Hardell Lennart, Carlberg Michael, Hansson Mild Kjell
Department of Oncology, University Hospital, SE-701 85 Örebro, Sweden.
Pathophysiology. 2013 Apr;20(2):85-110. doi: 10.1016/j.pathophys.2012.11.001. Epub 2012 Dec 21.
The International Agency for Research on Cancer (IARC) at WHO evaluation of the carcinogenic effect of RF-EMF on humans took place during a 24-31 May 2011 meeting at Lyon in France. The Working Group consisted of 30 scientists and categorised the radiofrequency electromagnetic fields from mobile phones, and from other devices that emit similar non-ionising electromagnetic fields (RF-EMF), as Group 2B, i.e., a 'possible', human carcinogen. The decision on mobile phones was based mainly on the Hardell group of studies from Sweden and the IARC Interphone study. We give an overview of current epidemiological evidence for an increased risk for brain tumours including a meta-analysis of the Hardell group and Interphone results for mobile phone use. Results for cordless phones are lacking in Interphone. The meta-analysis gave for glioma in the most exposed part of the brain, the temporal lobe, odds ratio (OR)=1.71, 95% confidence interval (CI)=1.04-2.81 in the ≥10 years (>10 years in the Hardell group) latency group. Ipsilateral mobile phone use ≥1640h in total gave OR=2.29, 95% CI=1.56-3.37. The results for meningioma were OR=1.25, 95% CI=0.31-4.98 and OR=1.35, 95% CI=0.81-2.23, respectively. Regarding acoustic neuroma ipsilateral mobile phone use in the latency group ≥10 years gave OR=1.81, 95% CI=0.73-4.45. For ipsilateral cumulative use ≥1640h OR=2.55, 95% CI=1.50-4.40 was obtained. Also use of cordless phones increased the risk for glioma and acoustic neuroma in the Hardell group studies. Survival of patients with glioma was analysed in the Hardell group studies yielding in the >10 years latency period hazard ratio (HR)=1.2, 95% CI=1.002-1.5 for use of wireless phones. This increased HR was based on results for astrocytoma WHO grade IV (glioblastoma multiforme). Decreased HR was found for low-grade astrocytoma, WHO grades I-II, which might be caused by RF-EMF exposure leading to tumour-associated symptoms and earlier detection and surgery with better prognosis. Some studies show increasing incidence of brain tumours whereas other studies do not. It is concluded that one should be careful using incidence data to dismiss results in analytical epidemiology. The IARC carcinogenic classification does not seem to have had any significant impact on governments' perceptions of their responsibilities to protect public health from this widespread source of radiation.
世界卫生组织下属的国际癌症研究机构(IARC)于2011年5月24日至31日在法国里昂召开会议,对射频电磁场(RF-EMF)对人类的致癌作用进行了评估。工作组成员由30位科学家组成,他们将手机及其他发射类似非电离电磁场(RF-EMF)设备产生的射频电磁场归类为2B组,即“可能”对人类致癌的物质。关于手机的这一判定主要基于瑞典的哈德尔研究小组及IARC的国际癌症研究项目(Interphone)的研究结果。我们对当前关于脑肿瘤风险增加的流行病学证据进行了概述,包括对哈德尔研究小组和国际癌症研究项目(Interphone)中手机使用情况的结果进行的荟萃分析。国际癌症研究项目(Interphone)缺乏无绳电话的相关结果。荟萃分析得出,在大脑最易受影响的部位颞叶,≥10年(哈德尔研究小组为>10年)潜伏期组的胶质瘤优势比(OR)=1.71,95%置信区间(CI)=1.04 - 2.81。同侧手机总使用时长≥1640小时时,OR = 2.29,95% CI = 1.56 - 3.37。脑膜瘤的结果分别为OR = 1.25,95% CI = 0.31 - 4.98和OR = 1.35% CI = 0.81 - 2.23。关于听神经瘤,潜伏期组同侧手机使用≥10年时,OR = 1.81,95% CI = 0.73 - 4.45。同侧累计使用≥1640小时时,OR = 2.55,95% CI = 1.50 - 4.40。哈德尔研究小组的研究还表明,使用无绳电话也会增加患胶质瘤和听神经瘤的风险。哈德尔研究小组对胶质瘤患者的生存率进行了分析,发现在潜伏期>10年的时间段内,使用无线电话的风险比(HR)=1.2,95% CI = 1.002 - 1.5。这一升高的HR是基于世界卫生组织IV级星形细胞瘤(多形性胶质母细胞瘤)的结果得出的。对于世界卫生组织I-II级的低级别星形细胞瘤,HR降低,这可能是由于RF-EMF暴露导致肿瘤相关症状,从而更早被发现并进行手术,预后更好。一些研究显示脑肿瘤发病率上升,而其他研究则未发现此现象。得出的结论是,在分析性流行病学中,使用发病率数据来否定研究结果时应谨慎。IARC的致癌分类似乎并未对各国政府在保护公众健康免受这种广泛存在的辐射源影响方面的责任认知产生重大影响。
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