Electromagnetic Fields From Mobile Phones and Their Base Stations: Health

Effects
Raika Durusoy and Hür Hassoy, Ege University Medical School, Izmir, Turkey
© 2019 Elsevier B.V. All rights reserved.

Introduction

Exposure to electromagnetic fields (EMF) has become a part of modern life. In the last 130 years, domestic and industrial use of
electricity for energy, heating and illumination has increased exposure to EMF dramatically. Among sources of EMF, radars, mobile
phones, radio and television transmitters have high frequency while power lines, home and medical appliances have low frequency.
Mobile phones are increasingly being used in recent years and they emit and receive low radiofrequency (RF) signals. Their frequen-
cies are between microwave ovens and radio waves in the electromagnetic spectrum.
Radiofrequency waves transmitted by GSM communication may affect the human body through two distinct ways: the first are
thermal effects which are readily measurable and the second is classified as nonthermal effects. Studies are on-going to elucidate the
mechanisms and impacts of these. While radiofrequency waves emitted by mobile phones affect more the closest parts of the body,
especially the head, EMF from their base stations might have impacts on all of the body. These two emissions are in the same
frequency bands but they differ in terms of magnitude and intensity. Another difference between these two exposures is that people
are deliberately exposed to their mobile phone’s radiation and they can control their exposure’s duration, frequency and intensity
while exposure to base stations is involuntary and continuous.
Each day more people and younger people are becoming increasingly exposed to radiofrequency waves originating from mobile
phones and their base stations. There are different frequency bands applied in different countries. Worldwide, 7.74 billion mobile-
cellular subscriptions are estimated for 2017, equivalent to 101.5 per 100 habitants. The dramatic rise in mobile phone use has
increased the number of base stations, since each phone mast has a limited capacity (n) for the number of simultaneous connec-
tions and the (n þ 1)th person trying to connect will not have access unless there are other base stations nearby. Besides, the instal-
lation of 3G after 2G, and then 4.5G after 3G technologies have also increased the demand for base stations since they increase the
amount of data transferred, like images and videos instead of the voice calls and simple texts in 2G. As both the number of users and
the number of phone masts are on the rise, the level of exposure is also rising and thus the importance of this topic is increasing in
terms of public health. Furthermore, the development of smart phones and Wi-Fi technology, has caused a shift of EMF frequency,
causing more exposure to 2100 and 2400 MHz of 3G and Wi-Fi instead of 900 or 1800 MHz of the 2G. Another significant aspect is
the increase of children and adolescents’ use, who start to become exposed at an earlier age when the developing brain is more
susceptible to electromagnetic waves. In PubMed, the yearly number of publications found with the keyword “mobile phone”
has logarithmically increased from < 10 between 1992 and 1996 to 1445 in 2014 and continued to be > 1000 until 2017, reaching
a total of 11,737 articles (PubMed search conducted on August 8, 2018). The WHO International Agency for Research on Cancer
(IARC) classification of RF-EMF as possible carcinogen (Group 2B) due to an increased risk for glioma related to mobile phone use
has also raised the emphasis to the topic.
The human body does not have a sensory system to detect radiofrequency electromagnetic fields (RF-EMF), while our eyes detect
visible light, another band of the electromagnetic spectrum, though cumulating literature about electromagnetic hypersensitivity
(this term recently being replaced by idiopathic environmental intolerance to EMF) has revealed an argument on variations among
people in a kind of sensation of electromagnetic fields (or a sense of changes occurring in their body when exposed to EMF), with
many randomized provocation studies unable to prove a link between such sensitivity and RF-EMF. Our nervous system functions
with electrical signals and physically it is known that electromagnetic fields affect electrical conduction.
The aim of this article is to review the effects of mobile phones and base stations on health in light of the recent scientific
evidence, to present up-to-date information and to discuss possible sources of bias in studies conducted in this field. The health
impacts of mobile phones will be presented first, followed by studies on their base stations. After an introductory mention on
cellular-level impacts, some effects on the functioning or symptoms of the human body will be presented, followed by findings
of epidemiologic studies on especially cancer.

Mobile Phones
Effects at the Cellular Level and on Experimental Animals
There are experimental studies finding various impacts of electromagnetic waves on cells, tissues and organs. Since 1992, there are
increasingly more studies finding evidence that EMF due to mobile phones causes some changes at the cellular level like calcium
efflux from cell membranes, increased expression of stress proteins, alterations in channels/gap junctions in the cell membrane,
overproduction of reactive oxygen species, ornithine decarboxylase activation, decrease in melatonin levels, reduced protein kinase
C activity, damage to DNA and changes in gene expression in brain cells and altered blood–brain barrier. Animal studies have also
shown the development of oxidative stress due to radiation from mobile phones. Free radicals are very reactive molecules

300 Encyclopedia of Environmental Health, 2nd edition, Volume 2 https://doi.org/10.1016/B978-0-12-409548-9.11078-4

 Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects 301

RF-EMW

Chronic exposure Short-term exposure

+
ROS +
ROS EGF
+
NADH oxidase EGF-R

CCF Ca++ channels

©2009
Stress kinases RAS

RAF ERK
+ pathway
p38 MAP kinase
MEK MEK-P

hsp27 hsp27-P
MAPK-P

ODC enzyme

−
hsp27-P hsp27-P
inhibits
Stabilizes
endothelial
stress fiber
Alters secretion of bFGF Apoptosis
(inhibition)
Blood-testis barrier

Infertility

Cancer

Fig. 1 Various targets of radiofrequency EMF in cells. Acute exposure can stimulate the NADH oxidase enzyme in the cell membrane and this can
increase reactive oxygen species (ROS) formation. Increase in ROS’s can stimulate endothelial growth factor (EGF) receptors, which consequently
trigger the extracellular signal regulated kinase (ERK) pathway. The ERK pathway activates Ras, Raf proteins and mitogen-activated protein kinase
(MAPK). The MAPK pathway increases tumor growth. Chronic exposure to ROS’s can stimulate several stress kinases including p38 MAP kinase
which can trigger the ERK pathway and the phosphorylation of heat shock proteins (Hsp), which in turn inhibits apoptosis. The inhibition of
apoptosis increases the life span of cells with DNA damage and might increase cancer development. Hsp also stabilize endothelial stress fibers and
cause changes in bFGF release. This in turn can increase the permeability of the blood-testis barrier and lead to infertility. RF-EMF also increases
carcinogenesis by stimulating ornithine decarboxylase (ODC) which is a rate limiting enzyme in the polyamine synthesis pathway and by changing
the functioning of calcium channels in the plasma membrane.

containing uncoupled electrons in their last orbit. Free radicals originating from oxygen metabolism are called reactive oxygen
species (ROS). The ROS’s are continuously inactivated by antioxidants found in the tissues of the body. When ROS production
surpasses the inactivation capacity of the antioxidants, oxidative stress occurs. When exposed in the short term and long term,
mobile phones cause the formation of ROS’s. Fig. 1 summarizes both these effects and other impacts through calcium channels
and the enzyme ornithine decarboxylase. There are also some other mechanisms identified through which mobile phones affect
gene and protein expression and DNA damage.
Studies have found various alterations in many different organs and tissues in experimental studies exposing animals to RF-EMF.
Among studies on the learning processes of experimental animals, some have found effects of EMF while others have not. Studies on
the immune, nervous, neuroendocrine, cardiovascular systems and on blood parameters are also controversial. A reason why some
studies find a relationship while others do not might be the differences in their experimental procedures while another reason might
be funding bias revealed by Henry Lai examining 326 studies on the biological impacts of mobile phones and finding that 67.0% of
those financed independently had found significant impacts versus 28.1% of industry-financed studies (P < .0001). The repeat-
ability of these studies have been questioned and thus they are re-tested through novel studies.

