A precautionary public health protection strategy for the possible risk of childhood leukaemia from exposure to power frequency magnetic fields

Myron Maslanyj*, Tracy Lightfoot, Joachim Schüz, Zenon Sienkiewicz, Alastair McKinlay

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Background. Epidemiological evidence showing a consistent association between the risk of childhood leukaemia and exposure to power frequency magnetic fields has been accumulating. This debate considers the additional precautionary intervention needed to manage this risk, when it exceeds the protection afforded by the exposure guidelines as recommended by the International Commission on Non-Ionizing Radiation Protection. Methods. The Bradford-Hill Criteria are guidelines for evaluating the scientific evidence that low frequency magnetic fields cause childhood leukaemia. The criteria are used for assessing the strength of scientific evidence and here have been applied to considering the strength of evidence that exposures to extremely low frequency magnetic fields may increase the risk of childhood leukaemia. The applicability of precaution is considered using the risk management framework outlined in a European Commission (EC) communication on the Precautionary Principle. That communication advises that measures should be proportionate, non-discriminatory, consistent with similar measures already taken, based on an examination of the benefits and costs of action and inaction, and subject to review in the light of new scientific findings. Results. The main evidence for a risk is an epidemiological association observed in several studies and meta-analyses; however, the number of highly exposed children is small and the association could be due to a combination of selection bias, confounding and chance. Corroborating experimental evidence is limited insofar as there is no clear indication of harm at the field levels implicated; however, the aetiology of childhood leukaemia is poorly understood. Taking a precautionary approach suggests that low-cost intervention to reduce exposure is appropriate. This assumes that if the risk is real, its impact is likely to be small. It also recognises the consequential cost of any major intervention. The recommendation is controversial in that other interpretations of the data are possible, and low-cost intervention may not fully alleviate the risk. Conclusions. The debate shows how the EC risk management framework can be used to apply the Precautionary Principle to small and uncertain public health risks. However, despite the need for evidence-based policy making, many of the decisions remain value driven and therefore subjective.

Original languageEnglish
Article number673
JournalBMC Public Health
Volume10
DOIs
Publication statusPublished - 2010

Bibliographical note

Funding Information:
The conclusion is in accord with the findings of a number of authoritative bodies that have reviewed the scientific evidence and acknowledged the possibility of a risk, including the independent Advisory Group on Non-ionising Radiation [15-17], ICNIRP [18], the International Agency for Research on Cancer (IARC) [19] and the National Radiological Protection Board (now the Health Protection Agency) [20]. More recent reviews which continue to acknowledge the possibility of a risk include those by the Health Council of the Netherlands [21,22], the Swedish Radiation Protection Institute [23,24], the World Health Organization (WHO) [25], the Danish Cancer Society [26], and the EU Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) [27,28].

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