The radiation literature survey provides updates on published literature related to radiation (both ionising and non-ionising) and health.

Published literature includes articles in peer-reviewed scientific journals, scientific-body reports, conference proceedings, etc.

The updates on new radiation literature that are of high quality and of public interest will be published as they arise. For each update, a short summary and a link to the abstract or to the full document (if freely available) are provided. The update may also include a commentary from ARPANSA and links to external websites for further information. The links may be considered useful at the time of preparation of the update however ARPANSA has no control over the content or currency of information on external links. Please see the ARPANSA website disclaimer.

Explanations of the more common terms used in the updates are found in the glossary.

The radiation literature that is listed in the updates is found by searching various databases and is not exhaustive.

Find out more about how you can search for scientific literature.

The intention of the radiation literature survey is to provide an update on new literature related to radiation and health that may be of interest to the general public. ARPANSA does not take responsibility for any of the content in the scientific literature and is not able to provide copies of the papers that are listed.

Are you looking for earlier editions of the Radiation literature survey?

Visit the National Library of Australia Australian Government Web Archive to access archived information no longer available on our website.

Does exposure to ionizing radiation during adulthood pose a risk of developing central nervous system tumours?

Date:
Dec 2022

Date:

December  2022

Article publication date:

September 2022

Authored by:

Lopes et al.

Summary:

This systematic review and metaanalysis reviewed current evidence on the risk of developing central nervous system (CNS)  tumours in relation to the ionising radiation (IR) exposure at low-to-moderate doses received during adulthood or adolescence. A total of 18 studies were included in the systematic review, whilst data from 12 studies were used in the meta-analysis in order to estimate the pooled excess relative risk (ERRpooled). The IR exposures considered were occupational (e.g., nuclear workers and uranium miners, military using nuclear materials, medical workers, flight attendants, Chernobyl clean-up workers) and environmental (atomic bomb exposure/background). The study found that ERRpooled at 0.1 Gray was − 0.01; 95% CI: − 0.05, 0.04). The review and meta-analysis, which mostly reviewed the studies involving IR doses of 0.1 Gray, concluded that there is no evidence of a dose–response association between IR exposure and risk of CNS tumours. The authors also acknowledged the limitations in the studies including the lack of histological information on CNS tumours, large uncertainties in IR dose assessment, and the over-representation of men in the different occupational cohorts.

Link to: 

Ionizing radiation exposure during adulthood and risk of developing central nervous system tumors: systematic review and meta-analysis

Published in:

Scientific Reports

Commentary by ARPANSA:

This study showed that low-to-moderate doses of IR exposure in adulthood is not associated with the risk of CNS tumours. The United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) states at low levels (less than 0.1 Gray) IR exposure, the possible increased risk of cancer is uncertain (UNSCEAR, 2017). These findings contrast with those provided by other studies; Little et al., 2022 suggest higher risk of cancer following low to high doses (less than 0.1 Gray) of IR exposures in childhood. In particular, a large population-based Australian study has also indicated that medical radiation exposure (e.g., CT scans) during childhood and adolescence could increase cancer incidence rates in populations for all cancers, including brain tumours (Mathews et al 2013). The differences in the overall conclusion of these studies could be partly attributed to children’s higher radiosensitivity compared to that of adult humans, and study methods adopted in the different included studies. Future studies need to consider accurate IR dosimetry and collection of information on potential confounders – this would help enhance our knowledge on the effects of low-to-moderate doses of IR in adulthood/adolescence on the risk of CNS tumours.

ARPANSA publishes a series of evidence-based documents to guide Australian radiation protection principles and practices for radiation workers and the general public. For example,

The Code for Radiation Protection in Planned Exposure Situations (2020) established a framework in Australia for the protection of occupationally exposed persons, the public and the environment in planned IR exposure situations. This guide applies the three main principles of radiation protection: i) justification (that any activity involving IR exposure should do more good than harm), ii) optimisation (that actual IR exposure, likelihood of exposures and number of exposed persons should be as low as reasonably achievable taking into account economic and societal factors), and dose limits (levels of radiation dose that must not, under normal circumstances, be exceeded). ARPANSA will continue to update the latest science on human radiation protection, including cancer risk associated with IR exposure, in order to protect Australian population.

Study falls short on showing Wi-Fi affects male fertility

Date:
Dec 2022

Article publication date:

November 2022.

Authored by:

Chu et al.