Impacts on the Functioning of the Human Body and Various Symptoms

Detectable changes occur in brain functions and behavior with mobile phone use. An experimental study has detected signif-
icant alterations in EEG activity after a duration of 15 min with a 3G dialing mobile phone located on the ear, but no
302 Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects

significant change was observed when the same phone was placed on the chest, indicating the importance of the position of the
phone. Exposure to mobile phone EMF can even alter the electrical activity of the brain at low Specific Absorption Rate (SAR)
values like 0.1 W/kg. However, the International Commission on Non-Ionizing Radiation Protection (ICNIRP) recommends
2.0 W/kg as a safety limit and the limit value in the United States is 1.6 W/kg. Studies on the nervous system and brain func-
tioning have mostly focused on acute, short-term effects and various changes in the brain’s electrical activities have been
detected. There are important differences in the results of these studies due to divergence in their experimental designs.
Some studies report several impacts of mobile phone EMF on working memory or brain activity like speeding up response
time, effects on preparatory slow brain potentials under visual monitorization or impacts on rapid eye movements during
REM sleep. A study exploring the impacts of mobile phones on young adolescents’ cognitive functions has found that 7th grade
students with higher number of calls responded more quickly in cognitive tests but their error rates were higher. There are
studies finding an increased permeability of the blood–brain barrier due to mobile phone EMF, thus increasing the brain’s
exposure to hazardous chemicals.
A study following 13,000 pregnant women in Denmark has found that the children of women who had used mobile phones
before and after pregnancy had a 1.8 higher risk of behavioral disorders, more prominently mood problems and hyperactivity,
when they attained 7 years of age. The researchers have pointed out that a causal relationship might be lacking, that some unmea-
sured confounders might be present, but if there is really such a relationship, the public health impacts would be very significant
considering the wide use of this technology.
Chronic exposure to RF-EMF can also cause various biological effects like headache, fatigue, sleep, concentration, memory
disturbances, and heating around the ear. These biological effects have been termed as “nonspecific symptoms” in the literature.
In a study on symptoms encountered among mobile phone users in a French engineering school, feeling of discomfort during
calls and warming in the ear were more frequent among participants speaking more than 2 min/day on their mobile phone. Feeling
of discomfort, warming in the ear and numbness of the ear were more frequent among students having more than two calls per day.
A study on 808 participants in Singapore has found that headache was more frequent in mobile phone users and that the frequency
of headache increased with increasing daily call duration in minutes, indicating a possible dose-response relationship. A study on
Swedish adolescents had found increasing and significant ORs with increasing duration of calls per day for the symptoms allergy,
asthma, hay fever, dizziness, headache, concentration difficulties, stress, and tiredness. Similarly, a study on 2150 high school
students in Turkey has found dose–response relationships between especially the number of calls per day, the total duration of calls
per day, the total number of text messages sent/received per day, the position and status of the mobile phone at night and making
calls while charging as exposures and especially headache, concentration difficulties, fatigue, sleep disturbances, warming of the ear
and flushing among the 23 symptoms questioned. According to the same study, increasing SAR values of mobile phones were
related to increases in the prevalence of headache, concentration difficulties, fatigue and sleep disturbances. Another study on
medical students had found increasing prevalence of eight symptoms with increasing duration of calls per day. In a population
survey using personal dosimeters, headache was the only symptom observed 1.5 times more among adolescents in the last quartile
of exposure. An experimental provocation study has found a significant increase in headache after 3 h of exposure, among 15 symp-
toms questioned. According to a prospective study with 1-year follow-up, heavy use of mobile phones was related to difficulties in
falling asleep among male college students. Review studies mention other research finding a possible link between exposure to EMF
and such symptoms.

Mobile Phones and Cancer

The establishment of a link between EMF radiating from electrical wiring configurations and childhood cancer has been a turning
point for studies in this field. In 1979, Wertheimer and Leeper have published a study conducted in Denver and have found a 3.0-
fold increased risk of leukemia, 2.4-fold for central nervous system tumors and 2.8-fold for lymphoma, which was supported by
further studies and has resulted in WHO International Agency for Research on Cancer’s (IARC) “possibly carcinogenic to humans”
classification of extremely low-frequency magnetic fields (Group 2B). This was a landmark on nonionizing radiation’s link to cancer
and a strong opposition against the then-popular belief that nonionizing radiation would not cause cancer.
Five pioneer studies conducted in the beginning era of cell phone technologies and published between 2000 and 2002 have not
detected a significant risk of brain tumors. The duration of exposure in these studies were not sufficient for tumor development,
however, two of them have found P < .10 and another has found a significant 20% increase in risk per each year of cell phone
use. These studies could be considered as precursors of a problem to be revealed in the future.
WHO IARC has organized a series of 16 multicenter case-control studies called Interphone, to which centers from 13 countries
have participated (Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and
the United Kingdom) with a common protocol and method, where 2600 glioma, 2300 meningioma, 1100 acoustic neuroma, 400
parotid gland tumor cases and their relevant controls have been evaluated for their mobile phone related RF-EMF exposure in the
past.
Table 1 summarizes the Interphone and other studies on cell phones and cancer risk according to the cancer type evaluated. The
odds ratios (OR) of short-term exposure to cell phones are presented in the first columns, followed by ORs of 10 years or more
exposure, unless otherwise specified. If present, findings on the ipsilateral tumor evaluations are presented in the last columns,
all ORs presented with their relevant numbers of cases (The development of the tumor on the same side of the head that the tele-
phone is used). The statistically significant ORs are marked in bold letters.
Table 1 Risk of tumor (OR) according to tumor type, duration of cell phone use and laterality in Interphone and other case-control studies on cancer

Year of diagnosis Phone type/tumor Exposed to mobile >10 years use OR >10 years and ipsilateral
Tumor type and study for cases subtype phones OR (95% CI) Cases (95% CI) Cases use OR (95% CI) Cases

Glioma
Hardell et al. (1999) 1994–96 1.0 (0.7–1.4) 78 1.2 (0.6–2.6) 16
Hardell et al. (2002a,b) 1997–2000 Analogous 1.1 (0.7–1.8) 36 1.2 (0.8–1.8)a 43 1.8 (1.0–3.4)
Digital 1.1 (0.8–1.4) 100 1.7 (0.7–4.3) 12 2.3 (0.6–8.9)
Hardell et al. (2006a,b,c) 2000–03 Analogous 1.6 (1.1–2.4) 0 3.5 (2.0–6.4) 48
Digital 100 3.6 (1.7–7.5) 19
Hardell et al. (2006a,b,c) 1997–2003 Analogous 1.2 (0.8–1.8) 39 2.4 (1.6–3.4) 8
(combined analysis) Digital 1.2 (1.0–1.5) 256 2.8 (1.4–5.7) 19

Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects
Christensen et al. (2005) 2000–02 Low grade 1.1 (0.6–2.0) 47 1.6 (0.4–6.1) 68
High grade 0.6 (0.4–0.9) 9 0.5 (0.2–1.3) 21
Hours et al. (2007) 2001–03 1.2 (0.7–2.1) 59 2.0 (0.7–5.2)b 21
Schuz et al. (2006) 2000–03 1.0 (0.7–1.3) 138 2.2 (0.9–5.1) 12
Takebayashi et al. (2008) 2000–04 1.2 (0.6–2.4) 56 0.6 (0.2–1.8)a 7
Klaeboe et al. (2007) 2001–02 0.6 (0.4–0.9) 161 0.8 (0.5–1.2)a 70 1.3 (0.8–2.1)a 39
Lönn et al. (2005) 2000–02 1.6 (0.8–3.4) 15
Hepworth et al. (2006) 2000–04 0.9 (0.8–1.1) 508 0.9 (0.6, 1.3) 66 1.6 (0.9–2.8)
Lahkola et al. (2007) 2000–04 0.8 (0.7–0.9) 867 1.0 (0.7–1.2) 143 1.4 (1.01–1.9) 77
(combined analysis)
Aydin et al. (2011) 2004–08 1.4 (0.9–2.0) 352 1.3 (0.7–2.3)
(CEFALO-childhood)
Hardell et al. (2013) 2007–09 Analogous 1.8 (1.04–3.3) 144 3.3 (1.6–6.9)c 30 2.3 (1.2–4.5) 84
Digital 2G 1.6 (1.0–2.7) 546 2.1 (1.2–3.6)d 104 1.7 (1.02–2.9) 322
Coureau et al. (2014) (CERENAT) 2004–06 1.2 (0.9–1.8) 142 1.6 (0.9–3.1) 22 2.1 (0.7–6.1) 167
2.9 (1.4–5.9)e 24
2.1 (1.0–4.3)f 21
Meningioma
Hardell et al. (2005) 2000–03 Analogous 1.2 (0.1–12) 1 2.1 (1.1–4.3) 20
Digital 1.2 (0.8–1.8) 96 1.5 (0.6–3.9) 8
Hardell et al. (2006a,b,c) 1997–2003 Analogous 1.2 (0.8–1.8) 32 1.6 (1.0–2.5) 34
(combined analysis) Digital 1.0 (0.8–1.3) 220 1.3 (0.5–3.2) 8
Christensen et al. (2005) 2000–02 0.8 (0.5–1.3) 67 1.0 (0.3–3.2) 6
Hours et al. (2007) 2001–03 0.7 (0.4–1.3) 71 0.7 (0.3–1.9)b 15
Schuz et al. (2006) 2000–03 0.8 (0.6–1.1) 104 1.1 (0.4–3.4) 5
Takebayashi et al. (2008) 2000–04 0.7 (0.4–1.2) 55 1.1 (0.5–2.1)g 30
Klaeboe et al. (2007) 2001–02 0.8 (0.5–1.1) 98 1.0 (0.6–1.8)a 36 1.1 (0.6–2.3)a 17
Lönn et al. (2005) 2000–02 0.7 (0.5–0.9) 118 0.9 (0.4–1.9) 8 1.3 (0.5–3.9) 5
Lahkola et al. (2007) 2000–04 0.8 (0.7–0.9) 573 0.9 (0.7–1.3) 73 1.1 (0.7–1.7) 33
(combined analysis)
Coureau et al. (2014) (CERENAT) 2004–06 0.9 (0.6–1.3) 194 1.6 (0.6–3.9) 10 2.3 (0.6–9.0) 140
2.6 (1.02–6.4)e 13
1.7 (0.6–4.6)f 10

303
(Continued)
 304
Table 1 Risk of tumor (OR) according to tumor type, duration of cell phone use and laterality in Interphone and other case-control studies on cancerdcont'd

Year of diagnosis Phone type/tumor Exposed to mobile >10 years use OR >10 years and ipsilateral
Tumor type and study for cases subtype phones OR (95% CI) Cases (95% CI) Cases use OR (95% CI) Cases

Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects
Acoustic neuroma
Hardell et al. (2002a,b) 1997–2000 Analogous 3.0 (1.0–9.3) 12 3.5 (0.7–16.8) 7
Digital 1.2 (0.6–2.2) 21
Hardell et al. (2005) 2000–2003 Analogous 9.9 (1.4–69) 2 2.6 (0.9–8.0) 7
Digital 1.7 (0.9–3.5) 29 0.8 (0.1–6.7) 1
Hardell et al. (2006a,b,c) 1997–03 Analogous 2.3 (1.2–4.1) 16 3.1 (1.7–5.7) 19
(combined analysis) Digital 1.4 (1.0–2.1) 75 0.6 (0.1–5.0) 1
Christensen et al. (2005) 2000–02 0.9 (0.5–1.6) 45 0.2 (0.0–1.1) 2
Hours et al. (2007) 2001–03 0.9 (0.5–1.6) 58 0.7 (0.3–1.6)b 14
Schlehofer et al. (2007) 2000–03 0.7 (0.4–1.2) 29
Takebayashi et al. (2008) 2000–04 0.7 (0.4–1.2) 51 0.8 (0.2–2.7)h 4
Klaeboe et al. (2007) 2001–02 0.5 (0.2–1.0) 22 0.5 (0.2–1.4)a 8 0.9 (0.3–2.8)a 5
Lönn et al. (2004) 2000–02 1.0 (0.6–1.5) 89 1.9 (0.9–4.1) 14 3.9 (1.6–9.5) 12
Schoemaker et al. (2005) 1999–2004 0.9 (0.7–1.1) 360 1.0 (0.7–1.5) 47 1.8 (1.1–3.1) 23
(combined analysis)
Moon et al. (2014) 1991–2010 1.0 (0.9–1.0) 119
Parotid gland tumors
Hardell et al. (2004) 1994–2000 0.9 (0.6–1.4) 31 0.7 (0.3–1.7) 6
1.0 (0.7–1.5) 45
Lönn et al. (2005) 2000–02 Benignant 0.9 (0.5–1.5) 77 1.4 (0.5–3.9) 7 2.6 (0.9–7.9) 6
Sadetzki et al. (2008) 2001–03 Total Benignant Malignant 0.9 (0.7–1.1) 460 1.0 (0.5–2.1) 13 1.6 (1.1–2.2)i 121
0.9 (0.6–1.1) 402 0.9 (0.4–2.0) 12
1.1 (0.5–2.1) 58 0.5 (0.1–4.5) 1
Pituitary gland tumors
Takebayashi et al. (2008) 2000–04 0.9 (0.5–1.6) 101 0.8 (0.3–1.8)j 13
Schoemaker and Swerdlow (2009) 2001–05 0.9 (0.7–1.3) 291 1.0 (0.5–1.9) 24
Shrestha et al. (2015) 2000–03 0.4 (0.2–0.7) 80 0.6 (0.2–1.7) 7
Leng and Zhang (2016) 2006–10 7.6 (2.6–21.4) 204 8.5 (2.8–24.4)k

OR, Odds ratio. A measure of risk showing how many times cancer cases were exposed to mobile phones in the past compared to controls.
The Interphone Studies: Denmark (Christensen et al., 2005), France (Hours et al., 2007), Germany (Schuz et al., 2006), Japan (Takebayashi et al., 2008), United Kingdom (Hepworth et al., 2006), Israel (Sadetzki et al., 2007), Norway (Klaeboe et al.,
2007), Sweden (Lönn et al., 2005), Finland (Shrestha et al., 2015), Five North European countries combined (Schoemaker et al., 2005 and Lahkola et al., 2007, the latter with further cases recruited).
a
6 years.
b
46 months.
c
>25 years.
d
15–10 years.
e
Life-long cumulative duration  896 h.
f
 18,360 calls.
g
>5.2 years.
h
>8 years.
i
Cumulative no. of calls > 5479.
j
7.4 years or more.
k
stated as “duration of use.”
 Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects 305

The findings are summarized below according to tumor type:

