Leukaemia, brain tumours and exposure to extremely low frequency magnetic fields: cohort study of Swiss railway employees

Malignant lymphoma and occupational exposure to extremely low frequency magnetic fields and electrical shocks: a nested case-control study in a cohort of four Nordic countries

BACKGROUND

Exposure to extremely low frequency magnetic fields (ELF-MFs) and electric shocks is a common occupational risk factor in many workplaces. Recent investigations have highlighted a possible association between such exposures and lymphoma risk. This study was carried out to further explore the association between occupational exposure to ELF-MFs and electric shocks and risk of lymphoma in a large Nordic census-based cohort.

METHODS

We included cases of non-Hodgkin's lymphoma (NHL, n=68 978), chronic lymphocytic leukaemia (CLL, n=20 615) and multiple myeloma (MM, n=35 467) diagnosed between 1961 and 2005 in Finland, Iceland, Norway and Sweden. Cases were matched to five controls by year of birth, sex and country. Lifetime occupational ELF-MF and electric shock exposures were assigned to jobs reported in population censuses using job-exposure matrices. The risk of cancer was assessed based on cumulative exposure to ELF-MF and electric shocks. ORs with 95% CIs were estimated using logistic models adjusted for occupational co-exposures relevant to lymphomas.

RESULTS

Less than 7% of the cases experienced high levels of ELF-MF. We observed no increased risks among workers exposed to high levels of ELF-MF for NHL (OR: 0.93; CI 0.90 to 0.97), CLL (OR: 0.98; CI 0.92 to 1.05) or MM (OR: 0.96; CI 0.90 to 1.01).

CONCLUSION

Our results do not provide support for an association between occupational exposure to ELF-MFs and electric shocks and lymphoma risk.

Magnetic Fields and Cancer: Epidemiology, Cellular Biology, and Theranostics

Humans are exposed to a complex mix of man-made electric and magnetic fields (MFs) at many different frequencies, at home and at work. Epidemiological studies indicate that there is a positive relationship between residential/domestic and occupational exposure to extremely low frequency electromagnetic fields and some types of cancer, although some other studies indicate no relationship. In this review, after an introduction on the MF definition and a description of natural/anthropogenic sources, the epidemiology of residential/domestic and occupational exposure to MFs and cancer is reviewed, with reference to leukemia, brain, and breast cancer. The in vivo and in vitro effects of MFs on cancer are reviewed considering both human and animal cells, with particular reference to the involvement of reactive oxygen species (ROS). MF application on cancer diagnostic and therapy (theranostic) are also reviewed by describing the use of different magnetic resonance imaging (MRI) applications for the detection of several cancers. Finally, the use of magnetic nanoparticles is described in terms of treatment of cancer by nanomedical applications for the precise delivery of anticancer drugs, nanosurgery by magnetomechanic methods, and selective killing of cancer cells by magnetic hyperthermia. The supplementary tables provide quantitative data and methodologies in epidemiological and cell biology studies. Although scientists do not generally agree that there is a cause-effect relationship between exposure to MF and cancer, MFs might not be the direct cause of cancer but may contribute to produce ROS and generate oxidative stress, which could trigger or enhance the expression of oncogenes.

Residential extremely low frequency magnetic fields and skin cancer

OBJECTIVE

Photoinduced radical reactions have a fundamental role in skin cancer induced by ultraviolet radiation, and changes in radical reactions have also been proposed as a mechanism for the putative carcinogenic effects of extremely low frequency (ELF) magnetic fields (MFs). We assessed the association of melanoma and squamous cell carcinoma with residential MF exposure.

METHODS

All cohort members had lived in buildings with indoor transformer stations (TSs) during the period from 1971 to 2016. MF exposure was assessed based on apartment location. Out of the 225 492 individuals, 8617 (149 291 person-years of follow-up) living in apartments next to TSs were considered as exposed, while individuals living on higher floors of the same buildings were considered as referents. Associations between MF exposure and skin cancers were examined using Cox proportional hazard models.

