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REVIEW
published: 13 August 2019
doi: 10.3389/fpubh.2019.00223
Frontiers in Public Health | www.frontiersin.org 1August 2019 | Volume 7 | Article 223
Edited by:
Dariusz Leszczynski,
University of Helsinki, Finland
Reviewed by:
Lorenzo Manti,
University of Naples Federico II, Italy
Sareesh Naduvil Narayanan,
Ras al-Khaimah Medical and Health
Sciences University,
United Arab Emirates
*Correspondence:
Anthony B. Miller
ab.miller@utoronto.ca
Specialty section:
This article was submitted to
Radiation and Health,
a section of the journal
Frontiers in Public Health
Received: 10 April 2019
Accepted: 25 July 2019
Published: 13 August 2019
Citation:
Miller AB, Sears ME, Morgan LL,
Davis DL, Hardell L, Oremus M and
Soskolne CL (2019) Risks to Health
and Well-Being From
Radio-Frequency Radiation Emitted by
Cell Phones and Other Wireless
Devices. Front. Public Health 7:223.
doi: 10.3389/fpubh.2019.00223
Risks to Health and Well-Being From
Radio-Frequency Radiation Emitted
by Cell Phones and Other Wireless
Devices
Anthony B. Miller 1
*, Margaret E. Sears 2, L. Lloyd Morgan 3, Devra L. Davis 3,
Lennart Hardell 4, Mark Oremus 5and Colin L. Soskolne 6,7
1Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, 2Ottawa Hospital Research Institute,
Prevent Cancer Now, Ottawa, ON, Canada, 3Environmental Health Trust, Teton Village, WY, United States, 4The Environment
and Cancer Research Foundation, Örebro, Sweden, 5School of Public Health and Health Systems, University of Waterloo,
Waterloo, ON, Canada, 6School of Public Health, University of Alberta, Edmonton, AB, Canada, 7Health Research Institute,
University of Canberra, Canberra, ACT, Australia
Radiation exposure has long been a concern for the public, policy makers, and
health researchers. Beginning with radar during World War II, human exposure to
radio-frequency radiation1(RFR) technologies has grown substantially over time. In
2011, the International Agency for Research on Cancer (IARC) reviewed the published
literature and categorized RFR as a “possible” (Group 2B) human carcinogen. A broad
range of adverse human health effects associated with RFR have been reported
since the IARC review. In addition, three large-scale carcinogenicity studies in rodents
exposed to levels of RFR that mimic lifetime human exposures have shown significantly
increased rates of Schwannomas and malignant gliomas, as well as chromosomal DNA
damage. Of particular concern are the effects of RFR exposure on the developing
brain in children. Compared with an adult male, a cell phone held against the head
of a child exposes deeper brain structures to greater radiation doses per unit volume,
and the young, thin skull’s bone marrow absorbs a roughly 10-fold higher local dose.
Experimental and observational studies also suggest that men who keep cell phones
in their trouser pockets have significantly lower sperm counts and significantly impaired
sperm motility and morphology, including mitochondrial DNA damage. Based on the
accumulated evidence, we recommend that IARC re-evaluate its 2011 classification
of the human carcinogenicity of RFR, and that WHO complete a systematic review of
multiple other health effects such as sperm damage. In the interim, current knowledge
provides justification for governments, public health authorities, and physicians/allied
health professionals to warn the population that having a cell phone next to the body
is harmful, and to support measures to reduce all exposures to RFR.
Keywords: brain cancer, electromagnetic hypersensitivity, glioma, non-cancer outcomes, policy
recommendations, radiofrequency fields, child development, acoustic neuroma
1Per IEEE C95.1-1991, the radio-frequency radiation frequency range is from 3 kHz to 300 GHz and is non-ionizing.
Miller et al. Risks From Radiofrequency Radiation
INTRODUCTION
We live in a generation that relies heavily on technology. Whether
for personal use or work, wireless devices, such as cell phones,
are commonly used around the world, and exposure to radio-
frequency radiation (RFR) is widespread, including in public
spaces (1,2).
In this review, we address the current scientific evidence
on health risks from exposure to RFR, which is in the non-
ionizing frequency range. We focus here on human health effects,
but also note evidence that RFR can cause physiological and/or
morphological effects on bees, plants and trees (3–5).
