Electromagnetic hypersensitivity

Electromagnetic hypersensitivity (EHS) - sometimes also called electrosensitivity or electrical sensitivity (ES) - is a condition in which people experience medical symptoms that they believe are caused by exposure to electromagnetic fields. Although effects of electromagnetic fields on the body are established, sufferers of electromagnetic hypersensitivity report responding to non-ionizing electromagnetic fields (or electromagnetic radiation) at intensities well below those permitted by international safety standards. The majority of provocation trials to date have found that sufferers of electromagnetic hypersensitivity are unable to distinguish between the exposure to real and sham electromagnetic fields.

ymptoms and severity

Initial reports of electromagnetic hypersensitivity in the medical literature focused on individuals who reported symptoms following work with visual display units.Fact|date=June 2008 Many other electrical devices have been reported as causing symptoms and recent surveys of electromagnetic hypersensitivity sufferers have found that base stations for mobile and cordless phones, overhead power lines, electrical transformers, and mobile phone handsets are now the most commonly cited sources of ill health related to electromagnetism.cite journal | last = Roosli | first = Martin | authorlink = | coauthors = M Moser, Y Baldinini, M Meier, C Braun-Fahrlander | title = Symptoms of ill health ascribed to electromagnetic field exposure--a questionnaire survey | journal = Int J Hyg Environ Health | volume = 207 | issue = 2 | pages = 141–50 | publisher = |month=February | year=2004 | url = http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15031956
doi = | id = | accessdate = ]

Electromagnetic hypersensitivity sufferers tend to report non-specific subjective symptoms: that is, the symptoms can occur with many different illnesses or diseases. [http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1195733810369?p=1197637096018 "Definition, epidemiology and management of electrical sensitivity"] , Irvine, N, Report for the Radiation Protection Division of the UK Health Protection Agency, HPA-RPD-010, 2005] Initial Swedish and Nordic reports were mainly of facial skin effects attributed to extensive use of visual display units, such as dry eyes and burning skin.

Recently a smaller group of people in Europe as a whole and in the USA have reported general and severe symptoms such as headache, fatigue, tinnitus, dizziness, memory deficits, irregular heart beat, and whole-body skin symptoms. [cite web | last = Sage | first = Cindy | authorlink = | coauthors = | title = "Microwave And Radiofrequency Radiation Exposure: A Growing Environmental Health Crisis?" | work = | publisher = San Francisco Medical Society web page | date = | url = http://www.sfms.org/AM/Template.cfm?Section=Home&template=/CM/HTMLDisplay.cfm&ContentID=1770 | format = html | doi = | accessdate = 2008-05-31] A 2005 Health Protection Agency report noted the overlap in many sufferers with other syndromes known as symptom-based conditions, FSS (Functional Somatic Syndromes) and IEI (Idiopathic Environmental Intolerance). Levitt proposed ties between electromagnetic fields and some of these 20th century maladies, including Chronic Fatigue Syndrome, Gulf War Syndrome, and Autism. [cite book | last = Levitt | first = B. Blake | authorlink = | coauthors = | title = Electromagnetic Fields | publisher = Harcourt Brace & Company | year = 1995 | location = San Diego | pages = 181-218 | url = | doi = | id = | isbn = ]

Figures from Carlsson "et al."cite journal | last = Carlsson | first = F | authorlink = | coauthors = B Karlson B, P Orbaek, K Osterberg, PO Ostergren | title = Prevalence of annoyance attributed to electrical equipment and smells in a Swedish population, and relationship with subjective health and daily functioning | journal = Public Health | volume = 119 | issue = 7 | pages = 568–77 | publisher = |month=July | year=2005 | url = http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15925670 | doi = | id = | accessdate = ] show that over 50% of people reporting electromagnetic hypersensitivity in their study also reported multiple chemical sensitivity or similar conditions. Other authors have noted that people reporting severe electromagnetic hypersensitivity generally have these conditions or have had high levels of use of electrical equipment such as mobile phones. cite journal| last = Rea | first = William | authorlink = | coauthors = Yaqin Pan, Ervin Yenyves, Iehiko Sujisawa, Hideo Suyama, Nasrola Samadi, Gerald Ross | title = Electromagnetic field sensitivity | journal = Journal of Bioelectricity | volume = 10 | issue = | pages = 241–256 | publisher = |year=1991 | url = http://www.aehf.com/articles/em_sensitive.html | doi = | id = | accessdate = ]

