Radiofrequency electromagnetic fields,screen time,and emotional and behavioural problems in 5-year-old children

Background

Little is known about the exposure of young children to radiofrequency electromagnetic fields (RF-EMF) and potentially associated health effects. We assessed the relationship of RF-EMF exposure from different sources and screen time exposure with emotional and behavioural problems in 5-year-old children.

Assessment of radiofrequency exposure from cellular telephone daily use in an epidemiological study: German Validation study of the international case-control study of cancers of the brain--INTERPHONE-Study

OBJECTIVE: The objective of the study is to validate self-reported cellular phone use information by comparing it with the cumulative emitted power and duration of calls measured by software-modified cellular phones (SMP). The information was obtained using a questionnaire developed for the international case-control study on the risk of the use of mobile phones in tumours of the brain or salivary gland (INTERPHONE-study). METHOD: The study was conducted in Bielefeld, Germany. Volunteers were asked to use SMPs instead of their own cellular phones for a period of 1 month. The SMP recorded the power emitted by the mobile phone handset during each base station contact. Information on cellular phone use for the same time period from traffic records of the network providers and from face-to-face interviews with the participants 3 months after the SMP use was assessed. Pearson's correlation coefficients and linear regression models were used to analyse the association between information from the interview and from the SMP. RESULTS: In total, 1757 personal mobile phone calls were recorded for 45 persons by SMP and traffic records. The correlation between the self-reported information about the number and the duration of calls with the cumulative power of calls was 0.50 (P<0.01) and 0.48 (P<0.01), respectively. Almost 23% of the variance of the cumulative power was explained by either the number or the cumulative duration of calls. After inclusion of possible confounding factors in the regression model, the variance increased to 26%. Minor confounding factors were "network provider", "contract form", and "cellular phone model". DISCUSSION: The number of calls alone is a sufficient parameter to estimate the cumulative power emitted by the handset of a cellular telephone. The cumulative power emitted by these phones is only associated with number of calls but not with possible confounding factors. Using the mobile phone while driving, mainly in cities, or mainly in rural areas is not associated with the recorded cumulative power in the SMP.     

Validation of short term recall of mobile phone use for the Interphone study

Aim

To validate short term recall of mobile phone use within Interphone, an international collaborative case control study of tumours of the brain, acoustic nerve, and salivary glands related to mobile telephone use.

Methods

Mobile phone use of 672 volunteers in 11 countries was recorded by operators or through the use of software modified phones, and compared to use recalled six months later using the Interphone study questionnaire. Agreement between recalled and actual phone use was analysed using both categorical and continuous measures of number and duration of phone calls.

Results

Correlations between recalled and actual phone use were moderate to high (ranging from 0.5 to 0.8 across countries) and of the same order for number and duration of calls. The kappa statistic demonstrated fair to moderate agreement for both number and duration of calls (weighted kappa ranging from 0.20 to 0.60 across countries). On average, subjects underestimated the number of calls per month (geometric mean ratio of recalled to actual = 0.92, 95% CI 0.85 to 0.99), whereas duration of calls was overestimated (geometric mean ratio = 1.42, 95% CI 1.29 to 1.56). The ratio of recalled to actual use increased with level of use, showing underestimation in light users and overestimation in heavy users. There was substantial heterogeneity in this ratio between countries. Inter‐individual variation was also large, and increased with level of use.

Conclusions

Volunteer subjects recalled their recent phone use with moderate systematic error and substantial random error. This large random error can be expected to reduce the power of the Interphone study to detect an increase in risk of brain, acoustic nerve, and parotid gland tumours with increasing mobile phone use, if one exists.     

Bridging the Communication Gap: Successes and Challenges of Mobile Phone Technology in a Health and Demographic Surveillance System in Northern Nigeria

Maternal and child health indicators are generally poor in Nigeria with the northern part of the country having the worst indicators than the southern part. Efforts to address maternal and health challenges in Nigeria include, among others, improvement in health and management information systems. We report on the experience of mobile phone technology in supporting the activities of a health and demographic surveillance system in northern Nigeria. Our experience calls for the need for the Nigerian Government, the mobile network companies, and the international community at large to consolidate their efforts in addressing the mobile network coverage and power supply challenges in order to create an enabling environment for socio-economic development particularly in rural and disadvantaged areas. Unless power and mobile network challenges are addressed, health interventions that rely on mobile phone technology will not have a significant impact in improving maternal and child health.     

