Radiofrequency electromagnetic fields emitted from base stations of DECT cordless phones and the risk of glioma and meningioma (Interphone Study Group, Germany).

The objective of this study was to test the hypothesis that exposure to continuous low-level radiofrequency electromagnetic fields (RF EMFs) increases the risk of glioma and meningioma. Participants in a population-based case-control study in Germany on the risk of brain tumors in relation to cellular phone use were 747 incident brain tumor cases between the ages of 30 and 69 years and 1494 matched controls. The exposure measure of this analysis was the location of a base station of a DECT (Digital Enhanced Cordless Telecommunications) cordless phone close to the bed, which was used as a proxy for continuous low-level exposure to RF EMFs during the night. Estimated odds ratios were 0.82 (95% confidence interval: 0.29-2.33) for glioma and 0.83 (0.29-2.36) for meningioma. There was also no increasing risk observed with duration of exposure to DECT cordless phone base stations. Although the study was limited due to the small number of exposed subjects, it is still a first indication that residential low-level exposure to RF EMFs may not pose a higher risk of brain tumors.

[Can communication with terminally ill patients be taught? Evaluation of a course model]. / Kann Kommunikation mit unheilbar kranken Patienten gelehrt werden?Evaluation eines Kursmodells.

BACKGROUND AND PURPOSE: Communication with terminally ill patients is a main responsibility of physicians. However, many physicians feel insufficiently prepared for this task. Models of courses resulting in improvements of communicative skills of participants have been published mainly in the Anglo-American literature. This study describes the realization of a 2-day course model based on the experiences of the first three courses of this kind in Rhineland-Palatinate, and analyzes changes of participants' communication behavior. METHODS: After each seminary, an evaluation form concerning participants' satisfaction with the course was filled in. Furthermore, all course participants received a questionnaire at the beginning and at the end of the course, as well as 3 months afterwards. The participants were asked to assess their own sense of security in seven different communication settings on a visual analog scale, and to specify perceived changes in their communication behavior 3 months after the course. RESULTS: The first three courses were attended by 31 participants. Course evaluation revealed high satisfaction scores with methods as well as with clarity and relevance of the contents. Self-assessment of participants showed a growing sense of security in different communication settings. Important increases could be demonstrated for communicating a diagnosis of cancer with good or less good prognosis, recurrence of cancer or a far progressive cancer disease without curative approach. 3 months after the course, participants described multiple changes indicating increased sensibility and professionalism in communication behavior. CONCLUSION: The realized communication skills courses resulted in relevant changes in communication behaviour and self-confidence of participants. Communication with terminally ill patients can be taught.

Adjusted population attributable fractions and preventable potential of risk factors for childhood obesity.

OBJECTIVE: A number of individual risk factors for childhood obesity have been identified, but only some of these are amenable to prevention. To assess the amount of cases in a general population attributable to these risk factors, adjusted population-attributable fractions were estimated. DESIGN: Cross-sectional study. SETTING: Obligatory school entry examination in 2001/2002 in six Bavarian communities (Germany). SUBJECTS: 5472 children at age 5-6 years. MEASURES: Anthropometric measures were ascertained by public health nurses, and measures concerning sociodemographics, lifestyle and child behaviour such as child's daily meal frequency were obtained with self-administered parental questionnaires. Obesity was defined according to sex- and age-specific body mass index cut-off points proposed by the International Obesity Task Force. Adjusted population-attributable fractions were calculated based on logistic regression. RESULTS: A combination of the risk factors low meal frequency, decreased physical activity, watching television >1 h day- 1, formula feeding and smoking in pregnancy accounted for 48.2% of obese children. This combination yielded a maximal achievable prevalence reduction of 1.5% for obesity (3.2% observed prevalence). CONCLUSIONS: A modification of five known risk factors for childhood overweight and obesity could reasonably lower obesity prevalences at school entry. These risk factors should be particularly considered in decision making on preventive measures.

Cellular phones, cordless phones, and the risks of glioma and meningioma (Interphone Study Group, Germany).

The widespread use of cellular telephones has generated concern about possible adverse health effects, particularly brain tumors. In this population-based case-control study carried out in three regions of Germany, all incident cases of glioma and meningioma among patients aged 30-69 years were ascertained during 2000-2003. Controls matched on age, gender, and region were randomly drawn from population registries. In total, 366 glioma cases, 381 meningioma cases, and 1,494 controls were interviewed. Overall use of a cellular phone was not associated with brain tumor risk; the respective odds ratios were 0.98 (95% confidence interval (CI): 0.74, 1.29) for glioma and 0.84 (95% CI: 0.62, 1.13) for meningioma. Among persons who had used cellular phones for 10 or more years, increased risk was found for glioma (odds ratio = 2.20, 95% CI: 0.94, 5.11) but not for meningioma (odds ratio = 1.09, 95% CI: 0.35, 3.37). No excess of temporal glioma (p = 0.41) or meningioma (p = 0.43) was observed in cellular phone users as compared with nonusers. Cordless phone use was not related to either glioma risk or meningioma risk. In conclusion, no overall increased risk of glioma or meningioma was observed among these cellular phone users; however, for long-term cellular phone users, results need to be confirmed before firm conclusions can be drawn.