Those reporting electromagnetic hypersensitivity will usually describe different levels of susceptibility to electric fields, magnetic fields and various frequencies of electromagnetic waves (including fluorescent and low-energy lights, and microwaves from mobile and cordless/portable phones), with no consistency in the severity of symptoms between sufferers.Philips, Alasdair and Jean (2003). [http://www.emfields.org/publications/es.asp Electromagnetic hypersensitivity (EHS) - a modern illness] ] Other surveys of electromagnetic hypersensitivity sufferers have not been able to find any consistent pattern to these symptoms.cite journal | last = Hillert | first = L | authorlink = | coauthors = N Berglind, BB Arnetz, T Bellander
title = Prevalence of self-reported hypersensitivity to electric or magnetic fields in a population-based questionnaire survey | journal = Scand J Work Environ Health | volume = 28 | issue = 1 | pages = 33–41 | publisher = |month=February | year=2002
url = http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11871850 | doi = | id =
accessdate = ] Instead symptoms reflecting almost every part of the body have been attributed to electromagnetic field exposure.

A minority of people who report electromagnetic hypersensitivity claim to be severely affected by it. For instance, one survey has estimated that approximately 10% of electromagnetic hypersensitivity sufferers in Sweden were on sick leave or have taken early retirement or a disability pension, compared to 5% of the general population, while a second survey has reported that of 3046 people who experienced 'annoyance' from electrical equipment, 340 (11%) reported 'much' annoyance. For those who report being severely affected, their symptoms can have a significant impact on their quality of life; with sufferers reporting physical, mental and social impairment and psychological distress.

Prevalence

The prevalence of this condition has been estimated as being between a few cases per million to 5% of the population depending on the location and definition of the disease.

In 2002, a questionnaire survey of 2,072 people in California found that the prevalence of claimed electromagnetic hypersensitivity within the sample group was 3.24% (95% CI 2.8–3.68%), with electromagnetic hypersensitivity being defined as "being allergic or very sensitive to getting near electrical appliances, computers, or power lines" (response rate 58.3%).cite journal
last = Levallois
first = P
authorlink =
coauthors = R Neutra, G Lee, L Hristova
title = Study of self-reported hypersensitivity to electromagnetic fields in California
journal = Environ Health Perspect
volume = 110
issue = Suppl 4
pages = 619–23
publisher =
month=August | year=2002
url = http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12194896
doi =
id =
accessdate = ]

A similar questionnaire survey from the same year in Stockholm County (Sweden), found a 1.5% prevalence of electromagnetic hypersensitivity within the sample group, with electromagnetic hypersensitivity being defined as "hypersensitivity or allergy to electric or magnetic fields" (response rate 73%).

A 2004 survey in Switzerland found a 5% prevalence of electromagnetic hypersensitivity in the sample group of 2,048. [The prevalence of symptoms attributed to electromagnetic field exposure: a cross-sectional representative survey in Switzerland - http://www.springerlink.com/content/q5n731u88v6m1642/]

A more recent survey of prevalence of 'annoyance' relating to visual display units, fluorescent tube lighting, and other electrical equipment within the general Swedish population reported the prevalence of 'much annoyance' relating to these devices to be 0.8%, 1.4%, and 0.4% respectively.

