The risk of subjective symptoms in mobile phone users in Poland--an epidemiological study

Headache in the international cohort study of mobile phone use and health (COSMOS) in the Netherlands and the United Kingdom

Headache is a common condition with a substantial burden of disease worldwide. Concerns have been raised over the potential impact of long-term mobile phone use on headache due to radiofrequency electromagnetic fields (RF-EMFs). We explored prospectively the association between mobile phone use at baseline (2009-2012) and headache at follow-up (2015-2018) by analysing pooled data consisting of the Dutch and UK cohorts of the Cohort Study of Mobile Phone Use and Health (COSMOS) (N = 78,437). Frequency of headache, migraine, and information on mobile phone use, including use of hands-free devices and frequency of texting, were self-reported. We collected objective operator data to obtain regression calibrated estimates of voice call duration. In the model mutually adjusted for call-time and text messaging, participants in the high category of call-time showed an adjusted odds ratio (OR) of 1.04 (95 % CI: 0.94-1.15), with no clear trend of reporting headache with increasing call-time. However, we found an increased risk of weekly headache (OR = 1.40, 95 % CI: 1.25-1.56) in the high category of text messaging, with a clear increase in reporting headache with increasing texting. Due to the negligible exposure to RF-EMFs from texting, our results suggest that mechanisms other than RF-EMFs are responsible for the increased risk of headache that we found among mobile phone users.

Association Between Smartphone Usage and Primary Headaches in Taif, Saudi Arabia: A Hospital-Based Study

Background Integrating smartphones into human life has transformed various daily activities. Numerous symptoms, including headaches, have been linked to smartphone use. The excessive use of these devices raises significant health concerns. This study aimed to investigate the relationship between smartphone use and the progression, type, and severity of primary headaches, as well as the necessity for both abortive and prophylactic medications in treating such conditions. Materials and methods In this study, we utilized a cross-sectional survey involving 403 participants aged 14 years and older, all experiencing primary headaches and seeking care at three governmental hospitals in Taif, Saudi Arabia. The participants were divided into two groups based on their smartphone usage: high and low smartphone users. Data were collected through a hospital-based questionnaire administered across the three centers. Descriptive analysis and Pearson chi-square tests were conducted using IBM SPSS Statistics for Windows, Version 21 (released 2012; IBM Corp., Armonk, New York, United States). Results Of the participants, 128 (31.8%) were classified as low users, while 275 (68.2%) were identified as high users. The most frequently reported type of headache was undiagnosed headache, among 109 (27%), followed by migraine, at 86 (21.3%). Headaches were severe in 112 (40.9%) of cases and moderate in 134 (48.9%) of users. Around 62 (72.1%) of participants diagnosed with migraine reported a severe impact on their daily lives. In terms of medication usage, 166 (60.6%) of participants reported consuming zero to five pills monthly, while 52 (19%) reported taking more than 10 pills monthly. Additionally, 58 (21.2%) of participants utilized prophylactic medications. Conclusion No significant association was observed between smartphone use and the impact of headaches. Notably, pain severity was higher among low smartphone users who reported a high intake of medications. Migraine was the most severe and intense headache type. On average, the participants consumed fewer than five pills per month.

Review of the scientific evidence on the individual sensitivity to electromagnetic fields (EHS)

Part of the population considers themselves as sensitive to the man-made electromagnetic radiation (EMF) emitted by powerlines, electric wiring, electric home appliance and the wireless communication devices and networks. Sensitivity is characterized by a broad variety of non-specific symptoms that the sensitive people claim to experience when exposed to EMF. While the experienced symptoms are currently considered as a real life impairment, the factor causing these symptoms remains unclear. So far, scientists were unable to find causality link between symptoms experienced by sensitive persons and the exposures to EMF. However, as presented in this review, the executed to-date scientific studies, examining sensitivity to EMF, are of poor quality to find the link between EMF exposures and sensitivity symptoms of some people. It is logical to consider that the sensitivity to EMF exists but the scientific methodology used to find it is of insufficient quality. It is time to drop out psychology driven provocation studies that ask about feelings-based non-specific symptoms experienced by volunteers under EMF exposure. Such research approach produces only subjective and therefore highly unreliable data that is insufficient to prove, or to disprove, causality link between EHS and EMF. There is a need for a new direction in studying sensitivity to EMF. The basis for it is the notion of a commonly known phenomenon of individual sensitivity, where individuals' responses to EMF depend on the genetic and epigenetic properties of the individual. It is proposed here that new studies, combining provocation approach, where volunteers are exposed to EMF, and high-throughput technologies of transcriptomics and proteomics are used to generate objective data, detecting molecular level biochemical responses of human body to EMF.

