Thermal Response of Human Skin to Microwave Energy: A Critical Review

Three-dimensional analysis for measuring volumetric changes after a noninvasive treatment performed with a new system delivering microwave energy for unwanted abdominal fat reduction

BACKGROUND

A growing demand for aesthetic treatments for localized abdominal unwanted fat has developed as a healthy lifestyle is not always able to improve abdomen appearance.

AIMS

The purpose of this retrospective nonrandomized observational study was to evaluate the efficacy and safety of a new device delivering microwaves energy for unwanted fat reduction, using three-dimensional (3D) imaging analysis.

METHODS

Twenty patients (both female and male) were treated in the abdominal area. Subjects received 4 treatments with the study device. Follow-up evaluations were conducted to estimate safety and efficacy. A Numerical Rating Scale (NRS) was used for pain assessment. Patient's 3D imaging analysis was performed at baseline and at 3 months follow-up. Finally, a satisfaction questionnaire was filled in by all the patients.

RESULTS

All subjects completed the whole cycle of treatments and presented for the follow-up visits. Analysis of 3D imaging yielded a significantly reduction in circumference (cm) and volume (cm3 ), passing, respectively, from 85.2 ± 8.1 cm and 1950.6 ± 471.0 cm3 at baseline to 80.8 ± 8.2 cm and 1728.9 ± 490.9 cm3 (p < 0.001) at 3-months follow-up after the last treatment. According to the NRS results, the treatment was well tolerated. From the analysis of the satisfaction questionnaire the 90% of patients are interested in carrying out the same treatment in other body areas.

CONCLUSION

With the use of three-dimensional imaging techniques, the efficacy of a new system delivering microwaves energy for the reduction of abdominal volume correlated to a subdermal fat reduction while preserving/improving skin tightening, was quantitatively and objectively demonstrated.

Reply to Foster, K.R.; Balzano, Q. Comment on "Redmayne, M.; Maisch, D.R. ICNIRP Guidelines' Exposure Assessment Method for 5G Millimetre Wave Radiation May Trigger Adverse Effects. Int. J. Environ. Res. Public Health 2023, 20, 5267"

We would like to thank Foster and Balzano for their interest in our paper [...].

[Results on reduction of subcutaneous adipose tissue using a novel body contouring system based on microwave technology]

BACKGROUND

Over the past decade, the body shaping market has seen steady growth. In order to improve procedures to reduce localized fat deposits, a novel method specifically targeting subcutaneous adipose tissue was developed.

OBJECTIVE

The objective of this study is to demonstrate that a novel microwave device with a frequency of 2.45 GHz achieves visible results with greater safety and consistency in reducing adipose tissue.

MATERIALS AND METHODS

In all, 19 healthy patients (10 women and 9 men; age 24-55 years, average age 39 years) and visible abdominal fat received three microwave treatment sessions (each 4 weeks apart) using the new Onda Plus Body Shaping System (DEKA, Italy). The device uses a handpiece that generates microwaves with a frequency of 2.45 GHz and integrated cooling for optimal patient comfort during treatment. An appropriate treatment protocol was established and applied for approximately 10 min in each treatment area. Before the start of treatment, informed consent and photo release forms were signed by all patients. Before each treatment session, the following were collected: body weight, height, waist circumference, and photographs of the area to be treated. All areas to be treated were premarked with a white skin marker pen while standing. Obese patients and those in whom fat deposits were distributed over the entire body or whose skin was in a state of irreversible flaccidity were excluded. A blood test was performed for each patient, both before the start of treatment (T0) and at the end of the entire treatment protocol (T3).

RESULTS

All patients met the inclusion/exclusion criteria of the study and signed an informed consent form. The 19 healthy adults were divided into three groups according to the size of the abdominal fold (pinch): group 1 comprised 4 patients with a pinch greater than 4.5 cm, group 2 had 10 patients with a pinch of 2.5-4.5 cm, and group 3 had 5 patients with a pinch less than 2.5 cm. At the 3‑month follow-up, the clinically measurable reduction in abdominal circumference was 3.80 ± 1.21 cm in all patients.

CONCLUSION

The microwave-based body contouring system was shown to be safe and effective to reduce abdominal circumference. No severe pain or noticeable discomfort was reported during any of the treatment sessions.

Use of a microwave device for the treatment of cellulite and localized fat adiposity: a 1-year follow-up study

BACKGROUND

The body contour market has grown steadily over the last years, due to the persistent demand for non-invasive treatments for localized fat adiposities, cellulite, and skin laxity.

MATERIALS AND METHODS

The purpose of this observational study was to evaluate the efficacy and safety of a new device delivering microwaves (MWs) energy for unwanted fat and cellulite reduction after a full cycle of treatments and 1 year later. A total of 45 patients with localized adiposity and/or cellulite in different body areas (inner thigh, upper arm, abdomen, culotte de cheval, buttocks), received four treatment sessions, 4 weeks apart. Photographic records and global aesthetic improvement scale (GAIS) score were performed.

RESULTS

For the treatment of cellulite the average GAIS score passed from 3.65 ± 0.49 at 1-month follow-up (1MFU) to 2.7 ± 0.66 at 1-year follow-up (1YFU). For the treatment of localized adiposity, the average GAIS score passed from 3.52 ± 0.51 at 1MFU to 2.82 ± 0.88 at 1YFU. No particular red area was detected either during or after the treatment. There was no mention of assessment of pain or side effects.

CONCLUSIONS

The study findings showed that MWs allow for the treatment of cellulite and localized fat adiposity in a safe and effective way, with results lasting over time up to 1 year after the end of the treatment.

