Dramatic increase in hand-held cellular telephone use since the 1980s and excess risk of lymphoproliferative malignancies associated with radio-frequency radiation (RFR) exposures in epidemiological and experimental studies motivated assessment of cellular telephones within a comprehensive US case-control investigation of non-Hodgkin lymphoma (NHL). A questionnaire ascertained cellular telephone use in 551 NHL cases and 462 frequency-matched population controls. Compared to persons who had never used cellular telephones, risks were not increased among individuals whose lifetime use was fewer than 10 (odds ratio (OR) 5 0.9, 95% confidence intervals (CI): 0.6, 1.3), 10-100 (OR 5 1.0, 95 % CI: 0.7, 1.5) or more than 100 times (e.g., regular users, OR 5 0.9, 95% CI: 0.6, 1.4). Among regular users compared to those who had never used hand-held cellular telephones, risks of NHL were not significantly associated with minutes per week, duration, cumulative lifetime or year of first use, although NHL was non-significantly higher in men who used cellular telephones for more than 8 years. Little evidence linked use of cellular telephones with total, diffuse large B-cell lymphoma or follicular NHL. These findings must be interpreted in the context of less than 5% of the population reporting duration of use of 6 or more years or lifetime cumulative use of 200 or more hours. ' 2006 Wiley-Liss, Inc.Key words: lymphoma; non-Hodgkin; hand-held cellular telephone; radiofrequency/microwave radiation; case-control study; epidemiology For more than 60 years, researchers have undertaken investigations of the possible role of radio-frequency radiation (RFR) exposures, including microwave frequencies (which range from 300 MHz to 300 GHz), in the etiology of cancer or other serious health outcomes.1-4 The only consistent health effects linked with microwaves are heating of tissue and cataracts, which occur when energy levels are high and thermoregulation processes are insufficient.
5-7Most hand-held cellular telephones operate via RFR signals sent to and from base stations. Initially, hand-held cellular telephones were analog or frequency modulated, utilizing RFR in the range of 800-900 MHz. Subsequently, digital cellular telephones, which emit pulsed RFR in the range of 1,850-1,990 MHz, have largely replaced the analog technology. A small subset of digital wireless telephones operates via satellite at assigned frequencies around 2,200 MHz. Hand-held or mobile cellular phones are widely used internationally. At the end of 2005, it was estimated that there were more than 207.9 million US wireless telephone subscribers (69% of the population) 8 and 2 billion wireless telephone users worldwide. 9 The explosive growth in usage internationally along with potential health concerns about the close positioning of handheld cellular telephone antennas to the head led investigators to launch epidemiological studies of brain, central nervous system and other head and neck tumors in more than 15 countries during the 1990s. 10 To date, investigatio...