1. Mobile Phone Use, Brain Tumor Risk and Public Health Policy Joel M. Moskowitz, Ph.D., Director Center for Family and Community School of Public Health University of California, Berkeley The Commonwealth Club November 18, 2010

2. Overview Review studies of mobile phone use and tumor risk Results of 2010 Interphone Study paper Trends in cell phone use in U.S. Public health policy options

3. Meta-analysis: publication Mobile Phone Use and Risk of Tumors: A Meta-Analysis. Journal of Clinical Oncology, 27(33):5565-72. 2009. –Seung-Kwon Myung, National Cancer Center, S. Korea –Woong Ju, Ewha Womans University, S. Korea –Yeon Li Gee, Seoul National Univ. Hospital, S. Korea –Chih-Tao Cheng, Koo Foundation Sun Yat-Sen Cancer Center, Taiwan –Diana McDonnell, Gene Kazinets, and Joel M. Moskowitz, UC Berkeley http://jco.ascopubs.org/content/27/33/5565.abstract

4. Meta-analysis: study selection One cohort study –No association between cell phone use and brain tumor risk –Weak study 23 case-control studies –37,916 participants—12,344 patient cases & 25,572 controls

5. Meta-analysis: case-control study What is a case-control study? –Compare “cases” to matched “controls.” –Determine if characteristics differ between 2 groups. –“Exposure” is mobile phone use. –Compute Odds Ratio (OR) (Odds of having tumor for people using phones) ÷ (Odds of having tumor for people not using phones) –OR interpreted as Relative Risk 1 = increased risk

6. Meta-analysis: overall tumor risk Overall no association between mobile phone use & tumor risk (OR = 0.98; n = 23 studies) –High research quality–increased tumor risk -govt. or foundation-funded (OR=1.17; n = 8) -Low research quality–reduced tumor risk -mostly industry-funded (OR = 0.85; n=15)

7. Meta-analysis: brain tumor risk for 10+ years mobile phone use Overall increased brain tumor risk (OR = 1.24; n = 8) -High quality – increased risk; Hardell (OR = 1.54; n = 4) -Low quality – no risk; Interphone (OR =1.00; n = 4)

8. Meta-analysis: lessons learned Know –Increased brain tumor risk for 10+ years –Results vary Research quality Research group –1994–2004 Don’t Know? –Longer durations –Heavier use –Children & teens –2005 and beyond –Other tumors & health risks

9. Interphone study 13 nation case-control study –funded by World Health Org. & Industry ($25 million) 2010 - overall results for 2 brain tumors reported –meningioma (n = 2,409) and glioma (n = 2,708) –2000-2004 - data collected –average lifetime cell phone use < 100 hours Numerous shortcomings  bias –Reduce estimates of tumor risk

10. Interphone study: results Meningioma Risk –Any regular use -- reduced risk –After bias correction no risk Glioma Risk –Any regular use -- reduced risk likely due to bias –Heavy use (1,640+ hrs) -- increased risk (OR=1.40) replicates in 44 tests greater after bias correction (OR=1.82) –Dose-response relationship w/ more years of use after bias correction 10-yr risk (OR=2.18)

11. Tumor risk for 10+ yrs. cell phone use by study group & tumor type Relative Risk: 1 = harmful Interphone results from Appendix 2 Table (corrects for bias) ? ? ?

12. Mobile Phone Use in U.S. 2010 -- 293 million subscribers 2.5 hours/ week CTIA, 10/6/10 1985 -- 203,000

13. U.S. government position U.S. Food and Drug Administration, May 2010

14. Public health policy options U.S. govt. position –Cell phones meet safety standards –Wait for conclusive evidence –Invest in minimal research funding Our position –Precautionary principle Harm reduction approach Safe use recommendations Precautionary health warnings Update safety standards –Call for major government research funding initiative

15. Precautionary Principle

16. Policy: Precautionary warnings HP1207, LD 1706, 124th Maine State Legislature, 2009-2010 An Act To Create the Children's Wireless Protection Act

17. Policy: independent research

18. Contact information Joel M. Moskowitz, Ph.D., Director Center for Family and Community School of Public Health University of California, Berkeley jmm@berkeley.edu A CDC Center for Health Promotion and Disease Prevention Research