SCAMP: Study of Cognition, Adolescents, and Mobile Phones

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Datasets: − Bridge file: Hospital Episode Statistics to Diagnostic Imaging Dataset; − Bridge file: Hospital Episode Statistics to Mental Health Minimum Data Set

Objective for processing

In the UK, approximately 70% of 11-12 year old children own a mobile phone. However, scientists remain uncertain as to whether children’s developing brains might be more vulnerable than adults to radio frequency electromagnetic field (RF-EMF) exposure. Imperial College London (ICL) requires access to NHS England data for the purpose of the following research project: Study of Cognition, Adolescents, and Mobile Phones (SCAMP). Imperial College London is the sole data controller for the Study of Cognition, Adolescents, and Mobile Phones (SCAMP). SCAMP is a prospective cohort study which aims to address current scientific uncertainties by investigating whether the use of mobile phones and/or other technologies that use radio waves e.g. portable landline phones and wireless internet, might affect adolescents cognitive (e.g. language comprehension, memory, attention) or behavioural development (e.g. anxiety and hyperactivity), as well as exploring wider health outcomes. The following is a summary of the aims of the research project provided by Imperial College London: Baseline and Follow-up Assessments consist of standardised neurocognitive tests, validated behavioural screening scales and questionnaires. In addition, a broad range of information is being collected from children and parents on their health, lifestyle, social and physical environments via school- and home-based questionnaires. Parents are invited to provide consent for their child’s school assessment data to be linked with their child’s routine records including mobile traffic data, health data and educational data. Biological samples (e.g. urine, saliva) are being collected in a subset of SCAMP participants to provide additional information about potential con founders such as puberty. A Radio Frequency (RF) personal monitoring study is also being conducted in a subset of the cohort when they are in Year 8 (aged 12-13) to gain an in-depth understanding of children’s personal RF exposure and the relative contribution of each RF source. In the UK, 70-80% of 11-12 year olds own a mobile phone. Scientists remain uncertain as to whether children’s developing brains might be more vulnerable than adults to radio wave exposures emitted from mobile phone and other wireless devices. SCAMP is the first research project aiming to answer this important question. Technologies that use radio waves e.g. portable landline phones and wireless internet, might affect children’s health including neurocognitive or behavioural development e.g. memory, problem solving skills. The SCAMP study has already recruited and gathered baseline data from ~7,000 Year 7 pupils (age 11-12 years) from 39 schools across London. Follow-up took place for the pupils in Year 9 and 10 (age 13-15 years). SCAMP is a prospective cohort study which aims to address current scientific uncertainties by investigating whether the use of mobile phones and/or other technologies that use radio waves e.g. portable landline phones and wireless internet, might affect adolescents cognitive (e.g. language comprehension, memory, attention) or behavioural development (e.g. anxiety and hyperactivity), as well as exploring wider health outcomes. Of the ~7,000 participating pupils (currently aged 15-17 years), SCAMP has received consent from pupils aged 15+ years and their parents for ~2500 pupils authorising SCAMP to access their routine health data from NHS Digital to be used for research purposes. This Agreement is limited to the data of SCAMP participants who are aged 16 or older and who have given informed consent. Imperial College London must not supply identifying details of any other participants and is not permitted to receive data relating to participants who do not meet this criteria under this Data Sharing Agreement. With nearly a decades-worth of research, SCAMP has entered its “second wave”, with the focus on investigating how digital technology use, cognition, physical activity, and sleep have an impact on young people’s mental health when they move into higher education or get their first job. A new cohort of sixth-form students (aged 16-18 years) have joined since Nov 2022. Organisations involved: The following NHS England Data will be accessed: 1) Imperial College London are listed as sole data controller for this study for the following reasons: • Hospital Episode Statistics Admitted Patient Care, Critical Care, Outpatients – necessary to allow the study to perform statistical analysis to enable the study to investigate whether a link exists between mobile phone use (and other environmental exposures such as air pollution, noise and light) and neurocognitive and behavioural development outcomes, and to explore the possible implications of these exposures and new emerging technologies on wider health outcomes. - The PI is employed solely by Imperial College • Emergency Care Data Set (ECDS) – necessary to allow the study to perform statistical analysis to enable the study to investigate whether a link exists between mobile phone use (and other environmental exposures such as air pollution, noise and light) and neurocognitive and behavioural development outcomes, and to explore the possible implications of these exposures and new emerging technologies on wider health outcomes. - The PI is responsible for undertaking all decisions pertaining to the collection and processing of the data under this Agreement. • Diagnostic Imaging Dataset (DID) – necessary because this will include data appertaining to brain scans due to concussion or injury to the head, or even due to brain cancers. When combined with the study's other data, such scans would provide vital information to account/adjust for when analysing the relationship between mobile phone use and any health outcomes related to healthy brain function or neurological development. 2) The Swiss Tropical and Public Health Institute (Swiss TPH) are collaborators for the study; they undertook analysis of data from the validation study. The validation study is a sub-study on ~200 SCAMP participants to assess total RF-EMF body exposure and the relative contribution of each RF-EMF source. This validation used only data collected from participant questionnaires. Record-level NHS Digital data are not required for data analysis of the validation study. Swiss TPH will only access aggregated data with small numbers suppressed in line with NHS Digital guidelines. Swiss TPH do not determine the purpose of the study or the manner in which the data is processed, as described in this Agreement. • Mental Health – necessary because where mental health datasets cover outpatient and community services, this is instrumental for the aim of investigating the impact of Radiofrequency Electromagnetic Fields (RF-EMF) and mobile phone use (and other environmental variables) on adolescent mental health. Those receiving treatment in hospital will often be the most extreme cases and will over represent particular mental health problems, whereas these datasets will tell us any and all members of the cohort that have received NHS mental health services. It is also hugely important that researchers can look at clinical outcomes closely and accurately, thus creating research that convincingly evaluates and demonstrates the role of the environment in mental health outcomes. 3) Steering Group: • Civil Registration Mortality – necessary because in the unlikely event that a participant passes away during the course of the study, it is important that the study is notified of this to ensure that the participant’s family are not contacted regarding study developments. In addition, it is important to know the cause of death so that this can be taken into account during analysis and the potential contribution of exposure to radio frequency sources and/or other environmental exposures can be explored. The Deputy Director of the Institute of Cognitive Neuroscience at University College London will chair the Steering Group with four additional members. The four members will comprise expertise in EMF, epidemiology, EMF exposure assessment, neurocognitive functioning in adolescents (in particular executive function) and in education/school-based research. They will be selected from across Europe. The committee will meet twice per year and will provide guidance and feedback on key scientific issues e.g. selection of cognitive tests for web-based assessment. The committee do not have access to any study data or data requested under this Agreement. They may access any published results at an aggregated level (with small numbers suppressed). The steering group are not responsible for any decisions regarding the data collected or processed for the study and are purely there in an advisory compacity. • Cancer Registration – necessary to allow the researchers' to perform statistical analysis to enable SCAMP to investigate whether a link exists between mobile phone use (and other environmental exposures such as air pollution, noise and light) and cancer in young people. In addition, cancer data information is important since such diagnoses could impact upon the child’s behavioural, cognitive or educational development, which are primary outcomes of interest in SCAMP. This Agreement is to request bespoke data linkage of the SCAMP cohort to HES Admitted Patient Care, HES Critical Care, HES A&E, HES Outpatient, ECDS, DIDs, mental health, and birth data plus patient tracking to deaths and cancers for the purpose of academic research. SCAMP is an observational study, with no clinical intervention. Data requested from NHS Digital will be used for research purposes only. • Demographics – necessary because to allow the researchers to have participants’ up-to-date addresses to accurately estimate individual-level environmental exposure such as air pollution, noise, and access to green and blue spaces. In addition, it allows the researchers to contact participants via mailing. Data will be requested from as early as 2002 where available, in order to include data for each participant from when they were born (the oldest participant was born in 2002). This will enable researchers to identify any pre-existing conditions so as to compare participants' health before and after mobile phone exposure. • Birth notification - Access to participants’ birth addresses will allow researchers to model and predict prenatal pollution exposure, and see if this has an impact on cognitive and mental health outcomes. Other factors such as birth weight, gestational length, birth complications, the