Electromagnetic interference with cardiac pacemakers and implantable cardioverter-defibrillators from low-frequency electromagnetic fields in vivo.

AIMS: Electromagnetic interference (EMI) can pose a danger to workers with pacemakers and implantable cardioverter-defibrillators (ICDs). At some workplaces electromagnetic fields are high enough to potentially inflict EMI. The purpose of this in vivo study was to evaluate the susceptibility of pacemakers and ICDs to external electromagnetic fields. METHODS AND RESULTS: Eleven volunteers with a pacemaker and 13 with an ICD were exposed to sine, pulse, ramp, and square waveform magnetic fields with frequencies of 2-200 Hz using Helmholtz coil. The magnetic field flux densities varied to 300 µT. We also tested the occurrence of EMI from an electronic article surveillance (EAS) gate, an induction cooktop, and a metal inert gas (MIG) welding machine. All pacemakers were tested with bipolar settings and three of them also with unipolar sensing configurations. None of the bipolar pacemakers or ICDs tested experienced interference in any of the exposure situations. The three pacemakers with unipolar settings were affected by the highest fields of the Helmholtz coil, and one of them also by the EAS gate and the welding cable. The induction cooktop did not interfere with any of the unipolarly programmed pacemakers. CONCLUSION: Magnetic fields with intensities as high as those used in this study are rare even in industrial working environments. In most cases, employees can return to work after implantation of a bipolar pacemaker or an ICD, after an appropriate risk assessment. Pacemakers programmed to unipolar configurations can cause danger to their users in environments with high electromagnetic fields, and should be avoided, if possible.

Exposure classification of MRI workers in epidemiological studies.

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

Inappropriate implantable cardioverter-defibrillator magnet-mode switch induced by a laptop computer.

An implantable cardioverter-defibrillator (ICD) experienced electromagnetic interference from a laptop computer's hard disk. The patient with the ICD was using his laptop computer at home while lying on his bed. The laptop was positioned on his chest, when he heard a beeping sound from the ICD, indicating magnet mode conversion. This situation was replicated in a controlled environment, and the conversion was found to be due to the static magnetic field produced by the laptop's hard disk. The ICD's conversion to magnet mode can be dangerous because it ends all tachyarrhythmia detections and therapies.

Interference of low frequency magnetic fields with implantable cardioverter-defibrillators.

OBJECTIVES: The aim of this study was to find the electromagnetic interference (EMI) thresholds for several commonly used implantable cardioverter-defibrillators (ICD). DESIGN: Seventeen ICDs were exposed to magnetic fields with different intensities produced by the Helmholtz coil system. Sinusoidal, pulse, ramp, and square-waveforms with a frequency range of 2 Hz to 1 kHz were used. RESULTS: ICD malfunctions occurred in 11 of the 17 ICDs tested. The ICD malfunctions that occurred were false detections of ventricular tachycardia (6/17 ICDs) and ventricular fibrillation (3/17 ICDs), false detection of atrial tachycardia (4/6 dual chamber ICDs) and tachycardia sensing occurring during atrial or ventricular refractory periods (1/17 ICD). In most cases, no interference occurred at magnetic field levels below the occupational safety limits of the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Nevertheless, some frequencies using sine, ramp or square waveforms did interfere with certain ICDs at levels below these limits. No EMI occurred with any of the ICDs below the ICNIRP limits for public exposure. CONCLUSION: Evaluation of EMI should be part of the risk assessment of an employee returning to work after an ICD implantation. The risk assessment should consider magnetic field intensities, frequencies and waveforms.

Assessment of exposure to intermediate frequency electric fields and contact currents from a plasma ball.

While electric fields at intermediate frequencies are not widely utilized for industrial technologies, surprisingly, certain toys emit the highest electric fields found in our living environment. These toys, plasma balls, are devices that use high voltage to create ionized light discharges. In this study, we assessed exposure to electric fields and contact/induced current from a recreational plasma ball device. The electric field strength was measured as a function of distance from the device, and the contact/induced current was measured with a current clamp in different exposure situations with point or grasping contact. The characteristic spectra of the electric field and contact current were measured, and both the multiple frequency rule and weighting of the spectra were applied according to the International Commission on Non-Ionizing Radiation Protection (ICNIRP) 1998 and 2010 guidelines. The results indicate that the recommended reference levels for the general public are exceeded at distances <1.2 m, and that the contact currents in the hand may be twice higher than recommended by the general public guidelines.