Mobile phone carrying locations and risk perception of men: A cross-sectional study

Little was known about the relationship between carrying mobile phone handsets by men and their risk perception of radiofrequency-electromagnetic field (RF-EMF) exposure due to carrying handsets close to the body. This study aimed to determine where men usually carried their handsets and to assess the relationship to risk perception of RF-EMF. Participants completed a self-administered questionnaire about mobile phone use, handset carrying locations, and levels of risk perception to RF-EMF. Data were analysed using linear regression models to examine if risk perception differed by mobile phone carrying location. The participants were 356 men, aged 18–72 years. They owned a mobile phone for 2–29 years, with over three quarters (78.7%) having a mobile phone for over 20 years. The most common locations that men kept their handsets when they were ‘indoors’ were: on a table/desk (54.0%) or in close contact with the body (34.7%). When outside, 54.0% of men kept the handset in the front trouser pocket. While making or receiving calls, 85.0% of men held their mobile phone handset against the head and 15.0% either used earphones or loudspeaker. Men who carried their handset in close contact with the body perceived higher risks from RF-EMF exposure compared to those who kept it away from the body (p<0.01). A substantial proportion of men carried their mobile phone handsets in close proximity to reproductive organs i.e. front pocket of trousers (46.5%). Men who kept their handset with the hand (p < .05), and those who placed it in the T-shirt pocket (p < .05), while the phone was not in use, were more likely to perceive health risks from their behaviour, compared to those who kept it away from the body. However, whether this indicates a causal relationship, remains open.

An idiographic approach to Idiopathic Environmental Intolerance attributed to Electromagnetic Fields (IEI-EMF) Part II. Ecological momentary assessment of three individuals with severe IEI-EMF

IEI-EMF refers to a self-reported sensitivity characterized by attribution of non-specific physical symptoms to exposure to weak EMFs. The majority of empirical results do not support the existence of a causal relationship between EMF and IEI-EMF. However, this conclusion was drawn from environmental and experimental studies that are not without methodological limitations. In the current study, as part of a complex biopsychosocial approach, an ecological momentary assessment (EMA) protocol was applied for the investigation of the temporal relationship between actual radio frequency (RF) EMF exposure and IEI-EMF, at the individual level. Continuous measurement of autonomic variables by holter electrocardiogram (ECG) monitors and the ambient RF EMF by personal dosimeters, as well as repeated (8/day) paper-and-pencil assessments of momentary internal states (symptoms, mood, perceived EMF intensity) and situational factors was conducted for 21 days with the participation of three individuals with severe IEI-EMF. Temporal relationships were examined by time series analyses. For two participants, the results did not support the association between the suspected EMF frequency range(s) and symptom reports. Nevertheless, the results revealed a reverse association with respect to another frequency range (GSM900 downlink), which contradicts the IEI-EMF condition. Autonomic activation related findings were inconsistent. For the third participant, the claimed association was partly supported, both for symptom reports and autonomic reactions (UMTS downlink, total RF; RMS values). The findings of this study suggest that IEI-EMF does not have a unitary aetiology. For certain individuals, a biophysical background cannot be excluded, whereas no such underlying factor appears to be at work for others. EMA is a useful method for the investigation of the aetiology of IEI-EMF.

