Effects of radiofrequency electromagnetic fields on the human nervous system

The effect of exposure to radiofrequency electromagnetic fields on cognitive performance in human experimental studies: Systematic review and meta-analyses

BACKGROUND

The objective of this review is to evaluate the associations between short-term exposure to radiofrequency electromagnetic fields (RF-EMF) and cognitive performance in human experimental studies.

METHODS

Online databases (PubMed, Embase, Scopus, Web of Science and EMF-Portal) were searched for studies that evaluated effects of exposure to RF-EMF on seven domains of cognitive performance in human experimental studies. The assessment of study quality was based on the Risk of Bias (RoB) tool developed by the Office of Health Assessment and Translation (OHAT). Random effects meta-analyses of Hedges's g were conducted separately for accuracy- and speed-related performance measures of various cognitive domains, for which data from at least two studies were available. Finally, the certainty of evidence for each identified outcome was assessed according to Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

RESULTS

57,543 records were identified and 76 studies (80 reports) met the inclusion criteria. The included 76 studies with 3846 participants, consisting of humans of different age, sex and health status from 19 countries, were conducted between 1989 and 2021. Quantitative data from 50 studies (52 reports) with 2433 participants were included into the meta-analyses. These studies were performed in 15 countries between 2001 and 2021. The majority of the included studies used head exposure with GSM 900 uplink. None of the meta-analyses observed a statistically significant effect of RF-EMF exposure compared to sham on cognitive performance as measured by the confidence interval surrounding the Hedges's g or the significance of the z-statistic. For the domain Orientation and Attention, subclass Attention - Attentional Capacity RF-EMF exposure results in little to no difference in accuracy (Hedges's g 0.024, 95 % CI [-0.10; 0.15], I2 = 28 %, 473 participants). For the domain Orientation and Attention, subclass Attention - Concentration / Focused Attention RF-EMF exposure results in little to no difference in speed (Hedges's g 0.005, 95 % CI [-0.17; 0.18], I2 = 7 %, 132 participants) and probably results in little to no difference in accuracy; it does not reduce accuracy (Hedges's g 0.097, 95 % CI [-0.05; 0.24], I2 = 0 %, 217 participants). For the domain Orientation and Attention, subclass Attention - Vigilance RF-EMF exposure probably results in little to no difference in speed and does not reduce speed (Hedges's g 0.118, 95 % CI [-0.04; 0.28], I2 = 41 %, 247 participants) and results in little to no difference in accuracy (Hedges's g 0.042, 95 % CI, [-0.09; 0.18], I2 = 0 %, 199 participants). For the domain Orientation and Attention, subclass Attention - Selective Attention RF-EMF exposure probably results in little to no difference in speed and does not reduce speed (Hedges's g 0.080, 95 % CI [-0.09; 0.25], I2 = 63 %, 452 participants); it may result in little to no difference in accuracy, but it probably does not reduce accuracy (Hedges's g 0.178, 95 % CI [-0.02; 0.38], I2 = 68 %, 480 participants). For the domain Orientation and Attention, subclass Attention - Divided Attention RF-EMF exposure results in little to no difference in speed (Hedges's g -0.010, 95 % CI [-0.14; 0.12], I2 = 5 %, 307 participants) and may result in little to no difference in accuracy (Hedges's g -0.089, 95 % CI [-0.35; 0.18], I2 = 53 %, 167 participants). For the domain Orientation and Attention, subclass Processing Speed - Simple Reaction Time Task RF-EMF exposure results in little to no difference in speed (Hedges's g 0.069, 95 % CI [-0.02; +0.16], I2 = 29 %, 820 participants). For the domain Orientation and Attention, subclass Processing Speed - 2-Choice Reaction Time Task RF-EMF exposure results in little to no difference in speed (Hedges's g -0.023, 95 % CI [-0.13; 0.08], I2 = 0 %, 401 participants), and may result in little to no difference in accuracy (Hedges's g -0.063, 95 % CI [-0.38; 0.25], I2 = 63 %, 117 participants). For the domain Orientation and Attention, subclass Processing Speed - >2-Choice Reaction Time Task RF-EMF exposure results in little to no difference in speed (Hedges's g -0.054, 95 % CI [-0.14; 0.03], I2 = 0 %, 544 participants) and probably results in little to no difference in accuracy (Hedges's g -0.129, 95 % CI [-0.30; 0.04], I2 = 0 %, 131 participants). For the domain Orientation and Attention, subclass Processing Speed - Other Tasks RF-EMF exposure probably results in little to no difference in speed and does not reduce speed (Hedges's g 0.067, 95 % CI [-0.12; 0.26], I2 = 38 %, 249 participants); it results in little to no difference in accuracy (Hedges's g 0.036, 95 % CI [-0.08; 0.15], I2 = 0 %, 354 participants). For the domain Orientation and Attention, subclass Working Memory - n-back Task (0-3-back) we found Hedges's g ranging from -0.090, 95 % CI [-0.18; 0.01] to 0.060, 95 % CI [-0.06; 0.18], all I2 = 0 %, 237 to 474 participants, and conclude that RF-EMF exposure results in little to no difference in both speed and accuracy. For the domain Orientation and Attention, subclass Working Memory - Mental Tracking RF-EMF exposure results in little to no difference in accuracy (Hedges's g -0.047, 95 % [CI -0.15; 0.05], I2 = 0 %, 438 participants). For the domain Perception, subclass Visual and Auditory Perception RF-EMF exposure may result in little to no difference in speed (Hedges's g -0.015, 95 % CI [-0.23; 0.195], I2 = 0 %, 84 participants) and probably results in little to no difference in accuracy (Hedges's g 0.035, 95 % CI [-0.13; 0.199], I2 = 0 %, 137 participants). For the domain Memory, subclass Verbal and Visual Memory RF-EMF exposure probably results in little to no difference in speed and does not reduce speed (Hedges's g 0.042, 95 % CI [-0.15; 0.23], I2 = 0 %, 102 participants); it may result in little to no difference in accuracy (Hedges's g -0.087, 95 % CI [-0.38; 0.20], I2 = 85 %, 625 participants). For the domain Verbal Functions and Language Skills, subclass Verbal Expression, a meta-analysis was not possible because one of the two included studies did not provide numerical values. Results of both studies did not indicate statistically significant effects of RF-EMF exposure on both speed and accuracy. For the domain Construction and Motor Performance, subclass Motor Skills RF-EMF exposure may reduce speed, but the evidence is very uncertain (Hedges's g -0.919, 95 % CI [-3.09; 1.26], I2 = 96 %, 42 participants); it probably results in little to no difference in accuracy and does not reduce accuracy (Hedges's g 0.228, 95 % CI [-0.01; 0.46], I2 = 0 %, 109 participants). For the domain Concept Formation and Reasoning, subclass Reasoning RF-EMF exposure results in little to no difference in speed (Hedges's g 0.010, 95 % CI [-0.11; 0.13], I2 = 0 %, 263 participants) and probably results in little to no difference in accuracy and does not reduce accuracy (Hedges's g 0.051, 95 % CI [-0.14; 0.25], I2 = 0 %, 100 participants). For the domain Concept Formation and Reasoning, subclass Mathematical Procedures RF-EMF exposure results in little to no difference in speed (Hedges's g 0.033, 95 % CI [-0.12; 0.18], I2 = 0 %, 168 participants) and may result in little to no difference in accuracy but probably does not reduce accuracy (Hedges's g 0.232, 95 % CI [-0.12; +0.59], I2 = 86 %, 253 participants). For the domain Executive Functions there were no studies.

