Health Effects Of Chronic Exposure Research Articles

General toxicity and screening of reproductive and developmental toxicity following bioaccumulation of oral-dosed perfluorooctanoic acid: Loss of the Golgi apparatus

Despite its widespread use as a stabilizer across various industries over the past several decades, the health effects of chronic exposure to PFOA are still unclear. We administered PFOA by oral gavage (0, 12.5, 50, and 200 μg/day/mouse, eight groups) to male and female mice for six months. Body weight gain decreased with dose accompanied by increased liver weight, and PFOA altered liver damage-related-blood biochemical indicators and induced pathological lesions, including hepatocellular hypertrophy, cholangiofibrosis, and centrilobular hepatocellular vacuolation. Loss of the Golgi apparatus, formation of lamellar body-like structures, and lipid accumulation were observed in the liver of PFOA-treated mice. We also cohabited five pairs of male and female mice for the last ten days of administration, dosed PFOA to dam up to 28 days after birth, and investigated effects on reproduction and development. The survival rate of pups and the sex ratio of surviving mice decreased significantly at the highest dose. PFOA tissue concentration increased with the dose in the parent mice's liver and the pups' blood and brain. Taken together, we suggest that PFOA primarily affects the liver and reproduction system and that disturbance in lipid metabolism and Golgi's structural stability may be involved in PFOA-induced toxicity.

Noise and PM2.5 levels in children's park adjacent to airport

Background: Sanuki Kodomo-no-Kuni Children's park adjacent to Takamatsu airport is a facility where visitors can watch airplanes take off and land up close and learn about science and technology. However, because it is not a school facility, the hygienic conditions such as noise and PM2.5 levels are not well known despite the current situation where many infants and elementary school students use this facility. Method: Noise and PM2.5 levels were measured at a point in the park 170 m from the runway center. Rsults: Three takeoffs and three landings were made during the measurement period. Instantaneous noise levels of 92.5 to 96.5 dB(A) were recorded during takeoff and 79.9 to 82.2 dB(A) during landing. The PM2.5 level every 30 minutes was 8 μg/m3 at the beginning of the measurement, but 21 μg/m3 was measured at the end, and a trend of increasing PM2.5 levels over time was observed. Conclusion: Noise levels during takeoffs and landings were instantaneous but high. Since previous studies have reported health effects of chronic exposure to aircraft noise, including misbehaviours in young children, memory loss in school children, increased birth rate of low birthweight infants, and hearing loss due to chronic exposure. It was considered desirable to avoid excessive exposure to aviation noise.

Assessment of noise complaints as an indicator of long-term effects of aircraft noise on communities surrounding aerodromes

Aircraft noise is considered by many as the most burdensome part of aircraft operations. Communities neighbouring airports often express concerns about the possible health effects of chronic exposure to noise. To quantify the long-term effects of environmental noise exposure, researchers often use the metric of annoyance. Annoyance is widely considered to be the most well-corroborated health effect of aircraft noise and a moderating factor for other suspected health effects. Annoyance can also be correlated to average cumulative noise levels, such that higher levels of chronic noise likely evoke higher levels of annoyance within the population. Annoyance data is typically collected using extensive surveys and/or interviews, which are costly and time-consuming. In the absence of annoyance data, complaints are often used as a proxy for annoyance. This research used complaint, noise and annoyance data to demonstrate that complaints do not equate to annoyance, nor do they correlate to cumulative noise metrics. Thus, while complaint data may prove useful in analyzing short-term response to operations, it should not be relied upon for the assessment of long-term impacts from aircraft noise exposure, nor should it be used to direct noise and annoyance mitigation initiatives.

Estimating long-term average household air pollution concentrations from repeated short-term measurements in the presence of seasonal trends and crossover.

Estimating long-term exposure to household air pollution is essential for quantifying health effects of chronic exposure and the benefits of intervention strategies. However, typically only a small number of short-term measurements are made. We compare different statistical models for combining these short-term measurements into predictions of a long-term average, with emphasis on the impact of temporal trends in concentrations and crossover in study design. We demonstrate that a linear mixed model that includes time adjustment provides the best predictions of long-term average, which have lower error than using household averages or mixed models without time, for a variety of different study designs and underlying temporal trends. In a case study of a cookstove intervention study in Honduras, we further demonstrate how, in the presence of strong seasonal variation, long-term average predictions from the mixed model approach based on only two or three measurements can have less error than predictions based on an average of up to six measurements. These results have important implications for the efficiency of designs and analyses in studies assessing the chronic health impacts of long-term exposure to household air pollution.

