks from interactions between ultrasound and contrast agent.
This statement provides useful reference and advice on the potential health risks from the use of NIR in clinical settings. A statement on MRI has been published separately, which can be found on the ICNIRP website.
In this statement, particularly in Table 4a, some examples of legally-binding regulations associated with NIR diagnostic devices were mentioned. It is important to note that for Australia, all of the three documents mentioned in the table have been withdrawn by ARPANSA. The safety guidelines for magnetic resonance diagnostic facilities (1991) have been withdrawn as the material is covered by the ICNIRP Statement on Medical Magnetic Resonance (MR) Procedures: Protection of Patients (PDF 4.53 mb) (published in 2004).
By: Prasad M et al.
Published in: Neurol Sci 2017
This systematic review investigated the association between mobile phone use and brain tumours. The authors investigated whether factors such as source of study funding and quality of studies affected the study results. The review included 22 case-control studies, where 8 studies were part of the INTERPHONE study. The meta‑analysis that was performed on the remaining 14 studies revealed no increased risk of brain tumour (odds ratio, OR = 1.03; 95% confidence interval, 95% CI = 0.92 – 1.14). There was an association between long-term mobile phone use (10 years or longer) and brain tumour (OR = 1.33, 95% CI = 1.07 – 1.66). It was found that higher quality studies tended to show a statistically significant association with brain tumours. The authors reported that government-funded studies were generally of higher methodological quality than those partially or fully funded by industry. Somewhat confusingly, the authors also reported that there was no significant association between funding source and study outcomes.
By: Bortkiewicz A et al.
Published in: Int J Occup Med Environ Health 2017; 30 (1): 27-43
This meta-analysis looked into whether mobile phone use is associated with intracranial and salivary gland tumours. A total of 24 case-control studies published between 2009 and 2014 were included in the meta‑analysis which captured over 26,000 cases and 50,000 controls. The authors found a significantly higher risk of an intracranial tumour (including salivary gland tumour) with long-term mobile phone use (OR = 1.32, 95% CI = 1.03-1.7). The authors concluded that long-term mobile phone use (more than 10 years) increases the risk of intracranial tumours.
By: Wang Y et al.
Published in: J Cancer Res Ther 2016; 12 (Supplement): C298-C300
This meta-analysis evaluated whether mobile phone use causes glioma. A total of eleven studies which were a combination of case-control and cohort studies, published from 2001 to 2008, were included. For mobile phone use of one year or more, no association with glioma was found (OR = 1.08, 95% CI = 0.91 – 1.25). However the association was found to be statistically significant for mobile phone use of five years or more (OR = 1.35, 95% CI = 1.09 – 1.62). Further analysis by the authors revealed no publication bias on those eleven studies. According to this meta-analysis, long-term mobile phone use may increase the risk of developing glioma.