International study of childhood leukemia in residences near electrical transformer rooms.

OBJECTIVES: New epidemiologic approaches are needed to reduce the scientific uncertainty surrounding the association between extremely low frequency magnetic fields (ELF-MF) and childhood leukemia. While most previous studies focused on power lines, the Transformer Exposure study sought to assess this association using a multi-country study of children who had lived in buildings with built-in electrical transformers. ELF-MF in apartments above built-in transformers can be 5 times higher than in other apartments in the same building. This novel study design aimed to maximize the inclusion of highly exposed children while minimising the potential for selection bias. METHODS: We assessed associations between residential proximity to transformers and risk of childhood leukemia using registry based matched case-control data collected in five countries. Exposure was based on the location of the subject's apartment relative to the transformer, coded as high (above or adjacent to transformer), intermediate (same floor as apartments in high category), or unexposed (other apartments). Relative risk (RR) for childhood leukemia was estimated using conditional logistic and mixed logistic regression with a random effect for case-control set. RESULTS: Data pooling across countries yielded 16 intermediate and 3 highly exposed cases. RRs were 1.0 (95% CI: 0.5, 1.9) for intermediate and 1.1 (95% CI: 0.3, 3.8) for high exposure in the conditional logistic model. In the mixed logistic model, RRs were 1.4 (95% CI: 0.8, 2.5) for intermediate and 1.3 (95% CI: 0.4, 4.4) for high. Data of the most influential country showed RRs of 1.1 (95% CI: 0.5, 2.4) and 1.7 (95% CI: 0.4, 7.2) for intermediate (8 cases) and high (2 cases) exposure. DISCUSSION: Overall, evidence for an elevated risk was weak. However, small numbers and wide confidence intervals preclude strong conclusions and a risk of the magnitude observed in power line studies cannot be excluded.

Seguridad del paciente en Resonancia Magnética / Patient safety in magnetic resonance imaging

El uso de campos magnéticos estáticos, gradientes de campo y ondas de radiofrecuencia suponen un reto de seguridad diferente a otras modalidades de imagen. Cada vez más centros trabajan con equipos de 3,0T que presentan mayores riesgos para el paciente frente a los de 1,5T. Hay una necesidad de actualización para el personal de radiología que le permita entender los riesgos y disminuirlos, pues pueden producirse incidentes graves e incluso mortales. El objetivo de este trabajo es presentar una revisión y actualización de los riesgos a los que se ven sometidos los pacientes durante la realización de un estudio de resonancia magnética.(AU)

Image acquisition involves the use of static magnetic fields, field gradients and radiofrequency waves. These elements make the MRI a different modality. More and more centers work with 3.0 T equipment that present higher risks for the patient, compared to those of 1.5 T. Therefore, there is a need for updating for radiology staff that allows them to understand the risks and reduce them, since serious and even fatal incidents can occur. The objective of this work is to present a review and update of the risks to which patients are subjected during the performance of a magnetic resonance imaging study.(AU)

Liver tissues oxidative status, epigenetic and molecular characteristics in rats administered magnetic and microwave treated water.

Physical and chemical changes in the natural of water may affect biological organisms. In this study, we highlight the effect of magnetized-water and microwave-water on rats' liver tissues. Three groups of albino rats were separated. The first, rats were administered tap-water. The second, rats were administered magnetized-water. The third, rats were administered microwave-water. After two months, the results revealed a significant increase in liver functioning enzymes' levels and bilirubin in rats administered microwave-water, compared to tap- and magnetic-water. In relation to oxidative stress, there was a significant increase and decrease in oxidative and antioxidant parameters respectively in liver tissues of rat's administrated microwave-water. At the molecular level, there was a significant down-regulation in Metallothionein, CYP genes in magnetic-water compared to tap-water. Rats administered microwave-water have shown a significant down-regulation in GST, Metallothionein and CYP genes' expression, however, Amylase and HDAC3 genes were significantly up-regulated, compared to the other groups. The intake of microwave-water resulted in notable histopathological changes in liver tissues. Rats administered magnetic-water showed no clear changes in their liver tissues. In summary, microwave-water induced stress and epigenetic effects compared with magnetic-water and tap-water. Also, magnetic-water produced from the higher magnetic power had no side effect on liver tissues.

Health effects related to exposure of static magnetic fields and acoustic noise-comparison between MR and CT radiographers.

