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EMF Editorial from NEJM July 3, 1997



Dear Radsafers,

I here copy paste the Editorial on EMF that was published on
July 3, 1997 in New England Journal of Medicine in case you
didn't see it. Hope the people NEJM don't mind - after all
it concerns how we spend money (has anyone an idea of the
total annual costs in the U.S. for example? Not only costs
for research, but also from law suits, administration, technical
costs and so on).  It is from  http://www.nejm.com/

If you have little time to read - start with the last paragraph.
I apologize for any paragraph break that may not follow the
original - some of this was lost in the copy-pasting.

bjorn_cedervall@hotmail.com
Depts. Medical Radiation Biology and Medical Radiation Physics,
Karolinska Institutet, Box 260,
S-171 76 Stockholm,
Sweden
--------------------------------------------------------------
Power Lines, Cancer, and Fear

Over the past 18 years, there has been considerable interest in the 
possible link between electromagnetic fields and cancer, especially 
leukemia.
              
The story of this highly publicized research has been marked by mystery, 
contradiction, and confusion. When something as ubiquitous and 
misunderstood as extremely-low-frequency electromagnetic fields is 
accused of causing cancer in children, people's reactions may be driven 
more by passion than by reason. 

Each year in this country about 2000 children are given a diagnosis of 
acute lymphoblastic leukemia (ALL), the most common childhood cancer.
 Despite the remarkable advances in treatment, ALL still carries a 30 
percent mortality. Other than exposure to ionizing radiation, its cause 
remains a mystery. ALL is more common among whites and children of 
higher socioeconomic class, and for unclear reasons the incidence of ALL 
has increased by about 20 percent in the past two decades. (1,2) During 
the past 50 years, per capita use of electricity has increased more than 
10 times. Some investigators have claimed that living close to major 
power lines causes cancer, particularly leukemia in children. 

In this issue of the Journal, Linet et al. (3) report the results of a 
major study showing that the risk of ALL does not increase with 
increasing electromagnetic-field levels in children's homes. This study 
has several strengths. It was large, including 629 children with 
leukemia and 619 controls, and it included measurements of 
electromagnetic fields, made by technicians blinded to the case or 
control status of the subjects, both in the houses where the children 
had lived and, in 41 percent of cases, in the homes in which their 
mothers resided while pregnant. Linet et al. also found no relation 
between the risk of ALL and residential wire-code classifications, again 
determined by technicians blinded to the children's health status. The 
wire-code classifications are important, because several of the earlier 
positive studies relied on these proxy indicators rather than on actual 
measurements of electromagnetic fields. 

This whole saga began when two Denver researchers, puzzled by small 
clusters of cancer in children, came to believe that living in close
proximity to high-voltage power lines was a cause of leukemia. (4) The 
analysis they published in 1979 was crude and relied on distances from 
homes to power lines and on wiring configurations rather than on direct 
measures of exposure to electromagnetic fields. They found that the risk 
of childhood leukemia was more than doubled among children living near 
such power lines, a finding that led to more studies and more concern. 
Soon activists and the media began to spread the word that 
electromagnetic fields cause cancer. 

The hypothesized cause was exposure to extremely-low-frequency magnetic 
fields generated by the electrical current in power lines. Physicists 
understand these invisible fields well, but most physicians, parents, 
and patients do not. The movement of any electrical charge creates a 
magnetic field that can be measured. (5) Even the 60-Hz residential 
electric current (50 Hz in Europe) creates a very weak oscillating 
field, which, like all magnetic fields, penetrates living tissue. These 
low-frequency electromagnetic fields are known as nonionizing radiation, 
since the amount of energy in them is far below that required to break 
molecular bonds such as those in DNA. 

One ironic fact about low-frequency electromagnetic fields is that we 
live and worry about them within the Earth's static magnetic field of 50 
microteslas, which is hundreds of times greater than the oscillating 
magnetic field produced by 110/220-V current in houses (0.01 to 0.05 
microtesla). (5,6) Even directly under high-voltage transmission lines, 
the magnetic field is only about 3 to 10 microteslas, which is less than 
that in an electric railway car and much weaker than the magnetic field 
close to my head when I use an electric razor (about 60 microteslas). 