Trigger of a migraine headache among Thai adolescents smartphone users: a time series study

The study aims to investigate the effect of modern technology in the trigger of migraine headaches in high school students by using generalized estimating equation analysis. The prospective time series study was conducted in one hundred and forty-five smartphones using high school students in Chiang Mai Province who each completed a headache diary giving a total of 12,969 data entries. The smartphone output power was measured and recorded by a smartphone application. Smartphone use, sleep quality, anxiety, and depression also were assessed. Results revealed that the prevalence of repeated headache be 13.4% and migraine 16.9%. The migraine had the strongest association with hand-free device use and internet use, followed by age and anxiety. Furthermore, the strongest effect of smartphone output power in triggering a migraine was found at ≤ 1.79×10⁻⁵ and 1.80–1.99×10⁻⁵ mW ranges. Meanwhile, Lag_6 of daily smartphone output power exposure produced the migraine effect in a reverse dose-response manner. The smartphone electromagnetic radiation was a primary migraine trigger. The study results led to the recommendation to avoid triggers by use of smartphone talking with hand-free devices to prevent a recurrent migraine.

Primary headache and factors associated in university students: a cross sectional study

Introduction: Primary headaches, defined as disorders in themselves caused by independent pathomechanisms and not by other disorders, are prevalent in university students and considered one important health problems in the world. Objective: To investigate the prevalence of primary headaches and analyze associations with sociodemographic characteristics and the use of electronic devices by university students. Methods: A cross-sectional observational study analysis was carried out with a sample of 1,143 students of both genders who responded to the questionnaire on demographic, socioeconomic aspects, use of electronic devices, and on the primary headaches. Descriptive analysis, bivariate analysis, and Poisson regression were performed. Results: The overall prevalence of primary headache of 60.7%, being that, in relation to the type, 33.2% presented tension-type headache, 54.3% migraine, and 12.3% other types of headache. Regression analysis showed that female gender and income of up to two minimum wages were associated with primary headache and migraine type. The primary headache was associated with subjects of the white race; watching television and playing video games for more than 3 hours per day, for example. The sitting posture, semi-lying down, and distance from the eyes to the mobile phone and tablet longer than 20 cm were associated with primary headache and the three types of headaches. Conclusion: The results allow us to conclude that there is a high prevalence of primary headaches in college students and that socioeconomic factors related to the use of electronic devices are associated with the presence of primary headaches.

Electromagnetic hypersensitivity (EHS, microwave syndrome) - Review of mechanisms

Electromagnetic hypersensitivity (EHS), known in the past as "Microwave syndrome", is a clinical syndrome characterized by the presence of a wide spectrum of non-specific multiple organ symptoms, typically including central nervous system symptoms, that occur following the patient's acute or chronic exposure to electromagnetic fields in the environment or in occupational settings. Numerous studies have shown biological effects at the cellular level of electromagnetic fields (EMF) at magnetic (ELF) and radio-frequency (RF) frequencies in extremely low intensities. Many of the mechanisms described for Multiple Chemical Sensitivity (MCS) apply with modification to EHS. Repeated exposures result in sensitization and consequent enhancement of response. Many hypersensitive patients appear to have impaired detoxification systems that become overloaded by excessive oxidative stress. EMF can induce changes in calcium signaling cascades, significant activation of free radical processes and overproduction of reactive oxygen species (ROS) in living cells as well as altered neurological and cognitive functions and disruption of the blood-brain barrier. Magnetite crystals absorbed from combustion air pollution could have an important role in brain effects of EMF. Autonomic nervous system effects of EMF could also be expressed as symptoms in the cardiovascular system. Other common effects of EMF include effects on skin, microvasculature, immune and hematologic systems. It is concluded that the mechanisms underlying the symptoms of EHS are biologically plausible and that many organic physiologic responses occur following EMF exposure. Patients can have neurologic, neuro-hormonal and neuro-psychiatric symptoms following exposure to EMF as a consequence of neural damage and over-sensitized neural responses. More relevant diagnostic tests for EHS should be developed. Exposure limits should be lowered to safeguard against biologic effects of EMF. Spread of local and global wireless networks should be decreased, and safer wired networks should be used instead of wireless, to protect susceptible members of the public. Public places should be made accessible for electrohypersensitive individuals.

