Possible Health Effects of Exposure to RESIDENTIAL ELECTRIC AND MAGNETIC FIELDS

Committee on the Possible Effects of Electromagnetic Fields on Biologic Systems

Board on Radiation Effects Research

Commission on Life Sciences

National Research Council

NATIONAL ACADEMY PRESS
Washington, D.C. 1997



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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields Possible Health Effects of Exposure to RESIDENTIAL ELECTRIC AND MAGNETIC FIELDS Committee on the Possible Effects of Electromagnetic Fields on Biologic Systems Board on Radiation Effects Research Commission on Life Sciences National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 1997

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields National Academy Press 2101 Constitution Avenue, N.W. Washington, DC 20418 The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. This report was prepared under Grant No. DE-FG01-92CE34100 between the National Academy of Sciences and the U.S. Department of Energy. Possible Health Effects of Exposure to Residential Electric and Magnetic Fields is available from the National Academy Press, 2101 Constitution Ave., NW, Box 285, Washington, DC 20055 (1-800-624-6242; http://www.nap.edu) Library of Congress Cataloging-in-Publication Data National Research Council (U.S.). Committee on the Possible Effects of Electromagnetic Fields on Biologic Systems. Possible health effects of exposure to residential electric and magnetic fields. p. cm. Includes bibliographical references and index. ISBN 0-309-05447-8 1. Electromagnetic fields—Health aspects. 2. Electromagnetism—Physiological effect. I. Title. RA569.3.N378 1997 612'.01442—dc21 96-51230 Copyright 1997 by the National Academy of Sciences. All rights reserved. Printed in the United States of America

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields COMMITTEE ON THE POSSIBLE EFFECTS OF ELECTROMAGNETIC FIELDS ON BIOLOGIC SYSTEMS CHARLES F. STEVENS (Chair), Howard Hughes Medical Institute, Salk Institute, La Jolla, Calif. DAVID A. SAVITZ (Vice Chair), Department of Epidemiology, University of North Carolina, Chapel Hill, N.C. LARRY E. ANDERSON, Pacific Northwest National Laboratory, Richland, Wash. DANIEL A. DRISCOLL, Department of Public Service, State of New York, Albany, N.Y. FRED H. GAGE, Laboratory of Genetics, Salk Institute, San Diego, Calif. RICHARD L. GARWIN, IBM Research Division, T.J. Watson Research Division, Yorktown Heights, N.Y. LYNN W. JELINSKI, Center for Advanced Technology-Biotechnology, Cornell University, Ithaca, N.Y. BRUCE J. KELMAN, Golder Associates, Inc., Redmond, Wash. RICHARD A. LUBEN, Division of Biomedical Sciences, University of California, Riverside, Calif. RUSSEL J. REITER, Department of Cellular and Structural Biology, University of Texas Health Sciences Center, San Antonio, Tex. PAUL SLOVIC, Decision Research, Eugene, Oreg. JAN A. J. STOLWIJK, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn. MARIA A. STUCHLY, Department of Electrical and Computer Engineering, University of Victoria, B.C., Canada DANIEL WARTENBERG, UMDNJ-Robert Wood Johnson, Medical School, Piscataway, N.J. JOHN S. WAUGH, Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Mass. JERRY R. WILLIAMS, The Johns Hopkins Oncology Center, Baltimore, Md. Board on Radiation Effects Research Liaison to the Committee LEONARD S. LERMAN, Massachusetts Institute of Technology, Cambridge, Mass.

