60Hz EMF Health Effects-
A Scientific Uncertainty
R esearch in biological effects of ex-
tremely low frequency (ELF) electro-
magnetic fields (EMFs) may be
conveniently grouped into three catego-
ries: 1) epidemiological studies, 2) labora-
tory studies and 3) exposure assessments.
Epidemiological studies may be further
categorized as: 1) studies of children with
cancer who were exposed to residential
sources of ELF EMFs; 2) studies of adults
who where exposed as well; and 3) occu-
pational studies of adults exposed to ELF
EMFs in the work place. Epidemiological
studies seek to determine an association
between exposure to ELF EMFs and
health effects. Two groups of laboratory
studies exist: in vivo, or whole animal
studies, and in vitro, or tissue studies.
Laboratory studies on whole animals and
tissues seek to determine systemic, or
physiological, effects and mechanisms of
interaction of ELF EMFs, and especially
to characterize dose-response relation-
ships. Exposure assessments seek to deter-
mine the EMFs generated by various
sources, such as power lines, appliances,
etc., and what the exposures from such
sources would be.
This article reviews the scientific is-
sues involved; summarizing the results of
statistical (epidemiological) and labora-
tory studies of ELF EMF biological ef-
fects and providing a background on the
scientific uncertainty concerning them.
Epidemiological Studies
Epidemiology has played a central role
in public health over the last century. It is
an observational science, and, fundamen-
tally, amounts to finding an association
between two events: a health problem in
some population and a possible cause. The
importance of such studies to public, and
especially occupational health, is beyond
question. Epidemiological studies have
led the way in drawing attention to toxic
substances, such as benzene, asbestos and
tobacco; substances that later have been
found to have adverse human health con-
sequences. Epidemiologists have also led
the way in examining the possible health
consequences of exposure to ELF EMFs.
Wertheimer and Leeper, in 1979 [ 11, were
the first to draw attention to the possible
370
Stephan P. Albert Bren
Science Applications International Corporation
human health consequences of exposure
to ELF EMFs. Many studies have fol-
lowed, with mixed results.
A number of epidemiological studies
have been done on children to determine if
any link exists between residential expo-
sure to ELF EMFs (50/60Hz) and cancer.
Some studies have used surrogate meas-
ures of assessing exposures, such as using
wiring codes, or some other method, to
calculate the EMFs in a house. These stud-
ies have found either weak or conflicting
correlations [ 1-51, or no correlations at all
[6-81. Some of the epidemiologicalstudies
cited above have assessed exposures by
taking actual measurements of ELF EMFs
in the home, using “spot” measurements,
or using exposure meters left in place over
a 24-hour period [3, 41. Curiously, when
actual measurements were used to assess
ELF EMF exposures, no correlations be-
tween cancer and EMFs were noted.
Recently, the results of two meta-analy-
ses of childhood cancer studies were pub-
lished (A meta-analysis is a statistical
technique for combining the results of two
or more statistical studies). In one meta-
analysis, the results of two case-control
studies and one cohort study were pooled
[9]. A slightly elevated risk of leukemia
and nervous system tumors was found, but
no elevated risk for lymphoma. The
authors noted that the elevated risk for
nervous system tumors was partially based
upon multiple cancers in one individual in
the cohort study. In the other meta-analy-
sis, 12 studies of childhood cancer were
analyzed collectively [ 101. The authors
found no statistically significant risks for
leukemia and lymphoma, but statistically
significant risks for nervous system tu-
mors. Across all the studies, the authors
found the adequacy of EMF exposure as-
sessment to be imperfect and imprecise.
While the bulk of epidemiological studies
of residential exposure have been done on
IEEE ENGINEERING IN MEDICINE AND BIOLOGY
children, a few have been done on adults.
The first study of health effects among
adults exposed to EMFs from residential
sources found weak correlations for can-
cer [l 13, but subsequent studies have
failed to substantiate this finding [12-141.
By far, most of the epidemiological
studies performed to date have examined
occupational exposures. Epidemiologists
in the U.S. and other countries have exam-
ined cancer, reproduction, and neuro-
physiological effects of EMF exposure. A
1991 workshop held by the National Insti-
tute for Occupational Safety and Health
(NIOSH) provides an excellent summary
of many of these studies [15]. The follow-
ing are samples of studies discussed at the
workshop, which examined cancer inci-
dence among exposed workers:
. The pooled analysis of 12 explora-
tory studies, published between
1982-8, noted weak associations for
leukemias, but the authors of the
studies noted several problems with
their results, such as small numbers,
weak statistical analysis, no evalu-
ation of confounders, and poorly de-
fined exposure assessments.
Five case control studies, published
between 1985-9, and using more rig-
orous methods, noted elevated inci-
dences of leukemia. However, all the
studies were found to suffer from
poor exposure assessment. In these
studies, exposure was usually based
on occupational history secured
through postal questionaires or tran-
. scribed from registration forms.
