School of Public Health


Airwave Health Monitoring Study

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1. Introduction

In May 2003, the Home Office commissioned Imperial College to conduct a research program on "Airwave Health Monitoring". Airwave, the new communications system for the police service in England, Wales and Scotland, is based on Terrestrial Trunked Radio (TETRA) technology. The aim of the Airwave Health Monitoring program is to investigate any possible impact of the use of Airwave on the health of police officers and staff. The program addresses needs raised in the recent report by the National Radiological Protection Board's Advisory Group on Non-ionizing Radiation on "Possible health effects from TETRA" [].

The AGNIR experts concluded that it was unlikely that the specific features of TETRA technology could pose a risk to health, but made recommendations for further research.  Only by including large numbers of people and following their health over many years will it be possible to determine whether or not there may be a health risk associated with TETRA use. By taking part in this study, participants will be helping to further scientific knowledge on this question, which ultimately will help inform risk assessment and may benefit future users of the system.

The objectives of the research programme are as follows:

1) To pilot among police officers and staff within two police forces (West Midlands and Lancashire) the necessary procedures and mechanisms to administrate a health questionnaire, health screening and Airwave data collection for the long-term health monitoring study (see objective (3)). The pilot study will take approximately 12 months to complete.

2) To conduct an electroencephalogram and cognitive study to examine the relationship between Airwave use and psychological wellbeing, or cognitive/ neurophysiological function. The study will be based on Airwave exposure (high vs low) and symptoms (symptomatic vs asymptomatic) in three samples of police officers and staff (50 in each) recruited from the initial pilot project. This study component will commence after the pilot study. The electroencephalogram and cognitive study will take approximately 2.5 years to complete.

3) Following the pilot study, to conduct long-term health monitoring of the whole police force (England, Wales and Scotland) via the procedures developed in the pilot phase. Decisions on extending health screening to all forces will be made at the end of the pilot phase. The main health monitoring study will take approximately 12 years to complete.

2.  Background

No human epidemiological or occupational study has yet explored the possible short-term or long-term health risk associated with TETRA exposure. Of the epidemiological studies that have investigated conventional mobile phone use and health, the results so far have provided no persuasive evidence of any adverse health effect (Rothman et al. 1996, Dreyer et al. 1999, Hardell et al. 1999, Muscat et al. 2000, 2002, Inskip et al. 2001, Johansen et al. 2001). As a whole, these studies have been limited by a lack of detailed information on mobile phone use, insufficient numbers of participants (with insufficient statistical data to detect possible health effects) and various methodological drawbacks.

Relatively few occupational studies have examined the relationship between microwave radiation and health, and no large-scale study has ever been established among the police force in the UK. Table 1 (shown at the end of this document) reviews the main relevant occupational cohort studies of microwave exposure and health to date. All the studies were conducted in the US. The police cohort studies were relatively small (et al. (1990) among US Naval personnel (ca.40,000), Morgan et al. (2000) among Motorola employees (195,775) and Grayson (1996) among US Airforce personnel (880,000 at baseline) were sufficiently powered to investigate rare health outcomes. In the study of Grayson (1996) there was a small but (marginally) statistically significant association between brain tumour risk and RF/microwave exposure (OR 1.39, 95% CI 1.01 – 1.90).

Overall, most studies to date have not indicated any significant health effects in relation to GSM digital mobile phone technology. However, studies have not been conducted to investigate TETRA exposure. The current Airwave Health Monitoring Study will examine any possible impact of the use of Airwave on the health of police officers and staff and at the same time improve upon previous study designs by including (1) a longer period of follow-up with sufficient numbers of participants (and sufficient statistical data to detect possible health effects), and (2) better resolution of exposure data leading to better exposure classification.


3. Study Outline

3.1  Pilot study

One of the key parts of the program is to pilot among Airwave users within two police forces (the West Midlands and Lancashire police forces) the necessary procedures to administer a health questionnaire, health screening and Airwave data collection for short and long-term health monitoring. Following this pilot phase, the health monitoring study will be scaled up and extended to the whole of the police force (England, Wales and Scotland) using the procedures developed in the West Midlands and Lancashire forces.

The study is fully supported by management and staff associations and unions in both pilot forces, and it has been agreed that staff would be given the necessary time to participate. 

Whereas the Lancashire constabulary is currently using Airwave, it is estimated that the West Midlands force will not start using Airwave operationally until mid-2004.

For the West Midlands pilot, early in 2004, a random cross section of 1000 police officers and staff will be selected from those who are likely to be future Airwave users. Imperial College will monitor these participants before they start using Airwave to obtain baseline health information. The same people will then be re-examined after Airwave has been introduced (in the second half of 2004) to monitor health information post-Airwave use. After the pilot, Airwave Health Monitoring will be extended to the whole of the West Midlands Police user community. 