Assessment of Children's Exposure to Intelligent Transport System 5.9 GHz Vehicular Connectivity Using Numerical Dosimetry

This study investigates the radio-frequency electromagnetic field exposure (RF-EMF) levels in pedestrians generated by vehicular communication technology. We specifically investigated exposure levels in children of different ages and both genders. This study also compares the children's exposure levels generated by such technology with those of an adult investigated in our previous study. The exposure scenario consisted of a 3D-CAD model of a vehicle equipped with two vehicular antennas operating at 5.9 GHz, each fed with 1 W power. Four child models were analyzed near the front and back of the car. The RF-EMF exposure levels were expressed as the Specific Absorption Rate (SAR) calculated over the whole body and 10 g mass (SAR_10g) of the skin and 1 g mass (SAR_1g) of the eyes. The maximum SAR_10g value of 9 mW/kg was found in the skin of the head of the tallest child. The maximum whole-body SAR was 0.18 mW/kg and was found in the tallest child. As a general result, it was found that children's exposure levels are lower than those of adults. All the SAR values are well below the limits recommended by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) in the general population.

Machine learning-assisted antenna modelling for realistic assessment of incident power density on non-planar surfaces above 6 GHz

In this paper, the analysis of exposure reference levels is performed for the case of a half-wavelength dipole antenna positioned in the immediate vicinity of non-planar body parts. The incident power density (IPD) spatially averaged over the spherical and cylindrical surface is computed at the 6-90 GHz range, and subsequently placed in the context of the current international guidelines and standards for limiting exposure to electromagnetic (EM) fields which are defined considering planar computational tissue models. As numerical errors are ubiquitous at such high frequencies, the spatial resolution of EM models needs to be increased which in turn results in increased computational complexity and memory requirements. To alleviate this issue, we hybridise machine learning and traditional scientific computing approaches through differentiable programming paradigm. Findings demonstrate a strong positive effect the curvature of non-planar models has on the spatially averaged IPD with up to 15% larger values compared to the corresponding planar model in considered exposure scenarios.

Some considerations on the challenges related to the use of the new ICNIRP restrictions for human exposure to radiofrequency fields

ICNIRP 2020 guidelines for limiting exposure to radiofrequency fields replace the radiofrequency part of the ICNIRP 1998 guidelines for limiting exposure to time-varying electric, magnetic and electromagnetic fields. Besides setting new restrictions that prevent thermal effect they also took over the 100 kHz to 10 MHz part of the ICNIRP 2010 guidelines for limiting exposure to low-frequency electromagnetic fields, which provides restrictions that prevent nerve stimulation effect. The latest guidelines brought many changes to the system of protection against exposure to radiofrequency fields starting with the physical quantities used to express restrictions and continuing with specific restrictions and new exposure metrics employed. For the first time, the case of brief local exposure to intense radiofrequency fields was accounted by ICNIRP for setting new types of exposure restrictions. All these changes led to more detailed and complex guidelines, but their provisions are more difficult to apply in practice. Our paper presents some of the challenges related to the use in practice of the new ICNIRP restrictions for human exposure to radiofrequency fields.

Non-invasive system delivering microwaves energy for unwanted fat reduction and submental skin tightening: Clinical evidence

BACKGROUND

Cervicomental contour represents an important aesthetic problem.

AIMS

This research evaluates the safety and the efficacy of a new non-invasive system delivering microwave energy for the treatment of submental skin laxity and fat.

METHODS

Forty-eight subjects underwent submental treatment with the device at hand at Poliambulatorio San Michele, Reggio Emilia, Italy. The treatment was performed on the submental area starting from 1.5 cm below the lower border of the mandible up to the hyoid bone. Treatment consisted of 6 sessions of 10 min, with a 2-week interval between each session. At the baseline and upon follow-up 12 weeks from the last treatment, the following evaluations were performed: Photographic evaluation, Clinician-Reported Submental Fat Rating Scale (CR-SMFRS), Submental Skin Laxity Grade (SMSLG), Five-Point Likert Scale Questionnaire (LSQ) for Skin Laxity, Patient-Reported Submental Fat Rating Scale (PR-SMFRS) and Numeric Rating Scale (NRS) for pain evaluation.

RESULTS

Mean submental fat and laxity scores evaluation significantly decrease respectively from 3.4 ± 0.5 and 3.7 ± 0.5 at baseline to 1.7 ± 0.6 and 2.4 ± 0.6 (p < 0.01) at 12-week follow-up after the last treatment. The treatment was well-tolerated according to the NRS results. Out of the 47 participants (70.2%), 33 were very satisfied or satisfied. Most patients denied experiencing any discomfort during and after the treatment with the non-invasive device delivering microwaves. The submental subcutaneous fat reduction, the improvement of submental skin tightening, and aesthetic results are confirmed also by photographic evaluation. No side effects were observed.

CONCLUSIONS

Our results showed the potential microwaves role in the treatment of localized submental subcutaneous adiposities and skin laxity.

Scientific evidence invalidates health assumptions underlying the FCC and ICNIRP exposure limit determinations for radiofrequency radiation: implications for 5G

In the late-1990s, the FCC and ICNIRP adopted radiofrequency radiation (RFR) exposure limits to protect the public and workers from adverse effects of RFR. These limits were based on results from behavioral studies conducted in the 1980s involving 40-60-minute exposures in 5 monkeys and 8 rats, and then applying arbitrary safety factors to an apparent threshold specific absorption rate (SAR) of 4 W/kg. The limits were also based on two major assumptions: any biological effects were due to excessive tissue heating and no effects would occur below the putative threshold SAR, as well as twelve assumptions that were not specified by either the FCC or ICNIRP. In this paper, we show how the past 25 years of extensive research on RFR demonstrates that the assumptions underlying the FCC's and ICNIRP's exposure limits are invalid and continue to present a public health harm. Adverse effects observed at exposures below the assumed threshold SAR include non-thermal induction of reactive oxygen species, DNA damage, cardiomyopathy, carcinogenicity, sperm damage, and neurological effects, including electromagnetic hypersensitivity. Also, multiple human studies have found statistically significant associations between RFR exposure and increased brain and thyroid cancer risk. Yet, in 2020, and in light of the body of evidence reviewed in this article, the FCC and ICNIRP reaffirmed the same limits that were established in the 1990s. Consequently, these exposure limits, which are based on false suppositions, do not adequately protect workers, children, hypersensitive individuals, and the general population from short-term or long-term RFR exposures. Thus, urgently needed are health protective exposure limits for humans and the environment. These limits must be based on scientific evidence rather than on erroneous assumptions, especially given the increasing worldwide exposures of people and the environment to RFR, including novel forms of radiation from 5G telecommunications for which there are no adequate health effects studies.

