The objective of this preliminary study was to derive an estimate of acoustic neuroma risk by combining data from several case control epidemiological studies. The review will be extended for another year and its results will be used to plan a prospective study for Brunei.

            The key words cell phone and neuroma were used to retrieve articles using pubmed. Only case control studies that are part of the INTERPHONE collaborative network were selected. Essential data from each article was abstracted after ascertaining quality, consistency, and comparability. The inverse variance meta analytic method was used compute a pooled odds ratio over several studies by summation of the odds ratios of individual studies each being weighted by the inverse of its variance. OR_p = ∑ w_i OR_{i /} ∑ w_i . The 95% Confidence Intervals were computed using the standard error  S(OR_p) = 1/ ∑ w_i. . Heterogeneity was tested using χ = ∑ w_i (OR_i - OR_p)² where w_i = 1/S_i² with all data log-transformed for the computations.

            There was no strong, consistent, and significant association between cell phone use and acoustic neuroma in the short term (less than 10 years of use). The data did however suggest increasing risk with long-term use, use of analog cell phones as compared to digital phones, and disease on the same side of the head as the cell phone is usually held.

            The data quality was high being collected under a uniform INTERPHONE protocol. Lack of detailed raw data prevented use of the Mantel-Haenszel method and sparsity of the data prevented using meta-analysis to control for confounding. Use of self-reported questionnaires has limitations in accurate measurement of the total duration of use, frequency of use every day, position in which the cell phone is used, type and power of the phone used. Accurate exposure information can be obtained from the billing records of cell phone subscriber companies which have detailed automated data on times of calls, duration of the calls, type of phone and strength of the radiation energy emitted. It is however doubtful that these companies will cooperate because of business self-interest.

Conclusion: The current analysis has not showed a strong, consistent, or conclusive evidence of a link between cell phone use and acoustic neuroma although the data suggests such a link. Definitive answers will be obtained from studies of longer-term cell phone use because cancer has a long induction period.

TABLE #1: SUMMARY OF THE STUDIES (TYPE OF PHONE NOT KNOWN)

TABLE #2: COMPUTATION OF THE COMBINED EFFECT ESTIMATE FOR SHORT-TERM EXPOSURES (TYPE OF PHONE NOT KNOWN)

Pooled OR =  exp {17.0989 / 44.9533 = 0.3804} = 1.4629

TABLE #3: COMPUTATION OF THE COMBINED EFFECT ESTIMATE FOR LONG-TERM EXPOSURES (TYPE OF PHONE NOT KNOWN)

Pooled OR = exp {3.1686 / 28.5403 = 0.1110} = 2.1980

TABLE #4: SUMMARY OF THE STUDIES (TYPE OF PHONE MENTIONED)

TABLE #5: COMPUTATION OF THE COMBINED EFFECT ESTIMATE FOR SHORT TERM EXPOSURE TO ANALOG PHONES

Pooled OR = exp [2.3049/2.0465] = 3.00

TABLE #6: COMPUTATION OF THE COMBINED EFFECT ESTIMATE FOR SHORT TERM EXPOSURE TO DIGITAL PHONES

Pooled OR = exp {1.3886/2.9962} = 1.6

TABLE #7: COMPUTATION OF THE COMBINED EFFECT ESTIMATE FOR LONG TERM EXPOSURE TO ANALOG PHONES

Pooled OR = exp {0.5365/0.3485} = 4.7

Σ

Takebayashi T, Akiba S, Kikuchi Y, Taki M, Wake K, Watanabe
                           S, Yamaguchi N. Mobile phone use and acoustic neuroma risk in Japan.Occup Environ Med. 2006 Dec;63(12):802-7. Epub 2006 Aug
                           15.Department of Preventive Medicine and Public Health, Keio University
                           School of Medicine, Tokyo, Japan. OBJECTIVES: The rapid increase of mobile phone use has increased public
                           concern about its possible health effects in Japan,
                           where the mobile phone system is unique in the characteristics of its signal transmission. To examine the relation between
                           mobile phone use and acoustic neuroma, a case-control study was initiated. METHODS: The study followed the common, core protocol
                           of the international collaborative study, INTERPHONE. A prospective case recruitment was done in Japan for 2000-04. One hundred and one acoustic neuroma cases, who were 30-69 years
                           of age and resided in the Tokyo area, and 339 age, sex, and residency matched controls were interviewed using a common computer
                           assisted personal interview system. Education and marital status adjusted odds ratio was calculated with a conditional logistic
                           regression analysis. RESULTS: Fifty one cases (52.6%) and 192 controls (58.2%) were regular mobile phone users on the reference
                           date, which was set as one year before the diagnosis, and no significant increase of acoustic neuroma risk was observed, with
                           the odds ratio (OR) being 0.73 (95% CI 0.43 to 1.23). No exposure related increase in the risk of acoustic neuroma was observed
                           when the cumulative length of use (<4 years, 4-8 years, >8 years) or cumulative call time (<300 hours, 300-900 hours,
                           >900 hours) was used as an exposure index. The OR was 1.09 (95% CI 0.58 to 2.06) when the reference date was set as five
                           years before the diagnosis. Further, laterality of mobile phone use was not associated with tumours. CONCLUSIONS: These results
                           suggest that there is no significant increase in the risk of acoustic neuroma in association with mobile phone use in Japan. PMID: 16912083 [PubMed - indexed for MEDLINE]