RESULTS

The HR for MF exposure ≥6 month was 1.05 (95% CI 0.72 to 1.53) for melanoma and 0.94 (95% CI 0.55 to 1.61) for squamous cell carcinoma. Analysis of the age at the start of residence showed an elevated HR (2.55, 95% CI 1.15 to 5.69) for melanoma among those who lived in the apartments when they were less than 15 years old. This finding was based on seven exposed cases.

CONCLUSIONS

The results of this study suggested an association between childhood ELF MF exposure and adult melanoma. This is in agreement with previous findings suggesting that the carcinogenic effects of ELF MFs may be associated particularly with childhood exposure.

Exposure levels of ELF magnetic fields in the residential areas of Mangaung Metropolitan Municipality

The aim of this study was to evaluate the exposure levels of ELF magnetic fields in the residential areas of Mangaung metropolitan municipality. Fifteen residential sites were randomly selected in Bloemfontein, nine in Botshabelo and six in Thaba Nchu areas of Mangaung. Measurements were collected at the distances of 3 m, 6 m and 9 m outside electrical substations, near every corner, using a Trifield meter model XE 100. Measurements were also collected from four different corners inside substations, near barrier screening and were referred to as a distance of 0 m (reference point). The results indicated a non-significant difference among 15 residential areas; BRE1 to BRE15 and six areas; TNRE1 to TRNE6. The exposure levels were significantly high in one residential area BORE1 (0.55 μT) as compared to other residential sites in Botshabelo (p < 0.001). The results obtained from the measurements also show a significant difference between the residential areas BORE4 and BORE8 (p < 0.01) as well as BORE4 and BORE9 (p < 0.006). The four distance interims also demonstrated a highly significant difference (p < 0.0001) when compared to one another. The t test showed a statistically significant difference for exposure levels recorded at 3 m, 6 m and 9 m in comparison to 0 m (p < 0.01). The exposure levels recorded at 3 m were also significantly different to those recorded at 6 m (p < 0.05) and 9 m (p < 0.01). The exposure levels measured at all distances are below the ICNIRP guidelines and the fields decrease rapidly with an increased distance from the source.

No evidence of DNA damage by co-exposure to extremely low frequency magnetic fields and aluminum on neuroblastoma cell lines

Whether exposure to 50-60Hz extremely low frequency magnetic fields (ELF-MF) exerts neurotoxic effects is a debated issue. Analogously, the potential role of Aluminum (Al) in neurodegeneration is a matter of controversial debate. As all living organisms are exposed to ELF-MF and/or Al daily, we found investigating the early effects of co-exposure to ELF-MF and Al in SH-SY5Y and SK-N-BE-2 human neuroblastoma (NB) cells intriguing. SH-SY5Y5 and SK-N-BE-2 cells underwent exposure to 50Hz ELF-MF (0.01, 0.1 or 1mT) or AlCl₃ (4 or 40μM) or co-exposure to 50Hz ELF-MF and AlCl₃ for 1h continuously or 5h intermittently. The effects of the treatment were evaluated in terms of DNA damage, redox status changes and Hsp70 expression. The DNA damage was assessed by Comet assay; the cellular redox status was investigated by measuring the amount of reduced glutathione (GSH) and glutathione disulfide (GSSG) while the inducible Hsp70 expression was evaluated by western blot analysis and real-time RT-PCR. Neither exposure to ELF-MF or AlCl₃ alone induced DNA damage, changes in GSH/GSSG ratio or variations in Hsp70 expression with respect to the controls in both NB cell lines. Similarly, co-exposure to ELF-MF and AlCl₃ did not have any synergic toxic effects. The results of this in vitro study, which deals with the effects of co-exposure to 50Hz MF and Aluminum, seem to exclude that short-term exposure to ELF-MF in combination with Al can have harmful effects on human SH-SY5Y and SK-N-BE-2 cells.

Occupational exposure to extremely low-frequency magnetic fields and brain tumor risks in the INTEROCC study

BACKGROUND

Occupational exposure to extremely low-frequency magnetic fields (ELF) is a suspected risk factor for brain tumors, however the literature is inconsistent. Few studies have assessed whether ELF in different time windows of exposure may be associated with specific histologic types of brain tumors. This study examines the association between ELF and brain tumors in the large-scale INTEROCC study.

