On radar and radio exposure and cancer in the military setting
Graphical abstract
Introduction
This work is an update on radio frequency radiation (RFR) exposure and cancer in the military setting following the work Peleg et al. (2018), using the same methodologies developed therein. We present a new group of 46 cancer patients and compare them to groups in three countries reported previously.
RFR is used worldwide to provide cellular communication for smartphones and for other uses such as the Internet of Things. In the military setting, RFR is used for communications, radar, and electronic warfare. The frequency range of RFR is from around 100 kHz to around 300 GHz. This includes also microwaves and millimeter waves.
The International Agency for Research on Cancer (IARC) classified radio frequency radiation as a possible human carcinogen (IARC group 2 B) in 2011; see IARC 2013. The epidemiological basis was principally cancer in mobile phone users reviewed recently by Choi et al. (2020) Since then, research papers have identified RFR carcinogenicity and recommended RFR reclassification as a human carcinogen (IARC group 1), e.g., Hardell and Carlberg (2013) using the Hill viewpoints, Hardell and Carlberg (2019), Miller et al. (2018), Peleg et al. (2018) and the reviews by Clegg et al. (2020) and Hardell and Carlberg (2021).
Our work focuses on military and occupational settings where RFR exposure is typically high, involves the whole body and occurs mostly over a period of a few years per person, as investigated by e.g., Szmigielski (1996), Degrave et al. (2009), in our publications, Peleg (2009) and Peleg et al. (2018) and in the early review by Goldsmith (1997). These studies point to increased cancer risks in military settings with occupational exposure to RFR. The association of RFR with hematolymphoid cancers was reported by Szmigielski (1996), Telle-Lamberton (2010), Peleg et al. (2018) and others. Most of the findings in military settings are on radiation levels within the International Commission on Non-Ionizing Radiation Protection (ICNIRP) radiation standards as used by the military and industry, see ICNIRP 1998 and ICNIRP 2020. Whole-body exposure occurs also in communities near mobile base stations, as investigated by Wolf and Wolf (2004) and López et al. (2021) and the review by Balmori (2022).
RFR-related tumors have also been identified in large-scale animal model studies (see, for example, Chou et al. 1992; NTP on mice, 2018; NTP on rats, 2018; Falcioni et al, 2018).
Possible mechanisms for the interactions of RFR with living tissues have been presented, e.g. Friedman et al. (2007) reported changes in protein signaling pathways caused by RFR at sub-thermal levels of 5 μW/cm2 and Pooam et al (2022) reported formation of Reactive Oxygen Species. Possible physical principles were reported e.g. Barnes and Greenebaum, 2014, Vistnes and Gjotterud (2001) and Peleg (2012).
The question of the carcinogenicity of RFR is still considered open, and it was not settled by the WHO, see IARC 2013 and the numerous references therein, some of which reported the carcinogenicity of RFR and some did not. Many studies show little or no relationship between RFR and health relevant outcomes, see for example the review within ICNIRP 2020. The recent work of Nordhagen and Flydal, 2022 discusses the tendency of ICNIRP 2020 to emphasize negative results and lists more review documents on the subject. We examine an in-depth investigation from the occupational military setting, showing little evidence of adverse health effects, Dabouis et al. (2016), and also Groves et al. (2002) which did report some adverse effects, see the discussion section of this paper.
In Peleg et al. 2018, we reported a group of 47 cancer patients who worked previously as radio and radar operators and developers and were exposed repeatedly to whole-body RFR at levels much higher than exposure from cellular base stations in the community, see Koppel et al. (2019) and Table 3, but still usually not exceeding the occupational ICNIRP limits. We found that the cancers in this group of patients had unusual characteristics. Most notably, there was a much higher proportion of hematolymphoid 1 (HL) cancers than expected for the appropriate age and sex profiles from the Israeli Cancer Registry (CR). Also, multiple primaries occurred significantly more frequently than expected. The data were analyzed by means of the percentage frequency (PF) of cancer types, that is, proportion of cancer types, see the Materials and methods section below.
Next, we found that this same characteristic of very high PF of HL cancers occurred together with elevated HL and other cancers risks in three other groups of cancer patients exposed to RFR in similar settings reported in Poland, Belgium and Israel during the last decades. Additionally, there is a fifth such group reported in Tables 2 and 3 of Richter et al. (2000).
The 47 patients reported in 2018 were diagnosed mostly within the period from 1984 until 2007, none later than 2009. Starting from 2019 through 2021, we received new data on additional 46 cancer patients from similar military settings. These were diagnosed from 2002 until 2021 (median 2017), which is approximately 20 years later than the group reported in 2018.
This paper examines these new findings and their implications. We address the question of whether the same pattern of morbidity occurs now, 20 years after the diagnoses of the group reported in 2018.
Section snippets
Cases: selection and diagnoses
All the patients served in the Israeli Defense Forces (IDF). They either operated radar and/or radio communications transmitters or performed duties nearby the facilities. They all contacted Zoar – a volunteer NGO whose mission is to assist cancer patients by providing administrative counseling and legal and social services. Zoar and the patients themselves suspected a high incidence of cancer cases among soldiers serving near RFR emitting equipment and started to record a list of patients. All
PF analysis results
The PF of HL cancers, of Hodgkin's lymphomas (subset of HL) and sarcomas was computed and analyzed, see Table 6.
Comparison with previous reports
Our main result on HL PF and on general cancer risks together with results from five other groups reported in previous publications are listed in Table 7. All those are studies of personnel in the defense sector with whole body occupational exposure to RFR in contrast to studies on brain cancers among cellphone users. We suggest that the shift from local exposure of the head among the mobile phones users to occupational whole-body exposure explain the additional types of cancers observed,
Conclusion
This work reports a new group of cancer patients with previous RFR exposure in the occupational/military setting and reviews five similar groups in three countries reported formerly. The six groups of cancer patients with occupational and military RFR exposure are summarized in Table 7 and in Fig. 4. In all the six groups, there was a consistent, statistically significant, and well-documented atypically high HL PF, distinctly higher than expected in the community (Cancer Registry) or computed
Funding sources
There was no external funding of this research.
Human research approval
The manuscript reports questionary-based non-interventional retrospective research on human subjects. The compliance of the research to the Helsinki rules was reviewed and approved by the accredited ethics (Helsinki) committee of the Hadassah university hospital, Jerusalem, Israel, under research number HMO-0804-21.
Declaration of competing interest
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: M.P. is employed by a company producing RFR transmitting equipement. M.D. is a foundder and the CEO of Zoar. E.R. : The Unit of Occupational and Environmental Medicine in the Hebrew University-Hadassah School of Public Health and Community Medicine provided medical opinions to previous cancer patients. The fees went directly into the Unit research budget in the
6 Acknowledgments
We wish to thank the patients for their vital cooperation with the Zoar organization, which made this study possible. We thank the investigative journalists Gabi Bar Haim and Ido Shvartztuch from Yedioth Aharonoth, who identified the subgroup recruited to Iron Dome in 2011. We thank the reviewers for their comments and advice which improved the quality and readability of the paper. Amir Borenstein provided advice on human exposure and useful suggestions. Norman B. Grover provided helpful advice
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