DISCUSSION

Overall, the results from all domains and subclasses across their speed- and accuracy-related outcome measures according to GRADE provide high to low certainty of evidence that short-term RF-EMF exposure does not reduce cognitive performance in human experimental studies. For 16 out of 35 subdomains some uncertainty remains, because of limitations in the study quality, inconsistency in the results or imprecision of the combined effect size estimate. Future research should focus on construction and motor performance, elderly, and consideration of both sexes.

OTHER

This review was partially funded by the WHO radioprotection programme. The protocol for this review was registered in Prospero reg. no. CRD42021236168 and published in Environment International (Pophof et al. 2021).

Assessment of Inflammation in 3D Reconstructed Human Skin Exposed to Combined Exposure to Ultraviolet and Wi-Fi Radiation

In the human environment, the increasing exposure to radiofrequency (RF) radiation, especially that emitted by wireless devices, could be absorbed in the body. Recently, mobile and emerging wireless technologies (UMTS, DECT, LTE, and Wi-Fi) have been using higher frequencies than 2G GSM systems (900/1800 MHz), which means that most of the circulating RF currents are absorbed into the skin and the superficial soft tissue. The harmful genotoxic, cytotoxic, and mutagenic effects of solar ultraviolet (UV) radiation on the skin are well-known. This study aimed at investigating whether 2422 MHz (Wi-Fi) RF exposure combined with UV radiation in different sequences has any effect on the inflammation process in the skin. In vitro experiments examined the inflammation process by cytokines (IL-1α, IL-6, IL-8) and MMP-1 enzyme secretion in a 3D full-thickness human skin model. In the first study, UV exposure was immediately followed by RF exposure to measure the potential additive effects, while in the second study, the possible protective phenomenon (i.e., adaptive response) was investigated when adaptive RF exposure was challenged by UV radiation. Our results suggest that 2422 MHz Wi-Fi exposure slightly, not significantly increased cytokine concentrations of the prior UV exposure. We could not detect the adaptive response phenomenon.

Evaluating the Effect of Jammer Radiation on Learning and Memory in Male Rats

Background

Previous studies shown that mobile phone can impairment of working memory in humans.

Objective

In this study, the effect of radiofrequency radiation emitted from common mobile jammers have been studied on the learning and memory of rats.

Material and Methods

In this prospective study, 90 Sprague-Dawley rats, were divided into 9 groups (N=10): Control, Sham^1st (exposed to a switched-off mobile jammer device at a distance of 50 or 100 cm/1 day, 2 hours), Sham^2nd (similar to Sham^1st, but for 14 days, 2 h/day), Experimental^1st -50 cm/1 day &100 cm/1 day (exposed to a switched-on device at a distance of 50 or 100 cm for 2 hours), Experimental^2nd (similar to experimental^1st, but for 14 days, 2 h/day). The animals were tested for learning and memory the next day, by the shuttle box. The time that a rat took to enter the dark part was considered as memory.

Results

Mean short-term memory was shorter in the experimental- 50 cm/1 day than control and sham- 50 cm/1 day (P=0.034), long-term memory was similar. Mean short- and long-term memory were similar in the experimental- 100 cm/1 day, control and sham- 100 cm/1 day (P>0.05). Mean short-term memory was similar in experimental- 50 cm/14 days, control, and sham- 50 cm/14 days (P=0.087), but long-term learning memory was shorter in the radiated group (P=0.038). Mean short- and long-term were similar among experimental-100 cm/14 days, control or sham 100 cm/14 days (P>0.05).

Conclusion

Rats exposed to jammer device showed dysfunction in short- and long-term memory, which shown the unfavorable effect of jammer on memory and learning. Our results indicated that the distance from radiation source was more important than the duration.

Comparative study between radiofrequency-induced and muscimol-induced inhibition of cultured networks of cortical neuron

Previous studies have shown that spontaneously active cultured networks of cortical neuron grown planar microelectrode arrays are sensitive to radiofrequency (RF) fields and exhibit an inhibitory response more pronounced as the exposure time and power increase. To better understand the mechanism behind the observed effects, we aimed at identifying similarities and differences between the inhibitory effect of RF fields (continuous wave, 1800 MHz) to the γ-aminobutyric acid type A (GABA_A) receptor agonist muscimol (MU). Inhibition of the network bursting activity in response to RF exposure became apparent at an SAR level of 28.6 W/kg and co-occurred with an elevation of the culture medium temperature of ~1°C. Exposure to RF fields preferentially inhibits bursting over spiking activity and exerts fewer constraints on neural network bursting synchrony, differentiating it from a pharmacological inhibition with MU. Network rebound excitation, a phenomenon relying on the intrinsic properties of cortical neurons, was observed following the removal of tonic hyperpolarization after washout of MU but not in response to cessation of RF exposure. This implies that hyperpolarization is not the main driving force mediating the inhibitory effects of RF fields. At the level of single neurons, network inhibition induced by MU and RF fields occurred with reduced action potential (AP) half-width. As changes in AP waveform strongly influence efficacy of synaptic transmission, the narrowing effect on AP seen under RF exposure might contribute to reducing network bursting activity. By pointing only to a partial overlap between the inhibitory hallmarks of these two forms of inhibition, our data suggest that the inhibitory mechanisms of the action of RF fields differ from the ones mediated by the activation of GABA_A receptors.

Improvement of several stress response and sleep quality hormones in men and women after sleeping in a bed that protects against electromagnetic fields

BACKGROUND

The electromagnetic fields (EMFs) emitted by the technologies affect the homeostatic systems (nervous, endocrine, and immune systems) and consequently the health. In a previous work, we observed that men and women, after 2 months of using a bed with a registered HOGO system, that prevents and drain EMFs, improved their immunity, redox and inflammatory states and rejuvenated their rate of aging or biological age. Since, EMFs can act as a chronic stressor stimulus, and affect the sleep quality. The objective of this work was to study in men and women (23-73 years old) the effect of sleeping for 2 months on that bed in the blood concentrations of several hormones related to stress response and sleep quality as well as to corroborate the rejuvenation of their biological age.

METHODS

In 18 men and women, plasma concentration of cortisol, dehydroepiandrosterone (DHEA), catecholamines (epinephrine, norepinephrine and dopamine), serotonin, oxytocin and melatonin were analyzed before and after 2 months of using the HOGO beds. A group of 10 people was used as placebo control. In another cohort of 25 men (20 experimental and 5 placebo), the effects of rest on the HOGO system on the concentration of cortisol and testosterone in plasma were studied. In all these volunteers, the biological age was analyzed using the Immunity Clock model.

RESULTS

There is a significant increase in plasma concentration of DHEA, norepinephrine, serotonin, oxytocin, and melatonin as well as in testosterone, after resting for 2 months in that bed with the EMFs avoiding system. In addition, decreases in Cortisol/DHEA and Testosterone/cortisol ratio and plasma dopamine concentration were observed. No differences were found in placebo groups. In all participants that slept on HOGO beds, the biological age was reduced.

CONCLUSIONS

Sleeping in a bed that isolates from EMFs and drain them can be a possible strategy to improve the secretion of hormones related to a better response to stress and sleep quality, which means a better endocrine system, and consequently better homeostasis and maintenance of health. This fact was confirmed with the slowdown in the rate of aging checked with a rejuvenation of the biological age.

The effect of exposure to radiofrequency electromagnetic fields on cognitive performance in human experimental studies: A protocol for a systematic review

BACKGROUND

The World Health Organization (WHO) is currently assessing the potential health effects of exposure to radiofrequency electromagnetic fields (RF-EMFs) in the general and working population. Related to one such health effect, there is a concern that RF-EMFs may affect cognitive performance in humans. The systematic review (SR) aims to identify, summarize and synthesize the evidence base related to this question. Here, we present the protocol for the planned SR.