We recognize a diversity of opinions on the potential adverse
effects of RFR exposure from cell or mobile phones and other
wireless transmitting devices (WTDs) including cordless phones
and Wi-Fi. The paradigmatic approach in cancer epidemiology,
which considers the body of epidemiological, toxicological,
and mechanistic/cellular evidence when assessing causality,
is applied.
CARCINOGENICITY
Since 1998, the International Commission on Non-Ionizing
Radiation Protection (ICNIRP) has maintained that no evidence
of adverse biological effects of RFR exist, other than tissue heating
at exposures above prescribed thresholds (6).
In contrast, in 2011, an expert working group of the
International Agency for Research on Cancer (IARC) categorized
RFR emitted by cell phones and other WTDs as a Group 2B
(“possible”) human carcinogen (7).
Since the IARC categorization, analyses of the large
international Interphone study, a series of studies by the Hardell
group in Sweden, and the French CERENAT case-control
studies, signal increased risks of brain tumors, particularly
with ipsilateral use (8). The largest case-control studies on cell
phone exposure and glioma and acoustic neuroma demonstrated
significantly elevated risks that tended to increase with increasing
latency, increasing cumulative duration of use, ipsilateral phone
use, and earlier age at first exposure (8).
Pooled analyses by the Hardell group that examined risk of
glioma and acoustic neuroma stratified by age at first exposure
to cell phones found the highest odds ratios among those first
exposed before age 20 years (9–11). For glioma, first use of cell
phones before age 20 years resulted in an odds ratio (OR) of 1.8
(95% confidence interval [CI] 1.2–2.8). For ipsilateral use, the
OR was 2.3 (CI 1.3-4.2); contralateral use was 1.9 (CI 0.9-3.7).
Use of cordless phone before age 20 yielded OR 2.3 (CI 1.4–3.9),
ipsilateral OR 3.1 (CI 1.6–6.3) and contralateral use OR 1.5 (CI
0.6–3.8) (9).
Although Karipidis et al. (12) and Nilsson et al. (13) found
no evidence of an increased incidence of gliomas in recent years
in Australia and Sweden, respectively, Karipidis et al. (12) only
reported on brain tumor data for ages 20–59 and Nilsson et al.
(13) failed to include data for high grade glioma. In contrast,
others have reported evidence that increases in specific types of
brain tumors seen in laboratory studies are occurring in Britain
and the US:
•The incidence of neuro-epithelial brain cancers has
significantly increased in all children, adolescent, and
young adult age groupings from birth to 24 years in the
United States (14,15).
•A sustained and statistically significant rise in glioblastoma
multiforme across all ages has been described in the UK (16).
The incidence of several brain tumors are increasing at
statistically significant rates, according to the 2010–2017 Central
Brain Tumor Registry of the U.S. (CBTRUS) dataset (17).
•There was a significant increase in incidence of
radiographically diagnosed tumors of the pituitary from
2006 to 2012 (APC =7.3% [95% CI: 4.1%, 10.5%]), with no
significant change in incidence from 2012 to 2015 (18).
•Meningioma rates have increased in all age groups from 15
through 85+years.
•Nerve sheath tumor (Schwannoma) rates have increased in all
age groups from age 20 through 84 years.
•Vestibular Schwannoma rates, as a percentage of nerve sheath
tumors, have also increased from 58% in 2004 to 95% in
2010-2014.
Epidemiological evidence was subsequently reviewed and
incorporated in a meta-analysis by Röösli et al. (19). They
concluded that overall, epidemiological evidence does not
suggest increased brain or salivary gland tumor risk with mobile
phone (MP) use, although the authors admitted that some
uncertainty remains regarding long latency periods (>15 years),
rare brain tumor subtypes, and MP usage during childhood. Of
concern is that these analyses included cohort studies with poor
exposure classification (20).
In epidemiological studies, recall bias can play a substantial
role in the attenuation of odds ratios toward the null hypothesis.
