Wake-up call

Recently published research strengthens the claim that mobile-phone use could cause a global brain cancer epidemic, with Hong Kong likely to suffer more than most

Daniel Jeffreys and Mark FooterUpdated on Apr 11, 2010

Chris Newman was a successful neurologist with three young children when he first met Joanne Suder, a lawyer based in Baltimore, on the east coast of the United States. The tall, handsome, blue-eyed doctor loved running and was regarded by colleagues as a gifted physician. He started out as Suder's client and then became her friend, but now he's dead and she is left to mourn his memory with a mixture of sadness and anger.

"Dr Newman died of a brain tumour and his cellphone use caused the cancer," says Suder, who has now reviewed more than 200 similar cases in the US. "Chris had nine years of documented heavy cellphone use and the tumour that killed him was located in the exact anatomical location where the radiation from his cellphone entered his skull."

Unlike Hong Kong, the US has aggressive product liability legislation and Suder has taken on six more clients like Newman. Their cases are being heard in the District of Columbia, where the US Congress sits and the mobile-phone industry has spent hundreds of millions of dollars to battle similar cases, as well as any attempt to put health warnings on the devices. Suder knows she faces overwhelming odds but she has taken the cases in part to honour Newman's memory.

"Chris had young children and he knew he was going to die before they came of age," she says. "But he accepted his terminal illness with good grace. His gift to the world was to file his case [against Motorola]. He wanted people to know that he and his colleagues in neurology believed that there was a problem with mobile phones."

Newman died in May 2006 after battling his debilitating tumour for six years. His case is visceral and heartbreaking but Motorola consistently denied any liability and suits like his have not won a cent in damages, largely because, as yet, there has been no conclusive evidence that mobile-phone use causes brain cancer.

Yes, Newman did use his phone a lot. As a sole practitioner he used it in his office, in his car, at home and on the golf course. But there are millions of others who have done the same thing and are perfectly healthy. And given that there are more than four billion registered mobile-phone users worldwide, it's likely the majority of people who get brain cancer use a handset - but that does not establish cause and effect.

Hong Kong has one of the highest cellphone usage rates in the world and the city's population density ensures that most residents live close to a transmission tower, which, unlike the phones themselves, pump out a constant stream of non-ionising radiation (electromagnetic [EM] radiation that does not carry enough energy to remove an electron from an atom or molecule). And yet the city's phone retailers seem largely unaware of any potential risk.

Mobile phones have different radiation-emission ceilings and, based on those, specific absorption rates (SAR): the watts per kilogram of tissue that a brain will absorb. SARs fluctuate during a call. According to the US-based Environmental Working Group, the BlackBerry 8820 is one of the worst phones in terms of radiation, with a maxim um SAR that comes close to the limit of 1.6 allowed in the US (the European standard is two and, since April 2003, that has been the limit in Hong Kong, too). SARs for popular devices such as Apple's iPhone are easily accessible on the internet and Hong Kong has a labelling scheme for manufacturers to follow - but that is voluntary and local retailers do not seem to have this information.

Last weekend, inquiries about the iPhone's SAR were met with blank looks. Staff at the Apple store in IFC Mall, Central, the SmarTone store on Johnston Road, Wan Chai, and the 3G store opposite, all said they had no information about SARs or indeed any kind of radiation data, despite having encyclopaedic knowledge of almost every other aspect of the device and its various payment plans.

An assistant called Shan at SmarTone said the company "does not keep that kind of information". A staffer at the Apple store searched the company's Hong Kong website and found nothing and Edmond at 3G said his company had "no guidance to offer" regarding radiation levels. More revealing was Edmond's confession that he began using a mobile phone at 12 years old but was, nonetheless, a "late adopter" because he gets a steady stream of parents buying phones for their six year olds.

"Hong Kong could become the No1 centre for brain cancer in the world," says an aghast Suder. "Hong Kong should be at the forefront of efforts to warn against excessive mobile-phone use, especially among children."

There is no evidence yet to suggest that our obsession with mobile phones is causing an epidemic of brain cancer. The Hong Kong Cancer Registry (HKCR), under the Hospital Authority, maintains statistics for cancer cases and deaths in the city. According to the HKCR, over the past decade, the age-standardised incidence rates of tumours of the brain and nervous system have been stable at about three to four cases per 100,000 of population per year.

However, Henry Lai, a Hong Kong native who is a professor of bioengineering at the University of Washington, in the US, warns that the stability of cancer statistics should not lull the city's residents into a false sense of security.

"I don't think it is valid to say that, because there has been no significant increase in cancer rates over the past 10 years, cellphone radiation does not cause cancer," says Lai. "Brain cancer has a long latency period, of several decades," he says. "So it is too early to see a statistically significant effect."

Lai's description of the way mobile-phone use causes cancer is as simple as it is chilling. For him, handsets are small microwave-emitting devices that people clamp to the side of their head, allowing EM radiation to penetrate up to 6cm inside the brain. Once the EM waves are inside our heads, says Lai, they cause biological effects, changing the structure of enzymes. Microwave ovens do a similar thing to the cell structure of food, making it hot.