OBJECTIVES

The main objective is to present a protocol for a SR which will evaluate the associations between short-term exposure to RF-EMFs and cognitive performance in human experimental studies.

DATA SOURCES

We will search the following databases: PubMed, Embase, Web of Science, Scopus, and the EMF-Portal. The reference lists of included studies and retrieved review articles will be manually searched.

STUDY ELIGIBILITY AND CRITERIA

We will include randomized human experimental studies that assess the effects of RF-EMFs on cognitive performance compared to no exposure or lower exposure. We will include peer-reviewed articles of any publication date in any language that report primary data.

DATA EXTRACTION AND ANALYSIS

Data will be extracted according to a pre-defined set of forms developed and piloted by the review author team. To assess the risk of bias, we will apply the Rating Tool for Human and Animal Studies developed by NTP/OHAT, supplemented with additional questions relevant for cross-over studies. Where sufficiently similar studies are identified (e.g. the heterogeneity concerning population, exposure and outcome is low and the studies can be combined), we will conduct random-effects meta-analysis; otherwise, we will conduct a narrative synthesis.

ASSESSMENT OF CERTAINTY OF EVIDENCE

The certainty of evidence for each identified outcome will be assessed according to Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Performing the review according to this protocol will allow the identification of possible effects of RF-EMFs on cognitive performance in humans. The protocol has been registered in PROSPERO, an open-source protocol registration system, to foster transparency.

The Effects of Ionising and Non-Ionising Electromagnetic Radiation on Extracellular Matrix Proteins

Exposure to sub-lethal doses of ionising and non-ionising electromagnetic radiation can impact human health and well-being as a consequence of, for example, the side effects of radiotherapy (therapeutic X-ray exposure) and accelerated skin ageing (chronic exposure to ultraviolet radiation: UVR). Whilst attention has focused primarily on the interaction of electromagnetic radiation with cells and cellular components, radiation-induced damage to long-lived extracellular matrix (ECM) proteins has the potential to profoundly affect tissue structure, composition and function. This review focuses on the current understanding of the biological effects of ionising and non-ionising radiation on the ECM of breast stroma and skin dermis, respectively. Although there is some experimental evidence for radiation-induced damage to ECM proteins, compared with the well-characterised impact of radiation exposure on cell biology, the structural, functional, and ultimately clinical consequences of ECM irradiation remain poorly defined.

Association Between Mobile Phone Radiation Exposure and the Secretion of Melatonin and Cortisol, Two Markers of the Circadian System: A Review

The extremely important use of mobile phones in the world, at all ages of life, including children and adolescents, leads to significant exposure of these populations to electromagnetic waves of radiofrequency. The question, therefore, arises as to whether exposure to these radiofrequencies (RFs) could lead to deleterious effects on the body's biological systems and health. In the current article, we review the effects, in laboratory animals and humans, of exposure to RF on two hormones considered as endocrine markers: melatonin, a neurohormone produced by the pineal gland and cortisol, a glucocorticosteroid synthesized by the adrenal glands. These two hormones are also considered as markers of the circadian system. The literature search was performed using PubMed, Medline, Web of Sciences (ISI Web of Knowledge), Google Scholar, and EMF Portal. From this review on RF effects on cortisol and melatonin, it appears that scientific papers in the literature are conflicting, showing effects, no effects, or inconclusive data. This implies the need for additional research on higher numbers of subjects and with protocols perfectly controlled with follow-up studies to better determine whether the chronic effect of RF on the biological functioning and health of users exists (or not). Bioelectromagnetics. 2021;42:5-17. © 2020 Bioelectromagnetics Society.

Adverse health effects of 5G mobile networking technology under real-life conditions

This article identifies adverse effects of non-ionizing non-visible radiation (hereafter called wireless radiation) reported in the premier biomedical literature. It emphasizes that most of the laboratory experiments conducted to date are not designed to identify the more severe adverse effects reflective of the real-life operating environment in which wireless radiation systems operate. Many experiments do not include pulsing and modulation of the carrier signal. The vast majority do not account for synergistic adverse effects of other toxic stimuli (such as chemical and biological) acting in concert with the wireless radiation. This article also presents evidence that the nascent 5G mobile networking technology will affect not only the skin and eyes, as commonly believed, but will have adverse systemic effects as well.

Radiofrequency Electromagnetic Field Exposure and the Resting EEG: Exploring the Thermal Mechanism Hypothesis

There is now strong evidence that radiofrequency electromagnetic field (RF-EMF) exposure influences the human electroencephalogram (EEG). While effects on the alpha band of the resting EEG have been repeatedly shown, the mechanisms underlying that effect have not been established. The current study used well-controlled methods to assess the RF-EMF exposure effect on the EEG and determine whether that effect might be thermally mediated. Thirty-six healthy adults participated in a randomized, double-blind, counterbalanced provocation study. A water-perfusion suit (34 °C) was worn throughout the study to negate environmental influences and stabilize skin temperature. Participants attended the laboratory on four occasions, the first being a calibration session and the three subsequent ones being exposure sessions. During each exposure session, EEG and skin temperature (8 sites) were recorded continuously during a baseline phase, and then during a 30 min exposure to a 920 MHz GSM-like signal (Sham, Low RF-EMF (1 W/kg) and High RF-EMF (2 W/kg)). Consistent with previous research, alpha EEG activity increased during the High exposure condition compared to the Sham condition. As a measure of thermoregulatory activation, finger temperature was found to be higher during both exposure conditions compared to the Sham condition, indicating for the first time that the effect on the EEG is accompanied by thermoregulatory changes and suggesting that the effect of RF-EMF on the EEG is consistent with a thermal mechanism.

Decreased spontaneous electrical activity in neuronal networks exposed to radiofrequency 1,800 MHz signals

The rapid development of wireless communications has raised questions about their potential health risks. So far, the only identified biological effects of radiofrequency fields (RF) are known to be caused by heating, but the issue of potential nonthermal biological effects, especially on the central nervous system (CNS), remains open. We previously reported a decrease in the firing and bursting rates of neuronal cultures exposed to a Global System for Mobile (GSM) RF field at 1,800 MHz for 3 min (Moretti D, Garenne A, Haro E, Poulleier de Gannes F, Lagroye I, Lévêque P, Veyret B, Lewis N. Bioelectromagnetics 34: 571-578, 2013). The aim of the present work was to assess the dose-response relationship for this effect and also to identify a potential differential response elicited by pulse-modulated GSM and continuous-wave (CW) RF fields. Spontaneous bursting activity of neuronal cultures from rat embryonic cortices was recorded using 60-electrode multielectrode arrays (MEAs). At 17-28 days in vitro, the neuronal cultures were subjected to 15-min RF exposures, at specific absorption rates (SAR) ranging from 0.01 to 9.2 W/kg. Both GSM and CW signals elicited a clear decrease in bursting rate during the RF exposure phase. This effect became more marked with increasing SAR and lasted even beyond the end of exposure for the highest SAR levels. Moreover, the amplitude of the effect was greater with the GSM signal. Altogether, our experimental findings provide evidence for dose-dependent effects of RF signals on the bursting rate of neuronal cultures and suggest that part of the mechanism is nonthermal. NEW & NOTEWORTHY In this study, we investigated the effects of some radiofrequency (RF) exposure parameters on the electrical activity of neuronal cultures. We detected a clear decrease in bursting activity, dependent on exposure duration. The amplitude of this effect increased with the specific absorption rate (SAR) level and was greater with Global System for Mobile signal than with continuous-wave signal, at the same average SAR. Our experiment provides unique evidence of a decrease in electrical activity of cortical neuronal cultures during RF exposure.