Mobile phone consultation for community health care in rural north India

We conducted a study to ascertain the acceptability and feasibility of consultation by mobile phone in a rural area of northern India. The mobile phone number of a community physician was advertised to the general public and people were invited to telephone at any time for a medical consultation. Details of the calls received were recorded. During a seven-month study, 660 calls were received. The mean call duration was 2.7 min. Eighty percent of calls were made by men. Forty-eight percent of calls were made during office hours. A total of 417 (63%) calls were for seeking advice, 146 (22%) were for outpatient follow-up, 23 (4%) were for seeking appointments and the remaining 74 (11%) for other reasons. The most common problems were skin, respiratory, mental health and sexual problems. Of the 387 callers who were interviewed at follow-up, 302 (78%) stated that they had followed the advice provided. Of these, 91% found the advice very helpful in managing their health problems. About 96% of users wished to continue to use the service in future. The majority of calls made were of a primary care nature which could easily be dealt with by phone. The concept of using mobile phones for medical consultation seemed to be acceptable to people in rural Haryana.     

Environmental safety conditions for mobile base stations in Alexandria

The use of wireless communications devices e.g. cellular phones is increasing rapidly all over the world and in Egypt as well. This translates into a potentially significant public health problem: how far is the risk associated with these devices? Another risk is expected from the cellular towers or base stations, which transmit and receive these electromagnetic waves. Usually, these base stations should be constructed over residential buildings to cover all areas. Considering the increased public awareness about electromagnetic fields (EMF) exposure associated with these towers, this work aimed at investigation and evaluation of authorized environmental safety conditions for some mobile base stations in different districts of Alexandria city. The different mobile base stations were investigated for 12 standard safety specifications of the buildings' roofs on which mobile base stations are constructed. Although some of the standard specifications in the examined base stations were in compliance with standard specifications, some items were not in a safe condition. Only base stations F & G had complete safe conditions for all investigated items because of being erected on lighting towers of a sports stadium. On the other hand, base stations C, D, E, I, J, K, L1 & L2 needed a raise in the height of the antennas over buildings' roofs of 1-4.5 m. However, base stations C, D, H, K, L1 & L2 may pose a risk to near living population and consequently the towers have to be moved away. The violating distances are 3, 5.5, 3, 4.5, 4, 3 meters, respectively, while the environmental standard is 6 m. Therefore, the towers should be moved away from these populated areas Nevertheless, guided directions should be constructed in all base stations to warn close living population. Safety regulations as well as frequent inspection need to be applied, on both Egyptian mobile phone companies, to ensure the application of all standard specifications. A significant research effort is needed to assess the risk to human health of wireless communication devices.     

An international prospective cohort study of mobile phone users and health (COSMOS): Factors affecting validity of self-reported mobile phone use

This study investigates validity of self-reported mobile phone use in a subset of 75 993 adults from the COSMOS cohort study. Agreement between self-reported and operator-derived mobile call frequency and duration for a 3-month period was assessed using Cohen’s weighted Kappa (κ). Sensitivity and specificity of both self-reported high (≥10 calls/day or ≥4 h/week) and low (≤6 calls/week or <30 min/week) mobile phone use were calculated, as compared to operator data. For users of one mobile phone, agreement was fair for call frequency (κ = 0.35, 95% CI: 0.35, 0.36) and moderate for call duration (κ = 0.50, 95% CI: 0.49, 0.50). Self-reported low call frequency and duration demonstrated high sensitivity (87% and 76% respectively), but for high call frequency and duration sensitivity was lower (38% and 56% respectively), reflecting a tendency for greater underestimation than overestimation. Validity of self-reported mobile phone use was lower in women, younger age groups and those reporting symptoms during/shortly after using a mobile phone. This study highlights the ongoing value of using self-report data to measure mobile phone use. Furthermore, compared to continuous scale estimates used by previous studies, categorical response options used in COSMOS appear to improve validity considerably, most likely by preventing unrealistically high estimates from being reported.     

Temporal and spatial variability of personal exposure to radio frequency electromagnetic fields

Background

Little is known about the population's exposure to radio frequency electromagnetic fields (RF-EMF) in industrialized countries.

Objectives

To examine levels of exposure and the importance of different RF-EMF sources and settings in a sample of volunteers living in a Swiss city.

Methods

RF-EMF exposure of 166 volunteers from Basel, Switzerland, was measured with personal exposure meters (exposimeters). Participants carried an exposimeter for 1 week (two separate weeks in 32 participants) and completed an activity diary. Mean values were calculated using the robust regression on order statistics (ROS) method.