Exposure of workers to electromagnetic fields. A review of open questions on exposure assessment techniques.

European Directive 2004/40/EC on occupational exposure to electromagnetic fields (EMF), based on the guidelines of the International Commission on Non-Ionizing Radiation Protection, was to be implemented in the Member States of the European Union by 2008. Because of some unexpected problems the deadline was postponed until 2012. This paper reviews some of the problems identified and presents some suggestions for possible solutions based on the authors' experience in assessing occupational exposure to EMF. Among the topics discussed are movement in static magnetic fields, ways to time average extreme low frequency signals, the difference between emission and exposure standards, and ways of dealing with those issues.

A practical method to evaluate radiofrequency exposure of mast workers.

Assessment of occupational exposure to radiofrequency (RF) fields in telecommunication transmitter masts is a challenging task. For conventional field strength measurements using manually operated instruments, it is difficult to document the locations of measurements while climbing up a mast. Logging RF dosemeters worn by the workers, on the other hand, do not give any information about the location of the exposure. In this study, a practical method was developed and applied to assess mast workers' exposure to RF fields and the corresponding location. This method uses a logging dosemeter for personal RF exposure evaluation and two logging barometers to determine the corresponding height of the worker's position on the mast. The procedure is not intended to be used for compliance assessments, but to indicate locations where stricter assessments are needed. The applicability of the method is demonstrated by making measurements in a TV and radio transmitting mast.

A pilot study on the reproductive risks of maternal exposure to magnetic fields from electronic article surveillance systems.

PURPOSE: We investigated the feasibility of a large-scale epidemiological study on reproductive effects of intermediate frequency (IF) magnetic field (MF) exposure among cashiers working near electronic article surveillance (EAS) systems. MATERIALS AND METHODS: The study cohort included 4157 women who had worked as cashiers in supermarkets with EAS devices (considered as exposed) or grocery stores without EAS devices (considered as unexposed) between 2008 and 2015. 536 births and 38 miscarriages occurred among these women during the study period, based on information from nationwide health registries. Measurements were also performed to characterize the MF exposure of cashiers. RESULTS: Cashiers were found to be exposed to 8.2 MHz MFs only when passing by the gates at short distance. Static fields of about 0.1 mT were observed at cashier's seat. Extremely low frequency MFs were higher at stores without EAS devices. No differences on the risk of miscarriage, reduced birth weight or preterm birth were observed between cashiers in different store types. CONCLUSIONS: Any further studies should attempt to include study subjects working near EAS systems that produce stronger IF MFs at kHz frequencies. Exposure to ELF MFs should be assessed as a possible confounding factor.

Occupational exposure to low frequency magnetic fields and dementia: a case-control study.

BACKGROUND: Several studies point to a potential aetiological relevance to dementia of exposure to low-frequency magnetic fields, but the evidence is inconclusive. OBJECTIVE: To further examine the relationship between low frequency magnetic fields and dementia. METHODS: From 23 general practices, 195 patients with dementia were recruited. Of these, 108 had possible Alzheimer's disease, 59 had possible vascular dementia and 28 had secondary or unclassified dementia. A total of 229 controls were recruited: 122 population controls and 107 ambulatory patients free from dementia. Data were gathered in a structured personal interview; in cases, the interview was administered to the next of kin. Exposure to low-frequency electromagnetic fields was assessed by expert rating. To identify occupations suspected to be associated with dementia, major occupations were a priori formed. Odds ratios were calculated using logistic regression, to control for age, region, sex, dementia in parents and smoking. RESULTS: Exposure to magnetic fields was not significantly associated with dementia; restriction of the analysis to cases with possible Alzheimer's disease or possible vascular dementia did not lead to statistically significant results. We found an increased risk of dementia in blue-collar occupations (electrical and electronics workers, metal workers, construction workers, food and beverage processors and labourers). CONCLUSIONS: Our study does not support a strong association between occupational exposure to low-frequency magnetic fields and dementia. Further studies should consider the relationship between blue-collar work and the late development of dementia.

Effects of cellular phone use on ear canal temperature measured by NTC thermistors.

