• Mobile Phone Masts
• HYENA - Hypertenstion and Exposure to Noise near Airports
• APMoSPHERE - Air Pollution Modelling for Support to Policy on Health and Environmental Risk in Europe
• Rapid Inquiry Facility (RIF) - A tool for Environmental Public Health Tracking
• Powerlines
• GEMS - Global Environmental Monitoring with Satellites
• INTARESE - Integrated Assessment of Health Risks of Environmental Stressors in Europe

 

Funding: Mobile Telecommunications Health Research (MTHR) programme
Start date: April 2003
End date: Study deadline extended from summer 2005 to end of June 2007

This case-control study considers the association between residential exposure to radiofrequency (RF) from mobile phone base stations and early childhood cancers. Cases are children aged 0-4 years who were diagnosed with cancer between 1999 and 2001 in England, Wales and Scotland. Controls are matched to cases by sex and date of birth. Cases were obtained from the national cancer registration data held by SAHSU, and controls from the national births registers. Addresses for both cases (at registration and birth) and controls (birth) have been obtained from Office for National Statistics (ONS), and the Information and Statistics Division and General Registers Office for Scotland.

Three exposure measures are being explored with respect to the risk of childhood cancer. The first investigates disease risk with proximity to the nearest base station, within a 1000m buffer; the second investigates the total power output of all base stations in a 500m radius of the residence. The final exposure measure utilises a model developed by SAHSU to estimate power density at a given point, taking into account transmitter characteristics and the geography of the intervening environment. Population mixing, urban/rural status, deprivation and traffic volume will all be considered as confounders during the epidemiological analysis of the data.

Progress:

Nearly 2000 childhood cancer cases have been identified, and their birth and registration addresses obtained. Four controls have been chosen per case and their birth addresses obtained. Case and control addresses will be geo-referenced using AddressPoint, and initial statistical analyses based on distance and total power output from base stations will be carried out.

The power density exposure model has been developed in a GIS and is currently being validated and calibrated using field measurements and generic antennae patterns. Exposure modelling will then take place.

The project uses a multi-centre approach with scientific expertise from six European countries, including cross-sectional studies with retrospective exposure assessment in Germany, Greece, Italy, the Netherlands, Sweden and the UK, to analyse the exposure-response relationships in adults between long-term exposure to airport-related noise and hypertension and to evaluate the modifying effects of air pollution on noise associated cardiovascular effects. Acute changes in blood pressure following short-term changes in noise levels will be assessed. The studies are being conducted near airports with a wide range of exposures, which permit analyses of exposure-response relationships for the general population. The results will provide scientific support for guidelines for a European policy on noise and health. For further information, click on HYENA.

GIS, statistical and EO techniques were used, together with ground-based data, to develop 1 km scale air pollution maps (for particles, NO2, SO2, CO & 03) and an enhanced air pollution database for the EU. After adding data from national networks into the AIRBASE database, high resolution emission maps for each pollutant were produced based on national CORINAIR totals, using land cover and other source-related data. A range of statistical models and satellite-derived data were tested and evaluated against data from the AIRBASE database, and the optimum method(s) chosen for mapping air pollution at the EU level. Maps were then intersected with population and habitat data to derive indicators of health and habitat risk, and results interpreted to assess the air pollution situation in the EU and implications for policy and environmental monitoring. For further information, click on APMoSPHERE.

What is the Rapid Inquiry Facility?
The Rapid Inquiry Facility (RIF) has been developed by the Small Area Health Statistics Unit (SAHSU) at the Department of Epidemiology and Public Health, Imperial College London.

The RIF is an automated tool that provides an extension to ESRI® ArcGIS functions, and uses both database and GIS technologies. The purpose of this facility is to rapidly address epidemiological and public health questions using routinely collected health and population data.

The RIF can perform risk analysis around putative hazardous sources, and can be used for disease mapping. It generates standardised rates and relative risks for any given health outcome, for specified age and year ranges, for any given geographical area.

This facility was initially designed as a tool for SAHSU staff to analyse routinely collected health data in relation to environmental exposures in the UK, but this UK RIF was subsequently transformed for use by several European countries as part of the European Health and Environment Information System (EUROHEIS) project.