Schoemaker MJ, Swerdlow AJ, Ahlbom A, Auvinen A, Blaasaas KG, Cardis E, Christensen HC,
                           Feychting M, Hepworth SJ, Johansen C, Klaeboe L, Lonn S,McKinney PA, Muir K, Raitanen J, Salminen T, Thomsen J, Tynes T. Mobile
                           phone use and risk of acoustic neuroma: results of the Interphone case-control study in five North European countries. Section
                           of Epidemiology, Institute of Cancer Research,
                           Brookes Lawley Building,
                           Sutton, UK.
                           Br J Cancer. 2005 Oct 3;93(7):842-8.There is public concern that use of mobile phones could increase the risk of brain tumours.
                           If such an effect exists, acoustic neuroma would be of particular concern because of the proximity of the acoustic nerve to
                           the handset. We conducted, to a shared protocol, six population-based case-control studies in four Nordic countries and the
                           UK to assess the risk of acoustic neuroma
                           in relation to mobile phone use. Data were collected by personal interview from 678 cases of acoustic neuroma and 3553 controls.
                           The risk of acoustic neuroma in relation to regular mobile phone use in the pooled data set was not raised (odds ratio (OR)
                           = 0.9, 95% confidence interval (CI): 0.7-1.1). There was no association of risk with duration of use, lifetime cumulative
                           hours of use or number of calls, for phone use overall or for analogue or digital phones separately. Risk of a tumour on the
                           same side of the head as reported phone use was raised for use for 10 years or longer (OR = 1.8, 95% CI: 1.1-3.1). The study
                           suggests that there is no substantial risk of acoustic neuroma in the first decade after starting mobile phone use. However,
                           an increase in risk after longer term use or after a longer lag period could not be ruled out. PMID: 16136046 [PubMed - indexed
                           for MEDLINE]

Hardell L, Carlberg M, Hansson Mild K. Case-control study
                           on cellular and cordless telephones and the risk for acoustic neuroma or meningioma in patients diagnosed 2000-2003. Neuroepidemiology.
                           2005;25(3):120-8. Epub 2005 Jun 13.Department of Oncology, University Hospital, Orebro University, Sweden. lennart.hardell@orebroll.se We performed a case-control study on the use of cellular and cordless telephones
                           and the risk for brain tumors. We report the results for benign brain tumors with data from 413 cases (89% response rate),
                           305 with meningioma, 84 with acoustic neuroma, 24 with other types and 692 controls (84% response rate). For meningioma, analogue
                           phones yielded odds ratio (OR) = 1.7, 95% confidence

interval
                           (CI) = 0.97-3.0, increasing to OR = 2.1, 95% CI = 1.1-4.3 with a >10-year latency period. Also digital cellular phones
                           and cordless phones increased the risk to some extent. For acoustic neuroma, analogue phones gave OR = 4.2, 95% CI = 1.8-10
                           increasing to OR = 8.4, 95% CI = 1.6-45 with a >15-year latency period, but based on low numbers. Digital phones yielded
                           OR = 2.0, 95% CI = 1.05-3.8, whereas for cordless phones OR was not significantly increased. In the multivariate analysis,
                           analogue phones represented a significant risk factor for acoustic neuroma. Copyright 2005 S. Karger AG, Basel. PMID: 15956809 [PubMed - indexed for MEDLINE]

Lonn S, Ahlbom A, Hall P, Feychting M. Mobile phone use and the risk of
                           acoustic neuroma. Epidemiology. 2004 Nov;15(6):653-9. Institute of Environmental Medicine, Karolinska Institutet, S-171 77
                           Stockholm,

