IEI-EMF provocation case studies: A novel approach to testing sensitive individuals.

The etiology of Idiopathic Environmental Intolerance attributed to Electromagnetic Fields (IEI-EMF) is controversial. While the majority of studies have indicated that there is no relationship between EMF exposure and symptoms reported by IEI-EMF sufferers, concerns about methodological issues have been raised. Addressing these concerns, the present experiment was designed as a series of individual case studies to determine whether there is a relationship between radiofrequency-electromagnetic field (RF-EMF) exposure and an IEI-EMF individual's self-reported symptoms. Three participants aged 44-64 were tested during a series of sham and active exposure trials (2 open-label trials; 12 randomized, double-blind, counterbalanced trials), where symptom severity and exposure detection were scored using 100 mm visual analogue scales. The RF-EMF exposure was a 902-928 MHz spread spectrum digitally modulated signal with an average radiated power output of 1 W (0.3 W/m2 incident power density at the participant). In the double-blind trials, no significant difference in symptom severity or exposure detection was found for any of the participants between the two conditions. Belief of exposure strongly predicted symptom severity score for all participants. Despite accounting for several possible limitations, the present experiment failed to show a relationship between RF-EMF exposure and an IEI-EMF individual's symptoms. Bioelectromagnetics. 39:132-143, 2018. © 2017 Wiley Periodicals, Inc.

Significant RF-EMF and thermal levels observed in a computational model of a person with a tibial plate for grounded 40 MHz exposure.

Using numerical modeling, a worst-case scenario is considered when a person with a metallic implant is exposed to a radiofrequency (RF) electromagnetic field (EMF). An adult male standing on a conductive ground plane was exposed to a 40 MHz vertically polarized plane wave field, close to whole-body resonance where maximal induced current flows are expected in the legs. A metal plate (50-300 mm long) was attached to the tibia in the left leg. The findings from this study re-emphasize the need to ensure compliance with limb current reference levels for exposures near whole-body resonance, and not just rely on compliance with ambient electric (E) and magnetic (H) field reference levels. Moreover, we emphasize this recommendation for someone with a tibial plate, as failure to comply may result in significant tissue damage (increases in the localized temperature of 5-10 °C were suggested by the modeling for an incident E-field of 61.4 V/m root mean square (rms)). It was determined that the occupational reference level for limb current (100 mA rms), as stipulated in the 1998 guidelines of the International Commission on Non-Ionizing Radiation Protection (ICNIRP), is satisfied if the plane wave incident E-field levels are no more than 29.8 V/m rms without an implant and 23.4 V/m rms for the model with a 300 mm implant.

SAR versus VAR, and the size and shape that provide the most appropriate RF exposure metric in the range of 0.5-6 GHz.

Basic restrictions for protecting against localized tissue heating induced from exposure to radiofrequency (RF) fields are typically specified as the specific energy absorption rate (SAR), which is mass averaged in recognition of the thermal diffusion properties of tissues. This article seeks to determine the most appropriate averaging mass (1, 3, 5, 7, or 10 g) and averaging shape (cube or sphere). We also consider an alternative metric, volumetric energy absorption rate (VAR), which uses volume averaging (over 1, 3, 5, 7, and 10 cm(3) ; cube and sphere). The SAR and VAR averaging approaches were compared by considering which was a better predictor of tissue temperature rise (ΔT) induced by near- and far-field RF exposures (0.5-6 GHz), calculated in a detailed human body model. For the exposure scenarios that we examined, VAR is better correlated with ΔT than SAR, though not at a statistically significant level for most of the metric types we studied. However, as VAR offers substantive advantages in ease of assessment we recommend this metric over SAR. Averaging over a cube or a sphere provides equivalent levels of correlation with ΔT, and so we recommend choosing the averaging shape on the basis of which is easier to assess. The optimal averaging volume is 10 cm(3) for VAR, and the optimal mass is 10 g for SAR. The correlation between VAR or SAR and ΔT diminishes substantially at 6 GHz, where incident power flux density may be a better exposure metric.

SAR versus S(inc): What is the appropriate RF exposure metric in the range 1-10 GHz? Part II: Using complex human body models.