Centers for Disease Control and Prevention (CDC) and SAHSU are collaborating to adapt and enhance the UK RIF software for use in CDC’s National Environmental Public Health Tracking (EPHT) Network.

The goal of this project is to increase the functionality and versatility of the RIF for evaluating temporal and spatial relationships between disease and environmental hazards in the National EPHT Network.

RIF development
The software has been reprogrammed to be database independent.

In addition to the point source ‘hazard analysis' and disease mapping options, it is now also possible to import detailed exposure data, such as output from dispersion modelling.

RIF provides a tool that allows users with skills in epidemiology take advantage of the many of the functions that a GIS offers without requiring an in-depth knowledge of GIS. Since the application is embedded in ArcGIS, those with GIS skills will of course still be able to use all the functionality that ArcGIS offers.

Within the disease mapping tool, the RIF also performs empirical Bayes smoothing of the raw relative risks.

The RIF can also export data for further analysis in other (statistical) software packages such as WinBUGS and SaTScan.

The new RIF system is being tested in several case studies in the UK and USA, including a pilot project studying cancer outcomes associated with living over a plume of trichloroethylene contaminated ground water in Utah.

RIF output
The RIF automatically generates contextual maps showing the area under study.

A report is generated summarising the study details, and reporting the crude and adjusted rates and risks for each health outcome investigated. Graphs comparing the age, gender and socio-economic (or other covariate) structure of the study and comparison populations are provided to aid interpretation.

As well calculating rates and relative risks (and associated 95% confidence intervals) for each exposure group or distance band, the RIF runs Chi-square tests for homogeneity and linear trend to test the global association between distance/exposure covariate and disease risk.

In disease mapping analyses, maps showing crude, adjusted and smoothed risks by area are also displayed.

Why develop the RIF?
There has been increased interest expressed in developing ‘environmental public health tracking systems’ in the UK, as well as elsewhere around the world. The RIF is able to rapidly link environmental and health databases, and is thus a powerful tool for evaluation of spatial relationships between disease and environmental hazards in such tracking systems.

Demos
The demos are large .avi video files. The files must first be unzipped (use WinZip on Windows), and then they can be viewed using Windows Media Player.

• Disease Mapping (58.8 MB)
• Risk Analysis (71 MB)

RIF-Related Links

• EPHT at the CDC: http://www.cdc.gov/nceh/tracking/
• SAHSU 'Partner profile' at the CDC: http://www.cdc.gov/nceh/tracking/sahsu.htm

RIF Software
Click here for information on how to register for RIF software access.

 

Following the successful pilot study in 1998, the Powerlines project aims to quantify risks of certain adult cancers in relation to overhead power lines, using a case-control design. Both cases and controls are adults aged 15-74 years living within 1000m of a power line who were diagnosed with cancer between 1974 and 2003 in England and Wales. Cases and controls were selected from the national cancer registry held by SAHSU and addresses were supplied by the Office for National Statistics (ONS) and geo-referenced using AddressPoint. Two hypotheses are being investigated:

1. The primary hypothesis explores the association between magnetic fields produced by power lines and the risk of leukaemias, central nervous system cancers, breast cancer and malignant melanomas. Exposure will firstly be measured by modelled magnetic field strength at residence (calculated by National Grid Transco (NGT)), and secondly as a function of distance of residence from the nearest power line.


2. The secondary hypothesis investigates the theory of the deposition or inhalation of charged particles produced by power lines and excess risk of cancers of the respiratory system, cancers of the mouth and non-melanoma skin cancer. Exposure will be calculated firstly using a simple model comparing incidence of cases living 'upwind' to incidence of cases living 'downwind' of a power line, and secondly using a more sophisticated model taking into account distance, prevailing wind patterns and electric field strength of the power line (calculated by NGT).

The same set of control cancers - which comprises cancers not currently thought to be associated with power lines - will be used for both hypotheses. Controls will be matched to cases by region and year of diagnosis; however cases of breast cancer will also be matched by sex. One to three controls will be assigned per case. For the more common female breast, respiratory and non-melanoma skin cancers, only 50% of cases located 100-1000m away from a power line will be used. Age, sex, migration and socioeconomic position will be controlled for at the statistical analysis stage.

The number of adults in England and Wales with residential exposure to significant low frequency electromagnetic fields from high-voltage overhead power lines will be estimated.

