HEALTH CARE JUNE 2, 2011
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Like many other people umbilically linked to my mobile e-mailing, tweets, calls, and texts, I’m concerned by the World Health Organization’s recent findings regarding mobile phone use and brain tumors. This latest pronouncement prods me to make some lifestyle changes—my favorite one being to waste less time being a slave to my damn cell phone.
Yet, as someone who has spent years trying to mobilize economic and political resources for public health, I am very frustrated by this debate. Much of the public conversation concerns whether there is a statistically significant relationship between long-term mobile phone use and elevated risk of certain brain cancers. The absolute magnitude of this elevated risk receives far less attention—as does our society’s wildly unbalanced response to different individual and community-wide health risks.
After reading newspaper accounts of the WHO’s findings, I tracked down some meta-analyses of cell phone-related risks. A nice 2009 article by Seung-Kwon Myung and colleagues in the Journal of Clinical Oncology presents the basic indictment. As these authors synthesize the evidence, “Mobile phone use of 10 years or longer was associated with a risk of tumors in 13 studies reporting this association (odds ratio = 1.18; 95% CI, 1.04 to 1.34).” Given such a rare outcome, these authors effectively conclude that risk of brain tumors rises by 24 percent* with prolonged cell phone use, with a 95 percent probability that the true risk actually falls between 4 percent and 34 percent. As with many such studies, these authors focus on the proportional increase in risk. Much of the accompanying scientific debate is then concerned with whether the proportional increase can truly be distinguished from zero.
WHO’s expert panel believes that they can do such distinguishing. But many experts dispute this conclusion. For the sake of argument, let’s assume the statistics are right. (To be clear, it’s not obvious that the statistics are right, but, for the purposes of the piece, let’s go with it.) Glioblastoma multiforme (GBM) accounts for about 60 percent of the 17,000 primary brain tumors diagnosed in the U.S. The age-adjusted GBM death rate is approximate 4.3 per 100,000 people per year. (I still get a lump in my throat when I consider Edward Kennedy’s poignant struggle with this condition.) If one accepts the above 24 percent* figure as a valid prediction of elevated mortality, heavy cell phone use might be expected to increase annual GBM deaths by roughly 1.03 deaths per 100,000 people. If one assumes there are 150 million chronic cell phone users across the U.S., this corresponds to almost 1,548 additional deaths every year. That’s not a trivial number. If something like it holds up, manufacturers and regulators must take proper measures to sensibly reduce these risks.
Yet this additional risk, 0.0000103 deaths/user/year—if the statistics from the Myung article are are right in the first place—is far smaller than the risk associated with many other things that get far less attention. Right now, efforts to provide basic public health services are being cut at every level of government. Surveys conducted by the National Association of County and City Health Officials indicate that local health departments lost 16,000 jobs in 2009 alone. Congressional Republicans have made several efforts to zero out the Affordable Care Act’s prevention and public health fund. (One aide called this a “slush fund for jungle gyms.”) The budget proposed by House Republicans would cut discretionary programs to prevent or diagnose diabetes and cancer, reduce the spread of blood-borne and sexually transmitted infections, provide basic reproductive health services, and treat substance use and mental health disorders. Many in Congress would also curb regulation of particulate pollution and other efforts to address environmental health concerns. Then, there is tobacco control. The ACA requires all states to provide smoking cessation services to all pregnant Medicaid recipients, yet the law does not require states to provide the same benefits to other Medicaid recipients, one-third of whom are cigarette smokers. What’s more, state smoking cessation phone lines are highly cost-effective, but these services face significant challenges due to the state and local budget crisis.
In other words, I remain much more concerned about myriad public health risks than I about whether my Verizon guy sold me a carcinogen. Radiation—from power lines, microwave ovens, cell phones, and (went there) nuclear power—has always occupied outsized concern in the public mind relative to its true health impact. Meanwhile, our collective choices and private behaviors on so many matters display rather astonishing neglect of basic public health concerns. By all means, let’s address the potential radiation hazards of cell phones. Let’s just discuss and address this issue with some sense of priority and perspective regarding other threats we routinely choose to downplay or ignore.