Skeptical approaches concerning the effect of exposure to electromagnetic fields on brain hormones and enzyme activities

This review discusses the effects of various frequencies of electromagnetic fields (EMF) on brain hormones and enzyme activity. In this context, the mechanism underlying the effects of EMF exposure on tissues generally and cellular pathway specifically has been discussed. The cell membrane plays important roles in mediating enzymatic activities as to response and reacts with extracellular environment. Alterations in the calcium signaling pathways in the cell membrane are activated in response to the effects of EMF exposure. Experimental and epidemiological studies have demonstrated that no changes occur in serum prolactin levels in humans following short-term exposure to 900 Mega Hertz (MHz) EMF emitted by mobile phones. The effects of EMF on melatonin and its metabolite, 6-sulfatoxymelatonin, in humans have also been investigated in the clinical studies to show a disturbance in metabolic activity of melatonin. In addition, although 900 MHz EMF effects on NF-κB inflammation, its effects on NF-κB are not clear. Abbreviations: ELF-EMF, extremely low frequency electromagnetic fields; EMF, electromagnetic fields; RF, Radiofrequency; ROS, reactive oxygen species; VGCCs, voltage-gated calcium channels; MAPK, mitogen-activated phosphokinase; NF-κB, nuclear factor kappa B; ERK-1/2, extracellular signal-regulated kinase; GSH-Px, glutathione peroxidase; JNK, Jun N-terminal kinases; SOD, superoxide dismutase; MnSOD, manganese-dependent superoxide dismutase; GLUT1, glucose transporter 1; GSSG-Rd, glutathione reductase MDA malondialdehyde; NO, nitric oxide; LH, luteinizing hormone; FSH, follicle-stimulating hormone.

Mobile phone use, school electromagnetic field levels and related symptoms: a cross-sectional survey among 2150 high school students in Izmir

BACKGROUND

Health outcomes of electromagnetic fields (EMF) from mobile phones and their base stations are of concern. Conducting multidisciplinary research, targeting children and exploring dose-response are recommended. Our objectives were to describe the mobile phone usage characteristics of high school students and to explore the association between mobile phone usage characteristics, high school EMF levels and self-reported symptoms.

METHODS

This cross-sectional study's data were collected by a survey questionnaire and by measuring school EMF levels between November 2009 and April 2011. A sample size of 2530 was calculated from a total of 20,493 students in 26 high schools and 2150 (85.0%) were included in the analysis. The frequencies of 23 symptoms were questioned and analysed according to 16 different aspects of mobile phone use and school EMF levels, exploring also dose-response. School EMF levels were measured with Aaronia Spectran HF-4060 device. Chi square and trend tests were used for univariate and logistic regression was used for multivariate analyses.

RESULTS

Among participants, 2021 (94.0%) were using mobile phones and 129 (6.0%) were not. Among users, 49.4% were speaking <10 min and 52.2% were sending/receiving 75 or more messages per day. Headache, fatigue and sleep disturbances were observed respectively 1.90 (95% CI 1.30-2.77), 1.78 (1.21-2.63) and 1.53 (1.05-2.21) times more among mobile phone users. Dose-response relationships were observed especially for the number of calls per day, total duration of calls per day, total number of text messages per day, position and status of mobile phone at night and making calls while charging as exposures and headache, concentration difficulties, fatigue and sleep disturbances as general symptoms and warming of the ear and flushing as local symptoms.

CONCLUSIONS

We found an association between mobile phone use and especially headache, concentration difficulties, fatigue, sleep disturbances and warming of the ear showing also dose-response. We have found limited associations between vicinity to base stations and some general symptoms; however, we did not find any association with school EMF levels. Decreasing the numbers of calls and messages, decreasing the duration of calls, using earphones, keeping the phone away from the head and body and similar precautions might decrease the frequencies or prevalence of the symptoms.

Biological effects and mechanisms of shortwave radiation: a review

With the increasing knowledge of shortwave radiation, it is widely used in wireless communications, radar observations, industrial manufacturing, and medical treatments. Despite of the benefits from shortwave, these wide applications expose humans to the risk of shortwave electromagnetic radiation, which is alleged to cause potential damage to biological systems. This review focused on the exposure to shortwave electromagnetic radiation, considering in vitro, in vivo and epidemiological results that have provided insight into the biological effects and mechanisms of shortwave. Additionally, some protective measures and suggestions are discussed here in the hope of obtaining more benefits from shortwave with fewer health risks.

Radiofrequency exposure in the Neonatal Medium Care Unit

The aims of this study were to characterize electromagnetic fields of radiofrequency (RF-EMF) levels generated in a Neonatal Medium Care Unit and to analyze RF-EMF levels inside unit's incubators. Spot and long-term measurements were made with a dosimeter. The spot measurement mean was 1.51±0.48V/m. Higher values were found in the proximity to the window and to the incubator evaluated. Mean field strength for the entire period of 17h was 0.81 (±0.07)V/m and the maximum value was 1.58V/m for long-term RF-EMF measurements in the incubator. Values found during the night period were higher than those found during the day period. It is important to consider RF-EMF exposure levels in neonatal care units, due to some evidence of adverse health effects found in children and adults. Characterization of RF-EMF exposure may be important to further investigate the mechanisms and underlying effects of electromagnetic fields (EMF) on infant health. A prudent avoidance strategy should be adopted because newborns are at a vulnerable stage of development and the actual impact of EMF on premature infants is unknown.

Does exposure to environmental radiofrequency electromagnetic fields cause cognitive and behavioral effects in 10-year-old boys?

The relationship between exposure to electromagnetic fields from non-ionizing radiation and adverse human health effects remains controversial. We aimed to explore the association of environmental radiofrequency-electromagnetic fields (RF-EMFs) exposure with neurobehavioral function of children. A subsample of 123 boys belonging to the Environment and Childhood cohort from Granada (Spain), recruited at birth from 2000 through 2002, were evaluated at the age of 9-11 years. Spot electric field measurements within the 100 kHz to 6 GHz frequency range, expressed as both root mean-square (S(RMS) and maximum power density (S(MAX)) magnitudes, were performed in the immediate surrounds of childreńs dwellings. Neurocognitive and behavioral functions were assessed with a comprehensive battery of tests. Multivariate linear and logistic regression models were used, adjusting for potential confounders. All measurements were lower than reference guideline limits, with median S(RMS) and S(MAX) values of 285.94 and 2759.68 μW/m(2), respectively. Most of the cognitive and behavioral parameters did not show any effect, but children living in higher RF exposure areas (above median S(RMS) levels) had lower scores for verbal expression/comprehension and higher scores for internalizing and total problems, and obsessive-compulsive and post-traumatic stress disorders, in comparison to those living in areas with lower exposure. These associations were stronger when S(MAX) values were considered. Although some of our results may suggest that low-level environmental RF-EMF exposure has a negative impact on cognitive and/or behavior development in children; given limitations in the study design and that the majority of neurobehavioral functioning tasks were not affected, definitive conclusions cannot be drawn.

Bioelectromagnetics Research within an Australian Context: The Australian Centre for Electromagnetic Bioeffects Research (ACEBR)

Mobile phone subscriptions continue to increase across the world, with the electromagnetic fields (EMF) emitted by these devices, as well as by related technologies such as Wi-Fi and smart meters, now ubiquitous. This increase in use and consequent exposure to mobile communication (MC)-related EMF has led to concern about possible health effects that could arise from this exposure. Although much research has been conducted since the introduction of these technologies, uncertainty about the impact on health remains. The Australian Centre for Electromagnetic Bioeffects Research (ACEBR) is a National Health and Medical Research Council Centre of Research Excellence that is undertaking research addressing the most important aspects of the MC-EMF health debate, with a strong focus on mechanisms, neurodegenerative diseases, cancer, and exposure dosimetry. This research takes as its starting point the current scientific status quo, but also addresses the adequacy of the evidence for the status quo. Risk communication research complements the above, and aims to ensure that whatever is found, it is communicated effectively and appropriately. This paper provides a summary of this ACEBR research (both completed and ongoing), and discusses the rationale for conducting it in light of the prevailing science.

