Abstract
BACKGROUND: Each new generation of mobile phone technology has triggered discussions about potential carcinogenicity from exposure to radiofrequency electromagnetic fields (RF-EMF). Available evidence has been insufficient to conclude about long-term and heavy mobile phone use, limited by differential recall and selection bias, or crude exposure assessment. The Cohort Study on Mobile Phones and Health (COSMOS) was specifically designed to overcome these shortcomings.
METHODS: We recruited participants in Denmark, Finland, the Netherlands, Sweden, and the UK 2007-2012. The baseline questionnaire assessed lifetime history of mobile phone use. Participants were followed through population-based cancer registers to identify glioma, meningioma, and acoustic neuroma cases during follow-up. Non-differential exposure misclassification was reduced by adjusting estimates of mobile phone call-time through regression calibration methods based on self-reported data and objective operator-recorded information at baseline. Hazard ratios (HR) and 95% confidence intervals (CI) for glioma, meningioma, and acoustic neuroma in relation to lifetime history of mobile phone use were estimated with Cox regression models with attained age as the underlying time-scale, adjusted for country, sex, educational level, and marital status.
RESULTS: 264,574 participants accrued 1,836,479 person-years. During a median follow-up of 7.12 years, 149 glioma, 89 meningioma, and 29 incident cases of acoustic neuroma were diagnosed. The adjusted HR per 100 regression-calibrated cumulative hours of mobile phone call-time was 1.00 (95 % CI 0.98-1.02) for glioma, 1.01 (95 % CI 0.96-1.06) for meningioma, and 1.02 (95 % CI 0.99-1.06) for acoustic neuroma. For glioma, the HR for ≥ 1908 regression-calibrated cumulative hours (90th percentile cut-point) was 1.07 (95 % CI 0.62-1.86). Over 15 years of mobile phone use was not associated with an increased tumour risk; for glioma the HR was 0.97 (95 % CI 0.62-1.52).
CONCLUSIONS: Our findings suggest that the cumulative amount of mobile phone use is not associated with the risk of developing glioma, meningioma, or acoustic neuroma.
| Original language | English |
|---|---|
| Article number | 108552 |
| Number of pages | 8 |
| Journal | Environment International |
| Volume | 185 |
| DOIs | |
| Publication status | Published - Mar 2024 |
Bibliographical note
Publisher Copyright:© 2024 The Authors
Funding
The Finnish cohort has previously been supported by funding from the National Technology Agency (TEKES), with contributions to the research program but no control of the use of funding from Nokia, mobile network providers TeliaSonera and Elisa; Pirkanmaa Hospital District competitive research funding (grant no. VTR 9T003); Yrjö Jahnsson Foundation (grant no. 5692); Kone Foundation, and an unrestricted grant from Mobile Manufacturers’ Forum (with Pirkanmaa Hospital District as a firewall) with a contract guaranteeing the complete scientific independence of the researchers to analyse, interpret and report the results with no influence for the funding sources. The UK part of COSMOS was supported for an initial 5-year period by the Mobile Telecommunications and Health Research (MTHR), an independent programme of research into mobile phones and health jointly supported by the UK Department of Health and the mobile telecommunications industry (project reference number 091/0006) and, subsequently, funded by the UK Department of Health & Social Care via its Policy Research Programme (project reference number PR-ST-0713-00003); as well as by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards at King’s College London in partnership with Public Health England (now UK Health Security Agency, UKHSA) and Imperial College London (HPRU-2012-10141) and subsequently the NIHR HPRU in Chemical and Radiation Threats and Hazards at Imperial College London and UK HSA (grant award reference NIHR-200922). