What\'s the hang-up about cellular phones?

by Debra Wood, RN

Warnings that cell phones cause brain tumors and that chatting contributes to car crashes have not stopped more than 91 million Americans from enjoying tether less links to friends, family, and business associates.

The all-too-familiar chirp of a cellular phone shatters the peace at the beach, breaks up conversations, and intrudes just about everywhere. But such encroachments on privacy may be the least of our concerns.

Health problems?

For years, people have voiced concern about the dangers of radiofrequency (RF) energy from cell phones. To put this in perspective, cell phones use about the same range of RF as your microwave oven uses to cook food. After reviewing the results of multiple studies, though, scientists still can't say for sure whether wireless radiation contributes to health problems.

Science searches for answers

A few animal studies showed that low levels of RF accelerated cancer development in mice exposed to high doses. Others didn't.

"The scientific and medical information is in a gray area," says George L. Carlo, PhD, who headed up a six-year, cellular industry-funded study about wireless health risks. "We can't say clearly that these things are safe. We have a hint that they are dangerous. [But] we don't know how dangerous. What we do know is that in the four different epidemiologic studies we've done, there are hints of health risks."

Dr. Carlo is referring to research indicating that people who use cell phones experience higher rates of rare cancers than nonusers. One study indicated tumors occurred more often on the side of the head where the user held the phone.

Dr. Carlo can't quantify the risk, or whether shorter or fewer calls are better. The amount of radiation to connect the call and the subsequent dialing and ringing is greater than what's needed to maintain the call.

"We know the plume of radiation from the antenna will penetrate two to three inches into the body," he adds. "We also know that children's heads are more susceptible to radiation, because their tissues are not mature."

Playing it safe

Jeffrey Nelson, spokesperson for the Cellular Telecommunications Industry Association (CTIA), says, "Obviously there has been a wealth of science done, and some issues [are still] out there. We have long supported scientific inquiry in cellular phone use and public health, and there's no reason to believe they are not safe."

Nelson says his organization is working with the U.S. Food and Drug Administration (FDA) to determine the need for additional research. FDA considers the risk small but has recommended the industry design mobile phones to minimize RF exposure and suggests several steps consumers can take to lower risk:

  • Hold longer calls on a conventional phone, restricting cell-phone use to shorter calls and situations where traditional phones are not available.
  • Switch to a phone with an antenna mounted outside the car.
  • Use a headset with a remote antenna carried at the waist.

Dr. Carlo adds that callers should hold the antenna away from the body and suggests that parents give children pagers rather than cell phones.

Traffic talk

Radiation risk may be subject to debate, but few dispute the pitfalls of driving while conversing. In 1999, the Center for Urban Transportation Research at the University of South Florida (USF) in Tampa, Florida reported that several factors influenced safe phone use in the car, including the type of phone and the conversation.

"The use of mobile phones when driving was found to have a distractive effect, caused primarily by the additional mental workload imposed on the driver and, to a lesser extent by the physical restrictions imposed by hand-held phone use," says Alasdair Cain, co-author of the center's report.

The National Highway Traffic Safety Administration (NHTSA) knows that driver inattention, from a variety of distractions, plays a role in half of US accidents and reports more instances of inattention, erratic/reckless driving and running off the road in fatal crashes involving cellular phones than in other fatal auto accidents.

"Distraction is a big problem," says Tim Hurd of the NHTSA. "Our recommendation is to park in a safe place [before you make or receive a call]."

Driven to distraction

Dr. Donald A. Redelmeier reported in the New England Journal of Medicine that talking on a cellular phone quadrupled the risk of a collision. His research showed people of all ages and driving experiences shared the same relative risk and that hands-free phones offered no safety benefit over handheld units.

A recent Spanish study offers insight into why. Psychologists discovered that thinking about something other than driving can decrease a person's ability to assess surroundings and notice changes in traffic.

"The potential hazard of using a cellular phone is one thing," says L.M. Nunes, PhD. "But add in-depth conversation that requires a considerable amount of mental effort, like recalling a route on a map, performing a mathematical computation or discussing an emotionally charged subject, and you compound an already risky behavior."

Road rules for cell phone users

To decrease the risk of accidents, the CTIA and the National Safety Council recommend that drivers:

  • Understand and use special phone features, like speed dial.
  • Use a hands-free speakerphone, even though some studies concluded that holding the phone is not the problem.
  • Keep the phone within easy reach.
  • Don't talk during hazardous conditions, such as inclement weather or heavy traffic. Call the person later.
  • Don't take notes while talking.
  • Don't look up phone numbers.
  • Make calls when stopped at a traffic light or pull off the road.
  • Avoid making or participating in stressful conversations. "The logic is if you're having an intense call, you're not paying as much attention to driving, and driving becomes a secondary task," says USF's Cain.

Good news

Cellular phones also offer opportunities to improve safety, by making it easier to report road conditions and accidents. More than one-third of calls placed to 9-1-1 emergency centers originate from cell phone callers.

The prognosis

Focusing on driving will keep roads safer for everyone. Answers are not quite so obvious when it comes to radiation fears. But with 400 million cellular phone owners worldwide, 25,000 more signing up daily and the possibilities of wireless Internet service, the freedom of communicating from afar may exact a heavy toll.

"Within the next five years, virtually every man, woman and child in the United States will be exposed to RF radiation every day of their lives. This is the most rapidly penetrating technology in the history of mankind," Dr. Carlo concludes. "I would like nothing better than for the findings that we have...to not be able to be corroborated or repeated. I have kids and family that use these things. But right now the data we have suggest problems, and we have to act on that."

Research update

In July 2000, another of Dr. Carlo's studies was published in Medscape General Medicine. In his article, Dr. Carlo raises concerns about the safety of cell phone use among children and pregnant women, and the ability of RF energy to cause genetic damage to human blood.

See: "Scientific Progress - Wireless Phones and Brain Cancer: Current State of the Science," by George Carlo and Rebecca Steffens Jenrow. Medscape General Medicine, July 31, 2000.