OBJECTIVES: We explored the prevalence of health complaints subjectively associated with static magnetic field (SMF) and acoustic noise exposure among MR radiographers in Sweden, using CT radiographers as a control group. Additionally, we explored radiographers' use of strategies to mitigate adverse health effects. METHODS: A cross-sectional survey was sent to all hospitals with MR units in Sweden. MR and/or CT personnel reported prevalence and attribution of symptoms (vertigo/dizziness, nausea, metallic taste, illusion of movement, ringing sensations/tinnitus, headache, unusual drowsiness/tiredness, forgetfulness, difficulties concentrating, and difficulties sleeping) within the last year. We used logistic regression to test associations between sex, age, stress, SMF strength, working hours, and symptom prevalence. Data regarding hearing function, work-environmental noise, and strategies to mitigate adverse symptoms were also analysed. RESULTS: In total, 529 out of 546 respondents from 86 hospitals were eligible for participation. A ≥ 20 working hours/week/modality cut-off rendered 342 participants grouped into CT (n = 75), MR (n = 121), or mixed personnel (n = 146). No significant differences in symptom prevalence were seen between groups. Working at ≥ 3T increased SMF-associated symptoms as compared with working at ≤ 1.5T (OR: 2.03, CI95: 1.05-3.93). Stress was a significant confounder. Work-related noise was rated as more troublesome by CT than MR personnel (p < 0.01). MR personnel tended to use more strategies to mitigate adverse symptoms. CONCLUSION: No significant differences in symptom prevalence were seen between MR and CT radiographers. However, working at 3T increased the risk of SMF symptoms, and stress increased adverse health effects. Noise nuisance was considered more problematic by CT than MR personnel. KEY POINTS: • No significant differences in symptom prevalence were seen between MR and CT radiographers. • Working at ≥ 3 T doubled the odds of experiencing SMF symptoms (vertigo/dizziness, nausea, metallic taste, and/or illusion of movement) as compared to working exclusively at ≤ 1.5 T. • Work-related acoustic noise was less well mitigated and was rated as more troublesome by CT personnel than by MR personnel.

Magnetic Fields and Cancer: Epidemiology, Cellular Biology, and Theranostics.

Humans are exposed to a complex mix of man-made electric and magnetic fields (MFs) at many different frequencies, at home and at work. Epidemiological studies indicate that there is a positive relationship between residential/domestic and occupational exposure to extremely low frequency electromagnetic fields and some types of cancer, although some other studies indicate no relationship. In this review, after an introduction on the MF definition and a description of natural/anthropogenic sources, the epidemiology of residential/domestic and occupational exposure to MFs and cancer is reviewed, with reference to leukemia, brain, and breast cancer. The in vivo and in vitro effects of MFs on cancer are reviewed considering both human and animal cells, with particular reference to the involvement of reactive oxygen species (ROS). MF application on cancer diagnostic and therapy (theranostic) are also reviewed by describing the use of different magnetic resonance imaging (MRI) applications for the detection of several cancers. Finally, the use of magnetic nanoparticles is described in terms of treatment of cancer by nanomedical applications for the precise delivery of anticancer drugs, nanosurgery by magnetomechanic methods, and selective killing of cancer cells by magnetic hyperthermia. The supplementary tables provide quantitative data and methodologies in epidemiological and cell biology studies. Although scientists do not generally agree that there is a cause-effect relationship between exposure to MF and cancer, MFs might not be the direct cause of cancer but may contribute to produce ROS and generate oxidative stress, which could trigger or enhance the expression of oncogenes.

Residential extremely low frequency magnetic fields and skin cancer.

OBJECTIVE: Photoinduced radical reactions have a fundamental role in skin cancer induced by ultraviolet radiation, and changes in radical reactions have also been proposed as a mechanism for the putative carcinogenic effects of extremely low frequency (ELF) magnetic fields (MFs). We assessed the association of melanoma and squamous cell carcinoma with residential MF exposure. METHODS: All cohort members had lived in buildings with indoor transformer stations (TSs) during the period from 1971 to 2016. MF exposure was assessed based on apartment location. Out of the 225 492 individuals, 8617 (149 291 person-years of follow-up) living in apartments next to TSs were considered as exposed, while individuals living on higher floors of the same buildings were considered as referents. Associations between MF exposure and skin cancers were examined using Cox proportional hazard models. RESULTS: The HR for MF exposure ≥6 month was 1.05 (95% CI 0.72 to 1.53) for melanoma and 0.94 (95% CI 0.55 to 1.61) for squamous cell carcinoma. Analysis of the age at the start of residence showed an elevated HR (2.55, 95% CI 1.15 to 5.69) for melanoma among those who lived in the apartments when they were less than 15 years old. This finding was based on seven exposed cases. CONCLUSIONS: The results of this study suggested an association between childhood ELF MF exposure and adult melanoma. This is in agreement with previous findings suggesting that the carcinogenic effects of ELF MFs may be associated particularly with childhood exposure.

