Pilot study of extremely low frequency magnetic fields emitted by transformers in dwellings. Social aspects

A large number of epidemiologic studies examining the potential effect of residential exposure to extremely-low frequency (ELF) magnetic fields and childhood leukemia have been published. Two pooled analyses [Ahlbom A, Day N, Feychting M, Roman E, Skinner J, Dockerty J, Linet M, et al. (2000). A pooled analysis of magnetic fields and childhood leukaemia. Br J Cancer. 83(5):692–698; Greenland S, Sheppard AR, Kaune WT, Poole C, Kelsh AM (2000). A pooled analysis of magnetic fields, wire codes, and childhood leukemia. Epidemiology. 11(6):624–634], which included the major epidemiologic studies on ELF magnetic fields and childhood leukemia showed twofold increase in childhood leukemia risk in association with residential ELF exposure above 0.3–0.4 μT. Based on “limited” epidemiologic evidence linking ELF exposure to childhood leukemia and “inadequate evidence” for carcinogenicity of ELF in rodent bioassays, the International Agency for Research on Cancer (IARC) classified ELF magnetic fields as a possible human carcinogen (2B classification) [International Agency for Research on Cancer (IARC) (2002). Non-ionizing radiation, Part 1: Static and extremely low-frequency (ELF) electric and magnetic fields. IARC monographs on the evaluation of carcinogenic risks to humans. Vol. 80. IARC Press: Lyon], confirmed by WHO on the basis of studies published after 2000 [World Health Organization. Extremely low frequency fields. In: 238 Environmental health criteria, Geneva: WHO; 2007]. The analysis of more recent studies of ELF magnetic fields and childhood leukemia had small findings and propose methodological improvements concerning the uncertainties in epidemiological approaches and exposure assessment, bias in selection of controls [Kheifets L, Oksuzyan S (2008). Exposure assessment and other challenges in non-ionizing radiation studies of childhood leukaemia. Radiat Prot Dosimetry. 132(2):139–147]. By the end of 2010, 37 countries had been identified for possible participation in the International study TRANSEXPO. The pilot work has been completed in five countries (Finland, Hungary, Israel, Switzerland and Bulgaria). In 2008, Bulgaria through the National Centre of Public Health Protection joined with pilot study in TRANSEXPO Project. At this first stage of the project our investigation was directed to performing measurements in dwellings with built-in transformer stations, collecting data of population and cancer registry and choosing the epidemiology design feasible for continuing the project. Taking into account the available sources of information in Bulgaria (different registers of the population) needed for epidemiological approach, it was found that the most appropriate epidemiology design would be the nested case-control study. Control group could be collected in accordance with the international requirements for such epidemiological studies. This approach could be modified in the course of the further study in order to ensure achievement of the purposes of the main international requirements of the study.     

The relationship between residential magnetic fields and contact voltage: a pooled analysis

It has been suggested that residential exposure to contact currents may be more directly associated with the potential for an increased risk of leukemia in childhood than magnetic fields. Contact current exposure occurs when a child contacts a bathtub's water fixtures, which are usually contiguous with a residence's electrical ground, and when the drainpipe is conductive. The Northern California Childhood Leukemia Study (NCCLS) is the only epidemiological study known to address whether contact current may confound the reported association between residential magnetic fields and childhood leukemia. The study contributed contact voltage and magnetic-field data for over 500 residences of leukemia cases and control children. We combined these data with the results of previous measurement studies of contact voltage in other communities to conduct an analysis of the relationship of magnetic fields with contact voltage for a total sample of 702 residences. The Spearman correlation of magnetic field with contact voltage was 0.29 (Spearman, P < 0.0001). Magnetic-field and contact voltage data were both divided into tertiles, with an upper magnetic-field cutpoint of 0.3 μT suggested by values used in epidemiological results and an upper contact voltage cutpoint of 60 mV based on dosimetric considerations. Expressed as an exposure odds ratios (EOR), we report an association of contact voltage with magnetic fields of 15.1 (95% CI 3.6-61) as well as a statistically significant positive trend across magnetic-field strata (EOR of 4.2 per stratum with 95% CI 2.4-7.4). The associations appear to be large enough to support the possibility that contact current could be responsible for the association of childhood leukemia with magnetic fields.     

Residential magnetic fields predicted from wiring configurations: II. Relationships To childhood leukemia.

