In response to a call for precaution coming from the pres- tigious journal Environmental Health Perspectives, a 2009 review of the scientific literature found no evidence of risk from cell phone use.6 However, European studies continue to publish conflicting studies, fueling confusion.2,5 From a policy stand- point, Finland, France, and Israel all have policies limiting chil- dren’s use of cell phones.

Is there a risk of bodily harm from cell phone radiation? What about cell phone towers or wireless headsets? How are we to understand and make healthy choices? What is the proper advice to give to our patients? Let’s look at the evidence carefully.

277 million cell phones in use in the United States as of June 2009 and more about 4.1 billion worldwide.7 Cell phones oper- ate at an electromagnetic wave frequency of either 800 to 900 megahertz (MHz) or 1800 to 1900 MHz. Often referred to as radiofrequency (RF), since radios and TVs operate in the same portion of the electromagnetic spectrum, the electromagnetic radiation transmitted by a cell phone occurs through the antenna and the circuit elements inside the handset. These ele- ments in the cell phone send out RFs to transmit a signal at a power level significant enough to deliver a signal to the base transceiver station. The radiation emitted by a cell phone is not very directional, thus similar amounts of radiation are trans- mitted both outward toward the base station and inward toward the ear and head of the cell phone user.

Little evidence exists for short-term health impacts of cell phone electromagnetic radiation; however, researcher Siegal Sadetzk,MD, head of the Cancer Epidemiology Unit at the Sackler School of Medicine’s Gertner Institute in Tel Aviv, Israel, observes that studies of survivors of the atomic bomb- ings in Japan often exhibit negative health consequences for more than 30 years.8 With such long-term consequences, in her mind, any study that shows negative consequences of cell phone use is worrisome.

Sadetzki headed up a study published in the February 15, 2008, issue of the American Journal of Epidemiology3 that reported an elevated risk of ipsilateral parotid gland tumors among cell phone users who spent the most time on the phone. The study considered the parotid gland because its juxtaposi- tion to cell phone RFs is 4 mm to10 mm below the surface of the skin and is anatomically within range of common cell phone use. The study looked at cumulative exposure, finding that people who had been using cells phones for more than 10

years had the highest risk. As well, the study compared single- side cell phone use compared to alternating sides, and, again, a dose response was suggested. In addition, researchers found that the more local the electromagnetic radiation, the greater the risk. Absorption of RF is attenuated by 90% within 40 to 50 mm of exposure.

Other studies are showing effects, without conclusive results (See sidebar). The Environmental Working Group recently released an executive summary that offers a summary of evidence for increased risks of glioma, acoustic neuroma, and hospitalization for migraines and vertigo as well as emotional hyperactivity in children from increased cell phone use. (www. ewg.org). However, none of these studies are conclusive enough to make the case that cell phones have a negative impact on your health . . . yet.

Recently, physician Ronald Haberman,MD, founding and former director of the University of Pittsburgh Cancer Center in Pennsylvania, provided testimonial to the Senate Domestic Policy Subcommittee on Oversight, Government and Reform that “(a)dults can reduce direct exposure of the head and bone marrow to radiofrequency radiation by using ear pieces or the speaker phone mode whenever possible. Cell phone use by children should be restricted.”9 Devra Davis,PhD,MPH, author

tional and hyperactivity problems among young chil- dren who use cell phones and whose mothers also used cell phones during pregnancy was found in a survey of 13 159 Danish children.2

phones for greater than 10 years give a consistent pat- tern of increased risk for acoustic neuroma and glio- ma. The risk is highest for ipsilateral cell phone use/ exposure.1,4

were 10% to 20% more likely to be hospitalized for migraines and vertigo than people who began cell phone use more recently.5