Application of Higuchi's fractal dimension from basic to clinical neurophysiology: A review

BACKGROUND AND OBJECTIVE

For more than 20 years, Higuchi's fractal dimension (HFD), as a nonlinear method, has occupied an important place in the analysis of biological signals. The use of HFD has evolved from EEG and single neuron activity analysis to the most recent application in automated assessments of different clinical conditions. Our objective is to provide an updated review of the HFD method applied in basic and clinical neurophysiological research.

METHODS

This article summarizes and critically reviews a broad literature and major findings concerning the applications of HFD for measuring the complexity of neuronal activity during different neurophysiological conditions. The source of information used in this review comes from the PubMed, Scopus, Google Scholar and IEEE Xplore Digital Library databases.

RESULTS

The review process substantiated the significance, advantages and shortcomings of HFD application within all key areas of basic and clinical neurophysiology. Therefore, the paper discusses HFD application alone, combined with other linear or nonlinear measures, or as a part of automated methods for analyzing neurophysiological signals.

CONCLUSIONS

The speed, accuracy and cost of applying the HFD method for research and medical diagnosis make it stand out from the widely used linear methods. However, only a combination of HFD with other nonlinear methods ensures reliable and accurate analysis of a wide range of neurophysiological signals.

Thirty-minutes’ exposure to smartphone call triggers neutrophil activation in vitro

Background:

Despite accumulating evidence about the negative health effects of exposure to electromagnetic fields emitted by mobile phones, no information is available on the potential impact of radiofrequency (RF) waves on polymorphonuclear leukocytes biology.

Methods:

Two sequential whole blood tubes were collected from 16 ostensibly healthy volunteers. After placing the former tube of each subject in a plastic rack, 1 cm from a commercial smartphone (carrier frequency, 900 MHz), a call was placed on the smartphone and a communication lasting 30 min was manually activated. The latter blood tube of each volunteer was placed in another plastic rack, for an identical period of time, avoiding close contact with sources of RF waves. A complete blood count was then assessed in all whole blood samples, using Advia 2120.

Results:

The 30-min exposure of blood to RF waves did not induce significant variations of total and differential leukocyte counts. A significant decrease was however observed for many neutrophils parameters, with median percentage variation of −3.9% for the lobularity index (LI), −29.8% for the myeloperoxidase index (MPXI), −0.6% for the neutrophil cluster mean x (NEUTx) and −0.7% for the neutrophil cluster mean y (NEUTy), respectively. The percentage of blood samples with reduced values after exposure to RF waves was 81% for LI, 88% for NEUTx and 100% for both MPXI and NEUTy.

Conclusions:

The results of this study show that exposure to smartphone RF waves triggers activation of neutrophils in vitro, as mirrored by the significant variations observed in many activation parameters in Advia 2120.

Influence and Correction from the Human Body on the Measurement of a Power-Frequency Electric Field Sensor

According to the operating specifications of existing electric field measuring instruments, measuring technicians must be located far from the instruments to eliminate the influence of the human body occupancy on a spatial electric field. Nevertheless, in order to develop a portable safety protection instrument with an effective electric field warning function for working staff in a high-voltage environment, it is necessary to study the influence of an approaching human body on the measurement of an electric field and to correct the measurement results. A single-shaft electric field measuring instrument called the Type LP-2000, which was developed by our research team, is used as the research object in this study. First, we explain the principle of electric field measurement and describe the capacitance effect produced by the human body. Through a theoretical analysis, we show that the measured electric field value decreases as a human body approaches. Their relationship is linearly proportional. Then, the ratio is identified as a correction coefficient to correct for the influence of human body proximity. The conclusion drawn from the theoretical analysis is proved via simulation. The correction coefficient kb = 1.8010 is obtained on the basis of the linear fitting of simulated data. Finally, a physical experiment is performed. When no human is present, we compare the results from the Type LP-2000 measured with Narda EFA-300 and the simulated value to verify the accuracy of the Type LP-2000. For the case of an approaching human body, the correction coefficient kb* = 1.9094 is obtained by comparing the data measured with the Type LP-2000 to the simulated value. The correction coefficient obtained from the experiment (i.e., kb*) is highly consistent with that obtained from the simulation (i.e., kb). Two experimental programs are set; under these programs, the excitation voltages and distance measuring points are regulated to produce different electric field intensities. Using kb = 1.9094, the corrected measurement of electric field intensity can accurately reflect the original environmental electric field intensity, and the maximal error is less than 6% in all the data comparisons. These results verify the effectiveness of our proposed method.

Analysis of gene expression in mouse brain regions after exposure to 1.9 GHz radiofrequency fields

PURPOSE

To assess 1.9 GHz radiofrequency (RF) field exposure on gene expression within a variety of discrete mouse brain regions using whole genome microarray analysis.

MATERIALS AND METHODS

Adult male C57BL/6 mice were exposed to 1.9 GHz pulse-modulated or continuous-wave RF fields for 4 h/day for 5 consecutive days at whole body average (WBA) specific absorption rates of 0 (sham), ∼0.2 W/kg and ∼1.4 W/kg. Total RNA was isolated from the auditory cortex, amygdala, caudate, cerebellum, hippocampus, hypothalamus, and medial prefrontal cortex and differential gene expression was assessed using Illumina MouseWG-6 (v2) BeadChip arrays. Validation of potentially responding genes was conducted by RT-PCR.

RESULTS

When analysis of gene expression was conducted within individual brain regions when controlling the false discovery rate (FDR), no differentially expressed genes were identified relative to the sham control. However, it must be noted that most fold changes among groups were observed to be less than 1.5-fold and this study had limited ability to detect such small changes. While some genes were differentially expressed without correction for multiple-comparisons testing, no consistent pattern of response was observed among different RF-exposure levels or among different RF-modulations.

CONCLUSIONS

The current study provides the most comprehensive analysis of potential gene expression changes in the rodent brain in response to RF field exposure conducted to date. Within the exposure conditions and limitations of this study, no convincing evidence of consistent changes in gene expression was found in response to 1.9 GHz RF field exposure.

Environmental Radiofrequency Electromagnetic Fields Exposure at Home, Mobile and Cordless Phone Use, and Sleep Problems in 7-Year-Old Children

BACKGROUND

We evaluated if exposure to RF-EMF was associated with reported quality of sleep in 2,361 children, aged 7 years.

METHODS

This study was embedded in the Amsterdam Born Children and their Development (ABCD) birth cohort study. When children were about five years old, school and residential exposure to RF-EMF from base stations was assessed with a geospatial model (NISMap) and from indoor sources (cordless phone/WiFi) using parental self-reports. Parents also reported their children's use of mobile or cordless phones. When children were seven years old, we evaluated sleep quality as measured with the Child Sleep Habits Questionnaire (CSHQ) filled in by parents. Of eight CSHQ subscales, we evaluated sleep onset delay, sleep duration, night wakenings, parasomnias and daytime sleepiness with logistic or negative binomial regression models, adjusting for child's age and sex and indicators of socio-economic position of the parents. We evaluated the remaining three subscales (bedtime resistance, sleep anxiety, sleep disordered breathing) as unrelated outcomes (negative control) because these were a priori hypothesised not to be associated with RF-EMF.

RESULTS

Sleep onset delay, night wakenings, parasomnias and daytime sleepiness were not associated with residential exposure to RF-EMF from base stations. Sleep duration scores were associated with RF-EMF levels from base stations. Higher use mobile phones was associated with less favourable sleep duration, night wakenings and parasomnias, and also with bedtime resistance. Cordless phone use was not related to any of the sleeping scores.