number of previous children, age of mother, multiple births, and parents' demographic information, may prove to be effect modifiers. This will result in high quality epidemiological research outputs evaluating the relationship between air pollution exposure and cognitive and mental health outcomes in young people, with potentially vital public health policy implications. The study requires HES data linked to cohort participants for all requested years as on the following basis: The level of the Data will be: For prospective epidemiological analyses: • Identifiable – necessary to enable linkage of the data with data collected from other sources, including the participants themselves. HES data provides a more comprehensive medical history, providing information on underlying conditions and treatment of these conditions. SCAMP requires HES data linked to cohort participants for all requested years to allow the study to perform statistical analysis to enable the study to investigate whether a link exists between mobile phone use (and other environmental exposures such as air pollution, noise and light) and neurocognitive and behavioural development outcomes, and to explore the possible implications of these exposures and new emerging technologies on wider health outcomes. The Data will be minimised as follows: The study requires mortality data linked to cohort participants on the following basis: • Limited to a study cohort identified by Imperial College London– This is estimated to be 4,500 and will not exceed 5,000. Ages ranging from 16 to 24. In the unlikely event that a participant passes away during the course of the study, it is important that the study is notified of this to ensure that the participant’s family are not contacted regarding study developments. In addition, it is important to know the cause of death so that this can be taken into account during analysis and the potential contribution of exposure to radio frequency sources and/or other environmental exposures can be explored. • Limited to data from 2002- latest available The study requires cancer data linked to cohort participants for all requested years as on the following basis: • Limited to the following geographic areas: England – all participant involved in the study were recruited from Greater London SCAMP requires cancer data linked to the cohort participants for all requested years to allow the researchers' to perform statistical analysis to enable SCAMP to investigate whether a link exists between mobile phone use (and other environmental exposures such as air pollution, noise and light) and cancer in young people. In addition, cancer data information is important since such diagnoses could impact upon the child’s behavioural, cognitive or educational development, which are primary outcomes of interest in SCAMP. Imperial College London is the research sponsor and the controller as the organisation responsible for ensuring that the Data will only be processed for the purpose described above. The study requests the inclusion of diagnostic imaging data (DIDs) as this will include data appertaining to brain scans due to concussion or injury to the head, or even due to brain cancers. When combined with the study's other data, such scans would provide vital information to account/adjust for when analysing the relationship between mobile phone use and any health outcomes related to healthy brain function or neurological development. The lawful basis for processing personal data under the UK GDPR is: The study requires mental health data linked to cohort participants for all requested years as on the following basis: Article 6(1)(e) - processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller; Where mental health datasets cover outpatient and community services, this is instrumental for the aim of investigating the impact of RF-EMF and mobile phone use (and other environmental variables) on adolescent mental health. Those receiving treatment in hospital will often be the most extreme cases and will over represent particular mental health problems, whereas these datasets will tell us any and all members of the cohort that have received NHS mental health services. It is also hugely important that researchers can look at clinical outcomes closely and accurately, thus creating research that convincingly evaluates and demonstrates the role of the environment in mental health outcomes. The lawful basis for processing special category data under the UK GDPR is: The study requires birth data linked to cohort participants as on the following basis: Article 9(2)(j) - processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes in accordance with Article 89(1) based on Union or Member State law which shall be proportionate to the aim pursued, respect the essence of the right to data protection and provide for suitable and specific measures to safeguard the fundamental rights and the interests of the data subject. Imperial College London previously requested participants' NHS number in order to send to ONS for birth data linkage. Given that birth data products (e.g. Births Registration and Births Notification) are now held by NHS Digital, the data controller requests the following birth data linked to the cohort participants: The SCAMP team is dedicated to protecting the confidentiality of the data of study participants. Only appropriately minimised, pseudonymised subsets of health data are requested for conducting scientific analysis. The data requested under this Agreement is the least obtrusive way of obtaining the required data. - Residential address at birth The funding is provided by the Medical Research Council (MRC). The funding is specifically for the study described. The funder will have no ability to suppress or otherwise limit the publication of findings. - Birth weight A Public and Patient Involvement and Engagement group helped refine the purpose of the research. The SCAMP Young People’s Advisory Group (YPAG) and cohort ambassadors have been established as a route for co-design of the research and engagement in translation and dissemination of study findings in a way that is understandable and relevant to young people. In 2022, SCAMP launched the Research Challenge programme, where a small team of Year 12 students at each school were trained by SCAMP staff to organise data collection at their school, and design and pitch their own research questions using SCAMP data. - Baby complications at birth - Birth order - The interval between participants' birth and any previous births - Multiple births (e.g. twins, triplets, etc) - Gestational length of mother - Parents' age - Parents’ place of birth - Parents’ marital status - Parents' occupation and employment status Access to participants’ birth addresses will allow researchers to model and predict prenatal pollution exposure, and see if this has an impact on cognitive and mental health outcomes. Other factors such as birth weight, gestational length, birth complications, the number of previous children, age of mother, multiple births, and parents' demographic information, may prove to be effect modifiers. This will result in high quality epidemiological research outputs evaluating the relationship between air pollution exposure and cognitive and mental health outcomes in young people, with potentially vital public health policy implications. A detailed justification for requesting each maternity/birth data field is as follows: MOTHER_OCCUPATION, MOTHER_NSSEC, MOTHER_SOC: These three variables are indicative of various aspects of maternal socioeconomic status, which are needed to account for when analysing the relationships between environmental exposures and psychological outcomes. Further, the study team have data for maternal occupation in secondary school, so it will tell researchers if there has been a change in a family's circumstances from early life to adolescence, which is important to evaluate the impact of early life experiences including socioeconomic circumstances. Mother’s occupation will additionally tell the study team about potential occupational exposures the parents are subject to, potentially impacting their health and psychological outcomes and thus the health and psychological outcomes of their children. FATHER_OCCUPATION, FATHER_NSSEC, FATHER_SOC: These three variables are indicative of various aspects of paternal socioeconomic status, which the study team need to account for when analysing the relationships between environmental exposures and psychological outcomes. Further, the study team have data for paternal occupation in secondary school, so it will tell the study team if there has been a change in a family's circumstances from early life to adolescence, which is important to evaluate the impact of early life experiences including socioeconomic circumstances. Father’s occupation will additionally tell the study team about potential occupational exposures the parents are subject to, potentially impacting their health and psychological outcomes and thus the health and psychological outcomes of their children. MOTHER_DOB (month and year): We require the age of mother in years and months at the time of the birth record. Age of mother at the time of the child’s birth is associated with a range of psychiatric and developmental outcomes; the research questions pertain to the environmental exposures young people are subject to including in early life and their psychological outcomes therefore mothers age is an important covariate we need to account for when analysing the relationships between environmental exposures and psychological outcomes. FATHER_DOB (month and year): the study team require the age of father in years and months at the time of the birth record. As paternal age at birth is related to many of the health, social, and psychiatric outcomes the study team are investigating, it is an important covariate the study team need to account for when analysing the relationships between environmental exposures and psychological outcomes. MOTHER_POB,  MOTHER_CCPOB (either/or, country of birth of mother): the study team require either field, which tells us the country of birth of the mother (the data could be reduced to just contain this information). As immigration status and generation is related to certain psychological outcomes (e.g., psychosis), it is an important sociodemographic consideration when modelling how exposure to air pollution, noise and radiation relate to later mental health and cognition. FATHER_POB, FATHER_CCPOB: (either/or, country of birth of father): the study team require either field, which tells us the country of birth of the father (the data could be reduced to just contain this information). Immigration status and generation is related to certain psychological outcomes (e.g., psychosis), therefore it is an important sociodemographic consideration when modelling how exposure to air pollution and noise relate to later mental health and cognition. BIRTH_INMARRIAGE: Whether parents are married and whether they are cohabiting at birth is associated with a range of birth, health, developmental, and psychological outcomes, which are associated with our main outcomes of adolescent mental health and cognition. Therefore, this is an important consideration when evaluating how various environmental characteristics in early life are associated with psychological development. BABY_BIRTH_DATE:  the study team require baby birth date in order to confirm existing data on age/DOB and fill in missing data where the study team don't have this. As well as being a standard covariate in epidemiological studies, age is an important factor contributing to cognition and mental health as these are developmental questions. The study team need the precise date of birth because this is crucial to assign time-specific and temporally varying air pollution exposures relating to the prenatal exposure window. The prenatal exposure window is short, and accuracy in temporal assignment is very important to avoid exposure misclassification, which is why exact birth date is required. Birth date is also required to adjust for birth season when analysing the relationships between air pollution exposures and health outcomes. BABY_SEX : the study team require baby sex in order to confirm existing data on sex and fill in missing data, and also elucidate if participants sex assigned at birth is the same or different to their gender in teenage years. This is because sex and gender are important covariates for health and mental health questions. BIRTH_WEIGHT: the study team require birth weight because it is associated with a range of mental health and health outcomes, and some of the exposures (air pollution) we are interested in. Therefore, to answer our research questions adequately the study team need to control for this. It could also be a mechanism through which there exists a relationship between exposure to air pollution and psychological outcomes, which is important to investigate. GESTATION: the study team require gestation for similar reasons to birth weight; early gestation is associated with exposure to air pollution and developmental outcomes. Therefore, we need to adjust for gestation when assessing the relationships between the environment and psychological outcomes and is crucial for us to comprehensively answer these research questions. CONGENITAL:  the study team require data on congenital disorders because they are related to adverse environmental exposures prenatally, and to health and psychological outcomes in later life. Therefore, the study team need to adjust for congenital disorders when assessing the relationships between the environment and psychological outcomes. BABY_ETHNICITY: the study team require the field of baby ethnicity because ethnicity is an important covariate in epidemiological questions and could be a confounder of the relationships between exposure to environmental stressors and psychological outcomes. It could also modify these relationships, acting as a vulnerability factor. This data will also help validate existing cohort data from adolescence and fill in missing data. BABY_USUAL_ADDRESS_1 BABY_USUAL_ADDRESS_2 BABY_USUAL_ADDRESS_3 BABY_USUAL_ADDRESS_4 BABY_USUAL_ADDRESS_5 BABY_USUAL_POSTCODE BABY_DISCHARGE_ADDRESS_1 BABY_DISCHARGE_ADDRESS_2 BABY_DISCHARGE_ADDRESS_3 BABY_DISCHARGE_ADDRESS_4 BABY_DISCHARGE_ADDRESS_5 BABY_DISCHARGE_POSTCODE The study team need the exact early life address of the child in order to accurately model early life exposure to noise, air pollution and radiation, so the study team can answer the questions of whether these exposures are related to adolescent psychological outcomes. This must be the exact flat or door number so that the study team can ascertain the building type (which affects the permutation of noise and air pollution indoors to expose residents). MOTHER_ADDRESS; MOTHER_FLAT_NUMBER MOTHER_BUILDING_OR_HOUSE MOTHER_BUILDING_NAM MOTHER_LINE_1 MOTHER_LINE_2 MOTHER_LINE_3 MOTHER_LINE_4 MOTHER_TOWN MOTHER_COUNTY MOTHER_POSTCODE MOTHER_STAT_POSTCODE In order to accurately model prenatal exposure to environmental exposures such as noise, air pollution, radiation, and answer the questions of how these exposures affect later psychological outcomes, the study team need to be able to geocode the prenatal residence of the mother and be able to ascertain the exact building type (which affects the permutation of noise and air pollution indoors to expose residents). POB_COMMEST, POB_ESTTYPE: Birth place factors (e.g. hospital setting vs home birth, hospital type) may impact on birth outcomes, and their sequelae, which may impact on psychological outcomes. These may be important explanatory factors to understand, and account for when analysing birth data. ORG NAME, ORG_CODE, ORG_TYPE_CODE: Hospital of birth reflects hospital area with spatial variation in air pollution. The study team need to adjust for the hospital clustering effect when analysing the relationships between environmental exposures and psychological outcomes. MOTHER_PREVLIVECHILD, MOTHER_PREVSBCHILD, NUM_BIRTHS, NUMBER_LIVE_BIRTHS, NUMBER_STILL_BIRTHS, MOTHER_TOTALBIRTHS: Mother’s reproductive/pregnancy history is a risk factor for adverse birth outcomes, e.g. low birth weight, and their sequelae, which may impact on psychological outcomes. The study team need to account for mother’s reproductive/pregnancy history when analysing the relationships between environmental exposures and psychological outcomes. MULTIPLE_INDICATOR, MULTIPLE_TYPE: Multiple birth is a risk factor for adverse birth outcomes, e.g. low birth weight, and their sequelae, which may impact on psychological outcomes. The study team need to account for multiple birth when analysing the relationships between environmental exposures and psychological outcomes. BIRTH ORDER: Parity (i.e. birth order) is a risk factor for adverse birth outcomes, e.g. low birth weight, and their sequelae, which may impact on psychological outcomes. The study team need to account for parity when analysing the relationships between environmental exposures and psychological outcomes. The objectives for processing of the data are therefore: 1.To provide additional information about a child’s health status e.g. establishing accurate diagnosis for autistic spectrum disorders, Attention deficit hyperactivity disorder (ADHD), or any other psychological or psychiatric referrals, and/or cancer diagnoses and treatments (which could impact upon the child’s behavioural, cognitive or educational development) that may have occurred either prior to establishing the cohort or afterwards. 2.To enable epidemiological and statistical analyses on mobile phones and other RF exposures and a wide range of health outcomes 3. To conduct epidemiological analyses on other environmental exposures (e.g. noise, air pollution) and health outcomes. 4.To maintain contact throughout the course of the study. Data will be restricted to only those consenting participants within the study cohort (to date SCAMP have parental consent and consent from pupils aged 16+ years to access the routine records, including health data, of ~2,500 SCAMP pupils). SCAMP have requested all the datasets and have not restricted the data request to specific health outcomes since SCAMP is a prospective cohort investigating the potential impact of mobile phone use, other radio frequency wave sources, and other environmental exposures (e.g. noise, air pollution) on health. SCAMP is therefore undertaking ‘health surveillance’ in response to these environmental exposures and new emerging technologies. Parents were provided with study invitation materials and information packs, all of which had been user-tested to ensure that information provided and consent methods were comprehensible. All pupils in Year 7 from a participating SCAMP school took part in the SCAMP school-based computer assessment unless their parents informed the school/the SCAMP team otherwise. Parents were invited to provide additional and optional ‘opt-in’ consent for SCAMP to access their child’s routine records, including health data, and link these to their child’s school assessment data. This research will enable review of current UK health policy precautionary advice to limit children’s mobile phone use. With an improved understanding of UK children’s radio frequency exposures from mobile phones and other radio frequency technologies, specific ways to reduce exposure levels may be identified to provide targeted advice to parents and children as appropriate. The data requested is limited to the cohort, and to that required for currently planned and envisaged analyses. The data controller has only requested those data required in order to effectively meet the study needs and the SCAMP team cannot further minimise the scope or the amount of the data requested as it might affect achievements of the project. Article 89(1) of the GDPR requires that when processing special categories of personal data for scientific research: “…safeguards shall ensure that technical and organisational measures are in place in particular in order to ensure respect for the principle of data minimisation. Those measures may include pseudonymisation provided that those purposes can be fulfilled in that manner. Where those purposes can be fulfilled by further processing which does not permit or no longer permits the identification of data subjects, those purposes shall be fulfilled in that manner.” The SCAMP team is dedicated to protecting the confidentiality of the data of study participants. Only appropriately minimised, pseudonymised subsets of health data are requested for conducting scientific analysis, thus complying with Art. 89(1) of the GDPR. The data requested under this Agreement is the least obtrusive way of obtaining the required data. The data are requested in the public interest under GDPR Article 6(1)(e), as the outcomes of this research will influence guidance on mobile phone usage in the general public. This is Special Category data for the purposes of research and therefore Article 9(2)(j) will also apply. Funding is provided by National Institute of Health Research (NIHR) and is in place until 31st December 2021. NIHR make no decisions regarding the collation or dissemination of data under this Agreement and will only receive aggregated outputs (with small number suppressed). Data will be stored in line with Imperial College London's data retention policy for 10 years upon completion of the project. This has been communicated to participants in the Privacy Notice and HRA Transparency statement.