Motorola, which has consistently rejected Lai's findings, was so worried by his initial research project in 1994 that it set up a team to "war-game" his experiments and find ways to minimise the damage his work might cause.

"My work suggests that cellphone use causes breaks in DNA chains," says Lai. "The most recent research, based on an epidemiological study conducted by the International Agency for Research on Cancer, suggests that people who have used cellphones for more than 10 years have a 2.4 times higher risk of developing brain cancer."

The American Cancer Society (ACS) has conducted a thorough review of the research in the field and has concluded that "most studies to date have not found a link between cellphone use and the development of tumours". ACS also says that "the waves given off by cellphones don't have enough energy to damage DNA directly".

Lai says this last conclusion conceals a vital point. "It's true that cellphone radiation does not have the energy to directly damage DNA, but DNA molecules can be damaged indirectly by the radiation, for example, by changing enzymatic functions. Actually, in our body, chemical bonds in molecules are broken and formed mainly by enzymatic processes. One possible mechanism is that electromagnetic fields affect free radicals in cells that in turn break DNA molecules."

A paper published in this month's edition of the International Journal of Radiation Biology makes this point. The three authors, from the School of Environmental Sciences, at Jawaharlal Nehru University, in India, conducted an experiment with rats, which have similar brain tissue to that of humans. They detected significant changes in the rats' DNA and concluded that "chronic exposure to these radiations may cause significant damage to the brain, which may be an indication of possible tumour promotion".

Furthermore, according to Lai, if somebody is continually subjected to EM radiation, their chances of falling ill increase significantly.

"Somebody can have DNA damage but that does not mean they will get cancer," says Lai. "There must be at least two instances of critical damage in the genome before cancer develops and even then there might be no tumour for 20 or 30 years. Cellphone use began to accelerate 15 years ago so we could see a large increase in cases between 2015 and 2025."

The groundbreaking research in this field was done by Allan Frey, in 1960, when he was a researcher with General Electric's Advanced Electronics Centre at Cornell University, in the US. His work suggested that EM waves can breach the bloodbrain barrier, causing harmful substances to seep into the brain. He also distinguished between the effects of two types of microwave radiation. The first is the carrier wave, which transports the signal of a mobile phone. The second is the modulating wave, which carries the data, such as voice, text and pictures. It was modulation, Frey claimed, that caused the widest variety of biological effects, including the "leakage" between the circulatory system and the brain.

Lai built upon Frey's work and now believes that modulating radiation could increase the formation of free radicals in the brain, which then damage the DNA. That is the analysis that was given to Suder when she was preparing her case for Newman.

"I was told that the cellphone's radiation had indirectly damaged Chris' DNA and the DNA could not repair itself because of his continued cellphone use," she says. "That led to the creation of abnormal cells, which are the usual precursor to cancer."

The research conducted by Frey and Lai has been repeatedly attacked by the mobile-phone industry. The industry has funded the bulk of the research on the biological effects of EM waves but Steve Largent, president of the Cellular Telecommunications Industry Association (CTIA), the mobile-phone industry's main representative body in the US, denies that this has led to biased conclusions.

"The industry relies on the conclusions of impartial groups such as the US Food and Drug Administration, the World Health Organisation [WHO], the American Cancer Society and the National Institute of Health," he says. "They have all concluded that the scientific evidence to date does not demonstrate any adverse effects associated with the use of wireless phones."

The Office of the Telecommunications Authority (Ofta), the government body that oversees Hong Kong's mobile-phone industry, relies for its health information on the Department of Health, which concurs with CTIA's position, although it also advises: "As a precautionary measure, if individuals are concerned, they might choose to limit their own exposure to mobile-phone use; and children should be discouraged from using mobile phones for non-essential calls."
Lai says that about 200 studies of mobile-phone radiation have been published and half of them suggest there are damaging effects. However, when he examined only those papers that had been funded independently, he found that three-quarters had concluded there was an effect, whereas only one in three of the industry-funded papers said there was cause for alarm.

Suder laughs at CTIA's position, especially Largent's claim that nobody has established that there are "any adverse effects". She points out that scientists want mathematical certainty whereas in the US, in her field - the law - it's more about the weight of evidence.

"In Chris Newman's case, and in all my other six cases that are currently under litigation, the preponderance of the evidence excludes any other cause of cancer and points only to radiation," she says. "Cellphones emit radiation, which can cause brain tumours, and they were never supposed to replace land lines, they were never supposed to be ubiquitous and now every kid has them and God knows what damage that will cause."

While Largent's description of ACS' position is accurate in general terms, it lacks nuance. In their detailed analysis of the issue, ACS scientists have stressed that the studies of brain cancer and mobile-phone use have important limitations. First, because they have not yet been able to follow people for long periods and thus "it is not possible to rule out future health effects". Second, because studies have focused on adults and "it is possible that if there are health effects they might be more pronounced in children because their nervous systems are still developing and their lifetime exposure will be greater than adults".

