Radiation literature survey

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This was a case-control study that investigated the association between exposure to radiofrequency electromagnetic fields (RF-EME) from broadcast and mobile phone antennas and risk of lymphoma. The study included 322 cases and 444 controls. Exposure to RF was assessed via self-reported and quantified distance from the RF transmitters to the residential address and some residential measurements. There was an association between self-reported residential distances less than 50 meters (odds ratio 2.7, 95% confidence interval 1.5-4.6). However there was no statistically significant association with any type of lymphoma when exposure was assessed via quantifying distance to addresses or residential measurements. The authors concluded that there was no association between RF-EME exposure from mobile phone antennas and lymphoma development.

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Commentary by ARPANSA:

The evidence on the effects of RF fields and human health has been reviewed recently by the European Scientific Committee on Emerging and Newly Identified Health Risks (SCENHIR, 2015). SCENHIR concluded that there is no substantiated evidence that exposure to RF from base stations and broadcast antennas increases cancer risk.

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The French Agency for Food, Environmental and Occupational Health & Safety (ANSES) at the end of March 2018 published the results of its expert appraisal on electromagnetic hypersensitivity (EHS). It was acknowledged that current scientific evidence shows no cause and effect link between the symptoms of EHS and electromagnetic fields and that it is only possible to identify EHS individuals by their self-reporting. Regardless of this ANSES stated that the suffering and pain of those who declare themselves EHS is real and has significant impact on their daily lives. ANSES recommended suitable training for health and social services professionals to ensure suitable care and counselling for people declaring themselves EHS and for better coordination between facilitators of their care. It was also highlighted that further research is needed and that it should be performed in consultation with the EHS community. ANSES said that long-term funding is required for research on the health effects of electromagnetic fields including long-term studies performed under controlled experimental conditions.

The findings of the expert appraisal by ANSES is in-line with the position of ARPANSA as found on our website and the full news release from ANSES can be found on their website.

ANSES website

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In 2011, the International Commission on Radiological Protection (ICRP) made changes to their recommendations for the annual limit of ionising radiation exposure to the lens of the eye for occupational workers. The new limit was 20 mSv per annum, averaged over defined periods, with no year exceeding 50 mSv. This adjustment was due to epidemiological evidence relating to tissue reaction effects for doses to the lens of the eye and possible cataract formation.

Researchers in the USA carried out a prospective study in the years 2003-2005 and 2012-2013 and published the findings. The purpose of the research was to estimate the risk of cataract incidents in a cohort of nuclear medicine (NM) technologists based on their work histories and radiation protection practices. Findings indicated an increased risk of cataracts observed among U.S. radiologic technologists who had performed an NM procedure at least once. The study recommended future studies incorporating estimated lens doses.

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Commentary by ARPANSA:

Previous work in the area of eye dosimetry internationally has been centred on image-guided x-ray interventional procedures (IGIP) that make use of high dose angiographic acquisitions and/or CT fluoroscopy guided interventions¹ with the emphasis for the need for optimisation of protection measures with respect to the lens of the eye. Recommendations that staff wear appropriate eye protection and use protective screens have been made. In Australia currently there is no requirement for medical staff to wear eye dosimeters to measure the radiation exposure to the lens of eye. Furthermore, no research has taken place to estimate the doses these people receive and in particular staff that use unsealed radiopharmaceuticals. Based on the published paper above, Australia may have an opportunity to contribute to international knowledge by carrying out clinical surveys and providing analysis of data from across the country.

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Burgard et al conducted a meta-analysis of solarium use and the risk of malignant melanoma. The authors identified 2 cohort and 29 case-control studies that were deemed eligible for the meta-analysis. These studies included 11,706 malignant melanoma cases and 93,236 controls. The studies covered in the meta-analysis were primarily from Europe, North America and Australia.

The authors found that the data support an association between solarium use and malignant melanoma (Odds Ratio, OR=1.19; 95% Confidence Interval, CI=1.04-1.35). In addition, there was a higher association for high exposure to ultraviolet radiation from a solarium (>10 sessions in a lifetime) and melanoma risk (OR=1.43; 95% CI=1.17-1.74). This supports the existence of a dose-response relationship (i.e. the more UV exposure in a solarium, the higher the risk of melanoma). The authors also reported that they found an association between first exposure to ultraviolet radiation from a solarium before age 25 years and melanoma risk (OR=1.59; 95% CI=1.38-1.83).

