Leukemia Attributable to Residential Magnetic Fields: Results from Analyses Allowing for Study Biases

Nearly every epidemiologic study of residential magnetic fields and childhood leukemia has exhibited a positive association. Nonetheless, because these studies suffer from various methodologic limitations and there is no known plausible mechanism of action, it remains uncertain as to how much, if any, of these associations are causal. Furthermore, because the observed associations are small and involve only the highest and most infrequent levels of exposure, it is believed that the public health impact of an effect would be small. We present some formal analyses of the impact of power-frequency residential magnetic-field exposure (as measured by attributable fractions), accounting for our uncertainties about study biases as well as uncertainties about exposure distribution. These analyses support the idea that the public health impact of residential fields is likely to be limited, but both no impact and a substantial impact remain possibilities in light of the available data.     

Methods to Explore Uncertainty and Bias Introduced by Job Exposure Matrices

Job exposure matrices (JEMs) are used to measure exposures based on information about particular jobs and tasks. JEMs are especially useful when individual exposure data cannot be obtained. Nonetheless, there may be other workplace exposures associated with the study disease that are not measured in available JEMs. When these exposures are also associated with the exposures measured in the JEM, biases due to uncontrolled confounding will be introduced. Furthermore, individual exposures differ from JEM measurements due to differences in job conditions and worker practices. Uncertainty may also be present at the assessor level since exposure information for each job may be imprecise or incomplete. Assigning individuals a fixed exposure determined by the JEM ignores these uncertainty sources. We examine the uncertainty displayed by bias analyses in a study of occupational electric shocks, occupational magnetic fields, and amyotrophic lateral sclerosis.     

Health‐Economics Analyses Applied to ELF Electric and Magnetic Fields

Extremely low frequency electric and magnetic fields (ELF EMFs) are a common exposure for modern populations. The prevailing public‐health protection paradigm is that quantitative exposure limits are based on the established acute effects, whereas the possible chronic effects are considered too uncertain for quantitative limits, but might justify precautionary measures. The choice of precautionary measures can be informed by a health‐economics analysis (HEA). We consider four such analyses of precautionary measures that have been conducted at a national or state level in California, the Netherlands, the United Kingdom, and Israel. We describe the context of each analysis, examine how they deal with some of the more significant issues that arise, and present a comparison of the input parameters and assumptions used. The four HEAs are methodologically similar. The most significant qualitative choices that have to be made are what dose‐response relationship to assume, what allowance if any to make for uncertainty, and, for a CBA only, what diseases to consider, and all four analyses made similar choices. These analyses suggest that, on the assumptions made, there are some low‐cost measures, such as rephasing, that can be applied to transmission in some circumstances and that can be justifiable in cost‐benefit terms, but that higher cost measures, such as undergrounding, become unjustifiable. Of the four HEAs, those in the United Kingdom and Israel were influential in determining the country's EMF policy. In California and Netherlands, the HEA may well have informed the debate, but the policy chosen did not stem directly from the HEA.     

Risk Governance for Mobile Phones,Power Lines,and Other EMF Technologies

Power‐frequency electric and magnetic fields (EMFs) have been present in industrialized countries since the late 19th century and a considerable amount of knowledge has been accumulated as to potential health effects. The mainstream scientific view is that even if there is a risk, it is unlikely to be of major public‐health significance. EMFs from cellular communications and other radio‐frequency technologies have increased rapidly in the last decade. This technology is constantly changing, which makes continued research both more urgent and more challenging. While there are no persuasive data suggesting a health risk, research and particularly exposure assessment is still immature. The principal risk‐governance issue with power frequencies is how to respond to weak and uncertain scientific evidence that nonetheless causes public concern. For radio‐frequency electromagnetic fields, the issue is how to respond to large potential consequences and large public concern where only limited scientific evidence exists. We survey these issues and identify deficits in risk governance. Deficits in problem framing include both overstatement and understatement of the scientific evidence and of the consequences of taking protective measures, limited ability to detect early warnings of risk, and attempted reassurance that has sometimes been counterproductive. Other deficits relate to the limited public involvement mechanisms, and flaws in the identification and evaluation of tradeoffs in the selection of appropriate management strategies. We conclude that risk management of EMFs has certainly not been perfect, but for power frequencies it has evolved and now displays many successful features. Lessons from the power‐frequency experience can benefit risk governance of the radio‐frequency EMFs and other emerging technologies.     

Developing Policy in the Face of Scientific Uncertainty: Interpreting 0.3 μT or 0.4 μT Cutpoints from EMF Epidemiologic Studies

There has been considerable scientific effort to understand the potential link between exposures to power-frequency electric and magnetic fields (EMF) and the occurrence of cancer and other diseases. The combination of widespread exposures, established biological effects from acute, high-level exposures, and the possibility of leukemia in children from low-level, chronic exposures has made it both necessary and difficult to develop consistent public health policies. In this article we review the basis of both numeric standards and precautionary-based approaches. While we believe that policies regarding EMF should indeed be precautionary, this does not require or imply adoption of numeric exposure standards. We argue that cutpoints from epidemiologic studies, which are arbitrarily chosen, should not be used as the basis for making exposure limits due to a number of uncertainties. Establishment of arbitrary numeric exposure limits undermines the value of both the science-based numeric EMF exposure standards for acute exposures and precautionary approaches. The World Health Organization's draft Precautionary Framework provides guidance for establishing appropriate public health policies for power-frequency EMF.