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields National Research Council Staff LARRY H. TOBUREN, Study Director (now with the Department of Physics, East Carolina University, Greenville, N.C.) JOHN D. ZIMBRICK, Director, Board on Radiation Effects Research LEE R. PAULSON, Senior Staff Officer DORIS E. TAYLOR, Staff Assistant LARA ADAMO, Project Assistant until July 1995 RUTH E. CROSSGROVE, Editor Sponsor's Project Officer IMRE GYUK, U.S. Department of Energy

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields BOARD ON RADIATION EFFECTS RESEARCH JOHN B. LITTLE (Chair), Harvard School of Public Health, Cambridge, Mass. MERRILL EISENBUD, Chapel Hill, N.C. MAURICE S. FOX, Massachusetts Institute of Technology, Cambridge, Mass. R. MICHAEL FRY, Radiation Research, Oak Ridge, Tenn. PHILIP C. HANAWALT, Stanford University, Stanford, Calif. MAUREEN M. HENDERSON, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, Wash. JONATHAN M. SAMET, The Jons Hopkins University, Baltimore, Md. WILLIAM J. SCHULL, University of Texas Health Science Center, Houston, Texas SUSAN S. WALLACE, University of Vermont, Burlington, Vt. H. RODNEY WITHERS, University of California Los Angeles Medical Center, Los Angeles, Calif. National Research Council Staff JOHN D. ZIMBRICK, Director EVAN B. DOUPLE, Senior Program Officer DORIS E. TAYLOR, Staff Assistant CATHERINE S. BERKLEY, Administrative Associate

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields COMMISSION ON LIFE SCIENCES THOMAS D. POLLARD (Chair), The Johns Hopkins University, Baltimore, Md. FREDERICK R. ANDERSON, Cadwalader, Wickersham & Taft, Washington, D.C. JOHN C. BAILAR III, University of Chicago, Chicago, Ill. JOHN E. BURRIS, Marine Biological Laboratory, Woods Hole, Mass. MICHAEL T. CLEGG, University of California, Riverside, Calif. GLENN A. CROSBY, Washington State University, Pullman, Wash. URSULA W. GOODENOUGH, Washington University, St. Louis, Mo. SUSAN E. LEEMAN, Boston University School of Medicine, Boston, Mass. RICHARD E. LENSKI, Michigan State University, East Lansing, Mich. THOMAS E. LOVEJOY, Smithsonian Institution, Washington, D.C. DONALD R. MATTISON, University of Pittsburgh, Pittsburgh, Penn. JOSEPH E. MURRAY, Wellesley Hills, Mass. EDWARD E. PENHOET, Chiron Corporation, Emeryville, Calif. EMIL A. PFITZER, Research Institute for Fragrance Materials, Hackensack, N.J. MALCOLM C. PIKE, University of Southern California, Los Angeles, Calif. HENRY C. PITOT III, University of Wisconsin, Madison, Wisc. JONATHAN M. SAMET, The Johns Hopkins University, Baltimore, Md. HAROLD M. SCHMECK, JR., North Chatham, Mass. CARLA J. SHATZ, University of California, Berkeley, Calif. JOHN L. VANDEBERG, Southwest Foundation for Biomedical Research, San Antonio, Tex. PAUL GILMAN, Executive Director

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields Preface Can routine exposures to electric and magnetic fields found in homes and communities cause cancer, reproductive abnormalities, or neurobiologic disease? That question has been asked by a large number of people who live in today's highly industrialized world. It was asked of Congressman Joseph McDade by constituents of his Pennsylvania legislative district and prompted his proposal for a National Academy of Sciences study of the possible health consequences of exposure to low-strength low-frequency electric and magnetic fields. Subsequently, the Congress, in Public Law 102-104, designated the U.S. Department of Energy (DOE) as the lead agency for electric and magnetic field research and specified that DOE enter into an agreement with the National Research Council (NRC) to conduct an evaluation of the possible health effects of electric and magnetic fields. The interest of DOE and the Congress is a response to the public's concern about possible adverse health effects resulting from exposure to power-frequency electric and magnetic fields in the residential setting. The NRC Board on Radiation Effects Research responded to DOE's request by convening an expert committee to review and evaluate the literature on the possible health effects of exposure to electric and magnetic fields. This report is the result of nearly 3 years of committee study and numerous hours of committee deliberations. Scientists often can be precise in pinpointing the cause and the remedy for a well-defined disease. Smallpox has become an extinct disease because its cause (a virus) was identified, and scientists developed an effective vaccine because of their knowledge of the human immune response system. The situation for