Seven case-control studies, publish-
ed between 1985-90, have examined
brain cancer and occupational expo-
sures to EMFs. Elevated incidences
of brain cancer were found to be as-
sociated with EMF exposure, with
some dose-response relationships
noted. Unfortunately, poor exposure
assessment is again a problem. Expo-
sures were based on surrogate meas-
ures, using the same techniques noted
previously: job registries and postal
. questionaires.
Fully 15 cohort studies, published be-
tween 198l and 1990,have been con-
0739-5175/95/$4.00@1995
 ducted on electrical workers. Occu- linked to various biochemical pathways
pations from lineman to radioman with EMFs [33-361; or the result of con-
were studied. One study found an formational changes to macromolecules
elevated risk of acute myeloid leuke- induced by EMFS [61]. However, it is
mia (AML), another one for all
leukemias, but not one noted an ex- The evidence on been noted that internal electric field
“noise” of the cellular environment is of
cess of brain cancers. Curiously, five health eRects is mixed the order of or greater than induced elec-
of the seven cohort studies, which tric gradients via external E m s [58, 59,
also examined skin cancer, found an
621. EMFs may also act to perturb cellular
elevated risk of it among exposed
populations. processes that are in non-equilibrium [63].
The in vitro evidence suggests that ELF
More recently, two published studies EMFs can influence events at the cellular
found an elevated risk of breast cancer level, however, credible mechanisms to
among female workers in electrical occu- explain the reported effects have yet to be
pations [16, 171, though a third study examined the effects of electric fields, developed. Certainly, electrical phenom-
failed to obtain this finding [18]. The rather than magnetic fields. For example, ena are integral to cellular processes; it
authors of the two positive studies stressed numerous in vitro studies have implicated may be that EMFs perturb normal cell
caution in weighing the results, as no al- the cell membrane as a site of transduction processes by mimicking endogenous
lowance had been made for potential con- of EMFs. RF electric fields modulated at fields [64-651.
founding effects and also that exposures ELF, or sinusoidal ELF electric fields ap- While in vitro studies have searched
were assessed through death surveillance pear to effect the binding of Ca+>to brain for fundamental mechanisms for ELF
records or through estimates based upon tissue. Curiously, the effects were often EMF biological effects, in vivo studies
job category. A 1992 Swedish case-con- evident only over a limited range, or “win- have examined systemic effects of ELF
trol study found elevated risk for lym- dow” of frequencies [33-371. In some EMFs. Reported detection thresholds for
phoma among electrical workers, but little cases, ELF electric and magnetic fields ELF electric fields are 4-10 kV/m for rats
risk for brain tumors or leukemia [ 191.The have effected rates of DNA, RNA and [66]; 9-10 kV/m for humans [67]; and in
study attempted to account for such con- protein synthesis [38-4 11. However, no the 25-35 kV/m range for other animal
founding factors as age, benzene expo- mutagenic or genotoxic properties have species [68-701. Early studies in mice and
sure, ionizing radiation, industrial been observed-[42-461 (causing chromo- rats found behavioural effects from expo-
solvents, pesticides, and smoking. Other somal changes, single strand breaks, point sure to ELF magnetic fields [71-731,
recent studies have found no elevated risks mutations, etc.). Another effect of interest though later studies conducted at higher
for leukemia or other cancers for occupa- is alteration of ornithine decarboxylase field intensities found no such effects [74,
tionally exposed workers [20, 211. (ODC) activity by ELF electric fields [47- 751. More recently, rats exposed to ELF
Reproductiveand neurobehaviouralef- 481. ODC has been linked with the induc- electric and magnetic fields tuned to cal-
fects have also been associated with ELF tion of proliferation of normal and tumor cium or magnesium cyclotron resonance
EMFexposure. Early studies linked the use cells. Sixty-Hz (and non-ionizing) EMFs frequencies evidenced no significantly al-
of electric blankets with fetal loss [22,23], are not energetic enough to cause chromo- tered behaviour [76,77]. ELF EMFs have
but the methodology used in these studies somal alterations, but some evidence sug- been reported to alter biological rythmns,
was later criticized [24]. Three case-con- gests that they may act as a “promotor” of such as circadian rythmns in rats and mice
trol studies have linked the children of cancer in conjunction with another car- [78, 681; and pineal glandular production
ELFEMF exposed fathers to brain cancer cinogen [49-501. However other studies in rats [79- 811. Studies of pineal gland
[25-271. However, exposure was assessed have not obtained this finding [51, 521. effects are especially interesting, for there
based upon job title and not through actual The results of a National Toxicology Pro- is the possibility that alteration of mela-
measurements, which may make the re- gram (NTP) project to address the poten- tonin secretion by the pineal gland may
sults difficult to interpret.One case-control tial toxicology and carcinogenecity of 60 contribute to cancer [82]. Human studies
study found an excess of suicide among Hz magnetic fields, currently in progress, on ELF EMF biological effects have
individuals exposed to magnetic fields may provide conclusive results on found altered cardiac rates [67, 83, 841;
[28], However, more recent studies have whether ELF EMFs can act as “promo- and changes in melatonin production [85].