Processing activities

All organisations party to this Agreement must comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract i.e.: employees, agents and contractors of the Data Recipient who may have access to that data). Imperial College London will transfer data to NHS England. The data will consist of identifying details (specifically NHS Number, Date of Birth, Postcode, Gender and a unique person ID) for the cohort to be linked with NHS England data. There will be no data linkage undertaken with NHS Digital data provided under this Agreement that is not already noted in the Agreement. NHS England will provide the relevant records from the HES Admitted Patient Care, Critical Care, Outpatient, Emergency Care Dataset, DIDs, mental health, Cancer registrations, Demographics and Birth notification datasets to Imperial College London. This Agreement is to request bespoke data linkage of the SCAMP cohort to HES Admitted Patient Care, Critical Care, A&E, Outpatient, ECDS, DIDs, mental health, and birth data plus patient tracking to deaths and cancers for the purpose of academic research. The Data will 1) The following cohort identifiers will be sent from Imperial College London to NHS Digital: • contain directly identifying data items including Names, NHS Number, Date of Birth, Postcode, Gender which are required to link the Data at record level with data already held by the recipient NHS number The Data will not be transferred to any other location. Gender ICL uses offsite data centre services provided by VIRTUS data centre. VIRTUS does not have access to the data. Postcode The Data will be accessed by authorised personnel via remote access. Date of Birth The Controller(s) must confirm and provide evidence upon audit by NHS England that access via any remote device complies with the data security obligations within this DSA and the Data Sharing Framework Contract. Study ID For remote access: 2) NHS Digital will run these identifiers through the Demographics database to: - Remote access will only be from secure locations situated within the territory of use (as further restricted elsewhere within the DSA if so done) stated within this DSA; a) retrieve any missing identifiers (NHS numbers, DOB, Postcode, Address) and - Access controls granting users the minimum level of access required are in place; b) update the cohort to the latest data for these variables. Automatic and manual matching will be carried out. - Remote access is only via secure connections (e.g., VPNs or secure protocols) to protect data; 3) The cleaned cohort will then be linked to HES Admitted Patient Care, Critical Care, Outpatient, Accident & Emergency data, Emergency Care Dataset, DIDs, mental health, and birth data. - Multifactor authentication (MFA) is required for remote access; The sensitive and identifiable outputs will be returned to Imperial College London. The datasets will then be provided on an annual basis for the duration of this Agreement. - Device security, including up-to-date software and operating systems, antivirus software, and enabled firewalls are utilised for the remote access; Health event/mortality data supplied by NHS Digital will be linked by Imperial College London, using a randomly assigned unique ID number for each participant, to other SCAMP school assessment data and any other data to allow epidemiological analyses of exposure and cognitive and behavioural outcomes. - All remote access is undertaken within the scope of the organisation’s DSPT (or other security arrangements as per this DSA) and complies with the organisation’s remote access policy. Any personal identifiers such as Name, Address, Postcode that are supplied by NHS Digital, will be stored separately from health data. Access to personal identifying information is limited to the database team at Imperial College London, who have all signed strict non-disclosure agreements. The above applies in addition to any condition set out elsewhere within the DSA (e.g. who may carry out processing, and for what purpose). Name, Address, Postcode are required to verify quality of matching, to improve quality of demographic data, and to ascertain any change in detail over the course of this longitudinal study. Over time, these personally identifiable data fields from ‘Latest Patient Information’, which Imperial College London are requesting as part of ‘Patient Tracking’, may become the most up to date records as the study progresses. The Data will not leave England at any time. Should the study find from the data that the SCAMP study participants’ details have changed, they may use updated names and addresses provided by NHS Digital to re-contact study subjects. No data provided under this Agreement is shared with any of the mobile phone companies. Where data is shared, this is data which was sourced at consent and written agreements to ensure confidentiality and non-disclosure of data are in place between Imperial College London and mobile phone network operators. Imperial Collage London have ethical approval to use the personally identifiable data fields (Name, Address, Postcode) from ‘Latest Patient Information’ for all the purposes stated above. Access is restricted to employees or agents of Imperial College London who have authorisation from the Principal Investigator. It is important to note that the SCAMP researchers and the database where the data under this Agreement are received and processed, are kept separate. On receipt of the datasets from NHS Digital, the SCAMP Database Manager will separate identifiable data for individuals from their health data, by the use of pseudonyms and records identifiers. The SCAMP study researchers then receive this pseudonymised dataset for the purpose of performing statistical analysis for research purposes only. Researchers therefore only have access to pseudonymised data. All personnel accessing the Data have been appropriately trained in data protection and confidentiality. Access to personal or identifiable personal data requires the use of specialised coding, which is limited to a limited number of specified staff within the Department, who (for example) may need to check back with raw data provided, for the purpose of ensuring that a participant is accurately identified and linked to their personal information. The Data will be linked at person record level with other SCAMP school assessment data to allow epidemiological analyses of exposure and cognitive and behavioural outcomes. Data will only be accessed and processed by substantive employees of Imperial College London and will not be accessed or processed by any other third parties not mentioned in this Agreement. There will be no requirement and no attempt to reidentify individuals when using the Data. No record level data will be shared outside of the study research team at Imperial College London. Any data shared will only consist of aggregated data with small number suppressed in line with HES Analysis guidelines. The identifying details will be stored in a separate database to the linked dataset used for analysis. All analyses will use the pseudonymised dataset. There will be no requirement and no attempt to reidentify individuals when using the pseudonymised dataset. When a participant wishes to withdraw from the study, the study team would not be able to remove data from analyses that has already  been  completed. Instead, the data in the Masterfile will be anonymised by erasing all personally identifying information linked to the research data. Personal identifiers stored in secure archives (i.e. Consent form) may remain for the lifetime of the project but will not be used again. Researchers from Imperial College London will analyse the Data for the purposes described above.

