The rapid increase in mobile phone use in young people has generated concern about pos- sible 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 communi- cations 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 expo- sure 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 lowresponse rates among population controls; (2) investigating a young study population spanning a relatively wide age range; (3) conducting a large, multinational epidemiologi- cal 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.
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We would like to thank all of the research assistants and interviewers in the study centers for their enormous efforts to ensure that the study was carried out with care and with due consideration for the participants. All the hospital services (neurosurgery, neurology, oncology, pediatric oncology, general surgery, etc.) are gratefully acknowledged for their cooperation and collaboration in recruiting participants. We would also like to thank mobile network operators for their collaboration in this study. Finally, we would like to thank all participants and their relatives who took part in this study. We appreciate it very much. France: we would like to thank Dr. Martine Hours for her valuable advice and assistance in the implementation of the study in France. We are grateful to Dr. Luc Bauchet for supporting the implementation of the study and for helping us in the solicitation of neurosurgeons. Germany: we are very grateful to Vanessa Kiessling, Jenny Schlichtiger, and Iven-Alex Heim for their dedication to the conduct of the study in Germany.Also,wewould liketothankSusanneBrilmayer andSilke Thomas for their contribution to the planning and implementation of MOBI-Kids in Germany. India: we are deeply thankful to Dr. Rakesh Jalali for helping us with the recruitment of study participants. Italy: we thank all cooperating professionals who made this study possible, Antonio Argentino, Anna Maria Badiali, Emma Borghetti, Valentina Cacciarini, Laura Davico, Laura Fior-ini, Francesco Marinelli, Sara Piro, and Caterina Salce. Japan: we appreciate generous support and advice offered by the Japanese Epidemiological Committee. Spain: we would like to thank Carmen Caban for setting up, and Alex Albert for establishing and maintaining the complex electronic database. We are grateful to Patricia de Llobet for her valuable contribution in testing the electronic database as well as creating and updating the mobile phone database. We would also like to acknowledge Laura Argenté as project manager. Finally, we appreciate the enormous time and effort of the regional coordinators (Irene Gavidia, Eva Ferreras, Marta Cervantes, Angeles Sierra, and Angela Zumel). The Netherlands: we would like to acknowledge the following contributions: the Dutch Society for Pediatric Oncology (SKION), represented by A. Antoinette Y. N. Schouten-van Meeteren, for the support and collaboration in setting up the case–control study in The Netherlands, the Dutch Childhood Cancer Parent Organization (VOKK), represented by M. C. Naafs-Wilstra, for the collaboration in patient recruitment. Funding: the research leading to these results has received funding from by the European Community’s Seventh Framework Programme (FP7/2007–2013) under grant agreement number 22687 3 – the MOBI-Kids project. International coordination of the project is partly supported by a grant from the Spanish Ministry of Science and Innovation (MICCIN). Australia: Australian participation in MOBI-Kids is supported by the Australian National Health and Medical Research Council with a five-year research grant (grant number: 546130 and Chief Investigators are: Malcolm R. Sim, Bruce Armstrong, Elizabeth Milne, and Geza Benke). Austria: Austrian participation in MOBI-Kids is partly supported by a grant from the Ministry of Science. Canada: Canadian participation in MOBI-Kids is supported by a university– industry partnership grant from the Canadian Institutes of Health Research (CIHR), with the Canadian Wireless Telecommunications Association (CWTA) serving as the industrial partner. CWTA provides technical information on wireless telecommunications in Canada and facilitates access to billing records from Canadian network operators, but has no involvement in the design, conduct, analysis, or interpretation of the MOBI-KIDS study. Health Canada has also provided financial support to facilitate coordination between Canadian and international MOBI-Kids investigators. Daniel Krewski is the Natural Sciences and Engineering Research Council of Canada Chair in Risk Science at the University of Ottawa. France: this project received funds from the French National Agency for Sanitary Safety of Food, Environment and Labour (ANSES, contract FSRF 2008-3), French National Cancer Institute (INCa), Pfizer Foundation and League against cancer. Germany: the German branch of MOBI-Kids is supported by the Federal Office for Radiation Protection. Greece: Greek participation is partially supported by ELKE (Special Account for Research Grants of the National and Kapodistrian University of Athens) and GGET (General Secretariat for Research and Technology). India: MOBI-Kids India is supported by the Board of Research in Nuclear Sciences (BRNS). Italy: Ministry of Health RF-2009-1546284. Japan: Japanese participation in MOBI-Kids is supported by the Ministry of Internal Affairs and Communications. Korea: MOBI-Kids Korea is financially supported by the Ministry of Science, ICT and Future Planning (MSIP), Korea in the ICT R&D Program. New Zealand: MOBI-Kids New Zealand is supported by grants from Cure Kids New Zealand and the New Zealand Health Research Council. Spain: Spanish participation is partially supported by the Spanish Health Research Fund (FIS PI10/02981), the Andalusian Consejeria de Salud (PI-0317/2010) and Conselleria de Sanitat, Generalitat Valenciana under grant number 025/2010. The Netherlands: Dutch participation in MOBI-KIDS is partly supported by The Netherlands Organisation for Health Research and Development (ZonMw) within the program Electromagnetic Fields and Health Research under grant number 85800001, and by the ODAS foundation, a private foundation supporting activities in the field of pediatric oncology and visual disabilities.