Results

Mean weekly exposure to all RF-EMF sources was 0.13 mW/m² (0.22 V/m) (range of individual means 0.014-0.881 mW/m²). Exposure was mainly due to mobile phone base stations (32.0%), mobile phone handsets (29.1%) and digital enhanced cordless telecommunications (DECT) phones (22.7%). Persons owning a DECT phone (total mean 0.15 mW/m²) or mobile phone (0.14 mW/m²) were exposed more than those not owning a DECT or mobile phone (0.10 mW/m²). Mean values were highest in trains (1.16 mW/m²), airports (0.74 mW/m²) and tramways or buses (0.36 mW/m²), and higher during daytime (0.16 mW/m²) than nighttime (0.08 mW/m²). The Spearman correlation coefficient between mean exposure in the first and second week was 0.61.

Conclusions

Exposure to RF-EMF varied considerably between persons and locations but was fairly consistent within persons. Mobile phone handsets, mobile phone base stations and cordless phones were important sources of exposure in urban Switzerland.     

The public's knowledge of mobile communication and its influence on base station siting preferences

The present paper explores what people know about mobile communication and how this understanding influences people's perceptions and preferences in regard to this omnipresent technology. As shown in the past, cell phone base station siting often turns out to be a conflictive process. Citizens are not willing to tolerate base stations in their neighbourhoods because they fear health consequences. They insist on siting base stations outside residential areas. This solution resolves social conflict, but it may lead to more radiation for the phoning population. From a public health perspective, base stations should be located close to the people using cell phones. Knowledge and beliefs therefore play a critical role. A questionnaire, based on mental model methodology, was designed to learn more about people's knowledge, intuitive understanding, exposure awareness, and base station siting preferences. The mail-survey, conducted in the German-speaking part of Switzerland (N = 765; response rate 41%), showed that laypeople's knowledge varied considerably across knowledge domains and depended on demographic characteristics. Participants had limited knowledge about interaction patterns between cell phones and base stations, and they misjudged the resulting exposure magnitudes. The observed knowledge gaps or misconceptions were related to respondents' preferences regarding base station siting. These findings provide guidance to improved conceptualisation of consumer information in regard to personal exposure awareness and, if desired, prevention.     

Preliminary Study on the Induction of Sperm Head Abnormalities in Mice, Mus musculus, Exposed to Radiofrequency Radiations from Global System for Mobile Communication Base Stations

The exposure of male mice to radiofrequency radiations from mobile phone (GSM) base stations at a workplace complex and residential quarters caused 39.78 and 46.03%, respectively, in sperm head abnormalities compared to 2.13% in control group. Statistical analysis of sperm head abnormality score showed that there was a significant (p < 0.05) difference in occurrence of sperm head abnormalities in test animals. The major abnormalities observed were knobbed hook, pin-head and banana-shaped sperm head. The occurrence of the sperm head abnormalities was also found to be dose dependent. The implications of the observed increase occurrence of sperm head abnormalities on the reproductive health of humans living in close proximity to GSM base stations were discussed.     

Estimating transmitted power density from mobile phone: an epidemiological pilot study with a software modified phone

The aims of this study were to evaluate the weekly and annual cumulative radiofrequency-electromagnetic field (RF-EMF) exposure attributed to mobile phone (MP) use, and assess whether a novel app (Quanta Monitor?) could be employed in a small human sample to characterise the RF-EMF exposures associated with the use of MPs. Ten participants provided their two months’ daily objective data on their MP exposures (i.e. transmitted and received power densities) attributed to different modes of MP usage such as cellular calls, cellular data and Wi-Fi. The results demonstrated that total transmitted power density (cellular phone calls, data and Wi-Fi surfing) could be many orders of magnitude higher than that from the total received power density. Of the total transmitted power density, cellular data use contributed the largest portion. Our study showed that Quanta Monitor? could be employed in prospective assessment of exposures to MPs in epidemiological studies.     

A Study on the Role of Mobile Phone Communication in Tuberculosis DOTS Treatment

Background:

Every year, a lot of Tuberculosis (TB) patients undergo Directly Observed Treatment Short-course (DOTS) in Salem city, one of the high TB districts in South India. Mobile phone usage among these patients and health workers is common. Mobile phone communication has a great potential in TB treatment.

Objectives:

To analyze the mobile phone usage and its effectiveness in TB DOTS treatment.

Materials and Methods:

A cross-sectional survey with 150 TB patients was followed by a focus group discussion with treatment supervisors, DOTS providers, and health workers.

Results:

Majority of patients use mobile phones to make calls to health workers to clarify their doubts on side effects, food, and symptoms of the disease. TB treatment supervisors effectively use mobile phones to counsel patients to adhere to the treatment regimen. Patients see mobile phones as a useful communication tool in TB treatment though they prefer direct interpersonal communication with health workers. Though the mobile ownership is 68% among the TB patients, many of them are not able to send text messages or read messages in English.

