Department of Medical Sciences

Project description

The rapid worldwide increase in mobile phone use in adolescents and, more recently, children has generated considerable interest in the possible health effects of exposure to radio frequency (RF) fields. The current project aims to assess the potential carcinogenic effects of childhood and adolescent exposure to RF and ELF from mobile telephones on tumours of the central nervous system. The study will include approximately 1,000 cases of malignant and benign brain tumours aged 10 to 24 years and their respective controls from 15 countries (7 of which have funding under this contract). The project will build upon the methodological experience (both in terms of exposure assessment and epidemiological design) collected within the INTERPHONE study. Particular attention will be paid to issues of: potential selection bias related to the very low response rates of population-based controls – by selecting hospitalized controls with specific diagnoses, representative of the general population and unrelated to mobile phone use –; and potential recall errors – by validating questionnaire responses with the help of network operators and repeat questionnaires. Improved exposure indices for RF will be derived taking into account spatial distribution of energy in the brain at different ages; ELF from the phones will also be considered, as well as other important sources of EMF in the general environment of young people. The proposed age range is the most cost efficient to answer the question (because of latency) of brain cancer risk from exposure in childhood and adolescence. The timing of the project is optimal (2010-2014) because of the increasing prevalence of heavy use among adolescents and, in the last 5-10 years, children, without hands-free kits, particularly in Southern European countries and Israel.

Results and publications

The current project aims to assess the potential carcinogenic effects of childhood and adolescent exposure to radiofrequency (RF) and extremely low frequency (ELF) from mobile telephones on tumours of the central nervous system. Because brain tumours in children, adolescents, and young people are rare, and because the effect of EMF exposures from mobile phones, if any, is expected to be small, studies in single countries will generally lack sufficient statistical power to evaluate the possible relation between these exposures and the risk of brain tumours. Only careful large-scale collaborative studies, with detailed exposure assessment and major efforts to avoid and characterise possible biases will therefore be able to address this aim. The MOBI-KIDS study will include over 2,000 cases of malignant and benign brain tumours aged 10 to 24 years and their respective controls from 15 countries: Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain, and Taiwan, which are included in the current contract, and India, Japan, Korea, and Taiwan (countries which have newly joined the project and not included in the current contract). To achieve the overall aim of the project, MOBI-KIDS has the following operational objectives:

• To conduct a multinational epidemiological case-control study of brain tumours diagnosed in young people in relation to EMF exposure from mobile telephones and other sources of RF in eight countries under the current grant, and subject to funds being secured separately, in a number of non-European countries;

• To develop and validate improved indices of RF and extremely low frequency (ELF) exposure, and assess related uncertainties, for all of the subjects in the study;

• To analyse the relation between risk of brain tumours and exposures to RF and ELF from mobile phones and other relevant and important sources of exposure in the general environment of young people. The project builds upon the methodological experience (both in terms of exposure assessment and epidemiological design) collected within the INTERPHONE study2. Particular attention is being paid to issues of: potential selection bias related to the very low response rates of population-based controls – by selecting hospitalized controls with a 2/55 specific diagnosis, representative of the general population and unrelated to mobile phone use –; and potential recall errors – by validating questionnaire responses with the help of network operators and repeat questionnaires. Improved exposure indices for RF are being derived taking into account spatial distribution of energy in the brain at different ages. ELF from the phones will also be considered, as well as other important sources of EMF in the general environment of young people. Work since the beginning of the project included the development, pilot testing, optimisation and finalisation of study documents, establishing the infrastructure for data collection and validation, obtaining ethics approvals from several hundred hospitals and institutional review boards in the participating countries, development of dissemination tools and start of data collection in the majority of the countries. It is noted that a number additional countries, not included in the current grant, have recently joined the Mobi-Kids study (India, Japan, Korea, Taiwan) thus increasing substantially the power and representativeness of the study. Extensive work has gone into characterising and modelling ELF and RF exposure from different types of mobile and cordless phones, from different communication systems and from other environmental sources of EMF. A protocol for exposure assessment for potential occupation and environmental risk factors is under development. Substantial work has also gone into the development of the study databases and computer assisted personal interview including data validation. The main outcome of the MOBI-Kids project is to assess whether exposure to EMF from mobile communications technologies in childhood and adolescence can increase the risk of brain tumours. Because such tumours in young people are rare, and because the effect of EMF exposures from mobile phones, if any, is expected to be small, inclusion of a large number of countries is essential in order to achieve sufficient power to detect an association between EMF exposure and risk of brain tumours if it exists. In addition to the project partners a number of additional countries have joined the project resulting in an important increase in statistical power. Results of this project are therefore expected to be of great importance in the assessment of potential health risks from mobile telephone use as well as from EMF in general, as well as to increase our understanding about the aetiology of brain tumours in young people.

Pubblicazioni

Sadetzki S, Langer CE, Bruchim R, Kundi M, Merletti F, Vermeulen R, Kromhout H, Lee AK, Maslanyj M, Sim MR, Taki M, Wiart J, Armstrong B, Milne E, Benke G, Schattner R, Hutter HP, Woehrer A, Krewski D, Mohipp C, Momoli F, Ritvo P, Spinelli J, Lacour B, Delmas D, Remen T, Radon K, Weinmann T, Klostermann S, Heinrich S, Petridou E, Bouka E, Panagopoulou P, Dikshit R, Nagrani R, Even-Nir H, Chetrit A, Maule M, Migliore E, Filippini G, Miligi L, Mattioli S, Yamaguchi N, Kojimahara N, Ha M, Choi KH, Mannetje A', Eng A, Woodward A, Carretero G, Alguacil J, Aragones N, Suare-Varela MM, Goedhart G, Schouten-van Meeteren AA, Reedijk AA, Cardis E. The MOBI-Kids Study Protocol: Challenges in Assessing Childhood and Adolescent Exposure to Electromagnetic Fields from Wireless Telecommunication Technologies and Possible association with Brain Tumor Risk. Front Public Health. 2014 Sep 23;2:124. doi: 10.3389/fpubh.2014.00124. eCollection 2014. PubMed PMID: 25295243; PubMed Central PMCID: PMC4172002. 

Milena Maule, Elisabeth Cardis, Chelsea Eastman Langer, Siegal Sadetzki, Graziella Filippini, Mariangela Farinotti, Lucia Miligi, Stefano Mattioli, Franco Merletti and the MOBI-KIDS Study Group. MOBI-Kids study: exposure to communication technologies and brain tumour risk in children and adolescents.Poster presentato a 11th meeting of the European Association of Neuro-Oncology, Torino 2014.