Bulletin of the World Health Organization

Systematic review on the health effects of exposure to radiofrequency electromagnetic fields from mobile phone base stations

Martin Röösli, Patrizia Frei, Evelyn Mohler & Kerstin Hug

Volume 88, Number 12, December 2010, 887-896F

Table 2. Overview of epidemiological studies included in a systematic review of studies of MPBS exposure and self-reported non-specific symptoms conducted before March 2009

Reference Study design Study population (participation rate) Inclusion/exclusion criteria Outcome Exposure assessment Statistical model/covariables Results
Hutter 200624 Cross-sectional 365 subjects from Vienna and Carinthia in the vicinity of 10 base stations
Mean age: 44 years (range: 18–91 years)
Female: 59%
(Participation rate: approximately 60% in Vienna, 68% in Carinthia)
Inclusion: age > 18 years, living in the present house for at least 1 year and staying there for a minimum of 8 hours a day on average Von Zerssen complaint list,25 PSQI26 Spot measurements in the bedroom
Main source was GSM 900
3 exposure categories: < 0.19 V/m, 0.19–0.43 V/m, > 0.43 V/m
ANCOVA for PSQI, logistic regression for Von Zerssen complaint list; age, sex, region, regular use of mobile telephone and fear of adverse effects of the base station Highest vs lowest exposure levels: Headache: RR = 3.1 (95% CI: 1.2 to 7.7)
Cold hands or feet: RR = 2.6 (95% CI: 1.2 to 5.7)
Difficulties in concentration: RR = 2.6 (95% CI: 1.1 to 6.1)
Remaining 11 symptoms and sleep quality measures not associated with exposure.
Abdel-Rassoul 200727 Cross-sectional 85 exposed inhabitants/employees (living near an MPBS)
Mean age: 38.2 years
Female: 57%;
80 unexposed employees (working 2 km from the MPBS)
Mean age: 39.8 years
Female: 59%
(Participation rate not reported.)
Exclusion: epilepsy, psychiatric disorders, specific cause of headache Prevalence of headache, irritability, memory changes, tremors, dizziness, blurred vision, depressive symptoms Two sites with different distances to an MPBS;
Frequency band not reported, no meaningful exposure measurements
χ2 test, Student’s t-test, ANCOVA; age, sex, occupation, education level, smoking and mobile phone use Exposed vs unexposed:
Headache: OR = 2.8 (95% CI: 1.1 to 7.4)
Memory changes: OR = 7.5 (95% CI: 2.3 to 27.0)
Dizziness: OR = 4.4 (95% CI: 1.3 to 16.5)
Depressive symptoms: OR = 2.8 (95% CI: 1.0 to 8.0)
Blurred vision: OR = 1.6 (95% CI: 0.7 to 3.9)
Sleep disturbances: OR = 2.8 (95% CI: 1.1 to 7.4)
Irritability: OR = 1.5 (95% CI: 0.7 to 3.3)
Lack of concentration: OR = 1.8 (95% CI: 0.7 to 5.0)
Heinrich 200728 Field intervention 95 employees of an office building in Bavaria (Germany)
Median age 40 years (range: 26–62 years)
Female: 30%
(Participation rate: ca. 32%)
Not mentioned Questionnaire with 21 symptoms: difference of the score between evening and morning UMTS base station on the roof of the building randomly turned on/off during 1–3 consecutive days over a period of 70 daysa
E-field during exposure: maximum 0.53 V/m, mean 0.1 V/m
Mixed linear regression models with autocorrelation; sex, air pressure, day of week, self-reported EHS and ability to perceive EMF During exposure non-significant increase of symptom score (P = 0.08).
Cumulative exposure was not associated with symptom score (P = 0.42).
Danker-Hopfe 200829 Field intervention 397 individuals of 10 German towns with no mobile phone coverage, only weak other RF-EMF sources and no emotional public debate about base station setting