In 2007, a UK survey aimed at a randomly selected group of 20,000 people found a prevalence of 4% for symptoms attributed to electromagnetic exposure. [Development and evaluation of the electromagnetic hypersensitivity questionnaire. - http://www.ncbi.nlm.nih.gov/pubmed/17013888]

A group of scientists also attempted to estimate the number of people reporting "subjective symptoms" from electromagnetic fields for the European Commission.cite journal
last = Bergqvist
first = U
authorlink =
coauthors = E Vogel, L Aringer, J Cunningham, F Gobba, N Leitgeb, L Miro, G Neubauer, I Ruppe, P Vecchia and C Wadman
title = Possible health implications of subjective symptoms and electromagnetic fields. A report prepared by a European group of experts for the European Commission, DG V.
journal = Arbete och Halsa
volume = 19
issue =
pages =
publisher =
year=1997
url = https://gupea.ub.gu.se/dspace/handle/2077/4156
doi =
id =
accessdate = ] In the words of a HPA review, they concluded that "the differences in prevalence were at least partly due to the differences in available information and media attention around electromagnetic hypersensitivity that exist in different countries. Similar views have been expressed by other commentators."

There are currently over thirty support groups across the world for people reporting electromagnetic hypersensitivity. [List of support groups worldwide - http://www.feb.se/FEB/Addresses.html]

Etiology and evidence

Although individuals who report electromagnetic hypersensitivity believe that electromagnetic fields from common electrical devices trigger or exacerbate their symptoms, it has not been established that these fields play any role in the etiology of sensitivity symptoms. Exposures are to intensity levels below those generally accepted to cause physiological effects, and the diverse physiological effects reported are not what would be expected from high intensity electromagnetic fields. Sufferers and their support groups are convinced of a causal relationship with electromagnetic fields, but presently the scientific literature does not support such a link. Some professionals consider electromagnetic hypersensitivity to be a physical condition with an unclear cause, while others suggest that some aspects may be psychological.cite journal
last = Rubin
first = James
authorlink =
coauthors = J Das Munshi J, Simon Wessely
title = Electromagnetic hypersensitivity: a systematic review of provocation studies
journal = Psychosomatic Medicine 2005 Mar-Apr;67(2):224-32
volume = 67
issue = 2
pages = 224–32
publisher =
date=March-April 2005
url = http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15784787
doi =
id =
accessdate = ] Psychological reveiwers have suggested that psychologic mechanisms may play at least some role in causing or exacerbating EHS symptoms. cite journal |author=Rubin GJ, Das Munshi J, Wessely S |title=Electromagnetic hypersensitivity: a systematic review of provocation studies |journal=Psychosom Med |volume=67 |issue=2 |pages=224–32 |year=2005 |pmid=15784787 |doi=10.1097/01.psy.0000155664.13300.64 |url=] Where as other researchers find neurophysiological effects, altered central nervous system function and a more general imbalance in autonomic nervous system regulation. cite journal |author=Lyskov E, Sandström M, Hansson Mild K |title=Neurophysiological study of patients with perceived 'electrical hypersensitivity' |journal=Int J Psychophysiol |volume=42 |issue=3 |pages=233–41 |year=2001 |month=November |pmid=11812390 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0167-8760(01)00141-6] cite journal |author=Landgrebe M, Hauser S, Langguth B, Frick U, Hajak G, Eichhammer P |title=Altered cortical excitability in subjectively electrosensitive patients: results of a pilot study |journal=J Psychosom Res |volume=62 |issue=3 |pages=283–8 |year=2007 |month=March |pmid=17324677 |doi=10.1016/j.jpsychores.2006.11.007 |url=] cite journal |author=Sandström M, Lyskov E, Berglund A, Medvedev S, Mild KH |title=Neurophysiological effects of flickering light in patients with perceived electrical hypersensitivity |journal=J. Occup. Environ. Med. |volume=39 |issue=1 |pages=15–22 |year=1997 |month=January |pmid=9029427 |doi= |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1076-2752&volume=39&issue=1&spage=15] cite journal |author=Eltiti S, Wallace D, Ridgewell A, "et al" |title=Does short-term exposure to mobile phone base station signals increase symptoms in individuals who report sensitivity to electromagnetic fields? A double-blind randomized provocation study |journal=Environ. Health Perspect. |volume=115 |issue=11 |pages=1603–8 |year=2007 |month=November |pmid=18007992 |pmc=2072835 |doi=10.1289/ehp.10286 |url=] [http://www.who.int/mediacentre/factsheets/fs296/en/ Electromagnetic fields and public health: Electromagnetic Hypersensitivity] , World Health Organisation (WHO) factsheet 296, 2005]

