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Epidemiological Study (case-control study)

Cellular phones, cordless phones, and the risks of glioma and meningioma (Interphone Study Group, Germany). epidemiol.

By: Schüz J, Bohler E, Berg G, Schlehofer B, Hettinger I, Schlaefer K, Wahrendorf J, Kunna-Grass K, Blettner M
Published in: Am J Epidemiol 2006; 163 (6): 512 - 520 ( open external web page PubMed Entry , open external web page Journal web site )

Aim of study (according to author)
To examine whether the risk of glioma and meningioma is associated with the use of cellular phones or cordless phones, a population-based case-control study was conducted in Germany.
Background/further details:
This study is part of the INTERPHONE project.
Regular use of cellular phone was defined as at least one incoming or outgoing call per week for 6 months or more.

Endpoint/type of risk estimation

Estimate of incidence by odds ratio (OR)

Exposure

groups of exposure:

Reference group 1:  regular cellular phone use: never 
group 2:  regular cellular phone use: ever 
group 3:  time since first regular use: never, < 1 year 
group 4:  time since first regular use: 1-4 years 
group 5:  time since first regular use: ≥ 5 years 
group 6:  time since first regular use: 5-9 years 
group 7:  time since first regular use: ≥ 10 years 
Reference group 8:  lifetime number of calls: never use 
group 9:  lifetime number of calls: ≤ 1176 
group 10:  lifetime number of calls: > 1176 ≤ 4350 
group 11:  lifetime number of calls: > 4350 
Reference group 12:  lifetime duration of calls: never use 
group 13:  lifetime duration of calls: ≤ 44 
group 14:  lifetime duration of calls: > 44 ≤ 195 
group 15:  lifetime duration of calls: > 195 
Reference group 16:  intensity of use: never 
group 17:  intensity of use: < 30 minutes/day 
group 18:  intensity of use: ≥ 30 minutes/day 
Reference group 19:  duration of calls ≥ 5 years before reference date: never  
group 20:  duration of calls ≥ 5 years before reference date: < 5 years  
group 21:  duration of calls ≥ 5 years before reference date: ≥ 5 years, ≤ 34.5 hours 
group 22:  duration of calls ≥ 5 years before reference date: ≥ 5 years, > 34.5 hours 
Reference group 23:  cordless phone use: no 
group 24:  cordless phone use: yes (at home or at work) 
group 25:  cordless phone use: yes, at work only 
group 26:  cordless phone use: yes, at home only 
group 27:  cordless phone use: yes, at home and at work 
Reference group 28:  time since first cordless phone use: no use or < 5 years 
group 29:  time since first cordless phone use: 1-4 years 
group 30:  time since first cordless phone use: ≥ 5 years 
Reference group 31:  time since first use (cordless and/or cellular phones): no use or < 1 year 
group 32:  time since first use (cordless and/or cellular phones): 1-4 years 
group 33:  time since first use (cordless and/or cellular phones): ≥ 5 years 

Population

  • case group
    men and women, aged from 30 to 69 years
    diagnosis: glioma and meningioma, histologically confirmed
    observation period: October 2000 - October 2003
    study location: Germany (3 study regions)
    source of data: neurosurgical clinics in Bielefeld, Heidelberg, Mainz and Mannheim, Germany
    exclusion criteria: no histological confirmation, recurrent tumors, insufficient knowledge of the German language, main residence outside the study region

  • control group
    selection: population-based
    matching: sex, age, area, 1:2 (case:control)
    exclusion criteria: moved out of study region, insufficient knowledge of the German language, main residence outside the study region

Study size i cases  controls 
number eligible 8912,449
number participating 7471535
rate of participating 84%63%

Other: glioma: 460 cases eligible, 366 participating; meningioma: 431 cases eligible, 381 participating

Statistical analysis using conditional logistic regression (adjusted for age, sex, socioeconomic status, study center, living in a city (≥ 100,000 inhabitants vs. < 100,000))

Results/conclusion (according to author)
The results did not indicate an overall increased risk of glioma or meningioma among regular cellular telephone users. An elevated risk of glioma was observed among persons who had used cellular phones for 10 or more years, but based on small numbers. No association between cordless telephone use and the risks of glioma or meningioma was found. An increased risk of high-grade glioma was observed for women, which might be a chance finding.

Limitations (according to author): The number of cellular phone users for 10 years or more was low and effects of recall bias cannot to be ruled out.

(Study character: epidemiological study, case-control study)

Study funded by

  • Bundesamt für Strahlenschutz (BfS; Federal Office for Radiation Protection), Salzgitter, Germany
  • Bundesministerium für Umwelt, Naturschutz und Reaktorsicherheit (Federal Ministry of the Environment, Nature Conservation, and Nuclear Safety), Germany
  • Deutsches Mobilfunk Forschungsprogramm (DMF; German Mobile Phone Research Programme) at Federal Office for Radiation Protection (BfS)
  • European Union (EU)/European Commission
  • GSM Association, UK/Ireland
  • International Union against Cancer (UICC; Union Internationale Contre le Cancer), Switzerland
  • MAIFOR Program (Mainzer Forschungsförderungsprogramm) of the University of Mainz, Germany
  • Ministerium für Umwelt und Naturschutz, Landwirtschaft und Verbraucherschutz, Nordrhein-Westfalen (Ministry for the Environment of the state of North Rhine-Westphalia), Germany
  • Ministerium für Umwelt und Verkehr, Baden-Württemberg (Ministry for the Environment and Traffic of the state of Baden-Württemberg), Germany
  • Mobile Manufacturers Forum (MMF), Belgium

Published comment on this article:Related articles i
Glossary: analog, base station, brain tumor, case-control study, cellular phone, conditional logistic regression, cordless telephone, DECT, digital, epidemiological, exposure, glioma, histological, incidence, Interphone project, matching, meningioma, mobile communication, OR, population-based, recall bias, risk, socioeconomic status, statistical, tumors

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