Road User Exposure from ITS-5.9 GHz Vehicular Connectivity

This study addressed an important but not yet thoroughly investigated topic regarding human exposure to radio-frequency electromagnetic fields (RF-EMF) generated by vehicular connectivity. In particular, the study assessed, by means of computational dosimetry, the RF-EMF exposure in road users near a car equipped with vehicle-to-vehicle (V2V) communication antennas. The exposure scenario consisted of a 3D numerical model of a car with two V2V antennas, each fed with 1 W, operating at 5.9 GHz and an adult human model to simulate the road user near the car. The RF-EMF dose absorbed by the human model was calculated as the specific absorption rate (SAR), that is, the RF-EMF power absorbed per unit of mass. The highest SAR was observed in the skin of the head (34.7 mW/kg) and in the eyes (15 mW/kg); the SAR at the torso (including the genitals) and limbs was negligible or much lower than in the head and eyes. The SAR over the whole body was 0.19 mW/kg. The SAR was always well below the limits of human exposure in the 100 kHz-6 GHz band established by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). The proposed approach can be generalized to assess RF-EMF exposure in different conditions by varying the montage/number of V2V antennas and considering human models of different ages.

Analysis of ICNIRP 2020 Basic Restrictions for Localized Radiofrequency Exposure in the Frequency Range above 6 GHz

ABSTRACT

ICNIRP 2020 guidelines have defined a practical temperature elevation threshold for human health effects, namely the operational adverse health effect threshold that forms the basis of the absorbed power and energy density basic restrictions. These basic restrictions for localized exposures at frequencies above 6 GHz were evaluated by comparing numerically computed temperature rise against the target temperature rise of 2.5 o C, which is the operational adverse health effect threshold divided by the occupational safety factor of 2. The numerical model employs the maximum absorbed power and energy density levels allowed by the occupational basic restriction for both pulsed and continuous wave exposures. These analyses were performed considering 3- and 4-tissue layer models and a variety of beam diameters, frequencies, and exposure durations. The smallest beam diameters were based on a study of theoretically achievable beam widths from half-wave resonant dipoles and show the impact of the averaging area on the computed temperature elevation. The results demonstrated that ICNIRP's assumed occupational safety factors in the frequency range above 6 GHz were not sufficiently maintained for all exposure scenarios and particularly for short pulse exposures at frequencies of 30 GHz or higher with small beam diameters. Worst-case tissue temperature elevations were estimated to be as much as 3.6 times higher than ICNIRP's target temperature increases. Consequently, the authors suggest a small modification in the application of the ICNIRP 2020 localized basic restrictions, thereby limiting the worst-case tissue temperature increases to 1.4 times the target value.

A New Protocol to Treat Abdominal Subcutaneous Fat Combining Microwaves and Flat magnetic stimulation

Background: A healthy lifestyle is not always able to improve the abdomen’s appearance, especially in those patients who have undergone sudden weight changes. Objective: We aimed at evaluating the efficacy of combined microwaves and flat magnetic stimulation (FMS) to treat abdominal localized adiposity and laxity. Methods: Twenty-five patients were subjected to two treatment sessions per month on the abdominal area with microwaves. FMS was also performed twice per week, with a minimum of two days between each session for two months. The technology uses three types of different protocols: massage, muscle definition (shaping), and muscular strengthening. Measurements, including body mass index (BMI) and waist, and abdominal ultrasound were performed at baseline and three months after the last treatment session. Blood examinations were performed, and a 5-Likert scale questionnaire was used to assess patient satisfaction. Results: At follow-up, three months after the last treatment, the mean waist circumference (WC) was significantly reduced, and skin laxity improved in all patients (p < 0.001). A significant improvement in abdominal muscle tissue thickness was also shown in all abdominal areas, and the thickness of the adipose tissue evaluated by ultrasound was reduced. Conclusions: This study proves that the combination of microwaves and FMS treatment is secure and efficient for treating abdominal subcutaneous fat and skin laxity.

Effects of non-ionizing electromagnetic fields on flora and fauna, part 1. Rising ambient EMF levels in the environment

Ambient levels of electromagnetic fields (EMF) have risen sharply in the last 80 years, creating a novel energetic exposure that previously did not exist. Most recent decades have seen exponential increases in nearly all environments, including rural/remote areas and lower atmospheric regions. Because of unique physiologies, some species of flora and fauna are sensitive to exogenous EMF in ways that may surpass human reactivity. There is limited, but comprehensive, baseline data in the U.S. from the 1980s against which to compare significant new surveys from different countries. This now provides broader and more precise data on potential transient and chronic exposures to wildlife and habitats. Biological effects have been seen broadly across all taxa and frequencies at vanishingly low intensities comparable to today's ambient exposures. Broad wildlife effects have been seen on orientation and migration, food finding, reproduction, mating, nest and den building, territorial maintenance and defense, and longevity and survivorship. Cyto- and geno-toxic effects have been observed. The above issues are explored in three consecutive parts: Part 1 questions today's ambient EMF capabilities to adversely affect wildlife, with more urgency regarding 5G technologies. Part 2 explores natural and man-made fields, animal magnetoreception mechanisms, and pertinent studies to all wildlife kingdoms. Part 3 examines current exposure standards, applicable laws, and future directions. It is time to recognize ambient EMF as a novel form of pollution and develop rules at regulatory agencies that designate air as 'habitat' so EMF can be regulated like other pollutants. Wildlife loss is often unseen and undocumented until tipping points are reached. Long-term chronic low-level EMF exposure standards, which do not now exist, should be set accordingly for wildlife, and environmental laws should be strictly enforced.