Case-control data on childhood leukemia in Los Angeles County were reanalyzed with residential magnetic fields predicted from the wiring configurations of nearby transmission and distribution lines. As described in a companion paper, the 24-h means of the magnetic field's magnitude in subjects' homes were predicted by a physically based regression model that had been fitted to 24-h measurements and wiring data. In addition, magnetic field exposures were adjusted for the most likely form of exposure assessment errors: classic errors for the 24-h measurements and Berkson errors for the predictions from wire configurations. Although the measured fields had no association with childhood leukemia (P for trend=.88), the risks were significant for predicted magnetic fields above 1.25 mG (odds ratio=2.00, 95% confidence interval=1.03-3.89), and a significant dose-response was seen (P for trend=.02). When exposures were determined by a combination of predictions and measurements that corrects for errors, the odds ratio (odd ratio=2.19, 95% confidence interval=1.12-4.31) and the trend (p =.007) showed somewhat greater significance. These findings support the hypothesis that magnetic fields from electrical lines are causally related to childhood leukemia but that this association has been inconsistent among epidemiologic studies due to different types of exposure assessment error. In these data, the leukemia risks from a child's residential magnetic field exposure appears to be better assessed by wire configurations than by 24-h area measurements. However, the predicted fields only partially account for the effect of the Wertheimer-Leeper wire code in a multivariate analysis and do not completely explain why these wire codes have been so often associated with childhood leukemia. The most plausible explanation for our findings is that the causal factor is another magnetic field exposure metric correlated to both wire code and the field's time-averaged magnitude.     

Hypothesis: The risk of childhood leukemia is related to combinations of power-frequency and static magnetic fields

We present a hypothesis that the risk of childhood leukemia is related to exposure to specific combinations of static and extremely-low-frequency (ELF) magnetic fields. Laboratory data from calcium efflux and diatom mobility experiments were used with the gyromagnetic equation to predict combinations of 60 Hz and static magnetic fields hypothesized to enhance leukemia risk. The laboratory data predicted 19 bands of the static field magnitude with a bandwidth of 9.1 μT that, together with 60 Hz magnetic fields, are expected to have biological activity. We then assessed the association between this exposure metric and childhood leukemia using data from a case-control study in Los Angeles County. ELF and static magnetic fields were measured in the bedrooms of 124 cases determined from a tumor registry and 99 controls drawn from friends and random digit dialing. Among these subjects, 26 cases and 20 controls were exposed to static magnetic fields lying in the predicted bands of biological activity centered at 38.0 μT and 50.6 μT. Although no association was found for childhood leukemia in relation to measured ELF or static magnetic fields alone, an increasing trend of leukemia risk with measured ELF fields was found for subjects within these static field bands (P for trend = 0.041). The odds ratio (OR) was 3.3 [95% confidence interval (CI) = 0.4–30.5] for subjects exposed to static fields within the derived bands and to ELF magnetic field above 0.30 μT (compared to subjects exposed to static fields outside the bands and ELF magnetic fields below 0.07 μT). When the 60 Hz magnetic fields were assessed according to the Wertheimer-Leeper code for wiring configurations, leukemia risks were again greater with the hypothesized exposure conditions (OR = 9.2 for very high current configurations within the static field bands: 95% CI = 1.3–64.6). Although the risk estimates are based on limited magnetic field measurements for a small number of subjects, these findings suggest that the risk of childhood leukemia may be related to the combined effects of the static and ELF magnetic fields. Further tests of the hypothesis are proposed. © 1995 Wiley-Liss, Inc.     

Power lines and the geomagnetic field

The metric of prime interest in power line epidemiological studies has been AC magnetic intensity. To consider also possible geomagnetic involvement, the orientation of a long straight power line is examined relative to a uniform geomagnetic field (GMF) with dip angle α. An expression is derived for the component of the total GMF that is parallel, at an elevation β, to the circuital magnetic field that surrounds the line. This component is a function of the angles α and β, the total geomagnetic intensity B_T, and the angle θ between the axis of the power line and magnetic north. Plotting these geomagnetic parameters for known leukemia residences allows one to test for possible ion cyclotron resonance or other GMF interactions. This approach, in principle, is an easy addition to existing or planned studies, because residential access is not required to obtain local values for α, β, θ, and B_T. We recommend including these parameters in the design of epidemiological studies examining power line fields and childhood leukemia. © 1995 Wiley-Liss, Inc.     

