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 Background
• Reported association between residence close to
power lines and childhood leukaemia
• Wertheimer & Leeper (1979) reported increased
childhood leukaemia associated with certain
‘household wiring codes’
• Multiple studies since gave variable results
• Meta-analysis reported doubling of risk
• Subject remains highly controversial
• Public concern
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Electric and Magnetic Fields
Electric fields (kV/m)
related to voltage

Magnetic fields (microT)

related to current
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 Diseases Studied
• Lymphoproliferative disorders (LPD)
– Cancers of lymphoid cells
• Lymphoid leukaemias (acute, chronic)
• Lymphomas (Hodgkin & non-Hodgkin)
• Multiple myeloma
• Myeloproliferative disorders (MPD)
– Cancers of myeloid (bone marrow) cells
• Myeloid leukaemias (acute, chronic)
• Polycythaemia & related disorders
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 Aim

• to determine whether there is an

increased risk of LPD & MPD
associated with residence ≤300 m from
high tension power lines.

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 Methods

• Case-control study using data collected 1972-80

of all LPD & MPD cases in Tasmania (n=854)
– Ascertainment thought virtually complete
• Island, limited number of labs
– Full residential histories available
– Controls age/sex matched, from electoral roll
– Location of all power lines known

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 Cases & controls
• We used an existing dataset collected 1972-80
• Included all diagnosed cases of LPD & MPD in Tasmania
• 783 adult cases and 71 childhood cases
• One control per patient
– By random numbers from electoral role (registration compulsory)
– Matched for sex and age ± 5 years
• Original study sought links between diagnoses &
– Occupation
– Place of residence
– Published x 2 in Journal of the Natl Cancer Institute 1984
• Contained complete residential history 9
 Risk Factors Considered

• Distance from nearest power line

– 0-50 m, 51-100 m, 101-300 m
• Voltage of nearest line ≤300 m (88 kV, 110 kV,
220 kV)
• Number of years of residential exposure (≤300 m)
• Timing of residential exposure
– 0-15 years, 15 years prior to diagnosis, ever
• Age at time of residential exposure
– 0-5 years, 6-11 years, 12-17 years 10
 Diagnoses of
Category
Cases
Diagnosis n
LPD NHL 263
MM 123
CLL 87
HD 83
ALL 47
MPD C-MPD 113
CML 104
AML 34
TOTAL 854 11
 Distance from Power Lines
• Tasmanian power grid comprises lines of
88, 110 & 220 kV
• Commenced in 1895
• Dates of commissioning, decommissioning known
• Distances determined from maps or visit
• Exact distances calculated if ≤300 m
• Help from Australia Post, archives office, etc
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 Statistical methods
• Conditional logistic regression model
• Calculated odds ratios & 95% confidence intervals
• Controlled for
– Socio-economic status
– Occupations previously found to increase risk
• Farming, foundry work, mining, female hairdressing
– Number of addresses (cases > controls)
– Tasmania-only residence (201 case-control pairs)
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 Number of cases and
controls studied

Tasmanian
All pairs
only

Adults 768 201

Children 71 52
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 Results

• Total number of addresses 9249

• Of which Tasmanian 7590

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 Closest distance ever lived
to a power transmission line

Patients Controls
Distance
n=854 n=854

0-50 m 19 9

51-300 m 75 55

Crude odds ratio 1.5; p<0.01 17

 Socio-economic status
• Higher SE group taken as baseline
• Lower two SE groups had increased OR in dose-
dependent manner: 1.6 & 1.7 (p<0.01)
• For Tasmanian pairs only, OR were 2.1 & 2.8
(p≤0.01)
• All analyses (except crude relationship) have been
corrected for SE status

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Risk associated with ever having
lived
0-50 m or 51-300 m from a power
line compared with ‘never’
Distance (m) Odds Ratio 95% CI

0-50 2.06 0.87, 4.91

51-300 1.30 0.88, 1.91

>300 1.00 -
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Risk associated with ever having
lived
0-50 m or 51-300 m from a power
line compared with ‘never’ -
Tasmanian pairs
Distance (m) Odds Ratio 95% CI

0-50 2.93 0.22, 38.4

51-300 1.69 0.77, 3.69

>300 1.00 -
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Risk associated with every year of
residence 0-50 m or 51-300 m from a
power line compared with ‘never’

Distance (m) Odds Ratio 95% CI

0-50 1.07 0.99, 1.17

51-300 1.01 0.98, 1.04

>300 1.00 -
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 Added risks relating to
line voltage, compared to
never
88 kV 33%

110 kV 44%

220 kv 45%
P= ns
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Risk associated with having lived 0-
300 m from a power line at 0-5 years
or 6-17 years compared with ‘≥18
years or never’

Age at exposure Odds Ratio 95% CI

0-5 years 4.74 0.98, 22.9

6-17 years 2.31 0.83, 6.43

≥18 years or never 1.00 -

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Risk associated with having lived 0-
300 m from a power line at 0-5 years
or 6-17 years compared with ‘≥18
years or never’ - Tas pairs

Age at exposure Odds Ratio 95% CI

0-5 years 9.41 0.87, 101.4

6-17 years 4.54 0.22, 92.2

≥18 years or never 1.00 -

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 Early exposure vs recent
exposure compared with
‘never’
Time of exposure OR 95% CI
All pairs 0-15 years of age 3.23 1.26, 8.29
15 y before diagnosis 1.32 0.88, 1.98
Ever 1.40 0.98, 2.00
Tasmanian
0-15 years of age 6.63 0.73, 60.5
pairs only
15 y before diagnosis 1.63 0.66, 4.03
Ever 1.74 0.81, 3.76 25
Risk associated with having lived
0-300 m from a power line at 0-15
years compared with never, by
diagnosis

Diagnosis Odds Ratio 95% CI

LPD 6.18 1.37, 27.90

MPD 1.69 0.45, 6.37

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Exposure at time of birth

Patients 8
Controls 1
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 Methodological concerns
• Problems with controls
– Controls & cases selected differently
– Only a minority of invited controls accepted
• Controls more likely to have been born outside Tasmania
– Cases interviewed, controls sent mail questionnaire
• Possible ascertainment bias of case addresses
– However we attempted to control for these concerns
• Small numbers - wide CIs
• LPD, MPD pooled
• Observational study – cannot infer causality
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 Difficulties in
interpretation
• Factors other than lines themselves or EMFs
– SE status (perhaps incompletely controlled for)
• Lack of laboratory support for a link
– However no tests on newborn animals or in utero
• Difficult to measure exposure (1/rn?)
• 300 m too far for an effect?
– But consider ionised particles
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But our findings are
consistent
• Consistent dose-response effect
– Distance categories (p for trend 0.02)
– Years of exposure
– Line voltage (n.s.)
– Age of exposure (p for trend 0.01)
• Findings strengthened when restricted to
201 Tasmania-only pairs
• Numerous precedents for finding of greatest
risk in childhood or in utero
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 Conclusion

• Our major finding was that prolonged residence

close to high voltage power lines in early
childhood substantially increases the risk of the
later development (in adulthood) of
lymphoproliferative and myeloproliferative
disorders
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 Acknowledgements
• Ethel Young bequest
• Jean Panton
• Konrad Jamrosik
• Richard Bevan & staff of Hydro Tasmania,
Transend and Aurora
• Norelle Lickiss and co-authors of original papers
• Staff of Tasmanian Archives, Electoral Office,
Australia Post, Nomenclature Board 32