Sweden.
                           Stefan.Lonn@imm.ki.se BACKGROUND: Radiofrequency exposure from mobile phones is concentrated to the

tissue closest to the handset, which includes the auditory
                           nerve. If this type of exposure increases tumor risk, acoustic neuroma would be a potential concern. METHODS: In this population-based
                           case-control study we identified all cases age 20 to 69 years diagnosed with acoustic neuroma during 1999 to 2002 in certain

parts of Sweden.
                           Controls were randomly selected from the study base, stratified on age, sex, and residential area. Detailed information about
                           mobile phone use and other environmental exposures was collected from 148 (93%) cases and 604 (72%) controls. RESULTS: The
                           overall odds ratio for acoustic neuroma associated with regular mobile phone use was 1.0 (95% confidence interval = 0.6-1.5).
                           Ten years after the start of mobile phone use the estimates relative risk increased to 1.9 (0.9-4.1); when restricting to
                           tumors on the same side of the head as the phone was normally used, the relative risk was 3.9 (1.6-9.5). CONCLUSIONS: Our
                           findings do not indicate an increased risk of acoustic neuroma related to short-term mobile phone use after a short latency
                           period. However, our data suggest an increased risk of acoustic neuroma associated with mobile phone use of at least 10 years'
                           duration.PMID: 15475713 [PubMed - indexed for MEDLINE]

Hardell
                           L, Carlberg M, Hansson Mild K. Pooled analysis of two case-control studies on the use of cellular and cordless telephones
                           and the risk of benign brain tumours diagnosed during 1997-2003. Int J Oncol. 2006 Feb;28(2):509-18. Department of Oncology,
                           University Hospital, SE-701 85 Orebro, Sweden. lennart.hardell@orebroll.se The use of cellular and cordless telephones and the risk of brain tumours is of
                           concern since the brain is a high exposure area. We present the results of a pooled analysis of two case-control studies on
                           benign brain tumours diagnosed during 1997-2003 including answers from 1,254 (88%) cases and 2,162 (89%)controls aged 20-80
                           years. For acoustic neuroma, the use of analogue cellular phones gave an odds ratio (OR) of 2.9 and a 95% confidence interval
                           (CI) of 2.0-4.3; for digital cellular phones, OR=1.5; 95% CI=1.1-2.1; and for cordless telephones, OR=1.5, 95% CI=1.04-2.0.
                           The highest OR was found for analogue phones with a latency period of >15 years; OR=3.8, 95% CI=1.4-10. Regarding meningioma,
                           the results were as follows: for analogue phones, OR=1.3, 95% CI=0.99-1.7; for digital phones, OR=1.1, 95% CI=0.9-1.3; and
                           for cordless phones, OR=1.1, 95% CI=0.9-1.4. In the multivariate analysis, a significantly increased risk of acoustic neuroma
                           was found with the use of analogue phones. PMID: 16391807 [PubMed - indexed for MEDLINE]

------------

Hardell L, Mild KH, Carlberg M, Soderqvist F. Tumour
                           risk associated with use of cellular telephones or cordless desktop telephones.World J Surg Oncol. 2006 Oct 11;4:74.Department
                           of Oncology, University Hospital, SE-701 85 Orebro and Department of Natural Sciences, Orebro University, SE-701 82 Orebro,
                           Sweden. lennart.hardell@orebroll.se. ABSTRACT: BACKGROUND: The use of cellular and cordless telephones has increased
                           dramatically during the last decade. There is concern of health problems such as malignant diseases due to microwave exposure
                           during the use of these devices. The brain is the main target organ. METHODS: Since the second part of the 1990's we have
                           performed six case-control studies on this topic encompassing use of both cellular and cordless phones as well as other exposures.
                           Three of the studies concerned brain tumours, one salivary gland tumours, one non-Hodgkin lymphoma (NHL) and one testicular
                           cancer. Exposure was assessed by self-administered questionnaires. RESULTS: Regarding acoustic neuroma analogue cellular phones
                           yielded odds ratio (OR) = 2.9, 95 % confidence interval (CI) = 2.0-4.3, digital cellular phones OR = 1.5, 95 % CI = 1.1-2.1
                           and cordless phones OR = 1.5, 95 % CI = 1.04-2.0. The corresponding results were for astrocytoma grade III-IV OR = 1.7, 95
                           % CI = 1.3-2.3; OR = 1.5, 95 % CI = 1.2-1.9 and OR = 1.5, 95 % CI = 1.1-1.9, respectively. The ORs increased with latency
                           period with highest estimates using > 10 years time period from first use of these phone types. Lower ORs were calculated
                           for astrocytoma grade I-II. No association was found with salivary gland tumours, NHL or testicular cancer although an association
                           with NHL of T-cell type could not be ruled out. CONCLUSION: We found for all studied phone types an increased risk for brain
                           tumours, mainly acoustic neuroma and malignant brain tumours. OR increased with latency period, especially for astrocytoma
                           grade III-IV. No consistent pattern of an increased risk was found for salivary gland tumours, NHL, or testicular cancer.
                           PMID: 17034627 [PubMed - in process] [RESULTS ALREADY REPORTED ABOVE]