Association of exposure to deoxynivalenol with DNA methylation in white blood cells in children in China

Deoxynivalenol (DON) is a mycotoxin that commonly contaminates cereals worldwide. Dietary exposure to DON is a subject of great public health concern, but studies on the health effects of chronic exposure to DON are not available. In this study, we investigated the connection between DNA methylation levels and DON exposure in children. The DNA methylation status of white blood cells from 32 children aged 2~15 years old in Henan, China, was profiled. A total of 378 differentially methylated CpGs were identified between the high and low DON exposure groups, and 8 KEGG pathways were found to be significantly enriched among the differentially methylated genes. In addition, the quantitative methylation of EIF2AK4, EMID2 and GNASAS was analysed using the Sequenom MassARRAY platform. The results showed that the methylation level of EIF2AK4 was significantly different between the two groups, and the methylation levels were associated with exposure to DON. Conclusively, our study found that chronic exposure to DON during childhood could affect DNA methylation levels.

Health Effects of Hydrogen Sulfide Exposures: A Review of the Evidence Pertaining to Low Level Exposures

BACKGROUND AND AIM: Hydrogen sulfide (H2S) is a toxic gas well-known for its acute health risks in occupational settings and long considered a nuisance in community settings. Less is known about the health effects of chronic, low-level exposures (10 ppm). We review the health effects of chronic exposure to H2S at low concentrations that are relevant in community, and often occupational, settings. METHODS: We focus on the peer-reviewed epidemiological literature since 2004. Taking an interdisciplinary approach, we contextualize epidemiological studies with peer-reviewed toxicological, experimental, and exposure assessment studies as well as agency guidelines and standards. We examine all sources of H2S emissions, geothermal and industrial, yet limit the exposure route of interest to inhalation. RESULTS:Chronic exposure to H2S at levels below 10 ppm was associated with odor aversion, irritation, and harmful ocular, nasal, respiratory, and neurological effects. Exposure to an annual mean concentration between 7 and 27 ppb was associated with an increased prevalence of harmful neurological effects. Among people exposed to mean concentrations as low as 0.3 ppb, a slight increase of H2S as little as 1 ppb may be associated with increased eye irritation, nasal irritation, and respiratory effects. Few studies considered vulnerable and susceptible populations. In epidemiological studies, the strength of association between low-level H2S exposure and adverse health effects was primarily limited by exposure measurement error and confounding by co-pollutants. CONCLUSIONS:Long-term, community-based epidemiological studies with robust objective exposure assessment are needed. Still, the evidence linking chronic exposure to H2S in the ppb range with negative health effects, especially considering potential effects on sensitive populations, suggests that more stringent guidelines and standards are needed to protect communities. KEYWORDS: air pollution, long-term exposure, environmental epidemiology, exposure assessment

Thallium Contamination of Drinking Water: Health Implications in a Residential Cohort Study in Tuscany (Italy).

In 2014–2015, concentrations of thallium above the recommended reference value (EPA: 2 µg/L) were measured in some parts of the drinking water distribution system in the municipality of Pietrasanta (Tuscany, Italy). An extensive campaign of water samples and human biomonitoring surveys were implemented to quantify the exposure of population. A residential cohort epidemiological study was carried out on the population of the municipality of Pietrasanta, aimed at comparing the health status of residents in the areas affected by thallium contamination with residents living in the rest of the municipality. Cohort included people residing in the municipality of Pietrasanta from 1 January 2000 to 31 December 2015. Residence addresses were georeferenced and each subject living in one of the three contaminated areas were defined as exposed. Mortality, hospital discharge data and adverse pregnancy outcomes were taken from administrative health databases. Cox proportional hazard models and logistic models were used to test the association between thallium exposure and health outcome. This study did not show any excess of risk in terms of mortality and hospitalization in the population residing in the areas served by thallium-contaminated aqueduct branches, compared to the rest of the not contaminated area. Increased risks for low birth weight (OR = 1.43 95% CI 0.91–2.25) and pre-term birth (OR = 1.40 95% CI 0.82–2.37) were observed. In view of the paucity of epidemiological studies on thallium, this study is an important contribution to the state of knowledge of the health effects of chronic exposures to low concentrations of thallium.

An exploratory evaluation of the potential pulmonary, neurological and other health effects of chronic exposure to emissions from municipal solid waste fires at a large dumpsite in Olusosun, Lagos, Nigeria.

