Michael Repacholi

LOW-LEVEL EXPOSURE TO RADIOFREQUENCY ELECTROMAGNETIC FIELDS : HEALTH EFFECTS AND RESEARCH NEEDS

The World Health Organization (WHO), the International Commission on Non-Ionizing Radiation Protection (ICNIRP), and the German and Austrian Governments jointly sponsored an international seminar in November of 1996 on the biological effects of low-level radiofrequency (RF) electromagnetic fields. For purposes of this seminar, RF fields having frequencies only in the range of about 10 MHz to 300 GHz were considered. This is one of a series of scientific review seminars held under the International Electromagnetic Field (EMF) Project to identify any health hazards from EMF exposure. The scientific literature was reviewed during the seminar and expert working groups formed to provide a status report on possible health effects from exposure to low-level RF fields and identify gaps in knowledge requiring more research to improve health risk assessments. It was concluded that, although hazards from exposure to high-level (thermal) RF fields were established, no known health hazards were associated with exposure to RF sources emitting fields too low to cause a significant temperature rise in tissue. Biological effects from low-level RF exposure were identified needing replication and further study. These included in vitro studies of cell kinetics and proliferation effects, effects on genes, signal transduction effects and alterations in membrane structure and function, and biophysical and biochemical mechanisms for RF field effects. In vivo studies should focus on the potential for cancer promotion, co-promotion and progression, as well as possible synergistic, genotoxic, immunological, and carcinogenic effects associated with chronic low-level RF exposure. Research is needed to determine whether low-level RF exposure causes DNA damage or influences central nervous system function, melatonin synthesis, permeability of the blood brain barrier (BBB), or reaction to neurotropic drugs. Reported RF-induced changes to eye structure and function should also be investigated. Epidemiological studies should investigate: the use of mobile telephones with hand-held antennae and incidence of various cancers; reports of headache, sleep disturbance, and other subjective effects that may arise from proximity to RF emitters, and laboratory studies should be conducted on people reporting these effects; cohorts with high occupational RF exposure for changes in cancer incidence; adverse pregnancy outcomes in various highly RF exposed occupational groups; and ocular pathologies in mobile telephone users and in highly RF exposed occupational groups. Studies of populations with residential exposure from point sources, such as broadcasting transmitters or mobile telephone base stations have caused widespread health concerns among the public, even though RF exposures are very low. Recent studies that may indicate an increased incidence of cancer in exposed populations should be investigated further.

Interaction of static and extremely low frequency electric and magnetic fields with living systems: Health effects and research needs †

An international seminar was held June 4-6, 1997, on the biological effects and related health hazards of ambient or environmental static and extremely low frequency (ELF) electric and magnetic fields (0-300 Hz). It was cosponsored by the World Health Organization (WHO), the International Commission on Non-Ionizing Radiation Protection (ICNIRP), the German, Japanese, and Swiss governments. Speakers provided overviews of the scientific literature that were discussed by participants of the meeting. Subsequently, expert working groups formulated this report, which evaluates possible health effects from exposure to static and ELF electric and magnetic fields and identifies gaps in knowledge requiring more research to improve health risk assessments. The working groups concluded that, although health hazards exist from exposure to ELF fields at high field strengths, the literature does not establish that health hazards are associated with exposure to low-level fields, including environmental levels. Similarly, exposure to static electric fields at levels currently found in the living and working environment or acute exposure to static magnetic fields at flux densities below 2 T, were not found to have demonstrated adverse health consequences. However, reports of biological effects from low-level ELF-field exposure and chronic exposure to static magnetic fields were identified that need replication and further study for WHO to assess any possible health consequences. Ambient static electric fields have not been reported to cause any direct adverse health effects, and so no further research in this area was deemed necessary.

Health risks from the use of mobile phones

Widespread concerns have been raised about the possibility that exposure to the radiofrequency (RF) fields from mobile telephones or their base stations could affect peoples health. Such has been the rapid growth of mobile telecommunications that there will be about one billion mobile phone users before 2005. Already there are more mobile than fixed-line users. Developing countries are establishing mobile telecommunications rather than the more expensive fixed-line systems. Thus, if there is any impact on health from mobile telephones, it will affect everyone in the world. The World Health Organization (WHO) established the International EMF Project in 1996 to evaluate the science, recommend research to fill any gaps in knowledge and to conduct formal health risk assessments of RF exposure once recommended research had been completed. In addition, the UK government established an independent expert group to review all the issues concerning health effects of mobile telephones and siting of base stations. Cancer has been suggested as an outcome of exposure to mobile telephones by some scientific reports. This paper reviews the status of the science and WHOs programme to address the key issues. In addition, the main conclusions and recommendations of the UK expert group will be summarised.