failed to substantiate this finding [29,30]. tors” of cancer [53]. Magnetite has been found in some single-
Two other studies have also failed to detect Several theories have been advanced to cell organisms and animals. Recently,
any association between ELF EMF expo- explain the reported in vitro effects of magnetite has also been found in human
sure and altered behavioural or neurologi- EMFs. Efflux of cation species, such as tissues, and has been postulated to play a
cal reponses [31,321. Ca+* and Li’, has been postulated as a role in observed ELF EMF biological ef-
cyclotron resonance phenomena [54,55], fects [86], though this has been disputed
laboratory Studies though this model has been criticized [56, [87]. Another mechanism for ELF EMF
Across the non-ionizing EMF spec- 591. Studies which have tested for cyclo- biological effects is that they may be
trum, biological effects of EMFs have evi- tron resonance phenomena have not found caused by currents induced by external
denced a considerable range and any effects [60]. Alterations to cellular magnetic fields [58].
complexity. In vitro studies have been pri- processes have been postulated to be the
marily phenomenological rather than hy- result of coherent or cooperative interac- Conclusions
pothesis based, and, for the most part, have tions among membrane constituents Extensive epidemiological and labora-

July/August 1995 IEEE ENGINEERING IN MEDICINE AND BIOLOGY 371

tory research has been conducted over the
last 15 years on the biological and health
consequences of exposure to ELF EMFs
over the last 15years. Some epidemiologi-
cal studies have found weak associations
between exposure to power-frequency
EMFs and some forms of cancer, such as
leukemia; while other studies have failed
to find such associations. The primary
limitation with most epidemiological
studies has been with the methods of ex-
posure assessment [ 15, 88-95]. Rigorous
methods of exposure assessment that can
be associated with biological effects are
clearly needed. Epidemiological studies
also continue to suffer from significant
methodological difficulties associated
with the effects of confounding factors.
These difficulties hinder interpretation
and acceptance of epidemiological find-
ings. Laboratory studies have noted a wide
variety of interesting biological effects re-
sulting from exposure to power-frequency
EMFs. The most significant and replicated
findings are an apparent change in ion
efflux at cell membranes in response to
limited ranges and intensities of ELF elec-
tric fields, an effect of ELF magnetic fields
on melatonin production, and effects on
enzyme activity. Several concerns exist
with regard to the laboratory findings. One
concern is that the field strengths used are
often orders of magnitude greater than
commonly encountered in the home or
office. Another concern is that much of the
laboratory evidence remains to be inde-
pendently confirmed. Lastly, a credible
mechanism by which commonly encoun-
tered (milligauss) power-frequency EMFs
could produce human health effects such
as cancer still needs to be developed.
Thus, the significance of the laboratory
findings to human health is questionable.
Though the evidence on ELF EMF
health effects is mixed, it cannot be dis-
missed out of hand. Associations between
exposure to power-frequency EMFs and
human health effects may indeed exist, but
are at such a low level that they are lost in
the “noise.” Certainly, some interactions
between EMFs and biological systems
have been well-documented and inde-
pendently confirmed: the ability of elec-
trosensory organs of some fish to sense
EMFs, the existence of biomagnetic parti-
cles in some animals, and accelerated
bone healing in human beings. On the
other hand, standardized cancer screening
tests in animals have yielded results that
are generally negative, and thus EMFs
appear to lack the kind of obvious toxicity
311
that characterize well-established carcino- Bioelectromagnetics SOC,Copenhagan,Denmark,
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to electricity transmission and distribution equip-
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Acknowledgment haematological malignancies in relation to over-
The support of Science Applications head powerlines. British J Cancer 63:977-998,
International Corporation for this research 1991.
is gratefully acknowledged. 15. US Dept Health and Human Services, Public
Health Service, National Instituteof Occupational
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Stephan P. Albert Bren
received his BS in phys-
ics from the University
of Washington (1986)
and the MS in Electrical
Engineering from
Washington State Uni-
versity (1 99 1). Cur-
rently, Mr. Bren is a
scientist with Science Applications Inter-
national Corporation (SAIC) in German-
town, MD, and provides research and
analytical assistance to the Technical Sup-
port and Vitrification Divisions of the U.S.
Department of Energy, Office of Waste
Management. He is also providing techni-
cal assistance to SAIC on EMF health
effects, and has been investigating scien-
tific and policy issues concerning the bio-
logical effects of electromagnetic fields
(EMF) for over two years. He can be
reached at SAIC, 20300 Century Blvd,
Suite 200-B, Germantown, MD 20874;
Tel: (301) 601-5655.
July/August 1995