Open municipal solid waste (MSW) combustion is a major emission source of particulate air pollution, polycyclic aromatic hydrocarbons, and more exotic hazardous organic pollutants including polychlorinated biphenyls and brominated flame retardants. However, the adverse impact of MSW combustion emission on health among the general population is unknown. Therefore, a cross-sectional study was conducted to explore the associations between potential exposure to MSW combustion-related air pollution and symptoms of adverse health effects among residents of a community adjacent to a large open landfill in Lagos, Nigeria. Using ordinal logistic regression and controlling for age, sex, and smoking, it was observed that residence for ≥ 11years had increased odds (p < 0.05) of daily occurrence of tingling/numbness/whiteness of fingers (2.614), headaches (2.725), memory problems (2.869), tremor/cramps (2.748), and confusion (3.033) among other symptoms. These results indicate adverse health impacts of chronic exposure to MSW combustion emission.

Changes in extrapulmonary organs and serum enzyme biomarkers after chronic exposure to Buenos Aires air pollution.

Urban air pollution is a serious environmental problem in developing countries worldwide, and health is a pressing issue in the megacities in Latin America. Buenos Aires is a megacity with an estimated moderate Air Quality Index ranging from 42 to 74μg/m3. Exposure to Urban Air Particles from Buenos Aires (UAP-BA) induces morphological and physiological respiratory alterations; nevertheless, no studies on extrapulmonary organs have been performed. The aim of the present study was to explore the health effects of chronic exposure to UAP-BA (1, 6, 9, and 12months) on the liver, heart, and serum risk biomarkers. BALB/c mice were exposed to UAP-BA or filtered air (FA) in inhalation chambers, and liver and heart histopathology, oxidative metabolism (superoxide dismutase, SOD; catalase, CAT; lipoperoxidation, TBARS), amino transaminases (AST, ALT) as serum risk biomarkers, alkaline phosphatase (ALP), paraxonase-1 (PON-1), and lipoprotein-associated phospholipase A2 (Lp-PLA2) were evaluated. Chronic exposure to real levels of UAP in Buenos Aires led to alterations in extrapulmonary organs associated with inflammation and oxidative imbalance and to changes in liver and heart risk biomarkers. Our results may reflect the impact of the persistent air pollution in Buenos Aires on individuals living in this Latin American megacity.

Presence of the Carcinogen N'-Nitrosonornicotine in Saliva of E-cigarette Users.

Many harmful constituents are present in e-cigarettes at much lower levels than in cigarette smoke, and the results of analysis of urinary biomarkers in e-cigarette users are consistent with these findings. However, understanding the health effects of chronic exposures to e-cigarette aerosols may require thinking beyond these comparisons. In this study, we investigated the endogenous formation of the tobacco-specific oral and esophageal carcinogen N'-nitrosonornicotine (NNN) in e-cigarette users. Salivary NNN, nornicotine, and nicotine as well as urinary tobacco biomarkers, including total NNN, were analyzed in 20 e-cigarette users, 20 smokers, and 19 nonsmokers. Nornicotine and NNN levels in e-cigarettes used by the study participants were also analyzed. The mean of NNN in saliva of e-cigarette users was 14.6 (±23.1) pg/mL, ranging from nonquantifiable (below the limit of quantitation, LOQ) to 76.0 pg/mL. In smokers, salivary NNN ranged from below LOQ to 739pg/mL, with 80% of smokers having salivary NNN in the range of levels found in e-cigarette users. Consistent with a previous report, very low levels of urinary total NNN were present in only 5 out of 20 e-cigarette users (ranging from 0.001 to 0.01 pmol/mL urine). Only trace levels of NNN were found in e-cigarette liquids. Together, our findings demonstrate that NNN is formed endogenously in e-cigarette users. While the overall exposure to NNN in e-cigarette users is dramatically lower than in smokers, the known carcinogenic potency of NNN warrants further investigations into the potential consequences of its endogenous formation. Salivary NNN, rather than urinary total NNN, which accounts for only 1-3% of the NNN dose, should be used to monitor e-cigarette users' exposure to this carcinogen.

Association of Geography and Ambient Air Pollution with Urine Metal Concentrations in Six US Cities: The Multi-Ethnic Study of Atherosclerosis.