Expected output

To ensure dissemination to a wide academic audience, the findings of this research will be published in high-impact, peer-reviewed, international journals and will be presented at national and international conferences spanning education, neurocognitive science, toxicology and environmental epidemiology. The expected outputs of the processing will be: The findings will also be disseminated among wider stakeholders via the MRC Centre for Environment & Health’s Community Advisory Board (CAB) – comprising Non Government Organisation (NGOs), politicians, and representatives of press and industry – and Outreach Committee, which will facilitate public and school engagement with the proposed research. • Submissions to peer reviewed journals At the end of the SCAMP study, the team will hold a presentation evening for the • Presentations to head teachers of all participating schools and significant stakeholders, with live video [11 words unchanged] parents throughout, and a video podcast made available on the study website. The study team recently published several papers covering a wide range of topics including cohort profile, exposure validation, night-time screen-based device use in relation to sleep and quality of life, and social network use in relation to behavioural difficulties and quality of life. Details of these papers can be found here: • Presentations to the MRC Centre for Environment & Health’s Community Advisory Board (CAB) – comprising Non Government Organisation (NGOs), politicians, and representatives of press and industry – and Outreach Committee, which will facilitate public and school engagement. https://www.sciencedirect.com/science/article/pii/S001393511731664X • Presentations at appropriate conferences spanning education, neurocognitive science, toxicology and environmental epidemiology https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyy192/5132994. Public event- Presentations to head teachers of all participating schools and significant stakeholders, with live video feed via the study website, live Twitter feed allowing questions from parents throughout, and a video podcast made available on the study website. https://www.sciencedirect.com/science/article/pii/S0160412018312418?via%3Dihub • Briefing documents provided to the MRC Centre for Environment & Health’s Community Advisory Board (CAB) – comprising Non Government Organisation (NGOs), politicians, and representatives of press and industry – and Outreach Committee, which will facilitate public and school engagement. https://www.sciencedirect.com/science/article/pii/S0747563220300741 The outputs will not contain NHS England Data and will only contain aggregated information with small numbers suppressed as appropriate in line with the relevant disclosure rules for the dataset(s) from which the information was derived. All outputs will contain only data that is aggregated with small numbers suppressed in line with the HES Analysis Guide.

Expected measurable benefits

In the UK, 70-80% of 11-12 year olds own a mobile phone. Scientists remain uncertain as to whether children’s developing brains might be more vulnerable than adults to radio wave exposures emitted from mobile phone and other wireless devices. SCAMP is the first research project aiming to answer this important question. Technologies that use radio waves e.g. portable landline phones and wireless internet, might affect children’s health including neurocognitive or behavioural development e.g. memory, problem solving skills. By linking a child's mobile usage data with their educational records and health data from NHS Digital, researchers hope to be able to determine the effects of using mobile devices during adolescence on long term health outcomes. [2 paragraphs unchanged] The results of the studies, which will be placed in the public domain via peer reviewed publications in the next few years, are expected to provide reliable and robust scientific evidence to: The use of the data could: [3 paragraphs unchanged] Birth data linkage is instrumental for providing reliable and robust scientific evidence to achieve the above purposes, because the health and social factors contained within these data are considered as key confounders or effect modifiers in the relationship between young people's environmental exposures and their health and developmental outcomes. For example, effects could be particularly pronounced under certain early-life circumstances. This research will enable review of current UK health policy precautionary advice to limit children’s mobile phone use. With an improved understanding of UK children’s radio frequency exposures from mobile phones and other radio frequency technologies, specific ways to reduce exposure levels may be identified to provide targeted advice to parents and children as appropriate.

Benefits reported

No data was provided under previous iterations of this Data Sharing Agreement. Therefore, no benefits have been achieved to date. The study team recently published several papers covering a wide range of topics including cohort profile, exposure validation, night-time screen-based device use in relation to sleep and quality of life, and social network use in relation to behavioural difficulties and quality of life. https://www.sciencedirect.com/science/article/pii/S001393511731664X ICL investigated the agreement between self-reported mobile phone use data and objective mobile operator (eg. EE, Vodafone) traffic data in a subset of SCAMP cohort aged 11–12 years (n=350). The findings demonstrate that self-reported usage adequately distinguishes between high and low mobile phone use. However, the greater use of Wi-Fi means operator data may no longer be useful for assessing mobile phone use. https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyy192/5132994. The cohort profile paper reported the background and rationale of establishment of the SCAMP cohort. It also showed the recruitment process and detailed measurements including computerised school assessments, Bio-Zone, online child and parent survey, personal monitoring sub-study, and routine health, education, and traffic data linkage. The SCAMP cohort is representative of the general school-aged children across London in terms of gender, ethnicity, and socioeconomic status. Baseline data also showed that socio-demographic factors were associated with mobile phone use (including call duration, call frequency, and number of SMS texts and instant messages). https://www.sciencedirect.com/science/article/pii/S0160412018312418?via%3Dihub ICL investigated the relationship between night-time screen-based media devices use, in both lit and dark rooms, and sleep outcomes and health-related quality of life (HRQoL) among 6616 SCAMP adolescents aged 11 to 12-year-olds. More than 70 per cent reported using at least one screen-based device within one hour of their bedtime, and about a third (32.2%) reported using mobile phones at night-time in darkness. The results showed that those who used a phone or watched television in a room with a light on were 31% more likely to get less sleep than those who didn’t use a screen. The likelihood increased to 147% if the same activity took place in the dark. Screen use during bedtime was associated with insufficient sleep and poor sleep quality. https://www.sciencedirect.com/science/article/pii/S0747563220300741 ICL looked at the relationship between duration of social network site (SNS) use and behavioural difficulties and HRQoL among 5229 SCAMP participants aged 11 to 12-year-olds. Two-thirds of the study population used SNS. Higher SNS use and SNS use at night were both associated with increased behavioural difficulties for both boys and girls. Of the four difficulties, the strongest association was seen for conduct problems and hyperactivity, followed by emotional problems. Higher SNS use was associated with lower prosocial strengths. High levels of social media use at both weekdays and weekends were associated with lower HRQoL for girls, but not boys. SNS use at night was also significantly associated with lower HRQoL in girls but not boys. This research shows that social media may affect the wellbeing and behaviour of 11-12 year olds. ICL have leveraged the NHS Mental Health Service Data to identify the needs for early intervention to tackle mental health problems in young people. ICL were awarded a research grant by Rosetrees Trust in Oct 2023 to better understand and improve young people's mental health through novel and impactful peer-led mental health research and interventions, by supporting young people to design and execute research projects based on their lived experience, interests, and priorities.

Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.