Occupational exposure to radio frequency/microwave radiation and the risk of brain tumors: Interphone Study Group, Germany.

It is still under debate whether occupational exposure to radio frequency/microwave electromagnetic fields (RF/MW-EMF) contributes to the development of brain tumors. This analysis examined the role of occupational RF/MW-EMF exposure in the risk of glioma and meningioma. A population-based, case-control study including 381 meningioma cases, 366 glioma cases, and 1,494 controls aged 30-69 years was performed in three German regions in 2000-2003. An exposure matrix for occupational activity was constructed by using information on RF/MW-EMF exposure collected in a computer-assisted personal interview. "High" exposure was defined as an occupational exposure that may exceed the RF/MW-EMF exposure limits for the general public recommended by the International Commission on Non-Ionizing Radiation Protection. Multiple conditional logistic regressions were performed separately for glioma and meningioma. No significant association between occupational exposure to RF/MW-EMF and brain tumors was found. For glioma, the adjusted odds ratio for highly exposed persons compared with persons not highly exposed was 1.21 (95% confidence interval: 0.69, 2.13); for meningioma, it was 1.34 (95% confidence interval: 0.64, 2.81). However, the slight increase in risk observed with increasing duration of exposure merits further research with larger sample sizes.

Cellular telephone use among primary school children in Germany.

BACKGROUND: There is some concern about potential health risks of cellular telephone use to children. We assessed data on how many children own a cellular telephone and on how often they use it in a population-based sample. METHODS: We carried out a cross-sectional study among children in their fourth elementary school year, with a median-age of 10 years. The study was carried out in Mainz (Germany), a city with about 200,000 inhabitants. The study base comprised all 37 primary schools in Mainz and near surroundings. Altogether, 1933 children from 34 primary schools took part in the survey (participation rate of 87.8%). RESULTS: Roughly a third of all children (n = 671, 34.7%) reported to own a cellular telephone. Overall, 119 (6.2%) children used a cellular telephone for making calls at least once a day, 123 (6.4%) used it several times a week and 876 (45.3%) children used it only once in a while. The remaining 805 (41.6%) children had never used a cellular telephone. The probability of owning a cellular telephone among children was associated with older age, being male, having no siblings, giving full particulars to height and weight, more time spent watching TV and playing computer games, being picked up by their parents from school by car (instead of walking or cycling) and going to bed late. The proportion of cellular telephone owners was somewhat higher in classes with more children from socially disadvantaged families. CONCLUSIONS: Our study shows that both ownership of a cellular telephone as well as the regular use of it are already quite frequent among children in the fourth grade of primary school. With regard to potential long-term effects, we recommend follow-up studies with children.

Atopic disease and childhood acute lymphoblastic leukemia.

Our objective was to test the hypothesis that the risk of childhood leukemia is associated with allergies or a family history of allergy. We used a German population-based case-control study with self-reported information on allergies of the children and their first-degree relatives. Our study included a total of 1,130 cases of acute lymphoblastic leukemia (ALL), 164 cases of acute myeloid leukemia (AML) and 2,957 controls. A major finding of our study is that hay fever, neurodermatitis and contact eczema are underrepresented within the group of children with ALL, with respective odds ratios (OR) of 0.45 (95% confidence interval [CI] 0.31-0.66) for hay fever, of 0.49 (CI 0.34-0.71) for neurodermatitis and of 0.62 (CI 0.39-0.99) for eczema, respectively. Atopic diseases, comprising hay fever, neurodermatitis and asthma, are much stronger related with a reduced risk of ALL than other allergies (OR 0.52, CI 0.40-0.67 vs. OR 0.89, CI 0.66-1.21). The strongest association is seen with an atopy in the index child; however, ALL risk is also reduced if one of the parents or a sibling had an atopic disease. No such consistent pattern is seen for AML. Our data suggest that atopy or a family history of atopy are associated with a reduced risk of childhood ALL. Recall bias remains a concern, but sensitivity analysis provided some evidence that the protective effect is unlikely to be attributable to this bias in its entirety.