An analysis of data from one large multicenter case-control
study of RFR exposure, did not find that recall bias was
an issue (21). In another multi-country study it was found
that young people can recall phone use moderately well, with
recall depending on the amount of phone use and participants’
characteristics (22). With less rigorous querying of exposure,
prospective cohort studies are unfortunately vulnerable to
exposure misclassification and imprecision in identifying risk
from rare events, to the point that negative results from such
studies are misleading (8,23).
Another example of disparate results from studies of different
design focuses on prognosis for patients with gliomas, depending
upon cell phone use. A Swedish study on glioma found lower
survival in patients with glioblastoma associated with long term
use of wireless phones (24). Ollson et al. (25), however, reported
no indication of reduced survival among glioblastoma patients
in Denmark, Finland and Sweden with a history of mobile
phone use (ever regular use, time since start of regular use,
cumulative call time overall or in the last 12 months) relative to
no or non-regular use. Notably, Olsson et al. (25) differed from
Carlberg and Hardell (24) in that the study did not include use of
cordless phones, used shorter latency time and excluded patients
older than 69 years. Furthermore, a major shortcoming was that
patients with the worst prognosis were excluded, as in Finland
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Miller et al. Risks From Radiofrequency Radiation
inoperable cases were excluded, all of which would bias the risk
estimate toward unity.
In the interim, three large-scale toxicological (animal
carcinogenicity) studies support the human evidence, as do
modeling, cellular and DNA studies identifying vulnerable sub-
groups of the population.
The U.S. National Toxicology Program (NTP) (National
Toxicology Program (26,27) has reported significantly increased
incidence of glioma and malignant Schwannoma (mostly on the
nerves on the heart, but also additional organs) in large animal
carcinogenicity studies with exposure to levels of RFR that did
not significantly heat tissue. Multiple organs (e.g., brain, heart)
also had evidence of DNA damage. Although these findings have
been dismissed by the ICNIRP (28), one of the key originators of
the NTP study has refuted the criticisms (29).
A study by Italy’s Ramazzini Institute has evaluated lifespan
environmental exposure of rodents to RFR, as generated by 1.8
GHz GSM antennae of cell phone radio base stations. Although
the exposures were 60 to 6,000 times lower than those in the
NTP study, statistically significant increases in Schwannomas
of the heart in male rodents exposed to the highest dose, and
Schwann-cell hyperplasia in the heart in male and female rodents
were observed (30). A non-statistically significant increase in
malignant glial tumors in female rodents also was detected. These
findings with far field exposure to RFR are consistent with and
reinforce the results of the NTP study on near field exposure.
Both reported an increase in the incidence of tumors of the
brain and heart in RFR-exposed Sprague-Dawley rats, which are
tumors of the same histological type as those observed in some
epidemiological studies on cell phone users.
Further, in a 2015 animal carcinogenicity study, tumor
promotion by exposure of mice to RFR at levels below exposure
limits for humans was demonstrated (31). Co-carcinogenicity
of RFR was also demonstrated by Soffritti and Giuliani (32)
who examined both power-line frequency magnetic fields as
well as 1.8 GHz modulated RFR. They found that exposure to
Sinusoidal-50 Hz Magnetic Field (S-50 Hz MF) combined with
acute exposure to gamma radiation or to chronic administration
of formaldehyde in drinking water induced a significantly
increased incidence of malignant tumors in male and female
Sprague Dawley rats. In the same report, preliminary results
indicate higher incidence of malignant Schwannoma of the heart
after exposure to RFR in male rats. Given the ubiquity of many of
these co-carcinogens, this provides further evidence to support
the recommendation to reduce the public’s exposure to RFR to as
low as is reasonably achievable.
Finally, a case series highlights potential cancer risk from
cell phones carried close to the body. West et al. (33) reported
four “extraordinary” multifocal breast cancers that arose directly
under the antennae of the cell phones habitually carried within
the bra, on the sternal side of the breast (the opposite of
the norm). We note that case reports can point to major
unrecognized hazards and avenues for further investigation,
although they do not usually provide direct causal evidence.
In a study of four groups of men, of which one group did not
use mobile phones, it was found that DNA damage indicators in
hair follicle cells in the ear canal were higher in the RFR exposure
groups than in the control subjects. In addition, DNA damage
increased with the daily duration of exposure (34).