We investigated the associations of urinary concentrations of antimony, cadmium, tungsten and uranium with geographic locations and with ambient air pollution in 304 adults in the Multi-Ethnic Study of Atherosclerosis from six US cities. After adjustment for sociodemographics, body mass index, and smoking status, urinary cadmium was the highest in Winston-Salem among all study sites (the geometric mean [GM] in Winston-Salem was 0.84 µg/L [95% confidence interval (CI) 0.57–1.22]). The adjusted GMs of urinary tungsten and uranium were highest in Los Angeles (0.11 µg/L [95% CI 0.08–0.16] and 0.019 µg/L [95% CI 0.016–0.023], respectively). The adjusted GM ratio comparing fine particulate matter (PM2.5) tertiles 2 and 3 with the lowest tertile were 1.64 (95% CI 1.05–2.56) and 3.55 (95% CI 2.24–5.63) for tungsten, and 1.18 (95% CI 0.94–1.48) and 1.70 (95% CI 1.34–2.14) for uranium. The results for tungsten remained similar after adjustment for study site. Urinary cadmium, tungsten and uranium concentrations differed by geographic locations in MESA (Multi-Ethnic Study of Atherosclerosis) communities. PM2.5 levels could contribute to geographic differences in tungsten exposure. These findings highlight the need to implement preventive strategies to decrease toxic metal exposure and to evaluate the health effects of chronic exposure to those metals.

Concerted Uranium Research In Europe (Cure): Building A Collaborative Research Protocol Integrating Epidemiology, Dosimetry And Radiobiology.

Introduction The health effects of chronic exposure to uranium are not well known. Experimental studies have reported impairments of cerebral function, genotoxic, nephrotoxic and other biological effects, but the implications of these findings to human health are not clear. Most epidemiological studies carried out to date have major limitations (e.g.: dosimetry, power). New studies making use of modern biology approaches and enhanced epidemiological datasets are needed to have a higher potential to improve the characterization of the biological and health effects of uranium exposure. Methods CURE (Concerted Uranium Research in Europe) was an 18-month concerted action supported by the European Commission Network of Excellence DoReMi (http://www.doremi-noe.net/), involving 9 European Institutes. It aimed to elaborate a collaborative research project on the biological and health effects of uranium contamination, integrating epidemiology, biology and dosimetry. A work-package was dedicated to each of these di...

Hazard zoning around electric substations of petrochemical industries by stimulation of extremely low-frequency magnetic fields.

Electromagnetic fields in recent years have been discussed as one of the occupational hazards at workplaces. Hence, control and assessment of these physical factors is very important to protect and promote the health of employees. The present study was conducted to determine hazard zones based on assessment of extremely low-frequency magnetic fields at electric substations of a petrochemical complex in southern Iran, using the single-axis HI-3604 device. In measurement of electromagnetic fields by the single-axis HI-3604 device, the sensor screen should be oriented in a way to be perpendicular to the field lines. Therefore, in places where power lines are located in different directions, it is required to keep the device towards three axes of x, y, and z. For further precision, the measurements should be repeated along each of the three axes. In this research, magnetic field was measured, for the first time, in three axes of x, y, and z whose resultant value was considered as the value of magnetic field. Measurements were done based on IEEE std 644-1994. Further, the spatial changes of the magnetic field surrounding electric substations were stimulated using MATLAB software. The obtained results indicated that the maximum magnetic flux density was 49.90μT recorded from boiler substation, while the minimum magnetic flux density of 0.02μT was measured at the control room of the complex. As the stimulation results suggest, the spaces around incoming panels, transformers, and cables were recognized as hazardous zones of indoor electric substations. Considering the health effects of chronic exposure to magnetic fields, it would be possible to minimize exposure to these contaminants at workplaces by identification of risky zones and observation of protective considerations.

Extrolites ofWallemia sebi, a very common fungus in the built environment

Wallemia sebi has been primarily known as a spoilage fungus of dried, salted fish and other foods that are salty or sweet. However, this fungus is also very common in house dust. The health effects of chronic exposure to mold and dampness are known to be associated with both allergens and various inflammatory compounds, including the secondary metabolites of building associated fungi and their allergens. IgE sensitization to W.sebi has been long reported from housing and occupational exposures. However, its allergens have not been described previously. Strains from food have been reported to produce a number of compounds with modest toxicity. Strains from the built environment in Canada produced a number of metabolites including the known compound walleminone and a new compound 1-benzylhexahydroimidazo [1,5-α] pyridine-3,5-dione which we call wallimidione. Based on an in silico analysis, wallimidione is likely the most toxic of the metabolites reported to date from W.sebi. We found that the primary human antigen of W.sebi is a 47kDa excreted cellulase present in high concentrations in W.sebi arthrospores. This species is a basidiomycete and, unsurprisingly, the antigen was not found in extracts of other fungi common in the built environment, all ascomycetes.