Conclusion:

Mobile phone possession and usage is high among the patients. Patients need to be trained to use mobile phone features such as alarm, voice mail, and interactive voice response. Incentives like free talk time and short message service (SMS) will encourage patients to communicate frequently with health workers, thereby, increasing the chances of better adherence to DOTS. SMS could be made available in the regional languages.     

The Precautionary Principle in the Context of Mobile Phone and Base Station Radiofrequency Exposures

Background

No health hazard has been established from exposure to radiofrequency fields up to the levels recommended by the International Commission on Non-Ionizing Radiation Protection. However, in response to public concern and the perceived level of scientific uncertainty, there are continuing calls for the application of the precautionary principle to radiofrequency exposures from mobile phones and base stations.

Objective

We examined the international evolution of calls for precautionary measures in relation to mobile phones and base stations, with particular focus on Australia and the United Kingdom.

Results

The precautionary principle is difficult to define, and there is no widespread agreement as to how it should be implemented. However, there is a strong argument that precautionary measures should not be implemented in the absence of reliable scientific data and logical reasoning pointing to a possible health hazard. There is also experimental evidence that precautionary advice may increase public concern.

Conclusion

We argue that conservative exposure standards, technical features that minimize unnecessary exposures, ongoing research, regular review of standards, and availability of consumer information make mobile communications inherently precautionary. Commonsense measures can be adopted by individuals, governments, and industry to address public concern while ensuring that mobile networks are developed for the benefit of society.     

Communicating textual health information to the mobile phones of visually-impaired users

We investigated how short messages communicating health information would best be distributed to people with vision difficulties using mobile phones. Twelve visually-impaired persons who were unable to read short message service (SMS) messages directly compared three methods of presenting text messages as speech: (1) ordinary SMS messages were sent to the users and converted into speech by the mobile phone; (2) multimedia messages were sent to the users with prerecorded speech-synthesized information; and (3) mobile phone calls were placed to the users and prerecorded speech-synthesized messages were streamed to them. The latter two approaches used server-generated sound files. Over a three-month trial period, we sent a total of 88 SMS messages to the subjects, 111 multimedia messaging service (MMS) messages and 104 telephone calls. All of the SMS messages, 88% of the MMS messages and 69% of the telephone calls were received. In subsequent interviews, we asked the users which presentation method they preferred. SMS scored significantly better than both MMS (P = 0.033) and telephones (P = 0.006). All three methods had serious drawbacks. However, the study suggests that it might be possible to develop suitable technology for communicating with people with vision difficulties by mobile phone.     

Mobile phone reminders for enhancing uptake,completeness and timeliness of routine childhood immunization in low and middle income countries: A systematic review and meta-analysis

Immunization remains one of the most effective public health interventions offering protection for children from vaccine preventable diseases. However, many children living in low- and- middle income countries do not get adequate immunization due to several factors. Mobile phone reminder interventions have shown great potential in enhancing a number of immunization outcomes. However, the evidence supporting its use in these countries is vague. This systematic review was conducted to provide evidence for mobile phone reminder in enhancing immunization uptake, completeness and timeliness. This review was conducted in accordance to the PRISMA recommendations. Three online databases; PubMed, Cochrane Library and African Journals Online, were systematically searched for potentially relevant studies. Screening of records (titles/abstracts from and full-texts) was done using Covidence. Meta-analyses were conducted using the Cochrane Collaboration Review Manager (v5.4). The GRADEpro was used to evaluate the certainty of evidence/summary of findings. Eleven RCTs assessing immunization uptake, completeness and/or timeliness by means of SMS, phone calls or a combination of voice message and SMS were included in both quantitative and qualitative synthesis. Overall, the included studies were of moderate quality. Majority of the included studies indicated that mobile phone reminders were beneficial. Meta-analyses indicated that using mobile phone reminder interventions for the review outcomes was of variable effect with high level of heterogeneity. A combination of voice message and SMS has a greater effect followed by phone calls then SMS reminders for immunization completeness. The use of SMS for immunization uptake and timeliness were largely insignificant (p > 0.05). Furthermore, evidence to support the efficacy of mobile phone reminder from the GRADE synthesis was between low and moderate. Mobile phone reminders, particularly a combination of voice message + SMS and perhaps phone calls appears to be more effective in enhancing immunization outcomes. However, more studies are required in view of methodological inadequacies in existing studies.     

Subjective symptoms, sleeping problems, and cognitive performance in subjects living near mobile phone base stations

Background

The erection of mobile telephone base stations in inhabited areas has raised concerns about possible health effects caused by emitted microwaves.

