1. What the History of Epidemiology and Toxicology Teach Us
About Understanding
Cell Phone Risks
Devra Davis, Ph.D. MPH
Porto Allegre, Brasil
May 19,2009

2. Caveat Emptor

3. International Congress of Scientific and Social Campaign Against Cancer held in Brussels in 1936

4. Chapter 2 Known Cancer Causes --
International Congress of Scientific and
Social Campaign Against Cancer, 1936
Hormones
X-Radiation
Solar radiation
Coal tars/ soots
Benzene
Cobalt-uranium mining

5. Clarence Cook Little headed the American Cancer Society until 1954, when the geneticist became the founding Director of the Scientific Advisory Board of the Tobacco Industry Research Council.
In 1959, as Director of this board, he refuted an earlier assertion that he made as head of ACS that inhaling fine particles is unhealthy. He denied a link between cigarettes and illness. He claimed to believe that cancer was mostly a genetic issue. Dr. Little was just one of many medical professionals to go to work for Big Tobacco in an effort to cloud the truth about cigarette smoking.

6. Chapter 7: Saving Cigarettes
Three independent research organizations conducted a nationwide poll with doctors, surgeons, and specialists in every branch of medicine.  113,597 doctors in all participated in this poll.  The brand of cigarette the doctors named most often was Camel. The doctors’ recommendation of Camels lasted until the early 1950’s--- when the first rumblings about smoking and heath were beginning to surface.  It was only a matter of time before the doctors began to publicly distance themselves.

7. 7

8. The Secret Ingredient in Kent Cigarettes???
Crocidolite Asbestos 8

9. Cell Phone Science Follows Tobacco Playbook
Raise doubts about experimental findings
Fund and develop studies
“War Gaming” of challenging results

10. Changing Cell Phone Patterns phones per 1000 users
Region US
127
683
946
Western
Europe 60
930
1008
Asia
7.1
230
379
World
2.1
123
319

11. Use among 1,600 13-to-15-year-olds in Belgium, Katholieke University Leuven
almost 60% of students (ages 13-15) used cell phones to talk or text message after turning their lights out at bedtime.
teens who used their cell phone more than once a week after lights-out were five times more likely than those who never did so to indicate fatigue and sleep difficulties.

12. Cell Signals Penetrate the Brains of Children More than Adults
With Permission of Om P. Gandhi

13. [Gandhi and Kang, 2002]

14. SAR in plane of antenna feed point
Adult
10 year old
5 year old
Bit-Babik et al. “Simulation of Exposure and SAR Estimation for Adult and Child Heads Exposed to RF Energy from Portable Communication Devices” Radiation Research 163, (2005)

15. French Telecom Estimate of Differential
Absorption of Radiofrequency with Age
Wiart et al Phys Med Biol 2008;53:

16. Marketing Cell Phones For Children
glowPhone Gift Package
glowPhone everything active kids and parents
need to keep in touch during their increasingly
busy days.
The glowPhone features a full color screen,
built in games, customizable ringtones and wallpapers
also has a flashlight.
$74.98
Show Color:

17. Marketing to Five Year Olds

18. Pew Center Estimates on Children’s cell phone patterns
63% of teenagers age have cell phones
Girls age most likely to have them (79 percent).
55% of teens with cell phones use them to talk daily. 60% of teens with cell phones send text messages daily. 54% of kids age 8-12 are expected to have a cell phone in the next three years.
Sources: Pew Internet & American Life Project report “Teens and Social Media”
and the Center on Media and Child Health, 2008

19. Changing Use of Cell Phones in U.S. Children/Young Adults 2008
20% of seven year olds
40-60% of middle school children
Changing use patterns
The average cell phone call in 2003 lasted 2.87 minutes, and the average monthly bill was $49.91.
Growing marketing to children

20. Changing Patterns of Cell Phone Use in Teenagers
No students had their own mobile phones 20 years ago
2008 more than three-fourths of all teens age possess cell phones

21. Special Packaging for Children

22. Cell phone use among children
Children are a sensitive population:
For most tumors and a large number of carcinogens there is an inverse association between age at exposure and development of the disease.
Children can experience a long latency period between exposure and development of the disease.
Sadetzki, 2009