Of course, parents can prevent their children from using mobile phones, just as adults can limit their use or employ a hands-free device that will keep antennae at a safe distance from the brain. But few of us can escape the millions of mobile-phone masts that have bloomed over the urban landscape. Many a local landlord - of tower blocks to village houses - is making a bit of extra money by renting out their rooftop to house multiple transmission units.

Ofta - which accepts as safe an ambient limit adopted by many countries: 42 volts per metre (a measurement of the intensity of the electric field) - points to the findings of the International Agency for Research on Cancer and the International Commission on Non-Ionising Radiation Protection (ICNIRP) in asserting that such masts are harmless, but the commission itself has issued an important caveat: "In the case of potential longterm effects of exposure, such as an increased risk of cancer, ICNIRP concluded that available data are insufficient to provide a basis for setting exposure restrictions."

Lai explains that most of the research on this issue has examined short-term exposure to the type of radiation that comes from transmission masts. He is concerned about the effects of living in close proximity to such masts, resulting in almost constant exposure to the whole body.

"Low-level RFR [radio-frequency radiation, which is EM radiation with a specific wavelength] is not biologically inert," he says. "There is research that suggests RFR effects can accumulate over time."

Lai cites a study published in Bioelectromagnetics magazine in 1986. It looked at what happened to a group of rats after chronic exposure to low-level RFR for seven hours a day, seven days a week, for 90 days. This is the kind of exposure somebody might experience if their office or home looked out onto roof-based masts - a common situation in Hong Kong. The study detected both behavioural and physiological effects.

"This research showed that RFR can produce an effect at much lower intensities after an animal is chronically exposed," says Lai. "This can have very significant implications for people exposed to RFR from transmission devices."

Upon request, Ofta will take measurements in a home or office. Recently, its operatives visited two apartments in a Sai Kung village, one 20 metres from a roof bearing eight transmission units, one on the other side of the village, behind a hill.

All readings within the distant flat were below 1v/m but those from the property next to the masts ranged from 0.8v/m (taken behind a thick concrete wall) to 3.8v/m (taken on the roof, in the beam being emitted from one of the transmission units). Placing a ringing mobile phone next to the measuring bulb made the 3.8 figure rise to 7.8v/m. These are all well within Ofta guidelines but, Lai says, "this limit was set based on research on acute exposure. Exposure to base-station radiation is chronic. Also, this guideline was based on old data and did not take more recent research into account."

Peter Leung Sai-wing, a specialist in radiation at the City University of Hong Kong, puts it another way: "It's very difficult for me to say if [the limit of 42v/m] is safe or not; it depends on a person's reaction. [It is] like there are a lot of factors that determine if driving at 75m/h is safe or not."

Perhaps recognising that residents may be placed in harm's way by the erection of a mobile-phone mast, the Department of Health recommends that "any decision on siting of mobile-phone base stations should be made through a consultative approach with potential stakeholders", says spokesman Simon Lau.

Ofta failed to clarify whether it considers local residents whose health is potentially being put on the line as "stakeholders" or whether that term only applies to those who stand to make a profit.
Readers who feel the uncertainties in the current research are enough to make them cautious have a number of options regarding their mobile-phone use. Finding a phone with a low SAR is a good precaution and the absorption rate for a wide range of phones can be found on the internet. CNET.com and the Environmental Working Group have recently published comprehensive lists of mobile-phone SARs. Experts from both recommend that people buy a phone with a low SAR, text rather than call, always keep the phone at least one inch from the body and use the speaker-phone function.

Children absorb RFR and EM at levels that are much higher than adults in certain parts of the head such as the bone marrow and the eye, according to Lai, and the waves also tend to penetrate deeper. Limiting a child's use or ensuring that a mobile phone is held at a distance from the head - where the amount of radiation absorbed shrinks to infinitesimal levels - will help ensure peace of mind. And if faced with a choice between living close to a mobile-phone tower and not, choose the latter - or lobby the government or landlords to keep masts off buildings in residential areas.

"There's no need to put [masts] so close [to homes and schools]," says Leung. "Instead of putting them on rooftops, you can build a tower and put masts on it; build them higher and not so close to buildings. But that involves cost."

Back in the US, Newman's family and friends continue to mourn his loss. A book of condolences on the internet has a long series of poignant entries. The first is tragically ironic.

"Chris my brother, I miss you every day. I can't take your number off my phone," it reads. "I've even left messages on it for you. LOL. Man is that silly or what?"

It's this constant and sometimes desperate need to feel connected - even to a deceased relative - that has helped create four billion mobile-phone users. But it has also caused a change in the EM environment, and for human organisms, in which all nerve signals are electric, that could be catastrophic.

"We see effects but we don't yet know what the consequences are," says Lai. "The largest experiment in the history of the world is already underway and, with so many people using cellphones, in 10 to 15 years we will know the results."