Some sufferers and support groups argue that studies may be influenced by the possible political implications of negative health effects from electromagnetic fields."Waybackdate|site=http://www.electrosensitivity.org.uk/HPA-RPD+Report.htm|date=20060819192622|title=Fairs Fair, or Less than Fair?" [sic] (ElectroSensitivity-UK) Archive copy dated 2006-08-19 at the Internet Archive Wayback Machine]

In 2005, a systematic review looked at the results of 31 experiments testing the role of electromagnetic fields in causing ES. Each of these experiments exposed people who reported electromagnetic hypersensitivity to genuine and sham electromagnetic fields under single- or double-blind conditions. The review concluded that:

"The symptoms described by 'electromagnetic hypersensitivity' sufferers can be severe and are sometimes disabling. However, it has proved difficult to show under blind conditions that exposure to electromagnetic fields can trigger these symptoms. This suggests that 'electromagnetic hypersensitivity' is unrelated to the presence of electromagnetic fields, although more research into this phenomenon is required."

Seven studies were found which did report an association, while 24 could not find any association with electromagnetic fields. However, of the seven positive studies, two could not be replicated even by the original authors, three had serious methodological shortcomings, and the final two presented contradictory results. Since then, several more double-blind experiments have been published, each of which has suggested that people who report electromagnetic hypersensitivity are unable to detect the presence of electromagnetic fields and are as likely to report ill health following a sham exposure, as they are following exposure to genuine electromagnetic fields.cite journal
last = Regel
first = Sabine
authorlink =
coauthors = Sonja Negovetic, Martin Roosli, Veronica Berdinas, Jurgen Schuderer, Anke Huss, Urs Lott, Niels Kuster, and Peter Achermann
title = UMTS base station-like exposure, well-being, and cognitive performance
journal = Environ Health Perspect
volume = 114
issue = 8
pages = 1270–5
publisher =
month=August | year=2006
url = http://www.ehponline.org/members/2006/8934/8934.html
doi =
id =
accessdate = ] cite journal
last = Rubin
first = James
authorlink =
coauthors = G Hahn, BS Everitt, AJ Clear, Simon Wessely
title = Within-participants, double-blind, randomised provocation study
journal = British Medical Journal
volume 332
issue =
pages = 886–889
publisher =
year=2006
url = http://www.bmj.com/cgi/content/full/332/7546/886
doi =
id =
accessdate = ] cite journal
last = Wilen
first = J
authorlink =
coauthors = A Johansson, N Kalezic, E Lyskov, M Sandstrom
title = Psychophysiological tests and provocation of subjects with mobile phone related symptoms
journal = Bioelectromagnetics
volume = 27
issue = 3
pages = 204–14
publisher =
month=April | year=2006
url = http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16304699
doi =
id =
accessdate = ]

One of the studies which Rubin et al reviewed, known as the Essex study, received some criticism for its methodology and analysis, and the authors responded in full to these initial criticisms. [cite journal|date=2008-02-01|title=Correspondence|journal=Environmental Health Perspectives|volume=116|issue=2|pages=A62|url=http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2235218&blobtype=pdf] The authors' noted that their study says nothing about the long-term effects of exposure to electromagnetic fields, but those affected generally claimed to respond to the fields within a few minutes.