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields power-frequency electric and magnetic fields and their effects on biologic systems is quite different. There is no widely accepted understanding of how extremely low-frequency electric and magnetic fields, such as those associated with the distribution and use of electric power, could cause a disease or whether it causes a disease. Considerable research has been conducted in this area, and numerous research data can be found on the subject, but given the lack of a specific disease end point to track or a well-accepted theory of how the fields might affect biologic systems, the data are discordant; they have been gathered using different exposure conditions and have resulted in conflicting observations of different effects or no effects. Electricity has been a staple in U.S. homes for only the past 100 years. Questions about human health effects from exposure to electromagnetic fields (EMF) began only about 50 years ago, when persons in the armed forces were exposed to EMF from radar and other high-frequency radioactive devices. Only in the past 15 years have claims arisen about the possible health effects of the extremely-low-frequency electric and magnetic fields encountered in residential environments. Meanwhile, research funding for studies of the possible health effects of electric and magnetic fields has fluctuated over the years—at various times research programs have been pursued actively by the DOE, the U.S. Environmental Protection Agency (EPA), and the Electric Power Research Institute; at other times, such programs have been given less priority. Data are seldom sufficient to provide a definitive answer to the possible health effects of a physical or chemical agent in the environment. In such cases, professional judgment plays a large role in forming conclusions. It is especially important that the scientists selected for the evaluations be open to the evidence about the issues to be studied, wherever it might lead. The committee that prepared this report comprised persons with expertise in cancer, reproductive and developmental effects, and neurobiologic effects. Some of them were experienced in epidemiology, risk, and exposure assessment, others in laboratory studies using animal and cellular systems. Members represented a wide range of disciplines; academic credentials included physics, engineering, chemistry, and biology, complemented by applied fields, such as risk perception. Some of the members had spent large parts of their scientific careers studying the effects of electric and magnetic fields; others, including myself, were newcomers to the field and to its data. We learned early in our work that our initial points of view ranged from belief that residential electric and magnetic fields had been shown to cause disease to skepticism that such effects had been proved or even clearly demonstrated. Brief biographic sketches of the members of this committee can be found at the end of this report. Because some committee members were unfamiliar with the research on biologic effects of power-frequency electric and magnetic fields, informational workshops were held at several meetings. Scientists from the United States and abroad briefed the committee about their work and the state of knowledge

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields concerning effects of these fields. Much of the remainder of our committee meetings was spent in assessing and evaluating the data and synthesizing our conclusions based on the data. We were assisted in our discussions by experts invited to join us for some of our meetings. In particular, we called on several biostatisticians to give us their views on the strength of individual scientific papers and the significance of the body of evidence as a whole. The use of biostatisticians outside the committee became especially important when the biostatistician originally appointed to the committee was forced to resign because of the press of duties at his home institution. I wish to thank the members of the committee for their thoughtful and open-minded approach as they wrestled with the complexities of our charge and their hard work as we prepared the report. A significant burden of writing fell on those members who were experts in the field and were designated by the committee to prepare sections in their areas of expertise. We thank the staff of the Board on Radiation Effects Research, Larry Toburen, John Zimbrick, Doris Taylor, Lara Adamo, and Alvin Lazen, associate executive director of the Commission on Life Sciences. We also acknowledge the support of DOE and its program officer for this project, Imre Gyuk. We express our appreciation to the anonymous reviewers of this report whose comments and insights have sharpened the expression of the committee's views. Charles F. Stevens, Chairman Committee on the Possible Effects of Electromagnetic Fields on Biologic Systems

