Public health impact of extremely low-frequency electromagnetic fields

INTRODUCTION: The association between exposure to extremely low-frequency electric and magnetic fields (ELF) and childhood leukemia has led to the classification of magnetic fields by the International Agency for Research on Cancer as a "possible human carcinogen." This association is regarded as the critical effect in risk assessment. Creating effective policy in light of widespread exposure and the undisputed value of safe, reliable, and economic electricity to society is difficult and requires estimates of the potential public health impact and associated uncertainties. OBJECTIVES: Although a causal relationship between magnetic fields and childhood leukemia has not been established, we present estimates of the possible pubic health impact using attributable fractions to provide a potentially useful input into policy analysis under different scenarios. METHODS: Using ELF exposure distributions from various countries and dose-response functions from two pooled analyses, we calculate country-specific and worldwide estimates of attributable fractions (AFs) and attributable cases. RESULTS: Even given a wide range of assumptions, we find that the AF remains < 10%, with point estimates ranging from < 1% to about 4%. For small countries with low exposure, the number of attributable cases is less than one extra case per year. Worldwide the range is from 100 to 2,400 cases possibly attributable to ELF exposure. CONCLUSION: The fraction of childhood leukemia cases possibly attributable to ELF exposure across the globe appears to be small. There remain, however, a number of uncertainties in these AF estimates, particularly in the exposure distributions.