Glioma: (tumor of brain tissue) In Sweden, 1.6 and 1.2 times increased risks have been found after short-term exposure to digital
mobile phones. For 10 or more years-exposure to analogous phones, risks are elevated 3.5 and 2.4 times, and 3.6 and 2.8 times for
digital phones. For 10 years or more ipsilateral use, increased risks of 1.8 times for analogous and 2.3 times for digital cell phones
have been found. According to the combined analysis of North European country studies, 1.4-fold increase in risk has been detected
for 10 years or more ipsilateral use. In the CEFALO study on childhood brain tumors, a subgroup analysis of participants with oper-
ator data available, brain tumor risk was related to the duration of the child’s subscription of mobile phone but not to the amount
of use. The CERENAT study with data collected between 2004 and 2006 has found a 2.1 times significant risk of glioma in the last
quintile of cumulative number of calls. Hardell’s most recent case-control study, with cases diagnosed between 2007 and 2009, thus
newer than other studies providing the availability of more cases exposed longer has found higher increased significant ORs of 1.8
and 1.6 for analogous and digital 2G mobile phones for ever exposure, while the risks were more elevated (3.3 and 2.1) for latencies
of > 25 years and 15–20 years, respectively. In the same study, ipsilateral use was associated with higher risks compared to contra-
lateral mobile and cordless phone use.
Meningioma: (tumor of the membranes covering the brain) In studies from Sweden, 2.1- and 1.6-fold elevated risks have been
found for 10 years or more exposure to analogous mobile phones. An OR of 2.6 was found in the CERENAT study for life-long
cumulative duration of  896 h on the phone.
Acoustic neuroma: (tumor of the nerve for hearing) In studies from Sweden in 2002 and 2005, increased risks of 3.0 and 9.9 times
have been found for short-term exposure to analogous phones, respectively. Another study from Sweden has found 2.3-fold
elevated risk for digital and 1.4-fold for analogous phones. The risk was 3.1 times for 10 years or more exposure in the same study.
Another study from Sweden has found a significant increase of 3.9 times in risk for 10-years or more ipsilateral use while the
North European countries’ combined analysis has revealed a 1.8 times elevated risk.
Parotid gland tumors: (tumors of the largest salivary gland). An increased risk of 1.6 related to heavy use on the ipsilateral side has
been detected in a study from Israel.
Pituitary gland tumors: A reduced odds ratio of 0.4 was seen in a study among regular mobile phone users compared to never/
nonregular users, possibly reflecting methodological limitations. Other studies have not detected increased risks until a recent study
from China had found an elevated risk of 7.6 among cases diagnosed between 2006 and 2010 for ever use. The pituitary gland could
be considered at a location with less penetration of EMF waves compared to other cancers mentioned above, according to skull
penetration models (Fig. 2).
The publication of the Interphone studies have opened several discussions in this field. These studies have been criticized on
having methodological problems and bias. Other authors have stated that the time lag for tumor development was not enough
and that studies finding no risk were misleading and the emphasis on potential risks was insufficient. In the final combined analysis
of Interphone studies, an elevated risk for ipsilateral and temporal lobe glioma is mentioned for heavy users with a comment that
due to the limitations of the study, this relationship might not be causal and that long-term impacts on heavy users should be eval-
uated by future studies. Indeed, even for tobacco which includes so many carcinogens, a time lag of 20, 30 or sometimes 40 years

Fig. 2 The penetration of electromagnetic radiation from a cell phone based on age. https://www.mobilesafety.com.au/mobile-phone-radiation-
absorption-rates/ (accessed August 8, 2018).
306 Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects

passes between starting smoking and the diagnosis of a cancer, including the latency from the onset of the cancer to its diagnosis
which is estimated as 13.6 years for lung and even longer as 21.9 years for the brain.
Evidence from other types of epidemiologic studies not included in the table is as follows:
In a case-case study on acoustic neuromas, tumor volume significantly increased with increasing cumulative hours on mobile
phone (r2 ¼ 0.144, P ¼ .002) and regular mobile phone users had significantly larger tumors than nonregular users
(8.1  10.7 cm3 vs. 2.7  3.8 cm3, P < .001), indicating a possible link between mobile phone use and tumor growth.
In a nationwide cohort study from Denmark, 355,701 private mobile phone subscribers from 1987 to 1995 were followed until
2007 and incidence rate ratios (IRR) were calculated for skin cancers. After a follow-up period of at least 13 years, the IRRs for basal
cell carcinoma and squamous cell carcinoma were around 1.0. Among men, the IRR for melanoma of the head and neck was 1.2
(0.7–2.2) and the corresponding IRR for the torso and legs was 1.2 (0.9–1.5). Although relying on smaller numbers, a similar insig-
nificant risk pattern was seen among women.
The Million Women Study, a prospective cohort from the United Kingdom, has examined 791,710 middle-aged women to
explore the relation between mobile phone use and incidence of intracranial central nervous system (CNS) tumors and other
cancers. The risk among ever versus never mobile phone users was 1.0 (0.9–1.1) for all intracranial CNS tumors, with no significant
increased risk for specified CNS or 18 other site cancers. For > 10-year users compared with never users, the glioma risk was 0.8 (0.6–
1.1) and meningioma risk 1.1 (0.7–1.8). For acoustic neuroma, there was a significantly increased 2.5 times (1.1–5.6) risk for expo-
sure over 10 years, the risk increasing with duration of use (trend among users, P ¼ .03).
A recent meta-analysis on glioma evaluating 11 studies has found a significant relationship between > 5 years mobile phone use
and glioma risk with a pooled OR of 1.4 (1.1–1.6).
Fig. 3 shows an increasing trend in the incidence of especially benign/borderline cancers of the brain and other nervous system
(SEER 18 areas), along with the increase in U.S. mobile-cellular subscriptions per 10 inhabitants. All of acoustic neuromas and
approximately 90% of the meningiomas are benign cancers, while gliomas can be either benign or malignant.
A trend analysis from the U.S. has concluded that glioma incidence rates remained generally constant between 1992 and 2008.
Similarly, an ecological trend analysis from Australia between 1982 and 2012 has found significant elevations in brain cancer inci-
dence only in the age group > 70 years but this trend had started in 1982, before the introduction of mobile phones, possibly due to
increased diagnostic facilities. Another comprehensive time-series analysis from England between 1985 and 2014 has not found
evidence of an increase in malignant glioma, glioblastoma multiforme, or malignant neoplasms of the parietal lobe, however,
malignant neoplasms of the temporal lobe, the closest lobe to the ear and thus to mobile phones, had increased faster than
expected.

Fig. 3 Recent trends in cancer incidence rates and mobile-cellular telephone subscriptions in the United States, 2000–15. (Data sources: SEER
Recent Trends in Incidence Rates, 2000–15 (both sexes, all ages, all races, SEER 18 areas), NIH, NCI, Surveillance, Epidemiology, and End Results
Program (SEER), SEER*Explorer, accessed August 7, 2018, https://seer.cancer.gov/explorer/application.php and ITU Country ICT Data (Until 2016)
Mobile-cellular subscriptions, accessed August 8, 2018, https://www.itu.int/en/ITU-D/Statistics/Documents/statistics/2018/Mobile_cellular_2000-2016.
xls, with rates/ratios adapted to appropriate denominators to ease visualization of data in a scale between 0 and 15).
 Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects 307

Points to Be Considered When Reading Studies on the Impacts of Mobile Phones on Health
There are several sources of bias especially for studies on mobile phones and cancer. The most important bias in the first studies on
brain tumors was the too short duration of exposure to mobile phones for cancer development, precluding the detection of a rela-
tionship between them, mentioned above.
A study evaluating all mobile phone and brain tumor case-control studies up to March 2009, has detected that among the 11
single country studies of Interphone, 15 OR’s were under 1.0 versus only two OR’s greater than 1.0 indicating increased risk. Accord-
ing to the author, cell phones are either protective, or there are important design errors in the Interphone study protocol. According
to IARC, 3.5 million Euros were received from GSM firms and 3.85 million Euros from EU funds to conduct the Interphone studies.
On the other hand, Hardell et al. from Sweden, who conducted research financially independent of the industry, have found many
increases in risk related to mobile and wireless phone use. Morgan has identified 11 design flaws in the Interphone studies, 8 of
them with a tendency to underestimate the risk of brain tumors, like 0% prevalence of 10 years or more use in three of the studies
(Norway, France, Germany) or the higher nonresponse rate among the control groups due to the rejection by people not using
mobile phones, thus leading to control groups being composed of a higher prevalence of mobile use compared to the general
population.
If mobile phones cause cancer after a long latent period, mobile phone use today might be causing many cancers in the future
but as there were much fewer users in the years that these studies were conducted, they might have caused very few of the cancers
evaluated. The induction period of radiation-related cancers is usually more than 10 years.
Dr. Lai’s evidence-based warning on financing bias already mentioned above should be considered as well.

