Radiation literature survey

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There have been two separate reviews published by the same study group which have examined the literature on solarium use and the risk of melanoma. These reviews were conducted as a supplement to a meta-analysis of the same body of evidence published by Burgard et al in 2018. ARPANSA had previously reviewed this meta-analysis and provided comment. Briefly, in the 2018 meta-analysis, the authors included 2 cohort and 29 case-control studies and reported overall risk factors supporting an association between varying degrees of solarium exposure ranging from moderate to heavy use and a risk of malignant melanoma. Further, the risk of melanoma increased with higher use of solariums suggesting a dose-response relationship with ultraviolet radiation (UVR) exposure. Despite these results, the authors pointed to weaknesses in the included studies being a major cause of bias and thus concluded that there was no substantiated evidence of moderate solarium use being a causal factor for the development of malignant melanoma.

The current 2020 reviews provide further critique regarding the quality of the studies that form the basis of solarium use as a risk factor for melanoma. Specifically, they focus on “moderate” sunbed use being used as the criteria to question the scientific basis of current mainstream advice that the use of solaria is carcinogenic from exposure to artificial UVR, which is classified as a Group 1 carcinogen by the International Agency for Research on Cancer. The reviews discuss the impact of confounders including solar UVR exposure, age of exposure and smoking status and argue that the risk of bias presented by these factors would most likely lead to an overestimation of the risk. In relation to the criteria of “moderate” sunbed use, the authors argue that there is no strong evidence for melanoma development at UVR exposures below levels sufficient to cause erythema (sunburn).

Solarium Use and Risk for Malignant Melanoma: Many Open Questions, Not the Time to Close the Debate

Sunbeds and Melanoma Risk: Many Open Questions, Not Yet Time to Close the Debate

https://pubmed.ncbi.nlm.nih.gov/32918218/

Despite the critiques of the studies reporting an increased risk between solarium use and melanoma provided within the reviews, the included studies revealed a consistent relationship despite some of their weaknesses.

The authors’ assertions about the safety of moderate solarium use present the question about how ‘moderate’ is defined and, further, how use can be monitored and enforced. Before the total ban of commercial solaria in Australia by 2016, the solarium industry was guided by a voluntary code of practice which focussed on limiting use of sunbeds by factors such as age and skin type of the client. A 2011 study by Makin et al. demonstrated poor adherence by solarium operators to the requirements of this code when accepting clients.

Despite the conclusions of these reviews, the positive associations consistently demonstrating an increased risk between solarium use and melanoma in epidemiological studies continue to support Australia’s nation-wide policy to ban all commercial solaria as a strong health protection measure.

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The ‘Moscow signal’ incident occurred during the Cold War between 1953 and 1976. The former USSR reportedly irradiated the US embassy with a 2.5 – 4 GHz microwave beam with a maximum reported exposure of 15 μW/cm2 for 18 hours a day (Lilienfeld et al., 1978). This paper reviewed the evidence of adverse health effects to staff working in the US embassy. Based on medical records and a Health History Questionnaire, there were no observed differences to total mortality or in ‘mortality from cancer’ between the Moscow group and the comparison group (staff who served in other eastern European embassies). Likewise, the results for morbidity found no differences in health status between the Moscow exposure group and the comparison group except for an increased rate of protozoal infections in males, and a slightly increased frequency of common health conditions. However, hundreds of morbidity comparisons were made, and these are likely chance findings. The paper concludes that no adverse health effects related to increased exposure to radiofrequency electromagnetic energy (RF EME) from the ‘Moscow signal’ incident were found. This supports the findings of the original report by Lilienfeld et al. commissioned by the US Department of State.

Microwaves in the cold war: the Moscow embassy study and its interpretation. Review of a retrospective cohort study

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The exposure experienced by staff in the US embassy in Moscow is low compared to the current ARPANSA RF exposure standard. Further, there is no substantiated scientific evidence of adverse health effects from exposure to RF EME below the limits set by the ARPANSA RF Standard. The exposure limits are underpinned by several reviews of the body of scientific literature including: the ICNIRP review of RF EME and health, and The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR)’s opinion ‘Potential health effects of exposure to electromagnetic fields (EMF)’. The results of this study contribute further to the growing body of evidence supporting no adverse health effects from RF EME below the set exposure limits.