This is the second of the two articles that present modeling data and reasoned arguments for specifying the appropriate crossover frequency at which incident power flux density (S(inc)) replaces the peak 10 g averaged value of the specific energy absorption rate (SAR) as the designated basic restriction for protecting against radiofrequency electromagnetic heating effects in the 1-10 GHz range. In our first study, we compared the degree of correlation between these basic restrictions and the peak-induced tissue temperature rise (DeltaT) for a representative range of population/exposure scenarios using simple multi-planar models exposed to plane wave conditions. In this complementary study, complex heterogeneous head models for an adult and 12-year-old child were analyzed at 1, 3, 6, 8, and 10 GHz for a variety of exposure conditions. The complex models indicate that peak DeltaT is better correlated with peak 10 g SAR than S(inc) at 1 and 3 GHz and with S(inc) at 6-10 GHz, in contrast to the results from Part I. Considering the planar and complex body modeling results together, and given the equivocal indications of the two metrics in the 6-10 GHz range, we recommend that the breakpoint be set at 6 GHz. This choice is also based on other considerations such as ease of assessment. We also recommend that the limit level of S(inc) should be adjusted to provide a better match with 10 g SAR in the induced tissue temperature rise.

SAR versus S(inc): What is the appropriate RF exposure metric in the range 1-10 GHz? Part I: Using planar body models.

This is the first of two articles addressing the most appropriate crossover frequency at which incident power flux density (S(inc)) replaces the spatial peak value of the specific energy absorption rate (SAR) averaged over 1 or 10 g (i.e., peak 1 or 10 g SAR) as the basic restriction for protecting against radiofrequency (RF) heating effects in the 1-10 GHz range. Our general approach has been to compare the degree of correlation between these basic restrictions and the peak induced tissue temperature rise (DeltaT) for a representative range of population/exposure scenarios. In this article we particularly address the effect of human population diversity in the thickness of body tissue layers at eight different sites of the body. We used a Monte Carlo approach to specify 32000 models (400 models for each of 8 body sites for 10 frequencies) which were representative of tissue thicknesses for age (18-74 years) and sex at the eight body sites. Histogram distributions of S(inc) and peak 1 and 10 g SAR corresponding to a peak 1 degrees C temperature rise were obtained from RF and thermal analyses of 1D multiplanar models exposed to a normally incident plane wave ranging from 1 to 10 GHz in thermo-neutral environmental conditions. Examination of the distribution spread of the histograms indicated that peak SAR was a better predictor of peak tissue temperature rise across the entire 1-10 GHz frequency range than S(inc), as indicated by the smaller spread in its histogram distributions, and that peak 10 g SAR was a slightly better predictor than peak 1 g SAR. However, this result must be weighed against partly conflicting indications from complex body modeling in the second article of this series, which incorporates near-field effects and the influence of complex body geometries.

Novel team-based approach to quality improvement effectively engages staff and reduces adverse events in healthcare settings.

BACKGROUND: Despite significant attention to safety and quality in healthcare over two decades, patient harm in hospitals remains a challenge. There is now growing emphasis on continuous quality improvement, with approaches that engage front-line staff. Our objective was to determine whether a novel approach to reviewing routine clinical practice through structured conversations-map-enabled experiential review-could improve engagement of front-line staff in quality improvement activities and drive improvements in indicators of patient harm. METHODS: Once a week over a 10-month period, front-line staff were engaged in 35 min team-based conversations about routine practices relating to five national safety standards. Structure for the conversations was provided by interactive graphical logic maps representing each standard. Staff awareness of-and attitudes to-quality improvement, as well as their perceptions of the intervention and its impact, were canvassed through surveys. The impact of the intervention on measures of patient safety was determined through analysis of selected incident data reported in the hospital's risk management system. RESULTS: The map-enabled experiential review approach was well received by staff, who reported increased awareness and understanding of national standards and related hospital policies and protocols, as well as increased interest in quality issues and improvement. The data also indicate an improvement in quality and safety in the two participating units, with a 34% statistically significant decrease in the recorded incident rates of the participating units relative to the rest of the hospital for a set of independently recorded incidents relating to patient identification. DISCUSSION: This exploratory study provided promising initial results on the feasibility and effectiveness of map-enabled experiential review as a quality improvement approach in an acute clinical setting.

Assessment of SAR and thermal changes near a cochlear implant system for mobile phone type exposures.