An Experimental Study of Effects of Media Implication on Self-Report Symptoms Related With MP Use

Along with gradually increases in mobile phone (MP) use, the mass media has played a vital role in informing the public regarding the potential health hazards of MP use. These media warnings have prompted public worries about health. The aim of the present study is to investigate the effects of media warnings about the possible health hazards of MP use on self-reported symptoms. Participants were 703 undergraduate students who volunteered to take part in an experimental study between August 2013 and July 2015. After completing baseline questionnaires containing information on demographics, MP usage and possible confounding variables, the participants were randomly clustered assigned to a video treatment group (watching a 5-min video about the possible health hazards of MP use) or a control group. Then, they completed another set of questionnaires containing 6 self-reported physical symptoms and the Beck Depression Inventory (BDI). Chi-squared tests, Mann-Whitney U-tests and logistic regression models were applied in the data analysis. Participants in the video group reported significantly more frequent headache (P = 0.01), fatigue (P = 0.00), memory loss (P = 0.03), inattention (P = 0.00), and higher level of depression (P = 0.05) than those in the control group. Additionally, the prevalence of memory loss (β = 0.071, P = 0.03) and inattention (β = 0.110, P = 0.00) were significantly higher in participants with higher level of depression who watched the video. Media warnings about the possible health hazards of MP use promote people to report physical symptoms and psychological problems. Considering this tendency, more moderate and scientific media information is needed to alleviate public worries about MP use.

Smartphone use and primary headache: A cross-sectional hospital-based study

Objective

To determine the association of smartphone use with occurrence of new-onset headache and/or increased severity of headaches in patients with primary headache.

Methods

In a cross-sectional study between June 2017 and December 2018, patients with primary headache were divided into 2 groups: smartphone users (SUs) and non-smartphone users (NSUs). A questionnaire was administered for headache characteristics and treatment taken. The primary objective was to determine the association of smartphone use with new-onset headache or increase severity. The secondary objective was to determine any differences in the requirement of acute medication and prophylaxis.

Results

Four hundred patients were included in the study, of which 194 were NSUs and 206 were SUs. The NSUs were older with lower education and socioeconomic status. The headache characteristics were similar in both the groups, except for higher occurrence of aura (NSUs: 15 [7.7%] vs SUs: 36 [17.5%]; p = 0.003) in the SU group. There was, however, higher proportion of patients taking analgesics (NSUs: 157 [80.9%] vs SUs: 197 [95.6%]; p < 0.001), with less relief in headache with medication in the SU group. This was driven by increased pill count (low SUs: 5.0 [3.0; 10.0] vs high SUs: 10.0 [5.0; 15.0]; p = 0.007) and poor response to medication in the high SU group.

Conclusions

The use of smartphone was associated with increase in requirement of acute medication and less relief with acute medication. Longitudinal studies may be required to confirm these findings.

A pilot study of forearm microvascular impairment and pain while using a telephone

OBJECTIVE

To determine if using a telephone can induce forearm pain and ischemia.

DESIGN

Prospective case-control trial.

SETTING

Vascular laboratory in the university hospital in Angers between September 2018 and March 2019.

PARTICIPANTS

Fifteen apparently healthy subjects (controls) and 32 patients with suspected thoracic outlet syndrome (TOS) of vascular or non-vascular origin.

INTERVENTION

Hand-holding a cellular phone to answer a call from investigators.

MAIN OUTCOME MEASURES

Presence of forearm fatigue or pain (primary outcome), ability to hold the phone with each hand for 1 min (secondary outcome 1) and decrease in forearm transcutaneous oxygen pressure DROP index indicating forearm ischemia (secondary outcome 2). A DROP < -15 mm Hg defined ischemia.

RESULTS

Answering a phone call resulted in 25(78%) patients with forearm fatigue or pain and in 18 (56%) cases in the inability to hold the phone for 1 min, on one or both arms in patients with suspected TOS, but never occurred in healthy volunteers (p < .05 and p < .001). The presence of ischemia was observed in one or both arms in 10 (31%) patients with proved TOS and was always associated to phone-induced pain. Three (20%) of the controls had phone-induced ischemia. All had asymptomatic TOS and remained asymptomatic during the phone test (p = .42 from suspected-TOS patients).