Microwave Therapy for Cellulite: An Effective Non-Invasive Treatment

Background: Cellulite represents a common cosmetic problem that affects nearly all women. This study aimed to evaluate microwave therapy’s effectiveness for cellulite treatment. Methods: In this study, 26 women showing severe or moderate cellulite underwent four sessions of microwave therapy on the buttocks and posterior thighs. The following assessments were performed at baseline and the three-month follow-up after the last treatment: the Cellulite Severity Scale (CSS), Nürnberger–Müller classification scale, photographic evaluation, and buttocks/posterior thighs circumference measurements. A Likert scale questionnaire was used to assess patient satisfaction at the 3-month follow-up. Results: The treatment positively affected the cellulite severity as confirmed by the Cellulite Severity Scale (CSS) and Nürnberger–Müller classification scale results. CSS showed a significant amelioration in cellulite severity between the initial assessment and the 3-month follow-up for the buttocks and posterior thighs, with total average scores that ranged from 10.7 ± 3.1 to 4.5 ± 1.8 (p < 0.01). The treatment also resulted in a remarkable improvement in comfort/satisfaction and a buttocks and posterior thighs circumference reduction. No serious adverse events were observed. Conclusions: Microwave therapy has proven to be a safe treatment for improving cellulite appearance and reducing body circumferences.

The effect of radiofrequency electromagnetic fields (RF-EMF) on biomarkers of oxidative stress in vivo and in vitro: A protocol for a systematic review

BACKGROUND

Oxidative stress is conjectured to be related to many diseases. Furthermore, it is hypothesized that radiofrequency fields may induce oxidative stress in various cell types and thereby compromise human and animal health. This systematic review (SR) aims to summarize and evaluate the literature related to this hypothesis.

OBJECTIVES

The main objective of this SR is to evaluate the associations between the exposure to radiofrequency electromagnetic fields and oxidative stress in experimental models (in vivo and in vitro).

METHODS

The SR framework has been developed following the guidelines established in the WHO Handbook for Guideline Development and the Handbook for Conducting a Literature-Based Health Assessment). We will include controlled in vivo and in vitro laboratory studies that assess the effects of an exposure to RF-EMF on valid markers for oxidative stress compared to no or sham exposure. The protocol is registered in PROSPERO. We will search the following databases: PubMed, Embase, Web of Science Core Collection, Scopus, and the EMF-Portal. The reference lists of included studies and retrieved review articles will also be manually searched.

STUDY APPRAISAL AND SYNTHESIS METHOD

Data will be extracted according to a pre-defined set of forms developed in the DistillerSR online software and synthesized in a meta-analysis when studies are judged sufficiently similar to be combined. If a meta-analysis is not possible, we will describe the effects of the exposure in a narrative way.

RISK OF BIAS

The risk of bias will be assessed with the NTP/OHAT risk of bias rating tool for human and animal studies. We will use GRADE to assess the certainty of the conclusions (high, moderate, low, or inadequate) regarding the association between radiofrequency electromagnetic fields and oxidative stress.

FUNDING

This work was funded by the World Health Organization (WHO).

REGISTRATION

The protocol was registered on the PROSPERO webpage on July 8, 2021.

Time-temperature Thresholds and Safety Factors for Thermal Hazards from Radiofrequency Energy above 6 GHz

ABSTRACT

Two major sets of exposure limits for radiofrequency (RF) radiation, those of the International Commission on Nonionizing Radiation Protection (ICNIRP 2020) and the Institute of Electrical and Electronics Engineers (IEEE C95.1-2019), have recently been revised and updated with significant changes in limits above 6 GHz through the millimeter wave (mm-wave) band (30-300 GHz). This review compares available data on thermal damage and pain from exposure to RF energy above 6 GHz with corresponding data from infrared energy and other heat sources and estimates safety factors that are incorporated in the IEEE and ICNIRP RF exposure limits. The benchmarks for damage are the same as used in ICNIRP IR limits: minimal epithelial damage to cornea and first-degree burn (erythema in skin observable within 48 h after exposure). The data suggest that limiting thermal hazard to skin is cutaneous pain for exposure durations less than ≈20 min and thermal damage for longer exposures. Limitations on available data and thermal models are noted. However, data on RF and IR thermal damage and pain thresholds show that exposures far above current ICNIRP and IEEE limits would be required to produce thermally hazardous effects. This review focuses exclusively on thermal hazards from RF exposures above 6 GHz to skin and the cornea, which are the most exposed tissues in the considered frequency range.

Steady state temperature rise in multilayered tissue due to arbitrary periodic SAR using finite difference FFT and transfer function method

Steady state (SS) and transient temperature-rise in tissue from radiofrequency exposure forms the underlying basis for limits in international exposure guidelines. Periodically pulsed or intermittent exposures form a special case of having both peak and average levels, producing temperature-rise oscillations in the SS. Presented here is a method for determining tissue temperature-rise for periodic specific absorption rate (SAR) modulation having arbitrary waveform. It involves the finite difference solution of a form of the Pennes Bioheat Transfer equation (BHTE) and uses the concept of the transfer function and the Fast Fourier Transform (FFT). The time-dependent BHTE is converted to a SS harmonic version by assuming that the time-dependent SAR waveform and tissue temperature can both be represented by Fourier series. The transfer function is obtained from solutions of the harmonic BHTE for an assumed SAR waveform consisting of periodic impulses. The temperature versus time response for an arbitrary periodic SAR waveform is obtained from the inverse FFT of the product of the transfer function and the FFT of the actual SAR waveform. This method takes advantage of existing FFT algorithms on most computational platforms and the ability to store the transfer function for later re-use. The transfer function varies slowly with harmonic number, allowing interpolation and extrapolation to reduce the computational effort. The method is highly efficient for the case where repeated temperature-rise calculations for parameter variations in the SAR waveform are sought. Examples are given for a narrow, circularly symmetric beam incident on a planar skin/fat/muscle model with rectangular, triangular and cosine-pulsed SAR modulation waveforms. Calculations of temperature-rise crest factor as a function of rectangular pulse duty factor and pulse repetition frequency for the same exposure/tissue model are also presented as an example of the versatility of the method.