Results of Epidemiological Cancer Study Among Electrical Workers in Finland

Several epidemiological studies suggested a correlation between occupational exposure to electromagnetic fields and cancer (leukemia, brain tumors). Also, living close to high voltage powerlines has been reported to be associated with increased risk of cancer. Our studies with chick embryos suggested that low-frequency magnetic fields (LFMFs) had an adverse effect on embryonal development (1). The effects of LFMFs on growth and cell division could be the basis of both teratogenic effects and promotion of cancer.     

ELF magnetic fields: animal studies, mechanisms of action

Animal studies can contribute to addressing the issue of possible greater health risk for children exposed to 50–60 Hz extremely low frequency (ELF) magnetic fields (MFs), mostly in terms of teratological effects and cancer.Teratology has been extensively studied in animals exposed to ELF MFs but experiments have not established adverse developmental effects.Childhood leukaemia has been the only cancer consistently reported in epidemiological studies as associated with exposure to ELF MFs. This association has been the basis for the classification as “possibly carcinogenic to humans” by the International Agency for Research on Cancer in 2002. Animal experiments have provided only limited support for these epidemiological findings. However, none but one study used an animal model for acute lymphoblastic leukaemia (ALL), the main form of childhood leukaemia, and exposures to ELF MFs were not carried out over the whole pregnancy period, when the first hit of ALL is assumed to occur.Moreover, there are no generally accepted biophysical mechanisms that could explain carcinogenic effects of low-level MFs. The radical pair mechanism and related cryptochromes (CRY) molecules have recently been identified in birds and other non-mammalian species, as a sensor of the geomagnetic field, involved in navigation. The hypothesis has to be tested in mammalian models. CRY, which is part of the molecular circadian clock machinery, is a ubiquitous protein likely to be involved in cancer cell growth and DNA repair.In summary, we now have some clues to test for a better characterization of the interaction between ALL and ELF MFs exposure.     

Epidemiology of childhood leukemia in the presence and absence of Down syndrome

Down syndrome (DS) is a common congenital anomaly, and children with DS have a substantially higher risk of leukemia. Although understanding of genetic and epigenetic changes of childhood leukemia has improved, the causes of childhood leukemia and the potential role of environmental exposures in leukemogenesis remain largely unknown. Although many epidemiologic studies have examined a variety of environmental exposures, ionizing radiation remains the only generally accepted environmental risk factor for childhood leukemia. Among suspected risk factors, infections, exposure to pesticides, and extremely low frequency magnetic fields are notable. While there are well-defined differences between leukemia in children with and without DS, studies of risk factors for leukemia among DS children are generally consistent with trends seen among non-DS (NDS) children.We provide background on DS epidemiology and review the similarities and differences in biological and epidemiologic features of leukemia in children with and without DS. We propose that both acute lymphoblastic and acute myeloblastic leukemia among DS children can serve as an informative model for development of childhood leukemia. Further, the high rates of leukemia among DS children make it possible to study this disease using a cohort approach, a powerful method that is unfeasible in the general population due to the rarity of childhood leukemia.     

Biophysical mechanisms: a component in the weight of evidence for health effects of power-frequency electric and magnetic fields

Comparatively high exposures to power-frequency electric and magnetic fields produce established biological effects that are explained by accepted mechanisms and that form the basis of exposure guidelines. Lower exposures to magnetic fields (< 1 microT average in the home) are classified as "possibly carcinogenic" on the basis of epidemiological studies of childhood leukemia. This classification takes into consideration largely negative laboratory data. Lack of biophysical mechanisms operating at such low levels also argues against causality. We survey around 20 biophysical mechanisms that have been proposed to explain effects at such low levels, with particular emphasis on plausibility: the principle that to produce biological effects, a mechanism must produce a "signal" larger than the "noise" that exists naturally. Some of the mechanisms are impossible, and some require specific conditions for which there is limited or no evidence as to their existence in a way that would make them relevant to human exposure. Others are predicted to become plausible above some level of field. We conclude that effects below 5 microT are implausible. At about 50 microT, no specific mechanism has been identified, but the basic problem of implausibility is removed. Above about 500 microT, there are established or likely effects from accepted mechanisms. The absence of a plausible biophysical mechanism at lower fields cannot be taken as proof that health effects of environmental electric and magnetic fields are impossible. Nevertheless, it is a relevant consideration in assessing the overall evidence on these fields.     