Datasets: + Birth Notification Data; + Bridge file: Hospital Episode Statistics to Mental Health Minimum Data Set; + Cancer Registration Data; + Civil Registrations of Death; + Demographics; + Emergency Care Data Set (ECDS); + Mental Health Minimum Data Set (MHMDS); + Mental Health Services Data Set (MHSDS); + Mental Health and Learning Disabilities Data Set (MHLDDS) · − MRIS - Cause of Death Report; − MRIS - Cohort Event Notification Report; − MRIS - Flagging Current Status Report; − MRIS - List Cleaning Report

Objective for processing

[1 paragraph unchanged] Imperial College London is the sole data controller for the Study of Cognition, Adolescents, and Mobile Phones (SCAMP) (SCAMP). SCAMP is a prospective cohort study which aims to address current scientific uncertainties [33 words unchanged] development (e.g. anxiety and hyperactivity), as well as exploring wider health outcomes. Baseline and Follow-up Assessments consist of standardised neurocognitive tests, validated behavioural screening [72 words unchanged] participants to provide additional information about potential con founders such as puberty. An A Radio Frequency (RF) personal monitoring study is also being conducted in a [18 words unchanged] children’s personal RF exposure and the relative contribution of each RF source. The SCAMP study has already recruited and gathered baseline data from ~7,000 [11 words unchanged] Follow-up took place for the pupils in Year 9 and 10 (age 13-14 13-15 years). Of the ~7,000 participating pupils, pupils (currently aged 15-17 years), SCAMP has received consent from pupils aged 15+ years and their parents for >1600 ~2500 pupils authorising SCAMP to access their child’s routine health data from NHS Digital to be used for research purposes these purposes. This Agreement is limited to the data of SCAMP participants who are those aged 16 or older and who have given informed consent. Imperial College London must not supply identifying details of any other participants for whom and is not permitted to receive data are being requested from NHS Digital. SCAMP is an observational study, with no clinical intervention. relating to participants who do not meet this criteria under this Data requested from NHS Digital will be used for research purposes only. Sharing Agreement. The study requires HES data linked to the cohort participants for all requested years as on the following basis: Organisations involved: 1) Imperial College London are listed as sole data controller for this study for the following reasons: - The PI is employed solely by Imperial College - The PI is responsible for undertaking all decisions pertaining to the collection and processing of the data under this Agreement. 2) The Swiss Tropical and Public Health Institute (Swiss TPH) are collaborators for the study; they undertook analysis of data from the validation study. The validation study is a sub-study on ~200 SCAMP participants to assess total RF-EMF body exposure and the relative contribution of each RF-EMF source. This validation used only data collected from participant questionnaires. Record-level NHS Digital data are not required for data analysis of the validation study. Swiss TPH will only access aggregated data with small numbers suppressed in line with NHS Digital guidelines. Swiss TPH do not determine the purpose of the study or the manner in which the data is processed, as described in this Agreement. 3) Steering Group: The Deputy Director of the Institute of Cognitive Neuroscience at University College London will chair the Steering Group with four additional members. The four members will comprise expertise in EMF, epidemiology, EMF exposure assessment, neurocognitive functioning in adolescents (in particular executive function) and in education/school-based research. They will be selected from across Europe. The committee will meet twice per year and will provide guidance and feedback on key scientific issues e.g. selection of cognitive tests for web-based assessment. The committee do not have access to any study data or data requested under this Agreement. They may access any published results at an aggregated level (with small numbers suppressed). The steering group are not responsible for any decisions regarding the data collected or processed for the study and are purely there in an advisory compacity. This Agreement is to request bespoke data linkage of the SCAMP cohort to HES Admitted Patient Care, HES Critical Care, HES A&E, HES Outpatient, ECDS, DIDs, mental health, and birth data plus patient tracking to deaths and cancers for the purpose of academic research. SCAMP is an observational study, with no clinical intervention. Data requested from NHS Digital will be used for research purposes only. Data will be requested from as early as 2002 where available, in order to include data for each participant from when they were born (the oldest participant was born in 2002). This will enable researchers to identify any pre-existing conditions so as to compare participants' health before and after mobile phone exposure. The study requires HES data linked to cohort participants for all requested years as on the following basis: [2 paragraphs unchanged] The study requires mortality data linked to the cohort participants on the following basis: [1 paragraph unchanged] The study requires cancer data linked to the cohort participants for all requested years as on the following basis: [2 paragraphs unchanged] The study requires mental health data linked to cohort participants for all requested years as on the following basis: Where mental health datasets cover outpatient and community services, this is instrumental for the aim of investigating the impact of RF-EMF and mobile phone use (and other environmental variables) on adolescent mental health. Those receiving treatment in hospital will often be the most extreme cases and will over represent particular mental health problems, whereas these datasets will tell us any and all members of the cohort that have received NHS mental health services. It is also hugely important that researchers can look at clinical outcomes closely and accurately, thus creating research that convincingly evaluates and demonstrates the role of the environment in mental health outcomes. The study requires birth data linked to cohort participants as on the following basis: Imperial College London previously requested participants' NHS number in order to send to ONS for birth data linkage. Given that birth data products (e.g. Births Registration and Births Notification) are now held by NHS Digital, the data controller requests the following birth data linked to the cohort participants: - Residential address at birth - Birth weight - Baby complications at birth - Birth order - The interval between participants' birth and any previous births - Multiple births (e.g. twins, triplets, etc) - Gestational length of mother - Parents' age - Parents’ place of birth - Parents’ marital status - Parents' occupation and employment status Access to participants’ birth addresses will allow researchers to model and predict prenatal pollution exposure, and see if this has an impact on cognitive and mental health outcomes. Other factors such as birth weight, gestational length, birth complications, the number of previous children, age of mother, multiple births, and parents' demographic information, may prove to be effect modifiers. This will result in high quality epidemiological research outputs evaluating the relationship between air pollution exposure and cognitive and mental health outcomes in young people, with potentially vital public health policy implications. A detailed justification for requesting each maternity/birth data field is as follows: MOTHER_OCCUPATION, MOTHER_NSSEC, MOTHER_SOC: These three variables are indicative of various aspects of maternal socioeconomic status, which are needed to account for when analysing the relationships between environmental exposures and psychological outcomes. Further, the study team have data for maternal occupation in secondary school, so it will tell researchers if there has been a change in a family's circumstances from early life to adolescence, which is important to evaluate the impact of early life experiences including socioeconomic circumstances. Mother’s occupation will additionally tell the study team about potential occupational exposures the parents are subject to, potentially impacting their health and psychological outcomes and thus the health and psychological outcomes of their children. FATHER_OCCUPATION, FATHER_NSSEC, FATHER_SOC: These three variables are indicative of various aspects of paternal socioeconomic status, which the study team need to account for when analysing the relationships between environmental exposures and psychological outcomes. Further, the study team have data for paternal occupation in secondary school, so it will tell the study team if there has been a change in a family's circumstances from early life to adolescence, which is important to evaluate the impact of early life experiences including socioeconomic circumstances. Father’s occupation will additionally tell the study team about potential occupational exposures the parents are subject to, potentially impacting their health and psychological outcomes and thus the health and psychological outcomes of their children. MOTHER_DOB (month and year): We require the age of mother in years and months at the time of the birth record. Age of mother at the time of the child’s birth is associated with a range of psychiatric and developmental outcomes; the research questions pertain to the environmental exposures young people are subject to including in early life and their psychological outcomes therefore mothers age is an important covariate we need to account for when analysing the relationships between environmental exposures and psychological outcomes. FATHER_DOB (month and year): the study team require the age of father in years and months at the time of the birth record. As paternal age at birth is related to many of the health, social, and psychiatric outcomes the study team are investigating, it is an important covariate the study team need to account for when analysing the relationships between