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02/06/2000 - Vodafone et al sued for brain tumours. "George Carlo dishes the dirt." Muscat critiques

1st January 2000:   Lower down on this page are some very concerning discussion about the Muscat brain tumour study.

------------------------- Vodafone, etc, sued for brain cancers ------------------------

Mobile phone operators are facing a billion-dollar legal action brought by US brain tumour victims. The lawsuits, will be filed by Peter Angelos in the USA , who recently helped to win $4.2 billion (£3 billion) in damages from the tobacco industry in Maryland, USA. He is planning to launch two of the claims before March, and the remaining seven or eight within a year.

The first claim is on behalf of Dr Christopher Newman, a 41 year old brain surgeon, is suing Verizon, handset manufacturer Motorola, SBC Communications, the Cellular Telecommunications and Internet Association and the Telecommunications Industry Association. Verizon is the biggest mobile phone company in the US, with 26 million customers.

Mr Angelos intends to claim compensation for the pain suffered by brain tumour patients, plus the income that they lost as a result of the disease, and also compensation for the families of mobile phone users who have died from brain tumours, and punitive damages.

Vodafone who own 45% of Verizon, saw a drop in its share price yesterday following these reports. Its share price has dropped from a peak of 399 pence each last February, to a new low of only 230 pence on Thursday 28th December, a fall of 42% during the year 2000.

------------------------- CARLO dishes the dirt (etc)  ------------------------

REVIEW - Cell Phones: Invisible Hazards in the Wireless Age: An Insider's Alarming Discoveries About Cancer and Genetic Damage; by Dr George Carlo and Martin Schram.(released December 2000)

Recently the Media reported that new studies claimed that cell phones present no risk, one in the Journal of the American Medical Association and the other in the New England Journal of Medicine. Of course they did not tell us that both studies had caveats, reservations and the like. And there's more to the story. What of the risks of the growing number of telecommunications antennas in our communities? At any rate, most Americans got the message that cell phones and therefore other wireless technologies are A-OK. Well, it's not quite so.

This new book documents the risk of brain tumors, genetic damage, and the disproportional risk to children of wireless technologies. Carlo, a medical epidemiologist, was hired by the Cellular Telecommunications Industry Association (CTIA) to direct its $25 million study on the risks of cell phone useage. Carlo didn't end up finding the results the industry expected and was fired and discredited. Mike Meuser states that he thinks this is an excellent book if you are interested in wireless technology or another example of the politics of research.

Here is a gripping narrative of scientific detection that chronicles an unprecedented journey of discovery by Dr. George Carlo into the impact of cell phones on human health. This book is a clarion call sounding the message that consumers need not allow themselves to become guinea pigs for new technologies whose long-term health effects are unknown. It should be essential reading for the hundreds of millions of people currently using wireless phones, and the millions who may begin using them in the future.

In 1993, as news reports appeared of people using cell phones who'd also developed brain tumors, Carlo was hired by the cell-phone industry to affirm the safety of its product. He soon learned there was little research into whether these phones could impair human health, and no consensus among scientists on the question. Carlo's own research intensified his concern, especially the startling discovery that human blood cells could be damaged by the radiation emitted from a cell phone.

He made urgent recommendations to the industry, including a plea that cell phones not be marketed to children. Yet, phones emblazoned with cartoon characters soon hit the market. In 1999, the industry quit funding the independent research directed by Carlo, investigated his private life, and began a whispering campaign that sought to discredit him. Appalled but undeterred, he has now brought his case to the public in a powerful assessment of the dangers posed by wireless phones - suggesting safeguards readers can use to protect themselves. Some say that this is a classic like Rachel Carson's Silent Spring. Read it and spread the word!
partly from: http://www.mapcruzin.com/review_cell_phones.htm

Powerwatch's Alasdair Philips says: "Be wary of believing all that George Carlo tells. He is a chameleon who blows with the wind to his own advantage. He has publicly supported chemically polluting industries in Court. He was quiet while the cellular industry were funding him with mega-bucks, making re-assuring noises to the public and the media. After he lost his funding he starts to "dish up the dirt". Much that he says will be valuable insider information. Given his previous history, there are likely to be plenty of mis-truths in there too. However, I do recommend that people do read this book as it gives an insight into how multi-nationals control research and public and official (dis)information.