Human exposure to radiofrequency energy above 6 GHz: review of computational dosimetry studies

International guidelines/standards for human protection from electromagnetic fields have been revised recently, especially for frequencies above 6 GHz where new wireless communication systems have been deployed. Above this frequency a new physical quantity 'absorbed/epithelial power density' has been adopted as a dose metric. Then, the permissible level of external field strength/power density is derived for practical assessment. In addition, a new physical quantity, fluence or absorbed energy density, is introduced for protection from brief pulses (especially for shorter than 10 s). These limits were explicitly designed to avoid excessive increases in tissue temperature, based on electromagnetic and thermal modeling studies but supported by experimental data where available. This paper reviews the studies on the computational modeling/dosimetry which are related to the revision of the guidelines/standards. The comparisons with experimental data as well as an analytic solution are also been presented. Future research needs and additional comments on the revision will also be mentioned.

Assessment of absorbed power density and temperature rise for nonplanar body model under electromagnetic exposure above 6 GHz

The averaged absorbed power density (APD) and temperature rise in body models with nonplanar surfaces were computed for electromagnetic exposure above 6 GHz. Different calculation schemes for the averaged APD were investigated. Additionally, a novel compensation method for correcting the heat convection rate on the air/skin interface in voxel human models was proposed and validated. The compensation method can be easily incorporated into bioheat calculations and does not require information regarding the normal direction of the boundary voxels, in contrast to a previously proposed method. The APD and temperature rise were evaluated using models of a two-dimensional cylinder and a three-dimensional partial forearm. The heating factor, which was defined as the ratio of the temperature rise to the APD, was calculated using different APD averaging schemes. Our computational results revealed different frequency and curvature dependences. For body models with curvature radii of >30 mm and at frequencies of >20 GHz, the differences in the heating factors among the APD schemes were small.

Model-based approach for analyzing prevalence of nuclear cataracts in elderly residents

Recent epidemiological studies have hypothesized that the prevalence of cortical cataracts is closely related to ultraviolet radiation. However, the prevalence of nuclear cataracts is higher in elderly people in tropical areas than in temperate areas. The dominant factors inducing nuclear cataracts have been widely debated. In this study, the temperature increase in the lens due to exposure to ambient conditions was computationally quantified in subjects of 50-60 years of age in tropical and temperate areas, accounting for differences in thermoregulation. A thermoregulatory response model was extended to consider elderly people in tropical areas. The time course of lens temperature for different weather conditions in five cities in Asia was computed. The temperature was higher around the mid and posterior part of the lens, which coincides with the position of the nuclear cataract. The duration of higher temperatures in the lens varied, although the daily maximum temperatures were comparable. A strong correlation (adjusted R² > 0.85) was observed between the prevalence of nuclear cataract and the computed cumulative thermal dose in the lens. We propose the use of a cumulative thermal dose to assess the prevalence of nuclear cataracts. Cumulative wet-bulb globe temperature, a new metric computed from weather data, would be useful for practical assessment in different cities.

RF-INDUCED TEMPERATURE INCREASE IN A STRATIFIED MODEL OF THE SKIN FOR PLANE-WAVE EXPOSURE AT 6-100 GHZ

This study assesses the maximum temperature increase induced by exposure to electromagnetic fields between 6 and 100 GHz using a stratified model of the skin with four or five layers under plane wave incidence. The skin model distinguishes the stratum corneum (SC) and the viable epidermis as the outermost layers of the skin. The analysis identifies the tissue layer structures that minimize reflection and maximize the temperature increase induced by the electromagnetic field. The maximum observed temperature increase is 0.4°C for exposure at the present power density limit for the general population of 10 W m -2 . This result is more than twice as high as the findings reported in a previous study. The reasons for this difference are identified as impedance matching effects in the SC and less conservative thermal parameters. Modeling the skin as homogeneous dermis tissue can underestimate the induced temperature increase by more than a factor of three.

Guidelines for Limiting Exposure to Electromagnetic Fields (100 kHz to 300 GHz)

Radiofrequency electromagnetic fields (EMFs) are used to enable a number of modern devices, including mobile telecommunications infrastructure and phones, Wi-Fi, and Bluetooth. As radiofrequency EMFs at sufficiently high power levels can adversely affect health, ICNIRP published Guidelines in 1998 for human exposure to time-varying EMFs up to 300 GHz, which included the radiofrequency EMF spectrum. Since that time, there has been a considerable body of science further addressing the relation between radiofrequency EMFs and adverse health outcomes, as well as significant developments in the technologies that use radiofrequency EMFs. Accordingly, ICNIRP has updated the radiofrequency EMF part of the 1998 Guidelines. This document presents these revised Guidelines, which provide protection for humans from exposure to EMFs from 100 kHz to 300 GHz.

5G Wireless Communication and Health Effects-A Pragmatic Review Based on Available Studies Regarding 6 to 100 GHz

The introduction of the fifth generation (5G) of wireless communication will increase the number of high-frequency-powered base stations and other devices. The question is if such higher frequencies (in this review, 6-100 GHz, millimeter waves, MMW) can have a health impact. This review analyzed 94 relevant publications performing in vivo or in vitro investigations. Each study was characterized for: study type (in vivo, in vitro), biological material (species, cell type, etc.), biological endpoint, exposure (frequency, exposure duration, power density), results, and certain quality criteria. Eighty percent of the in vivo studies showed responses to exposure, while 58% of the in vitro studies demonstrated effects. The responses affected all biological endpoints studied. There was no consistent relationship between power density, exposure duration, or frequency, and exposure effects. The available studies do not provide adequate and sufficient information for a meaningful safety assessment, or for the question about non-thermal effects. There is a need for research regarding local heat developments on small surfaces, e.g., skin or the eye, and on any environmental impact. Our quality analysis shows that for future studies to be useful for safety assessment, design and implementation need to be significantly improved.

