And Now … Tinnitus
Users of cell phones have another reason to be cautious. An Austrian team has found that the risk of developing tinnitus, a ringing in the ears, doubled after four years. This is one of the first epidemiological studies to investigate the long-term effects of mobile phones on hearing.
Hans-Peter Hutter of the Institute of Environmental Health at the Medical University of Vienna, and coworkers report that the observed association is "unlikely" to be spurious and could have important implications for public health. Their new epidemiological study, based on 100 cases and 100 controls, will appear in an upcoming issue of Occupational and Environmental Medicine.
The "possible association of mobile phone use and tinnitus is plausible," according to Hutter, "because the cochlea [the inner ear] and the auditory pathway are located in an anatomical region where a considerable amount of the power emitted by mobile phones is absorbed." The risk of tinnitus was greatest on the side of the head the phone was used. The doubling of the incidence after long-term use is of borderline statistical significance. Hutter also raises the possibility that other factors may be responsible: For instance, blood flow near the ear could be affected when the user is in a constrained posture while on the phone.
Two large European research projects, GUARD and EMFnEAR, have investigated the possible impact of cell phones on human hearing. But both have focused on short-term exposures —mostly for just 10 or 20 minutes— and have generally found no effects (see, for example, a recent paper in Radiation Research.) These two projects cost a total of $3-4 million.
Michael Kundi, thancer (IARC) has recruited Joachim Schüz to lead its Section on Environment. Among his duties in Lyon, Schüz will supervise the still-unfinished work of the Interphone project. He will also play an advisory role in next year's IARC review of the possible cancer risks associated with RF radiation. Schüz, who begins at the agency on August 2, will report to Christopher Wild, the director of IARC.
The appointment signals a calculated gamble for IARC and for Wild, at least with respect to making further progress on Interphone. The $25 million, 13-country project has tarnished the agency's reputation as factions within Interphone have battled for years over whether cell phones present a cancer risk. Now, immediately following the release of the Interphone paper on brain tumors, Wild has picked Schüz, a well-known member of the project's no-risk camp, to bring the feuding parties together. Schüz must begin by forging a consensus on the equally contentious question of whether mobile phones can lead to a second type of tumor, acoustic neuroma. And he has to do so on a tight schedule.
Schüz, a prolific epidemiologist, has worked with both the German and Danish Interphone study groups. While at the University of Mainz, he led the German team, which published its first Interphone paper on brain tumor risks more than four years ago: Schüz himself reported that long-term users had more than twice the rate of brain tumors, but that the increase was not statistically significant (see "Is There a Ten-Year Latency for Cell Phone Tumor Development?" Jan'06). In 2005, he moved to the Danish Cancer Society in Copenhagen, where he has collaborated with Christoffer Johansen on the Danish analyses. Schüz is currently the head of the department of biostatistics and epidemiology at the society's Institute of Cancer Epidemiology. (See also Schüz's full CV.)
When Christopher Wild took over as the head of IARC in January 2009, he sought to break the deadlock over Interphone. Wild picked Schüz to join him on a three-member panel to redraft the Interphone brain tumor paper. Schüz represented the skeptics — also known as the ICNIRP contingent, which includes Sweden's Maria Feychting and the U.K.'s Tony Swerdlow. Rounding out the panel was Australia's Bruce Armstrong, who along with Elisabeth Cardis and Israel's Siegal Sadetzki, is seen as more open to the idea that there might be a long-term tumor risk (see Armstrong's lecture: "Cell Phone Link to Tumors? — 'We Don't Know'," Mar'09).
Interphone will move forward, Schüz told Microwave News. "The mandate is to finish all the work —the sooner, the better," he said. Wild is helping to meet that goal. Wild has recently allocated funds so that data analyses can continue at the agency's headquarters in Lyon, according to Nicolas Gaudin, the head of communications at IARC.
Elisabeth Cardis will continue as the head of the overall Interphone project, Schüz said. Cardis, the former chief of IARC's radiation group, led Interphone from its very beginnings in the late 1990s. She left the agency two years ago to join the Centre for Research in Environmental Epidemiology (CREAL) in Barcelona.
Completing the Interphone paper on acoustic neuroma is the top priority, according to Schüz: "The results for acoustic neuroma are the most urgent on our list." Asked about the current status of that work, he replied, "The analysis is still in progress." Schüz conceded that a paper has not yet been drafted.
The results on acoustic neuroma would no doubt play an important role at the IARC RF review, scheduled for May 24-31, 2011 —if they are finished in time. The cancer monograph finalized at that meeting will likely be the last word on RF radiation tumor risks for the foreseeable future. Vincent Cogliano, the head of IARC's Monograph Program, told Microwave News that due to "intense interest among national health agencies and among the general public," the review would not be delayed to wait for any further Interphone results. "We hope that this deadline —more than 11 months in the future— will encourage investigators to swiftly complete and publish their analyses of the data they have already collected," he said.
