Contents

Participants
1 Introduction 7
2 Occurrence and Measurement of Extremely Low Frequency Electromagnetic Fields 9

2.1 What are electromagnetic fields? 9
2.2 Measurements, unit conventions, and sources 14
2.3 Exposure assessment 17
2.3.1 Instrumentation 17
2.3.2 Exposure metrics 19
2.3.3 Exposure environments 22
2.3.4 Exposure assessment for epidemiological studies 23

2.4 Occupational exposure 24
2.4.1 General occupational environments 24
2.4.2 Visual display terminal operators 31
2.5 Residential exposure 32
2.5.1 Direct measurements 33
2.5.2 Calculated historical fields 39
2.5.3 Wire codes as an exposure surrogate 42

2.6 Exposure in transport 43
2.7 Exposure in schools 44
2.8 Exposure from appliances 452.9
2.9 Laboratory exposure systems 47
2.10 Summary 49

3.1 Electric field dosimetry for human exposure 79
3.2 Low-frequency magnetic field dosimetry 80
3.2.1 Magnetic fields induced in the body by external magnetic fields 80
3.2.2 Magnetic fields induced in the body by external magnetic fields 80
3.3 Scaling between different organisms, assuming that an observed effect is due to induced electric fields 81
3.4 Considerations for in vitro dosimetry 82
3.4.1 Electric field dosimetry 82
3.4.2 Magnetic field dosimetry 83
3.5 Summary 83

4.1 Carcinogenicity in animals 85
4.1.1 One- and two-year bioassays 86
4.1.2 Multistep carcinogenesis 89
4.1.2.1 Mammary Cancer 89
4.1.2.2 Skin tumor models 95
4.1.2.3 Liver cancer models 98
4.1.2.4 Leukemia/lymphoma model 98
4.1.3 Summary 101