METHODS

Cases of adult primary glioma and meningioma were recruited in seven countries (Australia, Canada, France, Germany, Israel, New Zealand, and the United Kingdom) between 2000 and 2004. Estimates of mean workday ELF exposure based on a job exposure matrix were assigned. Estimates of cumulative exposure, average exposure, maximum exposure, and exposure duration were calculated for the lifetime, and 1 to 4, 5 to 9, and 10+ years before the diagnosis/reference date.

RESULTS

There were 3,761 included brain tumor cases (1,939 glioma and 1,822 meningioma) and 5,404 population controls. There was no association between lifetime cumulative ELF exposure and glioma or meningioma risk. However, there were positive associations between cumulative ELF 1 to 4 years before the diagnosis/reference date and glioma [odds ratio (OR) ≥ 90th percentile vs. < 25th percentile, 1.67; 95% confidence interval (CI), 1.36-2.07; PLinear trend < 0.0001], and, somewhat weaker associations with meningioma (OR ≥ 90th percentile vs. < 25th percentile, 1.23; 95% CI, 0.97-1.57; PLinear trend = 0.02).

CONCLUSIONS

Results showed positive associations between ELF in the recent past and glioma.

IMPACT

Occupational ELF exposure may play a role in the later stages (promotion and progression) of brain tumorigenesis.

The epidemiology of glioma in adults: a "state of the science" review

Gliomas are the most common primary intracranial tumor, representing 81% of malignant brain tumors. Although relatively rare, they cause significant mortality and morbidity. Glioblastoma, the most common glioma histology (∼45% of all gliomas), has a 5-year relative survival of ∼5%. A small portion of these tumors are caused by Mendelian disorders, including neurofibromatosis, tuberous sclerosis, and Li-Fraumeni syndrome. Genomic analyses of glioma have also produced new evidence about risk and prognosis. Recently discovered biomarkers that indicate improved survival include O⁶-methylguanine-DNA methyltransferase methylation, isocitrate dehydrogenase mutation, and a glioma cytosine-phosphate-guanine island methylator phenotype. Genome-wide association studies have identified heritable risk alleles within 7 genes that are associated with increased risk of glioma. Many risk factors have been examined as potential contributors to glioma risk. Most significantly, these include an increase in risk by exposure to ionizing radiation and a decrease in risk by history of allergies or atopic disease(s). The potential influence of occupational exposures and cellular phones has also been examined, with inconclusive results. We provide a “state of the science” review of current research into causes and risk factors for gliomas in adults.

Work-related leukemia: a systematic review

Leukemia is a complex disease, which only became better understood during the last decades following the development of new laboratory techniques and diagnostic methods. Despite our improved understanding of the physiology of the disease, little is yet known about the causes of leukemia. A variety of potential risk factors have been suggested so far, including personal habits and lifestyle, and a wide range of occupational or environmental exposures. A causal association with leukemia has only been documented to date for ionizing radiation, benzene and treatment with cytostatic drugs, but there is an ongoing scientific debate on the possible association of leukemia with a number of other work-related hazards. In this article, we have reviewed scientific studies, published over the past 5 years, which investigated potential associations between leukemia and exposure to occupational risk factors. The systematic literature review took place via electronic databases, using specific search criteria, and independent reviewers have further filtered the search results to identify the number of articles, presented in our paper. A large number of studies included in the review referred to the effects of ionizing radiation, where new data suggest that the effects of exposure to small doses of ionizing radiation should probably be reevaluated. Some other works appear to substantiate a potential association of the disease with certain pesticides. Further research is also suggested regarding the role of infectious agents or exposure to certain chemicals like formaldehyde or butadiene in the pathogenesis of leukemia.

Effects of extremely low frequency electromagnetic field on the health of workers in automotive industry

OBJECTIVE

To observe the effects of extremely low frequency electromagnetic fields (ELF-EMFs) in automotive industry on occupational workers.