Cancer consequences of the Chernobyl accident: 20 years on

26 April 2006 marks the 20th anniversary of the Chernobyl accident. On this occasion, the World Health Organization (WHO), within the UN Chernobyl Forum initiative, convened an Expert Group to evaluate the health impacts of Chernobyl. This paper summarises the findings relating to cancer. A dramatic increase in the incidence of thyroid cancer has been observed among those exposed to radioactive iodines in childhood and adolescence in the most contaminated territories. Iodine deficiency may have increased the risk of developing thyroid cancer following exposure to radioactive iodines, while prolonged stable iodine supplementation in the years after exposure may reduce this risk. Although increases in rates of other cancers have been reported, much of these increases appear to be due to other factors, including improvements in registration, reporting and diagnosis. Studies are few, however, and have methodological limitations. Further, because most radiation-related solid cancers continue to occur decades after exposure and because only 20 years have passed since the accident, it is too early to evaluate the full radiological impact of the accident. Apart from the large increase in thyroid cancer incidence in young people, there are at present no clearly demonstrated radiation-related increases in cancer risk. This should not, however, be interpreted to mean that no increase has in fact occurred: based on the experience of other populations exposed to ionising radiation, a small increase in the relative risk of cancer is expected, even at the low to moderate doses received. Although it is expected that epidemiological studies will have difficulty identifying such a risk, it may nevertheless translate into a substantial number of radiation-related cancer cases in the future, given the very large number of individuals exposed.

Albinism in Africa as a public health issue.

BackgroundOculocutaneous albinism (OCA) is a genetically inherited autosomal recessive condition and OCA2, tyrosine-positive albinism, is the most prevalent type found throughout Africa. Due to the lack of melanin, people with albinism are more susceptible to the harmful effects of ultraviolet radiation exposure. This population must deal with issues such as photophobia, decreased visual acuity, extreme sun sensitivity and skin cancer. People with albinism also face social discrimination as a result of their difference in appearance. The World Health Organization is currently investigating the issues concerning this vulnerable population.MethodsSystematic electronic search of articles in PubMed concerning albinism in Africa. Furthermore, a World Health Organization (WHO) pilot survey of albinism was drafted in English, French and Portuguese, and distributed to African countries through WHO African Regional Offices (AFRO) in an attempt to gather further information on albinism.ResultsEpidemiologic data on albinism, such as prevalence, were available for South Africa, Zimbabwe, Tanzania and Nigeria. Prevalences as high as 1 in 1,000 were reported for selected populations in Zimbabwe and other specific ethnic groups in Southern Africa. An overall estimate of albinism prevalences ranges from 1/5,000 – 1/15,000. In addition, both the literature review and the survey underscored the medical and social issues facing people with albinism.ConclusionThe estimated prevalence of albinism suggests the existence of tens of thousands of people living with albinism in Africa. This finding reiterates the need for increased awareness of and public health interventions for albinism in order to better address the medical, psychological and social needs of this vulnerable population.

Static fields: biological effects and mechanisms relevant to exposure limits.

Recently, the International EMF Project of the World Health Organization (WHO) published an Environmental Health Criteria monograph on static electric and magnetic fields. In the present paper a short overview is given of the biological and health effects discussed in this document. The main conclusions are that no acute effects other than transient phenomena such as vertigo and nausea have been observed with exposure to static magnetic flux densities up to 8 T. There are no reports of long term or chronic adverse effects following prolonged static magnetic field exposure, but few data are available on which to base any judgment. The guidelines on static field exposure recommended by ICNIRP in 1994 are discussed in the light of current scientific knowledge.

