Rev Environ Health. 2013;28(2-3):97-106. doi: 10.1515/reveh-2013-0006.
BACKGROUND: Wireless phones, i.e., mobile phones and cordless phones, emit radiofrequency electromagnetic fields (RF-EMF) when used. An increased risk of brain tumors is a major concern. The International Agency for Research on Cancer (IARC) at the World Health Organization (WHO) evaluated the carcinogenic effect to humans from RF-EMF in May 2011. It was concluded that RF-EMF is a group 2B, i.e., a "possible", human carcinogen. Bradford Hill gave a presidential address at the British Royal Society of Medicine in 1965 on the association or causation that provides a helpful framework for evaluation of the brain tumor risk from RF-EMF. METHODS: All nine issues on causation according to Hill were evaluated. Regarding wireless phones, only studies with long-term use were included. In addition, laboratory studies and data on the incidence of brain tumors were considered. RESULTS: The criteria on strength, consistency, specificity, temporality, and biologic gradient for evidence of increased risk for glioma and acoustic neuroma were fulfilled. Additional evidence came from plausibility and analogy based on laboratory studies. Regarding coherence, several studies show increasing incidence of brain tumors, especially in the most exposed area. Support for the experiment came from antioxidants that can alleviate the generation of reactive oxygen species involved in biologic effects, although a direct mechanism for brain tumor carcinogenesis has not been shown. In addition, the finding of no increased risk for brain tumors in subjects using the mobile phone only in a car with an external antenna is supportive evidence. Hill did not consider all the needed nine viewpoints to be essential requirements. CONCLUSION: Based on the Hill criteria, glioma and acoustic neuroma should be considered to be caused by RF-EMF emissions from wireless phones and regarded as carcinogenic to humans, classifying it as group 1 according to the IARC classification. Current guidelines for exposure need to be urgently revised.
背景:无线电话,即移动电话和无绳电话,在使用时会发射射频电磁场(RF-EMF)。脑瘤风险增加是一个主要关注点。世界卫生组织(WHO)下属的国际癌症研究机构(IARC)于 2011 年 5 月评估了射频电磁场对人类的致癌作用。结论认为射频电磁场属于 2B 组,即“可能”的人类致癌物。1965 年,布拉德福德·希尔(Bradford Hill)在英国皇家医学会(British Royal Society of Medicine)发表主席演讲,探讨了提供有助于评估射频电磁场致脑瘤风险的关联或因果关系的框架。
方法:评估了根据希尔提出的因果关系的九个问题。关于无线电话,仅纳入了长期使用的研究。此外,还考虑了实验室研究和脑瘤发病率数据。
结果:满足了关于胶质瘤和听神经瘤风险增加的证据的强度、一致性、特异性、时间性和生物学梯度标准。来自实验室研究的合理性和类推为额外证据提供了支持。关于一致性,有几项研究显示脑瘤发病率增加,尤其是在暴露最严重的区域。实验的支持来自于抗氧化剂,它可以减轻涉及生物学效应的活性氧物质的产生,尽管尚未证明其对脑瘤致癌作用的直接机制。此外,在使用仅在外部天线车载电话的情况下,未发现脑瘤风险增加的研究结果也提供了支持证据。希尔并未认为所有需要的九个观点都是必要的要求。
结论:根据希尔标准,应将无线电话产生的射频电磁场引起的胶质瘤和听神经瘤视为由其引起,并将其归类为人类致癌物质,根据 IARC 分类将其归类为 1 组。当前的暴露指南需要紧急修订。
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