Joachim Schüz

To meet the ever‐growing demands of wireless communication and enable new applications, the 5th generation (5G) New Radio (NR) cellular system was developed to offer better connectivity, to reduce latency, and enable higher data transfer rates. The use of the 5G frequency spectrum is divided into two frequency ranges, Frequency Range 1 (5G NR FR1) from 0.41 GHz to 7.125 GHz, operating in the same frequency range as the 2G–4G cellular systems and WLAN systems, and Frequency Range 2 (5G NR FR2) from 24.25 to 52.60 GHz using millimetre waves (mmWaves) to enable fast transfer of large amounts of data. Since 2019, FR1 has been rapidly deployed in Europe. Until today, in Europe, FR2 has very limited applications. The objective of SEAWave project was to conduct two risk assessments, one for FR1 and one for FR2. Risk assessment procedure included evaluation of evidence of an association between skin cancer and exposure to FR1 and FR2 radiofrequency electromagnetic field (RF‐EMF), with the skin being the most exposed organ during use. Both assessments are based on: a comprehensive review of the scientific literature available before the end of the project and the consolidated findings from research studies generated within the SEAWave project. Experiments conducted within SEAWave project included: (i) In vivo experiments on Carcinogenesis‐susceptible (Car‐S) mice and Patched heterozygous knockout mice (Ptch1 +/−) to investigate the effects of prolonged exposure to 5G FR2 RF‐EMF at 27.5 GHz on the development of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), two of the most common skin tumours. In addition, skin inflammation and nociceptive signalling were analysed in dorsal skin samples taken from mice after early stage whole‐body exposure in the first 21 days of postnatal life and after 100 days and 6 months of exposure; (ii) Clinical trial where participants' inner arms were exposed to 5G FR2 RF‐EMF at 27.5 GHz to study transcriptomic changes in skin samples induced by 5G FR2 RF‐EMF exposure, with particular attention to inflammatory processes; (iii) In vitro experiments using different primary human skin cell lines, that is, light‐pigmented primary epidermal juvenile and adult keratinocytes (NHEK‐f.c. and NHEK‐c.) and light‐pigmented primary epidermal adult melanocytes (NHEM) exposed to 5G FR2 RF‐EMF at 27.5 GHz to study several endpoints including genotoxicity, aneugenicity, telomere measurement, DNA methylation and transcriptomics. The overall evidence for an association between skin cancer and 5G FR1 has been classified as ‘inconclusive’ based on the evaluations of human evidence, evidence from animal studies and mechanistic studies classified as ‘inadequate’. 5G FR1 evaluations were mainly based on literature review. The overall evidence for an association between skin cancer and 5G FR2 has been classified as ‘inconclusive’ based on the evaluations of human evidence, and evidence from animal studies and mechanistic studies classified as ‘inadequate’. 5G FR2 evaluations were mainly based on findings from the SEAWave project. All classifications were unanimous except for the 5G FR2 mechanistic evidence which a minority considered ‘limited’; even with limited evidence the overall assessment for 5G FR2 would have remained ‘inconclusive’. An impact evaluation completes the risk assessment, as for inconclusive evidence no quantitative risk assessment could be carried out.

Background: Occupational epidemiological analyses typically focus on a priori hypotheses relating disease to specific exposures or occupations. We used regularized regression models to agnostically identify occupations associated with lung cancer while accounting for known lung carcinogens. Methods: We pooled data from 14 European and Canadian lung cancer case–control studies. The main analysis included 13 587 cases and 16 410 controls for men and 3199 cases and 4408 controls for women. Associations between ever-employment in various occupations and lung cancer risks were evaluated using two selection approaches: a least absolute shrinkage and selection operator regression and a two-stage Bayesian hierarchical horseshoe model accounting for age, study, smoking, and occupational exposure to known lung carcinogens. Unconditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for selected occupations. Results: For men, occupations consistently identified as positively associated with lung cancer included miners (OR = 1.28, 95% CI: 1.06–1.54) and bricklayers (OR = 1.30, 95% CI: 1.12–1.52), while secondary education teachers (OR = 0.37, 95% CI: 0.22–0.60), production managers (OR = 0.66, 95% CI: 0.54–0.81), and government executive officials (OR = 0.72, 95% CI: 0.62–0.83) were negatively associated. For women, secondary language and literature teachers (OR = 0.39, 95% CI: 0.20–0.72) and government executive officials (OR = 0.63, 95% CI: 0.48–0.81) showed negative associations. Conclusion: Two agnostic, data-driven models identified several occupations associated with both increased and decreased lung cancer risks. These associations persisted after accounting for known exposures and covariates, highlighting the need to investigate unidentified occupational factors.

