1. European Foundation of Oncology and Environmental Sciences “B. Ramazzini” Cesare Maltoni Cancer Research Center June 28 2007 The potential carcinogenic risks of electromagnetic fields: what we know and what we still must learn Bologna Summer Event

2. 2 Power frequency EMF: what we know

3. 3 Power frequency EMF: epidemiological evidence  The first epidemiological study of childhood cancer and EMF was published in 1979.  Since then more than 20 studies have been conducted  The present position on EMF and the epidemiology of childhood leukemia is summarized in a pooled analysis of measurement and calculated field studies published by Ahlbom et al (3247 cases in total).

4. 4 Pooled results from Ahlbom et al 20.1 4.4 24.2 36 8 44 1.87 (1.1-3.2) 2.13 (0.9-4.9) 2.00 (1.3-3.1) 1.15 (0.9-1.5) 0.79 (0.3-2.3) 1.11 (0.8-1.5) 1.05 (0.9-1.3) 1.58 (0.8-3.3) 1.08 (0.9-1.3) Measurements studies Calculated field studies All studies Summary 0 0.2 2.7 1.5 21052105 2 cs/0 ct 6.21 0 cs/10 ct 3.74 0 cs/8 ct 4.11 1.06 0.57 2.68 0 cs/19 ct 1.75 Denmark Finland Norway Sweden Calculated field studies 10.3 0.9 0 4.4 4.7 13 2 0 4 17 1.55 2.00 0 cs/0 ct 1.00 3.44 1.39 1.67 4 cs/0 ct 0.98 1.01 1.29 1.24 0.67 0.84 1.11 Canada Germany New Zealand UK USA Measurement studies ExpectedObserved ≥ 0.4 µT 0.2-<0.4 µT0.1-<0.2 µTStudy Numbers of subjectsRelative risks (and 95% confidence intervals)

5. 5 Animals Treatment Result Comments Authors Species/strain No. Exposure Duration Margonato et al., 1995 Rats S.D. 256 males per group 0; 5 µT (50 Hz) 32 weeks (22 h/day) No evidence of carcinogenic effect Yasui et al., 1997 Rats F344 48 females per group 0;0,5; 5 mT (50 Hz) 2 years (22 h/day) No evidence of carcinogenic effect Mandeville et al., 1997 Rats F344 50 males and 50 females per group 0; 2; 20; 200; 2000 µT (60 Hz) 2 years, GLP (20 h/day) No evidence of carcinogenic effect NTP, 1998 Rats F344 Mice B6C3F1 100 males and 100 females per species and per group 0; 2; 200; 1000 µT 2 years, GLP (18.5 h/day) Equivocal evidence of carcinogenic effect for thyroid C cell tumour in male treated with 2 or 200 µT Only 1 sex (male); short duration (32 weeks) Few animals; short duration (104 weeks) Only 1 sex (male); short duration (104 weeks) Short duration (104 weeks) Power frequency EMF: experimental evidence

6. 6 There is an association between childhood leukemias and EMF exposure in the study populations. However, it is not yet possible to establish a cause- correlation for two reasons: 1) the absence of a plausible mechanism 2) lack of support from laboratory evidence Present position on power frequency EMF (part I)

7. 7  These factors led IARC to classify power frequency EMF as a possible carcinogen in 2001  Were there an accepted mechanism of action or robust supporting evidence from the laboratory, it is probable that EMF would have instead been classified as an established carcinogenic agent. Present position on power frequency EMF (part II)

8. 8 Radio frequency EMF (RFEMF): what we know

9. 9 1978-1995: Various epidemiological studies conducted on military personnel exposed to radar waves and on children living near radio-television aerials indicate a possible increase in limphomas/leukaemia 2001-2002: Initial epidemiological data on tumours of acustic nerves have been reassuringly negative RFEMF: epidemiological evidence (part I)

10. 10 2004: Preliminary results of an epidemiological study condicted in Sweden report an increase in tumours of the acustic nerve in population exposed to cellular telephones (RFEMF) (Ahlbom, 2004) 2006: Pooled analysis of two case-control studies on use of cellular and cordless telephones showed an increase risk of malignant brain-tumours diagnosed in 1997-2003, highest in the group with > 10 years latency period RFEMF: epidemiological evidence (part II)