METHODS

A total of 704 workers were investigated, and 374 workers were chosen and divided into two groups (control group and exposure group) according to the inclusive criteria, namely male with age 20-40 years old and ≥ 2 years of exposure. The intensities of ELF-EMFs and noise were detected with EFA-300 Field Analyzer (Narda company, Pfullingen, Germany) and AWA5610D integrating sound level meter (Hangzhou Aihua Instruments Co., Ltd, Hangzhou, China), respectively. Survey data were collected by questionnaire, and the physical check-up was done in hospital. All the data were input into SPSS17.0 software (SPSS Inc, Chicago, USA), and the appropriate statistic analyses were carried out.

RESULTS

The intensity of EMFs in exposure group was significantly higher than that in control group (p < 0.05), while the noise in two workplaces showed no difference (p>0.05). The survey data collected by questionnaires showed that the symptoms of loss of hair in exposure group were significantly different as compared with that in control group (p < 0.05). The check-up parameters of cardiovascular, liver and hematology system showed significant differences between the two groups (p < 0.05).

CONCLUSIONS

Survey and check-up data suggest that exposure to ELF-EMFs might have effects on the nervous, cardiovascular, liver, and hematology system of workers.

Assessment of occupational exposure to extremely low frequency magnetic fields in hospital personnel

It has been proposed that chronic exposure to extremely low frequency (ELF) magnetic fields (MF) in occupational environments could represent a risk factor for a number of disorders. Medical and technical workers in hospitals have been reported to be exposed to relatively strong ELF fields. The present work aims to characterize exposure to MF in the 5 Hz to 2 kHz frequency range in a large hospital through both instantaneous environmental measurements and personal monitoring of workers. The study was conducted in different working environments of a hospital with about 4400 employees, many of them working at two or more different work stations and consequently, exposed to MF levels that were expected to be unevenly distributed in space and time. The results indicate that: (1) The dominant frequency at the studied environments was 50 Hz (average 90.8 ± 6% of the total B value); (2) The best descriptive information on a worker's exposure is obtained from personal monitoring of volunteer workers; (3) The arithmetic averages of exposure levels obtained from the monitoring ranged from 0.03 ± 0.01 µT in nurses to 0.39 ± 0.13 µT in physiotherapists; and (4) The description of the MF environment through spot measurements in the workplace, although coherent with the data from personal monitoring, might not adequately estimate MF exposure in some professional categories.

Exposure to magnetic fields of railway engine drivers: a case study in Italy

A case study of exposure assessment of railway workers to static and extremely low frequency (ELF) magnetic fields is presented. A measurement campaign was conducted in aboard Italian main line trains. All measurements were performed on board during regular service (two engine drivers were simultaneously present), in all places potentially accessible to personnel, considering routes ranging from a few tens of kilometres to hundreds of kilometres. The measurement protocol was mostly based on broadband metres and personal metres were employed to assess individual exposure. Surveys on static and ELF magnetic fields were performed for seven different models of engine or electrified train. Traction motors were fed by alternating current (AC) current, except for two engines, where AC current fed only auxiliary services. The final result is that the average exposure to static magnetic field was a little higher than the background geomagnetic field; occasionally in few areas it could reach levels of the order of millitesla. The average exposure to ELF magnetic fields was in the order of 1-2 μT, with higher levels (few microtesla) only for one engine; occasionally in hot spots, close to wiring or specific equipment, the field values could reach several tens of microtesla.

Magnetic fields promote a pro-survival non-capacitative Ca2+ entry via phospholipase C signaling

The ability of magnetic fields (MFs) to promote/increase Ca(2+) influx into cells is widely recognized, but the underlying mechanisms remain obscure. Here we analyze how static MFs of 6 mT modulates thapsigargin-induced Ca(2+) movements in non-excitable U937 monocytes, and how this relates to the anti-apoptotic effect of MFs. Magnetic fields do not affect thapsigargin-induced Ca(2+) mobilization from endoplasmic reticulum, but significantly increase the resulting Ca(2+) influx; this increase requires intracellular signal transduction actors including G protein, phospholipase C, diacylglycerol lipase and nitric oxide synthase, and behaves as a non-capacitative Ca(2+) entry (NCCE), a type of influx with an inherent signaling function, rather than a capacitative Ca(2+) entry (CCE). All treatments abrogating the extra Ca(2+) influx also abrogate the anti-apoptotic effect of MFs, demonstrating that MF-induced NCCE elicits an anti-apoptotic survival pathway.