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This in vivo study examined the effects of radiofrequency electromagnetic energy (RF EME) on the reaction of rats to auditory stimulus. The study exposed rats to RF EME or sham for 2 hours 5 days a week over either a 1 or 10 week period. The RF exposure had a specific absorption rate (SAR) of 0.66 W/kg to the head and 0.005 W/kg to the body. After the exposure period, each animal’s hearing function was tested by measuring its auditory brainstem response (ABR). The authors reported no difference in the ABR threshold values between any of the groups. They did report a statistically significant increase in the latencies of the ABR in the one week exposure group and a decrease in the 10 week exposure group. The study also reported statistically significant changes in the concentration of some biomarkers in the brains of the exposed mice that could indicate changes in the concentration of reactive oxygen species (ROS) and imply oxidative stress.

The effects of acute and chronic exposure to 900 MHz radiofrequency radiation on auditory brainstem response in adult rats

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While there were some changes in biological indicators this did not result in any physiological effects. The effect of RF on ABR has previously been examined in newly born mice Kim et al, 2019. Kim et al also found that RF exposure for 5 days had no significant effects on ABR.

While there were changes in the concentration of biological indicators of ROS, a link between RF EME exposure and altered ROS production has not been substantiated. When the total body of available research on ROS production is considered there are no consistently demonstrated health risks to humans (SCENIHR, 2015).

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This study is a retrospective case series of staff from the US government embassy in Havana, Cuba, who reported experiencing an auditory stimulus that was associated with the onset of various health effects. The stimulus reported by the staff had differing physical characteristics such as high (n=18) or low (n=2) pitch and pressure (n=9) or vibrations (n=3). Of the 24 individuals with suspected exposure, 21 were evaluated 203 days after the reported exposure. The persistent symptoms reported by these individuals were highly variable and included cognitive (n=17), balance (n=15) and visual (n=18) effects, and auditory dysfunction (n=15), sleep impairment (n=18) and headaches (n=15). Different individuals reported various combinations of these health effects. MRI neuroimaging was conducted for the 21 individuals and only three showed changes outside of the normal range. Of these three cases, the authors mention that the changes observed could possibly be attributed to other pre-existing conditions or risk factors.

Neurological Manifestations Among US Government Personnel Reporting Directional Audible and Sensory Phenomena in Havana, Cuba

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It is not known how an auditory stimulus or any other exposure, including radio waves, could cause the health symptoms that US government personnel reported. Neither sound in the auditory range or exposure to radio waves is associated with any of the reported symptoms. Further, ARPANSA is not aware of how any other type of radiation exposure could cause the reported symptoms. As discussed by Swanson et al. (2018) the symptoms could possibly be due to a collective delusional disorder, such as a type of mass psychogenic illness. However, Swanson et al. (2018) states there is little evidence for this, and other occurrences of mass psychogenic illness don’t usually result in persistent symptoms. However, a report by Bartholomew et al. (2018) suggests a mass psychogenic illness is the most likely cause and that such occurrences have been reported before. Bartholomew et al. (2018) further suggests that the sound that was perceived was likely just the normal sounds of the city and was conflated with the reported symptoms.

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This review examined the scientific evidence of a connection between exposure to radiofrequency electromagnetic fields (RF EMF) and non-specific symptoms by individuals who identify as suffering from electromagnetic hypersensitivity (EHS). EHS individuals reported a wide range of non-specific health problems, which they attributed to RF EMF exposure. This study reported that short-term symptoms have been commonly examined using double-blinded provocation studies. These studies have used either typical environmental exposures (e.g. mobiles phones and wi-fi) or sham exposures on both non-EHS individuals and those that report to have EHS. The studies reported no difference in reported symptoms between real or sham exposure. These results suggest that it is the perception of exposure to RF EMF and not the exposure itself that triggers the symptoms reported by EHS individuals. The review also reported on the outcome of cohort studies and meta-analyses of cross-sectional studies that examined the long-term symptoms from RF EMF exposure. When examining the meta-analyses this review reported that lower quality studies or studies where participates were aware of their exposure more commonly reported positive associations between RF EMF exposure and EHS symptoms. In contrast, high quality cohort studies that measured exposures objectively, and compared this to the occurrences of symptoms in EHS individuals, did not demonstrate associations between RF EMF exposure and EHS symptoms. Overall, this review concluded that the symptoms experienced by EHS individuals are closely associated with perception of RF EMF exposure. This suggests that the symptoms experienced by those who report to be EHS are likely because of a nocebo response. 