Auvinen A, Toivo T, Tokola K. Eur J Cancer Prev. 2006 Dec;15(6):516-23.
                           Epidemiological risk assessment of mobile phones and cancer: where can we improve? STUK-Radiation and Nuclear Safety Authority,
                           Helsinki, Finland.
                           anssi.auvinen@uta.fi. This paper aims to provide an overview of factors affecting the validity of epidemiological
                           studies on health effects of mobile phone use. A qualitative review of published studies is presented, covering both risk
                           assessment and exposure assessment. Considerable random error is likely to have occurred in studies carried out so far, primarily
                           related to exposure assessment. Self-reported use of mobile phone appears to be imprecise. The relationship between the amount
                           of mobile phone use and the radio-frequency field is unclear. Several factors affect the strength of the radio-frequency field
                           emitted by the phone, and accommodating their effect has the potential to improve exposure assessment. The major opportunity
                           to improve the quality of evidence is, however, through prospective studies. The major limitation of epidemiological studies
                           addressing the health effects of mobile phone use is related to exposure assessment. These limitations are inherent in case-control
                           studies. Quality of evidence can be improved by conducting prospective cohort studies. PMID: 17106332 [PubMed - indexed for
                           MEDLINE]

Elwood JM. Bioelectromagnetics. 2003;Suppl 6:S63-73.
                           Epidemiological studies of radio frequency exposures and human cancer. National Cancer Control Initiative, Rathdowne St Carlton, Melbourne,
                           Australia. melwood@ncci.org.au. Epidemiological studies of radio frequency (RF) exposures and human cancers include
                           studies of military and civilian occupational groups, people who live near television and radio transmitters, and users of
                           mobile phones. Many types of cancer have been assessed, with particular attention given to leukemia and brain tumors. The
                           epidemiological results fall short of the strength and consistency of evidence that is required to come to a conclusion that
                           RF emissions are a cause of human cancer. Although the epidemiological evidence in total suggests no increased risk of cancer,
                           the results cannot be unequivocally interpreted in terms of cause and effect. The results are inconsistent, and most studies
                           are limited by lack of detail on actual exposures, short follow-up periods, and the limited ability to deal with other relevant
                           factors. In some studies, there may be substantial biases in the data used. For these same reasons, the studies are unable
                           to confidently exclude any possibility of an increased risk of cancer. Further research to clarify the situation is justified.
                           Priorities include further studies of leukemia in both adults and children, and of cranial tumors in relationship to mobile
                           phone use. Copyright 2003 Wiley-Liss, Inc. PMID: 14628307 [PubMed - indexed for MEDLINE]

Hansson Mild K, Carlberg M, Wilen J, Hardell L. How to combine the use of different mobile and cordless
                           telephones in epidemiological studies on brain tumours?. Eur J Cancer Prev. 2005 Jun;14(3):285-8. National Institute for Working
                           Life, Umea, Sweden.
                           mild@niwl.se. Mobile phone users in epidemiological studies have often used more than one phone
                           model, and sometimes also more than one mobile phone system (analogue and digital systems). Until now, this has not been taken
                           into account in epidemiological studies, mainly because we do not know the possible interaction mechanism(s) and, hence, how
                           to integrate exposure from different phones into one dosimetric measure. In this paper we take a step towards starting a discussion
                           about how to proceed with this important issue and the possible use of parameters such as weighting factors, measured specific
                           absorption rate (SAR) values and integrated specific absorption values are discussed. As a base of this discussion two previously
                           published studies are used, one on mobile phones and cancer and the other one on subjective symptoms. PMID: 15902000 [PubMed
                           - indexed for MEDLINE]

Hardell L, Carlberg M, Hansson Mild K. Use of cellular telephones and brain
                           tumour risk in urban and rural areas. Occup Environ Med. 2005 Jun;62(6):390-4. Department of Oncology, University
                           Hospital, Orebro, Sweden. lennart.hardell@orebroll.se. AIMS: To investigate the association between the use of cellular or cordless telephones
                           and the risk for brain tumours in different geographical areas, urban and rural. METHODS: Patients aged 20-80 years, living
                           in the middle part of Sweden, and diagnosed
                           between 1 January 1997 and 30 June 2000 were included. One control matched for sex and age in five year age groups was selected
                           for each case. Use of different phone types was assessed by a questionnaire. RESULTS: The number of participating cases was
                           1429; there were 1470 controls. An effect of rural living was most pronounced for digital cellular telephones. Living in rural
                           areas yielded an odds ratio (OR) of 1.4 (95% CI 0.98 to 2.0), increasing to 3.2 (95% CI 1.2 to 8.4) with >5 year latency
                           time for digital phones. The corresponding ORs for living in urban areas were 0.9 (95% CI 0.8 to 1.2) and 0.9 (95% CI 0.6
                           to 1.4), respectively. This effect was most obvious for malignant brain tumours. CONCLUSION: In future studies, place of residence
                           should be considered in assessment of exposure to microwaves from cellular telephones, although the results in this study
                           must be interpreted with caution due to low numbers in some of the calculations. PMID: 15901886 [PubMed - indexed for MEDLINE]