Mean age: 45 years
Female: 51%
(Participation rate: 17%)
Inclusion: place of residence < 500m from a base station, age > 17 years Sleep diary and polysomnography Transmission of GSM 900/GSM 1800 base station during 5 consecutive nights on or off, randomizeda
E-field during exposure: 1 V/m to 6 V/m, mean: ca. 0.1 V/m
Student's t-test or Wilcoxon test Exposed vs unexposed:
Sleep efficiency (P = 0.84)
Time spent in bed (P = 0.29)
Total sleep time (P = 0.39)
Sleep latency (P = 0.83)
Wake after sleep onset (P = 0.88)
Restfulness (P = 0.59)
Leitgeb 200830 Cross-sectional 43 EHS volunteers from Germany and Austria recruited by press release
Mean age: 56 years
Female: 61%
(Participation rate: 44%)
Inclusion: EHS, Pittsburgh index > 5
Exclusion: neurological and psychological disorders, somatic reasons for sleep disorders, drug consumption, medical treatment
Written questionnaire on subjective sleep quality 3 control nights without shield.
If unshielded: typical measured levels < 0.5% ICNIRP limit, maximum level: 3.5% of ICNIRP limitb
Linear regression Non-significant improvement of sleep score with increasing GSM-EMF at baseline (P > 0.05)
Field intervention 3 control nights without shield, 3 nights with sham shield and 3 nights with true shield;
randomized, single-blind
MANOVA, Kolmogorov–Smirnov Z test or Mann–Whitney U test 3 participants with improvement by true shield;
6 participants with placebo effects (improvement by true and sham shield compared to control nights);
34 volunteers with no effects
Polysomnography 2 participants with improvement by true shield;
6 participants with sleep impairment by true shield;
5 participants with mixed effects;
1 participant with placebo effects;
29 volunteers with no effects.
Thomas 200831 Cross-sectional 329 randomly selected residents of 4 German towns
Age range: 18–65 years
Female: 53%
(Participation rate: 30%)
Inclusion: age 18–65 years Selection of items from Freiburg symptom score32: occurrence of symptom at least twice per month Personal dosimetry of total RF-EMFc during waking hours of one day (in % of ICNIRP limit)
Lowest quartile (reference): < 0.15% of ICNIRP limit
Top quartile: 0.21–0.58% of ICNIRP limitd
Logistic regression; age, sex Top quartile vs reference:
Headache: OR = 1.2 (95% CI: 0.2 to 6.4)
Neurological symptoms: OR = 0.6 (95% CI: 0.1 to 4.2)
Cardiovascular symptoms: OR = 2.4 (95% CI: 0.6 to 9.9)
Sleeping disorders: OR = 1.1 (95% CI: 0.5 to 2.1)
Fatigue: OR = 0.7 (95% CI: 0.3 to 1.8)
Longitudinal within one day Selection of items from the Von Zerssen complaint list25: at least moderate symptom intensity Morning/afternoon:
Headache
Morning: OR = 0.6 (95% CI: 0.1 to 2.8) Afternoon: OR = 3.1 (95% CI: 0.8 to 12.6)
Neurological symptoms
Morning: OR = 0.5 (95% CI: 0.2 to 1.3) Afternoon: OR = 0.4 (95% CI: 0.2 to 1.2)
Fatigue
Morning: OR = 0.5 (95% CI: 0.2 to 1.1) Afternoon: OR = 0.5 (95%CI: 0.3 to 1.0)
Concentration problems
Morning: OR = 0.3 (95% CI: 0.1 to 1.8) Afternoon: OR = 1.4 (95% CI: 0.4 to 4.7)
Augner 200933 Field intervention 57 volunteers;
Mean age: 40.7 years,
Female: 61%
Not mentioned Standardized questionnaire on well-being (MDBF34) with 3 scales: mood, alertness, calmness In a “field laboratory” three exposure levels were created by shielding devices (5 50-minute exposure sessions):
Low = 0.04 V/m medium = 0.24 V/m high = 0.90 V/m;
exposure originated predominantly from a GSM 900 antenna