Many profess that RFR cannot be carcinogenic as it has
insufficient energy to cause direct DNA damage. In a review,
Vijayalaxmi and Prihoda (35) found some studies suggested
significantly increased damage in cells exposed to RF energy
compared to unexposed and/or sham-exposed control cells,
others did not. Unfortunately, however, in grading the evidence,
these authors failed to consider baseline DNA status or the fact
that genotoxicity has been poorly predicted using tissue culture
studies (36). As well funding, a strong source of bias in this field
of enquiry, was not considered (37).
CHILDREN AND REPRODUCTION
As a result of rapid growth rates and the greater vulnerability of
developing nervous systems, the long-term risks to children from
RFR exposure from cell phones and other WTDs are expected
to be greater than those to adults (38). By analogy with other
carcinogens, longer opportunities for exposure due to earlier use
of cell phones and other WTDs could be associated with greater
cancer risks in later life.
Modeling of energy absorption can be an indicator of potential
exposure to RFR. A study modeling the exposure of children 3–
14 years of age to RFR has indicated that a cell phone held against
the head of a child exposes deeper brain structures to roughly
double the radiation doses (including fluctuating electrical and
magnetic fields) per unit volume than in adults, and also that the
marrow in the young, thin skull absorbs a roughly 10-fold higher
local dose than in the skull of an adult male (39). Thus, pediatric
populations are among the most vulnerable to RFR exposure.
The increasing use of cell phones in children, which can be
regarded as a form of addictive behavior (40), has been shown
to be associated with emotional and behavioral disorders. Divan
et al. (41) studied 13,000 mothers and children and found that
prenatal exposure to cell phones was associated with behavioral
problems and hyperactivity in children. A subsequent Danish
study of 24,499 children found a 23% increased odds of emotional
and behavioral difficulties at age 11 years among children whose
mothers reported any cell phone use at age 7 years, compared to
children whose mothers reported no use at age 7 years (42). A
cross-sectional study of 4,524 US children aged 8–11 years from
20 study sites indicated that shorter screen time and longer sleep
periods independently improved child cognition, with maximum
benefits achieved with low screen time and age-appropriate
sleep times (43). Similarly, a cohort study of Swiss adolescents
suggested a potential adverse effect of RFR on cognitive functions
that involve brain regions mostly exposed during mobile phone
use (44). Sage and Burgio et al. (45) posit that epigenetic drivers
and DNA damage underlie adverse effects of wireless devices on
childhood development.
RFR exposure occurs in the context of other exposures, both
beneficial (e.g., nutrition) and adverse (e.g., toxicants or stress).
Two studies identified that RFR potentiated adverse effects of
lead on neurodevelopment, with higher maternal use of mobile
phones during pregnancy [1,198 mother-child pairs, (46)] and
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Attention Deficit Hyper-activity Disorder (ADHD) with higher
cell phone use and higher blood lead levels, in 2,422 elementary
school children (47).
A study of Mobile Phone Base Station Tower settings adjacent
to school buildings has found that high exposure of male students
to RFR from these towers was associated with delayed fine and
gross motor skills, spatial working memory, and attention in
adolescent students, compared with students who were exposed
to low RFR (48). A recent prospective cohort study showed
a potential adverse effect of RFR brain dose on adolescents’
cognitive functions including spatial memory that involve brain
regions exposed during cell phone use (44).
In a review, Pall (49) concluded that various non-thermal
microwave EMF exposures produce diverse neuropsychiatric
effects. Both animal research (50–52) and human studies of
brain imaging research (53–56) indicate potential roles of RFR
in these outcomes.
Male fertility has been addressed in cross-sectional studies
in men. Associations between keeping cell phones in trouser
pockets and lower sperm quantity and quality have been reported
(57). Both in vivo and in vitro studies with human sperm
confirm adverse effects of RFR on the testicular proteome and
other indicators of male reproductive health (57,58), including
infertility (59). Rago et al. (60) found significantly altered sperm
DNA fragmentation in subjects who use mobile phones for
more than 4 h/day and in particular those who place the device
in the trousers pocket. In a cohort study, Zhang et al. (61)
found that cell phone use may negatively affect sperm quality
in men by decreasing the semen volume, sperm concentration,
or sperm count, thus impairing male fertility. Gautam et al. (62)
studied the effect of 3G (1.8–2.5 GHz) mobile phone radiation
on the reproductive system of male Wistar rats. They found
that exposure to mobile phone radiation induces oxidative stress
in the rats which may lead to alteration in sperm parameters
affecting their fertility.