Summary:

This in-vitro experimental study examined the effects radiofrequency (RF) electromagnetic fields (EMF) from mobile phones on sperm. The study examined sperm quality from 18 men aged 25-35.  Sperm were exposed to RF EMF for 6 hours from mobile phones using the mobile phone network (e.g., 4G or 5G) or Wi-Fi. The authors reported that RF EMF exposure from mobile phone on the 4G or 5G networks had no impact on sperm quality when compared to controls. However, they did report that sperm exposure to mobile phones connected to Wi-Fi did reduce sperm quality.

Link to: 

Effect of Radiofrequency Electromagnetic Radiation Emitted by Modern Cellphones on Sperm Motility and Viability: An In Vitro Study

Published in:

European Urology Focus

Commentary  by ARPANSA:

This study by Chu et al has various methodological limitations that are also present in previous in-vitro studies of sperm quality (Zalata et al 2015 and Kim et al 2021). One of the main limitations is the lack of objective assessment of RF-EMF exposure (dosimetry) in this study. The RF EMF exposure in this study is not characterised and hence it is not clear what level of RF EMF the sperm were exposed to. The lack of dosimetry also makes it difficult to discern whether any reported effects are due to the RF EMF exposure or other factors such as heat from the device’s battery. The authors do state that heat emanating from devices may have contributed to the reported effects, but this is understating the role of heating from devices as it would be a far greater heat source than any RF EMF exposure from Wi-Fi or a mobile phone network. The authors also failed to control for exposure to environmental RF EMF sources, such as radio, TV, and mobile phone base station emissions. 

Previous studies have examined the link between RF EMF exposure and sperm quality. Some In-vitro studies report reduced sperm quality in relation to RF EMF exposure (Yu et al 2021 and Adams et al 2014). In contrast, human studies that have evaluated the impact of RF EMF on sperm quality (often based on mobile phone usage) show no consistent impact of RF EMF exposure on sperm quality (Liu et al 2014 and Kim et al 2021).This may indicate that in real world scenarios RF EMF exposure from mobile phones is unlikely to have an impact on fertility.

The World Health Organisation has funded a systematic review on the effects RF EMF  on male fertility (Pacchierotti et al, 2021). This systematic review is currently being undertaken, and the results are likely to be published in 2023. It will produce valuable information on the impact of RF EMF on sperm quality and/or fertility.

The ARPANSA radiofrequency exposure standard RPS S-1 sets limits that protect against all known health effects of RF EMF exposure, including impacts on fertility. The limits are set many times below the level where any health effects occur. There is no substantiated evidence that RF EMF exposure at levels below the safety limits will have any impact on fertility.  

Study investigates risk of brain cancer in children and young adults after radiation exposure from CT examinations

Date:
Dec 2022

Date:

December 2022

Article publication date:

December 2022

Authored by:

Hauptmann et al.

Summary:

This cohort study, conducted in nine European nations, assessed the risk of brain cancer in children and young adults who undertook at least one computed tomography (CT) scan. People who had had one or more CT scans under the age of 22 between 1977 and 2014 and were not diagnosed with cancer for at least 5 years after the first CT scan were eligible to participate in this study. A total of 658,752 people met the eligibility criteria and were included in the study. Incidents of brain cancer were identified through national or regional cancer registries. Ionising radiation dose to the brain  was calculated based on historical information on the CT machine settings, questionnaire data and metadata from a large sample of CT scans. The follow-up duration after 5 years from first CT scan for each participant was a median of 5.6 years (Interquartile range 2.4-10.1). This resulted in a total follow-up time of 4,536,716 person-years. In this period, there was a total of 165 cases of brain cancer, of which 121 (73%) were glioma. The average cumulative brain absorbed dose for all participants was 47.4 mGy , participants who developed brain cancer had an average cumulative dose of 76 mGy . A significant dose-response relationship was also found for all brain cancers with an excess relative risk (ERR) per 100mGy of 1.27 (95% Confidences Interval (CI) 0.51, 2.69) and for glioma separately (ERR per 100 mGy 1.11 95% CI 0.36, 2.59). The authors conclude that these findings emphasize the use of doses as low as reasonably possible and the need for careful justification of paediatric CT scans.