4.2 Epidemiological studies of carcinogenicity in adults 107
4.2.1 Occupational exposure 108
4.2.1.1 All cancers combined 109
4.2.1.2 Leukemia 111
4.2.1.3 Brain cancer 117
4.2.1.4 Breast cancer 119
4.2.1.5 Lung cancer 123
4.2.1.6 Other cancers 124
4.2.1.7 Central nervous system cancers in the offspring of parents exposed to electromagnetic fields 125
4.2.1.8 Meta-analyses of brain cancer and leukemia 127
4.2.1.9 Summary 129
4.2.2 Residential exposure 133
4.2.2.1 All cancers 133
4.2.2.2 Leukemia 134
4.2.2.3 Breast cancer 140
4.2.2.4 Tumors of the central nervous system 143
4.2.2.5 Summary 144
4.3 Epidemiological studies of carcinogenicity in children 167
4.3.1 Effects of power lines 167
4.3.2 Effects of appliances 178
4.3.3 Meta-analyses of studies of effects of power lines 183
4.3.4 Summary 184
4.4 Non-cancer health effects in experimental animals 209
4.4.1 Immunological effects 209
4.4.1.1 Magnetic and electric fields 209
4.4.1.2 Magnetic fields 210
4.4.1.3 Magnetic fields and 7,12-dimethylbenz[a]anthracene 211
4.4.1.4 Summary 212
4.4.2 Hematological effects 216
4.4.2.1 Magnetic and electric fields 216
4.4.2.2 Summary 217
4.4.3 Effects on the nervous system 217
4.4.3.1 Field detection 217
4.4.3.2 Avoidance and aversion 218
4.4.3.3 Learning and performance 221
4.4.3.4 Neurophysiology 224
4.4.3.5 Electrophysiology 227
4.4.3.6 Summary 229
4.4.4 Reproductive and developmental effects 237
4.4.4.1 Birds 237
4.4.4.2 Mice 238
4.4.4.3 Rats 239
4.4.4.4 Hamsters 240
4.4.4.5 Summary 240
4.4.5 Effects on melatonin 244
4.4.5.1 Electric fields 244
4.4.5.2 Exposure to magnetic fields for < 1 h 245
4.4.5.3 Exposure to magnetic fields for 1-24 h 247
4.4.5.4 Exposure to magnetic fields for > 24 h 248
4.4.5.5 Exposure to electric and magnetic fields 251
4.4.5.6 Summary 251
4.4.6 Bone and tissue repair and adaptation 256
4.4.6.1 Clinical bone healing with pulsed electromagnetic fields 256
4.4.6.2 Experimental studies 260
4.4.6.3 Summary 269
4.5 Epidemiological studies of non-cancer health effects in humans 272
4.5.1 Occupational exposure 272
4.5.1.1 Reproductive effects 272
4.5.1.2 Neurodegenerative diseases 276
4.5.1.3 Suicide and depression 282
4.5.1.4 Cardiovascular disease 283
4.5.1.5 Summary 284
4.5.2 Environmental exposure 287
4.5.2.1 Pregnancy outcome 287
4.5.2.2 Neurodegenerative diseases and neurobiological disorders 292
4.5.2.3 Summary 292
4.6 Laboratory studies of non-cancer health effects in humans 301
4.6.1 Sensation and perception 302
4.6.1.1 Field perception 302
4.6.1.2 Visual effects 302
4.6.2 Central nervous system 303
4.6.2.1 Electroencephalographic spectral analysis 303
4.6.2.2 Event-related potential 305
4.6.2.3 Sleep electrophysiology 306
4.6.2.4 Cognition and performance 308
4.6.3 Cardiovascular system 308
4.6.3.1 Heart rate 308
4.6.3.2 Heart-rate variability 309
4.6.4 Other effects 311
4.6.4.1 Melatonin 311
4.6.4.2 Neuroendocrinology 313
4.6.4.3 Immune system 313
4.6.5 Mood disturbances 314
4.6.6 Electromagnetic hypersensitivity 314
4.6.7 Summary 316
4.7 In vitro and mechanistic studies 326
4.7.1 Genotoxicity and regulation of gene expression 326
4.7.1.1 Genotoxicity 327
4.7.1.2 Transcription 330
4.7.1.3 Translation and protein synthesis 332
4.7.1.4 Summary 333
4.7.2 Signal transduction and proliferation 334
4.7.2.1 Calcium homeostasis and flux 335
4.7.2.2 Receptor-mediated signaling pathways 337
4.7.2.3 Cell proliferation 338
4.7.2.4 Enzyme synthesis and activity 340
4.7.2.5 Apoptosis 3414.7.2.6 Summary 342
4.7.3 Induction of cytological markers 342
4.7.3.1 Embryonic staging 343
4.7.3.2 Matrix synthesis and extracellular interactions 345
4.7.3.3 Cell surface markers 346
4.7.3.4 Matrix interactions: Adhesion, morphology, and motility 348
4.7.3.5 Cell-cell communication and gap junctions 351
4.7.3.6 Summary 352
4.7.4 Summary 354
4.8 Biophysics of interactions of ELF EMF with biological systems 355
4.8.1 Biologically important interactions at the molecular level 358
4.8.1.1 Forces and torques on ions and molecules 358
4.8.1.2 Perturbation of chemical reactions 359
4.8.1.3 Temporal averaging and time-dependent processes 360
4.8.2 Comparison of changes induced by EMF and competing physical processes 361
4.8.2.1 Comparison with the geomagnetic field 361
4.8.2.2 Comparison with endogenous electric fields 361
4.8.2.3 Comparison with thermal noise 362
4.8.2.4 Comparison with shot and 1/f noise 365
4.8.2.5 Magnitude of competing thermal effects 366
4.8.3 Proposed physical mechanisms 368
4.8.3.1 Effects of electric fields on cell surface structures and cell attachment 368
4.8.3.2 Cyclotron resonance and ion parametric resonance 371
4.8.3.3 Biological electron transfer 375
4.8.3.4 Effects on biogenic magnetite 376
4.8.3.5 Magnetochemistry: Effects of magnetic fields on free-radical reactions 377
4.8.3.6 Non-linear dynamics and application of stochastic resonance 380
4.8.4 Summary 382

5.1 Carcinogenicity in humans 396
5.1.1 Evidence from epidemiological studies to support the evaluation 396
5.1.2 Evidence from studies of carcinogenicity in experimental animals in vivo to support the evaluation 397
5.1.3 Mechanistic and in vitro evidence to support the evaluation 398
5.1.4 Discussion 399
5.2 Non-cancer health effects 399
5.2.1 Non-cancer adverse health effects 399
5.2.2 Other biological effects 401
5.3 Overall evaluation 402