Despite these findings, the authors concluded that the papers that were included in the analysis were of poor quality and had high risk of bias supporting these associations. Consequently, the meta-analysis concluded that there was no scientific evidence that moderate/responsible solarium use increases the risk of melanoma.

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Anticancer Research: International journal of Cancer Research and Treatment, February 2018; 38 (2) : 591 - 1219

Based on the reported associations between solarium use and malignant melanoma, the scientific evidence supports Australia’s nation-wide policy to ban all commercial solaria.

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This report produced by the Netherlands government compares the electromagnetic field (EMF) exposure policies for both the general public and occupational exposure between countries in the EU (European Union) and other countries including Australia. The report grouped countries by how they have responded to EU recommendations based on guidelines by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) for EMF frequencies and how this has influenced government policy. For group 1 EU recommendations were reflected in legislation and policy, for group 2 recommendations were not reflected in legislation and policy and for group 3 legislation and policy was stricter than recommendations. For power frequencies, Australia is within group 2 as there is no official regulations or guidelines for general public exposure. However Australian electricity grid operators do use the prudent avoidance principles and prescribe the ICNIRP guidelines. For radiofrequencies (RF), Australia is within group 1 as there are national standards regulating RF exposure from telecommunications sources.

Link to full report

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The opinion focussed on four main sources of risk associated with the use of Light Emitting Diodes (LEDs) lighting or displays. These included:

• Hazards to the eyes and skin from direct and diffuse light exposure and long-term health effects in the general population;
• Issues arising from direct viewing of some LED sources where the risk arises from impact on vision such as distraction, glare and after-images;
• Problems with temporal characteristics of the LED emission effecting visual perception of the light or the surrounding environment;
• The effect on the circadian rhythm (sleep wake cycle).

There was sufficient evidence to suggest that the blue light exposure caused disruptions in the circadian rhythm, especially if the exposure occurred in the evening hours before sleep times. This effect was more pronounced in children due to different light penetration properties of the young eye. It was not clear whether this disruption on the sleep wake cycle had any long-term health effects.

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The main strengths of the review conducted by SCHEER were:

• SCHEER looked at age-dependent effects including exposure to children under 3, adults, the elderly and susceptible groups;
• The potential health effects were examined for exposure to LEDs under normal use or any reasonably foreseeable misuse;
• The review included comparisons to exposures from traditional lighting sources showing lower exposure from LEDs at wavelengths in the UV and Infrared regions.

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This is a retrospective cohort study which investigated the association between radon and UV exposure and skin cancer. A total of 5.2 million people were included in the study, which contained a total of 2,989 skin cancer deaths primarily due to malignant melanoma. The individuals’ residential exposures to radon and UV were assessed using exposure prediction models which were based on environmental data. The study found that residential radon exposure increased the risk of skin cancer, when combined with UV or independently. The authors found that both radon and UV exposure are relevant risk factors for skin cancer.

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The strength of this study was its sample size – it used the famous Swiss National Cohort which consists of more than 5 million people and has been used for numerous studies.

The study assessed individual exposures to radon and UV based on modelled exposures at the place of residence of the subjects The study contained inherent disadvantages of this type of study design i.e. great potential for exposure misclassification as there are many behavioural factors that affect personal exposure to radon and UV compared to residential exposure. Nevertheless the exposure assessment was more convincing for radon compared to UV.

In conclusion, the methods employed were good for this type of study and were a better predictor of the radon skin cancer relationship compared to the UV skin cancer comparison.

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This is an Australian prospective cohort study that investigated the effect of wireless (mobile and cordless) phone use and cognitive function in children. A total of 412 children from 36 schools in Melbourne and Wollongong were followed for a period of up to 28 months. The information on socio-demographics and wireless phone use was obtained via questionnaires. The change in various cognitive outcomes (evaluated via computer-based tests) between the start of the study period and the follow-up at the end was assessed. The study found limited evidence that increased wireless phone use was associated with cognitive function.