In 2008, another systematic review reached the same conclusion as Rubin et al.cite journal |author=Röösli M |title=Radiofrequency electromagnetic field exposure and non-specific symptoms of ill health: a systematic review |journal=Environ. Res. |volume=107 |issue=2 |pages=277–87 |year=2008 |month=June |pmid=18359015 |doi=10.1016/j.envres.2008.02.003 |url=]

A 2005 report by the UK Health Protection Agency concluded that electromagnetic hypersensitivity needs to be considered in ways other than its etiology; that is, the suffering is real, even if the underlying cause is not thought to be related to electromagnetic fields. They also wrote that considering only whether electromagnetic radiation was a causative factor was not meeting the needs of sufferers, although continued research on etiology was essential.

In 2002, some controversy over the causal relationship was demonstrated by the Freiburger Appeal, a petition originated by the German environmental medical lobby group IGUMED, which stated that "we can see a clear temporal and spatial exposure between the appearance of [certain] disease and exposure to pulsed high-frequency microwave radiation", and demanding radical restrictions on mobile phone use.Original text:cite web |url= http://www.igumed.de/apell.html|title= Betreff: Mobilfunk - Freiburger Appell|accessdate=2008-02-06|date= 2002-10-09|language= German|publisher= Interisziplinäre Gesellschaft für Umweltmedezin (IGUMED) Translation: cite web |url= http://www.emrnetwork.org/news/IGUMED_english.pdf|title= Freiburger Appeal|accessdate=2008-02-06|date= 2002-10-09|format= PDF|language= English|publisher= IGUMED] To address some of these concerns, and others, Hocking advised in a 2006 WHO proceedings that the test type and duration should be tailored to the individual, and that washout times are needed to prevent a carry-over effect of previous exposure. [cite web |last = Hocking | url =http://www.who.int/peh-emf/publications/reports/EHS_Proceedings_June2006.pdf] However, in 2005 the World Health Organization concluded that there is no known scientific basis for the belief that electromagnetic hypersensitivity is caused by exposure to electromagnetic fields. [http://www.who.int/mediacentre/factsheets/fs296/en/ Electromagnetic fields and public health: Electromagnetic Hypersensitivity] , World Health Organisation (WHO) factsheet 296, 2005]

Diagnosis

Electromagnetic hypersensitivity is not currently an accepted diagnosis. In Sweden electromagnetic hypersensitivity is an officially recognized functional impairment, but it is not regarded as a disease.cite journal |author=Johansson O |title=Electrohypersensitivity: state-of-the-art of a functional impairment |journal=Electromagn Biol Med |volume=25 |issue=4 |pages=245–58 |year=2006 |pmid=17178584 |doi=10.1080/15368370601044150 |url=http://adante.vingar.se/electrohypersensitivity1.pdf] At present there is no accepted research criteria other than ‘self-reported symptoms’, and for clinicians there is no case definition or clinical practice guideline. There is no specific test that can identify sufferers, as symptoms other than skin disorders tend to be subjective or non-specific. It is important firstly to exclude all other possible causes of the symptoms. Researchers and the WHO have stressed the need for a careful investigation. For some, complaints of electromagnetic hypersensitivity may mask organic or psychiatric illness and requires both a thorough medical evaluation to identify and treat any specific conditions that may be responsible for the symptoms, and a psychological evaluation to identify alternative psychiatric/psychological conditions that may be responsible or contribute to the symptoms.cite journal |author=Rubin GJ, Cleare AJ, Wessely S |title=Psychological factors associated with self-reported sensitivity to mobile phones |journal=J Psychosom Res |volume=64 |issue=1 |pages=1–9; discussion 11–2 |year=2008 |month=January |pmid=18157992 |doi=10.1016/j.jpsychores.2007.05.006 |url=] [http://www.who.int/mediacentre/factsheets/fs296/en/ Electromagnetic fields and public health: Electromagnetic Hypersensitivity] , World Health Organisation (WHO) factsheet 296, 2005]