Model of Steady-state Temperature Rise in Multilayer Tissues Due to Narrow-beam Millimeter-wave Radiofrequency Field Exposure

The assessment of health effects due to localized exposures from radiofrequency fields is facilitated by characterizing the steady-state, surface temperature rise in tissue. A closed-form analytical model was developed that relates the steady-state, surface temperature rise in multilayer planar tissues as a function of the spatial-peak power density and beam dimensions of an incident millimeter wave. Model data was derived from finite-difference solutions of the Pennes bioheat transfer equation for both normal-incidence plane waves and for narrow, circularly symmetric beams with Gaussian intensity distribution on the surface. Monte Carlo techniques were employed by representing tissue layer thicknesses at different body sites as statistical distributions compiled from human data found in the literature. The finite-difference solutions were validated against analytical solutions of the bioheat equation for the plane wave case and against a narrow-beam solution performed using a commercial multiphysics simulation package. In both cases, agreement was within 1-2%. For a given frequency, the resulting analytical model has four input parameters, two of which are deterministic, describing the level of exposure (i.e., the spatial-peak power density and beam width). The remaining two are stochastic quantities, extracted from the Monte Carlo analyses. The analytical model is composed of relatively simple functions that can be programmed in a spreadsheet. Demonstration of the analytical model is provided in two examples: the calculation of spatial-peak power density vs. beam width that produces a predefined maximum steady-state surface temperature, and the performance evaluation of various proposed spatial-averaging areas for the incident power density.

Bioluminescence of Vibrio fischeri: bacteria respond quickly and sensitively to pulsed microwave electric (but not magnetic) fields

Biological systems with intrinsic luminescent properties serve as powerful and noninvasive bioreporters for real-time and label-free monitoring of cell physiology. This study employs the bioluminescent marine bacterium Vibrio fischeri to investigate the effects of separated microwave electric (E) and magnetic (H) fields. Using a cylindrical TM010 mode aluminum resonant cavity, designed to spatially separate E and H fields of a pulsed microwave (2.45 GHz) input, we sampled at 100-ms intervals the 490-nm emission of bioluminescence from suspensions of the V. fischeri. E-field exposure (at 4.24 and 13.4 kV/m) results in rapid and sensitive responses to 100-ms pulses. H-field excitation elicits no measurable responses, even at 100-fold higher power input levels (equivalent to 183 A/m). The observed effects on bacterial light output partially correlate with measured E-field-induced temperature increases. In conclusion, the endogenous bioluminescence of V. fischeri provides a sensitive and noninvasive method to assess the biological effects of microwave fields.

Systematic Derivation of Safety Limits for Time-Varying 5G Radiofrequency Exposure Based on Analytical Models and Thermal Dose

Extreme broadband wireless devices operating above 10 GHz may transmit data in bursts of a few milliseconds to seconds. Even though the time- and area-averaged power density values remain within the acceptable safety limits for continuous exposure, these bursts may lead to short temperature spikes in the skin of exposed people. In this paper, a novel analytical approach to pulsed heating is developed and applied to assess the peak-to-average temperature ratio as a function of the pulse fraction α (relative to the averaging time [INCREMENT]T; it corresponds to the inverse of the peak-to-average ratio). This has been analyzed for two different perfusion-related thermal time constants (τ1 = 100 s and 500 s) corresponding to plane-wave and localized exposures. To allow for peak temperatures that considerably exceed the 1 K increase, the CEM43 tissue damage model, with an experimental-data-based damage threshold for human skin of 600 min, is used to allow large temperature oscillations that remain below the level at which tissue damage occurs. To stay consistent with the current safety guidelines, safety factors of 10 for occupational exposure and 50 for the general public were applied. The model assumptions and limitations (e.g., employed thermal and tissue damage models, homogeneous skin, consideration of localized exposure by a modified time constant) are discussed in detail. The results demonstrate that the maximum averaging time, based on the assumption of a thermal time constant of 100 s, is 240 s if the maximum local temperature increase for continuous-wave exposure is limited to 1 K and α ≥ 0.1. For a very low peak-to-average ratio of 100 (α ≥ 0.01), it decreases to only 30 s. The results also show that the peak-to-average ratio of 1,000 tolerated by the International Council on Non-Ionizing Radiation Protection guidelines may lead to permanent tissue damage after even short exposures, highlighting the importance of revisiting existing exposure guidelines.

Comparison of Thermal Response for RF Exposure in Human and Rat Models

In the international guidelines/standards for human protection against electromagnetic fields, the specific absorption rate (SAR) is used as a metric for radio-frequency field exposure. For radio-frequency near-field exposure, the peak value of the SAR averaged over 10 g of tissue is treated as a surrogate of the local temperature elevation for frequencies up to 3⁻10 GHz. The limit of 10-g SAR is derived by extrapolating the thermal damage in animal experiments. However, no reports discussed the difference between the time constant of temperature elevation in small animals and humans for local exposure. This study computationally estimated the thermal time constants of temperature elevation in human head and rat models exposed to dipole antennas at 3⁻10 GHz. The peak temperature elevation in the human brain was lower than that in the rat model, mainly because of difference in depth from the scalp. Consequently, the thermal time constant of the rat brain was smaller than that of the human brain. Additionally, the thermal time constant in human skin decreased with increasing frequency, which was mainly characterized by the effective SAR volume, whereas it was almost frequency-independent in the human brain. These findings should be helpful for extrapolating animal studies to humans.