ObjectivesTo examine the association between self-reported mobile phone use and brain tumour risk in the UK Biobank Cohort.MethodsA total of 467,801 participants aged 40–69 years from the UK Biobank Cohort were included (recruited 2006–2010, followed up to 2023). ICD10 codes were used to identify all brain tumours and its subtypes (glioma (glioblastoma as subgroup), meningioma, acoustic neuroma). Regular mobile phone use was defined as making or receiving calls at least once per week. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazard regression models, with age as underlying time scale.ResultsOver a median follow-up of 13 years (5,583,093 person-years), 1,607 brain tumours were identified. Longest regular mobile phone use (>8 years) at baseline compared with never regular use was not associated with overall brain tumour risk (HR: 0.93, 95% CI: 0.79 to1.08) or any subtype (glioma (0.85, 95% CI: 0.69 to 1.04), glioblastoma (0.87, 95% CI: 0.69 to 1.11), meningioma (1.04, 95% CI: 0.79 to1.38), acoustic neuroma (0.91, 95% CI: 0.43 to 1.92).ConclusionThe result from this large-scale analysis adds to the evidence supporting absence of an association between mobile phone use and overall brain tumour risk or any subtype. Limitations in the exposure assessment remain, warranting further follow-up of studies with improved RF-EMF assessment.

Early life exposure to pesticides, in particular through pesticides drift in residents nearby agricultural crops, is suspected to increase testicular germ cell tumors (TGCT) risk. We conducted a hospital‐based case–control study of 472 TGCT cases and 683 matched controls aged 18–45 years in France and estimated adult TGCT risk associated with agricultural surfaces around residence as a surrogate for environmental exposure to agricultural pesticides at time of birth. Surface of arable lands, orchards and vineyards in 500 m buffer around the participants’ residential address at birth was assessed using geographic information system (GIS) methods and software semi‐automatic processing of historical aerial images. Odds ratios (OR) for TGCT (overall and by histological subtype) and 95% confidence intervals (CI) were estimated using conditional logistic regression. No increased risk of TGCT was observed for presence of arable lands (OR = 1.14, CI = 0.86–1.52), vineyards (OR = 0.88, CI = 0.56–1.36) and agricultural surfaces overall (OR = 1.13, CI = 0.84–1.51) in 500 m buffer around residence at birth. Presence of orchards (prevalence: 8.7%) was associated with a modest increase in TGCT risk (OR = 1.51, 95% CI = 0.99–2.32), slightly stronger for seminoma (OR = 1.78, 1.07–2.97) and in participants conceived or in their first trimester after conception during spring–summer (OR = 1.70, 1.03–2.82). In conclusion, the study found no overall association between adult TGCT risk and agricultural crops around residence at birth, except for the presence of orchards, with a possible increase in seminoma risks, as well as TGCT risk in participants for whom the first trimester after conception fell into spring–summer.

Approximately half of cancers are attributed to modifiable risk factors or inherited genetic mutations, thus there remains the potential for as-yet unidentified environmental risk factors to explain substantially more of the global cancer burden. Current estimates of the environmental and occupational cancer burden account for a relatively small number of exposures, because of challenges in characterizing exposure patterns and human cancer risks. Hence, the environmental cancer burden may be underestimated because of combinations of not having identified all carcinogenic agents, lack of understanding of cancer risks at very low exposure levels of even known carcinogens, and lack of understanding of joint effects. The International Agency for Research on Cancer has a long history of addressing these challenges, and of advancing our understanding of occupational and environmental causes of cancer, with primary research predominantly conducted by the Environment and Lifestyle Epidemiology Branch. The International Agency for Research on Cancer’s position within the World Health Organization has facilitated the conduct of cross-border collaborations on important and sensitive topics, ranging from asbestos, ionizing radiation, and pesticides to its current work on artisanal petroleum refining. Here, we highlight some important Environment and Lifestyle Epidemiology contributions to several areas of occupational and environmental cancer, describe recent progress in other important and emerging exposures, and finally, provide suggestions for future research. In our constantly changing world, with new products, technologies, and demands transforming our environment and workplaces, there is a continued need for high-quality human cancer investigations of potential occupational and environmental carcinogens, especially those characterizing environmental levels of exposure encountered by the general population in their daily life and in underresearched regions of the world.