Effects of extremely low-frequency magnetic field exposure on cognitive functions: results of a meta-analysis

There is extensive literature on possible effects of extremely low-frequency magnetic fields (ELF-MFs) on human cognitive functions. However, due to methodological deficits (e.g., low statistical power, small sample sizes) findings have been inconsistent. In the current study we try to overcome these problems by carrying out a meta-analysis. Literature research revealed 17 studies. Nine of these were included in the meta-analysis because they fulfilled minimum requirements (e.g., at least single-blind experimental study design and documentation of means and standard deviation of the dependent variables). All of the studies used a 50 Hz magnetic field exposure. Small but significant effect sizes could be detected in two cognitive dimensions: in the hard level of visual duration discrimination, task-exposed subjects performed better than controls; at the intermediate level however, exposed subjects performed worse. Additionally, a significant improvement of correct responses was observed in the dimension of "flexibility" under exposure. However, due to the small number of studies per performance dimensions and the resulting instability of estimates, these findings have to be treated with extreme caution. Taken together, the results of the meta-analysis provide little evidence that ELF-MFs have any effects on cognitive functions.

[Epidemiology of primary brain tumor]

Two main approaches are generally used to study the epidemiology of primary brain tumors. The first approach is to identify risk factors, which may be intrinsic or related to external causes. The second main approach is descriptive. Intrinsic factors potentially affecting risk include genetic predisposition and susceptibility, gender, race, birth weight and allergy. Radiation exposure is the main extrinsic factor affecting risk. A large body of work devoted, among others, to electromagnetic fields and especially cellular phones, substitutive hormonal therapy, pesticides, and diet have been published. To date, results have been discordant. Descriptive epidemiological studies have reported an increasing annual incidence of primary brain tumors in industrialized countries. The main reasons are the increasing age of the population and better access to diagnostic imaging. Comparing incidences from one registry to another is difficult. Spatial and temporal variations constitute one explanation and evolutions in coding methods another. In all registries, weak incidence of primary brain tumors constitute a very important limiting factor. Renewed interest from the neuro-oncological community is needed to obtain pertinent and essential data which could facilitate improved knowledge on this topic.

Global co-distribution of light at night (LAN) and cancers of prostate, colon, and lung in men

The incidence rates of cancers in men differ by countries of the world. We compared the incidence rates of three of the most common cancers (prostate, lung, and colon) in men residing in 164 different countries with the population-weighted light at night (LAN) exposure and with several developmental and environmental indicators, including per capita income, percent urban population, and electricity consumption. The estimate of per capita LAN exposure was a novel aspect of this study. Both ordinary least squares (OLS) and spatial error (SE) regression models were used in the analysis. We found a significant positive association between population exposure to LAN and incidence rates of prostate cancer, but no such association with lung cancer or colon cancer. The prostate cancer result is consistent with a biological theory and a limited number of previous studies of circadian disruption and risk. The LAN-prostate cancer connection is postulated to be due to suppression of melatonin and/or disruption of clock gene function. An analysis holding other variables at average values across the 164 countries yielded a risk of prostate cancer in the highest LAN-exposed countries 110% higher than in the lowest LAN exposed countries. This observed association is a necessary condition for a potentially large effect of LAN on risk of prostate cancer. However, it is not sufficient due to potential confounding by factors that increase the risk of prostate cancer and are also associated with LAN among the studied countries.

Occupational electromagnetic fields and leukemia and brain cancer: an update to two meta-analyses

OBJECTIVE

To update past meta-analyses on occupational electromagnetic fields (EMF) and adult brain cancer and leukemia.