-- Muscat study shenanigans - very concerning -  read to the bottom! --
This reports on the published study and then on other expert commentators' comments
What follows is mostly for people with a reasonable background understanding of science

HANDHELD CELLULAR TELEPHONE USE NOT ASSOCIATED WITH RISK OF BRAIN CANCER
Study suggests risk not increased with short-term cell phone use

CHICAGO - The use of handheld cellular telephones does not appear to be associated with the risk of brain cancer, but further studies are needed to account for longer induction periods, especially for slow-growing tumors, according to an article in the December 20 issue of The Journal of the American Medical Association (JAMA).

Joshua E. Muscat, M.P.H., of the American Health Foundation, Valhalla, N.Y., and colleagues conducted a case-control study from 1994 to 1998 to test the hypothesis that using handheld cellular telephones is related to the risk of primary brain cancer. A total of 469 men and women aged 18 to 80 with primary brain cancer and 422 matched controls without brain cancer took part in the study. Patients were interviewed at Memorial Sloan-Kettering Cancer Center, New York University Medical Center, and Columbia Presbyterian Hospital in New York; Rhode Island Hospital in Providence, R.I.; and Massachusetts General Hospital in Boston.

According to background information cited in the study, there were more than 86 million cellular phone users by the end of 1999. The use of cellular telephones is one of several suspected risk factors for brain cancer, although the causes of this disease remain poorly understood. The health effects due to using cellular telephones are currently being studied in a number of populations. In preliminary reports of a case-control study conducted in Sweden, the risk of brain cancer was unrelated to using a handheld cellular telephone.

Cellular telephones include handheld or mobile telephones, car telephones, and portable or bag telephones that operate on radiofrequency (RF) signals in the 800- to 900-MHz range. Concerns have been raised about possible adverse health effects due to exposure to these signals. In particular, the concern that the use of handheld cellular telephones causes brain cancer is based on the close proximity of the antenna, which is incorporated into the telephone receiver, to the head of the user.

The authors used a structured questionnaire to interview patients. The patients were asked if they had ever used a handheld cellular telephone on a regular basis. "Regular" was defined as having had a subscription to cellular telephone service. Information was obtained on the number of years of use, minutes/hours used per month, year of first use, manufacturer, and reported average monthly bill. Information on which hand was used to hold the cellular telephone was collected from 700 (78.6 percent) of the 891 patients.

"The use of handheld cellular telephones was unrelated to the risk of brain cancer in the current study," the authors write.

"The median monthly hours of use were 2.5 for cases and 2.2 for controls," they report. "Compared with patients who never used handheld cellular telephones, the multivariate odds ratio (OR) associated with regular past or current use was 0.85. The OR for infrequent users (less than 0.72 hours per month) was 1.0 and for frequent users (more than 10.1 hours per month) was 0.7."

"The mean duration of use was 2.8 years for cases and 2.7 years for controls; no association with brain cancer was observed according to duration of use," they continue.

The study found that among brain cancer cases, cerebral tumors occurred more frequently on the same side of the head where cellular telephones had been used (26 vs. 15 cases). But in cases of temporal lobe cancer, a greater proportion of tumors occurred in the opposite side of the head (9 vs. 5 cases).

The authors report the odds ratio was less than 1.0 (i.e., no increase in risk) for all histologic categories of brain cancer except for an uncommon type of brain cancer called neuroepitheliomatous.

"The current study shows no effect with short-term exposure to cellular telephones that operate on (primarily) analog signals," the authors conclude. "Further studies are needed to account for longer induction periods, especially for slow-growing tumors. The RF fields emitted from digital cellular telephones might have different effects on biological tissue than analog telephones, and studies are under way in several European countries that use primarily digital telecommunication networks."
(JAMA. 2000; 284:3001-3007)

Note: This work was supported by a contract from Wireless Technology Research LLC and by grants from the Public Health Service.

......NOW....>>>> form George Carlo......>

Here is the chronology of the Muscat data shift: The industry began direct communication with Muscat in March 1999, around me. Up to that point, I handled all of the communication with the WTR's investigators. When the results began to come in, the CTIA cut me out.

9/98 - data collection for the Muscat study is finished. No new patients were entered into the study. Data base for analysis is finalized according to Good Epidemiology Practices. GEP says that once the database is fixed, that is it.

NEUROEPITHELIAL TUMORS:

3/Mar/99 - Muscat gives us data showing 29 cases of neuroepithelial tumors, with 11 cell phone users among them. That yields a statistically significant risk increase of 2.8.

7/Apr/99 - Muscat presents these data to the FDA and the governmental Inter Agency Working Group.

3/May/99 - Muscat gives us an updated report that we sent out for peer review to Harvard. Now they have 35 cases of neuroepithelial tumors because they have re-done the pathology. This change was approved according to GEP procedures. 14 of the 35 are cell phone users. Risk is 2.4 and statistically significant. The report withstands peer review. This constitutes final report to WTR. That is what we have in the book.

