Radiation literature survey

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.

Evaluation of radiofrequency exposures to mobile phone base stations, Wi-Fi and Bluetooth in 13 countries

Authored By:

Boussad et al.

Published In:

Environment International

Date:

May 2022

Summary:

This longitudinal study assessed radiofrequency (RF) radiation population exposure in 13 countries, including Australia. A mobile phone-based tool (Electrosmart™ App) was used to collect data on 254,410 mobile phone users’ downlink RF exposure (i.e. received radio signal strength) to mobile phone base stations, and Wi-Fi/Bluetooth networks over the period of three years (2017 to 2020). The study showed that Wi-Fi and Bluetooth contributed most of the total measured RF population exposure; and the exposure to these sources seemed to increase over time. However, the exposure levels recorded were orders of magnitude lower than regulation limits in each of the countries.

Commentary by ARPANSA:

Overall, the paper reported that the measured RF exposure levels were much lower than the Australian and international public exposure limits. Of note, the study methodology utilised to ascertain population RF exposure is not quite accurate as the App, in fact, measured the background downlink RF exposure. Further, it provides no information on how the measured background RF exposure represented the population RF exposure. In order for the measured background RF exposure to be represented as the ‘population exposure’, the study participants (i. e., mobile phone users) should place the phone close to the body during the whole time when RF exposure was measured. Therefore, the reported RF exposure can only be a surrogate measure of population exposure and hence, the findings of this study should be carefully interpreted. 

ARPANSA has conducted RF measurement studies around mobile phone base stations and published the results on the ARPANSA website. In 2017, ARPANSA published a study assessing the RF exposure level due to Wi-Fi in Australian schools. Exposure levels from other RF sources such as mobile phone base stations, radio, and TV broadcasts were also measured. Overall, the exposure levels from all RF sources measured were much lower than the public exposure limits in the Australian RF Standard. There remains no substantiated scientific evidence that exposure to RF EMF below the limits in the Australian RF Standard causes any adverse health effects. 
 

The UK Million women study shows no risk of brain tumours from mobile phone use

Authored By:

Schüz et al

Published In:

Journal of the National Cancer Institute

Date:

May 2022

Summary:

The UK Million Women Study is a prospective cohort study examining the association between mobile phone use and brain tumours in women. The study initially recruited 1.3 million women born from 1935 to 1950. Between 2001 and 2013, 776 156 women completed surveys on their mobile phone use every 3-5 years. Of these, 489 769 women reported using a mobile phone. The study found no overall increase in the risk of brain tumours in women using mobile phones compared to women that never used one (risk ratio 0.97, 95% confidence interval = 0.90 to 1.04). Furthermore, the study also found no risk of brain tumours among mobile phone users when assessed by brain tumour subtype, different levels of mobile phone use or duration of use for at least 10 years. The authors concluded that the use of mobile phones does not increase the risk of brain tumours in women. 
 

Commentary by ARPANSA:

The results of this study are consistent with the results of a similar study and the only other prospective cohort study that has examined the association between mobile phones use and brain cancers, the Nationwide Danish cohort study. The Danish study divided the entire adult population of Denmark aged 30 and older into two groups - those who had a mobile phone subscription between 1990 and 2007, and those who didn’t. The Danish study reported no association between having a mobile phone subscription and brain tumour risk, even after at least 13 years of subscription. Similar findings were reported by an Australian study (a population-based ecological study) which found no increase in the incidence of brain tumours during 1982 to 2013. During this time there was a large increase in the number of mobile phone subscriptions in Australia (Karipidis et al, 2019). 

New review on cancer risk of medical diagnostic radiation exposure in early life without quantitative estimates of dose

Authored By:

Little et al.