Childhood cancer in relation to indicators of magnetic fields from ground current sources

This study examines childhood cancer risk in relation to certain factors likely to indicate magnetic field exposure from ground currents in the home. Substantial ground currents are most often found in homes having conductive plumbing, in which an uninterrupted metallic path in the water pipes and water main connects the grounding systems of neighboring houses. Information on plumbing conductivity was obtained from water suppliers for the homes of 347 cases and 277 controls identified in an earlier study of magnetic field exposure and childhood cancer in the Denver area. An increased cancer risk was observed for children in homes with conductive plumbing: The matched odds ratio was 1.72 (1.03–2.88) and increased to 3.00 (1.33–6.76) when analysis was limited to cases and controls who were residentially stable from the reference date to the study date. A measurement metric likely to indicate active ground currents (measurements having above-median intensity and a nonvertical orientation of <55° from the horizontal) was identified. In contrast to measured field intensity alone, for which only modest associations with cancer have been reported, this metric shows a high and significant cancer risk [matched O.R. = 4.0 (1.6–10.0)] consistent over a range of intensity and angle cutpoints. Such elevated nonvertical fields were also associated with cancer in an independent data set, which was gathered to study adult nonlymphocytic leukemia in the Seattle area. The associations of cancer with conductive plumbing and with this exposure metric both suggest that cancer risk is increased among persons with elevated magnetic field exposure from residential ground currents. © 1995 Wiley-Liss, Inc.     

Potential impacts of radon, terrestrial gamma and cosmic rays on childhood leukemia in France: a quantitative risk assessment

Previous epidemiological studies and quantitative risk assessments (QRA) have suggested that natural background radiation may be a cause of childhood leukemia. The present work uses a QRA approach to predict the excess risk of childhood leukemia in France related to three components of natural radiation: radon, cosmic rays and terrestrial gamma rays, using excess relative and absolute risk models proposed by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Both models were developed from the Life Span Study (LSS) of Japanese A-bomb survivors. Previous risk assessments were extended by considering uncertainties in radiation-related leukemia risk model parameters as part of this process, within a Bayesian framework. Estimated red bone marrow doses cumulated during childhood by the average French child due to radon, terrestrial gamma and cosmic rays are 4.4, 7.5 and 4.3 mSv, respectively. The excess fractions of cases (expressed as percentages) associated with these sources of natural radiation are 20 % [95 % credible interval (CI) 0–68 %] and 4 % (95 % CI 0–11 %) under the excess relative and excess absolute risk models, respectively. The large CIs, as well as the different point estimates obtained under these two models, highlight the uncertainties in predictions of radiation-related childhood leukemia risks. These results are only valid provided that models developed from the LSS can be transferred to the population of French children and to chronic natural radiation exposures, and must be considered in view of the currently limited knowledge concerning other potential risk factors for childhood leukemia. Last, they emphasize the need for further epidemiological investigations of the effects of natural radiation on childhood leukemia to reduce uncertainties and help refine radiation protection standards.     

Algal nitrogen fixation in the tropics

Summary a)Nitrogen fixation in rice fields. Nitrogen-fixing blue-green algae grow abundantly in tropical regions and are particularly common in paddy fields. Their possible role in the nitrogen accumulation of soil has been studied. The most vigorous nitrogen-fixing blue-green algae have been assessed for use as green manure in rice fields and favorable effects have been reported in India and other countries. b)Nitrogen fixation by algae in water. The planktonic blue-green algae occur abundantly at certain time of the year in sea water and lake water, and some of them are known to be nitrogen fixers. Certain Japanese species of blue-green algae can withstand high temperatures including ten nitrogen-fixing species from hot-spring waters. c)Nitrogen fixation by symbiotic blue-green algae. Certain species of blue-green algae form associations with other organisms such as fungi, liverworts, ferns and seed plants. The relationship between these two organisms is on one occasion commensal and on others symbiotic. Certain symbiotic blue-green algae are provided with the ability to fix the atmospheric nitrogen.     

Extremely low frequency magnetic fields in residences in Germany. Distribution of measurements, comparison of two methods for assessing exposure, and predictors for the occurrence of magnetic fields above background level

