Environmental illness: fatigue and cholinesterase activity in patients reporting hypersensitivity to electricity

Idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF): a systematic review of identifying criteria

BACKGROUND

Idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) remains a complex and unclear phenomenon, often characterized by the report of various, non-specific physical symptoms (NSPS) when an EMF source is present or perceived by the individual. The lack of validated criteria for defining and assessing IEI-EMF affects the quality of the relevant research, hindering not only the comparison or integration of study findings, but also the identification and management of patients by health care providers. The objective of this review was to evaluate and summarize the criteria that previous studies employed to identify IEI-EMF participants.

METHODS

An extensive literature search was performed for studies published up to June 2011. We searched EMBASE, Medline, Psychinfo, Scopus and Web of Science. Additionally, citation analyses were performed for key papers, reference sections of relevant papers were searched, conference proceedings were examined and a literature database held by the Mobile Phones Research Unit of King's College London was reviewed.

RESULTS

Sixty-three studies were included. "Hypersensitivity to EMF" was the most frequently used descriptive term. Despite heterogeneity, the criteria predominantly used to identify IEI-EMF individuals were: 1. Self-report of being (hyper)sensitive to EMF. 2. Attribution of NSPS to at least one EMF source. 3. Absence of medical or psychiatric/psychological disorder capable of accounting for these symptoms 4. Symptoms should occur soon (up to 24 hours) after the individual perceives an exposure source or exposed area. (Hyper)sensitivity to EMF was either generalized (attribution to various EMF sources) or source-specific. Experimental studies used a larger number of criteria than those of observational design and performed more frequently a medical examination or interview as prerequisite for inclusion.

CONCLUSIONS

Considerable heterogeneity exists in the criteria used by the researchers to identify IEI-EMF, due to explicit differences in their conceptual frameworks. Further work is required to produce consensus criteria not only for research purposes but also for use in clinical practice. This could be achieved by the development of an international protocol enabling a clearly defined case definition for IEI-EMF and a validated screening tool, with active involvement of medical practitioners.

Electromagnetic hypersensitivity (EHS) and subjective health complaints associated with electromagnetic fields of mobile phone communication--a literature review published between 2000 and 2004

Literature published between 2000 to 2004 concerning electromagnetic fields (EMF) of mobile communication and electromagnetic hypersensitivity (EHS) or unspecific symptoms of ill health, respectively, is reviewed. Basically, literature from established databases was systematically searched for. For each study, the design and quality were evaluated by means of a criteria list in order to judge evidence for causality of exposures on effects. Finally, 13 studies of sufficient quality were considered for this review. In only one provocation study, individuals with self-reported electromagnetic hypersensitivity were exposed to EMF. Their perception of field status was no better than would have been expected by chance. Results of five randomised cross-over studies on impaired well-being due to mobile phone exposure were contradictory. Even though these studies would allow more reliable exposure assessment, they are limited due to short exposure period and the small study size. No firm conclusion could be drawn from a few observational epidemiological studies finding a positive association between exposure and unspecific symptoms of ill health due to methodological limitations. Causality of exposure and effect was not derivable from these cross-sectional studies as field status and health complaints were assessed at the same time. In addition, exposure assessment has not been validated. In conclusion, based on the limited studies available, there is no valid evidence for an association between impaired well-being and exposure to mobile phone radiation presently. However, the limited quantity and quality of research in this area do not allow to exclude long-term health effects definitely.