environmental exposures and psychological outcomes. MOTHER_POB,  MOTHER_CCPOB (either/or, country of birth of mother): the study team require either field, which tells us the country of birth of the mother (the data could be reduced to just contain this information). As immigration status and generation is related to certain psychological outcomes (e.g., psychosis), it is an important sociodemographic consideration when modelling how exposure to air pollution, noise and radiation relate to later mental health and cognition. FATHER_POB, FATHER_CCPOB: (either/or, country of birth of father): the study team require either field, which tells us the country of birth of the father (the data could be reduced to just contain this information). Immigration status and generation is related to certain psychological outcomes (e.g., psychosis), therefore it is an important sociodemographic consideration when modelling how exposure to air pollution and noise relate to later mental health and cognition. BIRTH_INMARRIAGE: Whether parents are married and whether they are cohabiting at birth is associated with a range of birth, health, developmental, and psychological outcomes, which are associated with our main outcomes of adolescent mental health and cognition. Therefore, this is an important consideration when evaluating how various environmental characteristics in early life are associated with psychological development. BABY_BIRTH_DATE:  the study team require baby birth date in order to confirm existing data on age/DOB and fill in missing data where the study team don't have this. As well as being a standard covariate in epidemiological studies, age is an important factor contributing to cognition and mental health as these are developmental questions. The study team need the precise date of birth because this is crucial to assign time-specific and temporally varying air pollution exposures relating to the prenatal exposure window. The prenatal exposure window is short, and accuracy in temporal assignment is very important to avoid exposure misclassification, which is why exact birth date is required. Birth date is also required to adjust for birth season when analysing the relationships between air pollution exposures and health outcomes. BABY_SEX : the study team require baby sex in order to confirm existing data on sex and fill in missing data, and also elucidate if participants sex assigned at birth is the same or different to their gender in teenage years. This is because sex and gender are important covariates for health and mental health questions. BIRTH_WEIGHT: the study team require birth weight because it is associated with a range of mental health and health outcomes, and some of the exposures (air pollution) we are interested in. Therefore, to answer our research questions adequately the study team need to control for this. It could also be a mechanism through which there exists a relationship between exposure to air pollution and psychological outcomes, which is important to investigate. GESTATION: the study team require gestation for similar reasons to birth weight; early gestation is associated with exposure to air pollution and developmental outcomes. Therefore, we need to adjust for gestation when assessing the relationships between the environment and psychological outcomes and is crucial for us to comprehensively answer these research questions. CONGENITAL:  the study team require data on congenital disorders because they are related to adverse environmental exposures prenatally, and to health and psychological outcomes in later life. Therefore, the study team need to adjust for congenital disorders when assessing the relationships between the environment and psychological outcomes. BABY_ETHNICITY: the study team require the field of baby ethnicity because ethnicity is an important covariate in epidemiological questions and could be a confounder of the relationships between exposure to environmental stressors and psychological outcomes. It could also modify these relationships, acting as a vulnerability factor. This data will also help validate existing cohort data from adolescence and fill in missing data. BABY_USUAL_ADDRESS_1 BABY_USUAL_ADDRESS_2 BABY_USUAL_ADDRESS_3 BABY_USUAL_ADDRESS_4 BABY_USUAL_ADDRESS_5 BABY_USUAL_POSTCODE BABY_DISCHARGE_ADDRESS_1 BABY_DISCHARGE_ADDRESS_2 BABY_DISCHARGE_ADDRESS_3 BABY_DISCHARGE_ADDRESS_4 BABY_DISCHARGE_ADDRESS_5 BABY_DISCHARGE_POSTCODE The study team need the exact early life address of the child in order to accurately model early life exposure to noise, air pollution and radiation, so the study team can answer the questions of whether these exposures are related to adolescent psychological outcomes. This must be the exact flat or door number so that the study team can ascertain the building type (which affects the permutation of noise and air pollution indoors to expose residents). MOTHER_ADDRESS; MOTHER_FLAT_NUMBER MOTHER_BUILDING_OR_HOUSE MOTHER_BUILDING_NAM MOTHER_LINE_1 MOTHER_LINE_2 MOTHER_LINE_3 MOTHER_LINE_4 MOTHER_TOWN MOTHER_COUNTY MOTHER_POSTCODE MOTHER_STAT_POSTCODE In order to accurately model prenatal exposure to environmental exposures such as noise, air pollution, radiation, and answer the questions of how these exposures affect later psychological outcomes, the study team need to be able to geocode the prenatal residence of the mother and be able to ascertain the exact building type (which affects the permutation of noise and air pollution indoors to expose residents). POB_COMMEST, POB_ESTTYPE: Birth place factors (e.g. hospital setting vs home birth, hospital type) may impact on birth outcomes, and their sequelae, which may impact on psychological outcomes. These may be important explanatory factors to understand, and account for when analysing birth data. ORG NAME, ORG_CODE, ORG_TYPE_CODE: Hospital of birth reflects hospital area with spatial variation in air pollution. The study team need to adjust for the hospital clustering effect when analysing the relationships between environmental exposures and psychological outcomes. MOTHER_PREVLIVECHILD, MOTHER_PREVSBCHILD, NUM_BIRTHS, NUMBER_LIVE_BIRTHS, NUMBER_STILL_BIRTHS, MOTHER_TOTALBIRTHS: Mother’s reproductive/pregnancy history is a risk factor for adverse birth outcomes, e.g. low birth weight, and their sequelae, which may impact on psychological outcomes. The study team need to account for mother’s reproductive/pregnancy history when analysing the relationships between environmental exposures and psychological outcomes. MULTIPLE_INDICATOR, MULTIPLE_TYPE: Multiple birth is a risk factor for adverse birth outcomes, e.g. low birth weight, and their sequelae, which may impact on psychological outcomes. The study team need to account for multiple birth when analysing the relationships between environmental exposures and psychological outcomes. BIRTH ORDER: Parity (i.e. birth order) is a risk factor for adverse birth outcomes, e.g. low birth weight, and their sequelae, which may impact on psychological outcomes. The study team need to account for parity when analysing the relationships between environmental exposures and psychological outcomes. [5 paragraphs unchanged] Data will be restricted to only those consenting participants within the study cohort (to date SCAMP have parental consent and consent from pupils aged 16+ years to access the routine records, including health data, of ~1,200 ~2,500 SCAMP pupils). SCAMP have requested all the datasets and have not restricted [40 words unchanged] ‘health surveillance’ in response to these environmental exposures and new emerging technologies. Parents were provided with study invitation materials and information packs, all of [11 words unchanged] methods were comprehensible. All pupils in Year 7 from a participating SCAMP schools school took part in the SCAMP school-based computer assessment unless their parents informed the school/the SCAMP team otherwise i.e. the SCAMP school-based assessment was ‘opt-out’ consent. otherwise. Parents were invited to provide additional and optional ‘opt-in’ consent for SCAMP [6 words unchanged] including health data, and link these to their child’s school assessment data. [1 paragraph unchanged] The data requested is limited to the cohort, and to that required for currently planned and envisaged analyses. The data controller has only requested those data required in order to effectively meet the study needs and the SCAMP team cannot further minimise the scope or the amount of the data requested as it might affect achievements of the project. Article 89(1) of the GDPR requires that when processing special categories of personal data for scientific research: “…safeguards shall ensure that technical and organisational measures are in place in particular in order to ensure respect for the principle of data minimisation. Those measures may include pseudonymisation provided that those purposes can be fulfilled in that manner. Where those purposes can be fulfilled by further processing which does not permit or no longer permits the identification of data subjects, those purposes shall be fulfilled in that manner.” The SCAMP team is dedicated to protecting the confidentiality of the data of study participants. Only appropriately minimised, pseudonymised subsets of health data are requested for conducting scientific analysis, thus complying with Art. 89(1) of the GDPR. The data requested under this Agreement is the least obtrusive way of obtaining the required data. The data are requested in the public interest under GDPR Article 6(1)(e), as the outcomes of this research will influence guidance on mobile phone usage in the general public. This is Special Category data for the purposes of research and therefore Article 9(2)(j) will also apply. Funding is provided by National Institute of Health Research (NIHR) and is in place until 31st December 2021. NIHR make no decisions regarding the collation or dissemination of data under this Agreement and will only receive aggregated outputs (with small number suppressed). Data will be stored in line with Imperial College London's data retention policy for 10 years upon completion of the project. This has been communicated to participants in the Privacy Notice and HRA Transparency statement.