Published In:

Science of the Total Environment

Date:

Apr 2022

Summary:

This paper reviewed studies on cancer risk from medical diagnostic radiation exposure in utero, and postnatal stages of life where radiation quantitative dose estimates were not available. The type of procedure (e.g. fluoroscopy, CT scan, X-ray etc.) gives a general indication of the likely dose involved but this is not as informative as studies that include data on the actual doses received. The literature search identified 89 eligible studies that were included in this review and meta-analyses were conducted. This review found multiple studies that yielded statistically significant excess cancer risks due to in utero and postnatal exposure to medical diagnostic radiation. Significantly higher risk estimates were found for leukaemia, lymphoma, central nervous system (CNS) tumours and any other cancer in the meta-analysis for in utero exposure. This is mainly due to earlier studies which found more significant excess risk than later studies. The reduced excess risk in later studies could be explained by the progressive decrease in foetal dose per X-ray examination due to advances in radiographic technology. For postnatal exposure, significant excess risks were more apparent in later studies, particularly CT scan studies. The postnatal meta-analysis found statistically significant excess risks for leukaemia, CNS tumours and any other cancer outcomes. This data strengthens the evidence for a carcinogenic effect of low dose radiation exposure in utero. However, the interpretation of the postnatal exposure findings is more difficult due to the possibilities of reverse causation (i.e. conditions predisposing to cancer lead to an increase of radiation imaging) biasing the results. Subsequently, this reduces the strength of a causal interpretation for postnatal exposure.

Commentary by ARPANSA:

In Australia, the system for radiological protection draws on international best practice, particularly, the International Commission on Radiological Protection (ICRP) and the International Atomic Energy Agency (IAEA). Special concern in relation to radiation protection is afforded to children, and women of child-bearing age. Most diagnostic radiology procedures pose little risk to the mother or foetus. However, interventional radiology procedures, and CT scans of the abdomen or pelvis may result in an elevated foetal dose, and an increased risk of cancer. With the continuing advancement of the use of ionising radiation in medicine, it is important that safety guidance represents contemporary best practice. The Code for Radiation Protection in Medical Exposure (2019) (RPS C-5) sets out the Australian requirements for the protection of patients, including pregnant women and children, relating to their exposure to ionising radiation. 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. While the (Little et al) study’s meta-analysis supports a statistically significant increase in cancer risk, the increase is very small and the risks should be assessed against the benefits of having the procedure. 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 should work together on which tests are required and evaluate the risks and benefits in each child’s individual circumstances. If there are still questions at the radiology facility, these can be raised with the radiology team during the consent process before the imaging proceeds. 

New study shows that electromagnetic fields don’t cause EHS symptoms

Authored By:

Huang et al.

Published In:

Environmental Health

Date:

Apr 2022

Summary:

This is a human randomised crossover provocation study that investigated whether electromagnetic fields (EMF) exposure is associated with physiological changes and symptoms. The study recruited 58 participants with self-reported idiopathic environmental intolerance attributed to EMF (IEI-EMF) and 92 participants without IEI-EMF as a control group. In a double-blind controlled environment, participants were exposed to EMF signals mimicking those from a mobile phone base station and a sham exposure in a random sequence. Participants reported whether they could perceive EMF exposure and any symptoms they were experiencing while physiological parameters (heart rate, blood pressure etc.) were monitored. The IEI-EMF and control groups reported similar frequencies of symptoms during both the provocation and sham sessions. In both groups, physiological parameters were similar between the two sessions and no participant could accurately detect the presence of EMF. The results of this study indicate that radiofrequency EMF exposure from mobile phone base stations did not affect physiological parameters in people with or without IEI-EMF and that symptoms reported by participants were not related to EMF exposure.

Commentary by ARPANSA:

IEI-EMF, also referred to as electromagnetic hypersensitivity (EHS), has no clear diagnostic criteria and the science so far has not provided evidence that EMF exposure is the cause. The majority of scientific studies published to date, as well as this study, have found that under controlled laboratory conditions, EHS or IEI-EMF individuals cannot detect the presence of EMF sources any more accurately than non-EHS individuals. Several studies have indicated a nocebo effect (Van Moorselar et al. 2016; Verrender et al. 2018).  

Based on current scientific information, there is no established evidence that EHS symptoms are caused by exposure to EMF. However, ARPANSA acknowledges that the health symptoms experienced by the affected individuals are real and can be a disabling problem and advise those affected to seek medical advice from a qualified medical specialist. ARPANSA will continue to review the research into potential health effects of exposure to EMF to provide accurate and up-to-date advice.