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields OTHER REPORTS OF THE COMMISSION ON LIFE SCIENCES Carcinogens and Anticarcinogens in the Human Diet: A Comparison of Naturally Occurring and Synthetic Substances (1996) Toxicological and Performance Aspects of Oxygenated Motor Vehicle Fuels (1996) Upstream: Salmon and Society in the Pacific Northwest (1996) A Review of EPA's Environmental Monitoring and Assessment Program: Overal Evaluation (1995) Current Methodologies and Future Directions of the Fernald Dosimetry Reconstruction Project and Their Appropriateness and Soundness (1995) EMF Research Activities Completed Under the Energy Policy Act of 1992: Interim Report (1995) Evaluation of Centers for Disease Control/Marshall Islands Epidemiology Protocol: Letter Report (1995) Nitrate and Nitrite in Drinking Water (1995) Radiation Dose Reconstruction for Epidemiologic Uess (1995) Science and the Endangered Species Act (1995) Epidemiologic Research Program at the Department of Energy: Looking to the Future (1994) The Hanford Environmental Dose Reconstruction Project: A Review of Four Documents (1994) Health Effects of Exposure to Radon: Time for Reassessment? (1994) Health Effects of Permethrin-Impregnated Army Battle-Dress Uniforms (1994) Interpretation of Results of a Pilot Project by the Hanford Thyroid Disease Study and the Assessment of Feasibility of a Proposed Second-Phase Epidemiology Study (1994) Radiological Assessments for Resettlement of Rongelap in the Republic of the Marshall Islands (1994) Science and Judgment in Risk Assessment (1994) Assessment of the Possible Health Effects of Ground Wave Emergency Network (1993) Guidelines for Developing Community Emergency Exposure Levels for Hazardous Substances (1993) Health Effects of Ingested Fluoride (1993) Issues in Risk Assessment (1993) Pesticides in Diets of Infants and Children (1993) Research to Protect, Restore, and Manage the Environment (1993) Setting Priorities for Land Conservation (1993) Dose Reconstruction for the Fernald Nuclear Facility (1993)

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields Acknowledgments The committee was assisted by many experts in the field during the course of its study. It is impossible to name all the individuals who contributed their time and talents in aiding the committee to complete its task. In some instances the committee was able to build on previous reviews of possible health effects of electric and magnetic fields. We are especially indebted to William Mills and Diane Flack, managers of the Committee on Interagency Radiation Research and Policy Coordination's (CIRRPC) study of the health effects of electromagnetic fields, for their help in identifying important reports and lecturers to aid the committee in reaching an understanding of the potential health effects of power-frequency electric and magnetic fields. Informative discussions were also conducted with Robert McGaughy and James Walker of the Environmental Protection Agency and with Imre Gyuk and Robert Brewer of the Department of Energy. At the beginning of the study the committee held a workshop to gain insight from a number of individuals with experience in the study of biologic effects of electric and magnetic fields. Among those who contributed to that workshop were Anders Ahlbom, Karolinska Institute, whose presentation was on ''The Current Status of Epidemiological Studies of the Possible Health Risks of Residential Exposure to Electromagnetic Fields;" Edward P. Washburn, DOE, on "The Application of Techniques of Meta-analysis to the Investigation of the Potential Health Effects of Human Exposure to Electromagnetic Fields;" Keith Florig, Resources for the Future, on "Risk Perception and Public Policy;" Joseph V. Brady, Johns Hopkins University, on "Evidence for Neurobehavioral Effects

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields Resulting from Exposure to Electromagnetic Fields;" Robert L. Brent, A. I. duPont Institute and the Jefferson Medical College, on "Evidence for Reproductive and Teratological Effects of Exposure to Low-Frequency Electromagnetic Fields;" Gary S. Stein, University of Massachusetts, on "Evidence of Effects of Exposure to Electromagnetic Fields on Cellular Development, Growth, and Regulation;" James Weaver, Massachusetts Institute of Technology, on ''The Interaction of Electromagnetic Fields with Biological Cells;" Ken McLeod, State University of New York, Stonybrook, on "Mechanisms for the Interaction of Electromagnetic Fields with Biological Tissue: Bone Healing and Other Effects;" and Robert Tardiff, EA Engineering Sciences and Technology, Inc., on "Critical Factors in Risk Assessment." The committee is indebted to all these individuals for their participation in the workshop. A major effort of the committee was the detailed analysis of the epidemiologic evidence of possible electric-and magnetic-field-induced diseases. Of special concern to the committee was the reliability of the statistical approaches used in the studies. The committee wishes to acknowledge Jay Lubin, National Cancer Institute, and John Tukey, Princeton University, for their contributions to the committee in their review of the committee's evaluation of the statistical methods used to analyze the epidemiologic data and to thank Dr. Lubin for providing his insights regarding this important question at one of its committee meetings. The committee also wishes to thank William Feero, Electric Research and Management Inc., for attending a committee meeting to share his insights on the issues in exposure assessment.