Hardell L, Carlberg M, Mild KH. Case-control study of the association between
                           the use of cellular and cordless telephones and malignant brain tumors diagnosed during 2000-2003. Environ Res. 2006 Feb;100(2):232-41.
                           Epub 2005 Jul 14. Department of Oncology, University Hospital,
                           SE-701 85 Orebro, Sweden.
                           We performed a case-control study on the use of cellular and cordless telephones and the risk for brain tumors diagnosed during
                           2000-2003. We report the results for malignant brain tumors with data from 317 cases (88%) and 692 controls (84%). The use
                           of analog cellular phones yielded odds ratio (OR) of 2.6 and a 95% confidence interval (CI) of 1.5-4.3, increasing to OR=3.5
                           and 95% CI=2.0-6.4 with a >10-year latency period. Regarding digital cellular telephones, the corresponding results were
                           OR=1.9, 95% CI=1.3-2.7 and OR=3.6, 95% CI=1.7-7.5, respectively. Cordless telephones yielded OR=2.1, 95% CI=1.4-3.0, and with
                           a >10-year latency period, OR=2.9, 95% CI=1.6-5.2. The OR increased with the cumulative number of hours of use and was
                           highest for high-grade astrocytoma. A somewhat increased risk was also found for low-grade astrocytoma and other types of
                           malignant brain tumors, although not significantly so. In multivariate analysis, all three phone types studied showed an increased
                           risk. PMID: 16023098 [PubMed - indexed for MEDLINE]

Hardell
                           L, Hallquist A, Mild KH, Carlberg M, Pahlson A, Lilja A. Cellular and cordless telephones and the risk for brain tumours.
                           Eur J Cancer Prev. 2002 Aug;11(4):377-86. Department of Oncology, University Hospital, S-701 85 Orebro, Sweden. lennart.hardell@orebroll.se. Microwave exposure from the use of cellular telephones has been discussed in recent
                           years as a potential risk factor for brain tumours. We included in a case-control study 1617 patients aged 20-80 years of
                           both sexes with brain tumour diagnosed between 1 January 1997 and 30 June 2000. They were alive at the study time and had
                           histopathologically verified brain tumour. One matched control to each case was selected from the Swedish Population Register.
                           The study area was the Uppsala-Orebro, Stockholm, Linkoping
                           and Goteborg medical regions of Sweden.
                           Exposure was assessed by a questionnaire that was answered by 1429 (88%) cases and 1470 (91%) controls. In total, use of analogue
                           cellular telephones gave an increased risk with an odds ratio (OR) of 1.3 (95% confidence interval (CI) 1.02-1.6). With a
                           tumour induction period of >10 years the risk increased further: OR 1.8 (95% CI 1.1-2.9). No clear association was found
                           for digital or cordless telephones. With regard to the anatomical area of the tumour and exposure to microwaves, the risk
                           was increased for tumours located in the temporal area on the same side of the brain that was used during phone calls; for
                           analogue cellular telephones the OR was 2.5 (95% CI 1.3-4.9). Use of a telephone on the opposite side of the brain was not
                           associated with an increased risk for brain tumours. With regard to different tumour types, the highest risk was for acoustic
                           neurinoma (OR 3.5, 95% CI 1.8-6.8) among analogue cellular telephone users. PMID: 12195165 [PubMed - indexed for MEDLINE]

Hardell L, Hansson Mild K, Sandstrom M, Carlberg M, Hallquist A, Pahlson
                           A. Vestibular schwannoma, tinnitus and cellular telephones. Neuroepidemiology. 2003 Mar-Apr;22(2):124-9. Department of Oncology,
                           University Hospital, Orebro, Sweden. lennart.hardell@oreboll.se. Cases with tinnitus after using analogue cellular telephones are presented. An
                           increased odds ratio of 3.45, 95% confidence interval (CI) 1.77-6.76, was found for vestibular schwannoma (VS) associated
                           with the use of analogue cell phones. During the time period 1960-1998, the age-standardized incidence of VS in Sweden significantly increased yearly by +2.53% (CI
                           1.71-3.35). A significant increase in the incidence of VS was only found for the latter of the two time periods 1960-1979
                           and 1980-1998. For all other brain tumors taken together, the incidence significantly increased yearly by +0.80% (CI 0.59-1.02)
                           for the time period 1960-1998, although the increase was only significant for benign tumors other than VS during 1960-1979.
                           Copyright 2003 S. Karger AG, Basel PMID: 12629278 [PubMed - indexed for MEDLINE]