Comparison of Geostatistical Interpolation and Remote Sensing Techniques for Estimating Long-Term Exposure to Ambient PM2.5Concentrations across the Continental United States

Background: A better understanding of the adverse health effects of chronic exposure to fine particulate matter (PM2.5) requires accurate estimates of PM2.5 variation at fine spatial scales. Remote sensing has emerged as an important means of estimating PM2.5 exposures, but relatively few studies have compared remote-sensing estimates to those derived from monitor-based data.Objective: We evaluated and compared the predictive capabilities of remote sensing and geostatistical interpolation.Methods: We developed a space–time geostatistical kriging model to predict PM2.5 over the continental United States and compared resulting predictions to estimates derived from satellite retrievals.Results: The kriging estimate was more accurate for locations that were about 100 km from a monitoring station, whereas the remote sensing estimate was more accurate for locations that were > 100 km from a monitoring station. Based on this finding, we developed a hybrid map that combines the kriging and satellite-based PM2.5 estimates.Conclusions: We found that for most of the populated areas of the continental United States, geostatistical interpolation produced more accurate estimates than remote sensing. The differences between the estimates resulting from the two methods, however, were relatively small. In areas with extensive monitoring networks, the interpolation may provide more accurate estimates, but in the many areas of the world without such monitoring, remote sensing can provide useful exposure estimates that perform nearly as well.

A RETROSPECTIVE ASSESSMENT OF OCCUPATIONAL EXPOSURE TO ELEMENTAL CARBON IN THE U.S. TRUCKING INDUSTRY

Background and Aim: Despite considerable epidemiologic evidence about the health effects of chronic exposure to vehicle exhaust, efforts at defining the extent of risk have been limited by the lack...

New Device Measures Atmospheric Isocyanic Acid

Isocyanic acid (chemically HNCO), a contaminant linked to cataracts and heart disease, has for the first time been measured in the atmosphere.1 The discovery was made by researchers at the National Oceanic and Atmospheric Administration (NOAA) who designed a new detection system to measure HNCO in environments where conventional methods could not previously detect it. Study leader James Roberts and colleagues developed a specialized negative-ion proton-transfer chemical ionization mass spectrometer to measure organic acids emitted by wildfires2 [look for more information on health effects of wildfires in the September 2011 issue of EHP]. They tested the instrument on brush and tree branches burned in a test chamber, which generated levels of HNCO reaching 600 ppbv. Next they used the device on air samples collected in Boulder, Colorado, during the 2010 Fourmile Canyon wildfire and ambient air samples collected in downtown Los Angeles, California. These samples yielded HNCO concentrations up to 200 pptv and 100 pptv, respectively. No wildfires were burning near Los Angeles at the time, so “we assume isocyanic acid came from vehicle exhaust or photochemical reactions known to make it,” Roberts says. The investigators also observed HNCO in laboratory samples of cigarette smoke but noted “the levels were too high for us to quantify with the . . . instrument configured in the ambient measurement mode.” Drawing on a surrogate pyrolysis study that found nearly all the urea in tobacco decomposes to HNCO during burning,3 the researchers calculated mainstream cigarette smoke may contain 40–140 ppmv HNCO.1 Urea is added to cigarettes to enhance flavor. Urea is also used in selective catalytic reduction systems to break down toxic nitrogen oxides (NOX) in diesel exhaust into nitrogen and water. Roberts wants to measure HNCO emitted by these systems, which the European Union mandates for heavy-duty diesel trucks; a similar law is pending in California.4 “In trying to solve the problem of NOX we could be increasing HNCO,” Roberts says. The health effects of chronic exposure to environmental HNCO are unknown, although Roberts and colleagues note the concentrations they measured in smoke “cause carbamylation at physiologically significant levels.”1 In carbamylation, cyanate binds the amino acid lysine in proteins to form homocitrulline. Stanley Hazen, section head of Preventive Cardiology and Rehabilitation at the Cleveland Clinic, found that high blood levels of homocitrulline are a strong predictor of heart disease, especially in smokers, offering a possible mechanism linking smoking to atherosclerosis.5 “We assumed the exogenous source of cyanate in our study was smoking,” Hazen says. Now Roberts’ study suggests HNCO from air pollution also may increase cardiovascular disease risk. “Any degree of carbamylation has potential to be harmful,” Hazen says, although the levels required to raise cardiac and other health risks remain to be determined.