More information on EHS is available in a factsheet by ARPANSA as well as the World Health Organization.
 

Review of radiofrequency heating and burn injuries caused by magnetic resonance imaging

Authored By:

Tang and Yamamoto

Published In:

Magnetic Resonance in Medical Sciences

Date:

Apr 2022

Summary:

This review describes the current progress in understanding radiofrequency (RF) heating effect and injuries, particularly burns, that have occurred in patients during magnetic resonance imaging (MRI) procedures. MRI scans are produced by applying a strong static magnetic field, a fast-varying magnetic field gradient, and a RF field. While MRI injuries remain rare, the frequency of accidents is increasing in parallel to the increasing application of high magnetic field strength. RF burn injuries constitute nearly half of all MRI related injuries and are increasing. RF burn injuries occur either due to skin to skin contact or skin contact with a wire/cable or a wire acting as an antenna that interacts with the RF field of the MRI machine. Considerable local heating occurs that is concentrated at the contact points of the wire or skin, however, the mechanism for some of the RF burn injuries occurring at contact points is not well understood. This poses challenges for the application of adequate safety or preventive measures for RF related burns in MRI procedures.

Commentary by ARPANSA:

The review provides state-of-the-art knowledge on RF heating and burn injuries in medical MRI systems, including RF exposure limits. Internationally, the RF exposure limits for MRI procedures are guided by the recommendations of the International Commission on Non-Ionizing Radiation Protection (ICNIRP). These RF exposure limits are given in terms of specific absorption rate (SAR in W/kg), which is essentially the amount of RF energy absorbed per unit mass of human tissue. SAR limits applicable for the use of passive implants (e.g., hip and knee prostheses) or active implantable medical devices (e.g., cardiac pacemakers or cochlear implants) have been documented in other standards such as ASTM-F2182 and ISO/TS 109474:2018, respectively. 

The review also recommends key preventive measures to avoid the likelihood of RF related burns in MRI procedures. The recommendations include the use of foam pads (1-2 cm thick) to insulate the patient from cables, the bore, and between limbs to prevent RF burn injuries, avoiding positioning the body near the RF transmit coil and considering the antenna effect for patients with large implants and tattoos. These recommendations are consistent with those provided by the Royal Australian and New Zealand College of Radiologists (RANZCR).

In conclusion, this review is a useful guide to understanding MRI related RF burn injuries in medical imaging settings. 
 

Review on the impacts of electromagnetic fields on pregnancy and other health outcomes

Authored By:

El Jarrah & Rababa, Feb 2022

Published In:

Heliyon

Date:

Apr 2022

Summary:

This review aimed to investigate the possible link between exposure to electromagnetic fields (EMF) and adverse pregnancy outcomes and various other health effects. The authors state the review included all studies on the impacts of EMF from electronic devices on health outcomes among adults, pregnant women, and newborns or in non-human subjects or in vitro research published in the last 5 years. Based on this inclusion criteria the authors assessed 18 papers for the review. The authors concluded that EMF radiation is linked to various health effects and suggested women and children are at risk due to exposure during pregnancy.

Commentary by ARPANSA:

There are a number of methodological issues with this review that indicate the authors have not fully assessed the evidence and may have omitted evidence contrary to their desired conclusions. Although the authors mention that they conducted a systematic review and describe in the methods how it was conducted, the results do not indicate a properly conducted systematic review. Although the studies are given a risk of bias (RoB) rating the full RoB analysis is not presented and it is noted that the authors rate poor quality studies as being high quality. Also, systematic reviews only include original research papers, but Al-Jarrah and Rababa include a meta-analysis in the final list of included studies [Tsarna et al, 2019]. There was also no formal synthesis of results presented. Further, the authors mix in vitro, in vivo, epidemiological, and human experimental studies which would require separate systematic reviews. Instead, the authors present a biased narrative review. 