Hardell
                           L, Mild KH, Carlberg M, Hallquist A.  Cellular and cordless telephone use and
                           the association with brain tumors in different age groups. Arch Environ Health. 2004 Mar;59(3):132-7. Department of Oncology,
                           University Hospital, Orebro, Sweden. lennart.hardell@orebroll.se The authors' case-control study on the possible association between brain tumors
                           and mobile and cordless telephone use included 1,617 patients and 1,617 controls. A questionnaire was answered by 1,429 (88%)
                           cases and 1,470 (91%)controls. Use of analog cellular telephones yielded an odds ratio (OR) for brain tumors of 1.31, 95%
                           confidence interval (CI) = 1.04-1.64, increasing for ipsilateral use to OR = 1.65, 95% CI = 1.19-2.30. The authors found the
                           highest risk for the 20-29-yr age group, with OR = 5.91, 95% CI = 0.63-55 for ipsilateral use of analog phones. The highest
                           risks were associated with >5-year latency period in the 20-29-yr age group for analog phones (OR = 8.17, 95% CI = 0.94-71),
                           and cordless phones (OR = 4.30, 95% CI = 1.22-15). PMID: 16121902 [PubMed - indexed for MEDLINE]

4444

Hardell
                           L, Mild KH, Carlberg M. Case-control study on the use of cellular and cordless phones and the risk for malignant brain tumours.
                           Int J Radiat Biol. 2002 Oct;78(10):931-6. Department of Oncology, Orebro Medical Centre, S-701
                           85 Orebro, Sweden.
                           lennart.hardell@orebroll.se PURPOSE: To investigate the use of cellular and cordless phones and the risk for
                           malignant brain tumours. MATERIALS AND METHODS: A case-control study was performed on 649 patients aged 20-80 years of both
                           sexes with malignant brain tumour diagnosed from 1 January 1997 to 30 June 2000. All patients were alive during the time of
                           the study and had histopathology verified brain tumours. One matched control to each case was selected from the Swedish Population
                           Register. The study area was the Uppsala-Orebro, Stockholm, Linkoping
                           and Goteborg medical regions of Sweden.
                           RESULTS: Exposure was assessed by a questionnaire answered by 588 (91%) cases and 581 (90%) controls. Phone usage was defined
                           as 'ever use' and usage starting within 1 year before diagnosis was disregarded. Overall, no significantly increased risks
                           were found: analogue cellular phones yielded an odds ratio (OR)=1.13, 95% confidence interval (CI)=0.82-1.57, digital cellular
                           phones OR=1.13, CI=0.86-1.48, and cordless phones OR=1.13, CI=0.85-1.50. For ipsilateral (same side) radiofrequency exposure,
                           analogue mobile phones gave OR=1.85, CI=1.16-2.96, for all malignant brain tumours. For astrocytoma, this risk was OR=1.95,
                           CI=1.12-3.39. For all malignant brain tumours, digital mobile phones yielded OR=1.59, CI=1.05-2.41, and cordless phones yielded
                           OR=1.46, CI=0.96-2.23, in the analysis of ipsilateral exposure. CONCLUSION: The ipsilateral use of an analogue cellular phone
                           yielded a significantly increased risk for malignant brain tumours.PMID: 12465658 [PubMed - indexed for MEDLINE]

