What are the indicators that health-related litigation for mobile phone use could hit the re/insurance industry? ask Dr Jack Rowley and Brent Gerstle.

The re/insurance market is watching the global mobile industry for potential exposure to health-related litigation. Independent reviews have consistently concluded that there is no convincing scientific evidence of a link between low level radio signals and adverse human health effects. Despite this vindication, there is clearly confusion within the re/insurance community regarding the potential for health risks.

Many individuals would agree that mobile phones provide important communication benefits, yet stories surface at irregular intervals claiming new scientific evidence of health risks from mobile phone use or from living near a base station. Almost invariably the stories include a sentence to the effect that the `jury is still out' on safety and that further research is needed. This presents a pessimistic picture of the state of scientific knowledge related to mobile phone usage; recent independent expert reviews in several countries have concluded that there is no convincing evidence of health risk. Swiss Re, in a 1996 report1, concluded that the insurance industry should monitor this issue not because of "the incalculably small health risks" but because of the greater risk posed by groups that have "great political and financial interest in electrosmog being considered hazardous by society". To date, product liability litigation has been unsuccessful. The international GSM (global system for mobile communications) industry is responding to health research recommendations by supporting independent studies and engaging in open dialogue with those concerned about perceived risks.

Phones and radio signals
Mobile phones communicate via low power radio signals transmitted between the handset and antenna sites known as base stations. The handset is a low power radio transmitter, which constantly adjusts its output to operate at the lowest level that will support call quality. In good coverage areas, handset powers are comparable to cordless phones in the home. Base stations also operate at low powers with typical levels comparable to broadcast radio and TV services. A combination of the low power of the handset and the need to reuse the limited radio spectrum (analogous to broadcast channels) means that several base station sites are needed in order to service a given number of customers in a geographical area.

Radio signals are part of the electromagnetic spectrum. This energy is made up of electric and magnetic fields that have different biological effects in different parts of the spectrum. This spectrum includes power line fields, radio signals (including the subset called microwaves), infra-red (IR - such as used by physiotherapists' heat lamps), visible light, ultra-violet (UV - as used in tanning beds) and the more intrinsically powerful ionising part of the spectrum, such as x-rays and gamma rays. Radio signals are described as non-ionising, meaning that they have insufficient energy to directly cause genetic damage. Another important point to note is the emotionally loaded term `radiation'. This simply means transfer of energy, so we can talk about heat radiation (e.g. an electric bar heater), light radiation (e.g. a light bulb) or radiofrequency radiation (e.g. broadcast radio and TV).

Health hazards
It is important to distinguish between potential health hazards and reports of biological response. A response simply means a measurable change in a biological system and this does not directly equate to a health hazard. For example, in viewing stars at night, the pupil of our eye widens (a biological response to the light radiation) to allow more light to reach the back of the eye and transmit signals to our brain that allow us to register the star. This is a biological effect that few would suggest constitutes a health hazard.

Contrary to suggestions, much is known about the safety of radio signals with 50 years of research providing the information. Initially, this research was directed towards radar signals used by the military but later investigations have covered the full range of radio signals, and, in recent years, it has particularly focussed on those signals used by mobile phones. Research has shown that the primary means of interaction between radio signals and biological systems is via induced heating, the mechanism behind the operation of the microwave oven. It has been established medically that an excessive heat load from any source will cause stress to the body. Thresholds of radio signal exposure for potentially hazardous effects in humans have been confirmed by continued research. For these thresholds, safety standards have been developed that include substantial safety factors to restrict allowable exposure to levels far below the thresholds. Standards used to assess compliance with these thresholds have become more sophisticated as scientific understanding has advanced.

Many of the scientific reports that receive disproportionately alarmist coverage in some sections of the media fall into the category of showing biological responses with little credible link to likely health hazards. The studies are also often preliminary, have not been replicated by independent researchers and may not have been published in peer-reviewed journals. Peer-reviewed publication allows results to be subject to careful scrutiny by peer scientists. The process of experiment, peer review and attempted replication underlies the general scientific process by which claims are tested.

There is a tendency in specialist journals as well as the general media to give less attention to studies that find no effects. Thus the recent failures to confirm an earlier report of effects from mobile phone use on blood pressure or the failure by five groups of researchers to confirm suggestions of DNA damage are not given equal coverage. Similarly with brain cancer, some small studies suggesting a risk have been given extensive coverage, yet by contrast, a major review in 2002 for a Swedish health agency concluded: "...five well-designed epidemiologic studies have been conducted in three countries...In our view, a consistent picture has emerged from these studies that appears to rule out, with a reasonable degree of certainty, a causal association between cellular telephones and cancer to date." 2

Safety research
There can be considerable variability between results due to the complexity of biological systems, therefore the total body of relevant research needs to be assessed in determining possible health risks. Independent expert reviews by some 14 bodies (see table 1 overleaf) in the last three years consistently conclude that there is no convincing scientific evidence of a link between low level radio signals and adverse human health effects.