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields Contents     EXECUTIVE SUMMARY   1 1   INTRODUCTION   9     Background   9     Scope of the Study   10     Areas of Concern   10     Definitions and Descriptions of Terms   11     Sources of Exposure   16     Why Knowledge About Electric and Magnetic Fields Is Important   17     Related Reports   18     Organization of This Report   19 2   EXPOSURE AND PHYSICAL INTERACTIONS   21     Summary and Conclusions   21     Definition of Terms   22     Methods of Exposure Assessment   25     Typical Exposures   27     Exposures in Epidemiologic Studies   36     Exposures in Laboratory Experiments   40     Induced Fields and Currents   46

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields 3   CELLULAR AND MOLECULAR EFFECTS   52     Summary and Conclusions   52     Utility and Limitations of In Vitro Studies   53     Genotoxicity and Carcinogenic Potential of Power-Frequency Electric and Magnetic Fields   54     Experimental Studies of In Vitro Effects   55 4   ANIMAL AND TISSUE EFFECTS   73     Summary and Conclusions   73     Criteria for Consideration of Literature   74     Use of Animal Studies in Evaluating Risk   74     Carcinogenic and Mutagenic Effects   79     Reproductive and Developmental Effects   82     Neurobehavioral Effects   90     In Vivo Neurochemical and Neuroendocrine Effects   94     Bone Healing and Stimulated Cell Growth   106     Discussion   115 5   EPIDEMIOLOGY   117     Summary and Conclusions   117     Interpretation of Epidemiologic Evidence   118     Cancer Epidemiology—Residential Exposures   126     Cancer Epidemiology—Appliance Exposures   176     Cancer Epidemiology—Occupational Exposures   179     Reproduction and Development   181     Learning and Behavior   185 6   RISK ASSESSMENT   191     Summary and Conclusions   191     Risk Assessment   192 7   RESEARCH NEEDS AND RESEARCH AGENDA   200     Epidemiologic Studies   200     Laboratory Studies   204     Research Strategy   208 APPENDIX A:   TABLES   209 APPENDIX B:   EXPOSURE ASSESSMENT IN RESIDENTIAL STUDIES   285

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields     REFERENCES   302     GLOSSARY   338     BIOGRAPHIC SKETCHES OF COMMITTEE MEMBERS   342     INDEX   347 FIGURES FIGURE 2-1   A simplified schematic of the basic features of the differences in the wire codes as defined to support epidemiologic studies. VHCC, OHCC, OLCC, and VLCC stand for very high, ordinary high, ordinary low, and very low current configurations.   37 FIGURE 2-2   A comparison of mean residential magnetic-field measurements by wire-code category for six studies.   38 FIGURE 3-1   Experimental protocol for studies of the effects of EMF on calcium efflux in chick brain.   68 FIGURE 3-2   The ratio of Ca2+ ions in the culture media of chick-brain cultures for electric-field exposures and controls shown as a function of the electric-field strength for exposure at 16 Hz.   69 FIGURE 3-3   The ratio of Ca2+ ions in the culture media of chick-brain cultures for electric-field exposures and controls shown as a function of the electric-field strength and frequency. The electric field is given in volts per meter peak-to-peak (Vpp/m) (left) and volts per meter root-mean-square (Vrms/m) (right).   70 FIGURE 4-1   Illustration of the association of the retina with the pineal gland, in this case represented by a single pinealocyte. The pineal hormone melatonin is synthesized from the amino acid tryptophan; serotonin is an intermediate. The conversion of serotonin to melatonin requires two enzymes—N-acetyltransferase (NAT) and hydroxyindole-O-methyltransferase (HIOMT). The NAT-serotonin reaction is the rate limiting step in melatonin production.   96 FIGURE 4-2   The two theories that have been proposed to explain the potential association of reduced melatonin production with the alleged increase in cancer after exposure to electric and magnetic fields. On the left, reduced melatonin concentrations lead to an increased secretion of prolactin and gonadal steroids. That increase causes proliferation of cell division in breast or prostate tissue and stimulates growth of initiated cancer cells. On the right, melatonin suppression reduced the total antioxidative potential of the organism, thereby increasing the likelihood of    