Answers and Questions: Forty Years in Bioelectromagnetics.

The work began in 1972 when three young assistant professors used a slime mold to see if electromagnetic fields would affect it. The fields did, though the effects were small and hard to tease out of the noise. The cell cycle was lengthened and there were changes in respiration. So, the next question was "how and why?" Further changes were seen using these and then other bacterial and eukaryotic cells in respiration, in ATP, in the protein replication chain, and so forth. Changes occurred even in cell extracts that lacked an intact plasma membrane. Nerve cells showed changes in leakage of neurotransmitters and in neurite outgrowth from excised ganglia. Based on some experiments with nerve cells, I also did some computer calculations, modeling the internal electric and magnetic fields and current densities in simplified representations of bone fractures and also of spinal cords in vertebrae. More recently, I have collaborated on some theoretical models of what fields might be doing at the cellular and molecular level, particularly with reference to the radical model. With each piece of research, my collaborators and I generally found a small piece of information about fields and biological systems; and each answer raised another set of questions, which is the way of science. Though bioelectromagnetic scientists have learned much and can say much at greater depth about what happens when an organism is exposed to a field, the fundamental question still remains: What exactly is going on here? © 2021 Bioelectromagnetics Society.

Effect of High Static Magnetic Fields on Biological Activities and Iron Metabolism in MLO-Y4 Osteocyte-like Cells.

There are numerous studies that investigate the effects of static magnetic fields (SMFs) on osteoblasts and osteoclasts. However, although osteocytes are the most abundant cell type in bone tissue, there are few studies on the biological effects of osteocytes under magnetic fields. Iron is a necessary microelement that is involved in numerous life activities in cells. Studies have shown that high static magnetic fields (HiSMF) can regulate cellular iron metabolism. To illustrate the effect of HiSMF on activities of osteocytes, and whether iron is involved in this process, HiSMF of 16 tesla (T) was used, and the changes in cellular morphology, cytoskeleton, function-related protein expression, secretion of various cytokines, and iron metabolism in osteocytes under HiSMF were studied. In addition, the biological effects of HiSMF combined with iron preparation and iron chelator on osteocytes were also investigated. The results showed that HiSMF promoted cellular viability, decreased apoptosis, increased the fractal dimension of the cytoskeleton, altered the secretion of cytokines, and increased iron levels in osteocytes. Moreover, it was found that the biological effects of osteocytes under HiSMF are attenuated or enhanced by treatment with a certain concentration of iron. These data suggest that HiSMF-regulated cellular iron metabolism may be involved in altering the biological effects of osteocytes under HiSMF exposure.

The duration of exposure to 50 Hz magnetic fields: Influence on circadian genes and DNA damage responses in murine hematopoietic FDC-P1 cells.

We investigated the effects of 50 Hz extremely low-frequency magnetic fields (MFs) on gene expression related to the circadian rhythm or DNA damage signaling and whether these fields modify DNA damage repair rate after bleomycin treatment. Murine FDC-P1 hematopoietic cells were exposed for different durations (15 min, 2 h, 12 h, and 24 h) to either 200 µT MFs or sham-exposures. Cells were then collected for comet assay or real-time PCR to determine immediate DNA damage level and circadian rhythm gene expression, respectively. To assess DNA-damage signaling and DNA repair rate, the cells were subsequently treated with 20 µg/mL bleomycin for 1 h and then either assayed immediately or allowed to repair their DNA for 1 or 2 h. We found that circadian rhythm-related genes were upregulated after 12 h of MF exposure and downregulated after 24 h of MF exposure, but none of the affected genes were core genes controlling the circadian rhythm. In addition, we found that the repair rate for bleomycin-induced damage was only decreased after MF exposure for 24 h. In conclusion, our findings suggest that the effects of MFs are duration-dependent; they were observed predominantly after long exposures.

Exposure to extremely low-frequency magnetic fields and childhood cancer: A systematic review and meta-analysis.

