Table 4.18 Design of studies of leukemia and residential exposure to EMF

Study
Case selection
Control selection
Exposure metrics
Confounders analyzed

USA

Preston-Martin et al. (1988) Confirmed AML and CML cases aged 20-69, resident in LA county, alive at interview and English speaking from cancer registry (1979-85)
224 cases included in analyses
Neighborhood controls (1 per case) matched on sex, race and birth year, resident in LA country, alive at interview and English speaking
224 controls included in analyses
Electric blanket use from questionnaire (ever/never, duration, year of first and last regular use) Sex
Race
Age
Diagnostic X-rays
Work as a welder
Life on a farm
Severson et al. (1988) ANLL cases aged 20-79, resident in Western Washington State, from cancer registry (1981-84)
114 cases included in analyses (91 AML)
Population-based controls from random-digit dialing, matched on geographical area and frequency matched on age and sex
133 controls included in analyses
Wertheimer and Leeper wire-coding
Estimation of magnetic fields from maps and wire coding -- method of Kaune (1987)
One-time measurements of 60 Hz magnetic fields inside (kitchen, bedroom, family room in HPC1 and LPC1) and outside house 24-hour measurements in sample of houses
Electric appliance use from questionnaire
Age
Sex
Cigarette smoking
Family income
Race
Lovely et al. (1994) Same cases as Severson
67-70 cases included in analyses:, depending on appliance (missing data)
Same controls as Severson
66-69 controls included in analyses:, depending on appliance
Use of electric razors, hair dryers and massage units from questionnaire Age
Sex
Smoking
Sussman & Kheifets (1996) Same as Lovely and Severson, excluding proxy respondents
24 cases included in analyses
Same as Lovely and Severson Same as LovelySex

Sweden

Feychting and Ahlbom (1994) All incident cancer cases from cancer registry( 1960-1985),from cohort of Swedish population aged 16 or over, living on a property located within 300 meters of any 220 or 400 kV power lines 325 cases in analyses (72 AML, 57 CML, 14 ALL and 132 CLL) Two controls per case from same cohort
Matched on age, sex, parish and residence near same power line
1,091 controls in analyses
Distance to power lines from residenceIn-home magnetic field spot measurements under low and high power use conditions
Calculations of the magnetic fields generated by the power lines at the time spot measurements were assessed (calculated contemporary fields) and for the year closest in time to diagnosis (historical calculated fields)
Age
Sex
Year of diagnosis
Residing or not in the county of Stockholm
Type of residence
SES
Feychting et al. (1997) Same as Feychting and Ahlbom (1994)Same as above Same as above for residential
Occupational exposure from job-exposure matrix developed from workday measurements made for a large number of occupations outside the framework of this study and information on occupation held in the year prior to the reference date
Same as above
Occupational exposures to motor fuel/exhaust fumes, benzene, oil products, solvents and welding fumes

Finland

Verkasalo et al. (1996) All primary leukemia cases reported to the Finnish Cancer Registry (1974-89) from cohort of Finnish population, aged 20 or older, living within 500 m of overhead power lines of 110-400 kV in building with a calculated magnetic field of > 0.01 µT for any period between the years 1970-89203 cases identified Cohort study: consisting of 383 700 persons (189,300 men) who contributed 2.5 million person years of follow-up after age 20 Average annual magnetic fieldsCumulative exposure
Estimates based on residential history, distance between center of residential buildings and each power line in 500 m corridor and calculated average annual magnetic fields for each building. Takes into account current, typical locations of phase conductors in power lines, and distance
Sex
Age
Socioeconomic status
Verkasalo et al. (1998) Same as Verkasalo et al (1996)196 leukemia cases included (60 AML, 12 ALL, 30 CML, 73 CLL, and 21 other or unknown subtype) 10 controls per case from cohort
Matched on sex, age at diagnosis and alive in the year of diagnosis of the case
Cumulative exposure: total and within 0-4, 5-9, and 10 years or more of diagnosis
Annual average magnetic fields 1 through 20 years prior to diagnosis
Highest annual average magnetic field ever and in time windows before diagnosis
Age at first exposure to annual average magnetic field greater than a specified level
Duration and time since exposure to annual averages above that level.
Sex
Age
Type of municipality
Type of housing
Occupational exposure (none/possible or probable)

Taiwan

Li et al. (1997) Pathologically confirmed incident cases of leukemia from northern Taiwan from cancer registry (1987-92)
870 cases included in analyses
One control per case from cancer registry, excluding leukemia, brain and breast cancers, cancers of the haematopoietic and reticulo-endothelial system, skin, ovary, fallopian tube, and broad ligament.
Matched on date of birth, sex, and date of diagnosis889 controls included in analyses
Distance from lines
Average and maximum magnetic fields assessed using distance from the lines, distance between wires, height of wires above the ground, annual and maximum loads along the lines from 1987 to 1992, current phase, and geographical resistivity of earth
Age
Sex
Index of urbanization


AML, acute myelogenous leukemia; CML, chronic myelogenous leukemia; LA, Los Angeles; ANLL, acute nonlymphocytic leukemia; HPC: high power configuration; LPC: low power configuration; ALL, acute lymphocyte leukemia; CLL, chronic lymphocytic leukemia