Possible health implications of subjective symptoms and electromagnetic fields A report prepared by a European group of experts for the European Commission, DG V

Abstract

Summary, conclusions and recommendations The aim of the project was to investigate the occurrence of "electromagnetic hypersensitivity" across Europe. The relevant scientific literature was to be reviewed and the publications and case reports concerning symptoms or adverse health effects were to be analysed in view of a better health protection and prevention. Data on risk perception and communication as well as available public information in connection with this phenomenon and electromagnetic fields were to be evaluated, and specific advice on handling and further recommendations were to be deduced. The term "electromagnetic hypersensitivity" is used here to designate a phenomenon where individuals experience adverse health effects while using or being in the vicinity of electric, magnetic or electromagnetic field sources and devices (EMF devices). The use of the term "electromagnetic hypersensitivity" does not : by itself : presuppose or indicate any causes of these adverse reactions. The project was made possible by a grant from DG V of the European Commission. Description Certain individuals experience adverse health reactions while using or being in the vicinity of EMF devices. Symptoms vary substantially among different individuals, but in the majority of cases they present mild non-specific symptoms, with objective signs normally absent : unless another disease is present. There are, however, some cases experiencing severe problems with major consequences for work and everyday life. There are no known long-term diseases related to this phenomenon. In the absence of diagnostic criteria, the observed symptoms are attributed to "electromagnetic hypersensitivity". Both symptoms and attributions do vary substantially between different afflicted individuals. The occurrence and appearance of this phenomenon also vary considerably throughout Europe. It is possible that the varying use of a term like "electromagnetic hypersensitivity" for many different types of claimed adverse health effects could be one source of this diversity. Literature review The scientific literature was evaluated for information on relationships between relevant symptoms and exposure to electromagnetic fields (EMFs), and for information on possible causal factors for "electromagnetic hypersensitivity". There is a need to differentiate clearly between biological/physiological effects and adverse health reactions. In terms of relationships with EMFs, it should be noted that the report deals with situations where field levels are below accepted international limits. Extrapolation between frequencies is not justified. Some investigations are difficult to interpret because of inadequacies in exposure assessments, absence of clear definitions of medical terms etc. This review was unable to establish a relationship between low or high frequency fields and "electromagnetic hypersensitivity" or with symptoms typically occurring among such afflicted individuals. The results are often inconsistent and conflicting. Furthermore, the absence of credible mechanisms (both physical and physiological) should be noted. In addition, other possible causal factors were suggested, such as low humidity or flickering light. Among such other factors, the possibility that the risk perception/worry could be a causal factor for certain symptoms must be considered. Like most disorders and illnesses, there were indications of a multifactorial causation of "electromagnetic hypersensitivity". Two large groups of afflicted individuals have been identified; individuals with mostly neurasthenic symptoms with a general or varied attribution to various sources of electromagnetic fields, and individuals working with visual display units having primarily skin problems. These different groups may require separate descriptions and approaches, as their individual traits, symptoms, attributions and prognoses appear to differ Risk perception and risk communication The concepts of risk perception may be used to describe the reactions of people when using or being in the vicinity of EMF devices. As is the case with any risk, perception varies depending on social background, country and education. Risk perception appear to influence what symptoms are reported by people claiming "electromagnetic hypersensitivity", and would therefore contribute to the heterogeneity of the picture. Very different perceptions are found among different stakeholders, in particular between experts and the general public. This also has to be taken into account when risk perception is analysed in order to deduce communication concepts. It has to be kept in mind that inadequate communication, such as bias among the communicating parties, selecting wrong target groups or using ill prepared information invariably lead to misunderstandings and problems. In the worst case there is an increased concern, a loss of credibility of the experts and/or an increase of symptoms. It is acknowledged that public media information is of a transient nature and can change long-term habits only very slowly. However, as public media play an important role, journalists as opinion leaders are an important target group. It is also necessary that officials or scientists communicating with journalists are capable of presenting their knowledge and the results of studies and research. Available information In order to get a better understanding of the information people have about EMFs, information brochures available within different EU states were collected and reviewed. The main finding is that the availability of such leaflets is very non-homogeneous across the EU and the various groups. The leaflets obtained were prepared by different stake holders, such as authorities, industry, scientists, self-aid groups and other organisations. In the reviewed material, information on EMFs was fairly good and comprehensive. However, only a few different target groups were addressed, and "electromagnetic hypersensitivity" was mentioned very rarely or only marginally. For the layout and the preparation of such brochures, it appears that often no professional help, e.g. by communication specialists, was used. Handling In some countries and within some organisations, schemes to handle "electromagnetic hypersensitivity" center around: 1.Prevention, mainly concerned with information and mitigation of factors known to give rise to adverse health effects such as indoor air quality or stress conditions. 2.Intervention or early handling of afflicted cases, including medical examination to detect if the individual suffers from a known disease, and investigations of the relevant situations for other factors besides EMF. 3.Treament, primarily directed towards reducing symptoms and functional handicaps. Practical experience strongly suggests that early intervention greatly reduces the likelihood of more serious problems. To reduce the exposure to electromagnetic fields in the relevant situation(s) is a commonly asked for action by individuals claiming "electromagnetic hypersensitivity". There are, however, both advantages and disadvantages of such actions, such as measuring and reducing field emissions or avoiding field exposures. These must be carefully considered, case by case. Recommendations This project led to the following recommendations: The phenomenon known as "electromagnetic hypersensitivity" requires various actions. The extent to which such activities are needed may differ considerably between different European nations and between different organisations. It is strongly advocated that further information on "electromagnetic hypersensitivity" should be made available. Such information, however, must be based on currently available scientific information, and be carefully tailored to specified target groups. The limited number of seriously afflicted individuals, and the absence of evidence for EMFs as causal factors, do not justify alarmist reports. Well designed information plays a major role in prevention and early handling. The existence of individuals with severe health problems who claim to be "electromagnetic hypersensitive" is a clear motivation for adequate handling. Such handling would emphasise the need to reach afflicted individuals at an early stage, and to avoid concentrating on single factor explanations. A case-by-case approach within broad recommendations may prove to be effective. Because of the inability to clearly describe the syndrome and causation of "electromagnetic hypersensitivity", further scientific research is warranted. Research should be centred on the causation of specified symptoms or syndromes, and verification of specific hypotheses. The phenomenon also gives rise to other areas of investigations, such as the role of risk perception and risk communications.