20/Jun/99 - Muscat presents the 2.4 risk data to State of Science colloquium in Long Beach.

9/Sept/99 - Muscat submits paper to New England Journal of Medicine forpublication that is rejected -- they say not enough data relevant to cell phone users. Risk presented in that paper is now 1.8 and not statistically significant. This is based on a different statistical analysis with control variable worked in on the same 35 cancer cases, 14 of which are cellular phone users.

June/2000 - Muscat signs off on Chapter in my upcoming State of the Science II book, to be published by Kluwer this spring. In the book, he presents the 2.4 risk data that are statistically significant.

19/Dec/2000 - in JAMA, Muscat presents yet another analysis of the same 35 cancer cases. The risk presented is 2.1. Even though this is more than a doubling in the risk, the authors dismiss it because it is not statistically significant. The headlines carry this as evidence of no brain cancer risk.

TUMOR LATERALITY:

3/Mar/99 - Muscat in report to WTR shows that in 27 instances, the tumor is on the same side of the head as where the person uses the phone; in 15 instances it
is not. They give no statistical data on significance.

19/Dec/2000 - In JAMA article, they report that in 26 instances the tumor is on the same side as where the person used the phone, and in 15 instances it is not. The P value is .06 (.05 is statistically significant). If the original data of 27 is used, the result becomes statistically significant. No mention of where the missing patient is. The authors dismiss the finding of laterality because it is not statistically significant.

As you know, the media have carried this study as reassuring to consumers. In fact, this and the NCI studies are baseline studies against which future observations of cancer among cell phoneusers can be judged. As I point out in the book, no one could expect epidemiological studies to show much for 15 to 20 years. The fact that we found anything at all is the news. As an epidemologist, the doubling in risk of neuroepithelial tumors, statistical or not, would be a caution for me. Yet in the materials given to the press, this is not even mentioned.

The overinterpretation of the data in the Muscat study is dangerous to consumers. If this leads people to put phones up against the sides of their heads when they otherwise wouldn't, well that is tragic.

The NCI investigators are even handed in how they caveat their study. Note in their study that they say that their study is not adequate to look at rare tumors that would be very close to where the antenna from the phone is. They get it, but nonetheless, their study has been spun by the industry. It is peculiar that the study was made available at 4 p.m. -- many media put it in their stories without even reading it.

I also heard that the pre-release of the NCI study to coincide with the Muscat study was orchestrated by the FDA -- the public pressure that the release of the study cites is actually the FDA. They are now in bed with the CTIA and it appears that these folks are working in concert.

This was a pretty sophisticated media manipulation. How so little data could be used to make such broad assurances of safety is a Houdini trick. And most of the media went for it.

George C.
=======================================================================

>Lancet Volume 356, Number 9248 23 December 2000      Science and medicine
>
>Good news for mobile phone users?
>
>New research could help dispel fears that radiofrequency signals from handheld cellular telephones cause brain cancer. A team from the USA compared the patterns of cell phone use in 469 patients with primary brain cancer and 422 controls. "The data showed that the overall risk of brain cancer was not related to how often cell phones were used or the years of use", says Joshua Muscat, lead investigator (American Health Foundation, Valhalla, NY, USA).
>
>Study participants were asked about the type of cell phone they used, the numbers of years of use, the number of hours used per month, and the estimated monthly phone bill. Median monthly hours of use were 25 for patients with brain cancer and 22 for controls. Mean duration of use was 28 years for patients with brain cancer and 27 for controls.
>
>The area of highest exposure to radiofrequency signals is thought to be the temporal lobe on the side of the head where the phone is used. The research team reported no relation between the side of the head where the tumour was located and the hand used to hold the phone. In fact, there were more likely to be tumours on the side of the head where the phone was used, but tumours in the temporal lobe were more likely on the contralateral side (JAMA 2000; 284: 3001-07)
>
>Philip Dendy comments that "although this study is important, the short induction period means that the issue cannot be put to rest completely". In reply, Joshua Muscat emphasises that "unless the radiofrequencies of cellular phones change in the future, the current findings should be relevant to future interpretation of health risks". Minal Chande
>

-------- Original Message --------
Subject: Re: Brain Tumor/Cell Phone Epi Study                     From: Stewart Fist <fist@ozemail.com.au>
Reply-To: fist@ozemail.com.au       Organization: Independent writer and columnist

The protocol being used by the Muscat/American Health Foundation brain-cancer study and that being used by Repacholi's WHO/brain cancer study are pretty much the same, and both have very significant defects.