BACKGROUND: Extremely low frequency magnetic fields (ELF-MFs) are classified as a possible carcinogenic factor (Group 2B). This study assessed the association between ELF-MFs and childhood cancer through a systematic review and meta-analysis. METHODS: Three databases were searched in January 2020. We conducted a meta-analysis for the association between the ELF-MFs exposure level and childhood cancer. RESULTS: A total of 33 studies were identified. Thirty studies with 186,223 participants were included in the meta-analysis. Children exposed to 0.2-, 0.3-, and 0.4-µT ELF-MFs had a 1.26 (95% confidence interval [CI] 1.06-1.49), 1.22 (95% CI 0.93-1.61), and 1.72 (95% CI 1.25-2.35) times higher odds of childhood leukemia. In childhood brain tumors, children exposed to 0.2-µT had a 0.95 (95% CI 0.59-1.56) times higher odds, and those exposed to 0.4-µT ELF-MFs had a 1.25 (95% CI 0.93-1.61). Children exposed to 0.2- and 0.4-µT ELF-MFs had a 1.10 (95% CI 0.70-1.75) and 2.01 (95% CI 0.89-4.52) times higher odds of any childhood cancers. CONCLUSIONS: Significant associations were observed between exposure to ELF-MFs and childhood leukemia. Furthermore, a possible dose-response effect was also observed.

No evidence for genotoxicity in mice due to exposure to intermediate-frequency magnetic fields used for wireless power-transfer systems.

Time varying magnetic fields (MFs) are used for the wireless power-transfer (WPT) technology. Especially, 85 kHz band MFs, which are included in the intermediate frequency (IF) band (300 Hz - 10 MHz), are commonly used WPT system for charging electric vehicles. Those applications of WPT technology have elicited public concern about health effects of IF-MF. However, existing data from health risk assessments are insufficient and additional data are needed. We assessed the genotoxic effects of IF-MF exposure on erythroid differentiation in mice. A high-intensity IF-MF mouse exposure system was constructed to induce an average whole-body electric field of 54.1 V/m. Blood samples were obtained from male mice before and after a 2-week IF-MF exposure (1 h/day, total: 10 h); X-irradiated mice were used as positive controls. We analyzed the blood samples with the micronucleus (MN) test and the Pig-a mutation assay. No significant differences were seen between IF-MF-exposed and sham-exposed mice in the frequencies of either MN or Pig-a mutations in mature erythrocytes and reticulocytes. IF-MF exposure did not induce genotoxicity in vivo under the study conditions (2.36× the basic restriction for occupational exposure, 22.9 V/m, in the International Commission on Non-Ionizing Radiation Protection (ICNIRP) guidelines). The absence of significant biological effects due to IF-MF exposure supports the practical application of this technology.

Exposure to 50 Hz Extremely-Low-Frequency Magnetic Fields Induces No DNA Damage in Cells by Gamma H2AX Technology.

The current results for extremely-low-frequency magnetic fields (ELF-MF) on DNA damage are still debated. A sensitive indicator and systematic research are needed to assess the effects of ELF-MF. In this study, we used γH2AX as an early and sensitive molecular marker to evaluate the DNA damage effects of ELF-MF in vitro. Human amnion epithelial cells (FLs), human skin fibroblast cells (HSFs), and human umbilical vein endothelial cells (HUVECs) were exposed to 50 Hz ELF-MF at 0.4, 1, and 2 mT for 15 min, 1 h, and 24 h, respectively. After exposure, cells were subjected to γH2AX immunofluorescence and western blot. The results showed no significant difference in the average number of foci per cell, the percentage of γH2AX foci-positive cells, or the expression of γH2AX between the sham and 50 Hz ELF-MF exposure groups (P > 0.05). In conclusion, 50 Hz ELF-MF did not induce DNA damage in FLs, HSFs, or HUVECs, which was independent of the intensity or duration of the exposure.

Long-term exposure to a hypomagnetic field attenuates adult hippocampal neurogenesis and cognition.

Adult hippocampal neurogenesis contributes to learning and memory, and is sensitive to a variety of environmental stimuli. Exposure to a hypomagnetic field (HMF) influences the cognitive processes of various animals, from insects to human beings. However, whether HMF exposure affect adult hippocampal neurogenesis and hippocampus-dependent cognitions is still an enigma. Here, we showed that male C57BL/6 J mice exposed to HMF by means of near elimination of the geomagnetic field (GMF) exhibit significant impairments of adult hippocampal neurogenesis and hippocampus-dependent learning, which is strongly correlated with a reduction in the content of reactive oxygen species (ROS). However, these deficits seen in HMF-exposed mice could be rescued either by elevating ROS levels through pharmacological inhibition of ROS removal or by returning them back to GMF. Therefore, our results suggest that GMF plays an important role in adult hippocampal neurogenesis through maintaining appropriate endogenous ROS levels.