RELATED OBSERVATIONS, IMPLICATIONS
AND STRENGTHS OF CURRENT
EVIDENCE
An extensive review of numerous published studies confirms
non-thermally induced biological effects or damage (e.g.,
oxidative stress, damaged DNA, gene and protein expression,
breakdown of the blood-brain barrier) from exposure to RFR
(63), as well as adverse (chronic) health effects from long-
term exposure (64). Biological effects of typical population
exposures to RFR are largely attributed to fluctuating electrical
and magnetic fields (65–67).
Indeed, an increasing number of people have developed
constellations of symptoms attributed to exposure to RFR (e.g.,
headaches, fatigue, appetite loss, insomnia), a syndrome termed
Microwave Sickness or Electro-Hyper-Sensitivity (EHS) (68–70).
Causal inference is supported by consistency between
epidemiological studies of the effects of RFR on induction of
human cancer, especially glioma and vestibular Schwannomas,
and evidence from animal studies (8). The combined weight
of the evidence linking RFR to public health risks includes
a broad array of findings: experimental biological evidence of
non-thermal effects of RFR; concordance of evidence regarding
carcinogenicity of RFR; human evidence of male reproductive
damage; human and animal evidence of developmental harms;
and limited human and animal evidence of potentiation of effects
from chemical toxicants. Thus, diverse, independent evidence
of a potentially troubling and escalating problem warrants
policy intervention.
CHALLENGES TO RESEARCH, FROM
RAPID TECHNOLOGICAL ADVANCES
Advances in RFR-related technologies have been and continue
to be rapid. Changes in carrier frequencies and the growing
complexity of modulation technologies can quickly render
“yesterdays” technologies obsolete. This rapid obsolescence
restricts the amount of data on human RFR exposure to
particular frequencies, modulations and related health outcomes
that can be collected during the lifespan of the technology
in question.
Epidemiological studies with adequate statistical power must
be based upon large numbers of participants with sufficient
latency and intensity of exposure to specific technologies.
Therefore, a lack of epidemiological evidence does not necessarily
indicate an absence of effect, but rather an inability to
study an exposure for the length of time necessary, with an
adequate sample size and unexposed comparators, to draw
clear conclusions. For example, no case-control study has been
published on fourth generation (4G; 2–8 GHz) Long-term
Evolution (LTE) modulation, even though the modulation was
introduced in 2010 and achieved a 39% market share worldwide
by 2018 (71).
With this absence of human evidence, governments must
require large-scale animal studies (or other appropriate studies
of indicators of carcinogenicity and other adverse health effects)
to determine whether the newest modulation technologies incur
risks, prior to release into the marketplace. Governments should
also investigate short-term impacts such as insomnia, memory,
reaction time, hearing and vision, especially those that can occur
in children and adolescents, whose use of wireless devices has
grown exponentially within the past few years.
The Telecom industry’s fifth generation (5G) wireless
service will require the placement of many times more small
antennae/cell towers close to all recipients of the service,
because solid structures, rain and foliage block the associated
millimeter wave RFR (72). Frequency bands for 5G are separated
into two different frequency ranges. Frequency Range 1 (FR1)
includes sub-6 GHz frequency bands, some of which are bands
traditionally used by previous standards, but has been extended
to cover potential new spectrum offerings from 410 to 7,125
MHz. Frequency Range 2 (FR2) includes higher frequency
bands from 24.25 to 52.6 GHz. Bands in FR2 are largely of
millimeter wave length, these have a shorter range but a higher
available bandwidth than bands in the FR1. 5G technology is
being developed as it is also being deployed, with large arrays
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Miller et al. Risks From Radiofrequency Radiation
of directional, steerable, beam-forming antennae, operating at
higher power than previous technologies. 5G is not stand-alone—
it will operate and interface with other (including 3G and 4G)
frequencies and modulations to enable diverse devices under
continual development for the “internet of things,” driverless
vehicles and more (72).