Conclusions
Mobile phones could interfere with the functioning of our cells, tissues and organs and might be responsible from some of the
general, nonspecific symptoms observed daily by many people, showing dose-response in some studies. More research efforts
are needed to arrive to more specific conclusions. As for cancer, although many studies have not yet found significant increased risks,
the presence of significantly increased risks mostly after 10 years of exposure and on the ipsilateral side might be warnings of a longer
time-lag association with cancer. So further studies with more prolonged durations of exposure are needed, however, as in the
meantime the number of the unexposed has also dramatically decreased, cumulative exposure measures might be useful in these
studies. Although epidemiologic studies find might find associations, their confirmation by laboratory tests and experimental
studies, thus biologic plausibility is also important in the precision of the conclusions.
Thus, until scientific evidence is clear about the risks, it would be wise to take precautionary measures in daily life, like using
earphones with cables, choosing mobile phones with lower SAR values, limiting the use of mobile phones when inside vehicles
or when very far from base stations and in general, minimizing their use to only necessary situations and using alternatives like fixed
telephones and computers with cabled internet if accessible.

Possible Health Effects of Mobile Phone Base Stations

Introduction
The wireless technology has seen an unprecedented growth around the world and has become widespread. In addition to the
increasing number of subscribers, the amount of data transferred via new technologies is getting larger. Consequently, the
number of base stations is increasing steadily, especially in urban centers. In mobile communication, the whole field of
communication is divided into small sections called cells. At the center of each cell, there exists a base station which allows
us to communicate. The base stations are connected to one another with a network structure and this network structure carries
the call request from any mobile phone to the relevant user. Mobile phones and base stations are linked to each other
through electromagnetic waves. This cellular structure allows multiple users to communicate at the same time. However,
the connection capacity of each base station is limited. Increasing number of calls and data transmission result in the need
for establishment of new base stations day by day. On the other hand, the greater number of subscribers communicating within
the area covered by the base station means lower performance of data transmission. The speed of data transmission is getting
more and more important, so GSM operators need more base stations to fulfill their service commitments because of their
commercial roles.
In a review on the health impacts of base stations, it has been reported that findings about the adverse effects on health are not
yet sufficient. But the absence of any evidence does not mean that there is no risk. It is noted that the studies should be focused on
children and adolescents, and should be done prospectively. Base stations around public spaces such as playgrounds, parks, market
places, and schools have also become a subject of debate among public officials responsible for protecting public health. There is
conflicting information on the health effects of base stations in public opinion. Studies examining the health impacts of the elec-
tromagnetic radiation (EMR) have argued a wide range of effects such as various health symptoms, cancer, changes in hormone and
neurotransmitter levels. The goal of this review is to compile current scientific studies evaluating the health impacts of base stations
and emphasize the effects on human health, and it is aimed to contribute for meeting the need of scientific knowledge on this
subject.
 308
Table 2 Characteristics of studies that examine the health effects of base stations

Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects
Year of EMF
Study publication Journal Setting measurement Sample Results

Santini et al. 2002 Pathologie Biologie France  Total 530,270 men, Depression, memory loss, dizziness, loss of libido were
260 women found to be significantly more frequent up to 100 m of
the base station, compared to >300 m. Headache,
sleep disturbance, discomfort, irritability were more
frequent up to 200 m, only fatigue was significantly
more frequent in 200–300 m of the base station
Santini et al. 2003 Pathologie Biologie France  Total 530,270 men, More symptoms were detected among people
260 women living <300 m from the base station
Navarro et al. 2003 Electromagnetic Biology and Spain þ 101 The severity of symptoms for people living at <150 m
Medicine distance to the base station is higher than those living
250 m away
Eger et al. 2004 Umwelt Medizin Gesellschaft Germany  967 As a result of the 5-year follow-up, the incidence of
cancer was found to be three times higher in < 400 m
distance to the base station
Wolf and Wolf 2004 International Journal of Cancer Israel þ 622 cases The cancer incidence increases at a distance of < 350 m
Prevention 1222 controls and a fourfold increase in risk of cancer is observed
after 3–7 years of exposure
Hutter et al. 2006 Occupational and Environmental Austria þ 365 Headache is more common in people living less than
Medicine 150 m to a base station
Regel et al. 2006 Environmental Health Perspectives Switzerland þ 117 healthy subjects A short-term effect of UMTS base station-like exposure
33 sensitive, 84 nonsensitive on well-being was not confirmed. The reported effects
on brain functioning were marginal and may have
occurred by chance
Abdel-Rassoul et al. 2007 Neurotoxicology Egypt þ 85 cases The prevalence of neuropsychiatric complaints as
80 controls headache, memory changes, dizziness, tremors,
depressive symptoms and sleep disturbance were
significantly higher among exposed inhabitants than
controls
Eltiti et al. 2007 Environmental Health United þ 56 cases Short-term exposure to a typical GSM base station-like
Perspectives Kingdom 120 controls signal did not affect well-being or physiological
functions in both cases and controls
Riddervold et al. 2008 Bioelectromagnetics Denmark þ 40 adolescents 40 adults No significant changes were found in any of the
cognitive tasks. An increase in “headache rating” was
observed when data from the adolescents and adults
were combined. In conclusion, the primary hypothesis
that UMTS radiation reduces general performance in
the TMB test was not confirmed
Blettner et al. 2009 Occupational and Environmental Germany  30,047 Participants who were concerned about or attributed
Medicine adverse health effects to mobile phone base stations
and those living in the vicinity of a mobile phone base
station (500 m) reported slightly more health
complaints than others
Berg-Beckhoff et al. 2009 Occupational and Environmental Germany þ 3526 There was no relationship between electromagnetic
Medicine radiation emitted from base stations and adverse
health effects
Furubayashi et al. 2009 Bioelectromagnetics Japan þ 11 cases There was no causal relationship between the
43 controls symptoms of hypersensitivity and exposure to the
electromagnetic field


Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects
Augner et al. 2009 Indian Journal of Occupational Austria 57 Neighbors to the base station were found to be more
Environmental Medicine nervous than the other group and it was independent
from the anxiety about the electromagnetic field
Augner and Hacker 2009 Bioelectromagnetics Austria þ 57 Short-term exposure to GSM base station signals may
have an impact on well-being by reducing
psychological arousal
Augner et al. 2010 Biomedical and Environmental Austria þ 57 Elevated levels of cortisol and alpha-amylase were
Sciences detected at low to high exposure levels. IgA levels
were not significantly altered. It has been found that
psycho-biological stress markers are affected even at
lower values than ICNIRP limits
Eger and Jahn 2010 Umwelt-Medizin-Gesellschaft Germany þ 251 Significant correlation was found between neurological
symptoms and electromagnetic radiation, which
showed dose-response relationship
Elliott et al. 2010 BMJ United þ 1397 cases 5588 controls There was no relationship between the mother’s
Kingdom exposure to mobile phone in pregnancy and early
childhood cancers
Danker-Hopfe et al. 2010 American Journal of Human Germany þ 397 Objective and subjective sleep data did not differ
Biology between the different electromagnetic field
constructions. The presence of a base station affects
the quality of sleep negatively rather than its
electromagnetic radiation
Dode et al. 2011 Science of the Total Brazil þ 7191 cases Half of the cancer deaths in the city occurred in those
Environment living 100 m or less from a base station. Cancer
mortality was 32.1%00 in city and 43.4 in those living
nearer than 100 m of a base station. The greater the
distance to the base station, the lower the frequency of
death from cancer
Buchner and Eger 2011 Umwelt-Medizin-Gesellschaft Germany þ 60 cases Increase in adrenaline and noradrenaline levels,
decrease in dopamine levels, decrease in phenyl ethyl
alanine levels. It is determined a dose response
relationship is present, and this condition is seen
below the current limit values

309
(Continued)
 310
Table 2 Characteristics of studies that examine the health effects of base stationsdcont'd

Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects
Year of EMF
Study publication Journal Setting measurement Sample Results