We examined the results of 1,835 magnetic field measurements in German residences conducted between November 1997 and September 1999. The measurements were part of an epidemiological study on the relationship between magnetic fields and childhood leukemia. We performed a fixed-location measurement of the magnetic field at 50 Hz and 16 2/3 Hz (frequency of the German railway system) over 24 h in the child’s bedroom in the residence of each study participant. In addition, we conducted a second 24 h-measurement in the living room at 50 Hz, and spot measurements while walking through all rooms of the respective dwelling. Median 50 Hz magnetic fields above 0.2 μT were found to be infrequent in Germany (only 1.4% of all residences). Fields produced by high-voltage power lines (123–420 kV) were lower than expected: the median magnetic field was above 0.2 μT in only 8 (32.0%) of 25 residences located 50 m or closer to a high-voltage power line indicating that power lines in Germany are usually run well below the maximum power load. We found that magnetic fields were correlated with the type of residence and higher magnetic fields were measured in apartment buildings. There was also some evidence for a positive correlation between magnetic fields and traffic density and an inverse association between magnetic fields and family net income. The 24 h-magnetic field measurements correlated well with the spot measurements (r>0.7). However, when dichotomized with a cut-off point of 0.2 μT, there was only a poor agreement between the two measurement methods. A loss of the strength of the association after categorization was also observed when comparing the arithmetic mean and median of the same 24 h-measurement. In summary, these analyses give a valuable overview of magnetic field distributions in German residences. Received: 31 January 2000 / Accepted: 25 July 2000     

Power frequency magnetic fields and risk of childhood leukaemia: Misclassification of exposure from the use of the ‘distance from power line’ exposure surrogate

A recent study examining the relationship between distance to nearby power lines and childhood cancer risk re‐opened the debate about which exposure metrics are appropriate for power frequency magnetic field investigations. Using data from two large population‐based UK and German studies we demonstrate that distance to power lines is a comparatively poor predictor of measured residential magnetic fields. Even at proximities of 50 m or less, the positive predictive value of having a household measurement over 0.2 µT was only 19.4%. Clearly using distance from power lines, without taking account of other variables such as load, results in a poor proxy of residential magnetic field exposure. We conclude that such high levels of exposure misclassification render the findings from studies that rely on distance alone uninterpretable. Bioelectromagnetics 30:183–188, 2009. © 2008 Wiley‐Liss, Inc.     

Childhood leukemia, electric and magnetic fields, and temporal trends

During the past 25 years concern has been raised about the possible health effects of extremely low frequency (ELF) electric and magnetic fields (EMFs), particularly regarding childhood leukemia. Comparison of changes in electricity consumption (a surrogate for exposure) to changes in childhood-leukemia rates, known as ecologic correlation, have been used to argue both for and against the association between magnetic fields and childhood leukemia. In this paper we explore what can be learned from such an ecologic approach. We first examine separately the evidence on trends in exposure to EMFs and on trends in leukemia rates, and then compare the two. Both incidence rates and exposures have increased, but there are so many approximations and assumptions involved in connecting the two trends that we cannot regard the ecologic evidence as providing any meaningful evidence for or against a causal link.     

Evaluation of childhood acute leukemia incidence and underreporting in Brazil by capture–recapture methodology

Background: Population-based cancer registries (PBCR) are important in cancer epidemiology as they provide the basis for monitoring cancer incidence. Childhood acute lymphoblastic leukemia (ALL) is said to have lower incidence in developing countries, which has implications for its pathogenesis, but there are few studies concerning the completeness of cancer registries in developing countries. This study analyzes the number of cases and incidence of childhood acute lymphoblastic leukemia in three different cities in Brazil and estimates underreporting cases and possible PBCR failures. Methods: We evaluated the completeness of PBCR and the incidence rates of childhood ALL from three different Brazilian cities using the two-source capture–recapture method. The sources used were a population-based registry and databases from a diagnosis reference laboratory in 2001 and the Chapman's formula was used to calculate the estimates. Results: The estimated incidence was 5.76, 6.32 and 5.48 per 100,000 inhabitants for Salvador, Recife and Belo Horizonte, respectively. The estimated completeness of childhood ALL in PBCRs was 15.5%, 35.4% and 29.2%, respectively, for Salvador, Recife and Belo Horizonte. Conclusions: There was a high estimated underreporting of childhood leukemia cases in some Brazilian cities. The relationship between information systems and the capture–recapture method application improved epidemiological estimates. Childhood acute lymphoblastic leukemia incidence rates are similar to those of developed countries.     

