Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Ministry of Health, Jerusalem, Israel.
Environ Int. 2022 Feb;160:107069. doi: 10.1016/j.envint.2021.107069. Epub 2021 Dec 30.
In recent decades, the possibility that use of mobile communicating devices, particularly wireless (mobile and cordless) phones, may increase brain tumour risk, has been a concern, particularly given the considerable increase in their use by young people. MOBI-Kids, a 14-country (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain) case-control study, was conducted to evaluate whether wireless phone use (and particularly resulting exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF)) increases risk of brain tumours in young people. Between 2010 and 2015, the study recruited 899 people with brain tumours aged 10 to 24 years old and 1,910 controls (operated for appendicitis) matched to the cases on date of diagnosis, study region and age. Participation rates were 72% for cases and 54% for controls. The mean ages of cases and controls were 16.5 and 16.6 years, respectively; 57% were males. The vast majority of study participants were wireless phones users, even in the youngest age group, and the study included substantial numbers of long-term (over 10 years) users: 22% overall, 51% in the 20-24-year-olds. Most tumours were of the neuroepithelial type (NBT; n = 671), mainly glioma. The odds ratios (OR) of NBT appeared to decrease with increasing time since start of use of wireless phones, cumulative number of calls and cumulative call time, particularly in the 15-19 years old age group. A decreasing trend in ORs was also observed with increasing estimated cumulative RF specific energy and ELF induced current density at the location of the tumour. Further analyses suggest that the large number of ORs below 1 in this study is unlikely to represent an unknown causal preventive effect of mobile phone exposure: they can be at least partially explained by differential recall by proxies and prodromal symptoms affecting phone use before diagnosis of the cases. We cannot rule out, however, residual confounding from sources we did not measure. Overall, our study provides no evidence of a causal association between wireless phone use and brain tumours in young people. However, the sources of bias summarised above prevent us from ruling out a small increased risk.
近几十年来，人们一直担心使用移动通讯设备（特别是无线[移动和无绳]电话）可能会增加脑瘤的风险，尤其是考虑到年轻人对这些设备的使用量大幅增加。MOBI-Kids 是一项在 14 个国家（澳大利亚、奥地利、加拿大、法国、德国、希腊、印度、以色列、意大利、日本、韩国、荷兰、新西兰和西班牙）开展的病例对照研究，旨在评估无线电话的使用（特别是由此产生的射频[RF]和极低频[ELF]电磁场[EMF]暴露）是否会增加年轻人患脑瘤的风险。在 2010 年至 2015 年期间，该研究招募了 899 名年龄在 10 至 24 岁之间患有脑瘤的患者和 1910 名与病例相匹配的对照者（因阑尾炎而接受手术），这些对照者按诊断日期、研究区域和年龄进行匹配。病例组的参与率为 72%，对照组为 54%。病例组和对照组的平均年龄分别为 16.5 岁和 16.6 岁，男性占 57%。绝大多数研究参与者是无线电话使用者，即使在最年轻的年龄组也是如此，而且该研究包括大量长期（超过 10 年）使用者：总体占 22%，20-24 岁组占 51%。大多数肿瘤为神经上皮类型（NBT；n=671），主要为神经胶质瘤。NBT 的比值比（OR）似乎随无线电话使用起始时间、累积通话次数和累积通话时间的增加而降低，特别是在 15-19 岁年龄组。在肿瘤位置处的累积 RF 特定能量和 ELF 感应电流密度估计值增加的情况下，OR 也呈下降趋势。进一步分析表明，本研究中大量 OR 值低于 1 不太可能代表移动电话暴露的未知因果预防效应：它们至少可以部分通过对病例诊断前的代理和前驱症状影响电话使用的差异回忆来解释。然而，我们不能排除未测量的混杂来源的残余混杂。总体而言，我们的研究并未提供无线电话使用与年轻人脑瘤之间存在因果关系的证据。然而，上述汇总的偏倚来源使我们无法排除较小的风险增加。