Some reviews have noted that scientific uncertainties remain related to specific research questions, and the World Health Organisation (WHO) International EMF Project3 in 1998 identified a programme of work to support a formal health risk assessment for radio signals in 2005/2006. The WHO EMF project maintains a database of on-going and completed research projects. Table 2 (overleaf) shows the status of projects in early November 2002 related to mobile communication signals.

This database shows that a considerable body of research has been completed or is underway to address the remaining scientific uncertainties. It may be useful to note that the uncertainties primarily relate to exposure levels at or above those associated with handsets. Few experts believe there is any basis for concerns about the low level signals from base stations. Together, the GSM Association and the Mobile Manufacturers Forum (MMF), in cooperation with national authorities, are contributing more than ¤11m to support studies in Europe and China aligned with the WHO priorities. These projects are managed in a manner that assures maximum scientific independence for the researchers. In total, the WHO estimates that more than ¤100m has been committed to research related to the safety of mobile communication services. Directly or indirectly, industry is making a substantial contribution in financial and expertise terms to ensuring these studies meet the highest scientific standards, while preserving an arm's length relationship with the researchers.

Media stories regularly highlight the anxiety of residents when masts are planned for their community. From a consensus scientific perspective the hazard is inestimably small provided compliance with standards is maintained. However, the public perception is of greater scientific uncertainty and this leads to outrage among individuals and communities. In the terminology of risk communications, outrage describes the reaction by people to a perceived risk that is being imposed, that is unfamiliar and associated with a dread outcome such as cancer. The mobile communications industry has been better at dealing with scientific facts than the emotional content of these reactions. Recently, the WHO issued guidelines to improve risk communication practices for decision-makers faced with public controversy related to electromagnetic fields. Industry is taking an active role in working with stakeholders to improve trust and assist in the resolution of community concerns. Specific actions include commitments on network deployment, improved access to information about handset compliance with standards, and greater consultation with affected groups.

Phone health litigation
The only jurisdiction, of which we are aware, in which personal injury litigation has reached an evidentiary hearing stage is the US, though there have been planning- related cases in other jurisdictions. While previous US cases have been withdrawn or dismissed at earlier stages, in February 2002 US District Court Judge Catherine Blake conducted a `Daubert' hearing in the Newman case. Christopher Newman, a Maryland neurologist, had launched a substantial lawsuit against the US mobile phone industry, handset manufacturers and service providers, alleging that his mobile phone use had caused his brain cancer. Following the 1993 Supreme Court decision in the Daubert v Merrell Dow Pharmaceuticals case, US Federal Courts can now review the admissibility of expert evidence. In her judgment dismissing the evidence presented by all the plaintiff's experts Judge Blake stated: "Several published epidemiological studies have found no scientifically reliable basis to conclude that the use of wireless handheld phones causes brain cancer."4 While this judgment does not end all current US mobile phone health-related litigation, future litigants will be faced with overcoming the ruling of Judge Blake.

Some communities remain concerned about the safety of mobile phone use or living near a base station despite the assurance of independent experts. The position of the WHO remains: "None of the recent reviews have concluded that exposure to the RF [radiofrequency] fields from mobile phones or their base stations causes any adverse health consequence."5 A research agenda has been identified which will be followed by a formal health risk assessment in 2005/2006. The GSM industry is contributing positively to independent research consistent with the WHO priorities and supports efforts to improve the quality of information available to consumers.

To individuals and the community, mobile communications services provide personal, business and safety benefits allowing people to keep in touch while supporting freedom of movement. National governments, regulatory authorities and the GSM industry all have a part to play in ensuring that public concerns are appropriately addressed so that society can continue to benefit from the services of today and the enhanced 3GSM services promised for the future.

References
1. Electrosmog - a phantom risk at
http://www.swissre.com/

2. Epidemiologic Studies of Cellular Telephones and Cancer Risk - A Review at
http://www.ssi.se/english/

3. http://www.who.int/peh-emf/

4. http://www.mdd.uscourts.gov/

Opinions152/SelectOpsMenu.asp

5. Mobile Telephones and Their Base Stations, Fact Sheet No 193, revised June 2000 at
http://www.who.int/inf-fs/en/fact193.html

By Dr Jack Rowley and Brent Gerstle

Dr Jack Rowley is director of Environmental Affairs at the GSM Association. He can be contacted at
jrowley@gsm.org . Brent Gerstle is chair of the GSM Association Environment Working Group. He can be contacted at
brent.gerstle@optus.com.au .

The views expressed in this article are those of the authors and may not be representative of their organisations.

Further information on this issue is available at
www.gsmworld.com .