Novel 5G technology is being rolled out in several
densely populated cities, although potential chronic health
or environmental impacts have not been evaluated and are
not being followed. Higher frequency (shorter wavelength)
radiation associated with 5G does not penetrate the body as
deeply as frequencies from older technologies although its
effects may be systemic (73,74). The range and magnitude
of potential impacts of 5G technologies are under-researched,
although important biological outcomes have been reported with
millimeter wavelength exposure. These include oxidative stress
and altered gene expression, effects on skin and systemic effects
such as on immune function (74). In vivo studies reporting
resonance with human sweat ducts (73), acceleration of bacterial
and viral replication, and other endpoints indicate the potential
for novel as well as more commonly recognized biological
impacts from this range of frequencies, and highlight the need
for research before population-wide continuous exposures.
GAPS IN APPLYING CURRENT EVIDENCE
Current exposure limits are based on an assumption that the
only adverse health effect from RFR is heating from short-term
(acute), time-averaged exposures (75). Unfortunately, in some
countries, notably the US, scientific evidence of the potential
hazards of RFR has been largely dismissed (76). Findings of
carcinogenicity, infertility and cell damage occurring at daily
exposure levels—within current limits—indicate that existing
exposure standards are not sufficiently protective of public
health. Evidence of carcinogenicity alone, such as that from
the NTP study, should be sufficient to recognize that current
exposure limits are inadequate.
Public health authorities in many jurisdictions have not yet
incorporated the latest science from the U.S. NTP or other
groups. Many cite 28-year old guidelines by the Institute of
Electrical and Electronic Engineers which claimed that “Research
on the effects of chronic exposure and speculations on the
biological significance of non-thermal interactions have not
yet resulted in any meaningful basis for alteration of the
standard” (77)2.
Conversely, some authorities have taken specific actions to
reduce exposure to their citizens (78), including testing and
recalling phones that exceed current exposure limits.
While we do not know how risks to individuals from using cell
phones may be offset by the benefits to public health of being able
to summon timely health, fire and police emergency services, the
findings reported above underscore the importance of evaluating
potential adverse health effects from RFR exposure, and taking
pragmatic, practical actions to minimize exposure.
2The FCC adopted the IEEE C95.1 1991 standard in 1996.
We propose the following considerations to address gaps in
the current body of evidence:
•As many claim that we should by now be seeing an increase in
the incidence of brain tumors if RFR causes them, ignoring
the increases in brain tumors summarized above, a detailed
evaluation of age-specific, location-specific trends in the
incidence of gliomas in many countries is warranted.
•Studies should be designed to yield the strongest evidence,
most efficiently:
➢Population-based case-control designs can be more
statistically powerful to determine relationships with rare
outcomes such as glioma, than cohort studies. Such studies
should explore the relationship between energy absorption
(SAR3), duration of exposure, and adverse outcomes,
especially brain cancer, cardiomyopathies and abnormal
cardiac rythms, hematologic malignancies, thyroid cancer.
➢Cohort studies are inefficient in the study of rare outcomes
with long latencies, such as glioma, because of cost-
considerations relating to the follow-up required of very
large cohorts needed for the study of rare outcomes. In
addition, without continual resource-consuming follow-
up at frequent intervals, it is not possible to ascertain
ongoing information about changing technologies, uses
(e.g., phoning vs. texting or accessing the Internet)
and/or exposures.
➢Cross-sectional studies comparing high-, medium-, and
low-exposure persons may yield hypothesis-generating
information about a range of outcomes relating to
memory, vision, hearing, reaction-time, pain, fertility, and
sleep patterns.
•Exposure assessment is poor in this field, with very little fine-
grained detail as to frequencies and modulations, doses and
dose rates, and peak exposures, particularly over the long-
term. Solutions such as wearable meters and phone apps have
not yet been incorporated in large-scale research.
•Systematic reviews on the topic could use existing databases
of research reports, such as the one created by Oceania
Radiofrequency Science Advisory Association (79) or EMF
Portal (80), to facilitate literature searches.
•Studies should be conducted to determine appropriate
locations for installation of antennae and other broadcasting
systems; these studies should include examination of
biomarkers of inflammation, genotoxicity, and other health
indicators in persons who live at different radiuses around
these installations. This is difficult to study in the general
population because many people’s greatest exposure arises
from their personal devices.