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields     damage by a carcinogen to the DNA of any cell. DNA damage can increase the risk of cancer particularly if electric-and magnetic-field exposure also increases the half-life of production of free radicals.   107 FIGURE 5-1   Conceptual framework for evaluation of evidence on wire codes, magnetic fields, and childhood cancer.   127 FIGURE 5-2   Odds ratios (dots) and 95% confidence intervals (vertical lines) for each of the dichotomous cut points of each exposure metric of each study as listed in Table 5-1.   141 FIGURE 5-3   Age at incidence of childhood leukemia.   160 FIGURE 5-4   Incidence of acute lymphocytic leukemia in children in Massachusetts and Connecticut.   161 FIGURE B-1   Definition of the wiring codes in relation to the distances from wires to homes.   288 FIGURE B-2   Plot of calculated contemporary fields by low-power measurements: Children living close to 220- or 440-kV power lines in Sweden, 1960–1985.   297 FIGURE B-3   Plot of calculated historical fields by low-power measurements: Children living close to 220- or 440-kV power lines in Sweden, 1960–1985.   298 TABLES TABLE 2-1   Magnetic Fields as a Function of Distance from Power Lines   28 TABLE 2-2   Average and Percentile Values for the Magnetic Field in Homes According to Room   29 TABLE 2-3   Magnetic-Field Strengths of Common Household Appliances   30 TABLE 2-4   Percentile Values for the Magnetic Fields of Typical Appliances   31 TABLE 2-5   Average and Percentile Values for Personal Exposure and Spot and Long-term Measurements of the Magnetic Field in Homes   31 TABLE 2-6   Typical Magnetic-Field Levels Measured Near Workplace Devices   33 TABLE 2-7   Typical Magnetic-Field Personal Exposures in the Home and Workplace   34 TABLE 2-8   Typical Magnetic Fields from Commuter Trains   35 TABLE 2-9   Typical Personal Exposures Estimated for Transportation Workers   35 TABLE 2-10   Typical Exposure Specifications to be Defined, Evaluated, and Reported in Any Experiment   42