In both cases the researchers proceed in this way:
      1) They identify people with brain cancer in a hospital.
      2) Interview them to determine basic matching information (age, sex, etc.)
      3) Look through hospital records to find a match to each, using a patient admitted for some other reason (This is a way of establishing a control group).
      4) Interview both the brain-cancer patient and his/her match to determine cellphone use, asking such questions as:
                   a) Which hand is used to hold the phone (relying on the reporting)
                   b) How many hours use a month (relying usually on memory of past bills)

We should know from experience that people are notoriously bad at reporting such information. Which hand is used, depends entirely on the situation - and whether the person needs to write, or is driving, etc.

However, if there is no statistical difference between the brain-cancer group and the control group in this kind of epidemiological research, the findings are interpreted as meaning that cellphones don't cause or contribute to the brain cancer. However this interpretation relies on a number of assumptions that are
just not viable or acceptable:

The first, and most obvious assumption is that both groups have been using mobile phones for long enough to allow incipient brain cancers to incubate to a level where they will be detected. And as people have already pointed out, three years is not enough. You probably need five to ten at an absolute minimum.

However, another assumption being made here is that the whole population is equally susceptible to RF-induced brain cancer, in terms of both absolute numbers, and with the incubation period.

We can see the relevance of this if we were to take the RF exposure to an extreme in a quick thought-experiment, and assume that everyone in the community had an equal exposure to RF.  We would still then expect those people who were more susceptible to be the ones in the hospital with clearly identified brain cancer -- and for the controls to show the same average exposure.

Of course, in the real world not everyone gets the same RF exposure. But to completely ignore potential differences in susceptibility in conducting such research is ridiculous. It is only acceptable in a research protocol, if any publicity surrounding the release of the results clearly spells out the fact that there are multiple possible interpretations.

Muscat's finding that there are no significant difference between his control and exposured groups, could arise from any (or all) of these hypotheses:
    a) cellphone use does not normally influence brain cancer development, OR
    b) people who get brain cancer are more susceptible to RF damage than the average, OR
    c) people need to use cellphones for more than three years to get brain cancer.

The Muscat report only deals with the first hypothesis. Yet the second and third are equally as likely as the first, judging from current evidence found by other researchers.

The protocol also appears to assume that brain cancer can only be a related to RF exposure in some direct (one-to-one) way, and not via intermediary conditions such as the reduction in the immune response. Nor does it treat multi-causal factors (genetic predisposition, chemical DNA damage, virus infections, etc.) as a possibility. Nor does it discuss the possibility of off-setting factors.

For instance:  Say brain cancer rates were much higher in those people who have easy RF breaches of the blood-brain-barrier (a very likely scenario according to
Salford). I would expect these susceptible people also to get more discomfort from using a cellphone, and more headaches with longer phone use ... and therefore tend to use them less.

So it is quite feasible that the group most likely to get brain cancer will be those who have a natural disinclination to use their phones for long periods.
Yet this would still fit Muscat's findings.

Scientists always claim that they only test hypotheses as set out in the research protocols, and produce the results. They loudly protest that they don't create the interpretations that often circulate around and are reported by the media. But they can't shaft the responsibility for interpretation to the media when they know the media don't have the skills to intelligently interpret complex results.

Scientists are often very keen to disclaim responsibility for newspaper headlines of the sort that read "Study finds cellphones don't cause brain cancer" from their findings, and are quick to protest that no one can ever prove a negative ... and that we no one can or should draw conclusions based on just one study.

Yet here we have the Journal of the American Medical Association (JAMA) headlining with precisely the same sort of unwarranted interpretation in its report or the Muscat study.          "HANDHELD CELLULAR TELEPHONE USE NOT ASSOCIATED WITH RISK OF BRAIN CANCER"

Such conclusions are rubbish.
--
Stewart Fist - writer and columnist                            See http://www.australianIT.com.au/opinion/crossroads/
http://www.abc.net.au/http/sfist/ (some archives)
http://www.electric-words.com (main archives)
70 Middle Harbour Road, Lindfield, 2070, N.S.W, Australia  Phone +61 2 9416 7458 Fax +61 2 9416 4582

-----------------------------------------------------------

Date: Wed, 20 Dec 2000 13:40:45 -0600    From: "Bill P. Curry" <BPCurry@MCS.com>
Reply-To: BPCurry@MCS.com                     Organization: EMSciTek Consulting co.

I would like to suggest that people get the actual articles that present the studies on whether there is a relation between cell phone useage and brain cancer. I have not yet read the NEJM article, but I have read the JAMA article - which I call the Muscat article for the first author of the paper. I would like to comment on this article.