The Lancashire pilot will take place over the same time period as the West Midlands pilot. All Lancashire police officers and staff currently using Airwave will be invited to participate in the study.

The questionnaire will include questions on general health status, lifestyle and family medical history, as well as details on mobile phone use. Questions on Airwave use (e.g. position of handset, hours per week in various modes of use) will also be included for current Airwave users. The returned questionnaires will be electronically scanned and stored on secure servers at Imperial College for health analysis.

Electronic Airwave data for each participant will also be collected from monthly downloads of relevant parameters from the Airwave O2 database. This will allow the researchers to calculate each individual’s level of exposure to Airwave.

Imperial College will also provide the opportunity for those completing the questionnaire to undertake free voluntary health screening. Health screening will allow the researchers to take into account other clinical and/or lifestyle factors when estimating the possible health risks associated with long-term exposure to TETRA.  These additional factors are important for improving the risk assessment, and in helping to rule out other possible causes of ill-health and disease that may be explaining our findings. The data and subsequent research findings will also, in general, have the potential to provide vital information for improving future treatment of illness, health promotion, diagnosis and prevention of disease.

While participation in the study is voluntary, it is vital for its success that as many completed health questionnaires are returned to Imperial College as possible so that there is sufficient statistical data to detect possible health effects.

3.2  Electroencephalogram (EEG) and cognitive study

The primary aim of this part of the Airwave and Health Monitoring Study is to determine whether Airwave has any significant effect on the psychological wellbeing, or cognitive/neurophysiological function of users.

Around 150 participants will be selected after the pilot study according to their degree of Airwave exposure as assessed from Airwave records, and according to whether or not they report adverse symptoms, based on results of the initial pilot.

Effects will be determined by a provocation test conducted at Imperial College using a blinded randomized design, i.e. the participants will be assessed both with and without Airwave exposure in an order unknown to the participant. Special handsets designed for the Mobile Telecommunications Health Research Programme will be used.


3.3  Long-term health monitoring

Following the pilot study, the health monitoring study will be scaled up and extended to all police forces in England, Wales and Scotland, using the procedures developed in the West Midlands and Lancashire forces. Decisions on extending health screening to all forces will be made at the end of the pilot phase.

4. Confidentiality

The Airwave and Health Monitoring study will comply with the requirements of the Data Protection Act 1998.  The data collected will be dealt with in the strictest confidence by the Imperial College research team, and will not be passed on to the Constabulary or to the Home Office. 

Further information regarding the project can be obtained at or at the following address:

Airwave Health Monitoring Study,

Department of Epidemiology and Public Health,

Imperial College Faculty of Medicine,

Norfolk Place,


W2 1PG.

5. References

AGNIR. Possible Health Effects from Terrestrial Trunked Radio (TETRA). Report of the Advisory Group on Non-ionising Radiation. (2001) NRPB Documents Vol 12, No.2, NRPB, Chilton, Didcot, UK.

Auvinen A, Hietanen M, Luukkonen R, Koskela R-S. Brain tumours and salivary grand cancers among cellular telephone users. Epidemiology 13:356-359, 2002.

Cook CM, Thomas AW, Prato FS. Human electrophysiological and cognitive effects of exposure to ELF magnetic and ELF modulated RF and microwave fields: A review of recent studies. Bioelectromagnetics 23:144-157, 2002.

Croft RJ, Chandler JS, Burgess AP, Barry RJ, Williams JD, Clarke AR. Acute mobile phone operation affects neural function in humans. Clin Neurophysiol 2002; 113:1623-1632.

Dreyer NA, Loughlin JE, Rothman KJ. Cause-specific mortality in cellular telephone users. JAMA 282:1814-1816, 1999.

Finkelstein MM. Cancer incidence among Ontario police officers. Am J Ind Med 34:157-162, 1998.

Grayson JK. Radiation exposure, socioeconomic status, and brain tumour risk in the US Air Force: a nested case control study. Am J Epidemiol 143:480-486, 1996.

Hardell L, Nasman A, Pahlson A, Hallquist A, Hansson Mild K. Use of cellular telephones and the risk for brain tumours: A case-control study. Int J Oncol 15:113-116, 1999.

Hardell L, Hallquist A, Hansson Mild K, Carlberg M, Påhlson A, Lilja A. Cellular and cordless telephones and the risk for brain tumours Eur J Cancer Prev 11:377-386, 2002.