Eskander et al. 2012 Clinical Biochemistry Egypt  102 total; 82 cases Degenerative effects on ACTH, cortisol, thyroid,
20 controls prolactin, testosterone hormones are more
pronounced in long-term mobile phone users and
those living closer to base stations
Wallace et al. 2012 Bioelectromagnetics United þ 48 cases These findings are similar to previous double-blind
Kingdom 132 controls studies which could not establish any clear evidence
that mobile phone signals affect health or cognitive
function
Li et al. 2012 Science of the Total Taiwan þ 2606 cancer cases It has been found that exposure to electromagnetic
Environment 939 leukemia, 394 brain tumor radiation above the median value significantly
increases the risk for all cancers but leukemia and
brain tumors did not significantly increase with
electromagnetic radiation exposure
Bortkiewicz et al. 2012 International Journal of Poland þ 500 Total There is no relationship between the intensity of the
Occupational Medicine and 181 Male electromagnetic field and the subjective symptoms but
Environmental Health 319 Female it is determined by distance
Stewart et al. 2012 Perspectives in Public Health United States  19 Residents who developed We cannot conclude that the base station was
cancer responsible for the cancers. It is unlikely that
information around a single base station can either
demonstrate or exclude causality
Gomez-Perretta et al. 2013 BMJ Open Spain þ 88 Participants The symptoms most related to exposure were lack of
appetite, lack of concentration, irritability and trouble
in sleeping. The incidence of most of the symptoms
was related to exposure levels independently of the
demographic variables and some possible risk factors
Shahbazi-Gahrouei 2014 Electromagnetic Biology Iran  250 Total Symptoms such as nausea, headache, dizziness,
et al. and Medicine 133 Women 117 Men irritability, discomfort, nervousness, depression, sleep
disturbance, memory loss and lowering of libido were
statistically significant in inhabitants living near the
BTS antenna (<300 m distance) compared to those
living far from the BTS antenna (>300 m)
Gandhi et al. 2014 Electromagnetic Biology India þ 91 Individuals Statistically significant genetic damage was observed in
and Medicine those residing within 300 m of a mobile phone base
station. The study implies that the effects of radiations
from mobile phone base stations cannot be
overlooked, as unrepaired DNA damage can lead to
cancer, precocious aging and age-related effects
Eltiti et al. 2015 Bioelectromagnetics United þ 102 cases Findings are indicating that there is no causal
Kingdom 237 controls relationship between short-term exposure to EMFs
and subjective well-being in members of the public
whether or not they report perceived sensitivity to
EMFs
Malek et al. 2015 Scientific Reports Malesia þ 200 In total; 100 cases No significant effects of short-term GSM and UMTS
100 Controls base station signal exposure on cognitive
performance, body temperature, blood pressure and

Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects
heart rate of Malaysians
Meo et al. 2015 International Journal of Saudi Arabia þ 159 Students Exposure to high RF-EMF generated by MPBS is
Environmental Research associated with elevated level of HbA1c and
Public Health prevalence of pre-diabetes mellitus among school
aged adolescents
Singh et al. 2016 Journal of International Society India  20 cases A majority of subjects residing near the mobile base
of Preventive and Community 20 controls station complained of sleep disturbances, headache,
Dentistry dizziness, irritability, concentration difficulties, and
hypertension. A majority of the study subjects had
significantly lesser stimulated salivary secretion as
compared to the control subjects
Baliatsas et al. 2016 Science of the Total Environment Netherlands þ 1069 adults The before-after study found no evidence that RF-EMF
exposure from mobile phone base stations is
associated with the development of symptoms in the
general population
Zhou et al. 2017 Chinese Journal of Integrative China  34,417 Cases of pregnant Having a cold during pregnancy, decoration, keeping
Medicine women pets, living within 100 m of a mobile communication
base station and high self-rated anxiety are
independent risk factors of spontaneous abortion in
Beijing
Satta et al. 2018 Radiation Research Italy þ 322 patients 444 controls Results do not support the hypothesis of a link between
environmental exposure to RF-EMF from mobile
phone base stations and risk of lymphoma subtypes

311
312 Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects

Methods
A literature search was conducted up to July 27, 2018. “Base station” and “health” keywords were searched in the PubMed search
engine and 162 articles were identified. Among these articles, 57 were excluded in the review since they were conducted in different
fields. Additionally, 29 which were not examining health impacts were also excluded. In addition to these, 25 of them were meth-
odological studies or they contained only EMF measurement, 7 articles were carried out at cellular level or evaluated effects on
animals or plants, 6 research papers were on risk perception, and 2 studies on mobile phones were also not included in this review.
Finally, 36 original research articles related to the subject were reviewed.
Table 2 presents the characteristics of the original research articles examining the health effects of the base stations.

Conclusion
Among the studies found, 19 have detected an association between electromagnetic radiation and different health indicators, 13 of
the studies have not found any association, and in 5 of the studies the hypothesis was not totally confirmed. 21 of the studies have
investigated acute, 9 chronic and 3 both acute and chronic effects of base stations on health. EMF measurements were not conducted
in 10 of the studies and distance to base stations was used as a proxy instead. 26 of the studies measured EMF. Studies are showing
signs of possible health risks due to base stations. Sleep disorders, depressive symptoms, headache, dizziness, concentration diffi-
culties are the most frequently identified symptoms.
Exposure limit values for base stations are based on acute, short-term effects. Sufficient data has not been generated regarding
chronic long-term effects. In 1998, the ICNIRP established international standards for the protection of the public and employees.
In establishing these standards, only the thermal effect of radiation has been taken into account and standards have not yet been
established which take into account other biological effects on living organisms. As a result of the work done in this field, two opin-
ions have arisen in the scientific world. One opinion is that this kind of radiation causes negative effects on health and the other is
the opinion that such kind of radiation does not pose any harm to health. Long-term studies must be conducted by independent
researchers in order to establish a definite opinion in this regard.
In order to protect public health and to prevent a possible danger, implementations made in this area should be made in accor-
dance with the United Nations’ “Precautionary Principle” as emphasized in reports. In the long run, people living in the radiation
angle of phone masts may develop health problems depending on the time exposed, distance to base stations, the level of the EMF
and their somatic resistance.
In what follows are some suggestions to protect community health. The places where antennas and towers are to be installed
should be planned so as to minimize exposure. Universities and professional chambers should be consulted for studies on the
monitoring and supervision of electromagnetic pollution as well as on the selection of equipment and location of base stations.
Base stations planned to be installed near places such as hospitals, schools, kindergartens and children’s playgrounds should
not be licensed. Base stations should be periodically inspected. Safety certificates and measured values should be affixed to places
where the public can see them. Current regulations regarding electromagnetic fields should be updated in the light of scientific
studies.

See also: Electromagnetic Fields: Environmental Exposure; Low-Frequency Magnetic Fields: Potential Environmental Health Impacts; Radio Frequency
Electromagnetic Fields: Health Effects.

References

Aydin, D., Feychting, M., et al., 2011. Mobile phone use and brain tumors in children and adolescents: A multicenter case-control study. Journal of the National Cancer Institute 103
(16), 1264–1276.
Abdel-Rassoul, G., Abou El-Fateh, O., et al., 2007. Neurobehavioral effects among inhabitants around mobile phone base stations. Neurotoxicology 28 (2), 434–440.
Augner, C., Hacker, G.W., 2009. Are people living next to mobile phone base stations more strained? Relationship of health concerns, self-estimated distance to base station, and
psychological parameters. Indian Journal of Occupational and Environmental Medicine 13 (3), 141–145.
Augner, C., Florian, M., et al., 2009. GSM base stations: Short-term effects on well-being. Bioelectromagnetics 30 (1), 73–80.
Augner, C., Hacker, G.W., et al., 2010. Effects of exposure to GSM mobile phone base station signals on salivary cortisol, alpha-amylase, and immunoglobulin A. Biomedical and
Environmental Sciences 23 (3), 199–207.
Baliatsas, C., van Kamp, I., et al., 2016. Clinically defined non-specific symptoms in the vicinity of mobile phone base stations: A retrospective before-after study. Science of the
Total Environment 565, 714–720.
Berg-Beckhoff, G., Blettner, M., et al., 2009. Mobile phone base stations and adverse health effects: Phase 2 of a cross-sectional study with measured radio frequency elec-
tromagnetic fields. Occupational and Environmental Medicine 66 (2), 124–130.
Blettner, M., Schlehofer, B., et al., 2009. Mobile phone base stations and adverse health effects: Phase 1 of a population-based, crosssectional study in Germany. Occupational and
Environmental Medicine 66 (2), 118–123.
Bortkiewicz, A., Gadzicka, E., et al., 2012. Subjective complaints of people living near mobile phone base stations in Poland. International Journal of Occupational Medicine and
Environmental Health 25 (1), 31–40.
Buchner, K., Eger, H., 2011. Changes of clinically important neurotransmitters under the influence of modulated RF fields-a long term study under real-life conditions. Umwelt-
Medizin-Gesellshaft 24 (1), 44–57.
Christensen, H., Schuz, J., et al., 2005. Cellular telephones and risk for brain tumors: a population-based, incident case-control study. Neurology 64, 1189–1195.
 Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects 313