Harold Pollack is a professor at the University of Chicago School of Social Service Administration.
Follow @tnr on Twitter.
*This piece originally stated that the risk of brain tumors may rise by 18 percent with prolonged use. A revised calculation reveals that this figure may actually be closer to 24 percent. For a follow-up discussion of this piece, see here.
6 comments
Well said. Cell phones might increase cancer, and I suppose the public ought to know. It won't change much unless the cancer risk is catastrophic--we're not dealing with thalidomide here. Research and appropriate, but sensitive regulation are sufficient. Of course, if you don't believe in the concept of regulation, this could be a problem. In fact, this type of problem plagues our chemicals industry, which too often gets away with making hazardous substances ubiquitous. The macro-level public health issues of reducing smoking, obesity, and non-life saving hospital treatment trump the above several times over. This is the proverbial bank where the money in our health care system is.
- chaitless
June 2, 2011 at 12:49am
Life is fatal. 100%. I am grateful that after my dad died of a heart attack at 48, I am still alive and full of piss and vinegar at 67. Do the best you can to stay alive and enjoy life, but don't kill yourself worrying, either. As a recent excellent article in the print edition (don't have it right in front of me and no time to look) pointed out, as we get people to live longer, we create new problems, essentially the death of a thousand "cuts" (small breakdowns until we are too miserable to want to live). The small town newspaper on the island where I live publishes twice a week and each issue includes three or four passive and insipid obituaries written by grieving survivors. I am writing my own piss and vinegar, first-person, "I never believed in God and don't now that I am old" obituary. The newspaper tells me they will publish it if I pay $8 an inch. I call it my Ozymandias finale. Cheap at the price. (No funeral; either cremated or buried in my five acres of woods, whichever is cheapest. If my heirs decide to mourn or funeralize or whatever, no skin of my back. (Literally.)
- skahn
June 2, 2011 at 1:46am
I can see one upside to the scare: fewer idiots blathering about nothing while on the road, oblivious to everyone around them, doing 45 in a 70mph freeway in the left lane. One can only hope.
- tmmats
June 2, 2011 at 11:03am
Years of seating next to a powerful transmitter. If I ran out of matches to light my cigarette I simply brought a pencil close to the connection to the antenna. The spark was strong enough to replace the match. I did not get brain tumors, so a puny little cell phone whose radio wave output is non-existent compared to the transmitter I used to seat next to it should worry anyone? It is bad science for the self promotion of the fear mongers at the UN.
- Poupic
June 2, 2011 at 12:03pm
Poupic, I agree your cell phone's added risk is probably negligible, but remember the old saw: the plural of [your] anecdote is not data.
- benjamin81
June 2, 2011 at 1:25pm
The author implicitly assumes that cancer is the only health risk of cell phones, which if it were true may justify the author's complacency about the use of cell phones. But if cell phones can cause cancer they surely have the potential to cause other health related problems. Here's an article suggesting that cell phones can affect male fertility http://www.thedailybeast.com/blogs-and-stories/2011-06-02/do-cell-phones-cause-infertility/?cid=hp:beastoriginalsC2. In addition I know of two well respected doctors who strongly discourage use of cell phones during the use of certain medications, given their experience that the radiation neutralizes the beneficial effect of the medications. I also know several friends who get strong headaches and other distressing symptoms while useing cell phones. Given 5 billion cell phone users a surely the author is being myopic in dismissing the potential risks of cell phones to many body organs and systems. Hundreds of millions of cases of increased morbidity and mortality may well result from our uncontrolled introduction of this almost universal technology. So let's not be so fast or facile in dismissing the deleterious effects of cell phones, particularly on the youngest and most frequent users of these phones, here and across the world.
- hsimmens
June 4, 2011 at 6:31am