Objectives. Complementing the previously published cohort-internal comparison we hereby compare the cause-specific mortality in workers of the Asbest Chrysotile Cohort study (ACC) with the general population of Sverdlovsk Oblast where the mine and factories are located.Methods. The ACC cohort database and the regional Federal State Statistic Service for the Sverdlovsk Oblast population were used. We calculated sex-specific standardized mortality ratios (SMRs) and 95% confidence intervals (CI) for the main ICD-10 disease groups and for selected cancer sites for the populations ≥15 years from 1980 to 2015. In relation to exposure, we applied the Sverdlovsk rates to the person-years in each exposure category to obtain expected numbers of lung cancer deaths. For comparing types of ACC workers (mine, enrichment factories, both), we calculated lung cancer SMRs in men by duration of employment (< 5 years, 5–14 years, and ≥ 15 years) and start of employment (before or after 1975) with miners as reference in each stratum.Results. Overall mortality of men in the ACC was reduced by 14%, mainly because of the most common cause of death, circulatory disease; this effect was much weaker in women. Elevated mortality was observed for both sexes from diseases of the digestive system (10–30%) and blood and blood forming organs (121–181%). Lung cancer mortality in men was increased from the 3rd quartile of chrysotile containing dust and in the highest quartile with SMR 1.30, 95% CI 1.07–1.57, while the increase in high exposed women was not reaching statistical significance (SMR 1.69, 95% CI 0.87–2.96). No increased SMRs were seen for laryngeal, stomach or ovarian cancers. Male factory workers first employed before 1975 had higher lung cancer mortality compared to miners, but not when employed after 1974.Conclusions. The observed excess in lung cancer confirms previous observations in the ACC. Risk management measures in the enrichment factories may have reduced the lung cancer risk to the level of the miners in recent decades.Ethics. The ACC was approved by the International Agency for Research on Cancer (IARC/WHO) Ethics Committee (IEC No. 12–22, September 2012).Contributions:Ann Olsson — preparation of the manuscript, project administration, data processing, including quality control, interpretation of the received data;Joachim Schüz — manuscript preparation, cohort formation, project administration, formal analysis, interpretation of the data obtained;Hans Kromhout — preparation of the manuscript, evaluation of the exposition;Evgeny Kovalevskiy — manuscript preparation, cohort formation, project administration, data processing, including quality control, interpretation of the received data;Monika Moissonnier — preparation of tables and figures, data processing, including quality control, and formal analysis;Igor Bukhtiyarov — cohort formation, project administration, and data interpretation;Kurt Straif — cohort formation;Eleonora Feletto — conducting an exposure assessment, data processing, including quality control, and conducting a formal analysis;Iraklii Tskhomariia — project administration, data processing, including quality control, and data interpretation;Tatiana Morozova — project administration and data interpretation;Evgenia Ostroumova — data processing, including quality control and data interpretation;Gilles Ferro — data processing, including quality control, formal analysis;Graham Byrnes — conducting a formal analysis.Acknowledgements. Dr Sergey Kashanskiy from the Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers, Yekaterinburg, Russian Federation was instrumental in the conduct of the study but died on February 9, 2023 and is deeply missed by the entire study team. We acknowledge the data entry team in Asbest town who rigorously entered written information into electronic format: the late Isolina Smirnova, Zoya Lapuhina, and Yulia Nurdinova; and Dr Sara J. Schonfeld for her valuable contribution to the ACC overall and the re-coding of the oblast data from ICD-9 to ICD-10. The authors also wish to acknowledge the independent Scientific Advisory Board (SAB). The scientific advisory board members provided their reviews of this manuscript, but the integration of their comments remained at the discretion of the authors.Funding. The work was supported by the Ministry of Health of the Russian Federation in the framework of the Federal target program "National System of Chemical and Biological Safety of the Russian Federation" of 2009–2014 and of 2015–2020 under a general framework of action between the Federal state budgetary scientific institution “Izmerov Research Institute of Occupational Health” (IRIOH) and the International Agency for Research on Cancer (IARC).Conflict of interest. Dr Kovalevskiy reported receiving, on behalf of their institutes and personally through consulting firms, payments from companies to evaluate exposure to asbestos and risk of asbestos-related disease in those workplaces. All other authors have no competing interests to declare. For full transparency, Dr Kovalevskiy reported participation as an occupational and environmental health expert as part of the delegation of the Russian Ministry of Health at multiple World Health Assembly meetings as well as at the Conference of the Parties to the Basel and Rotterdam Conventions. Dr Kovalevskiy reported attending meetings organized by the International Chrysotile Association and reported that all expenses for attendance were paid by their respective institutes.Disclaimer. Where authors are identified as personnel of IARC/WHO, the authors alone are responsible for the views expressed in this article, and they do not necessarily represent the decisions, policy, or views of IARC/WHO.Data availability. Raw data cannot...