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Future needs of occupational epidemiology of extremely low frequency (ELF) electric and magnetic fields (EMF): review and recommendations
  1. Leeka Kheifets (kheifets{at}
  1. UCLA, United States
    1. Joseph D Bowman (jdb0{at}
    1. National Institute for Occupational Safety and Health,, United States
      1. Harvey Checkoway (checko{at}
      1. University of Washington, Seattle,, United States
        1. Maria Feychting (maria.feychting{at}
        1. Karolinska Institutet, Sweden
          1. Malcolm Harrington (jmharri6{at}
          1. University of Birmingham, United Kingdom
            1. Robert Kavet (rkavet{at}
            1. Electric Power Research Institute, United States
              1. Gary Marsh (gmarsh{at}
              1. University of Pittsburgh, United States
                1. Gabor Mezei (gmezei{at}
                1. Electric Power Research Institute, United States
                  1. David C. Renew (david.renew{at}
                  1. National Grid Transco, United Kingdom
                    1. Edwin van Wijngaarden (edwin_van_wijngaarden{at}
                    1. University of Rochester School of Medicine and Dentistry, United States


                      The occupational epidemiologic literature on extremely low frequency electric and magnetic fields (EMF) and health encompasses a large number of studies of varying design and quality that have addressed many health outcomes, including various cancers, cardiovascular disease, depression and suicide, and neurodegenerative diseases, such as Alzheimer disease and amyotrophic lateral sclerosis (ALS). At a 2006 workshop we reviewed studies of occupational EMF exposure with an emphasis on methodologic weaknesses, and proposed analytical ways to address some of these. We also developed research priorities that we hope will address remaining uncertainties. Broadly speaking, extensive epidemiologic research conducted during the past 20 years on occupational EMF exposure does not indicate strong or consistent associations with cancer or any other health outcomes. Inconsistent results for many of the outcomes may be attributable to numerous shortcomings in the studies, most notably in exposure assessment. There is, however, no obvious correlation between exposure assessment quality and observed associations. Nevertheless, for future research, the highest priorities emerge in both the areas of exposure assessment and investigation of ALS. To better assess exposure, we call for development of a more complete job-exposure matrix that combines job title, work environment and task, and an index of exposure to electric fields, magnetic fields, spark discharge, contact current, and other chemical and physical agents. For ALS, we propose an international collaborative study capable of illuminating a reported association with electrical occupations by disentangling the potential roles of electric shocks, magnetic fields, and bias. Such a study will potentially lead to evidence-based measures to protect public health.

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