World Health Organization’s International Radon Project

Following initial in vitro and in vivo studies and important studies of uranium miners, scientists have now completed impressive case-control studies of lung cancer risk from exposure to residential radon. Researchers have pooled these studies, in which all the information from the individual studies was reanalyzed. These pooled analyzes confirm that in the context of residential exposure, radon is now an established risk factor for lung cancer. Many of the initial uncertainties have been reduced, and health risk assessors are now confident that radon may contribute to as much as 10% of the total burden of lung cancer—that is, 2% of all cancers in the population, worldwide. To reduce residential radon lung cancer risk, national authorities must have methods and tools based on solid scientific evidence and sound public health policies. To meet these needs, the World Health Organization (WHO) has initiated the WHO International Radon Project. This three year project, to be implemented during the period 2005–2008, will include (1) a worldwide database on national residential radon levels, radon action levels, regulations, research institutions, and authorities; (2) public health guidance for awareness-raising and mitigation; and (3) an estimation of the global burden of disease (GDB) associated with radon exposure.

Long-term health implications of the chernobyl accident and relevant projects of the world health organization

The past two decades have witnessed dramatic changes in public health governance and international cooperation on the Chernobyl Nuclear Power Plant accident, especially after the end of the Cold War. The World Health Organization (WHO) has committed itself deeply to the public health issues around Chernobyl and has participated in various health projects such as health monitoring and cancer screening. WHO has also been engaged in research activities such as the Chernobyl Tissue Bank, in close collaboration with the Ministries of Health in Belarus, Russia, and Ukraine. In addition to the official report of the Chernobyl Forum “Health Expert Groups” in 2005, the task of WHO is to not only analyze and clarify the global burden of Chernobyl-related illness, but also to promote the well-being of the local residents who suffered chronic low-level radiation exposure from radiation fallout.

Global Solar UV Index: a physician's tool for fighting the skin cancer epidemic.

To reduce the global burden of disease resulting from exposure to ultraviolet radiation (UVR) and in recognition of the scope of the educational and investigative challenges, the World Health Organization (WHO) in partnership with the World Meteorological Organization (WMO), the United Nations Environment Program (UNEP), the International Agency for Cancer Research (IARC), the International Commission on Non-Ionizing Radiation Protection (ICNIRP) and other specialist agencies founded Intersun , the Global UV Project. 1 The program promotes and evaluates research that fills gaps in scientific knowledge, assesses and quantifies health risks, and develops public health advice through guidelines, recommendations and information dissemination. Beyond its scientific objectives, Intersun provides guidance to national authorities and other agencies about effective sun awareness programs. These address different target audiences such as workers, tourists, school children and the general public. Excess UVR exposure damages the skin and eyes, suppresses cutaneous and systemic immunity, predisposing people to microbial infections, exacerbation of latent disease and impaired endogenous tumor rejection. UVR is held to be the single most important preventable risk factor for melanoma and nonmelanoma skin cancer. Millions of skin cancers are diagnosed each year worldwide, and nonmelanoma skin cancer is more frequent than lung cancer, breast cancer, prostate cancer and colon cancer combined. 2,3 The incidence of malignant melanoma, an aggressive malignancy with poor response to systemic therapy and a poor prognosis if metastasized, 4 has increased continuously for the last three decades and today number an estimated 53,600 cases in the United States 3 and more than 200,000 cases worldwide. 5 Abating the skin cancer epidemic will require people to exercise proper sun protection measures. These include avoiding the sun around solar noon, wearing sun-protective clothing, using sunscreen with a sun-protection factor (SPF) of 15 or higher, and avoiding artificial sources of UVR. 6 Children and teenagers are especially at risk from the long-term adverse effects of UVR. 3,6

Does ultraviolet radiation affect vaccination efficacy

Throughout history, infectious diseases have ravaged mankind. Only since the beginning of the 20th century have we found ways to effectively contain and prevent epidemics through improving hygiene and sanitation as well as developing effective vaccines and vaccination programs. The history of vaccination dates back more than 200 years. In 1798, a vaccine against smallpox was developed, and was followed by vaccines against rabies, typhoid, cholera and plague in the 19th century. However, its use was not widespread until 1900. Since then, vaccines have been licensed against more than 20 other diseases, including measles, mumps, rubella, diphtheria, pertussis, tetanus and hepatitis B. 1 Morbidity for vaccine-preventable diseases in countries practicing universal child vaccination has dramatically decreased. For example, in the United States morbidity associated with smallpox and poliomyelitis has declined 100%, and nearly 100% for diphtheria, measles, hemophilus influenzae, mumps, rubella, tetanus and pertussis. These remarkable successes have eliminated enormous suffering and societal costs. 2