A cochlear implant system is a device used to enable hearing in people with severe hearing loss and consists of an internal implant and external speech processor. This study considers the effect of scattered radiofrequency fields when these persons are subject to mobile phone type exposure. A worst-case scenario is considered where the antenna is operating at nominal full power, the speech processor is situated behind the ear using a metallic hook, and the antenna is adjacent to the hook and the internal ball electrode. The resultant energy deposition and thermal changes were determined through numerical modelling. With a 900 MHz half-wave dipole antenna producing continuous-wave (CW) 250 mW power, the maximum 10 g averaged SAR was 1.31 W/kg which occurred in the vicinity of the hook and the ball electrode. The maximum temperature increase was 0.33 degrees C in skin adjacent to the hook. For the 1800 MHz antenna, operating at 125 mW, the maximum 10 g averaged SAR was 0.93 W/kg in the pinna whilst the maximum temperature change was 0.16 degrees C. The analysis predicts that the wearer complies with the radiofrequency safety limits specified by the International Commission on Non-Ionizing Radiation Protection (ICNIRP), the Institute of Electrical and Electronics Engineers (IEEE), and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) for 900 and 1800 MHz mobile phone type exposure and thus raises no cause for concern. The resultant temperature increase is well below the maximum rise of 1 degrees C recommended by ICNIRP. Effects in the cochlea were insignificant.

EEG electrode caps can reduce SAR induced in the head by GSM900 mobile phones.

This paper investigates the influence of EEG electrode caps on specific absorption rate (SAR) in the head from a GSM900 mobile phone (217-Hz modulation, peak power output 2 W). SAR measurements were recorded in an anthropomorphic phantom using a precision robotic system. Peak 10 g average SAR in the whole head and in just the temporal region was compared for three phantom arrangements; no cap, 64-electrode "Electro-Cap," and 64-electrode "Quick-Cap". Relative to the "no cap" arrangement, the Electro-Cap and Quick-Cap caused a peak SAR (10 g) reduction of 14% and 18% respectively in both the whole head and in the temporal region. Additional computational modeling confirmed that SAR (10 g) is reduced by the presence of electrode leads and that the extent of the effect varies according to the orientation of the leads with respect to the radiofrequency (RF) source. The modeling also indicated that the nonconductive shell between the electrodes and simulated head material does not significantly alter the electrode lead shielding effect. The observed SAR reductions are not likely to be sufficiently large to have accounted for null EEG findings in the past but should nonetheless be noted in studies aiming to measure and report human brain activity under similar exposure conditions.

A genotoxic analysis of the hematopoietic system after mobile phone type radiation exposure in rats.

PURPOSE: In our earlier study we reported that 900 MHz continuous wave (CW) radiofrequency radiation (RFR) exposure (2 W/kg specific absorption rate [SAR]) had no significant effect on the hematopoietic system of rats. In this paper we extend the scope of the previous study by testing for possible effects at: (i) different SAR levels; (ii) both 900 and 1800 MHz, and; (iii) both CW and pulse modulated (PM) RFR. MATERIALS AND METHODS: Excised long bones from rats were placed in medium and RFR exposed in (i) a Transverse Electromagnetic (TEM) cell or (ii) a waveguide. Finite-difference time-domain (FDTD) numerical analyses were used to estimate forward power needed to produce nominal SAR levels of 2/10 and 2.5/12.4 W/kg in the bone marrow. After exposure, the lymphoblasts were extracted and assayed for proliferation rate, and genotoxicity. RESULTS: Our data did not indicate any significant change in these end points for any combination of CW/PM exposure at 900/1800 MHz at SAR levels of nominally 2/10 W/kg or 2.5/12.4 W/kg. CONCLUSIONS: No significant changes were observed in the hematopoietic system of rats after the exposure of CW/PM wave 900 MHz/1800 MHz RF radiations at different SAR values.

Comparisons of peak SAR levels in concentric sphere head models of children and adults for irradiation by a dipole at 900 MHz.