METHODS

We collected and evaluated all relevant 1993 to 2007 publications. Summary estimates were obtained using various weighting schemes. To explore sources of heterogeneity, study characteristics were examined using regression analysis.

RESULTS

Overall, for new studies, both brain cancer and leukemia showed small increases in risk estimates, 10% and 13%, respectively. Notably, pooled risk estimates were lower than in past meta-analyses, and leukemia subtypes showed no consistent pattern when past and present meta-analyses were compared.

CONCLUSIONS

The lack of a clear pattern of EMF exposure and outcome risk does not support a hypothesis that these exposures are responsible for the observed excess risk. Findings were not sensitive to assumptions, influential studies, weighting schemes, publication bias, study characteristics, or funding source.

Cardiovascular mortality and exposure to extremely low frequency magnetic fields: a cohort study of Swiss railway workers

BACKGROUND

Exposure to intermittent magnetic fields of 16 Hz has been shown to reduce heart rate variability, and decreased heart rate variability predicts cardiovascular mortality. We examined mortality from cardiovascular causes in railway workers exposed to varying degrees to intermittent 16.7 Hz magnetic fields.

METHODS

We studied a cohort of 20,141 Swiss railway employees between 1972 and 2002, including highly exposed train drivers (median lifetime exposure 120.5 muT-years), and less or little exposed shunting yard engineers (42.1 muT-years), train attendants (13.3 muT-years) and station masters (5.7 muT-years). During 464,129 person-years of follow up, 5,413 deaths were recorded and 3,594 deaths were attributed to cardio-vascular diseases. We analyzed data using Cox proportional hazards models.

RESULTS

For all cardiovascular mortality the hazard ratio compared to station masters was 0.99 (95%CI: 0.91, 1.08) in train drivers, 1.13 (95%CI: 0.98, 1.30) in shunting yard engineers, and 1.09 (95%CI: 1.00, 1.19) in train attendants. Corresponding hazard ratios for arrhythmia related deaths were 1.04 (95%CI: 0.68, 1.59), 0.58 (95%CI: 0.24, 1.37) and 10 (95%CI: 0.87, 1.93) and for acute myocardial infarction 1.00 (95%CI: 0.73, 1.36), 1.56 (95%CI: 1.04, 2.32), and 1.14 (95%CI: 0.85, 1.53). The hazard ratio for arrhythmia related deaths per 100 muT-years of cumulative exposure was 0.94 (95%CI: 0.71, 1.24) and 0.91 (95%CI: 0.75, 1.11) for acute myocardial infarction.

CONCLUSION

This study provides evidence against an association between long-term occupational exposure to intermittent 16.7 Hz magnetic fields and cardiovascular mortality.

Mortality from Neurodegenerative Disease and Exposure to Extremely Low-Frequency Magnetic Fields: 31 Years of Observations on Swiss Railway Employees

AIMS

The objective of the present study was to investigate the relationship between extremely low-frequency magnetic field (ELF-MF) exposure and mortality from several neurodegenerative conditions in Swiss railway employees.

METHODS

We studied a cohort of 20,141 Swiss railway employees with 464,129 person-years of follow-up between 1972 and 2002. For each individual, cumulative exposure was calculated from on-site measurements and modelling of past exposure. We compared cause-specific mortality in highly exposed train drivers (mean exposure: 21 microT) with less exposed occupational groups (for example station masters: 1 microT).

RESULTS

The hazard ratio for train drivers compared to station masters was 1.96 [95% confidence interval (CI) = 0.98-3.92] for senile dementia and 3.15 (95% CI = 0.90-11.04) for Alzheimer's disease. For every 10 microT years of cumulative exposure senile dementia mortality increased by 5.7% (95% CI = 1.3-10.4), Alzheimer's disease by 9.4% (95% CI = 2.7-16.4) and amyotrophic lateral sclerosis by 2.1% (95% CI = -6.8 to 11.7). There was no evidence for an increase in mortality from Parkinson's disease and multiple sclerosis.

CONCLUSIONS

This study suggests a link between exposure to ELF-MF and Alzheimer's disease and indicates that ELF-MF might act in later stages of the disease process.