A self-matched leaky-wave antenna for ultrahigh-field magnetic resonance imaging with low specific absorption rate.

The technology of magnetic resonance imaging is developing towards higher magnetic fields to improve resolution and contrast. However, whole-body imaging at 7 T or even higher flux densities remains challenging due to wave interference, tissue inhomogeneities, and high RF power deposition. Nowadays, proper RF excitation of a human body in prostate and cardiac MRI is only possible to achieve by using phased arrays of antennas attached to the body (so-called surface coils). Due to safety concerns, the design of such coils aims at minimization of the local specific absorption rate (SAR), keeping the highest possible RF signal in the region of interest. Most previously demonstrated approaches were based on resonant structures such as e.g. dipoles, capacitively-loaded loops, TEM-line sections. In this study, we show that there is a better compromise between the transmit signal [Formula: see text] and the local SAR using non-resonant surface coils generating a low electric field in the proximity of their conductors. With this aim, we propose and experimentally demonstrate a leaky-wave antenna implemented as a periodically-slotted microstrip transmission line. Due to its non-resonant radiation, it induces only slightly over half the peak local SAR compared to a state-of-the-art dipole antenna but has the same transmit efficiency in prostate imaging at 7 T. Unlike other antennas for MRI, the leaky-wave antenna does not require to be tuned and matched when placed on a body, which makes it easy-to-use in prostate imaging at 7 T MRI.

Amyotrophic lateral sclerosis, occupational exposure to extremely low frequency magnetic fields and electric shocks: a systematic review and meta-analysis.

Exposure to extremely low frequency magnetic fields (ELF-MF) and electric shocks occurs in many workplaces and occupations but it is unclear whether any of these exposures cause Amyotrophic lateral sclerosis (ALS). The aim of this systematic review and meta-analysis is to explore whether occupational exposure to ELF-MF and/or electric shocks are risk factor for ALS. We searched PubMed, Embase, and Web of Science databases up to the end of 2019. Pooled risk estimates were calculated using random-effects meta-analysis including exploration of the sources of heterogeneity between studies and publication bias. Twenty-seven publications fulfilled the inclusion criteria. We found a weak, significant, association between occupational exposure to ELF-MF and the risk of ALS (RRPooled estimate: 1.20; 95%CI: 1.05, 1.38) with moderate to high heterogeneity (I2=66.3%) and indication of publication bias (PEgger's test=0.03). No association was observed between occupational exposure to electric shocks and risk of ALS (RRPooled estimate: 0.97; 95%CI: 0.80, 1.17) with high heterogeneity (I2=80.5%), and little indication for publication bias (PEgger's test=0.24). The findings indicate that occupational exposure to ELF-MF, but not electric shocks, might be a risk factor for ALS. However, given the moderate to high heterogeneity and potential publication bias, the results should be interpreted with caution.

Static magnetic field on behavior, hematological parameters and organ damage in spontaneously hypertensive rats.

Previous studies showed contradictory results of static magnetic field (SMF) influence on behavior, hematological parameters and organ damage. The aim of this study was to investigate influence of subchronic continuous exposure to upward and downward oriented SMF of moderate intensity on behavior, hematological characteristics, heart and kidney tissue of spontaneously hypertensive rats. SH rats exposed to downward oriented SMF demonstrated lack of anxious-like behavior. SMF of either orientation caused decrease in the number of platelets in peripheral blood, granulocytes in the spleen and bone marrow and increase in the number of erythrocytes in the spleen, in both exposed groups. We also demonstrated that spontaneously hypertensive rats exposed to upward oriented SMF exhibited decreased lymphocytes count in blood, decreased bone marrow erythrocytes count and rats exposed to downward oriented SMF had increased lymphocytes count in bone marrow. The results showed adverse effect of differently oriented SMF on hematological parameters of spontaneously hypertensive rats. Also, exposure to different oriented SMF didn't affect their heart and kidney morphological characteristics.

Effects of 3 Tesla magnetic resonance imaging exposure on the behavior and orientation of homing pigeons Columba livia domestica.