A WHO factsheet also recommends an assessment of the workplace and home for factors that might contribute to the presented symptoms. These could include indoor air pollution, excessive noise, poor lighting (flickering light) or ergonomic factors. They also point out that " [s] ome studies suggest that certain physiological responses of [electromagnetic hypersensitivity] individuals tend to be outside the normal range. In particular, hyper reactivity in the central nervous system and imbalance in the autonomic nervous system need to be followed up in clinical investigations and the results for the individuals taken as input for possible treatment." [http://www.who.int/mediacentre/factsheets/fs296/en/ Electromagnetic fields and public health: Electromagnetic Hypersensitivity] , World Health Organisation (WHO) factsheet 296, 2005]

Possible treatment and symptom alleviation

For individuals reporting electromagnetic hypersensitivity with long lasting symptoms and severe handicaps, treatment therapy should be directed principally at reducing symptoms and functional handicaps. This should be done in close co-operation with a qualified medical specialist to address the symptoms and a hygienist (to identify and, if necessary, control factors in the environment that have adverse health effects of relevance to the patient). [http://www.who.int/mediacentre/factsheets/fs296/en/ Electromagnetic fields and public health: Electromagnetic Hypersensitivity] , World Health Organisation (WHO) factsheet 296, 2005]

Those that feel that they are sensitive to electromagnetic fields generally try to reduce their exposure to electromagnetic sources as much as is practical. Complete avoidance of electromagnetic fields presents major practical difficulties in modern society. Methods often employed by sufferers include: avoiding sources of exposure; disconnecting or removing electrical devices; shielding or screening of self or residence; medication; and complementary and alternative therapy.cite journal | last = Roosli | first = Martin | authorlink = | coauthors = M Moser, Y Baldinini, M Meier, C Braun-Fahrlander | title = Symptoms of ill health ascribed to electromagnetic field exposure--a questionnaire survey | journal = Int J Hyg Environ Health | volume = 207 | issue = 2 | pages = 141–50 | publisher = |month=February | year=2004 | url = http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15031956
doi = | id = | accessdate = ]

The UK Health Protection Agency reviewed treatments for electromagnetic hypersensitivity, and success was reported with "neutralizing chemical dilution, antioxidant treatment, Cognitive Behavioural Therapy, Acupuncture and Shiatsu". It was noted that:

The studies reviewed suffer from a combination of the small numbers of subjectsincluded and the potential variation both within and between study populations. Little information is given as to the attributed exposures of the subjects. These factors limit their general applicability outside the immediate study group. For those studies where detail was available, only two were placebo controlled [Acupunture and nutrition intervention] .

It was also noted in the review that success may have more to do with offering a caring environment as opposed to a specific treatment.

A 2006 systematic review identified nine clinical trials testing different treatments for ES:cite paper |url = http://www.ncbi.nlm.nih.gov/pubmed/16361870?dopt=Abstract | title = A systematic review of treatments for electromagnetic hypersensitivity | author = Rubin GJ, Das Munshi J, Wessely S | journal = Psychother Psychosom. 2006;75(1):12-8 | year = 2006] four studies tested cognitive behavioural therapy, two tested visual display unit filters, one tested a device emitting 'shielding' electromagnetic fields, one tested acupuncture, and one tested daily intake of tablets containing vitamin C, vitamin E, and selenium. The authors of the review concluded that:

"The evidence base concerning treatment options for electromagnetic hypersensitivity is limited and more research is needed before any definitive clinical recommendations can be made. However, the best evidence currently available suggests that cognitive behavioural therapy is effective for patients who report being hypersensitive to weak electromagnetic fields."

ee also

* Electromagnetic radiation and health
* Mobile phone radiation and health
* Wireless electronic devices and health

References