Is there a syndrome caused by radiofrequency electromagnetic fields?

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This review contributes to our understanding of the evidence surrounding RF EMF exposure and the occurrence of EHS symptoms. ARPANSA has previously reviewed the evidence of an association between RF EMF exposure and EHS in technical report 164 and continues to review research on EHS to stay up to date on this topic. The symptoms experienced by people who report to have EHS are real and can have disabling effect for the affected individual. However, the scientific evidence suggests that exposure to RF EMF is not the cause of these symptoms. In 2017, ARPANSA published technical report 178 on the research needs for RF EMF and health. This report outlined a number of research aims for scientific investigation that will further elucidate the connection between EHS symptoms and RF exposure.

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

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This human experimental study examined whether all-night exposure to radiofrequency electromagnetic energy (RF EME) from Wi-Fi affected sleep-dependent memory consolidation and its biological indicators. Thirty males were recruited to spend 5 nights sleeping in the laboratory where they were exposed to the RF EME from Wi-Fi and sham exposure on the 3rd and 5th nights. Memory performance was evaluated with various cognitive tasks while learning-associated brain activity was collected via an electroencephalogram (EEG). The study found exposure to Wi-Fi had no effect on emotional or procedural memory, but there was improvement in the declarative memory task. However, there was no effect on the sleep-specific brain activity parameters recorded by the EEG for any of the assessed memory parameters. Therefore, the authors concluded that the beneficial effect of Wi-Fi exposure on declarative memory was likely a chance finding, and that Wi-Fi does not affect sleep-dependent memory consolidation.

Effects of 2.45 GHz Wi-Fi exposure on sleep-dependent memory consolidation

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Despite the small sample size of males for this study, the findings add to the growing scientific body of evidence that RF EME exposure from Wi-Fi sources does not adversely affect sleep. A replication study with a larger sample size is required before concluding that the beneficial effect on declarative memory is more than a chance finding. The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR)’s review on ‘Potential health effects of exposure to electromagnetic fields (EMF)’ also found a lack of evidence that RF affects cognitive functions in humans. This is in line with ARPANSA’s view that there is currently no substantiated scientific evidence that exposure to RF EME at levels below the limits set in the ARPANSA Standard (RPS S-1) cause any adverse health effects. 

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This study was the first to examine the possible association between exposure to radon and the expression of particular genes within breast cancer tumours. The study included 874 women who were diagnosed with breast cancer from two large cohort studies of nurses in the US (Nurses’ Health Study I and II). Breast cancer tumours were excised from each case during treatment and gene expression was analysed. Each participant’s radon exposure was estimated by using a combination of their geographical location and a US indoor radon model. The authors did not find any statistically significant gene expression differences in the tumour tissue between cases with high and low radon exposure. However, they did report some differences in adjacent tissue cells, but these were not statistically significant.

Low dose environmental radon exposure and breast tumor gene expression

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A previous study by the same research group also reported no significant association between risk of breast cancer and radon exposure (Vopham et al, 2017). The internal dosimetry models for radon exposure from the International Commission on Radiological Protection (ICRP) have recently been updated. These models predict how radionuclides move through the body, and which organs will receive the greatest exposure. The findings from these studies are consistent with the ICRP models that show radon and its progeny do not expose the breast to significant amounts of radiation.

It is important to note that radon exposure is an established risk factor for lung cancer, however, in Australian homes the average concentration of radon is low. For more information about radon, please see the ARPASNA factsheet on Radon exposure and health.  