CONCLUSION

Given the different results across the evaluated RF-EMF exposure sources and the observed association between mobile phone use and the negative control sleep scale, our study does not support the hypothesis that it is the exposure to RF-EMF that is detrimental to sleep quality in 7-year old children, but potentially other factors that are related to mobile phone usage.

Characterization and Evaluation of a Commercial WLAN System for Human Provocation Studies

This work evaluates the complex exposure characteristics of Wireless Local Area Network (WLAN) technology and describes the design of a WLAN exposure system built using commercially available modular parts for the study of possible biological health effects due to WLAN exposure in a controlled environment. The system consisted of an access point and a client unit (CU) with router board cards types R52 and R52n with 18 dBm and 25 dBm peak power, respectively. Free space radiofrequency field (RF) measurements were performed with a field meter at a distance of 40 cm from the CU in order to evaluate the RF exposure at several signal configurations of the exposure system. Finally, the specific absorption rate (SAR) generated by the CU was estimated computationally in the head of two human models. Results suggest that exposure to RF fields of WLAN systems strongly depends on the sets of the router configuration: the stability of the exposure was more constant and reliable when both antennas were active and vertically positioned, with best signal quality obtained with the R52n router board at channel 9, in UDP mode. The maximum levels of peak SAR were far away from the limits of international guidelines with peak levels found over the skin.

Do signals of a hand-held TETRA transmitter affect cognitive performance, well-being, mood or somatic complaints in healthy young men? Results of a randomized double-blind cross-over provocation study

BACKGROUND

TETRA (terrestrial trunked radio) is a digital radio communication standard, which has been implemented in several European countries and is used by public executives, transportation services, and by private companies. Studies on possible impacts on the users' health considering different exposure conditions are missing.

OBJECTIVES

To investigate possible acute effects of electromagnetic fields (EMF) of two different levels of TETRA hand-held transmitter signals on cognitive function and well-being in healthy young males.

METHODS

In the present double-blind cross-over study possible effects of short-term (2.5h) EMF exposure of handset-like signals of TETRA (385 MHz) were studied in 30 healthy male participants (mean±SD: 25.4±2.6 years). Individuals were tested on nine study days, on which they were exposed to three different exposure conditions (Sham, TETRA 1.5 W/kg and TETRA 6.0 W/kg) in a randomly assigned and balanced order. Participants were tested in the afternoon at a fixed timeframe.

RESULTS

Attention remained unchanged in two out of three tasks. In the working memory significant changes were observed in two out of four subtasks. Significant results were found in 5 out of 35 tested parameters, four of them led to an improvement in performance. Mood, well-being and subjective somatic complaints were not affected by TETRA exposure.

CONCLUSIONS

The results of the present study do not indicate a negative impact of a short-term EMF-effect of TETRA on cognitive function and well-being in healthy young men.

Radiofrequency signal affects alpha band in resting electroencephalogram

The aim of the present work was to investigate the effects of the radiofrequency (RF) electromagnetic fields (EMFs) on human resting EEG with a control of some parameters that are known to affect alpha band, such as electrode impedance, salivary cortisol, and caffeine. Eyes-open and eyes-closed resting EEG data were recorded in 26 healthy young subjects under two conditions: sham exposure and real exposure in double-blind, counterbalanced, crossover design. Spectral power of EEG rhythms was calculated for the alpha band (8-12 Hz). Saliva samples were collected before and after the study. Salivary cortisol and caffeine were assessed by ELISA and HPLC, respectively. The electrode impedance was recorded at the beginning of each run. Compared with the sham session, the exposure session showed a statistically significant (P < 0.0001) decrease of the alpha band spectral power during closed-eyes condition. This effect persisted in the postexposure session (P < 0.0001). No significant changes were detected in electrode impedance, salivary cortisol, and caffeine in the sham session compared with the exposure one. These results suggest that GSM-EMFs of a mobile phone affect the alpha band within spectral power of resting human EEG.

Using medaka embryos as a model system to study biological effects of the electromagnetic fields on development and behavior

The electromagnetic fields (EMFs) of anthropogenic origin are ubiquitous in our environments. The health hazard of extremely low frequency and radiofrequency EMFs has been investigated for decades, but evidence remains inconclusive, and animal studies are urgently needed to resolve the controversies regarding developmental toxicity of EMFs. Furthermore, as undersea cables and technological devices are increasingly used, the lack of information regarding the health risk of EMFs to aquatic organisms needs to be addressed. Medaka embryos (Oryzias latipes) have been a useful tool to study developmental toxicity in vivo due to their optical transparency. Here we explored the feasibility of using medaka embryos as a model system to study biological effects of EMFs on development. We also used a white preference test to investigate behavioral consequences of the EMF developmental toxicity. Newly fertilized embryos were randomly assigned to four groups that were exposed to an EMF with 3.2kHz at the intensity of 0.12, 15, 25, or 60µT. The group exposed to the background 0.12µT served as the control. The embryos were exposed continually until hatch. They were observed daily, and the images were recorded for analysis of several developmental endpoints. Four days after hatching, the hatchlings were tested with the white preference test for their anxiety-like behavior. The results showed that embryos exposed to all three levels of the EMF developed significantly faster. The endpoints affected included the number of somites, eye width and length, eye pigmentation density, midbrain width, head growth, and the day to hatch. In addition, the group exposed to the EMF at 60µT exhibited significantly higher levels of anxiety-like behavior than the other groups did. In conclusion, the EMF tested in this study accelerated embryonic development and heightened anxiety-like behavior. Our results also demonstrate that the medaka embryo is a sensitive and cost-efficient in vivo model system to study developmental toxicity of EMFs.

Mobile phone use and health symptoms in children

BACKGROUND/PURPOSE

To investigate the mobile phone (MP) use for talking in relation to health symptoms among 2042 children aged 11-15 years in Taiwan.

METHODS

A nationwide, cross-sectional study, using the computer assisted telephone interview (CATI) technique, was conducted in 2009 to collect information on children's utilization of MPs and the perceived health symptoms reported by their parents.

RESULTS

The overall prevalence of MP use in the past month was estimated at 63.2% [95% confidence interval (CI) = 61.1-65.3%]. MP use was associated with a significantly increased adjusted odds ratio (AOR) for headaches and migraine (1.42, 95% CI = 1.12-1.81) and skin itches (1.84, 95% CI = 1.47-2.29). Children who regularly used MPs were also considered to have a health status worse than it was 1 year ago (β = 0.27, 95% CI = 0.17-0.37).

CONCLUSION

Although the cross-sectional design precludes the causal inference for the observed association, our study tended to suggest a need for more cautious use of MPs in children, because children are expected to experience a longer lifetime exposure to radiofrequency electromagnetic fields (RF-EMF) from MPs.

Influence of non ionizing radiation of base stations on the activity of redox proteins in bovines

Background

The influence of electromagnetic fields on the health of humans and animals is still an intensively discussed and scientifically investigated issue (Prakt Tierarzt 11:15-20, 2003; Umwelt Medizin Gesellschaft 17:326-332, 2004; J Toxicol Environment Health, Part B 12:572–597, 2009). We are surrounded by numerous electromagnetic fields of variable strength, coming from electronic equipment and its power cords, from high-voltage power lines and from antennas for radio, television and mobile communication. Particularly the latter cause’s controversy, as everyone likes to have good mobile reception at anytime and anywhere, whereas nobody wants to have such a basestation antenna in their proximity.