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields TABLE 2-11   Typical Exposure Specifications for Animal Exposures to Electric Fields   43 TABLE 2-12   Typical Exposure Specifications for Animal and In Vitro Exposures to Magnetic Fields   43 TABLE 2-13   Typical Exposure Specifications for In Vitro Exposures to the Electric Field   45 TABLE 2-14   Typical Specifications for In Vitro Exposures to the Magnetic Field   46 TABLE 2-15   Typical Scaling Factors to Produce Equivalent Induced Currents for Grounded Animals Compared with a Grounded Person 1.7 m in Height Standing in a Vertical Field of 1 kV/m (Homogeneous Models)   48 TABLE 2-16   Typical Induced Currents and Fields for a 1-µT, 60-Hz Uniform Magnetic Field   50 TABLE 2-17   Current Densities Induced in a Person by a 60-Hz Magnetic Field Under Various Exposure Conditions   50 TABLE 5-1   Childhood Leukemia Case-Control Studies   130 TABLE 5-2   Wire Codes (Low-Current Configuration)   138 TABLE 5-3   Wire Codes (Low-Current Configuration) and Distance (<100 m)   139 TABLE 5-4   Summary of Alternative Meta-Analyses   140 TABLE 5-5   Subject Selection in Residential Childhood Cancer Studies   148 TABLE 5-6   Number of Subjects in Residential Childhood Cancer Studies   150 TABLE 5-7   Evaluation of How Well the Exposure Assessment Represents Average In-home Magnetic-Field Exposure   166 TABLE A3-1   In Vitro Assays of Electric-and Magnetic Field Exposure and Genotoxicity   210 TABLE A3-2   Peer-Reviewed Reports on Power-Frequency Electric-and Magnetic-Field Exposure and Calcium, October 1990-1994   220 TABLE A4-1   Electric-and Magnetic-Field Exposure and Carcinogenesis   223 TABLE A4-2   Electric-and Magnetic-Field Exposure and Reproductive and Developmental Effects   226 TABLE A4-3   Reports of Special Interest on Electric-and Magnetic-Field Exposure and Neurobehavioral Effects   238 TABLE A4-4   Electric-Field Exposure and Neurobiologic Effects   240 TABLE A4-5   Magnetic-Field Exposure and Neurobehavioral Effects   244 TABLE A4-6   Electric-and Magnetic-Field Exposure and Neurobehavioral Effects   247 TABLE A4-7   Effects of Sinusoidal Electric-Field Exposure on Pineal Melatonin Production   248

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields TABLE A4-8   Effects of Sinusoidal Magnetic-Field Exposure on the Pineal Gland in Animals in Morphologic Studies   250 TABLE A4-9   Effects of Sinusoidal Magnetic-Field Exposure on Pineal Melatonin Production   251 TABLE A4-10   Effects of Combined Sinusoidal Electric-and Magnetic-Field Exposure on Pineal Melatonin Production   253 TABLE A4-11   Effects of Different Types of Electric-and Magnetic-Field Exposure on Melatonin Metabolism in Humans   254 TABLE A5-1   Residential Electric-and Magnetic-Field Exposure and Cancer: Study Structure   255 TABLE A5-2   Residential Electric-and Magnetic-Field Exposure and Cancer: Case and Control Selection   258 TABLE A5-3   Residential Electric-and Magnetic-Field Exposure and Cancer: Exposure Assessment   260 TABLE A5-4   Residential Electric-and Magnetic-Field Exposure and Childhood Leukemia: Results   266 TABLE A5-5   Residential Electric-and Magnetic-Field Exposure and Childhood Brain Tumors: Results   269 TABLE A5-6   Residential Electric-and Magnetic-Field Exposure and Childhood Lymphoma: Results   272 TABLE A5-7   Electric-and Magnetic-Field Exposure and Childhood Cancers Other Than Leukemia and Brain Cancer: Results   274 TABLE A5-8   Residential Electric-and Magnetic-Field Exposure and All Childhood Cancers: Results   276 TABLE A5-9   Residential Electric-and Magnetic-Field Exposure and Cancer: Results of Cohort Studies Including Subjects of All Ages   279 TABLE A5-10   Residential Electric-and Magnetic-Field Exposure and Adult Leukemia: Results   281 TABLE A5-11   Residential Electric-and Magnetic-Field Exposure and Adult Cancer: Results   284 TABLE B-1   Measured Magnetic Fields and the Associated Wire-Code Current Configurations   291 TABLE B-2   Personal-Exposure Data from Kaune and Zaffanella (1994)   293 TABLE B-3   Personal-Exposure Data from the EMDEX Study (EPRI 1993c)   294 TABLE B-4   Spot-Measurement Data from the 1,000-Homes Study (EPRI 1993a,b)   294 TABLE B-5   Long-Term Measurements from the EMDEX Study (EPRI 1993c)   295

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Possible Health Effects of Exposure to Residential Electric and Magnetic Fields The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A. Wulf is interim president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an advisor to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and interim vice chairman, respectively, of the National Research Council.

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