Processing activities

All organisations party to this agreement Agreement must comply with the Data Sharing Framework Contract requirements, including those regarding [5 words unchanged] that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: i.e.: employees, agents and contractors of the Data Recipient who may have access to that data). [1 paragraph unchanged] This Agreement is an application for to request bespoke data linkage of the SCAMP cohort to HES Admitted Patient Care, Critical Care, A&E, Outpatient Outpatient, ECDS, DIDs, mental health, and DIDs birth data plus patient tracking to deaths and cancers for the purpose of academic research. Data will be received from Imperial College, and run through the patient status and list cleaning services to a) retrieve any missing identifiers (NHS numbers, DOB, Postcode, Address) and b) update the cohort to the latest data for these variables. Automatic and manual matching will be carried out. 1) The following cohort identifiers will be sent from Imperial College London to NHS Digital: Imperial College wish to receive NHS number in order send to ONS to link birth data to the cohort. To do this, we will provide personal contact details to NHS Digital to identify the participants. Then NHS Digital will send back their NHS number and updated contact details. This data linkage is outlined in the Participant Information Booklet. “In order to link your data, we will send your name, gender, date of birth, and address to NHS Digital or ONS who will then link the information on our behalf to your NHS number, update details where appropriate and return the data to us.” NHS number The cleaned cohort will then be linked to HES Inpatient, Critical Care, Outpatient, Accident & Emergency data., and DIDs. Gender The sensitive and identifiable output will be returned to Imperial College. The HES data will be run on an annual basis there afterwards, and the Civil Registration data/Cancers run on an annual basis. Postcode Date of Birth Study ID 2) NHS Digital will run these identifiers through the Demographics database to: a) retrieve any missing identifiers (NHS numbers, DOB, Postcode, Address) and b) update the cohort to the latest data for these variables. Automatic and manual matching will be carried out. 3) The cleaned cohort will then be linked to HES Admitted Patient Care, Critical Care, Outpatient, Accident & Emergency data, Emergency Care Dataset, DIDs, mental health, and birth data. The sensitive and identifiable outputs will be returned to Imperial College London. The datasets will then be provided on an annual basis for the duration of this Agreement. [1 paragraph unchanged] Any personal identifiers such as Name, Address, Postcode that are supplied by NHS Digital Digital, will be stored separately from health data. Access to personal identifying information [5 words unchanged] team at Imperial College London, who have all signed strict non-disclosure agreements. Name, Address, Postcode are required to verify quality of matching, to improve quality of demographic data, and to ascertain any change in details detail over the course of this longitudinal study. Over time, these personally identifiable data fields from ‘Latest Patient Information’ Information’, which Imperial College London are requesting as part of ‘Patient Tracking’ Tracking’, may become the most up to date records as the study progresses. Should the study find from the data that the SCAMP study participants’ [11 words unchanged] by NHS Digital to re-contact study subjects. No data provided under this agreement Agreement is shared with any of the mobile phone companies. Where data is shared shared, this is data which was sourced at consent and written agreements to [8 words unchanged] place between Imperial College London and mobile phone network operators. Imperial Collage London have ethical approval to use the personally identifiable data fields (Name, Address, Postcode) from ‘Latest Patient Information’ for all the purposes stated above. It is important to note that the SCAMP researchers and the database where the raw identifiable data is under this Agreement are received and processed processed, are kept separate. On receipt of the datasets from NHS Digital, the [37 words unchanged] for research purposes only. Researchers therefore only have access to pseudonymised data. Access to personal or identifiable personal data requires the use of specialised cryptography and SQL, coding, which is limited to a limited number of specified staff within the [18 words unchanged] that a participant is accurately identified and linked to their personal information. [1 paragraph unchanged] Any collaborators working on the study will not have access to No record level data will be shared under this agreement and outside of the study research team at Imperial College London. Any data shared will only access consist of aggregated data with small number suppressed in line with NHS Digital HES Analysis guidelines. When a participant wishes to withdraw from the study, the study team would not be able to remove data from analyses that has already  been  completed. Instead, the data in the Masterfile will be anonymised by erasing all personally identifying information linked to the research data. Personal identifiers stored in secure archives (i.e. Consent form) may remain for the lifetime of the project but will not be used again.

Expected output

[1 paragraph unchanged] The findings will also be disseminated among wider stakeholders via the MRC-PHE MRC Centre for Environment & Health’s Community Advisory Board (CAB) – comprising Non [13 words unchanged] Committee, which will facilitate public and school engagement with the proposed research. [1 paragraph unchanged] The study team recently published several papers covering a paper on the validation wide range of self-reported mobile phone topics including cohort profile, exposure validation, night-time screen-based device use in relation to sleep and a cohort profile paper. quality of life, and social network use in relation to behavioural difficulties and quality of life. Details of these papers can be found here: [2 paragraphs unchanged] All outputs will contain only data that is aggregated with small numbers suppressed in line with the HES Analysis Guide https://www.sciencedirect.com/science/article/pii/S0160412018312418?via%3Dihub https://www.sciencedirect.com/science/article/pii/S0747563220300741 All outputs will contain only data that is aggregated with small numbers suppressed in line with the HES Analysis Guide.

Expected measurable benefits

In the UK, 70-80% of 11-12 year olds own a mobile phone. [71 words unchanged] data with their educational records and health data from NHS Digital, researchers will hope to be able to determine the effects of using mobile devices during adolescence on long term health outcomes. [1 paragraph unchanged] The major benefit of the SCAMP project is understanding of the impact of mobile phone use and other RF-EMF exposure in adolescence on health and development. The SCAMP sub-study CLUE also evaluates the health and developmental impacts of exposure to air pollution and noise. Hence, it is mainly the general public who will may benefit from this knowledge. It knowledge as it is expected that hoped it will greatly add to the main findings would be published within the next few years. evidence base for reviewing UK health guidelines and informing policy-makers, parents, and children's decision making. The results of the studies, which will be placed in the public domain via peer reviewed publications, publications in the next few years, are expected to provide reliable and robust scientific evidence to: [2 paragraphs unchanged] 3. Identify specific ways to reduce RF-EMF RF-EMF/air pollution/noise exposure levels, if required, and thus provide more specific health advice to parents and their children. Birth data linkage is instrumental for providing reliable and robust scientific evidence to achieve the above purposes, because the health and social factors contained within these data are considered as key confounders or effect modifiers in the relationship between young people's environmental exposures and their health and developmental outcomes. For example, effects could be particularly pronounced under certain early-life circumstances.

Benefits reported

Not stated in the previous version; added here.

No data was provided under previous iterations of this Data Sharing Agreement. Therefore, no benefits have been achieved to date.