Coureau, G., Bouvier, G., et al., 2014. Mobile phone use and brain tumours in the CERENAT case-control study. Occupational and Environmental Medicine 71 (7), 514–522.
Danker-Hopfe, H., Dorn, H., et al., 2010. Do mobile phone base stations affect sleep of residents? Results from an experimental double-blind sham-controlled field study. American
Journal of Human Biology 22 (5), 613–618.
Dode, A.C., Leao, M.M., et al., 2011. Mortality by neoplasia and cellular telephone base stations in the Belo Horizonte municipality, Minas Gerais state, Brazil. Science of the Total
Environment 409 (19), 3649–3665.
Eger, H., Jahn, M., 2010. Specific symptoms and radiation from mobile basis stations in Selbitz, Bavaria, Germany: Evidence for a dose-effect relationship. umwelt medizin
gesellschaft 23 (2), 130–139.
Eger, H., Hagen, K., et al., 2004. Einfluss der räumlichen Nähe von Mobilfunksendeanlagen auf die Krebsinzidenz. Umwelt-Medizin-Gesellschaft 17 (4), 326–335.
Elliott, P., Toledano, M.B., et al., 2010. Mobile phone base stations and early childhood cancers: Case-control study. British Medical Journal 340, c3077.
Eltiti, S., Wallace, D., et al., 2007. Does short-term exposure to mobile phone base station signals increase symptoms in individuals who report sensitivity to electromagnetic fields?
A double-blind randomized provocation study. Environmental Health Perspectives 115 (11), 1603–1608.
Eltiti, S., Wallace, D., et al., 2015. Aggregated data from two double-blind base station provocation studies comparing individuals with idiopathic environmental intolerance with
attribution to electromagnetic fields and controls. Bioelectromagnetics 36 (2), 96–107.
Eskander, E., Estefan, S., et al., 2012. How does long term exposure to base stations and mobile phones affect human hormone profiles? Clinical Biochemistry 45 (1–2), 157–161.
Furubayashi, T., Ushiyama, A., et al., 2009. Effects of short-term W-CDMA mobile phone base station exposure on women with or without mobile phone related symptoms.
Bioelectromagnetics 30 (2), 100–113.
Gandhi, G., Kaur, G., et al., 2014. A cross-sectional case control study on genetic damage in individuals residing in the vicinity of a mobile phone base station. Electromagnetic
Biology and Medicine 34 (4), 344–354.
Gomez-Perretta, C., Navarro, E.A., et al., 2013. Subjective symptoms related to GSM radiation from mobile phone base stations: A cross-sectional study. BMJ Open 3 (12),
e003836.
Hardell, L., Carlberg, M., et al., 2005. Case-control study on cellular and cordless telephones and the risk for acoustic neuroma or meningioma in patients diagnosed 2000–2003.
Neuroepidemiology 25, 120–128.
Hardell, L., Carlberg, M., et al., 2006a. Case-control study of the association between the use of cellular and cordless telephones and malignant brain tumors diagnosed during
2000–2003. Environmental Research 100, 232–241.
Hardell, L., Carlberg, M., et al., 2006b. 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. International Journal of Oncology 28, 509–518.
Hardell, L., Carlberg, M., et al., 2006c. Pooled analysis of two case-control studies on use of cellular and cordless telephones and the risk for malignant brain tumours diagnosed in
1997–2003. International Archives of Occupational and Environmental Health 79, 630–639.
Hardell, L., Carlberg, M., et al., 2013. Case-control study of the association between malignant brain tumours diagnosed between 2007 and 2009 and mobile and cordless phone
use. International Journal of Oncology 43, 1833–1845.
Hardell, L., Hallquist, A., et al., 2002a. Cellular and cordless telephones and the risk for brain tumours. European Journal of Cancer Prevention 11, 377–386.
Hardell, L., Hallquist, A., et al., 2004. No association between the use of cellular or cordless telephones and salivary gland tumours. Occupational and Environmental Medicine 61,
675–679.
Hardell, L., Mild, K., et al., 2002b. Case-control study on the use of cellular and cordless phones and the risk for malignant brain tumours. International Journal of Radiation Biology
78, 931–936.
Hardell, L., Nasman, A., et al., 1999. Use of cellular telephones and the risk for brain tumours: A case-control study. International Journal of Oncology 15, 113–116.
Hepworth, S., Schoemaker, M., et al., 2006. Mobile phone use and risk of glioma in adults: Case-control study. British Medical Journal 332, 883–887.
Hours, M., Bernard, M., et al., 2007. Cell phones and risk of brain and acoustic nerve tumours: The French INTERPHONE case-control study. Revue d’Epidémiologie et de Santé
Publique 55, 321–332.
Hutter, H., Moshammer, H., et al., 2006. Subjective symptoms, sleeping problems, and cognitive performance in subjects living near mobile phone base stations. Occupational and
Environmental Medicine 63, 307–313.
Klaeboe, L., Blaasaas, K., et al., 2007. Use of mobile phones in Norway and risk of intracranial tumours. European Journal of Cancer Prevention 16, 158–164.
Lahkola, A., Auvinen, A., et al., 2007. Mobile phone use and risk of glioma in 5 North European countries. International Journal of Cancer 120, 1769–1775.
Leng, L., Zhang, Y., 2016. Etiology of pituitary tumors: A case control study. Turkish Neurosurgery 26 (2), 195–199.
Li, C.Y., Liu, C.C., et al., 2012. A population-based case-control study of radiofrequency exposure in relation to childhood neoplasm. Science of the Total Environment 435–436
(2012), 472–478.
Lönn, S., Ahlbom, A., et al., 2004. Mobile phone use and the risk of acoustic neuroma. Epidemiology 15, 653–659.
Lönn, S., Ahlbom, A., et al., 2005. Long-term mobile phone use and brain tumor risk. American Journal of Epidemiology 161, 526–535.
Malek, F., Rani, K.A., et al., 2015. Effect of short-term mobile phone base station exposure on cognitive performance, body temperature, heart rate and blood pressure of
Malaysians. Scientific Reports 5, 13206.
Meo, S.A., Alsubaie, Y., et al., 2015. Association of exposure to radio-frequency electromagnetic field radiation (RF-EMFR) generated by mobile phone base stations with glycated
hemoglobin (HbA1c) and risk of type 2 diabetes mellitus. International Journal of Environmental Research and Public Health 12 (11), 14519–14528.
Moon, I.S., Kim, B.G., et al., 2014. Association between vestibular schwannomas and mobile phone use. Tumor Biology 35, 581–587.
Navarro, E., Segura, J., et al., 2003. The microwave syndrome: A preliminary study in Spain. Electromagnetic Biology and Medicine 22 (283), 161–169.
Regel, S.J., Negovetic, S., et al., 2006. UMTS base station-like exposure, well-being, and cognitive performance. Environmental Health Perspectives 114 (8), 1270–1275.
Riddervold, I.S., Pedersen, G.F., et al., 2008. Cognitive function and symptoms in adults and adolescents in relation to rf radiation from UMTS base stations. Bioelectromagnetics 29
(4), 257–267.
Sadetzki, S., Chetrit, A., et al., 2008. Cellphone use and risk of benign and malignant parotid gland tumors – A nationwide case-control study. American Journal of Epidemiology
167 (4), 457–467.
Santini, R., Santini, P., et al., 2002. Enquête sur la santé de riverains de stations relais de téléphonie mobile: I/Incidences de la distance et du sexe. Pathologie-biologie 50,
369–373.
Santini, R., Santini, P., et al., 2003. Enquête sur la santé de riverains de stations relais de téléphonie mobile: II/ Incidences de l’âge des sujets, de la durée de leur exposition et de
leur position par rapport aux antennes et autres sources électromagnétiques. Pathologie et biologie 51 (7), 412–415.
Satta, G., Mascia, N., et al., 2018. Estimates of environmental exposure to radiofrequency electromagnetic fields and risk of lymphoma subtypes. Radiation Research 189 (5),
541–547.
Schlehofer, B., Schlaefer, K., et al., 2007. Environmental risk factors for sporadic acoustic neuroma (Interphone Study Group, Germany). European Journal of Cancer 43,
1741–1747.
Schoemaker, M., Swerdlow, A., 2009. Risk of pituitary tumors in cellular phone users. Epidemiology 20, 348–354.
Schoemaker, M., Swerdlow, A., et al., 2005. Mobile phone use and risk of acoustic neuroma: Results of the Interphone case-control study in five North European countries. British
Journal of Cancer 93, 842–848.
Schuz, J., Bohler, E., et al., 2006. Cellular phones, cordless phones, and the risks of glioma and meningioma (Interphone study group, Germany). American Journal of Epidemiology
163, 512–520.
314 Electromagnetic Fields From Mobile Phones and Their Base Stations: Health Effects