But the Interphone study team seems unlikely to meet the deadline. The brain tumor paper was finally published last month after four years of wrangling (see "Interphone Points to Long-Term Brain Tumor Risks; Interpretation Under Dispute," May'10). The acoustic neuroma paper promises to be just as controversial. The pooled data from five Northern European Interphone groups —as well as a separate study from Lennart Hardell's team in Sweden— have linked acoustic neuromas to long-term cell phone use. But here too, as with the brain tumor results, the no-risk faction within Interphone sees these results as unreliable.
Other Interphone work that still must be completed is the analysis of the parotid gland tumor data, as well as an investigation of the location of the tumors relative to the radiation plume of the phones. Using such already-collected Interphone data would be the quickest way to resolve some of the uncertainties about the tumor risks, according to Joe Bowman of the U.S. National Institute for Occupational Safety and Health (NIOSH), who helped the Interphone team assess radiation exposures. "Analyses of these other Interphone data should help clarify whether the reported increases in cancer risks are due to the phone's radiation or resulted from the study's design weaknesses," Bowman noted in a "Questions & Answers on Interphone," prepared with NIOSH's Robert Park. (In addition, no one has yet looked at what role the use of DECT, and other cordless phones, and the use of hands-free kits, may have played.)
Schüz on Long-Term Tumor Risks: “Very Unlikely”
In a wide-ranging interview, Schüz said that the Interphone study group had learned more about epidemiological methods than about cell phone tumor risks. "The entire association [seen in Interphone] can be explained by bias — There are a lot of competing biases," he said. "If there were a stronger effect, we would have seen it." Schüz believes that a doubling of the risk following 10-15 year of cell phone use is "very unlikely."
Schüz said that his outlook on long-term risk is largely based, not on Interphone, but on his and Johansen's Danish cohort studies and especially on their more recent analysis of the incidence of brain tumors in the Nordic countries, published late last year. Neither points to an increase in brain tumors among the general population.
Others, such as Michael Kundi of the Medical University of Vienna, argue that, it is still far too early to be able to detect any increase in national statistics that could be linked to the use of mobile phones. Even under "extreme assumptions," it would not be possible "to find an increased risk at the population level," Kundi told Microwave News. (See also "Spin, Spin, Spin," Dec'09.)
When asked whether he can heal the fractures within the Interphone group, Schüz replied that, "It's not unusual in science for there to be differences in opinions." He added: "At the end, all of the 17 principal investigators signed off on the [brain tumor] paper. A lot of work was done. We should look forward not backward." Armstrong, his colleague on Wild's three-member panel, told Microwave News that he has "great respect" for Schüz. "His motivation throughout was to get the science right."
Convincing members of the EMF activist community that he will serve as an impartial broker at IARC will be more difficult. Many of them see Schüz as too willing to discount possible risks. "Schüz does his best to serve industry," said Lothar Geppert of Diagnose Funk in Zurich.
According to his "declaration of interests", submitted to the EC last year, Schüz has received industry funding under a six-year contract with the Electric Power Research Institute (EPRI) for studies on childhood leukemia. He also received support from the mobile phone industry through the Interphone and COSMOS projects. In addition, Schüz has consulted for Wissenschaftlicher Beirat Funk (WBF), an Austrian mobile phone advisory group that has received funding from telecom companies.
When he joins IARC this summer, Schüz will become one of the most prominent EMF researchers in the international cancer establishment. He has been working in the field his entire professional career. Schüz wrote his doctoral thesis on the link between childhood leukemia and power-frequency EMFs at the University of Mainz in the mid-1990s. ("I am pretty sure that bias does not explain the association," he said recently; see also MWN, J/A97, p.10.) And Schüz has just been elected president of the Bioelectromagnetics Society (BEMS). A formal announcement will be made at the BEMS annual meeting in Seoul next week.
Schüz is a member of the EC's Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR). He is also a member of two ongoing research projects on the brain tumor risks associated with mobile phones: COSMOS and CEFALO. Schüz said that he would continue with CEFALO since it is drawing to a close, but that he would step down from COSMOS, which is still in its very early stages.
IARC's environment section has two groups, one on radiation and the other on lifestyle and cancer. Ausrele Kesminiene, the current leader of the radiation group, will stay on, reporting to Schüz. Kesminiene's research has focused on ionizing radiation, specifically on the effects of the meltdown of the Chernobyl nuclear reactor in 1986. Schüz himself will head the lifestyle group (see IARC's organizational chart).