Although most physicists find it inconceivable that power-line 
electromagnetic fields could pose a hazard to health, dozens of 
epidemiologic studies have reported weak positive associations between 
proximity to high-voltage power lines and the risk of cancer. (6,7) The 
negative or equivocal studies did not end the controversy. Fear of 
leukemia is a powerful force, and the media response amplified the 
perception of electromagnetic fields as a health hazard. In 1989 The New 
Yorker published three articles by journalist Paul Brodeur that 
described in mesmerizing detail how maverick researchers had discovered 
a cause of cancer that the establishment refused to accept. (8,9,10) 
Like many of the epidemiologic studies themselves, these widely quoted 
articles described biologic mechanisms of action for electromagnetic 
fields that were hypothetical, even fanciful. Brodeur went so far as to 
claim that the search for the truth about the hazards of electromagnetic 
fields was threatened most by the "obfuscation of industry, the 
mendacity of the military, and the corruption of ethics that industrial 
and military money could purchase
from various members of the medical and scientific community." (8) 
Suspicion spread to many other wavelengths on the nonionizing
electromagnetic spectrum, producing fears about occupational exposure to 
electricity as well as exposure to microwave appliances, radar,
video-display terminals, and even cellular telephones. Dozens of studies 
looked for associations with brain cancer, miscarriages, fetal-growth 
retardation, lymphoma, breast cancer, breast cancer in men, lung cancer, 
all cancers, immunologic abnormalities, and even changes in the behavior 
of animals. 

When people hear that a scientific study has implicated something new as 
a cause of cancer, they get worried. They get even more worried when the 
exposure is called radiation and comes from dangerous-looking 
high-voltage power lines controlled by government and industry, which 
some distrust deeply. Such exposure seems eerie when people hear that 
electromagnetic fields penetrate their homes, their bodies, their 
children. The worried citizens took action. Frightened people, including 
parents of children with leukemia, undertook their own epidemiologic 
studies and fought to get high-power transmission lines moved away from 
their children. Congress responded with large direct appropriations for 
wider research on the effects of electromagnetic fields. After a large 
apparently positive study in Sweden, (7) the Swedish government came 
close to mandating the relocation of schools to at least 1000 meters 
from large power lines. But cooler heads prevailed once it became clear 
that the absolute incremental risk was small at most, the conclusions 
were based on a tiny fraction of all Swedish children with leukemia, and 
the increase in risk was found only in relation to some estimates of 
magnetic fields, not to the actual fields measured in children's homes. 

Serious limitations have been pointed out in nearly all the studies of 
power lines and cancer. (11,12) These limitations include unblinded
assessment of exposure, difficulty in making direct measurements of the 
constantly varying electromagnetic fields, inconsistencies between the 
measured levels and the estimates of exposure based on wiring 
configurations, recall bias with respect to exposure, post hoc 
definitions of exposure categories, and huge numbers of comparisons with 
selective emphasis on those that were positive. Both study participation 
and residential wire-code categories may be confounded by socioeconomic 
factors. Often the number of cases of ALL in the high-exposure 
categories has been very small, and controls may not have been truly 
comparable. Moreover, all these epidemiologic studies have been 
conducted in pursuit of a cause of cancer for which there is no 
plausible biologic basis. There is no convincing evidence that exposure 
to electromagnetic fields causes cancer in animals, (6) and 
electromagnetic fields have no reproducible biologic effects at all, 
except at strengths that are far beyond those ever found in people's 
homes. 

In recent years, several commissions and expert panels have concluded 
that there is no convincing evidence that high-voltage power lines are a 
health hazard or a cause of cancer. (6,13) And the weight of the better 
epidemiologic studies, including that by Linet et al., now supports the 
same conclusion. It is sad that hundreds of millions of dollars have 
gone into studies that never had much promise of finding a way to 
prevent the tragedy of cancer in children. The many inconclusive and 
inconsistent studies have generated worry and fear and have given peace 
of mind to no one. The 18 years of research have produced considerable 
paranoia, but little insight and no prevention. It is time to stop 
wasting our research resources. We should redirect them to research that 
will be able to discover the true biologic causes of the leukemic clones 
that threaten the lives of children. 

              Edward W. Campion, M.D. 

______________________________________________________
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