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This cohort study investigated if maternal mobile phone use was associated with fetal development during pregnancy. The cohort included 1378children born between 2014 and 2017. The study’s assessment was based on self-reported maternal mobile phone use and hospital records of birth outcomes. The study reported that the children of mothers who used mobile phones for longer than thirty minutes per day were more likely to be in the 10th lowest fetal growth percentile (odds ratio 1.54 and 95% confidence interval of 1.03 – 2.31). The authors concluded that the results should be interpreted with caution because other indicators of fetal growth restriction, such as birth weight, were not significantly changed with mobile phone use. Further, the authors stated that their results did not account for some socioeconomic confounding factors such as housing type. 

Mobile phone use during pregnancy: Which association with fetal growth?

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Previous studies have found no association between maternal use of mobile phones and reduction in fetal growth (Mortazavi et al, 2013 and Tsarna et al, 2019). Although, the current study reported adverse effects on fetal development their results are limited by confounding factors that were not accounted for and the conflicting outcomes from other indicators of fetal growth. A number of reviews have assessed the body of evidence of the effect of radio waves on pregnancy outcomes including fetal growth. The reviews by the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR), Public Health England and by ARPANSA concluded there is no substantiated evidence that radio wave exposure can effect fetal growth or other pregnancy outcomes. 

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This study estimated the overall future economic and health benefit of banning commercial solaria in Australia. The study modelled the health and economic impact on the cohort of Australians aged 12-35 years in 2007, which amounted to 6.95 million people. The authors estimated the number of skin cancers and skin cancer death that would be averted due to the commercial solaria ban for this cohort and the resulting economic impact. They then compared this to similar estimates if no ban was in place. The authors reported that with the solaria ban there would be 31,009 fewer melanomas, 3017 fewer melanoma deaths and 468,249 fewer keratinocyte cancers over the lifetime of the cohort. It was also estimated that when accounting for both the loss of productivity associated with cancer and the cost of health there would be a saving of over 580 million dollars for the Australian economy. The authors concluded that banning commercial solaria is both an effective health policy and a good economic decision for government.

Consequences of banning commercial solaria in 2016 in Australia

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A previous study from the same research group (Gordon et al, 2008) estimated that, in Australia, 281 cases of melanoma, 43 melanoma related deaths, and 2572 new cases of squamous cell carcinoma were caused by exposure to ultraviolet radiation (UVR) from indoor tanning every year prior to banning commercial solaria.

Commercial solaria were banned in all states and territories across Australia by 2016. The estimates of skin cancer morbidity and mortality presented in this study offer a compelling argument for justification of the banning measures put into place. However, because the ban applied only to commercial solaria, it is still possible for an individual to have a tanning bed for personal use. People that use solariums should be aware that exposure to UVR from tanning beds increases the risk of developing skin cancers. This is especially topical in Australia where the skin cancer rates are among the highest in the world. Further, the World Health Organization through the International Agency for Research on Cancer categorises UVR as carcinogens. The ARPANSA factsheet Solaria and tanning beds further explains the ban of commercial solaria and the risk of their use.

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This was a double-blind, sham controlled, randomised cross-over study that recorded the brain waves of 34 participants being exposed to radio waves from a Wi-Fi router during sleep. The participants were also asked about how they personally felt after each night’s sleep. Participants slept under observation for 5 nights where the first night was to allow them to adapt to the sleeping environment and the last four nights were randomly assigned as either exposed or sham exposed nights. The authors reported no statistically significant effects of a Wi-Fi exposure on the participants’ reported sleep quality or in brain waves of the macrostructures of sleep. However, the authors reported a reduction in the power of alpha waves in the microstructure during one of the five stages of sleep during exposure. The authors concluded that the results were not indicative of any sleep disturbances that occurred because of Wi-Fi exposure.  

Spending the night next to a router – Results from the first human experimental study investigating the impact of Wi-Fi exposure on sleep

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An earlier study by the same author exposed participants to radio waves from mobile phones during sleep (Danker-Hopfe et al, 2011). Similarly, this study concluded that radio wave exposure did not affect the brain wave macrostructure of the sleeping participants. 

The conclusions of this study are consistent with ARPANSA’s review of the scientific evidence that there has been no consistently demonstrated effects of radio waves on sleep patterns (ARPANSA, 2014). Further, the ARPANSA RF exposure standard RPS3 sets limits to protect the public and workers from any harmful exposure to radio waves. This 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 radio waves.