Pubmed Link

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The World Health Organization (WHO) has previously identified in their radiofrequency (RF) research agenda that studies into children’s behavioural and neurological outcomes associated with RF electromagnetic fields (EMF) exposure are of high priority (http://whqlibdoc.who.int/publications/2010/9789241599948_eng.pdf?ua=1).  

ARPANSA recently published an RF research agenda, where it serves as an interim solution to identifying priority research needs for Australia, as the WHO’s 2010 research agenda has become dated. Prospective cohort studies of children and adolescents investigating exposure to RF EMF and various outcomes including cancer and behavioural and neurological disorders remain high in priority. The ARPANSA RF research agenda is available at Radiofrequency Electromagnetic Energy and Health: Research Needs.

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This is a cohort study which investigated any association between exposure to extremely low frequency (ELF) magnetic fields early in life and asthma in children. A total of 92,676 child and mother pairs were included in the study. The children’s exposures were estimated at the mothers’ residences during pregnancy and at the children’ residences from birth until diagnosis/end of follow up (estimations were based on distance from  transmission lines and transmission line configuration details).The study did not find any statistically significant results that indicated an increased risk of asthma in children exposed to different levels of ELF magnetic fields. The authors concluded that there is no association between ELF magnetic fields exposure and asthma in children.

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One of the major limitations of epidemiological studies investigating residential ELF magnetic fields exposure lies with the tiny proportion of study participants being exposed above the normal background level i.e. above .3 or .4 microtesla (µT). This leads to a low statistical power to reliably detect any association. ELF magnetic fields above .3 or .4 µT were shown by some epidemiological studies to be associated with childhood leukaemia – association that has not been established up until now. For example, the study by Sudan et al found that the proportion of subjects exposed above .2 µT was only 0.05%.

The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) in its opinion on potential health effects of exposure to electromagnetic fields in 2015 reported that there were recent studies that found an increased risk of asthma in the offspring associated with exposure to ELF magnetic fields during pregnancy. One major study that found this was a prospective cohort study conducted by Li et al (2011). SCENIHR concluded that even though recent studies for the first time have shown an association between ELF magnetic fields exposure and asthma, the results need to be reproduced to evaluate their significance for risk assessment. It was interesting to note that the study by Sudan et al was designed to replicate the study by Li et al; however the study by Sudan et al did not reproduce the results found by Li et al.

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This is a case-control study which investigated the link between exposure to ionising radiation from natural sources and childhood leukaemia. A total of 2,700 cases (diagnosed during the period 2002-2007) and 30,000 controls were included in the study. The exposure to radon, gamma, and total radiation were estimated using environmental exposure data, based on the child’s municipality at time of diagnosis. Overall, the study did not find any association between childhood leukaemia and exposure to natural background radiation, hence providing no support to the hypothesis that residential exposure to natural background radiation increases the risk of childhood leukaemia.

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Link to PubMed abstract

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Commentary by ARPANSA:

This study by Demoury et al did not find an association between childhood leukaemia and exposure to natural background radiation, whereas two older studies by Kendall et al in Switzerland and Spycher et al in the UK both found an increased risk of childhood leukaemia at a dose of 1 millisievert per year  over 10 years or so. It should be noted that the study by Demoury et al did not rule out a slight association with gamma radiation at the time of birth – which is in line with the findings in the Swiss and UK studies.

All of these three studies are well conducted and are large enough to provide a statistically significant result however differences in the methodology are likely accounting for the difference in results. The two biggest methodological issues in all three studies were (a) the assessment of exposure which was based on residence estimation and not individual dosimetry, and was estimated differently in all three and (b) all three studies used retrospective registry information.

Since all three studies used registry information, other lifestyle, genetic or environmental factors (requiring interview to be determined) were not accounted for. Nevertheless the registry information eliminates the potential for recall bias. Bias due to unknown confounding factors is very unlikely to explain the entire observed effect.

In conclusion, there is currently mixed results on whether background radiation is associated with childhood leukaemia and further research is needed in this area.