23. MOBI-KIDS Collaborative Project.
“Risk of brain cancer from exposure to radiofrequency fields in childhood and adolescence”
[Collaborative Project of the Seventh Framework Programme
Theme Environment (including climate change) – ]
Childhood brain cancer from exposure to radiofrequency fields in childhood and adolescence
Collaborative Project.
EC grant – topic of call: Health impacts of exposure to RF fields in childhood and adolescence (ENV )

24. FRANCE, DECEMBER 2008

25. (Vriheid M, Occup Environ Med 2006)
Detailed data on cell phone use (duration & frequency of calls, side of use, use while moving, use of handset and handheld devices, use in urban & rural areas)
r=0.7

26. “Based on the largest number of benign PGT patients reported to date, our results suggest an association between cellular phone use and PGTs”.
This research was funded by The Israel Cancer Association

27. Cellular phone use & the risk of benign & malignant Parotid Gland Tumors – a nationwide case-control study
Consistent elevated risks were shown in complementary analyses restricted to conditions that may yield higher levels of exposure:
After 5 y of cellphone use, an increase of 34% was observed in the risk to develop a tumor, in the same side of the head where the cell phone was held.
For ipsilateral use, an excess risk of about 50% was observed in the highest category of use.
An excess risk was found among cell phones heavy users in rural areas characterized by a relatively small number of antennas.
(Sadetzki S, Am J Epidemiol 2008)

28. Sadetzki INTERPHONE study:
% of cellphone heavy users (upper quintile) by center
Sadetzki
Interphone upper quintile=735h
Israel upper quintile=1324h
Interphone upper quintile=12800
Israel upper quintile=25328 calls

29. Hardell metanalysis, 2008

30. Interphone Summary

31. Interphone Release, October 8, 2008
No increased risk meningioma, parotid gland tumors
Doubled risk of gliomas in Denmark, France, Germany, Japan with 10 yrs of use
Some increase in acoustic neuroma

32. Acoustic Neuroma Meta-analysis Han et al., 2009
Cell phone use for at least 10 years had a 2.4-fold of acoustic neuroma (95% CI = )

33. Need for Industry Records for independent evaluation
reduce recall bias and increase statistical power
conduct retrospective analyses of first adopters & typical SAR with geocoding
evaluate impacts on children and teenagers
advise regarding engineering redesign

34. Existing Studies Biased Toward Null
Insufficient latency time.  The time between exposure and diagnosis of a brain tumor, similar to smoking and lung cancer could be several decades. 
"Regular" cellphone use is defined as once a week for 6 months or more.  Would you expect to find lung cancer in a smoker who had smoked for once a week for 6 months or more? 
No young adults or children included.  Because their brains are more susceptible, they are likely to be vulnerable.

35. Methodological Critiques
Cellphones used in rural areas radiate more power than in urban areas.  Studies have not included rural users.
Cordless phones are similar to cellphones yet cordless phones users are treated as unexposed. 
People who die before they can be interviewed are excluded.  This underestimates risks of most deadly brain tumors.
Interviews conducted in hospital after surgery
Recall bias (imperfect memory).  An Interphone study, using billing records, has shown that light users underestimate their use and heavy user overestimates their use. 

36. Cell Phone Studies Industry Effect No Effect Total
Funded (42%)
(32%) (68%)
Non-Industry (58%)
Funded (70%) (30%)
Total (54%) (46%)
c2 = (p< .001) Odds ratio=0.2 an industry funded study is 1/5 as likely to report a positive finding compared to an independent one (1/29/04) Source: Lai and Richter

37. Biological Plausibility
Alters heat shock proteins
Increases permeability of blood, brain barrier
Epigenetic effects on methylation and DNA repair
Some thermal effects

38. Ethical Questions??
Apparent release of peer review to attorneys engaged in litigation

39. Peer Review Compromised

40. Peer Reviewers Comments Provided to Attorneys

41. Department of Health “Mobile phones & Health” Leaflet (October 2006 )
If you use a mobile phone, you can choose to minimize your exposure to radio waves.
keep your calls short
consider relative SAR values when buying a new phone.
Radio waves above a certain level can cause heating effects to the body. International guidelines have been set to keep exposure to radio waves below that level.
The UK has a ban on handheld cell phone use while driving.