Link to: 

Brain cancer after radiation exposure from CT examinations of children and young adults: results from the EPI-CT cohort study

Published in:

The Lancet Oncology

Commentary by ARPANSA:

The results of this study support previous research conducted in Australia (Mathews et al.), as well as a meta- analysis conducted by Little et al. (Little et al 2002a; Little et al 2022b), which show an increased risk of cancer following early life exposure to CT scans. The Code for Radiation Protection in Medical Exposure (2019) (RPS C-5) sets out the Australian requirements for the protection of patients, including young children, relating to their exposure to ionising radiation. Most diagnostic radiology procedures pose little risk, however, it is ARPANSA’s goal to ensure that the highest standard of protection is made available through the implementation of the relevant Codes and Safety Guides. These safety materials give practitioners in diagnostic and interventional radiology a best practice approach to their day-to-day clinical work. ARPANSA advises parents concerned about their children’s exposure from radiological procedures to talk to the doctor requesting the radiological procedure. The child’s doctor and the staff at the radiology facility work together on which tests are required and evaluate the risks and benefits in each child’s individual circumstances. It is important that CT scans in young people are justified and the radiation dose is as low as reasonably achievable.

Study points to EHS being a more transient condition than previously assumed

Date:
Dec 2022
Article publication date:

October 2022

Authored by:

Traini et al.

Summary:

This study evaluated factors associated with developing, maintaining, or discarding electromagnetic hypersensitivity (EHS). The study collected data over 10 years (2011-2021) from the Dutch Occupational and Environmental Health cohort study (n=892 participants, mean age 50 at baseline). The data were collected at three time points (baseline, 2-year and 10-year follow ups) on their perceived radiofrequency electromagnetic field (RF-EMF) exposure and risk, self-reported non-specific symptoms and sleep disturbances, and self-reported EHS status at 10-year follow up. The results showed that 12% of participants reported EHS. Self-reporting of EHS was found to be associated with perceptions of high RF-EMF exposure and risk, and sleep disturbance. Also, there was a high probability of not attributing symptoms to RF-EMF exposure anymore over time.

Link to:

Time course of health complaints attributed to RF-EMF exposure and predictors of electromagnetic hypersensitivity over 10 years in a prospective cohort of Dutch adults

Published in:

Science of the Total Environment

Commentary by ARPANSA: 

Consistent with the findings of this study, two Australian experimental studies (Verrender et al., 2018a; 2018b) also did not indicate a relationship between RF-EMF exposure and EHS. Further, they also demonstrated that the belief of being exposed to RF-EMF (rather than EMF exposure per se) contributes to triggering symptoms in healthy people. The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) provides evidence-based public health messages in relation to RF-EMF exposure and health, including EHS. Based on current scientific evidence, EHS is not caused by RF-EMF exposure at levels below the ARPANSA safety standard. This advice is consistent to the conclusion of the World Health Organisation (WHO) that EHS has no clear diagnostic criteria and there is no scientific basis to link EHS symptoms to RF-EMF exposure. Nevertheless, ARPANSA (akin to the WHO) acknowledges that the health symptoms experienced by the affected individuals differ and are real, and therefore, advise those affected to seek medical advice from a qualified medical specialist.

Built-shades in parks protect us from ultraviolet radiation

Date:
Nov 2022
Article publication date:

August 2022

Authored by:

Dobbinson et al.

Summary:

This study assessed ultraviolet (UV) radiation exposure in public parks in Melbourne and Denver to assess the UV protection provided by built-shades located in the parks. The UV measurements were conducted as part of a randomized control trial of built-shade using a pretest-posttest controlled design. The study measured the UV levels of 144 park areas in three annual waves in each city as a pre-test; while during post-test, 108 of them remained as control and 36 had shade structures built. A total of 1,144 UV measurements were conducted in all park areas. UV exposure, in terms of Standard Erythemal Dose (SEDs), during 30-minute potential use of park areas was estimated. Further, observation of environmental conditions (e.g., clear skies, cloud present, solar elevation) was also conducted. The results showed that UV exposure levels in the parks, both during cloudy and clear sky days, tend to increase with solar elevation angle. Further, the built shades at PRAs provided a significant reduction of UV exposures. On average, the UV levels at the shaded areas of the parks were about 3 SEDs lower than the unshaded areas (5 SEDs), during times of high solar elevation (~75◦) on cloudless days. 