•Further work should be undertaken to determine the
distance that wireless technology antennae should be kept
away from humans to ensure acceptable levels of safety,
distinguishing among a broad range of sources (e.g., from
commercial transmitters to Bluetooth devices), recognizing
that exposures fall with the inverse of the square of the distance
3When necessary, SAR values should be adjusted for age of child in W/kg.
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Miller et al. Risks From Radiofrequency Radiation
(The inverse-square law specifies that intensity is inversely
proportional to the square of the distance from the source of
radiation). The effective radiated power from cell towers needs
to be regularly measured and monitored.
POLICY RECOMMENDATIONS BASED ON
THE EVIDENCE TO DATE
At the time of writing, a total of 32 countries or governmental
bodies within these countries4have issued policies and health
recommendations concerning exposure to RFR (78). Three U.S.
states have issued advisories to limit exposure to RFR (81–83)
and the Worcester Massachusetts Public Schools (84) voted to post
precautionary guidelines on Wi-Fi radiation on its website. In
France, Wi-Fi has been removed from pre-schools and ordered to
be shut off in elementary schools when not in use, and children
aged 16 years or under are banned from bringing cell phones
to school (85). Because the national test agency found 9 out of
10 phones exceeded permissible radiation limits, France is also
recalling several million phones.
We therefore recommend the following:
1. Governmental and institutional support of data collection and
analysis to monitor potential links between RFR associated
with wireless technology and cancers, sperm, the heart,
the nervous system, sleep, vision and hearing, and effects
on children.
2. Further dissemination of information regarding potential
health risk information that is in wireless devices and manuals
is necessary to respect users’ Right To Know. Cautionary
statements and protective measures should be posted on
packaging and at points of sale. Governments should follow
the practice of France, Israel and Belgium and mandate
labeling, as for tobacco and alcohol.
3. Regulations should require that any WTD that could be used
or carried directly against the skin (e.g., a cell phone) or in
close proximity (e.g., a device being used on the lap of a
small child) be tested appropriately as used, and that this
information be prominently displayed at point of sale, on
packaging, and both on the exterior and within the device.
4. IARC should convene a new working group to update the
categorization of RFR, including current scientific findings
4Argentina, Australia, Austria, Belgium, Canada, Chile, Cyprus, Denmark,
European Environmental Agency, European Parliament, Finland, France, French
Polynesia, Germany, Greece, Italy, India, Ireland, Israel, Namibia, New Zealand,
Poland, Romania, Russia, Singapore, Spain, Switzerland, Taiwan, Tanzania,
Turkey, United Kingdom, United States.
that highlight, in particular, risks to youngsters of subsequent
cancers. We note that an IARC Advisory Group has recently
recommended that RFR should be re-evaluated by the IARC
Monographs program with high priority.
5. The World Health Organization (WHO) should complete
its long-standing RFR systematic review project, using
strong modern scientific methods. National and regional
public health authorities similarly need to update their
understanding and to provide adequate precautionary
guidance for the public to minimize potential health risks.
6. Emerging human evidence is confirming animal evidence
of developmental problems with RFR exposure during
pregnancy. RFR sources should be avoided and distanced
from expectant mothers, as recommended by physicians and
scientists (babysafeproject.org).
7. Other countries should follow France, limiting RFR exposure
in children under 16 years of age.
8. Cell towers should be distanced from homes, daycare centers,
schools, and places frequented by pregnant women, men who
wish to father healthy children, and the young.
Specific examples of how the health policy recommendations
above, invoking the Precautionary Principle, might be practically
applied to protect public health, are provided in the Annex.
AUTHOR CONTRIBUTIONS
All authors listed have made a substantial, direct and intellectual
contribution to the work, and approved it for publication.