Hardell L, Mild KH, Carlberg M. Int J Oncol. 2003 Feb;22(2):399-407.Further
                           aspects on cellular and cordless telephones and brain tumours. Department of Oncology, University
                           Hospital, S-701 85 Orebro, Sweden. lennart.hardell@orebroll.se. We included in a case-control study on brain tumours and mobile and cordless telephones
                           1,617 patients aged 20-80 years of both sexes diagnosed during January 1, 1997 to June 30, 2000. They were alive at the study
                           time and had histopathology verified brain tumour. One matched control to each case was selected from the Swedish Population
                           Register. The study area was the Uppsala-Orebro, Stockholm, Linkoping
                           and Goteborg medical regions of Sweden.
                           Exposure was assessed by a questionnaire that was answered by 1,429 (88%) cases and 1,470 (91%) controls. In total use of
                           analogue cellular telephones gave an increased risk with odds ratio (OR)=1.3, 95% confidence interval (CI)=1.04-1.6,whereas
                           digital and cordless phones did not overall increase the risk significantly. Ipsilateral use of analogue phones gave OR=1.7,
                           95% CI=1.2-2.3, digital phones OR=1.3, 95% CI=1.02-1.8 and cordless phones OR=1.2, 95% CI=0.9-1.6. The risk for ipsilateral
                           use was significantly increased for astrocytoma for all studied phone types, analogue phones OR=1.8,95% CI=1.1-3.2, digital
                           phones OR=1.8, 95% CI=1.1-2.8, cordless phones OR=1.8, 95% CI=1.1-2.9. Use of a telephone on the opposite side of the brain
                           was not associated with a significantly increased risk for brain tumours. Regarding anatomical area of the tumour and exposure
                           to microwaves, the risk was increased for tumours located in the temporal area on the same side of the brain that was used
                           during phone calls, significantly so for analogue cellular telephones OR=2.3, 95% CI=1.2-4.1. For acoustic neurinoma OR=4.4,
                           95% CI=2.1-9.2 was calculated among analogue cellular telephone users. When duration of use was analysed as a continuous variable
                           in the total material, the risk increased per year for analogue phones with OR=1.04, 95% CI=1.01-1.08. For astrocytoma and
                           ipsilateral use the trend was for analogue phones OR=1.10, 95% CI=1.02-1.19, digital phones OR=1.11, 95% CI=1.01-1.22, and
                           cordless phones OR=1.09, 95% CI=1.01-1.19. There was a tendency of a shorter tumour induction period for ipsilateral exposure
                           to microwaves than for contralateral, which may indicate a tumour promotor effect. PMID: 12527940 [PubMed - indexed for MEDLINE]

Heynick LN, Johnston SA, Mason PA. Bioelectromagnetics. 2003;Suppl 6:S74-100.
                           Radio frequency electromagnetic fields: cancer, mutagenesis, and genotoxicity.Independent Consultant, Palo Alto, California 94303,
                           USA. heylou@mindspring.com. We present critiques of epidemiologic studies and experimental investigations,
                           published mostly in peer-reviewed journals, on cancer and related effects from exposure to nonionizing electromagnetic fields
                           in the nominal frequency range of 3 kHz to 300 GHz of interest to Subcommittee 4 (SC4) of the International Committee on Electromagnetic
                           Safety (ICES). The major topics discussed are presented under the headings Epidemiologic and Other Findings on Human Exposure,
                           Mammals Exposed In Vivo, Mammalian Live Tissues and Cell Preparations Exposed In Vitro, and Mutagenesis and Genotoxicity in
                           Microorganisms and Fruit Flies. Under each major topic, we present minireviews of papers on various specific endpoints investigated.
                           The section on Epidemiologic and Other Findings on Human Exposure is divided into two subsections, the first on possible carcinogenic
                           effects of exposure from emitters not in physical contact with the populations studied, for example, transmitting antennas
                           and other devices. Discussed in the second subsection are studies of postulated carcinogenic effects from use of mobile phones,
                           with prominence given to brain tumors from use of cellular and cordless telephones in direct physical contact with an ear
                           of each subject. In both subsections, some investigations yielded positive findings, others had negative findings, including
                           papers directed toward experimentally verifying positive findings, and both were reported in a few instances. Further research
                           on various important aspects may resolve such differences. Overall, however, the preponderance of published epidemiologic
                           and experimental findings do not support the supposition that in vivo or in vitro exposures to such fields are carcinogenic.
                           Published 2003 Wiley-Liss, Inc. PMID: 14628308 [PubMed - indexed for MEDLINE]