Progress:

Nearly 93,000 cases and 140,000 controls have been selected from the pool of cancers where registration address is located within 1000m of a power line. Exposure estimates will be modelled and a statistical analysis of the effects of proximity to a power line will be undertaken.

 

Web site: http://www.ecmwf.int/research/EU_projects/GEMS/

Increasing investment is being made in Europe, as elsewhere, in the implementation of satellite technology for environmental monitoring. The capability of these systems to support policy, however, remains undeveloped and to some extent unclear. This project is aimed at developing and using the models and analysis methods needed to make full use of satellite data for applications in meteorology and air pollution science. One important area of application in this context is public health; we are leading a work package (partners including the UK Meteorological Office and Irish Environmental Protection Agency) to examine the use of results from the GEMS study for health risk and health impact assessment and as a basis for an early warning system of meteorologically and air pollution driven episodes.

The primary aim of the health study is to assess the health risks associated with major long-range air pollution and heatwave episodes. To this effect, it will examine a range of health effects (including all cause mortality, CV mortality, respiratory mortality and COPD) during major episodes in SE England in 2003, compared to matched 'reference' periods (non-episodes) in 2002. Key exposures will include particulate air pollution (PM10 and black smoke), SO2, O3 and temperature). Exposure modelling will be done using a combination of long range dispersion models, meteorological models (both implemented by the Meteorological Office), local dispersion modelling and GIS-based interpolation techniques. Space-time comparisons will be made between episodes and reference periods using Bayesian methods.

This study will make use of SAHSU health data to analyse associations between mortality (and if possible hospital admissions) and air pollution during major pollution episodes.

 

Web site: http://www.intarese.org

INTARESE brings together a team of international lead scientists in the areas of epidemiology, environmental science and biosciences to collaborate on developing and applying new, integrated approaches to the assessment of environmental health risks and consequences, in support of European policy on environmental health.

This project is designed to support implementation of the European Environment and Health Action Plan, by providing the methods and tools that are essential to enable integrated assessment of environment and health risks. Drawing upon the large range of studies carried out in Europe over recent years and the advances made in specific areas of toxicology and epidemiology (especially air pollution), and in close collaboration with users, it will develop a methodological framework and a set of tools and indicators for integrated assessment that can be applied across different environmental stressors (including pollutants and physical hazards), exposure pathways (air, water, soil, food) and policy areas. It will review, bring together and enhance the monitoring systems needed to support such analyses, including routine environmental monitoring (ground-based and Earth observation), biomonitoring and health surveillance. The framework, tools and data will be tested and demonstrated through integrated assessments of exposures and health risks in a number of specific policy areas, including transport, housing, agriculture, water, wastes, household chemicals and climate.

Results from these will be used both to refine the assessment methods and to provide specific information on health implications of current and potential future policies. Based on the results, a toolbox for integrated environment and health risk assessment will be developed, which will be further tested and demonstrated through a series of higher level policy analyses. Particular attention will be given throughout to issues of uncertainty, sensitive or susceptible groups, and possible interactive and cumulative effects of different stressors. Deliverables will include new, integrated methods and indicators for environment and health risk assessment and monitoring, an operational assessment toolbox, and a set of validated assessments that can directly inform policy.

Key study components are:

• The development of a concept and procedure of integrated assessment for environment and health policies and risks;
• Use of this approach to assess seven major policy areas:
  1. Urban transport (including air pollution and noise);
  2. Housing (including energy efficiency and indoor air quality);
  3. Agriculture (including pesticides, allergens and ecotoxins);
  4. Water (including DBPs, nitrates and metals);
  5. Wastes (associated with landfill, incineration and recycling);
  6. Chemicals in household articles and products (including furnishings, solvents);
  7. Climate (including temperature, UV radiation);
• Development of a 'toolbox' for integrated assessment that can provide a basis for other policy assessments in the future;
• Review, evaluation and development of environmental, health and biomonitoring systems as a basis for integrated assessment.

This study has direct relevance to SAHSU in a number of ways. In particular, it will help to develop methods for framing studies in a more integrated way, and for translating epidemiological research into policy-relevant assessments of risk. It will also include assessments of risk in relation to several issues of specific concern to SAHSU sponsors, including pesticides, housing and transport, in all of which major UK-based case studies are envisaged.