Case-control study on radiology work, medical X-ray investigations, and use of cellular telephones as risk factors for brain tumors

Hardell L, Nasman A, Pahlson A, Hallquist A

Medscape General Medicine May 4, 2000

Context. Ionizing radiation is a well-established risk factor for brain tumors. During recent years, microwave exposure from the use of cellular telephones has been discussed as a potential risk factor.
Objective. To determine risk factors for brain tumors.
Design. A case-control study, with exposure assessed by questionnaires.

Participants. A total of 233 currently living men and women, aged 20 to 80 years, were included. The case patients had histopathologically verified brain tumors and lived in the Uppsala-Orebro region (1994-1996) or the Stockholm region (1995-1996). Two matched controls to each case were selected from the Swedish Population Register.

Main Outcome Measures. Ionizing radiation and use of cellular telephones as risk factors for brain tumors.

Results. A total of 209 cases (90%) and 425 controls (91%) answered the questionnaire.

• Work as a physician yielded an odds ratio (OR) of 6.00, with a 95% confidence interval (CI) of 0.62 to 57.7. All three case patients had worked with fluoroscopy.
• Radiotherapy of the head and neck region yielded an OR of 3.61 (95% CI, 0.65-19.9).
• Medical diagnostic x-ray examination of the same area yielded an OR of 2.10 (95% CI, 1.25-3.53), with a tumor induction period of 5 years or more.
• Chemical industry work yielded an OR of 4.10 (95% CI, 1.25-13.4), and laboratory work yielded an OR of 3.21 (95% CI, 1.16-8.85).
• Ipsilateral use of cellular telephones increased the risk for tumors in the temporal, temporoparietal, and occipital lobes (OR, 2.42; 95% CI, 0.97-6.05), ie, the anatomic areas with highest exposure to microwaves from a mobile telephone.

The result was further strengthened (OR, 2.62; 95% CI, 1.02-6.71) in a multivariate analysis that included laboratory work and medical diagnostic x-ray investigations of the head and neck.

Conclusion. Exposure to ionizing radiation, work in laboratories, and work in the chemical industry increased the risk of brain tumors. Use of a cellular telephone was associated with an increased risk in the anatomic area with highest exposure.