Mobile Phone Use, Brain Tumor Risk and Public Health Policyand Public Health Policy

J l M M k i Ph D DiJoel M. Moskowitz, Ph.D., Director

Center for Family and CommunitySchool of Public HealthSchool of Public Health

University of California, Berkeley

The Commonwealth ClubThe Commonwealth ClubNovember 18, 2010

Discussion/Action Item 1h CEAC April 7, 2011

Overview

• Review studies of mobile phone use and tumor risktumor risk

• Results of 2010 Interphone Study paper• Trends in cell phone use in U.S.• Public health policy optionsp y p

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

Meta-analysis: study selection

• One cohort studyOne cohort study – No association between cell phone use and

brain tumor riskbrain tumor risk– Weak study

23 case control studies• 23 case-control studies – 37,916 participants—12,344 patient cases &

25 572 t l25,572 controls

Meta-analysis: case-control study

• What is a case-control study?y– Compare “cases” to matched “controls.”– Determine if characteristics differ between 2 groups.– “Exposure” is mobile phone use– 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(Odds of having tumor for people not using phones)

– OR interpreted as Relative Risk• < 1 = reduced risk 1 = no risk > 1 = increased risk• < 1 = reduced risk, 1 = no risk, > 1 = increased risk

Meta-analysis: overall tumor risk

• Overall no association between• Overall no association between mobile phone use & tumor risk

(OR 0 98 23 t di )(OR = 0.98; n = 23 studies)

– High research quality–increased tumor risk- govt. or foundation-funded (OR=1.17; n = 8)g ( )

- Low research quality–reduced tumor risk- mostly industry-funded (OR = 0.85; n=15)

Meta-analysis: brain tumor risk for 10+ years mobile phone use10+ years mobile phone use

• Overall increased brain tumor risk• Overall increased brain tumor risk (OR = 1.24; n = 8)

- High quality – increased risk; Hardell g q y ;(OR = 1.54; n = 4)

- Low quality – no risk; InterphoneLow quality no risk; Interphone (OR =1.00; n = 4)

Meta-analysis: lessons learned

• Know • Don’t Know?– Increased brain tumor

risk for 10+ years– Results vary

– Longer durations– Heavier use

Children & teens– Results vary• Research quality• Research group

– Children & teens– 2005 and beyond– Other tumors & health

– 1994–2004Other tumors & health risks

Interphone study

13 ti t l t d• 13 nation case-control study – funded by World Health Org. & Industry ($25 million)

• 2010 - overall results for 2 brain tumors reported2010 overall results for 2 brain tumors reported– meningioma (n = 2,409) and glioma (n = 2,708)– 2000-2004 - data collected

lif ti ll h < 100 h– average lifetime cell phone use < 100 hours• Numerous shortcomings bias

– Reduce estimates of tumor risk

Interphone study: results• Meningioma Risk • Glioma Risk

– Any regular use --reduced risk

– Any regular use --reduced riskreduced risk

– After bias correction no 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)correction (OR 1.82)– Dose-response relationship

w/ more years of use• after bias correction• after bias correction

10-yr risk (OR=2.18)

Tumor risk for 10+ yrs. cell phone use by study group & tumor typeuse by study group & tumor type

3

2

3

Relative ??

1

Relative Risk

of Tumor InterphoneHardell

??

0Acoustic Meningioma Glioma

Hardell?Neuroma

Tumor Type

Relative Risk: < 1 = protective, 1 = no risk, > 1 = harmful

Interphone results from Appendix 2 Table (corrects for bias)

Mobile Phone Use in U.S.

1985 --203,000

U.S. government position

U S Food and Drug Administration May 2010U.S. Food and Drug Administration, May 2010

Public health policy options• U.S. govt. position

– Cell phones meet safety standardsCell phones meet safety standards– Wait for conclusive evidence– Invest in minimal research funding

• Our position– Precautionary principley p p

• Harm reduction approach• Safe use recommendations• Precautionary health warningsy g• Update safety standards

– Call for major government research funding initiativeg

Precautionary Principle

Policy: Precautionary warnings

HP1207, LD 1706, 124th Maine State Legislature, 2009-2010An Act To Create the Children's Wireless Protection Act

Policy: independent research

Contact information

Joel M. Moskowitz, Ph.D., Director

Center for Family and CommunityCenter for Family and CommunitySchool of Public Health

University of California, Berkeley

jmm@berkeley.edu

A CDC Center for Health PromotionA CDC Center for Health Promotion and Disease Prevention Research