CONCLUSION

The phone conversation resulted in pain in many patients with suspected TOS. Transcutaneous oximetry can document the underlying ischemia. Forearm phone-call-induced pain may be indicative of TOS provided that no earplug or headset is used. Trial registrationClinicalTrials.govNCT03355274.

Effects of smartphone overuse on headache, sleep and quality of life in migraine patients

Objectives:

To investigate the effects of smartphone overuse on headache, sleep quality, daytime sleepiness and quality of life in migraine patients.

Methods:

This study is a single-center, cross sectional comparative study. This study was conducted between July and September 2017 in the Neurology Clinic of a private hospital. Migraine disability assessment (MIDAS) questionnaire was used to evaluate the disability status, and Mobile Phone Problematic Use Scale (MPPUS) was used to evaluate smartphone use frequency. The Visual Analogue Scale (VAS), 24-h Migraine Quality of Life Questionnaire (24-h MQoLQ), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to evaluate the pain intensity, quality of life, sleep quality and daytime sleepiness, respectively.

Results:

The study included a total of 123 patients. There was a significant difference between the groups in terms of pain intensity, frequency and duration as well as VAS, PSQI, 24-h MQoLQ and ESS (p<0.05) scores. There was a negative correlation between MPPUS and PSQI (r=−0.367, p<0.05); a strong positive correlation between MPPUS and ESS (r=0.675, p<0.05) and a negative correlation between MPPUS and 24-h MQoLQ (r=−0.508, p<0.05).

Conclusion:

Smartphone use has been observed to increase headache duration and frequency in migraine patients. Its overuse in migraine patients is related to poor sleep quality and daytime sleepiness; furthermore, as the smartphone use increases, sleep quality decreases, daytime sleepiness increases and quality of life decreases.

Temperament and characteristics related to nomophobia

Nomophobia is defined as the fear of being out of mobile phone contact and is considered to be a phobia of the modern age. The current study set out to establish the relationship between temperament and personality and the development of nomophobia. The sample was composed of 968 participants selected from the Andalusian population, of which there were 182 males and 785 females aged from 23.19 years. The instruments used were the Questionnaire to Assess Nomophobia (QANIP; Olivencia-Carrión et al., 2018) and the Temperament and Character Inventory Revised (TCI-R; Cloninger et al., 1993). We found that cooperation is a characteristic that significantly reduces nomophobic levels, particularly for the two factors of Mobile Phone Addiction and Negative Consequences. Furthermore, Reward Dependence appears to be positively related to two of the factors involved in nomophobia, namely Mobile Phone Addiction and Loss of Control, suggesting a relationship between Nomophobia and personality. These findings are discussed in terms of their usefulness for identifying the personality predictors of nomophobia in order to develop preventive and intervention strategies.

Mobile Phone Use and The Risk of Headache: A Systematic Review and Meta-analysis of Cross-sectional Studies

Headache is increasingly being reported as a detrimental effect of mobile phone (MP) use. However, studies aimed to investigate the association between MP use and headache yielded conflicting results. To assess the consistency of the data on the topic, we performed a systematic review and meta-analysis of the available cross-sectional studies. Published literature from PubMed and other databases were retrieved and screened, and 7 cross-sectional studies were finally included in this meta-analysis. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated. We found that the risk of headache was increased by 38% in MP user compared with non-MP user (OR, 1.38; 95% CI, 1.18–1.61, p < 0.001). Among MP users, the risk of headache was also increased in those who had longer daily call duration (2–15 min vs. <2 min: OR, 1.62; 95% CI, 1.34–1.98, p < 0.001; >15 min vs. <2 min: OR, 2.50; 95% CI, 1.76–3.54, p < 0.001) and higher daily call frequency (2–4 calls vs. <2 calls: OR, 1.37; 95% CI, 1.07–1.76, p < 0.001; >4 calls vs. <2 calls: OR, 2.52; 95% CI, 1.78–3.58, p < 0.001). Our data indicate that MP use is significantly associated with headache, further epidemiologic and experimental studies are required to affirm and understand this association.