Link to:

Solar UV Measured under Built-Shade in Public Parks: Findings from a Randomized Trial in Denver and Melbourne

Published In:

The International Journal of Environmental Research and Public Health

Commentary by ARPANSA:

The study provides some key data on the extent of UV reduction after shades structures are built in public park areas. The main conclusion of the study that building shades provides considerable protection against UV exposure (by more than 50%) is consistent to previous similar investigations (e.g., Vanos et al., 2017). However, the estimated UV dose under built shades is still high and additional sun protection measures should be used (e.g., use of sunscreen, hats, clothing, sunglasses), especially on clear sky summer days to avoid sunburn during longer outdoor activities. The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) provides evidence-based public health messages in relation to UV protection measures, and provides a real time UV index and estimation of UV dose. ARPANSA recommends 1 SED per day as a safe UV exposure level for most people; and a typical spring day (e.g., 9th November) in Melbourne measured a total UV dose of 42 SEDs. Therefore, all sun protection measures are important, and hence, need to be used even when built shades are available while conducting outdoor activities. 

Commentary criticizing ICNIRP exposure limits falls flat

Date:
Nov 2022
Article publication date:

October 2022

Authored by:

International Commission on the Biological Effects of Electromagnetic Fields

Summary:

This is a commentary paper claiming the International Commission on Non-Ionizing Radiation Protection (ICNIRP) has made a series of assumptions in the ICNIRP Guidelines for Limiting Exposure to Electromagnetic Fields (100 kHz to 300 GHz).  A total of 14 assumptions are listed by the authors including that the ICNIRP guidelines assume there are no mechanisms for radiofrequency electromagnetic fields (RF EMF) causing non-thermal DNA damage and that 5G is safe due to penetration being limited to the skin. Another claimed assumption is that ICNIRP does not consider certain studies in regard to brain cancer risk due to flaws in the methodology and biases, and because brain cancer rates have remained steady in the time that wireless communication devices have become widespread. The authors claim that these assumptions are erroneous which means they do not adequately protect the general population from RF EMF.

Link to:

Scientific evidence invalidates health assumptions underlying the FCC and ICNIRP exposure limit determinations for radiofrequency radiation: implications for 5G

Published in:

Environmental Health 

Commentary by APRANSA:

ICNIRP is an independent body of scientific experts who provide advice on the potential health hazards from non-ionising radiation, including RF EMF. The guidelines provided by ICNIRP are based on scientifically substantiated effects; more information on the principles of protection used by ICNIRP and what is considered scientifically substantiated evidence is available here. The ICNIRP guidelines are widely regarded as international best practice and are endorsed by the World Health Organization. ICNIRP’s guidelines are based on an assessment of all the available scientific evidence, including studies reporting effects at non-thermal exposure levels. It is the assessment of ARPANSA and ICNIRP that there is no substantiated scientific evidence to support any adverse health effects at levels below the exposure limits set. However, in this commentary it appears the authors ignored the majority of the scientific evidence, which is contrary to their opinion, and “cherry picked” studies that suited their narrative. In order to make an informed conclusion, it is important to review the science in its totality. This is particularly evident in the “brain cancer assumption” which largely ignored major studies including the UK Million Women Study, the Mobi-kids study, a study in the Nordic countries as well as research conducted by APANSA (Karipidis et al.) which found no association between mobile phone use and the risk of brain cancer. More information on how ICNIRP assesses scientific evidence is available here. In regard to the 5G assumption, 5G uses RF EMF with higher frequencies, also called “millimetre waves”. Although millimetre waves do not penetrate the skin, the ICNIRP guidelines consider energy absorption within the skin and provide relevant exposure limits. It is important to note that higher frequencies do not mean higher or more intense exposure. Higher frequency RF EMF are already used in many applications, such as security screening units at airports, police radar equipment to check speed, remote sensors and in medicine. These uses have been thoroughly tested and found to have no negative impacts on human health. Recently, ARPANSA published world-first reviews into 5G which concluded that no substantiated evidence that low-level RF EMF, like those used by the 5G network, are hazardous to human health, and studies that did report biological effects were generally not independently replicated. For more information on 5G, please see our factsheets on 5G and health and misinformation about Australia’s 5G network. It is the assessment of ARPANSA that there is currently no substantiated scientific evidence that exposure to RF EMF at levels below the limits set in the ARPANSA Safety Standard (RPS S-1) cause any adverse health effects. These exposure limits are aligned with the ICNIRP guidelines. 