Methods

In a cross‐sectional study of randomly selected inhabitants living in urban and rural areas for more than one year near to 10 selected base stations, 365 subjects were investigated. Several cognitive tests were performed, and wellbeing and sleep quality were assessed. Field strength of high‐frequency electromagnetic fields (HF‐EMF) was measured in the bedrooms of 336 households.

Results

Total HF‐EMF and exposure related to mobile telecommunication were far below recommended levels (max. 4.1 mW/m²). Distance from antennae was 24–600 m in the rural area and 20–250 m in the urban area. Average power density was slightly higher in the rural area (0.05 mW/m²) than in the urban area (0.02 mW/m²). Despite the influence of confounding variables, including fear of adverse effects from exposure to HF‐EMF from the base station, there was a significant relation of some symptoms to measured power density; this was highest for headaches. Perceptual speed increased, while accuracy decreased insignificantly with increasing exposure levels. There was no significant effect on sleep quality.

Conclusion

Despite very low exposure to HF‐EMF, effects on wellbeing and performance cannot be ruled out, as shown by recently obtained experimental results; however, mechanisms of action at these low levels are unknown.     

Cellular phones: are they detrimental?

The issue of possible health effects of cellular phones is very much alive in the public's mind where the rapid increase in the number of the users of cell phones in the last decade has increased the exposure of people to the electromagnetic fields (EMFs). Health consequences of long term use of mobile phones are not known in detail but available data indicates the development of non specific annoying symptoms on acute exposure to mobile phone radiations. In an attempt to determine the prevalence of such cell phones associated health manifestations and the factors affecting their occurrence, a cross sectional study was conducted in five randomly selected faculties of Alexandria University. Where, 300 individuals including teaching staff, students and literate employee were equally allocated and randomly selected among the five faculties. Data about mobile phone's users and their medical history, their pattern of mobile usage and the possible deleterious health manifestations associated with cellular phone use was collected. The results revealed 68% prevalence of mobile phone usage, nearly three quarters of them (72.5%) were complainers of the health manifestations. They suffered from headache (43%), earache (38.3%), sense of fatigue (31.6%), sleep disturbance (29.5%), concentration difficulty (28.5%) and face burning sensation (19.2%). Both univariate and multivariate analysis were consistent in their findings. Symptomatic users were found to have significantly higher frequency of calls/day, longer call duration and longer total duration of mobile phone usage/day than non symptomatic users. For headache both call duration and frequency of calls/day were the significant predicting factors for its occurrence (chi2 = 18.208, p = 0.0001). For earache, in addition to call duration, the longer period of owning the mobile phone were significant predictors (chi2 = 16.996, p = 0.0002). Sense of fatigue was significantly affected by both call duration and age of the user (chi2 = 24.214, p = 0.0000), while burning sensation was only affected by frequency of calls/day (chi2 = 5.360, p = 0.020). According to the 95% confidence interval of frequency and duration of calls, the study recommended not to increase the call duration more than four minutes and limit their frequency to less than seven calls/day with total duration of exposure less than 22 min./day.     

The risk of subjective symptoms in mobile phone users in Poland – An epidemiological study

Objectives

To assess the type and incidence of subjective symptoms related to the use of mobile phones in Polish users.

Material and Methods

The study was conducted in 2005 using a questionnaire survey. Although it has been quite a long time, up to now, no such data have been published for Poland. The questionnaire consisted of 53 questions concerning sex, age, education, general health, characteristics of a mobile phone (hand-held, loud-speaking unit) as well as the habits associated with its use (frequency and duration of calls, text messages, etc.) and complaints associated with using a mobile phone.

Results

As many as 1800 questionnaires were sent. The response was obtained from 587 subjects aged 32.6±11.3 (48.9% women, 51.1% men); the age did not differ significantly between men and women. The subjects owned a cell phone for an average of 3 years. Majority of the respondents used the phone intensively, i.e. daily (74%) or almost daily (20%). Headaches were reported significantly more often by the people who talked frequently and long in comparison with other users (63.2% of the subjects, p = 0.0029), just like the symptoms of fatigue (45%, p = 0.013). Also, the feeling of warmth around the ear and directly to the auricle was reported significantly more frequently by the intensive mobile phone users, compared with other mobile phone users (47.3%, p = 0.00004 vs. 44.6%, p = 0.00063, respectively). Most symptoms appeared during or immediately after a call and disappeared within 2 h after the call. Continuous headache, persisting for longer than 6 h since the end of a call, was reported by 26% of the subjects.

Conclusions

Our results show that the mobile phone users may experience subjective symptoms, the intensity of which depends on the intensity of use of mobile phones.