Electromagnetic fields and breast cancer risk

  Introduction: People are exposed to electromagnetic fields (EMF) in different ways, such as through utility wires, electric blankets, microwave ovens and fluorescent lighting.

Regular exposure to EMF doesn’t appear to be linked to an increased risk of breast cancer. Large prospective cohort studies and a meta-analysis that combined the results from 15 studies have found no link between the two.

  The disparity between the rates of breast cancer in industrialized and less-industrialized regions has led to many hypotheses, including the theory that exposure to light-at-night and/or electromagnetic fields (EMF) may suppress melatonin and that reduced melatonin may increase the risk of breast cancer. In this comprehensive review we consider strengths and weaknesses of more than 35 residential and occupational epidemiologic studies that investigated the association between EMF and breast cancer. Although most of the epidemiologic data do not provide strong support for an association between EMF and breast cancer, because of the limited statistical power as well as the possibility of misclassification and bias present in much of the existing data, it is not possible to rule out a relationship between EMF and breast cancer. We make several specific recommendations for future studies carefully designed to test the melatonin-breast cancer and EMF-breast cancer hypotheses. Future study designs should have sufficient statistical power to detect small to moderate associations; include comprehensive exposure assessments that estimate residential and occupational exposures, including shift work; focus on a relevant time period; control for known breast cancer risks; and pay careful attention to menopausal and estrogen receptor status.

  Worldwide, breast cancer is the most common malignancy accounting for 20-32% of all female cancers. This review summarizes the peer-reviewed, published data pertinent to the hypothesis that increased breast cancer in industrialized countries is related to the increased use of electricity [Stevens, R.G., S. Davis 1996]. That hypothesis specifically proposes that increased exposure to light at night and electromagnetic fields (EMF) reduce melatonin production. Because some studies have shown that melatonin suppresses mammary tumorigenesis in rats and blocks estrogen-induced proliferation of human breast cancer cells in vitro, it is reasoned that decreased melatonin production leads to increased risk of breast cancer. To evaluate this hypothesis, the paper reviews epidemiological data on associations between electricity and breast cancer, and assesses the data on the effects of EMF exposure on melatonin physiology in both laboratory animals and humans. In addition, the results on the effects of melatonin on in vivo carcinogenesis in animals are detailed along with the controlled in vitro studies on melatonin's effects on human breast cancer cell lines. The literature is evaluated for strength of evidence, inter-relationships between various lines of evidence, and gaps in our knowledge. Based on the published data, it is currently unclear if EMF and electric light exposure are significant risk factors for breast cancer, but further study appears warranted. Given the ubiquitous nature of EMF and artificial light exposure along with the high incidence of breast cancer, even a small risk would have a substantial public health impact.

Purpose: Several statements have been issued to the effect that no consistent, significant link has been demonstrated between cancer and electromagnetic fields (EMF). However, there continues to be much interest in a possible association with breast cancer, in part because breast cancer risk is substantially higher in industrialized countries than in other areas, and electric power generation and consumption is one of the hallmarks of industrialized societies. In 1987, Stevens proposed a biological mechanism whereby two products of electric power generation, EMF and light at night, might contribute to mammary carcinogenesis through inhibition of melatonin.

Methods: We conducted a comprehensive review of the epidemiologic literature and hypothesized mechanisms pertaining to EMF exposure and the risk of breast cancer, in order to assess whether or not there was evidence to suggest a link between EMF and breast cancer.

Results: Some occupational epidemiological studies have demonstrated an increased incidence of breast cancer among mainly male electrical workers. It has been difficult to study women, as few are employed in these types of occupations. In all, there have been eleven occupational studies related to breast cancer in women, and statistically significant risk ratios have been observed: 1.98 for pre-menopausal women in occupations with high EMF exposure in one study, 2.17 in all women who worked as telephone installers, repairers, and line workers in another study, and 1.65 for system analysts/ programmers, 1.40 for telegraph and radio operators, and 1.27 for telephone operators in a third study. However, six of the studies did not find any significant effects and two found effects only in subgroups. The results of the eight studies of residential exposure and four electric blanket studies have been inconsistent, with most not demonstrating any significant association. However, this might be attributed, at least to some extent, to difficulties in assessing residential exposure in these studies, as well as other methodological considerations.

Conclusions: The biologic plausibility of an association between EMF and breast cancer, coupled with suggestive data from occupational studies and unexplained high incidence rates of breast cancer, suggests that further investigation of this possible association is warranted.