A follow-up study of the association between mobile phone use and symptoms of ill health

The duration and frequency of mobile phone calls, and their relationship with various health effects, have been investigated in our previous cross-sectional study. This 2-year period follow-up study aimed to assess the changes in these variables of same subjects. The study population comprised 532 non-patient adult subjects sampled from the Korean Genome Epidemiology Study. The subjects underwent a medical examination at a hospital in 2012/2013 and revisited the same hospital in 2014/2015 to have the same examination for the characteristics of mobile phone use performed. In addition, to evaluate the effects on health, the Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale, Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey were analyzed. For all these tests, the higher the score, the greater the effect on health. Variances between scores in all the indices in the baseline and follow-up surveys were calculated, and correlations of each index were analyzed. The average duration per call and HIT-6 score of the subjects decreased significantly compared with those recorded two years ago. The results showed a slight but significant correlation between call duration changes and HIT-6 score changes for female subjects, but not for males. HIT-6 scores in the follow-up survey significantly decreased compared to those in the baseline survey, but long-time call users (subjects whose call duration was ≥5 minutes in both the baseline and follow-up surveys) had no statistically significant reduction in HIT-6 scores. This study suggests that increased call duration is a greater risk factor for increases in headache than any other type of adverse health effect, and that this effect can be chronic.

A cross-sectional study of the association between mobile phone use and symptoms of ill health

OBJECTIVES

This study analyzed the associations between mobile phone call frequency and duration with non-specific symptoms.

METHODS

This study was conducted with a population group including 532 non-patient adults established by the Korean Genome and Epidemiology Study. The pattern of phone call using a mobile phone was investigated through face-to-face interview. Structured methods applied to quantitatively assess health effects are Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey where a higher score represents a higher greater health effect.

RESULTS

The average daily phone call frequency showed a significant correlation with the PSS score in female subjects. Increases in the average duration of one phone call were significantly correlated with increases in the severity of headaches in both sexes. The mean (standard deviation) HIT-6 score in the subgroup of subjects whose average duration of one phone call was five minutes or longer was 45.98 (8.15), as compared with 42.48 (7.20) in those whose average duration of one phone call was <5 minutes. The severity of headaches was divided into three levels according to the HIT-6 score (little or no impact/moderate impact/substantial or severe impact), and a logistic regression analysis was performed to investigate the association between an increased phone call duration and the headache severity. When the average duration of one phone call was five minutes or longer, the odds ratio (ORs) and the 95% confidence intervals (CIs) for the moderate impact group were 2.22 and 1.18 to 4.19, respectively. The OR and 95% CI for the substantial or severe impact group were 4.44 and 2.11 to 8.90, respectively.

CONCLUSIONS

Mobile phone call duration was not significantly associated with stress, sleep, cognitive function, or depression, but was associated with the severity of headaches.

Association between mobile phone use and self-reported well-being in children: a questionnaire-based cross-sectional study in Chongqing, China

OBJECTIVES

In the past decade, the mobile phone (MP) has become extremely popular among children and the average age at which children own their first MP has decreased. The potential health effects of children's exposure to MP have been the subject of widespread public concern. The aim of our study is to investigate the associations between MP use and well-being in children.

DESIGN

Cross-sectional study.

SETTING

The questionnaires were completed in class with items regarding demographics, MP usage, self-reported well-being (symptoms were taken from the questionnaire of the HBSC survey) and possible confounding factors between October 2011 and May 2012 in Chongqing, China. Data were analysed using χ(2) tests and logistic regression models.

PARTICIPANTS

Among the 793 children invited to participate, 781 returned the questionnaires.

RESULTS

In total, 746 (94.1%) valid questionnaires were received. Fatigue was significantly associated with the years of MP usage (OR 1.85; 95% CI 1.07 to 3.22) and the daily duration of MP calls (OR 2.98; 95% CI 1.46 to 6.12). Headache was significantly associated with the daily duration of MP calls (OR 2.85; 95% CI 1.23 to 6.57). However, after adjusting for confounders only, the association between fatigue and MP usage remained statistically significant. There was no significant association between MP use and other physical symptoms in children.

CONCLUSIONS

The present study indicated that there was a consistent significant association between MP use and fatigue in children. Further in-depth research is needed to explore the potential health effects of MP use in children.