A systematic review on UV exposure and the risk of keratinocyte carcinoma in people with darker skin colours

Date:
Nov 2022
Article publication date:

May 2022

Authored by:

Elysha Kolitz et al 

Summary

This systematic review examined the relationship between ultraviolet (UV) radiation exposure and keratinocyte carcinoma (also known as non-melanoma skin cancer) in people with a Fitzpatrick skin type of 4 to 6 and those who rarely experience sun burn and tan easily. UV index based on location, history of phototherapy, history of sunburn and occupational UV exposure were used as measures of exposure. The review screened 29,393 unique articles. Of those 454 articles were assessed by full text with 12 meeting the eligibility criteria and were included into the review. Of the included studies, 11 were conducted on East Asian populations with the remaining study conducted in Chile, and there was 1 ecological study, 2 case-control studies and 9 cohort studies. There were no associations reported between keratinocyte carcinoma and phototherapy exposure in 8 of the studies on East Asian populations. However, the other 4 studies reported an association between keratinocyte carcinoma and UV exposure based on location, occupation, and cumulative sun exposure. The authors also reported that the studies assessed in this review were of low to medium quality. 

Link to:

UV Exposure and the Risk of Keratinocyte Carcinoma in Skin of Color: A Systematic Review

Published in:

JAMA Dermatology

Commentary by ARPANSA:

The result from this study suggested that people of darker skin colour are at risk of skin cancers from outdoor jobs, living at lower latitudes, and greater cumulative sun exposure. This is in line with the advice of the Cancer Council and ARPANSA that recommends that all people in Australia should limit their UV exposure and use a combination of sun protection measures (e.g., clothing and sunglasses, shade and sunscreen). For more information see the ARPANSA factsheet, Sun exposure and health.

The study also reported that phototherapy is not a risk factor for keratinocyte carcinoma in darker skinned people. Other epidemiological studies have also shown no increased risk of skin cancer from phototherapy (Hearn et al 2008, Jeong Ju et al 2021). However, the narrow band UVB that is used in phototherapy has the energy levels to cause DNA damage and in turn cause skin cancer. It is likely that previous studies have not been large enough to identify the small increased risk of skin cancer that these treatments may cause (Hearn et al 2008). This is likely true for everyone regardless of their skin type. Phototherapy medical treatment for people with skin conditions if performed in consultation with a doctor is beneficial and would not inordinately increase a person’s risk of skin cancer. 
 

 

Brain cancer trends and mobile phone use in New Zealand from 1995 to 2020

Date:
Oct 2022
Article publication date:

October 2022

Authored by:

Elwood et al.

Summary:

There have been some case control studies that have found an increased risk of brain cancer associated with mobile phone use. If these results were true, due to the increasing prevalence in use of mobile phones, there would be an increased incidence of brain cancer over time. This study investigated whether the proliferation of mobile phone use had increased the incidence rate of brain cancer in the New Zealand population (aged 10 – 69 years) during 1995-2020. Data on incidence of brain cancers were collected from the New Zealand Cancer Registry, whereas mobile phone use data were estimated from information on mobile phone accounts and consumer surveys. Mobile phone use increased rapidly from 1990 to approximately 50% of the population by 2000 and almost all the population by 2006. There were 7,397 eligible brain cancer cases diagnosed in the study timeframe of which 6677 were glioma. The study found no increased incidence of glioma in the 10 – 69-year age bracket or in the parietal or temporal lobes of the brain which would receive the most radiofrequency electromagnetic energy from using a mobile phone. The authors conclude that the study found no increase in brain cancer related to mobile phone use.

Link to:

Trends in brain cancers (glioma) in New Zealand from 1995 to 2020, with reference to mobile phone use

Published In:

Cancer Epidemiology

Commentary by ARPANSA:

The results of this study are consistent with other major studies including the UK Million Women Study, the Mobi-kids study, the Nationwide Danish cohort study, as well as research conducted by APANSA (Karipidis et al.) and in the Nordic countries which found no association between mobile phone use and the risk of brain cancer. This study adds further evidence that there are no substantiated adverse health effects from exposure to radiofrequency electromagnetic energy from mobile phones and other wireless devices at levels below the limits set in the ARPANSA Safety Standard (RPS S-1). The ARPANSA Safety Standard provides protection to people of all ages and health statuses. It is the assessment of ARPANSA and other health authorities, including the World Health Organization and International Commission on Non-Ionizing Radiation Protection, that there is no substantiated scientific evidence that mobile phones cause any adverse health effect, including brain cancer. 

Association between exposures to radon and γ-ray radiation and lung cancer: Evidence from Canadian uranium mining and milling workers

Date:
Sep 2022
Article publication date:

September 2022

Authored by:

Zablotska et al.