The aim of this study is to examine the scale and significance of differences in peak specific energy absorption rate (SAR) in the brains of children and adults exposed to radiofrequency emissions from mobile phones. Estimates were obtained by method of multipole analysis of a three layered (scalp/cranium/brain) spherical head exposed to a nearby 0.4 lambda dipole at 900 MHz. A literature review of head parameters that influence SAR induction revealed strong indirect evidence based on total body water content that there are no substantive age-related changes in tissue conductivity after the first year of life. However, it was also found that the thickness of the ear, scalp and cranium do decrease on average with decreasing age, though individual variability within any age group is very high. The model analyses revealed that compared to an average adult, the peak brain 10 g averaged SAR in mean 4, 8, 12 and 16 year olds (yo) is increased by a factor of 1.31, 1.23, 1.15 and 1.07, respectively. However, contrary to the expectations of a recent prominent expert review, the UK Stewart Report, the relatively small scale of these increases does not warrant any special precautionary measures for child mobile phone users since: (a) SAR testing protocols as contained in the CENELEC (2001) standard provide an additional safety margin which ensures that allowable localized SAR limits are not exceeded in the brain; (b) the maximum worst case brain temperature rise (approximately 0.13 to 0.14 degrees C for an average 4 yo) in child users of mobile phones is well within safe levels and normal physiological parameters; and (c) the range of age average increases in children is less than the expected range of variation seen within the adult population.

Evaluation of hematopoietic system effects after in vitro radiofrequency radiation exposure in rats.

PURPOSE: This study was designed to investigate the effect of a 900-MHz continuous-wave (CW) radiofrequency radiation (RFR) exposure on the hematopoietic system in the rat. MATERIALS AND METHODS: Rat long bones (femur and tibia) were divided into two groups: Sham-exposed and radiofrequency (RF)-exposed. The mean Specific energy Absorption Rate (SAR) at 900-MHz averaged over the bone marrow (calculated by the finite-difference-time-domain ( fdtD) method) was 2 W/kg at 16.7 W root mean square (rms) forward power into a Transverse Electromagnetic (TEM) cell. The bones, placed in a Petri dish containing media, were kept in the TEM cell for 30 min duration of sham or RF exposure. After exposure, the bone marrow cells were extracted and the following end points were tested: (a) Proliferation rate of whole bone marrow cells, (b) maturation rate of erythrocytes, (c) proliferation rate of lymphocytes, and (d) DNA damage (strand breaks/alkali labile sites) of lymphocytes. RESULTS: Our data did not indicate any significant change in the proliferation rate of bone marrow cells and lymphocytes, erythrocyte maturation rate and DNA damage of lymphocytes. CONCLUSION: Our findings revealed no effect on the hematopoietic system in rats for 900 MHz CW RF exposure at the 2 W/kg localised SAR limit value recommended by the International Commission for Non-Ionising Radiation Protection (ICNIRP) for public exposures.

A numerical evaluation of SAR distribution and temperature changes around a metallic plate in the head of a RF exposed worker.

The 1998 International Commission for Non-Ionising Radiation (ICNIRP) Guidelines for human exposure to radiofrequency (RF) fields contain a recommendation to assess the potential impact of metallic implants in workers exposed up to the allowable occupational field limits. This study provides an example of how numerical electromagnetic (EM) and thermal modelling can be used to determine whether scattered RF fields around metallic implants in workers exposed to allowable occupational ambient field limits will comply with the recommendations of relevant standards and guidelines. A case study is performed for plane wave exposures of a 50 mm diameter titanium cranioplasty plate, implanted around 5-6 mm under the surface of the forehead. The level of exposures was set to the ambient power flux density limits for occupational exposures specified in the 1998 ICNIRP guidelines and the current 1999 IEEE C95.1 standard over the frequency range 100-3000 MHz. Two distinct peak responses were observed. There was a resonant response for the whole implant at 200-300 MHz where the maximum dimension of the implant is around a third of the wavelength of the RF exposure. This, however, resulted in relatively low peak specific energy absorption rate (SAR) levels around the implant at the exposure limits. Between 2100-2800 MHz, a second SAR concentrating mechanism of constructive interference of the wave reflected back and forth between the air-scalp interface and the scalp-plate interface resulted in higher peak SARs that were within the allowable limits for the ICNIRP exposures, but not for the IEEE C95.1 exposures. Moreover, the IEEE peak SAR limits were also exceeded, to a lesser degree, even when the implant was not present. However, thermal modelling indicated that the peak SAR concentrations around the implant did not result in any peak temperature rise above 1 degrees C for occupational exposures recommended in the ICNIRP guidelines, and hence would not pose any significant health risk.