11. 11 Animals Treatment Result Comments Authors Species/strain No. Exposure Duration Chou et al., 1992 Rats S.D. 100 males per group (2,450MHz) 25 months (21.5 h/day) Excess of primary malignant tumors Repacholi et al., 1997 Mice Em-Pim1 100 females per group (900 MHz) 18 months (1h/day) No evidence of carcinogenic effect Utteridge et al., 2002 120 females per group (900 MHz) 2 years (1h/day) No evidence of carcinogenic effect for mammary tumors Bartsch et al., 60 females (23 h/day) Only 1 sex (male); short duration (110 weeks) Only 1 sex (female); short duration (78 weeks) Few animals short duration (sacrificed within 1 year) 2002 Mice Em-Pim1; w.t. Rats S.D. per group (900 MHz and DMBA) Increase risk of lymphomas Only 1 sex (male); short duration (104 weeks) RFEMF: experimental evidence

12. 12 Present position on RFEMF  Use of cell phones for < 10 years have not demonstrated an increase in cancer  There is however some evidence regarding long- term use and lengthy latency period absence of evidence ≠ absence of risk

13. 13 EMF and RFEMF: what we still must learn

14. 14 EMF and RFEMF represent what are known as diffused carcinogenic risks. We use this term to describe carcinogenic risks of low potency, but to which almost the entire population of the planet may be exposed. Diffused carcinogenic risks

15. 15 1) agents which are slightly carcinogenic at any dose; 2) low or extremely low doses of strong carcinogenic agents; 3) mixtures of small doses of any carcinogenic agents. Examples of diffused carcinogenic risks

16. 16 In the case of diffused carcinogenic risks, it is not sufficient to follow the standard protocol used in ordinary experiments, but rather it is necessary to conduct what we define as mega-experiments. Tools for identifying diffused carcinogenic risks

17. 17 Characteristics of mega-experiments  reproduce the various conditions of human exposure  use vast numbers of animals per group, in order to express variations in the effects more sharply  are conducted until the natural death of the rodents, to allow an agent to express its full carcinogenic potential  evaluate all neoplastic and non-neoplastic pathologies

18. 18 35 years of mega-experiments at the ERF agent# rodents vinyl chloride> 7,000 vitamins> 8,000 coca-cola> 2,000 gamma radiation> 10,000 irradiated food > 2,000 electromagnetic fields> 9,000 extremely low frequency > 7,000 radiofrequency> 2,000

19. 19 Integrated project of the European Ramazzini Foundation (ERF)

20. 20 ERF mega-experiments to evaluate EMF (50Hz) 7,133 TOTAL 50Hz-magnetic field and aflatoxin B1 642 BT 4 CEM 50Hz-magnetic field and 10 gamma rads 657 BT 3 CEM 50Hz-magnetic field and formaldehyde 805 BT 2 CEM 50Hz-magnetic field 5,029 BT 1 CEM TreatmentNumber of animals (M+F) Experiment Duration Lifespan Age at start embryo

21. 21 ERF mega-experiment on EMF (50Hz)

22. 22 ERF mega-experiment to evaluate RFERF (1.8 GHz) 2,448TOTAL 0 Volt/meter (control) 817IV 5 Volt/meter 811III 25 Volt/meter 411II 50 Volt/meter409I Treatment (Volt/meter)Number of animals (M+F) Group number Experiment BT 1 CEMRF Duration Lifespan Age at start embryo

23. 23 ERF mega-experiment on RFEMF (1.8 GHz)

24. 24  The epidemiological evidence concerning EMF and long- term exposure to RFEMF show there are reasonable grounds for concern for the possibility of adverse effects  The absence of epidemiological evidence concerning short-term exposure RFEMF ≠ the absence of risk  While we await the results of the experiments currently underway (2009-2011), the precautionary principle guides us to “undertake provisional risk management measures…without having to wait until the reality and seriousness of those adverse effects become fully apparent” Conclusions