Shahbazi-Gahrouei, D., Karbalae, M., et al., 2014. Health effects of living near mobile phone base transceiver station (BTS) antennae: A report from Isfahan, Iran. Electromagnetic
Biology and Medicine 33 (3), 206–210.
Shrestha, M., Raitanen, J., et al., 2015. Pituitary tumor risk in relation to mobile phone use: A case-control study. Acta Oncologica 54 (8), 1159–1165.
Singh, K., Nagaraj, A., et al., 2016. Effect of electromagnetic radiations from mobile phone base stations on general health and salivary function. Journal of International Society of
Preventive and Community Dentistry 6 (1), 54–59.
Stewart, A., Rao, J., et al., 2012. Mobile telecommunications and health: Report of an investigation into an alleged cancer cluster in Sandwell, West Midlands. Perspect Public
Health 132 (6), 299–304.
Takebayashi, T., Varsier, N., et al., 2008. Mobile phone use, exposure to radiofrequency electromagnetic field, and brain tumour: A case-control study. British Journal of Cancer 98,
652–659.
Wallace, D., Eltiti, S., et al., 2012. Cognitive and physiological responses in humans exposed to a TETRA base station signal in relation to perceived electromagnetic hypersensitivity.
Bioelectromagnetics 33 (1), 23–39.
Wolf, R., Wolf, D., 2004. Increased incidence of cancer near a cell-phone transmitter station. International Journal of Cancer Prevention 1 (2).
Zhou, L.Y., Zhang, H.X., et al., 2017. Epidemiological investigation of risk factors of the pregnant women with early spontaneous abortion in Beijing. Chinese Journal of Integrative
Medicine 23 (5), 345–349.

Further Reading

Alexiou, G.A., Sioka, C., 2015. Mobile phone use and risk for intracranial tumors. Journal of Negative Results in Biomedicine 14, 23.
Desai, N.R., Kesari, K.K., Agarwal, A., 2009. Pathophysiology of cell phone radiation: Oxidative stress and carcinogenesis with focus on male reproductive system. Reproductive
Biology and Endocrinology 7, 114.
Dode, A.C., Leao, M.M., Tejo Fde, A., Gomes, A.C., Dode, D.C., Dode, M.C., et al., 2011. Mortality by neoplasia and cellular telephone base stations in the Belo Horizonte
municipality, Minas Gerais state. Brazil Science of the Total Environment 409 (19), 3649–3665.
IARC (2008) Interphone Study Latest results updated8 October 2008.
IARC, 2011. Non-ionizing radiation, Part II: Radiofrequency electromagnetic fields. Lyon, France, IARC Working Group on the Evaluation of Carcinogenic Risks to Humans.
Lagorio, S., Röösli, M., 2014. Mobile phone use and risk of intracranial tumors: A consistency analysis. Bioelectromagnetics 35, 79–90.
Morgan, L.L., 2009. Estimating the risk of brain tumor from cell phone use: Published case-control studies. Pathophysiology 16, 137–147.
Morgan, L.L., Miller, A.B., Sasco, A., Davis, D.L., 2015. Mobile phone radiation causes brain tumors and should be classified as a probable human carcinogen (2A) (review).
International Journal of Oncology 46, 1865–1871.
Nageswari, K.S., 2015. Mobile phone radiation: Physiological & Pathophysiologcal Considerations. Indian Journal of Physiology and Pharmacology 59 (2), 125–135.
Otto, M., Mühlendahl, K., 2007. Electromagnetic fields (EMF): Do they play a role in children’s environmental health (CEH)? International Journal of Hygiene and Environmental
Health 210, 635–644.
Röösli, M., Frei, P., Mohler, E., Hug, K., 2010. Systematic review on the health effects of exposure to radiofrequency electromagnetic fields from mobile phone base stations.
Bulletin of the World Health Organization 88 (12), 887–896F.
Rothman, K.J., 2009. Health effects of Mobile telephones. Epidemiology 20 (5), 653–655.
Rubin, G.J., Hillert, L., Nieto-Hernandez, R., Rongen, E.V., Oftedal, G., 2011. Do people with idiopathic environmental intolerance attributed to electromagnetic fields display
physiological effects when exposed to electromagnetic fields? A systematic review of provocation studies. Bioelectromagnetics 32 (8), 593–609.
Szmigielski, S., 2013. Cancer risks related to low-level RF/MW exposures, including cell phones. Electromagnetic Biology and Medicine 32 (3), 273–280.
Valentini, E., Curcio, G., Moroni, F., Ferrara, M., De Gennaro, L., Bertini, M., 2007. Neurophysiological effects of mobile phone electromagnetic fields on humans: A comprehensive
review. Bioelectromagnetics 28 (6), 415–432.
Wang, Y., Guo, X., 2016. Meta-analysis of association between mobile phone use and glioma risk. Journal of Cancer Research and Therapeutics 12 (Supplement), C298–C300.

Relevant Websites

European Community. n.d.. https://ec.europa.eu/health/scientific_committees/emerging/docs/scenihr_o_041.pdfdEuropean Community. Scientific Committee on Emerging and

Newly Identified Health Risks (SCENIHR) Opinion on Potential health effects of exposure to electromagnetic fields (EMF).
ICNIRP. n.d. https://www.icnirp.org/dInternational Commission on Non-Ionizing Radiation Protection (ICNIRP).
ITU (2018) http://www.itu.int/ict/statisticsdITU. Global mobile-cellular subscriptions, total and per 100 inhabitants, 2001–2017. [updated 2018; cited 2018 July 30]
Hardell L. n.d.. https://lennarthardellenglish.wordpress.com/dLennart Hardell’s Blog.
Moskowitz JM. https://www.saferemr.com/dElectromagnetic Radiation Safety. Scientific and policy developments regarding the health effects of electromagnetic radiation
exposure from cell phones, cell towers, Wi-Fi, Smart Meters, and other wireless technology.
NIH. n.d.. https://www.niehs.nih.gov/health/topics/agents/emf/index.cfmdNational Institute of Environmental Health Sciences. Electric & Magnetic Fields.
WHO (2014) http://www.who.int/en/news-room/fact-sheets/detail/electromagnetic-fields-and-public-health-mobile-phonesdElectromagnetic fields and public health: Mobile
phones. Fact Sheet 8 October 2014.