Summary A population-based case-control study of leukaemia and residential proximity to electricity supply equipment has been carried out in south-east England. A total of 771 leukaemias was studied, matched for age, sex, year of diagnosis and district of residence to 1,432 controls registered with a solid tumour excluding lymphoma; 231 general population controls aged 18 and over from one part of the study area were also used. The potential for residential exposure to power frequency magnetic fields from power-lines and transformer substations was assessed indirectly from the distance, type and loading of the equipment near each subject's residence. Only 0.6% of subjects lived within 100 m of an overhead power-line, and the risk of leukaemia relative to cancer controls for residence within 100 m was 1.45 (95% confidence interval (CI) 0.54-3.88); within 50 m the relative risk was 2.0 but with a wider confidence interval (95% CI 0.4-9.0). Over 40% of subjects lived within 100 m of a substation, for which the relative risk of leukaemia was 0.99. Residence within 25 m carried a risk of 1.3 (95% CI 0.8-2.0). Weighted exposure indices incorporating measures of the current load carried by the substations did not materially alter these risks estimates. For persons aged less than 18 the relative risk of leukaemia from residence within 50 m of a substation was higher than in adults (RR = 1.5, 95% CI 0.7-3.4).Epidemiological evidence suggests a possible leukaemogenic effect in man from exposure to electromagnetic fields in the extremely low frequency range (ELF, 0-300 Hz), which includes the usual public electricity power supply frequencies (50-60 Hz). Three case-control studies have shown a two-to three-fold increase in leukaemia risk in persons who lived close to electricity power-lines and supply equipment (Wertheimer & Leeper, 1979Savitz et al., 1988). Two studies showed no association (Tomenius, 1986;Severson et al., 1988), although the study by Tomenius showed a two-fold risk of all cancers. The subjects' exposure to ELF fields was categorised indirectly in these studies by the type and proximity of electricity transmission and distribution equipment variously within 40-150m of the subject's home. In addition, ELF magnetic field intensities were measured directly at all addresses in one study (Tomenius, 1986), and at most addresses in the two recent studies (Severson et al., 1988;Savitz et al., 1988).A number of studies of men likely to be exposed occupationally to power frequency electromagnetic fields have also suggested a raised risk of leukaemia, especially acute myeloid leukaemia (see Aldrich & Easterly, 1987;Savitz & Calle, 1987;Coleman & Beral, 1988). Interpretation of the evidence is made difficult by the complexity and ubiquity of human exposure to man-made ELF fields in modern society, and by the difficulty of obtaining satisfactory retrospective measures of this exposure. The National Research Council (NRC, 1986) and the reviews cited have emphasised the need for further human cancer studies, particular...