Comments on the Ramazzini study from Annie J. Sasco, MD, DrPH, SM, MPH, retired Director of Research at the INSERM (French NIH) and former Unit Chief at International Agency for the Research on Cancer/World Health Organization, France
“I am a physician and a scientist having spent the past 35 years working on the epidemiology of cancer
and to a lesser extent other chronic diseases. Over the decades, my focus switched from behavioral
to environmental risk factors as I was confronted by the huge increase in cancer occurrence
worldwide, not only in terms of burden of disease, but also in incidence rates after due consideration
to the changes in population size and age structure. As these increases cannot be linked to genetic
changes, nor only to behavioral or life-style modifications, and after taking into account the role of
screening, earlier detection, improvement in diagnosis and better registration of cancer, increases in
the occurrence of many cancers in different parts of the world have to be recognized as a true fact,
including in Europe childhood cancer. The most logical potential explanation of these increases is the
change in our environment in the past 50 to 70 years. Although some carcinogens always existed, the
presence of chemical and physical carcinogens in the air we breathe, the water we drink, the food we
eat and objects of daily living exploded. While I recognize the exact quantification of the attributable
role of these contaminants in cancer occurrence remains debatable, I contend it is scientifically
arguable a non neglectable part may be due to these pollutants. One of the most ubiquitous
exposure to physical agents is the exposure to ELF and EMF which has been one of the most rapidly
expanding, in particular over the past 30 years and this is accelerating. Soon the exposure to
radiofrequency radiations (RFR) will be so widespread that it will be also impossible to find
unexposed human populations and human epidemiology will face an unprecedented challenge.
Although epidemiology is often presented as showing limited evidence of carcinogenicity for RFR, my
contention is that most epidemiological studies and in particular case-control studies while finding no
overall increased risk when comparing exposed to unexposed do find increased risk in the group
where it is expected to be found, namely the most heavily exposed, whatever the exact definition is,
varying from study to study. This is for example the case of the Hardell studies conducted in the
Nordic countries, the Interphone international study and the CERENAT study in France. Such a
consistent finding should not be attributed to chance, but rather should be seen as what one can
expect, especially because the use of all these objects emitting EMF is relatively new and cancer
induction may take decades.
In this context, the information brought by experimental studies, conducted on mice and rats, are of
paramount importance. The NTP results released recently found evidence of carcinogenicity in
experimental animals for levels of exposures analogous to the ones experienced by humans using cell
phones. Now the Ramazzini study reveals similar effects, with brain glial tumors and heart
Schwannomas with life-long exposure of rats, from conception to death, to much lower levels of RFR.
Some of the results are not statistically significant due to the relatively small number of animals
involved. Yet, that does not mean they should be ignored. Larger studies could turn out statistically
significant results and in any event statistical significance is just one aspect of evaluation of the
relation between exposure and disease. Biological significance and concordance of results between
humans and animals clearly reinforces the strength of the evidence of carcinogenicity. The facts that
both experimental studies found the same types of rare tumors, which also have pertinence to the
human clinical picture, is striking. What’s more the Ramazzini study finds this at levels of exposure
much lower than in the NTP study. This new study therefore clearly asks the question of the danger
for humans to be exposed from environmental sources, such as cell phone base stations. This
publication is a serious cause for concern.
Almost 10 years ago, Dr David Servan-Schreiber and myself co-wrote what is known as the 20 doctors
and scientists appeal (Paris, France, June 2008), which was also signed by Dr Devra Davis, calling on
people to use their cell phones in a cautious way. We considered at that time there was already
enough evidence to advise people to follow 10 measures: when calling, keep their phone as far away
from their body as they could; use the loud speaker; keep conversations short; switch to the use of a
corded landline when possible or send text-messages rather than talk; avoid any use of cell phone by
children and young adolescents; keep the phone away from the bed or turned off at night; when not
in use avoid carrying the phone directly on your body or in your pocket, in particular for pregnant
women; change side when talking and avoid using the phone when the reception is poor; choose a
phone with the lowest SAR; try to stay at a distance from people using cell phones, in particular in
closed settings such as cars, trains or elevators.
In the past 10 years many more studies came out. Some may consider there is still not enough
evidence. How many more deaths should we wait for? Even if some consider there is still doubt,
what is the risk of being cautious? All the recommendations we stated are still valid, even more so
than before and the results of the NTP and the Ramazzini studies along with the revelations of the
Phonegate that SAR indicated on phones may be misleading are more steps in the direction of
advising precaution.
As a doctor, I never forget I took the Hippocratic oath and I obey to the rule “Primum non nocere”
(First, do no harm).”
-Annie J. Sasco, MD, DrPH, SM, MPH, retired Director of Research at the INSERM (French NIH) and former Unit Chief at International Agency for the Research on Cancer/World Health Organization , France
Watch Dr. Annie Sasco present on the International Agency for Cancer classification system in 2018.