First, the Muscat article uses a surrogate for the amount of cell phone exposure. The surrogate is whether or not the individual subscribed to a cell phone service and for how long. This can be misleading. My wife and I have a subscription to a cell phone provider, but we very rarely use our cell phone.  While we used the phone more frequently before I began to study the hazards of so doing, now we have shielded the earpiece of our phone, and we have restricted our use to emergencies for more than two years. Yet, we have maintained a subscription for the nearly four years that we have owned the phone. In the terms of the Muscat study, we would probably be considered regular cell phone users, even though we restrict our use to emergencies only.

Second, the Muscat study indicates clearly that it can shed no light on the consequences of long term use, because of the restricted period of time the users in the study had access to cell phones. The authors readily admit that long term effects are important and should be studied.

Third, the Muscat study does not say anything about whether pulsed digital PCS phones are more dangerous than the older type of cell phones, which were the phones used by people in the study. I have long maintained that these phones are probably safer than the pulsed digital phones, because they use frequency modulation, instead of pulses (the ultimate form of amplitude modulation) and because they are at a lower frequency than PCS phones - meaning that a smaller fraction of the incident microwave radiation is absorbed in a given distance than is true of a PCS pulsed digital phone.  Laboratory studies have shown that pulsed radiation is more damaging to biological tissue than steady state radiation.

Fouth, for tumors found in the cerebral tissues, the Muscat study showed a "handedness" - i.e., if the phone was used on the left side of the head, the tumor was on the left side of the head; if the phone was used on the right side of the head, the tumor was on the right side of the head. Curiously enough, the opposite effect was observed for tumors in the lobes of the brain - i.e., the tumor was on the opposite side of the head from the phone in those cases. While this fact has caused some people to dismiss the "handedness" argument, I believe it may be evidence that the head is acting as a damped cavity resonator. The wavelength of ordinary cell phone radiation in free space is about 35 centimeters; however, inside the brain it is considerably reduced to about 4.8 cm, on acount of the brain's dielectric properties.  Although the skull is not spherical, the brain is somewhat spherical. If the brain were regarded as spherical, its diameter would be about 14 cm. The ratio of the brain effective diamter to the wavelength is large enough to support weak resonances, even though the brain is an absorptive medium. When you look at the cavity resonances of an irradiated sphere, you find that there are conditions in which "hot spots" (regions of electric field enhancement) occur both on the side of the sphere closest to the source and on the opposite side of the sphere, as well. This means that the cavity is acting as a spherical lens. As the sphere becomes more absorbent, the hot spot on the opposite side diminishes in magnitude, whereas the other hot spot remains strong. Distorting the cavity resonator from its spherical shape simply shifts the wavelength at which the resonance occurs and broadens the range of frequencies that will resonate, so the fact that the brain is not completely
spherical will not prevent cavity resonances - it just makes it more difficult to calculate these resonances. The crucial question in regard to whether resonances can occur is whether there is a layer encircling the brain that is uniform enough to support such resonances. The meningial layer may have such properties. If this is the case, then the supported resonances would be those which can occur in a layer of a sphere, the central part of which would not support such resonances. I would like to know the opinion of your readers regarding whether such an argument as I have propounded here is plausible to them.

Fifth, the Muscat study found an odds ration of about 1.0 for all brain tumors - meaning that there was no correlation between tumor occurrence and cell phone useage, but they found an odds ratio of 2.1 for the occurrence of neuroepethelial tumors - tumos of soft tissue. Even though this a weaker statement of correlation of tumor occurrence with cell phone useage than the authors announced earlier in preliminary releases of their results, it still seems signficant to me, in the light of the rare occurrence of these tumors in general. Does anyone on the list know the relative frequency of occurrence of these tumors as compared with all brain tumors?

Bill (Dr W Curry, PhD)

Someone else has also commented:   "Muscat's data has no meaning without considering at least a two-dimensional or, more appropriately, a three-dimensional probability basis. I'm very surprised that the reviewers did not notice and point out the built-in confounders that were not considered in the report.

There is a fatal flaw (at least one) in the statistical methods employed for this study. The study should have employed a joint probability in determining association. By restricting the analysis to only those persons who presented with symptoms during the period, the investigators have placed their work on a questionable, perhaps fundamentally invalid, foundation. The joint probability refers to those persons who should have been included as representative sample candidates but were not by reason of DEATH and those persons who have NOT YET PRESENTED with symptoms It is not mathematically appropriate to restrict the analysis in the manner that has been described. Not good epidemiology."
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