The authors only assessed papers published in the last 5 years and there is no justification for the selection of this timeframe. This is a major source of bias as it excludes many modern high-quality papers on EMF and health. This short time frame for inclusion again highlights how the authors have ignored evidence on this topic. Additionally, the screening process as reported is flawed. The authors reportedly found 10,450 articles from 7 databases and yet only 311 articles remained after duplicates were removed meaning 10,139 articles were duplicates. This cannot be correct. Furthermore, the search strings used for each database search are not presented, nor is the number of articles retrieved from each database.

The authors’ assessment of pregnancy outcomes included nine papers. Of these, eight had clear limitations in their methods, particularly when assessing exposure that would prevent any causal association being made, and the other paper was a measurement study that was not assessing health outcomes. The authors of this review seem to have ignored these limitations when assessing the evidence of the included studies. 

Overall, this review by Al-Jarrah & Rababa failed to fully or adequately assess the available evidence on the impact of EMF on health and pregnancy outcomes. It also relied on papers with low quality methods and poor exposure assessment. Another recent review by Ashrafinia et al (2021) of higher quality studies assessed the impact of mobile phone exposure and adverse maternal, infant and child outcomes and reported no substantiated evidence of an impact from mobile phone exposure. It appears that the authors have “cherry picked” articles that suited their narrative and ignored or rejected papers that didn’t, as studies that did not find an association included in the Ashrafinia et al review were not included in this review despite being within the dubious 5-year timeframe. The particular papers that have been inexplicably excluded from the Al-Jarrah & Rababa review but are present in the Ashrafinia et al review include Sudan et al (2016), Papadopoulou et al (2017), and Choi et al (2017). Furthermore, a major review by the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) published in 2015 also found no substantiated evidence of a health impact from EMF exposure [SCENIHR, 2015].

Association between occupational exposure to solar ultraviolet radiation and skin cancers: The WHO systematic review and meta-analysis

Authored By:

World Health Organisation, December 2021

Published In:

The WHO website

Date:

Jan 2022

Summary:

This systematic review and meta-analysis assessed the associations between occupational exposure to solar ultraviolet radiation (UVR), and melanoma and non-melanoma skin cancer (NMSC). The results were based on data extracted from 53 eligible studies that involved over 457,000 participants in 26 countries. In most studies, the exposure to solar UVR was self-reported in questionnaires (e.g., during interviews), whereas the health outcome of skin cancers was based on histopathological diagnoses. The results showed that compared to non-exposed people, occupationally exposed UVR workers were 1.45 times and 1.60 times more likely to have melanoma and NMSC, respectively. Of NMSC subtypes, the risk of the incidence of squamous cell carcinoma was much higher (Risk Ratio 2.42) compared to that of basal cell carcinoma (Risk ratio 1.50). The report concluded that considering methodological limitations, such as bias and confounding, there is limited evidence for an association between occupational exposure to UVR and skin cancer. 

Commentary by ARPANSA:

Although the report concluded that there is overall limited evidence for an association between occupational UVR exposure and skin cancer, the results support the current sun protection recommendations of national (e.g., Cancer Council Australia Sun safety | Cancer Council) and international (International Agency for Research on Cancer, IARC) organisations. The  IARC classifies solar UVR as a Group 1 carcinogen (IARC, 1992). Skin cancer accounts for the largest number of cancers diagnosed in Australia each year (Australian Institute of Health and Welfare, 2016). ARPANSA recommends that all people including workers should limit their UVR exposures, and a combination of sun protection measures (e.g., clothing and sunglasses, shade and sunscreen) should be used, wherever applicable. For more information see the ARPANSA factsheet, Sun exposure and health

Estimated all-day and evening whole-brain radiofrequency electromagnetic fields doses, and sleep in preadolescents

Authored By:

Cabra-Riera et al.

