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Front Public Health. 2014 Sep 23;2:124. doi: 10.3389/fpubh.2014.00124. eCollection 2014.

The MOBI-Kids Study Protocol: Challenges in Assessing Childhood and Adolescent Exposure to Electromagnetic Fields from Wireless Telecommunication Technologies and Possible Association with Brain Tumor Risk.

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Cancer and Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center , Ramat Gan , Israel.
Centre for Research in Environmental Epidemiology (CREAL) , Barcelona , Spain ; Universitat Pompeu Fabra (UPF) , Barcelona , Spain ; Ciber Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain.
Center for Public Health, Institute of Environmental Health, Medical University Vienna , Vienna , Austria.
Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin , Turin , Italy.
Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University , Utrecht , Netherlands.
Radio Technology Research Department, Electronics and Telecommunication Research Institute (ETRI) , Daejeon , South Korea.
Centre for Radiation, Chemical and Environmental Hazards, Public Health England , Chilton , UK.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne , VIC , Australia.
Department of Electrical Engineering, Tokyo Metropolitan University , Tokyo , Japan.
Whist Laboratory , Paris , France.
The University of Sydney , Sydney, NSW , Australia.
Telecom Institute for Child Health Research Western Australia , Perth, WA , Australia.
Clinical Institute of Neurology, Medical University Vienna , Vienna , Austria.
McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health , Ottawa, ON , Canada ; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa , Ottawa, ON , Canada.
Children's Hospital of Eastern Ontario , Ottawa, ON , Canada ; University of Ottawa , Ottawa, ON , Canada.
Ottawa Hospital Research Institute , Ottawa, ON , Canada ; Children's Hospital of Eastern Ontario Research Institute , Ottawa, ON , Canada.
Research, Prevention and Cancer Control, Cancer Care Ontario , Ontario, ON , Canada.
Cancer Control Research, British Columbia Cancer Agency , Vancouver, BC , Canada.
French National Registry of Childhood Solid Tumors, CHU , Nancy , France ; UMRS 1018, CESP, INSERM , Villejuif , France.
French National Registry of Childhood Solid Tumors, CHU , Nancy , France.
Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU) , Munich , Germany.
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens , Athens , Greece.
Centre for Cancer Epidemiology, Tata Memorial Centre , Mumbai , India.
Unit of Cancer Epidemiology, Citta' della Salute e della Scienza, University of Turin , Turin , Italy.
Neuroepidemiology Research Unit, Instituto Nazionale Neurologico C. Besta , Milan , Italy.
Unit of Occupational and Environmental Epidemiology, Institute for the Study and Prevention of Cancer , Florence , Italy.
Department of Medical and Surgical Sciences, University of Bologna , Bologna , Italy.
Department of Public Health, Tokyo Women's Medical University , Tokyo , Japan.
Department of Preventive Medicine, Dankook University College of Medicine , Cheonan , South Korea.
Department of Public Health, Graduate School of Dankook University , Cheonan , South Korea.
Centre for Public Health Research, Massey University , Wellington , New Zealand.
School of Population Health, University of Auckland , Auckland , New Zealand.
Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva , Huelva , Spain ; Ciber Epidemiología y Salud Pública (CIBERESP) , Huelva , Spain.
Cancer and Environmental Epidemiology Area, National Center for Epidemiology, Carlos III Institute of Health , Madrid , Spain ; Ciber Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain.
Ciber Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain ; Área de Medicina Preventiva y Salud Pública, Universitat de Valencia , Valencia , Spain.
Department of Paediatric Oncology, Academic Medical Center, Emma Children's Hospital, University of Amsterdam , Amsterdam , Netherlands ; Dutch Childhood Oncology Group (DCOG) , Den Haag , Netherlands.
Dutch Childhood Oncology Group (DCOG) , Den Haag , Netherlands.


The rapid increase in mobile phone use in young people has generated concern about possible health effects of exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF). MOBI-Kids, a multinational case-control study, investigates the potential effects of childhood and adolescent exposure to EMF from mobile communications technologies on brain tumor risk in 14 countries. The study, which aims to include approximately 1,000 brain tumor cases aged 10-24 years and two individually matched controls for each case, follows a common protocol and builds upon the methodological experience of the INTERPHONE study. The design and conduct of a study on EMF exposure and brain tumor risk in young people in a large number of countries is complex and poses methodological challenges. This manuscript discusses the design of MOBI-Kids and describes the challenges and approaches chosen to address them, including: (1) the choice of controls operated for suspected appendicitis, to reduce potential selection bias related to low response rates among population controls; (2) investigating a young study population spanning a relatively wide age range; (3) conducting a large, multinational epidemiological study, while adhering to increasingly stricter ethics requirements; (4) investigating a rare and potentially fatal disease; and (5) assessing exposure to EMF from communication technologies. Our experience in thus far developing and implementing the study protocol indicates that MOBI-Kids is feasible and will generate results that will contribute to the understanding of potential brain tumor risks associated with use of mobile phones and other wireless communications technologies among young people.


ELF–EMF; RF-EMF; adolescents; brain tumors; children; mobile phones

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