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health & Social Care or the UK HSA. PE is Director of the MRC Centre for Environment and Health supported by the Medical Research Council and Public Health England (MR/L01341X/1, 2009-2019 and solely by the Medical Research Council MR/S019669/1, 2019-; and Director of the NIHR HPRU in Chemical and Radiation Threats and Hazards at Imperial College London. PE acknowledges support from the NIHR Imperial Biomedical Research Centre. PE is a UK Dementia Research Institute (DRI) group leader, UK DRI at Imperial College London (DRI is funded by the Medical Research Council, Alzheimer’s Society and Alzheimer’s Research UK) and also acknowledges funding from Health Data Research UK (HDR UK). MBT’s Chair and RBS’s fellowship are supported by a donation from Marit Mohn to Imperial College London to support Population Child Health through the Mohn Centre for Children’s Health and Wellbeing. The Danish part of COSMOS was funded by the Danish Strategic Research Council [grants 2103-05-0006/2064-04-0010]. We thank all participants who joined the COSMOS cohort study. We thank mobile phone network operators in Denmark, Finland, France, the Netherlands, Sweden, and the UK, for allowing invitation of their subscribers and/or provision of operator traffic data. We also thank the members of the Scientific Advisory Board of the COSMOS study: prof. Heidi Danker-Hopfe, prof. Hazel Inskip, and prof. Martin Röösli. We thank Anders Ahlbom, Institute of Environmental Medicine, Karolinska Institutet, Stockholm Sweden, for his essential role in commencing the COSMOS cohort collaboration. Several collaborators in each country have contributed to various stages of the cohort setup, data collection, management, and analyses. In Sweden, Lena Hillert and Mats Talbäck, Institute of Environmental Medicine, Karolinska Institutet, Stockholm. In Finland, Sirpa Heinävaara, Finnish Cancer Registry, Helsinki, Finland; Katja Kojo, STUK – Radiation and Nuclear Safety Authority, Environmental Surveillance, Vantaa; Susanna Lankinen, Aleksi Das, Turkka Näppilä and Taru Vehmasto, Tampere University, Faculty of Social Sciences, Tampere. In the UK, David Muller, James Brook, Margaret Douglass, Joe Gale, James Bennett, Samantha Udondem, and Tom Kennett, Imperial College London. In the Netherlands, Pauline Slottje, Lützen Portengen, Marije Reedijk and Eugenio Traini, University of Utrecht, Institute for Risk Assessment Sciences, Utrecht; Monique Verschuren, National Institute for Public Health and the Environment (RIVM). Where authors are identified as personnel of the International Agency for Research on Cancer / World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the International Agency for Research on Cancer/World Health Organization. The Swedish part of COSMOS was supported by the Swedish Research Council (50096102); AFA Insurance (T-26:04); the Swedish Research Council for Health, Working Life and Welfare (2010-0082, 2014-0889); the Swedish Radiation Safety Authority (SSM2015-2408); and VINNOVA (P31735-1). VINNOVA received funds for this purpose from TeliaSonera AB, Ericsson AB and Telenor Sverige AB, to cover part of the data collection (funding ended 2012). The provision of funds to the COSMOS study investigators via VINNOVA was governed by agreements that guarantees COSMOS’ complete scientific independence. The Danish part of COSMOS was funded by the Danish Strategic Research Council [grants 2103-05-0006/2064-04-0010]. The Finnish cohort has previously been supported by funding from the National Technology Agency (TEKES), with contributions to the research program but no control of the use of funding from Nokia, mobile network providers TeliaSonera and Elisa; Pirkanmaa Hospital District competitive research funding (grant no. VTR 9T003); Yrjö Jahnsson Foundation (grant no. 5692); Kone Foundation, and an unrestricted grant from Mobile Manufacturers’ Forum (with Pirkanmaa Hospital District as a firewall) with a contract guaranteeing the complete scientific independence of the researchers to analyse, interpret and report the results with no influence for the funding sources. The UK part of COSMOS was supported for an initial 5-year period by the Mobile Telecommunications and Health Research (MTHR), an independent programme of research into mobile phones and health jointly supported by the UK Department of Health and the mobile telecommunications industry (project reference number 091/0006) and, subsequently, funded by the UK Department of Health & Social Care via its Policy Research Programme (project reference number PR-ST-0713-00003); as well as by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards at King's College London in partnership with Public Health England (now UK Health Security Agency, UKHSA) and Imperial College London (HPRU-2012-10141) and subsequently the NIHR HPRU in Chemical and Radiation Threats and Hazards at Imperial College London and UK HSA (grant award reference NIHR-200922). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health & Social Care or the UK HSA. PE is Director of the MRC Centre for Environment and Health supported by the Medical Research Council and Public Health England (MR/L01341X/1, 2009-2019 and solely by the Medical Research Council MR/S019669/1, 2019-; and Director of the NIHR HPRU in Chemical and Radiation Threats and Hazards at Imperial College London. PE acknowledges support from the NIHR Imperial Biomedical Research Centre. PE is a UK Dementia Research Institute (DRI) group leader, UK DRI at Imperial College London (DRI is funded by the Medical Research Council, Alzheimer's Society and Alzheimer's Research UK) and also acknowledges funding from Health Data Research UK (HDR UK). MBT's Chair and RBS's fellowship are supported by a donation from Marit Mohn to Imperial College London to support Population Child Health through the Mohn Centre for Children's Health and Wellbeing. The Dutch part of the COSMOS study was supported by The Netherlands Organization for Health Research (ZonMW) within the programme Electromagnetic Fields and Health Research, under grant numbers 85200001, 85500003, 85200002 and 85800001. The French part of COSMOS is funded by the French Agency for Food, Environmental and Occupational Health & Safety (ANSES), project reference number 2013-CRD-17, 2015-CRD-30, 2018-CRD-03, 2020-CRD-RF20-01 and the International Agency for Research on Cancer. All financial support for the submitted work is described in the acknowledgments. The authors have no financial relationships with any organizations that might have an interest in the submitted work, nor any other relationships or activities that could appear to have influenced the submitted work. Expert committee work: M.F. has served as advisor to a number of national and international public advisory and research steering groups concerning the potential health effects of exposure to non-ionizing radiation, including the WHO (ongoing), Public Health England Advisory Group on Non-ionising Radiation - AGNIR (2009-17), the Norwegian Public Health Institute (2010-12), the Swedish Council for Working Life and Social Research (2003-2012), Swedish Radiation Safety Authority's independent scientific expert group on electromagnetic fields (2003-11). She was member of the International Commission on Non-Ionizing Radiation Protection (ICNIRP), an independent body setting guidelines for non-ionizing radiation protection (2008-May 2020), and vice chairman of the Commission May 2016-May 2020. A.H.P. Is a member of the Swedish Radiation Safety Authority's independent scientific expert group on electromagnetic fields since 2018. A.A. has been a member in expert panels on health effects of radiofrequency electromagnetic fields for International Commission on Non-Ionizing Radiation Protection (ICNIRP), Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) of the European Commission, Swedish Radiation Safety Authority (SSM), and World Health Organization (WHO). AH is a member of the Swedish Radiation Safety Authority's independent scientific expert group on electromagnetic fields since 2012, and since 2021 serves as chair of the group. She is a member of ICNIRP since 2020; and a board member of the BioEM society (2021-2023). She was member of the EMF committee of the Health Council of the Netherlands from 2015-2022. From 2014-2023, she was a member of the scientific council of the Swiss Research Foundation for Electricity and Mobile Communication (FSM), a non-profit foundation. H.K. was the chair of the EMF committee of the Health Council of the Netherlands from 2017-2022. He is currently a member of the WHO Task Group on Radiofrequency Fields and Health Risks. M.B.T is a member of the expert UK Committee on Medical Aspects of Radiation in the Environment (COMARE). The Dutch part of the COSMOS study was supported by The Netherlands Organization for Health Research (ZonMW) within the programme Electromagnetic Fields and Health Research, under grant numbers 85200001, 85500003, 85200002 and 85800001. The French part of COSMOS is funded by the French Agency for Food, Environmental and Occupational Health & Safety (ANSES), project reference number 2013-CRD-17, 2015-CRD-30, 2018-CRD-03, 2020-CRD-RF20-01 and the International Agency for Research on Cancer. The Swedish part of COSMOS was supported by the Swedish Research Council (50096102); AFA Insurance (T-26:04); the Swedish Research Council for Health, Working Life and Welfare (2010-0082, 2014-0889); the Swedish Radiation Safety Authority (SSM2015-2408); and VINNOVA (P31735-1). VINNOVA received funds for this purpose from TeliaSonera AB, Ericsson AB and Telenor Sverige AB, to cover part of the data collection (funding ended 2012). The provision of funds to the COSMOS study investigators via VINNOVA was governed by agreements that guarantees COSMOS’ complete scientific independence.