42. U.K. Advice (continued)
For children and young people (under the age of 16), the UK Chief Medical Officers strongly advise:
use mobile phones for essential purposes only
keep all calls short - talking for long periods prolongs exposure and should be discouraged
The UK CMOs recommend that if parents want to reduce potential risks to children they should restrict children’s use of mobile phones.

43. FRANCE, DECEMBER 2008

44. The Israeli Ministry of Health – Recommendations for cell phone use (July 2008)
“In general, the Israeli Ministry of Health embraces the guidelines published by most international entities, which recommend following the precautionary principle in relation to mobile phone use. Accordingly, the Israeli Ministry of Health recommends the following:”
Use of a speaker/hands free device or earphones. Reducing the number and duration of cell phone calls is another simple way of decreasing the exposure.
In areas where the reception is weak, the exposure level increases. Therefore, one should talk less in these areas.
It is highly recommended that the precautionary rules be followed by children, who are in general, more sensitive to develop cancer following exposure to carcinogenic factors.
While driving, it is best to speak as little as possible and, in any case, to follow regulation B28.
(2008)

45. Center for Environmental Oncology University of Pittsburgh Cancer Institute – Recommendations for cell phone use (July 2008)
“Precautionary Principle”
Use of a speaker/hands free device or earphones. Reducing the number and duration of cell phone calls is another simple way of decreasing the exposure.
In areas where the reception is weak, the exposure level increases. Therefore, one should talk less in these areas.
It is highly recommended that the precautionary rules be followed by children, who are in general, more sensitive to develop cancer following exposure to carcinogenic factors.
(2008)

46. UK, Department of Health “Mobile phones & Health” Leaflet (October 2006 )
Gaps in scientific knowledge led the Stewart Group to recommend a precautionary approach to the use of mobile phones and base stations.

47. French Government Proposed Restrictions on Cell Phones, January, 2009
Ban advertising to children under 12
Ban design of phones to be used by those under six.
Handsets must be sold with phones
City of Lyon official advertising campaign to discourage the use of the phones by children. 47

48. Finnish Authorities Warn of Cell Phone Risks to Children and Those with Pacemakers
Use text messages rather than calls
Use hands-free devices, with phone kept away from the body,
Avoid talking in an area with low connectivity
Disruption of pacemakers is usually harmless, but can increase heart beat 48

49. Finnish Authorities Warn of Cell Phone Risks to Children
“Although research to
date, has not
demonstrated health
effects from mobile
phone’s radiation,
precaution is
recommended for
children as all of the
effects are not known.” 49

50. Many governments advise against children using cell phones:
England
France
Germany
Israel
Finland
Bangalore, India 50

51. 51

52. Nick Naylor—Moral Flexibility52

53. 53

54. Truth is Stranger Than Fiction
“Gentlemen, practice these words in front of the mirror: Although we are constantly exploring the subject, currently there is no direct evidence that links cell phone usage to brain cancer.” 54

55. For more information visit:
preventingcancernow.org
ewg.org
thesimplebody.com
devradavis.com 55

56. Center for Environmental Oncology Leadership and Staff
Ronald B. Herberman, MD, Director of UPCI Cancer Centers
Devra Lee Davis, PhD. MPH, Director
Maryann Donovan,MPH,PhD,Scientific Director
Evelyn Talbott, PhD, Epidemiology
Joel Weissfeld, MD, Epidemiology
Monica Han, PhD, Post-Doctoral Fellow
Steven Bodnar, MS, Greening/Community Assessment
Mary Platt, MBA, Center Administrator

57. Martin Luther King, Jr. Cowardice asks the question, “Is it safe?”
Expediency asks the questions, “Is it politic?”
But Conscience asks the question: “Is it right?”
And there comes a time when one must take a position that is neither safe, nor politic, nor popular, but he must do it because Conscience tells him it is right.” 57

58. www.preventingcancernow.org www.devradavis.com www.thesimplebody.com