From International Journal of Epidemiology
International Case–Control Study
The INTERPHONE Study Group
Posted: 06/17/2010; International Journal of Epidemiology. 2010;39(3):675-694. © 2010 Oxford University Press
Background The rapid increase in mobile telephone use has generated concern about possible health risks related to radiofrequency electromagnetic fields from this technology.
Methods An interview-based case–control study with 2708 glioma and 2409 meningioma cases and matched controls was conducted in 13 countries using a common protocol.
Results A reduced odds ratio (OR) related to ever having been a regular mobile phone user was seen for glioma [OR 0.81; 95% confidence interval (CI) 0.70–0.94] and meningioma (OR 0.79; 95% CI 0.68–0.91), possibly reflecting participation bias or other methodological limitations. No elevated OR was observed ≥10 years after first phone use (glioma: OR 0.98; 95% CI 0.76–1.26; meningioma: OR 0.83; 95% CI 0.61–1.14). ORs were <1.0 for all deciles of lifetime number of phone calls and nine deciles of cumulative call time. In the 10th decile of recalled cumulative call time, ≥1640 h, the OR was 1.40 (95% CI 1.03–1.89) for glioma, and 1.15 (95% CI 0.81–1.62) for meningioma; but there are implausible values of reported use in this group. ORs for glioma tended to be greater in the temporal lobe than in other lobes of the brain, but the CIs around the lobe-specific estimates were wide. ORs for glioma tended to be greater in subjects who reported usual phone use on the same side of the head as their tumour than on the opposite side.
Conclusions Overall, no increase in risk of glioma or meningioma was observed with use of mobile phones. There were suggestions of an increased risk of glioma at the highest exposure levels, but biases and error prevent a causal interpretation. The possible effects of long-term heavy use of mobile phones require further investigation.
Mobile phone use has increased dramatically in many countries since its introduction in the early-to-mid 1980s. The expanding use of this technology has been accompanied by concerns about health and safety. In the late 1990s, several expert groups critically reviewed the evidence on health effects of low-level exposure to radiofrequency (RF) electromagnetic fields, and recommended research into the possible adverse health effects of mobile telephony.[1–4] As a result, the International Agency for Research on Cancer (IARC) coordinated a feasibility study in 1998 and 1999, which concluded that an international study of the relationship between mobile phone use and brain tumour risk would be feasible and informative.[5,6]
INTERPHONE was therefore initiated as an international set of case–control studies focussing on four types of tumours in tissues that most absorb RF energy emitted by mobile phones: tumours of the brain (glioma and meningioma), acoustic nerve (schwannoma) and parotid gland. The objective was to determine whether mobile phone use increases the risk of these tumours and, specifically, whether RF energy emitted by mobile phones is tumourigenic.
This article presents the results of analyses of brain tumour risk in relation to mobile phone use in all INTERPHONE study centres combined. Analyses of brain tumours in relation to mobile phone use have been reported from a number of cohort[7–9] and case–control studies, including several of the national components of INTERPHONE.[10–25] No studies, however, have included as many exposed cases, particularly long-term and heavy users of mobile phones, as this study.