ACKNOWLEDGMENTS
The authors acknowledge the contributions of Mr. Ali Siddiqui in
drafting the Policy Recommendations, and those from members
of the Board of the International Network for Epidemiology in
Policy (INEP) into previous iterations of this manuscript. We
are grateful to external reviewers for their thoughtful critiques
that have served to improve both accuracy and presentation.This
manuscript was initially developed by the authors as a draft of a
Position Statement of INEP. The opportunity was then provided
to INEP’s 23 member organizations to endorse what the INEP
Board had recommended, but 12 of those member organizations
elected not to vote. Of the 11 that did vote, three endorsed the
statement, two voted against it, and six abstained. Ultimately, the
Board voted to abandon its involvement with what it determined
to be a divisive topic. The authors then decided that, in the
public interest, the document should be published independent
of INEP.
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Conflict of Interest Statement: The authors declare that this manuscript was
drafted in the absence of any commercial or financial relationships that could be
construed as a potential conflict of interest, although subsequent to its preparation,
DD became a consultant to legal counsel representing persons with glioma
attributed to radiation from cell phones.
Copyright © 2019 Miller, Sears, Morgan, Davis, Hardell, Oremus and
Soskolne. This is an open-access article distributed under the terms of the
Creative Commons Attribution License (CC BY). The use, distribution or
reproduction in other forums is permitted, provided the original author(s)
and the copyright owner(s) are credited and that the original publication in
this journal is cited, in accordance with accepted academic practice. No use,
distribution or reproduction is permitted which does not comply with these
terms.
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Miller et al. Risks From Radiofrequency Radiation
ANNEX: EXAMPLES OF ACTIONS FOR
REDUCING RFR EXPOSURE
1. Focus actions for reducing exposure to RFR on pregnant
women, infants, children and adolescents, as well as males who
might wish to become fathers.
2. Reduce, as much as possible, the extent to which infants
and young children are exposed to RFR from Wi-Fi-enabled
devices such as baby monitors, wearable devices, cell phones,
tablets, etc.
3. Avoid placing cell towers and small cell antennae close to
schools and homes pending further research and revision
of the existing exposure limits. In schools, homes and
the workplace, cable or optical fiber connections to the
Internet are preferred. Wi-Fi routers in schools and
daycares/kindergartens should be strongly discouraged
and programs instituted to provide Internet access via cable
or fiber.
4. Ensure that WTDs minimize radiation by transmitting
only when necessary, and as infrequently as is feasible.
Examples include transmitting only in response to a
signal (e.g., accessing a router or querying a device, a
cordless phone handset being turned on, or voice or
motion activation). Prominent, visible power switches are
needed to ensure that WTDs can be easily turned on
only when needed, and off when not required (e.g., Wi-Fi
when sleeping).
5. Lower permitted power densities in close proximity to fixed-
site antennae, from “occupational” limits to exposure limits
for the general public.
6. Update current exposure limits to be protective against the
non-thermal effects of RFR. Such action should be taken
by all heath ministries and public health agencies, as well
as industry regulatory bodies. Exposure limits should be
based on measurements of RFR levels related to biological
effects (2).
7. Ensure that advisories relating to cell phone use are placed in
such a way that purchasers can find them easily, similar to the
Berkeley Cell Phone “Right to Know” Ordinance (86).
8. Advise the public that texting and speaker mode are preferable
to holding cell phones to the ear. Alternatively, use hands-free
accessories for cell phones, including air tube headsets that
interrupt the transmission of RFR.
9. When possible, keep cell phones away from the body (e.g., on
a nearby desk, in a purse or bag, or on a mounted hands-free
accessory in motor vehicles).
10. Delay the widespread implementation of 5G (and any
other new technology) until studies can be conducted to
assess safety. This includes a wide range of household
and community-wide infrastructure WTDs and self-driving
vehicles, as well as the building of 5G minicells.
11. Fiber-optic connections for the Internet should be made
available to every home, office, school, warehouse and factory,
when and where possible.
GLOSSARY
ALARA As Low a level As Reasonably Achievable
CBTRUS Central Brain Tumor Registry of the United States
CI Confidence Interval
EMR Electro Magnetic Radiation
IARC International Agency for Research on Cancer
ICNIRP International Commission on Non-Ionizing
Radiation Protection
INEP International Network for Epidemiology in Policy
LTE Long-Term Evolution modulation
NTP U.S. National Toxicology Program
OR Odds Ratio
RFR Radio-Frequency Radiation
SAR Specific Absorption Rate
WTD Wireless Transmitting Device
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