The possible role of contact current in cancer risk associated with residential magnetic fields

Residential electrical wiring safety practices in the US result in the possibility of a small voltage (up to a few tenths of a volt) on appliance surfaces with respect to water pipes or other grounded surfaces. This "open circuit voltage" (V(OC)) will cause "contact current" to flow in a person who touches the appliance and completes an electrical circuit to ground. This paper presents data suggesting that contact current due to V(OC) is an exposure that may explain the reported associations of residential magnetic fields with childhood leukemia. Our analysis is based on a computer model of a 40 house (single-unit, detached dwelling) neighborhood with electrical service that is representative of US grounding practices. The analysis was motivated by recent research suggesting that the physical location of power lines in the backyard, in contrast to the street, may be relevant to a relationship of power lines with childhood leukemia. In the model, the highest magnetic field levels and V(OC)s were both associated with backyard lines, and the highest V(OC)s were also associated with long ground paths in the residence. Across the entire neighborhood, magnetic field exposure was highly correlated with V(OC) (r = 0.93). Dosimetric modeling indicates that, compared to a very high residential level of a uniform horizontal magnetic field (10 mu T) or a vertical electric field (100 V/m), a modest level of contact current (approximately 18 mu A) leads to considerably greater induced electric fields (> 1 mV/m) averaged across tissue, such as bone marrow and heart. The correlation of V(OC) with magnetic fields in the model, combined with the dose estimates, lead us to conclude that V(OC) is a potentially important exposure with respect to childhood leukemia risks associated with residential magnetic fields. These findings, nonetheless, may not apply to residential service used in several European countries or to the Scandinavian studies concerned with populations exposed to magnetic fields from overhead transmission lines.     

Induction of cell activation processes by low frequency electromagnetic fields

Electromagnetic fields (EMF) such as those from electric power transmission and distribution lines (50/60 Hz) have been associated with increased risk of childhood leukemia, cancer of the nervous system, and lymphomas. Several in vitro studies on EMF effects were performed to clarify the existing controversies, define the risks, and determine the possible mechanisms of adverse effects. In some of these reports, the effects were related to other mechanisms of carcinogenesis. Modification in cell proliferation was observed after EMF exposure and a few reports on cytotoxic effects have also been published. This limited review gives an overview of the current results of scientific research regarding in vitro studies on the effects of power line frequency EMF, but also cell biological mechanisms and their potential involvement in genotoxicity and cytotoxicity are discussed. Cell cycle control and signal transduction processes are included to elucidate the biochemical background of possible interactions. Exposure to EMF has been also linked to the incidence of leukemia and other tumors in some epidemiological studies and is considered as "possibly carcinogenic to humans", but there is no well-established biological mechanism that explains such a relation. Furthermore, EMF is also shown as a stimulus for immune relevant cells (e.g., macrophages) to release free radicals. It is known that chronic activation of macrophages is associated with the onset of phagocytosis and leads to increased formation of reactive oxygen species, which themselves may cause DNA damage and are suggested to lead to carcinogenesis. To demonstrate a possible interaction between EMF and cellular systems, we present a mechanistic model describing cell activation as a major importance for cellular response.     

Childhood leukemia and residential magnetic fields: Are pooled analyses more valid than the original studies?

The association seen in epidemiological studies between childhood leukemia and magnetic field strength in the child's home has been very important in influencing reviews of international groups and standard setting organizations. This association is usually based on the results of two published pooled analyses, which use definitions of exposure that differ from those of some the original studies. However, the results and conclusions of the pooled analyses differ from those of the three largest recent studies, which have the most sophisticated methodology and together account for the majority of the exposed cases at high exposure levels in the pooled analyses. These recent studies, using the exposure methods and the cut-off levels set a priori, each concluded that there was little evidence of any association. The pooled analyses, using different exposure measures and different cut-offs, conclude that an association exists at high exposure levels. It is not clear if the results of the pooled analysis are more valid than those of the recent major studies, although this has been often assumed in influential reviews.     

Exposure to extremely low-frequency magnetic fields and the risk of childhood cancer: update of the epidemiological evidence

There is an ongoing scientific controversy whether the observed association between exposure to residential extremely low-frequency magnetic fields (ELF-MF) and the risk of childhood leukaemia observed in epidemiological studies is causal or due to methodological shortcomings of those studies. Recent pooled analysis confirm results from previous studies, namely an approximately two-fold risk increase at ELF-MF exposures ≥0.4 μT, and demonstrate consistency of studies across countries, with different design, different methods of exposure assessment, and different systems of power transmission and distribution. On the other hand, recent pooled analyses for childhood brain tumour show little evidence for an association with ELF-MF, also at exposures ≥0.4 μT. Overall, the assessment that ELF-MF are a possible carcinogen and may cause childhood leukaemia remains valid. Ongoing research activities, mainly experimental and few new epidemiological studies, hopefully provide additional insight to bring clarity to a research area that has remained inconclusive.