IEGMP. Mobile Phones and Health (2000). Independent Expert Group on Mobile Phones. ISBN 0-85951-450-1.

Inskip PD, Tarone RE, Hatch EE, Wilcosky TC, Shapiro WR, Selker RG, Fine HA, Black PM, Loeffler JS, Linet MS. Cellular-telephone use and brain tumors. N Engl J Med 344:79-86, 2001.

Johansen C, Boice J Jr, McLaughlin J, Olsen J. Cellular telephones and cancer-a nationwide cohort study in Denmark. J Natl Cancer Inst  93:203-207, 2001.

Milham S Jr. Increased mortality in amateur radio operators due to lymphatic and hematopoietic malignancies. Am J Epidemiol 127:550-554, 1998.

Morgan RW, Kelsh MA, Zhao K, Exuzides KA, Heringer S, Negrete W. Radiofrequency exposure and mortality from cancer of the brain and lymphatic/hematopoietic systems. Epidemiology 11:118-127, 2000.

Muscat JE, Malkin MG, Thompson S, Shore RE, Stellman SD, McRee D, Neugut AI, Wynder EL. Handheld cellular telephone use and risk of brain cancer. JAMA 284:3001-3007, 2000.

Muscat JE, Malkin MG, Shore RE, Thompson S, Neugot AI, Stellman SD, Bruce J. Handheld cellular telephones and the risk of acoustic neuroma. Neurology 58:1304-6, 2002.

Robinette CD, Silverman C, Jablon S. Effects upon health of occupational exposure to microwave radiation (radar). Am J Epidemiol 112:39-53, 1990.

Rothman KJ, Loughlin JE, Funch DP, Dreyer NA. Overall mortality of cellular telephone customers. Epidemiology 7:303-305, 1996.

Stang A, Anastassiou G, Ahrens W, Bromen K, Bornfeld N, Jöckel K-H. The possible role of radiofrequency radiation in the development of uveal melanoma. Epidemiology 12:7-12, 2001.

Violanti JM, Vena JE, Petralia S.  Mortality of a police cohort: 1950-1990. Am J Ind Med 33:366-373, 1998.

Table 1. Occupational studies: microwave radiation and health.





Robinette et al. (1990)

US enlisted Naval personnel; low & high exposure groups of ca.20,000 each; 1950 – 74.

Exposure from 1-5mW/ cm2. Max. exposure group (technicians) and min. exposure group (equipment operation)

Follow-up ended in 1974. Examination of hospital records, mortality & disability compensation showed no significant increase in mortality/cancer in high exposure group.

Grayson (1996)

Baseline ca.880,000 US Airforce male personnel; 1970 – 89. Within cohort: 230 cases & 920 matched controls. 

Cumulative ELF & RF/microwave radiation ascertained from job exposure matrix (JEM). Ionizing radiation from dosimeter records.

OR (ELF): 1.39 (95%CI 1.01-1.90); OR (RF/microwave): 1.28 (95%CI 0.95-1.74). Military rank associated with brain tumour risk - senior officers at highest risk cf. all other US Air Force members (age-race-adjusted OR: 3.30 (95%CI 1.99-5.45).

Milham (1998)

67, 829 men from California & Washington State: Amateur radio operators (radio licenses); 1979 – 84.

Not recorded.

No excess for combined total cancer mortality. Slight excess in deaths due to brain cancer (29 vs. 20.8 expected).

Finkelstein (1998)

Retrospective cohort: follow-up of 22,197 US police officers, Ontario; 1964 – 95.

No personal exposure assessment.

Increased incidence of testicular cancer (SIR: 1.3 (90%CI 0.9-1.8) & skin melanoma (1.45 (90%CI 1.1-1.9)). No exposure information.

Violanti et al. (1998)

Retrospective cohort: follow-up of 2,593 US police officers, Buffalo; 1950 – 90.

No personal exposure assessment.

Higher than expected mortality rates for all all-cause mortality (SMR: 1.1 (95%CI 1.04-1.17)) & all malignant neoplasms (SMR: 1.25 (95%CI 1.1-1.41)). All accidents were lower (SMR: 0.53 (95%CI 0.34-0.79)). No exposure information.

Morgan et al. (2000)

Occupational cohort. 195,775 U.S. Motorola employees; 1976 – 96.

Job exposure matrix (JEM) – each of 9,724 job titles into one of four RF exposure groups. Exposure validation study conducted to determine JEM.

SMRs: CNS/brain cancer: 0.53 (95%CI 0.21 – 1.09); all lymphomas & leukaemias: 0.54 (95%CI 0.33 – 0.83). Mobile phone use not incorporated into JEM. 




©2003 Imperial College London

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