A Retrospective Assessment of Occupational Exposure to Elemental Carbon in the U.S. Trucking Industry

Background: Despite considerable epidemiologic evidence about the health effects of chronic exposure to vehicle exhaust, efforts at defining the extent of risk have been limited by the lack of historical exposure measurements suitable for use in epidemiologic studies and for risk assessment.Objectives: We sought to reconstruct exposure to elemental carbon (EC), a marker of diesel and other vehicle exhaust exposure, in a large national cohort of U.S. trucking industry workers.Methods: We identified the predictors of measured exposures based on a statistical model and used this information to extrapolate exposures across the cohort nationally. These estimates were adjusted for changes in work-related conditions over time based on a previous exposure assessment of this industry, and for changes in background levels based on a trend analysis of historical air pollution data, to derive monthly estimates of EC exposure for each job and trucking terminal combination between 1971 and 2000.Results: Occupational exposure to EC declined substantially over time, and we found significant variability in estimated exposures both within and across job groups, trucking terminals, and regions of the United States. Average estimated EC exposures during a typical work shift ranged from < 1 μg/m3 in the lowest exposed category in the 1990s to > 40 μg/m3 for workers in the highest exposed jobs in the 1970s.Conclusions: Our results provide a framework for understanding changes over time in exposure to EC in the U.S. trucking industry. Our assessment should minimize exposure misclassification by capturing variation among terminals and across U.S. regions, and changes over time.

Pediatric Health Effects of Chronic Exposure to Extremely Low Frequency Electromagnetic Fields

Extremely low frequency electromagnetic radiation (ELF-EMR) is an omnipresent component of electricity, with a frequency of 3-30Hz, and wavelengths 3,450-5,996km long. We reviewed the scientific literature regarding pediatric health effects resulting from chronic exposure to ELF-EMR and compared these with the international safety standards. Articles published between 1980-2007 were identified using Medline, Cancerlite, Science Citation Index, and EMBASE. For the general population, the International Commission on Non-Ionizing Radiation Protection considers chronic exposure to magnetic fields lower than 100μT to be safe. However, even 0.3-0.4μT has been associated with an increased risk of acute lymphoblastic leukemia (ALL) in children. Although there is no experimental model to test the effects of ELF-EMR on organic systems, the Precautionary Principle is fundamental to the protection of children who are exposed to residential radiation doses higher than 0.3� T. 2. The International Commission on Non-Ionizing Radia- tion Protection considers chronic exposure levels lower than 100 � T as safe levels of exposure for the general population. However, the average residential exposure to magnetic field densities is � 0.3-0.4 μT and has been associated with an increased risk for developing childhood ALL. 3. The application of the Precautionary Principle is essen- tial and strongly prudent for all children who are exposed to residential radiation doses � 0.3 μT.

Disturbance of the immune system by electromagnetic fields—A potentially underlying cause for cellular damage and tissue repair reduction which could lead to disease and impairment

A number of papers dealing with the effects of modern, man-made electromagnetic fields (EMFs) on the immune system are summarized in the present review. EMFs disturb immune function through stimulation of various allergic and inflammatory responses, as well as effects on tissue repair processes. Such disturbances increase the risks for various diseases, including cancer. These and the EMF effects on other biological processes (e.g. DNA damage, neurological effects, etc.) are now widely reported to occur at exposure levels significantly below most current national and international safety limits. Obviously, biologically based exposure standards are needed to prevent disruption of normal body processes and potential adverse health effects of chronic exposure. Based on this review, as well as the reviews in the recent Bioinitiative Report [ http://www.bioinitiative.org/] [C.F. Blackman, M. Blank, M. Kundi, C. Sage, D.O. Carpenter, Z. Davanipour, D. Gee, L. Hardell, O. Johansson, H. Lai, K.H. Mild, A. Sage, E.L. Sobel, Z. Xu, G. Chen, The Bioinitiative Report—A Rationale for a Biologically-based Public Exposure Standard for Electromagnetic Fields (ELF and RF), 2007)], it must be concluded that the existing public safety limits are inadequate to protect public health, and that new public safety limits, as well as limits on further deployment of untested technologies, are warranted.