Results

In this experiment, the NIR has resulted in changes in the enzyme activities. Certain enzymes were disabled, others enabled by NIR. Furthermore, individual behavior patterns were observed. While certain cows reacted to NIR, others did not react at all, or even inversely.

Conclusion

The present results coincide with the information from the literature, according to which NIR leads to changes in redox proteins, and that there are individuals who are sensitive to radiation and others that are not. However, the latter could not be distinctly attributed – there are cows that react clearly with one enzyme while they do not react with another enzyme at all, or even the inverse. The study approach of testing ten cows each ten times during three phases has proven to be appropriate. Future studies should however set the post-exposure phase later on.

Nanometer-resolved radio-frequency absorption and heating in biomembrane hydration layers

Radio-frequency (RF) electromagnetic fields are readily absorbed in biological matter and lead to dielectric heating. To understand how RF radiation interacts with macromolecular structures and possibly influences biological function, a quantitative description of dielectric absorption and heating at nanometer resolution beyond the usual effective medium approach is crucial. We report an exemplary multiscale theoretical study for biomembranes that combines (i) atomistic simulations for the spatially resolved absorption spectrum at a single planar DPPC lipid bilayer immersed in water, (ii) calculation of the electric field distribution in planar and spherical cell models, and (iii) prediction of the nanometer resolved temperature profiles under steady RF radiation. Our atomistic simulations show that the only 2 nm thick lipid hydration layer strongly absorbs in a wide RF range between 10 MHz and 100 GHz. The absorption strength, however, strongly depends on the direction of the incident wave. This requires modeling of the electric field distribution using tensorial dielectric spectral functions. For a spherical cell model, we find a strongly enhanced RF absorption on an equatorial ring, which gives rise to temperature gradients inside a single cell under radiation. Although absolute temperature elevation is small under conditions of typical telecommunication usage, our study points to hitherto neglected temperature gradient effects and allows thermal RF effects to be predicted on an atomistically resolved level. In addition to a refined physiological risk assessment of RF fields, technological applications for controlling temperature profiles in nanodevices are possible.

Could myelin damage from radiofrequency electromagnetic field exposure help explain the functional impairment electrohypersensitivity? A review of the evidence

Myelin provides the electrical insulation for the central and peripheral nervous system and develops rapidly in the first years of life, but continues into mid-life or later. Myelin integrity is vital to healthy nervous system development and functioning. This review outlines the development of myelin through life, and then considers the evidence for an association between myelin integrity and exposure to low-intensity radiofrequency electromagnetic fields (RF-EMFs) typical in the modern world. In RF-EMF peer-reviewed literature examining relevant impacts such as myelin sheath, multiple sclerosis, and other myelin-related diseases, cellular examination was included. There are surprisingly little data available in each area, but considered together a picture begins to emerge in RF-EMF-exposed cases: (1) significant morphological lesions in the myelin sheath of rats; (2) a greater risk of multiple sclerosis in a study subgroup; (3) effects in proteins related to myelin production; and (4) physical symptoms in individuals with functional impairment electrohypersensitivity, many of which are the same as if myelin were affected by RF-EMF exposure, giving rise to symptoms of demyelination. In the latter, there are exceptions; headache is common only in electrohypersensitivity, while ataxia is typical of demyelination but infrequently found in the former group. Overall, evidence from in vivo and in vitro and epidemiological studies suggests an association between RF-EMF exposure and either myelin deterioration or a direct impact on neuronal conduction, which may account for many electrohypersensitivity symptoms. The most vulnerable are likely to be those in utero through to at least mid-teen years, as well as ill and elderly individuals.

In-vitro exposure of neuronal networks to the GSM-1800 signal

The central nervous system is the most likely target of mobile telephony radiofrequency (RF) field exposure in terms of biological effects. Several electroencephalography (EEG) studies have reported variations in the alpha-band power spectrum during and/or after RF exposure, in resting EEG and during sleep. In this context, the observation of the spontaneous electrical activity of neuronal networks under RF exposure can be an efficient tool to detect the occurrence of low-level RF effects on the nervous system. Our research group has developed a dedicated experimental setup in the GHz range for the simultaneous exposure of neuronal networks and monitoring of electrical activity. A transverse electromagnetic (TEM) cell was used to expose the neuronal networks to GSM-1800 signals at a SAR level of 3.2 W/kg. Recording of the neuronal electrical activity and detection of the extracellular spikes and bursts under exposure were performed using microelectrode arrays (MEAs). This work provides the proof of feasibility and preliminary results of the integrated investigation regarding exposure setup, culture of the neuronal network, recording of the electrical activity, and analysis of the signals obtained under RF exposure. In this pilot study on 16 cultures, there was a 30% reversible decrease in firing rate (FR) and bursting rate (BR) during a 3 min exposure to RF. Additional experiments are needed to further characterize this effect.

Cell phone exposures and hearing loss in children in the Danish National Birth Cohort

BACKGROUND

Children today are exposed to cell phones early in life, and may be the most vulnerable if exposure is harmful to health. We investigated the association between cell phone use and hearing loss in children.

METHODS

The Danish National Birth Cohort (DNBC) enrolled pregnant women between 1996 and 2002. Detailed interviews were conducted during gestation, and when the children were 6 months, 18 months and 7 years of age. We used multivariable-adjusted logistic regression, marginal structural models (MSM) with inverse-probability weighting, and doubly robust estimation (DRE) to relate hearing loss at age 18 months to cell phone use at age 7 years, and to investigate cell phone use reported at age 7 in relation to hearing loss at age 7.

RESULTS

Our analyses included data from 52 680 children. We observed weak associations between cell phone use and hearing loss at age 7, with odds ratios and 95% confidence intervals from the traditional logistic regression, MSM and DRE models being 1.21 [95% confidence interval [CI] 0.99, 1.46], 1.23 [95% CI 1.01, 1.49] and 1.22 [95% CI 1.00, 1.49], respectively.

CONCLUSIONS

Our findings could have been affected by various biases and are not sufficient to conclude that cell phone exposures have an effect on hearing. This is the first large-scale epidemiologic study to investigate this potentially important association among children, and replication of these findings is needed.

Health literacy and patient empowerment in health communication: the importance of separating conjoined twins

OBJECTIVE

Patient empowerment and health literacy have both been studied empirically, but they have hardly ever been explicitly linked.

METHODS

Pertinent literature from the development of both concepts was studied, drawing not only on health care literature, but also on management research.

RESULTS

This article argues that it is important to recognize that the concepts are distinct, both conceptually and empirically. At the same time, the impacts of health literacy and patient empowerment are deeply intertwined. High literacy does not necessarily entail empowerment and vice versa, and mismatches of the two can have deleterious consequences. High levels of health literacy without a corresponding high degree of patient empowerment creates an unnecessary dependence of patients on health professionals, while a high degree of empowerment without a corresponding degree of health literacy poses the risk of dangerous health choices.

CONCLUSION

We discuss the importance of carefully conceptualizing both approaches, the implications for their measurement and the design of health interventions.

PRACTICE IMPLICATIONS

Communication programs must include the empowerment that motivates consumers to engage and the literacy that enables them to make informed and reasoned choices.

Prenatal and Postnatal Cell Phone Exposures and Headaches in Children

OBJECTIVE

Children today are exposed to cell phones early in life, and may be at the greatest risk if exposure is harmful to health. We investigated associations between cell phone exposures and headaches in children.

STUDY DESIGN

The Danish National Birth Cohort enrolled pregnant women between 1996 and 2002. When their children reached age seven years, mothers completed a questionnaire regarding the child's health, behaviors, and exposures. We used multivariable adjusted models to relate prenatal only, postnatal only, or both prenatal and postnatal cell phone exposure to whether the child had migraines and headache-related symptoms.