| Funders | Funder number |
|---|---|
| Ericsson AB | |
| Health Council | 2015-2022 |
| Health Security Agency | |
| International Agency for Research on Cancer/World Health Organization | |
| Mobile Telecommunications and Health Research | |
| Mohn Centre for Children's Health and Wellbeing | |
| Mohn Centre for Children’s Health and Wellbeing | |
| NIHR-200922 | |
| National Institute for Public Health and the Environment | |
| National Technology Agency | |
| Netherlands Organization for Health Research | |
| STUK | |
| Telenor Sverige AB | |
| TeliaSonera AB | |
| UKHSA | |
| World Health Organization | |
| U.S. Public Health Service | 2009-17 |
| U.S. Public Health Service | |
| Strategiske Forskningsråd | 2103-05-0006/2064-04-0010 |
| Strategiske Forskningsråd | |
| Centre International de Recherche sur le Cancer | |
| Yrjö Jahnssonin Säätiö | 5692 |
| Yrjö Jahnssonin Säätiö | |
| National Institute for Health Research Health Protection Research Unit | |
| Medical Research Council | |
| National Institute for Health and Care Research | |
| Department of Health and Social Care | PR-ST-0713-00003 |
| Department of Health and Social Care | |
| Alzheimer's Society | |
| Humane Slaughter Association | |
| Imperial College London | HPRU-2012-10141 |
| Imperial College London | |
| European Commission | 2021-2023 |
| European Commission | |
| ZonMw | 85800001, 85200002, 85200001, 85500003 |
| ZonMw | |
| Vinnova | P31735-1 |
| Vinnova | |
| Forskningsrådet för Arbetsliv och Socialvetenskap | 2003-11, 2003-2012, 2008-May 2020 |
| Forskningsrådet för Arbetsliv och Socialvetenskap | |
| Public Health England | MR/S019669/1, 2009-2019, MR/L01341X/1 |
| Public Health England | |
| Alzheimer’s Research UK | |
| AFA Försäkring | |
| Tekes | |
| Karolinska Institutet | |
| Vetenskapsrådet | 50096102 |
| Vetenskapsrådet | |
| Tampereen Yliopisto | |
| Koneen Säätiö | |
| Forskningsrådet om Hälsa, Arbetsliv och Välfärd | 2014-0889, 2010-0082 |
| Forskningsrådet om Hälsa, Arbetsliv och Välfärd | |
| Rijksinstituut voor Volksgezondheid en Milieu | |
| Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail | 2015-CRD-30, 2018-CRD-03, 2020-CRD-RF20-01, 2013-CRD-17 |
| Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail | |
| Pirkanmaan Sairaanhoitopiiri | VTR 9T003 |
| Pirkanmaan Sairaanhoitopiiri | |
| Strålsäkerhetsmyndigheten | SSM2015-2408 |
| Strålsäkerhetsmyndigheten | |
| NIHR Imperial Biomedical Research Centre | |
| Norwegian Institute of Public Health | 2010-12 |
| Norwegian Institute of Public Health | |
| Tasmanian Department of Health | 091/0006 |
| Tasmanian Department of Health | |
| Health Data Research UK |
Keywords
- Brain neoplasms
- Cell phones
- Cohort study
- Electromagnetic fields
- Non-ionizing radiation
- Radiofrequency fields