Modeling Tissue Heating From Exposure to Radiofrequency Energy and Relevance of Tissue Heating to Exposure Limits: Heating Factor

This review/commentary addresses recent thermal and electromagnetic modeling studies that use image-based anthropomorphic human models to establish the local absorption of radiofrequency energy and the resulting increase in temperature in the body. The frequency range of present interest is from 100 MHz through the transition frequency (where the basic restrictions in exposure guidelines change from specific absorption rate to incident power density, which occurs at 3-10 GHz depending on the guideline). Several detailed thermal modeling studies are reviewed to compare a recently introduced dosimetric quantity, the heating factor, across different exposure conditions as related to the peak temperature rise in tissue that would be permitted by limits for local body exposure. The present review suggests that the heating factor is a robust quantity that is useful for normalizing exposures across different simulation models. Limitations include lack of information about the location in the body where peak absorption and peak temperature increases occur in each exposure scenario, which are needed for careful assessment of potential hazards. To the limited extent that comparisons are possible, the thermal model (which is based on Pennes' bioheat equation) agrees reasonably well with experimental data, notwithstanding the lack of theoretical rigor of the model and uncertainties in the model parameters. In particular, the blood flow parameter is both variable with physiological condition and largely determines the steady state temperature rise. We suggest an approach to define exposure limits above and below the transition frequency (the frequency at which the basic restriction changes from specific absorption rate to incident power density) to provide consistent levels of protection against thermal hazards. More research is needed to better validate the model and to improve thermal dosimetry in general. While modeling studies have considered the effects of variation in thickness of tissue layers, the effects of normal physiological variation in tissue blood flow have been relatively unexplored.

Effect of high frequency electromagnetic wave stimulation on muscle injury in a rat model

INTRODUCTION

The aim of this study was to investigate biological changes in tissues with muscle contusion after the application of high frequency (HF) electromagnetic wave.

METHODS

An acrylic pipe was placed on the right hind limb and a metallic ball was dropped inside the pipe, which resulted in a muscle contusion. After acquiring the optimal condition for muscle contusion, 20 Sprague-Dawley rats were allocated to the HF treatment (N = 10) and sham groups (N = 10), which then underwent muscle contusion injury at their right thigh. The thickness and circumference of the right thigh and the left thigh (negative control groups) were measured (day 0). HF electromagnetic wave stimulation for three days was performed on the contusion area in the HF group after one day. Thickness was measured at the thickest area of both hind limbs and the circumference was measured every day for three days. The sham group received no treatment, and the circumference and thickness were measured using the same method. After three days, Hematoxylin and eosin and immunohistochemical (IHC) staining for IL-1β were performed and TUNEL assay was conducted for apoptosis in the skin and muscle layers.

RESULTS

The thigh muscle thickness at day 1 was significantly different between groups (P = 0.018) and this difference was observed between both sham and control groups (corrected P = 0.007), and between sham and HF groups (corrected P = 0.043). Thigh circumference was significantly different at day 3 (P = 0.047) and this difference was found between sham and control groups (corrected P = 0.018), and between sham and HF groups (corrected P = 0.032). In the HF group, the inflammatory response was reduced to almost the same level as the control group. Evaluation of IL-1β level, the inflammatory cytokine, through IHC showed marked localization of IL-1β in muscle fibers of the sham group. However, significantly less IL-1β was observed in the muscle of the HF treatment group. There was neither injury nor apoptosis after HF stimulation.

CONCLUSIONS

Application of the HF showed therapeutic effect on muscle contusion by reducing muscle swelling. This effect might be caused by the anti-inflammatory action of the HF, which evoked energy into the injured muscle.

Temperature elevation in the human brain and skin with thermoregulation during exposure to RF energy

Background

Two international guidelines/standards for human protection from electromagnetic fields define the specific absorption rate (SAR) averaged over 10 g of tissue as a metric for protection against localized radio frequency field exposure due to portable devices operating below 3–10 GHz. Temperature elevation is suggested to be a dominant effect for exposure at frequencies higher than 100 kHz. No previous studies have evaluated temperature elevation in the human head for local exposure considering thermoregulation. This study aims to discuss the temperature elevation in a human head model considering vasodilation, to discuss the conservativeness of the current limit.

Methods

This study computes the temperature elevations in an anatomical human head model exposed to radiation from a dipole antenna and truncated plane waves at 300 MHz–10GHz. The SARs in the human model are first computed using a finite-difference time-domain method. The temperature elevation is calculated by solving the bioheat transfer equation by considering the thermoregulation that simulates the vasodilation.

Results

The maximum temperature elevation in the brain appeared around its periphery. At exposures with higher intensity, the temperature elevation became larger and reached around 40 °C at the peak SAR of 100 W/kg, and became lower at higher frequencies. The temperature elevation in the brain at the current limit of 10 W/kg is at most 0.93 °C. The effect of vasodilation became notable for tissue temperature elevations higher than 1–2 °C and for an SAR of 10 W/kg. The temperature at the periphery was below the basal brain temperature (37 °C).

Conclusions

The temperature elevation under the current guideline for occupational exposure is within the ranges of brain temperature variability for environmental changes in daily life. The effect of vasodilation is significant, especially at higher frequencies where skin temperature elevation is dominant.

Extremely high-frequency electromagnetic radiation enhances neutrophil response to particulate agonists

The growing use of extremely high-frequency electromagnetic radiation (EHF EMR) in information and communication technology and in biomedical applications has raised concerns regarding the potential biological impact of millimeter waves (MMWs). Here, we elucidated the effects of MMW radiation on neutrophil activation induced by opsonized zymosan or E. coli in whole blood ex vivo. After agonist addition to blood, two samples were prepared. A control sample was incubated at ambient conditions without any treatment, and a test sample was exposed to EHF EMR (32.9-39.6 GHz, 100 W/m² ). We used methods that allowed us to assess the functional status of neutrophils immediately after exposure: oxidant production levels were measured by luminol-dependent chemiluminescence, and morphofunctional changes to neutrophils were observed in blood smears. Results revealed that the response of neutrophils to both agonists was intensified if blood was exposed to MMW radiation for 15 min. Neutrophils were intact in both the control and irradiated samples if no agonist was added to blood before incubation. Similarly, exposing suspensions of isolated neutrophils in plasma to MMW radiation enhanced cell response to both zymosan and E. coli. Heating blood samples was shown to be the primary mechanism underlying enhanced EHF EMR-induced oxidant production by neutrophils in response to particulate agonists. Bioelectromagnetics. 39:144-155, 2018. © 2017 Wiley Periodicals, Inc.