RESULTS

Our analyses included data from 52,680 children. Children with cell phone exposure had higher odds of migraines and headache-related symptoms than children with no exposure. The odds ratio for migraines was 1.30 (95% confidence interval: 1.01-1.68) and for headache-related symptoms was 1.32 (95% confidence interval: 1.23-1.40) for children with both prenatal and postnatal exposure.

CONCLUSIONS

In this study, cell phone exposures were associated with headaches in children, but the associations may not be causal given the potential for uncontrolled confounding and misclassification in observational studies such as this. However, given the widespread use of cell phones, if a causal effect exists it would have great public health impact.

Mobile.net: Mobile Telephone Text Messages to Encourage Adherence to Medication and to Follow up With People With Psychosis: Methods and Protocol for a Multicenter Randomized Controlled Two-Armed Trial

BACKGROUND

Schizophrenia is a high-cost, chronic, serious mental illness. There is a clear need to improve treatments and expand access to care for persons with schizophrenia, but simple, tailored interventions are missing.

OBJECTIVE

To evaluate the impact of tailored mobile telephone text messages to encourage adherence to medication and to follow up with people with psychosis at 12 months.

METHODS

Mobile.Net is a pragmatic randomized trial with inpatient psychiatric wards allocated to two parallel arms. The trial will include 24 sites and 45 psychiatric hospital wards providing inpatient care in Finland. The participants will be adult patients aged 18-65 years, of either sex, with antipsychotic medication (Anatomical Therapeutic Chemical classification 2011) on discharge from a psychiatric hospital, who have a mobile phone, are able to use the Finnish language, and are able to give written informed consent to participate in the study. The intervention group will receive semiautomatic system (short message service [SMS]) messages after they have been discharged from the psychiatric hospital. Patients will choose the form, content, timing, and frequency of the SMS messages related to their medication, keeping appointments, and other daily care. SMS messages will continue to the end of the study period (12 months) or until participants no longer want to receive the messages. Patients will be encouraged to contact researchers if they feel that they need to adjust the message in any way. At all times, both groups will receive usual care at the discretion of their team (psychiatry and nursing). The primary outcomes are service use and healthy days by 12 months based on routine data (admission to a psychiatric hospital, time to next hospitalization, time in hospital during this year, and healthy days). The secondary outcomes are service use, coercive measures, medication, adverse events, satisfaction with care, the intervention, and the trial, social functioning, and economic factors. Data will be collected 12 months after baseline. The outcomes are based on the national health registers and patients' subjective evaluations. The primary analysis will be by intention-to-treat.

TRIAL REGISTRATION

International Standard Randomised Controlled Trial Number (ISRCTN): 27704027; http://www.controlled-trials.com/ISRCTN27704027 (Archived by WebCite at http://www.webcitation.org/69FkM4vcq).

Mobile phones and multiple sclerosis--a nationwide cohort study in Denmark

We investigated the risk of, prognosis of and symptoms of multiple sclerosis (MS) among all Danish residents who owned a mobile phone subscription before 1996. Using the Danish Multiple Sclerosis Registry and Civil Registration System, study subjects were followed up for MS through 2004. Poisson models were used to calculate incidence rate ratios (IRR, age range: 18–64 years) and mortality rate ratios (MRR, age range: 18+) and to compare presenting symptoms among subscribers and all non-subscribers. A total of 405 971 subscription holders accrued four million years of follow up, with men accounting for 86% of the observation time. Among subscription holding men, the IRR of MS was close to unity, overall as well as 13+ years after first subscription (IRR 1.02, 95% CI: 0.48–2.16). Among women, the IRR was 3.43 (95% CI: 0.86–13.72) 13+ years after first subscription, however, based on only two cases. Presenting symptoms of MS differed between subscribers and non-subscribers (p = 0.03), with slightly increased risk of diplopia in both genders (IRR: 1.38, 95% CI: 1.02–1.86), an increased risk of fatigue among women (IRR: 3.02, 95% CI: 1.45–6.28), and of optic neuritis among men (IRR: 1.38, 95% CI: 1.03–1.86). Overall the MRR was close to one (MRR: 0.91, 95%CI 0.70–1.19) among MS-patients with a subscription and although we observed some increased MRR estimates among women, these were based on small numbers. In conclusion, we found little evidence for a pronounced association between mobile phone use and risk of MS or mortality rate among MS patients. Symptoms of MS differed between subscribers and nonsubscribers for symptoms previously suggested to be associated with mobile phone use. This deserves further attention, as does the increased long-term risk of MS among female subscribers, although small numbers and lack of consistency between genders prevent causal interpretation.

Exposure classification of MRI workers in epidemiological studies

We estimate that there are about 100,000 workers from different disciplines, such as radiographers, nurses, anesthetists, technicians, engineers, etc., who can be exposed to substantial electromagnetic fields (compared to normal background levels) around magnetic resonance imaging (MRI) scanners. There is a need for well-designed epidemiological studies of MRI workers but since the exposure from MRI equipment is a very complex mixture of static magnetic fields, switched gradient magnetic fields, and radiofrequency electromagnetic fields (RF EMF), it is necessary to discuss how to assess the exposure in epidemiological studies. As an alternative to the use of job title as a proxy of exposure, we propose an exposure categorization for the different professions working with MRI equipment. Specifically, we propose defining exposure in three categories, depending on whether people are exposed to only the static field, to the static plus switched gradient fields or to the static plus switched gradient plus RF fields, as a basis for exposure assessment in epidemiological studies.

Thermal effects of mobile phone RF fields on children: a provocation study

The aim of this study was to examine thermal and local blood flow responses in the head area of the preadolescent boys during exposure to radiofrequency (RF) electromagnetic fields produced by a GSM mobile phone. The design was a double-blinded sham-controlled study of 26 boys, aged 14-15 years. The SAR distribution was calculated and modelled in detail. The duration of the sham periods and exposures with GSM 900 phone was 15 min each, and the tests were carried out in a climatic chamber in controlled thermoneutral conditions. The ear canal temperatures were registered from both ear canals, and the skin temperatures at several sites of the head, trunk and extremities. The local cerebral blood flow was monitored by a near-infrared spectroscopy (NIRS), and the autonomic nervous system function by recordings of ECG and continuous blood pressure. During the short-term RF exposure, local cerebral blood flow did not change, the ear canal temperature did not increase significantly and autonomic nervous system was not interfered. The strengths of this study were the age of the population, multifactorial physiological monitoring and strictly controlled thermal environment. The limitations of the study were large inter-individual variation in the physiological responses, and short duration of the exposure. Longer provocation protocols, however, might cause in children distress related confounding physiological responses.

Do people with idiopathic environmental intolerance attributed to electromagnetic fields display physiological effects when exposed to electromagnetic fields? A systematic review of provocation studies

Idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) is a controversial illness in which people report symptoms that they believe are triggered by exposure to EMF. Double-blind experiments have found no association between the presence of EMF and self-reported outcomes in people with IEI-EMF. No systematic review has assessed whether EMF exposure triggers physiological or cognitive changes in this group. Using a systematic literature search, we identified 29 single or double-blind experiments in which participants with IEI-EMF were exposed to different EMF levels and in which objectively measured outcomes were assessed. Five studies identified significant effects of exposure such as reduced heart rate and blood pressure, altered pupillary light reflex, reduced visual attention and perception, improved spatial memory, movement away from an EMF source during sleep and altered EEG during sleep. In most cases, these were isolated results that other studies failed to replicate. For the sleep EEG findings, the results reflected similar changes in the IEI-EMF participants and a non-IEI-EMF control group. At present, there is no reliable evidence to suggest that people with IEI-EMF experience unusual physiological reactions as a result of exposure to EMF. This supports suggestions that EMF is not the main cause of their ill health.