Kundi
                           M, Mild K, Hardell L, Mattsson MO. Mobile telephones and cancer--a review of epidemiological evidence. J Toxicol Environ Health
                           B Crit Rev. 2004 Sep-Oct;7(5):351-84. Institute of Environmental Health, Department for Occupational and Social Hygiene, Medical
                           Faculty, University of Vienna Kinderspitalgasse
                           15 A-1095 Vienna Austria.
                           Michael.Kundi@univie.ac.at There is considerable public concern about possible long-term adverse health effects
                           of mobile phones. While there is scientific controversy about long-term health effects of high-frequency electromagnetic fields
                           lasting for at least 50 yr, the rise and success of mobile telecommunication made it necessary to investigate the problem
                           more comprehensively and assess the possible risk cautiously because never before in history has a substantial proportion
                           of the population been exposed to microwaves in the near field and at comparably high levels. Because the mostly localized
                           exposure target region is the head, most epidemiological studies focus on brain tumors. Overall nine epidemiological studies
                           have been published, four from the United States, two from Sweden, and one each from Denmark, Finland, and Germany.
                           Seven studies were mainly on brain tumors, with one investigating in addition to brain tumors salivary gland cancer and another
                           cancer of the hematopoietic and lymphatic tissues, and one examining intraocular melanoma. All studies have some methodological
                           deficiencies: (1) too short duration of mobile phone use to be helpful in risk assessment, (2)exposure was not rigorously
                           determined, and (3) there is a possibility of recall and response error in some studies. Nevertheless, all studies approaching
                           reasonable latencies found an increased cancer risk associated with mobile phone use. Estimates of relative risk in these
                           studies vary between 1.3 and 4.6 with highest overall risk for acoustic neuroma (3.5) and uveal melanoma (4.2), and there
                           is evidence for enhanced cancer risk with increasing latency and duration of mobile phone use. PMID: 15371240 [PubMed - indexed
                           for MEDLINE]

Moulder JE, Erdreich LS, Malyapa RS, Merritt J, Pickard
                           WF, Vijayalaxmi. Cell phones and cancer: what is the evidence for a connection? Radiat Res. 1999 May;151(5):513-31. Radiation
                           Oncology, Medical College of Wisconsin,
                           Milwaukee 53226, USA. There have been allegations in the media and in the courts that cell phones
                           and other types of hand-held transceivers are a cause of cancer. There have also been numerous public objections to the siting
                           of TV, radio and cell phone transmission facilities because of a fear of cancer induction. A recent publication in Radiation
                           Research by Repacholi et al. (147, 631-640, 1997) which suggests that exposure to radiofrequency (RF) radiation may increase
                           lymphoma incidence in mice has contributed to this controversy. The goal of this review is to provide biomedical researchers
                           a brief overview of the existing RF radiation-cancer studies. This article begins with a brief review of the physics and technology
                           of cell phones. It then reviews the existing epidemiological studies of RF radiation, identifying gaps in our knowledge. Finally,
                           the review discusses the cytogenetics literature on RF radiation and the whole-animal RF-radiation carcinogenesis studies.
                           The epidemiological evidence for an association between RF radiation and cancer is found to be weak and inconsistent, the
                           laboratory studies generally do not suggest that cell phone RF radiation has genotoxic or epigenetic activity, and a cell
                           phone RF radiation-cancer connection is found to be physically implausible. Overall, the existing evidence for a causal relationship
                           between RF radiation from cell phones and cancer is found to be weak to nonexistent. PMID: 10319725 [PubMed - indexed for
                           MEDLINE]

Moulder JE, Foster KR, Erdreich LS, McNamee JP. Mobile
                           phones, mobile phone base stations and cancer: a review. Int J Radiat Biol. 2005 Mar;81(3):189-203. Radiation Oncology, Medical
                           College of Wisconsin, Milwaukee, WI 53226, USA. jmoulder@mcw.edu There have been reports in the media and claims in the courts that. radiofrequency
                           (RF) emissions from mobile phones are a cause of cancer, and there have been numerous public objections to the siting of mobile
                           phone base antennas because of a fear of cancer. This review summarizes the current state of evidence concerning whether the
                           RF energy used for wireless communication might be carcinogenic. Relevant studies were identified by searching MedLine with
                           a combination of exposure and endpoint terms. This was supplemented by a review of the over 1700 citations assembled by the
                           Institute of Electrical and Electronics Engineers (IEEE) International Committee on Electromagnetic Safety as part of their
                           updating of the IEEE C95.1 RF energy safety guidelines. Where there were multiple studies, preference was given to recent
                           reports, to positive reports of effects and to attempts to confirm such positive reports. Biophysical considerations indicate
                           that there is little theoretical basis for anticipating that RF energy would have significant biological effects at the power
                           levels used by modern mobile phones and their base station antennas. The epidemiological evidence for a causal association
                           between cancer and RF energy is weak and limited. Animal studies have provided no consistent evidence that exposure to RF
                           energy at non-thermal intensities causes or promotes cancer. Extensive in vitro studies have found no consistent evidence
                           of genotoxic potential, but in vitro studies assessing the epigenetic potential of RF energy are limited. Overall, a weight-of-evidence
                           evaluation shows that the current evidence for a causal association between cancer and exposure to RF energy is weak and unconvincing.
                           However, the existing epidemiology is limited and the possibility of epigenetic effects has not been thoroughly evaluated,
                           so that additional research in those areas will be required for a more thorough assessment of the possibility of a causal
                           connection between cancer and the RF energy from mobile telecommunications. PMID: 16019928 [PubMed - indexed for MEDLINE]