Published In:

Environmental Research

Date:

Jan 2022

Summary:

This cross-sectional study investigated the association between radiofrequency electromagnetic field (RF EMF) exposure and sleep disturbances in Dutch and Spanish preadolescents (9- to 12-year-olds). Using a questionnaire, information was gathered on the participants mobile and cordless phone use, as well as tablet and laptop use to estimate near-field RF EMF brain dose. Far-field RF-EMF exposure from mobile phone base stations, broadcast towers, FM radio and wi-fi was also estimated using exposure modelling. Sleep quality was assessed by measuring total sleep time, sleep efficiency, sleep onset latency and wake after sleep onset. The study found whole-brain RF EMF dose was not associated with sleep disturbances. However, the study found evening doses of RF EMF from phone calls were associated with shorter total sleep time. Although the authors acknowledged that this association may be due to behaviours and not RF EMF exposure.

Commentary by ARPANSA:

The conclusions of this study are consistent with ARPANSA’s review of the scientific evidence that there are no substantiated effects of RF EMF on sleep quality (ARPANSA, 2014). The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) opinion on Potential health effects of exposure to electromagnetic fields (EMF) also concluded that there was no substantiated scientific evidence to support disruptions to parameters affecting sleep quality. This supports ARPANSA’s view that exposure to RF EMF at levels below the limits set in the ARPANSA RF Standard (RPS S-1) do not cause any adverse health effects. The standard is based on scientific research that shows the levels at which harmful effects occur and it sets limits, based on international guidelines, well below these harmful levels. The standard is designed to protect people of all ages and health status against all known adverse health effects from exposure to RF EMF.

International MOBI-Kids study finds no link between mobile phone use and brain cancer in children

Authored By:

Castano-Vinyals et al.

Published In:

Environment International, 2022

Date:

Jan 2022

Summary:

This international case-control study examined the association between wireless (mobile and cordless) phone use in childhood and adolescence and brain tumour risk. The study, called MOBI-Kids, recruited 899 people with brain tumours and 1,910 controls aged 10 to 24 from 14 different countries (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain). The study reported no statistically significant increase in the risk of brain tumours. The authors did observe a statistically significant decreased risk, however, this was attributed to bias from wrong information reported on mobile use rather than a protective effect. The authors concluded that the study provides no evidence for a causal association between wireless phone use and brain tumours in children and adolescents. However, the authors stated that due to potential bias they could not rule out the possibility of a small increased risk.

Commentary by ARPANSA:

This is the largest case-control study ever to investigate the association between wireless phone use and brain tumours in children and adolescents. The authors’ findings are consistent with previous studies, including the CEFALO study, that also showed no association between the use of wireless phones and brain tumours in children and adolescents. The findings are also consistent with studies reporting no increase in the incidence of brain tumour despite the increased use of mobile phones (e.g. Karipidis et al 2019 and Villeneuve et al 2021).

Overall, this study provides further evidence that there are no substantiated adverse health effects from exposure to radiofrequency electromagnetic energy from wireless phones where the emissions are below the public exposure limits set in the ARPANSA Standard and the International Commission on Non-ionizing Radiation Protection’s radiofrequency guidelines.

European study finds exposure to radiofrequency electromagnetic fields is well below the safety limits in international guidelines

Authored By:

Huss et al

Published In:

Environment International

Date:

Jul 2021

Summary:

This study conducted measurements of radiofrequency (RF) electromagnetic energy (EME) in different every day settings (e.g. parks, residences, shopping centres etc.) across 5 European countries (Belgium, France, Spain, Switzerland and Netherlands). The measurements were conducted using a newly developed body-worn meter. The median RF-EME exposure across 267 locations using the new body-worn meter  was 0.13 mW/m2 which was similar to the median measurements using other types of meters.

Commentary by ARPANSA:

The measured RF-EMF levels across all environments in all countries were well below the public exposure limits set in the International Commission on Non-ionizing Radiation Protection’s 2020 radiofrequency exposure guidelines, and the ARPANSA radiofrequency exposure standard (RPS S-1). Although these results were expected, it is still a reassuring result that exposure in environments similar to what we would expect in Australia was well below the ARPANSA safety standard. There is currently no substantiated scientific evidence that exposure to RF-EME at levels below the limits set in the ARPANSA Standard cause any adverse health effects.

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