The earlier studies using phantom models and human subjects concerning warming effects during cellular phone use have been controversial, partly because radiofrequency (RF) exposures have been variable. In this randomized, double-blind, placebo-controlled crossover trial, 30 healthy subjects were submitted to 900 MHz (2W) and 1800 MHz (1W) cellular phone RF exposure, and to sham exposure in separate study sessions. Temperature signals were recorded continuously in both ear canals before, during and after the 35-min RF exposure and the 35-min sham exposure sessions. Temperature was measured by using small-sized NTC thermistors placed in the ear canals through disposable ear plugs. The mean temperature changes were determined during a set cardiovascular autonomic function studies: during a 5-min controlled breathing test, during a 5-min spontaneous breathing test, during 7-min head-up tilting, 1-min before, during and after two consecutive Valsalva manoeuvres and during a deep breathing test. Temperatures in the exposed ear were significantly higher during RF exposures compared with sham exposure in both 900 and 1800 MHz studies with maximum differences of 1 x 2 +/- 0 x 5 degrees C (900 MHz exposure) and 1 x 3 +/- 0 x 7 degrees C (1800 MHz exposure). Temperatures in the RF-exposed ear were also significantly higher during the postexposure period compared with post-sham exposure period with maximum differences of 0 x 6 +/- 0 x 3 degrees C for 900 MHz and 0 x 5 +/- 0 x 5 degrees C for 1800 MHz. The results of this study suggest that RF exposure to a cellular phone, either using 900 or 1800 MHz with their maximal allowed antenna powers, increases the temperature in the ear canal. The reason for the ear canal temperature rising is a consequence of mobile phone battery warming during maximal antenna power use. The earlier published articles do not indicate that temperature rising in the ear canal has any significant contribution from the RF fields emitted from mobile phones.

Electromagnetic interference from GSM and TETRA phones with life-support medical devices.

Disturbances in hospital devices caused by cellular telephone signals were investigated. The interference sources were GSM900, GSM1800, and TETRA380 phones. The number of medical appliances tested was 23. Most measurements were taken in a semi-anechoic laboratory. To simulate the worst situation, the phones were adjusted to emit at their maximum power levels. No interference was observed if the distance from GSM1800 phone was over 5 cm. Corresponding safety distance for GSM900 phone was 70 cm, and for TETRA phones over 3 m. Hence, the use of GSM1800 type mobile phones can be considered safe, whereas GSM 900 and TETRA phones may cause considerable interference in hospital devices, which can result in life-endangering situations.

Health risks of exposure to non-ionizing radiation--myths or science-based evidence.

INTRODUCTION: The non-ionizing radiation (NIR) contains large range of wavelengths and frequencies from vacuum ultraviolet (UV) radiation to static electric and magnetic fields. Biological effects of electromagnetic (EM) radiation depend greatly on wavelength and other physical parameters. OPTICAL RADIATION: The Sun is the most significant source of environmental UV exposure, so that outdoor workers are at risk of chronic over-exposure. Also exposure to short-wave visible light is associated with the aging and degeneration of the retina. Especially hazardous are laser beams focused to a small spot at the retina, resulting in permanent visual impairment. ELECTROMAGNETIC FIELDS: Exposure to EM fields induces body currents and energy absorption in tissues, depending on frequencies and coupling mechanisms. Thermal effects caused by temperature rise are basically understood, whereas the challenge is to understand the suspected non-thermal effects. Radiofrequency (RF) fields around frequencies of 900 MHz and 1800 MHz are of special interest because of the rapid advances in the telecommunication technology. The field levels of these sources are so low that temperature rise is unlikely to explain possible health effects. Other mechanisms of interaction have been proposed, but biological experiments have failed to confirm their existence.

EU Directive, ICNIRP guidelines and Polish legislation on electromagnetic fields.

This review describes the general provisions of and the philosophy behind European Directive 2004/40/EC and ICNIRP (International Commission on Non-Ionizing Radiation Protection) guidelines. As an example of national legislation on the protection of workers against excessive electromagnetic field exposure, regulations established in Poland are summarized. The problems of a practical implementation of the Directive's provisions are discussed.

Testing of common electromagnetic environments for risk of interference with cardiac pacemaker function.

BACKGROUND: Cardiac pacemakers are known to be susceptible to strong electromagnetic fields (EMFs). This in vivo study investigated occurrence of electromagnetic interference with pacemakers caused by common environmental sources of EMFs. METHODS: Eleven volunteers with a pacemaker were exposed to EMFs produced by two mobile phone base stations, an electrically powered commuter train, and an overhead high voltage transmission lines. All the pacemakers were programmed in normal clinically selected settings with bipolar sensing and pacing configurations. RESULTS: None of the pacemakers experienced interference in any of these exposure situations. However, often it is not clear whether or not strong EMFs exist in various work environments, and hence an individual risk assessment is needed. CONCLUSIONS: Modern pacemakers are well shielded against external EMFs, and workers with a pacemaker can most often return to their previous work after having a pacemaker implanted. However, an appropriate risk assessment is still necessary after the implantation of a pacemaker, a change of its generator, or major modification of its programming settings.