Human exposure to pulsed fields in the frequency range from 6 to 100 GHz

Restrictions on human exposure to electromagnetic waves at frequencies higher than 3-10 GHz are defined in terms of the incident power density to prevent excessive temperature rise in superficial tissue. However, international standards and guidelines differ in their definitions of how the power density is interpreted for brief exposures. This study investigated how the temperature rise was affected by exposure duration at frequencies higher than 6 GHz. Far-field exposure of the human face to pulses shorter than 10 s at frequencies from 6 to 100 GHz was modelled using the finite-difference time-domain method. The bioheat transfer equation was used for thermal modelling. We investigated the effects of frequency, polarization, exposure duration, and depth below the skin surface on the temperature rise. The results indicated limitations in the current human exposure guidelines and showed that radiant exposure, i.e. energy absorption per unit area, can be used to limit temperature rise for pulsed exposure. The data are useful for the development of human exposure guidelines at frequencies higher than 6 GHz.

Thermal Modeling for the Next Generation of Radiofrequency Exposure Limits: Commentary

This commentary evaluates two sets of guidelines for human exposure to radiofrequency (RF) energy, focusing on the frequency range above the "transition" frequency at 3-10 GHz where the guidelines change their basic restrictions from specific absorption rate to incident power density, through the end of the RF band at 300 GHz. The analysis is based on a simple thermal model based on Pennes' bioheat equation (BHTE) (Pennes 1948) assuming purely surface heating; an Appendix provides more details about the model and its range of applicability. This analysis suggests that present limits are highly conservative relative to their stated goals of limiting temperature increase in tissue. As applied to transmitting devices used against the body, they are much more conservative than product safety standards for touch temperature for personal electronics equipment that are used in contact with the body. Provisions in the current guidelines for "averaging time" and "averaging area" are not consistent with scaling characteristics of the bioheat equation and should be refined. The authors suggest the need for additional limits on fluence for protection against brief, high intensity pulses at millimeter wave frequencies. This commentary considers only thermal hazards, which form the basis of the current guidelines, and excludes considerations of reported "non-thermal" effects of exposure that would have to be evaluated in the process of updating the guidelines.

On the averaging area for incident power density for human exposure limits at frequencies over 6 GHz

Incident power density is used as the dosimetric quantity to specify the restrictions on human exposure to electromagnetic fields at frequencies above 3 or 10 GHz in order to prevent excessive temperature elevation at the body surface. However, international standards and guidelines have different definitions for the size of the area over which the power density should be averaged. This study reports computational evaluation of the relationship between the size of the area over which incident power density is averaged and the local peak temperature elevation in a multi-layer model simulating a human body. Three wave sources are considered in the frequency range from 3 to 300 GHz: an ideal beam, a half-wave dipole antenna, and an antenna array. 1D analysis shows that averaging area of 20 mm  ×  20 mm is a good measure to correlate with the local peak temperature elevation when the field distribution is nearly uniform in that area. The averaging area is different from recommendations in the current international standards/guidelines, and not dependent on the frequency. For a non-uniform field distribution, such as a beam with small diameter, the incident power density should be compensated by multiplying a factor that can be derived from the ratio of the effective beam area to the averaging area. The findings in the present study suggest that the relationship obtained using the 1D approximation is applicable for deriving the relationship between the incident power density and the local temperature elevation.

Multiphysics and Thermal Response Models to Improve Accuracy of Local Temperature Estimation in Rat Cortex under Microwave Exposure

The rapid development of wireless technology has led to widespread concerns regarding adverse human health effects caused by exposure to electromagnetic fields. Temperature elevation in biological bodies is an important factor that can adversely affect health. A thermophysiological model is desired to quantify microwave (MW) induced temperature elevations. In this study, parameters related to thermophysiological responses for MW exposures were estimated using an electromagnetic-thermodynamics simulation technique. To the authors’ knowledge, this is the first study in which parameters related to regional cerebral blood flow in a rat model were extracted at a high degree of accuracy through experimental measurements for localized MW exposure at frequencies exceeding 6 GHz. The findings indicate that the improved modeling parameters yield computed results that match well with the measured quantities during and after exposure in rats. It is expected that the computational model will be helpful in estimating the temperature elevation in the rat brain at multiple observation points (that are difficult to measure simultaneously) and in explaining the physiological changes in the local cortex region.

Time constants for temperature elevation in human models exposed to dipole antennas and beams in the frequency range from 1 to 30 GHz

This study computes the time constants of the temperature elevations in human head and body models exposed to simulated radiation from dipole antennas, electromagnetic beams, and plane waves. The frequency range considered is from 1 to 30 GHz. The specific absorption rate distributions in the human models are first computed using the finite-difference time-domain method for the electromagnetics. The temperature elevation is then calculated by solving the bioheat transfer equation. The computational results show that the thermal time constants (defined as the time required to reach 63% of the steady state temperature elevation) decrease with the elevation in radiation frequency. For frequencies higher than 4 GHz, the computed thermal time constants are smaller than the averaging time prescribed in the ICNIRP guidelines, but larger than the averaging time in the IEEE standard. Significant differences between the different head models are observed at frequencies higher than 10 GHz, which is attributable to the heat diffusion from the power absorbed in the pinna. The time constants for beam exposures become large with the increase in beam diameter. The thermal time constant in the brain is larger than that in the superficial tissues at high frequencies, because the brain temperature elevation is caused by the heat conduction of energy absorbed in the superficial tissue. The thermal time constant is minimized with an ideal beam with a minimum investigated diameter of 10 mm; this minimal time constant is approximately 30 s and is almost independent of the radiation frequency, which is supported by analytic methods. In addition, the relation between the time constant, as defined in this paper, and 'averaging time' as it appears in the exposure limits is discussed, especially for short intense pulses. Similar to the laser guidelines, provisions should be included in the limits to limit the fluence for such pulses.