Homing pigeons (Columba livia domestica) were used to test whether clinical magnetic resonance (MR) imaging disrupts orientation of animals that sense the earth's magnetic field. Thirty young pigeons were randomly separated into three groups (n = 10/group). Two groups were anaesthetized and exposed to either a constant (no sequence) or a varying (gradient echo and echo planar sequences) magnetic field within a 3 Tesla MR unit for 15 minutes. The control group was not exposed to the MR field but shared all other aspects of the procedure. One day later, animals were released from a site they had never visited, 15 km from the home loft. Three weeks after the procedure, animals were released from a different unfamiliar site 30 km from the loft. Measured variables included the time to disappear from sight (seconds), vanishing bearing (angle), and the time interval from release to entering the home loft (hours). On first release, the group exposed to varying field gradients during image acquisition using 2 different standard sequences showed more variability in the vanishing bearing compared to the other groups (p = 0.0003 compared to control group), suggesting interference with orientation. Other measures did not show significant differences between groups. On second release, there were no significant differences between groups. Our results on homing pigeons show that regular clinical MR imaging exposure may temporarily affect the orientation of species that have magnetoreception capabilities. If exposure to MR imaging disrupted processes that are not specific to magnetoreception, then it may affect other species and other capabilities as well.

Compatibility of endoclips in the gastrointestinal tract with magnetic resonance imaging.

There are no clear guidelines on the compatibility between endoclips that remain in the gastrointestinal (GI) tract and magnetic resonance imaging (MRI). The purpose of this study was to investigate the effect of 3T (T) MRI on endoclips placed in excised pig tissues. Two types of endoclips were assessed: Olympus EZ (HX-610-135L) and QuickClip Pro (HZ-202LR). We assessed tissue damage or perforation and detachment of endoclips under 3T MRI magnetic field. We also evaluated the magnitude of force required to detach the endoclips from the porcine tissue. We measured the magnetic force acting on the Olympus EZ clips. QuickClip Pro clips were used as a control in this study. There was no tissue damage and no detachment of the endoclips (Olympus EZ and QuickClip Pro) during 3T MRI. The force required to detach the Olympus EZ clips ranged from 0.9 to 3.0 N. The translational magnetic force acting on the endoclips was 3.18 × 10-3 N. Ex vivo experiments showed that the magnetic field generated by 3 MRI did not cause tissue damage or perforation and did not detach the endoclips. Olympus EZ clips and QuickClip Pro clips in the GI tract appear to be safe during 3T MRI.

Extremely Low-Frequency Magnetic Fields and the Risk of Childhood B-Lineage Acute Lymphoblastic Leukemia in a City With High Incidence of Leukemia and Elevated Exposure to ELF Magnetic Fields.

It is important to study the relationship between extremely low-frequency magnetic fields (ELF-MFs) and childhood leukemia, particularly in locations with a high incidence of this neoplasm in children and an elevated exposure to ELF-MF, such as Mexico City. The aim was to investigate the association between ELF-MF exposure and the risk of B-lineage acute lymphoblastic leukemia (B-ALL). A case-control study was conducted in Mexico City during the period from 2010 to 2011. Residential 24-h ELF-MF measurements were obtained for 290 incident B-ALL patients and 407 controls, aged less than 16 years. Controls were frequency-matched by sex, age (±18 months), and health institution. The adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were calculated. ELF-MF exposure at <0.2 µT was used to define the reference group. ELF-MF exposure at ≥0.3 µT was observed in 11.3% of the controls. Different ELF-MF intensity cutoff values were used to define the highest exposure category; the highest exposure category for each cutoff value was associated with an increased risk of B-ALL compared with the corresponding lower exposure categories. The aORs were as follows: ≥0.2 µT = 1.26 (95% CI: 0.84-1.89); ≥0.3 µT = 1.53 (95% CI: 0.95-2.48); ≥0.4 µT = 1.87 (95% CI: 1.04-3.35); ≥0.5 µT = 1.80 (95% CI 0.95-3.44); ≥0.6 µT = 2.32 (95% CI: 1.10-4.93). ELF-MF exposure as a continuous variable (per 0.2 µT intervals) was associated with B-ALL risk (aOR = 1.06; 95% CI: 1.01-1.12). In the present study, the proportion of children exposed to ≥0.3 µT is among the highest reported worldwide. Additionally, an ELF-MF exposure ≥0.4 µT may be associated with the risk of B-ALL. Bioelectromagnetics. © 2020 Bioelectromagnetics Society.