Experimental study on malfunction of pacemakers due to exposure to different external magnetic fields.

PURPOSE: Cardiac pacemaker malfunction due to exposure to magnetic fields may cause serious problems in some work environments for workers having cardiac pacemakers. The aim of this study was to find the magnetic field interference thresholds for several commonly used pacemaker models. METHODS: We investigated 16 pacemakers from three different manufacturers with the frequency range of 2 to 1,000 Hz, using sinusoidal, pulse, ramp, and square waveforms. The magnetic fields were produced by a computer-controlled Helmholtz coil system. RESULTS: Pacemaker malfunction occurred in six of 16 pacemakers. Interaction developed almost immediately after high-intensity magnetic field exposure started. With each waveform, at least two pacemakers exhibited interference. In most exposure settings, there was no interference at magnetic field levels below the international occupational safety limits. Nevertheless, some frequencies using ramp or square waveforms interfered with pacemakers even at levels below public exposure limits. The occurrence of interference depended greatly on the waveform, frequency, magnetic field intensity, and the sensing configuration of the pacemaker. Unipolar configurations were more susceptible for interference than the bipolar ones. In addition, magnetic fields perpendicular to the pacemaker loops were more likely to cause interference than parallel fields. CONCLUSION: There is a need for further investigations on pacemaker interference caused by different external magnetic fields to ensure safe working environment to workers with a pacemaker.

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

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

Brain tumors and salivary gland cancers among cellular telephone users.

BACKGROUND: Possible risk of cancer associated with use of cellular telephones has lately been a subject of public debate. METHODS: We conducted a register-based, case-control study on cellular phone use and cancer. The study subjects were all cases of brain tumor (N = 398) and salivary gland cancer (N = 34) diagnosed in Finland in 1996, with five controls per case. RESULTS: Cellular phone use was not associated with brain tumors or salivary gland cancers overall, but there was a weak association between gliomas and analog cellular phones. CONCLUSIONS: A register-based approach has limited value in risk assessment of cellular phone use owing to lack of information on exposure.

Hypersensitivity symptoms associated with exposure to cellular telephones: no causal link.

The hypothesis that there exist hypersensitive persons who perceive subjective symptoms from radiofrequency (RF) fields emitted by hand held mobile phones (cellular phones) was tested using double blind provocation experiments. We also tested whether sensitive subjects are able to determine whether the phone is on or off by sensing RF fields. The study group consisted of 20 volunteers (13 women and 7 men) who reported themselves as being sensitive to cellular phones. The RF exposure sources were one analogue NMT phone (900 MHz) and two digital GSM phones (900 and 1800 MHz). The duration of a test session was 30 min, and three or four sessions were performed in random order for each subject during 1 day. The subjects were asked to report symptoms or sensations as soon as they perceived any abnormal feelings. In addition, the subjects' blood pressure, heart rate, and breathing frequency were monitored every 5 min. The results of the study indicated that various symptoms were reported, and most of them appeared in the head region. However, the number of reported symptoms was higher during sham exposure than during real exposure conditions. In addition, none of the test persons could distinguish real RF exposure from sham exposure. Hence, we conclude that adverse subjective symptoms or sensations, though unquestionably perceived by the test subjects, were not produced by cellular phones.

Cellular phone use does not acutely affect blood pressure or heart rate of humans.

A recent study raised concern about increase of resting blood pressure after a 35 min exposure to the radiofrequency (RF) field emitted by a 900 MHz cellular phone. In this randomized, double blind, placebo controlled crossover trial, 32 healthy subjects were submitted to 900 MHz (2 W), 1800 MHz (1 W) cellular phone exposure, and to sham exposure in separate sessions. Arterial blood pressure (arm cuff method) and heart rate were measured during and after the 35 min RF and sham exposure sessions. We evaluated cardiovascular responses in terms of blood pressure and heart rate during controlled breathing, spontaneous breathing, head-up tilt table test, Valsalva manoeuvre and deep breathing test. Arterial blood pressure and heart rate did not change significantly during or after the 35 min RF exposures at 900 MHz or 1800 MHz, compared to sham exposure. The results of this study indicate that exposure to a cellular phone, using 900 MHz or 1800 MHz with maximal allowed antenna powers, does not acutely change arterial blood pressure and heart rate.