Summary:

This study assessed the association between the exposures to radon and gamma (γ) radiation and the incidence of lung cancer in a cohort of uranium mine workers in Canada. The cohort of 16,752 workers (~ 92% male) employed during 1932-1980 received exposures to radon and γ-ray radiation and were followed for the development of new lung cancer from 1969 to 1999. The mean (+/-SD) cumulative total dose to the lung in the cohort was 931.65 (+/-1990.90) millisieverts. The cohort data was linked to the Canadian Cancer Data Base, which had more than 82% of the lung cancers confirmed by histology or cytology. Incidence of lung cancer analysis was restricted to male workers (n=15,351), who contributed to a total of 367,253 person-years. The study found that lung cancer incidence was significantly higher in the workers compared with the general Canadian male population. Risks of lung cancer (n=594, 34% squamous cell, 16% small cell, 17% adenocarcinoma) increased with increasing radon exposure. No significant difference in risks by different histologic lung cancer types was found.

Link to:

Association between exposures to radon and γ-ray radiation and histologic type of lung cancer in Eldorado uranium mining and milling workers from Canada

Published in:

Cancer

Commentary by ARPANSA:

The study provides an update on the risk of lung cancer following exposure to radon and γ-ray radiation in an occupational mining setting. The overall conclusion of increased risk of lung cancer among radon-exposed mining workers is consistent with other cohort studies (Lane et al., 2019). Though comparable data from Australia are limited, an Australian study (Peters et al., 2013) has shown an elevated risk of lung cancer among underground mining workers. In Australia, occupational exposure to radon in the uranium mining and milling industry is low and regulated to minimise cancer risk. The Code for Radiation Protection in Planned Exposure Situations sets out the requirements for the protection of occupationally exposed persons in uranium mines. Though an additional risk of lung cancer from radon exposure has been established, the risk is much smaller compared to that from tobacco smoking (ICRP, 2010). Avoiding tobacco smoking ultimately reduces the total lung cancer risk, including that from radon exposure.

Review and meta-analysis on the association between childhood leukemia and extremely low frequency electric and magnetic fields (ELF EMF)

Date:
Sep 2022
Article publication date:

March 2022

Authored by:

Barbant et al.

Summary:

This systematic review and meta-analysis examined the association between extremely low frequency electric and magnetic fields (ELF EMF) and childhood leukemia. The literature search identified 863 studies of which 38 were included in the review. The main meta-analysis included 21 studies and reported a small association between ELF EMF and childhood leukemia when the study results were pooled together (Odds ratio (OR) 1.26; 95% confidence interval (CI) 1.06–1.49). However, when only the 10 studies published after 2000 were assessed the association was no longer present (OR 1.04, 95% CI 0.84-1.29). The authors reported the highest associations between ELF EMF and childhood leukemia in studies that assessed the use of electric blanket (OR 2.75; 95% CI 1.71-4.42) and ELF EMF exposure over 0.4 µT (OR 1.37; 95% CI 1.05–1.80). The authors concluded that prolonged exposure to ELF EMF over 0.4 µT is associated with a greater risk of childhood leukemia. 

Link to:

Exposure to magnetic fields and childhood leukemia: a systematic review and meta-analysis of case-control and cohort studies

Published In:

Reviews on Environmental Health

Commentary by ARPANSA:

The authors reported a decline in the risk of childhood leukemia in studies post 2000. This declining trend in more recent studies has previously been reported in pooled analyses by Kheifets et al (2010) and Swanson et al (2019). Another recent pooled analysis of over 40 studies by Amoon et al (2021) found no association between ELF EMF and childhood leukemia. The reducing risk that has been observed in recent papers could be due to improved methodology particularly in exposure assessment, however, this isn’t completely clear, and the reduced risk could be due to chance or other factors. 

The results from epidemiological studies on the association between childhood leukemia and exposure to ELF EMF have provided conflicting results with both positive and negative associations being reported. There are also problems with the methods in these studies that weaken the conclusion from their results. The factors that could be influencing the observed association include selection bias, misclassification, and other confounding factors (WHO, 2007). These factors are present in the studies used by this meta-analysis, and this prevents a causal association from being made between childhood leukemia and exposure to ELF EMF. 

Experimental studies have identified no substantiated biological mechanism that could explain a possible association between ELF MF and childhood leukaemia (SCENIHR, 2015). This, together with shortcomings of the epidemiological studies, limits any conclusions being made on reported associations between ELF MF and childhood leukaemia. 
 

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