The occupational epidemiological literature on extremely low frequency electric and magnetic fields (EMF) and health encompasses a large number of studies of varying design and quality that have addressed many health outcomes, including various cancers, cardiovascular disease, depression and suicide, and neurodegenerative diseases, such as Alzheimer disease and amyotrophic lateral sclerosis (ALS). At a 2006 workshop we reviewed studies of occupational EMF exposure with an emphasis on methodological weaknesses, and proposed analytical ways to address some of these. We also developed research priorities that we hope will address remaining uncertainties. Broadly speaking, extensive epidemiological research conducted during the past 20 years on occupational EMF exposure does not indicate strong or consistent associations with cancer or any other health outcomes. Inconsistent results for many of the outcomes may be attributable to numerous shortcomings in the studies, most notably in exposure assessment. There is, however, no obvious correlation between exposure assessment quality and observed associations. Nevertheless, for future research, the highest priorities emerge in both the areas of exposure assessment and investigation of ALS. To better assess exposure, we call for the development of a more complete job-exposure matrix that combines job title, work environment and task, and an index of exposure to electric fields, magnetic fields, spark discharge, contact current, and other chemical and physical agents. For ALS, we propose an international collaborative study capable of illuminating a reported association with electrical occupations by disentangling the potential roles of electric shocks, magnetic fields and bias. Such a study will potentially lead to evidence-based measures to protect public health.

Power-frequency magnetic fields in homes come from a variety of sources, internal (appliances and domestic wiring) and external (electricity distribution and transmission circuits). The authors present results from a survey of the fields encountered at home by 258 adults over one week each. Information on the major electrical features of each of the homes was collected and related to the exposures incurred. The strongest identified factor influencing exposure at home was the presence or absence of overhead lines at voltages of 132 kV or above within 100 m of the home (geometric-mean TWA field encountered by participants 208 nT near lines, 54 nT not near lines). Occupants of homes near overhead lines or supplies from 415 V to 66 kV did not on average encounter fields significantly different to those in homes without such lines (50 and 54 nT, respectively). Occupants of flats incurred greater exposures than those incurred by occupants of semi-detached and terraced houses, which were in turn greater than those incurred by occupants of detached houses (109, 60, 56 and 43 nT, respectively).

Much of the research and reviews on extremely low frequency (ELF) electric and magnetic fields (EMFs) have focused on magnetic rather than electric fields. Some have considered such focus to be inappropriate and have argued that electric fields should be part of both epidemiologic and laboratory work. This paper fills the gap by systematically and critically reviewing electric-fields literature and by comparing overall strength of evidence for electric versus magnetic fields. The review of possible mechanisms does not provide any specific basis for focusing on electric fields. While laboratory studies of electric fields are few, they do not indicate that electric fields should be the exposure of interest. The existing epidemiology on residential electric-field exposures and appliance use does not support the conclusion of adverse health effects from electric-field exposure. Workers in close proximity to high-voltage transmission lines or substation equipment can be exposed to high electric fields. While there are sporadic reports of increase in cancer in some occupational studies, these are inconsistent and fraught with methodologic problems. Overall, there seems little basis to suppose there might be a risk for electric fields, and, in contrast to magnetic fields, and with a possible exception of occupational epidemiology, there seems little basis for continued research into electric fields.

There is an unexplained association between exposure to the magnetic fields arising from the supply and use of electricity, and increase in risk of childhood leukaemia. The UK Childhood Cancer Study (UKCCS) provides a large and unique source of information on residential magnetic field exposure in the UK. The purpose of this supplementary study was to investigate a sample of UKCCS homes in order to identify the particular sources that contribute to elevated time-averaged exposure. In all, 196 homes have been investigated, 102 with exposures estimated on the basis of the original study to be above 0.2 microT, and 21 higher than 0.4 microT, a threshold above which a raised risk has been observed. First, surveys were carried out outside the property boundaries of all 196 study homes, and then, where informed consent had been obtained, assessments were conducted inside the properties of 19 homes. The study found that low-voltage (LV) sources associated with the final electricity supply accounted together for 77% of exposures above 0.2 microT, and 57% of those above 0.4 microT. Most of these exposures were linked to net currents in circuits inside and/or around the home. High-voltage (HV) sources, including the HV overhead power lines that are the focus of public concern, accounted for 23% of the exposures above 0.2 microT, and 43% of those above 0.4 microT. Public health interest has focused on the consideration of precautionary measures that would reduce exposure to power frequency magnetic fields. Our study provides a basis for considering the options for exposure mitigation in the UK. For instance, in elevated-exposure homes where net currents are higher than usual, if it is possible to reduce the net currents, then the exposure could be reduced for a sizeable proportion of these homes. Further investigations would be necessary to determine whether this is feasible.

A new method for assessing both current and historical occupational exposures to magnetic fields has been developed and used in health studies involving a cohort of electricity generation and transmission workers in England and Wales. The exposure values are derived by calculation from engineering and operational data about the power stations rather than from measurements. They are provided for each of 11 job categories for each year of operation of each power station represented in the cohort. The engineering data are used to determine the average magnetic fields in specified areas of work within the power station and then applied to information about the time spent in these areas by each of the job categories. The operational data are used to adjust the exposures for each year according to the power station output for the year. Earlier methods used measurements or the advice of panels of experts to provide exposure scores for a number of job categories across all power stations and years. Such methods were not able to distinguish exposures from different power facilities or during the different years of their operation. Measurement surveys at 10 power stations of the magnetic fields in the work areas gave confidence that the calculations were realistic. Exposure measurements on 215 workers at three power stations were compared in job groups with the exposures predicted by the method. The Pearson correlation coefficient was 0.86 and the slope and intercept of the line of best fit were 0.87 and 0.07 microT respectively. The method gives a good prediction of measured exposure and is being used for studies of occupational exposure to magnetic fields and leukaemia, and of cardiovascular disease, and a reanalysis of brain cancer.