ANOVA; age, sex and degree of possible EHS Increase in calmness (P = 0.042) for participants in scenarios with high and medium exposure compared with low exposure. No effects for “good mood” and “alertness.”
Berg-Beckhoff 200935 Cross-sectional 1326 individuals from 8 urban German regions
Age range: 15–71 years
Female: 51%
(Participation rate: 21%)
Participants in the panel survey by Blettner 20091 5 symptom scales: sleep quality (PSQI),26 headache (HIT-6)36, symptom score (Von Zerssen list),25 SF-3637 Sum of GSM 900, GSM 1 800 and UMTS from a spot measurement in the bedroom,
dichotomized at 90th percentile (i.e. > 0.1 V/m)
Linear regression model; age, sex, rural/urban, education level, mobile phone use, risk perception and stress Score difference between subjects with high and low exposure:
PSQI: −0.15 (95% CI: −0.69 to 0.38)
HIT-6: −0.24 (95% CI: −1.57 to 1.08)
Von Zerssen: 0.55 (95% CI: −1.05 to 2.15)
SF-36, physical: −0.14 (95% CI: −1.80 to 1.51)
SF-36, mental: 0.37 (95% CI: −0.93 to 1.68)
Blettner 20091 Cross-sectional 26 039 German residents of a panel survey that is regularly carried out
Age range: 14–69 years
Female: 52%
(Participation rate: 58.6%)
Not mentioned Frick symptom score38 Geo-coded distance to the closest MPBS Multiple linear regression model; age, sex, income, education, region, city inhabitants and concerns/attribution Difference in Frick score < 500 m vs > 500 m (95% CI: 0.32–0.37 (95% CI: 0.32 to 0.37)
Worries were associated with self-reported distance but not with objectively geo-coded distance.
Kühnlein 200939 Cross-sectional 1433 randomly selected children of 4 German towns
Age range: 8–12 years
(Participation rate: 53%)
Inclusion: age 8–12 years, German nationality, only 1 participant per household Computer- assisted personal interview: questions on chronic symptoms during the last 6 months Personal dosimetry of total RF-EMFc over 24 hours (in % of ICNIRP limit);
mean exposure dichotomized at 90th percentile (value of cut-off not reported)
Multiple logistic regression models; age, sex, parents’ level of education, parents’ environmental worries, mobile phone use, DECT use, estimated distance to next MPBS and study site > 90th percentile vs < 90th percentile:
Headache: OR = 0.6 (95% CI: 0.3 to 1.0)
Irritation: OR = 1.0 (95% CI: 0.6 to 1.5)
Nervousness: OR = 0.8 (95% CI: 0.5 to 1.4)
Dizziness: OR = 1.1 (95% CI: 0.5 to 2.4)
Fear: OR = 0.6 (95% CI: 0.2 to 2.0)
Sleeping problems: OR = 1.0 (95% CI: 0.6 to 1.5)
Fatigue: OR = 0.8 (95% CI: 0.6 to 1.3)

ANCOVA, analysis of covariance; CI, confidence interval; DECT, Digital Enhanced Cordless Telecommunications; EHS, electromagnetic hypersensitivity; EMF, Electromagnetic field; GSM, Global System for Mobile Communications; HIT-6, Headache Impact Test; ICNIRP, International Commission on Non-Ionizing Radiation Protection; MANOVA, multivariate analysis of variances; MDBF, Mehrdimensionale Befindlichkeitsfragebogen [Multidimensional Mood State Questionnaire]; MHz, megahertz; MPBS, mobile phone base station; OR, odds ratio; PSQI, Pittsburgh Sleep Quality Index; RF, radiofrequency; RR, relative risk; SF-36, Short Form (36) Health Survey; UMTS, Universal Mobile Telecommunications System; V/m, volts per metre; WLAN, wireless local area network.

a Transmission status of base station was not detectable by mobile phone.

b The maximum level (3.5% of the ICNIRP limit) corresponds to 2 V/m at a frequency of 1800 MHz.

c Total RF-EMF: sum of GSM 900, GSM 1800, UMTS (up- and downlink), DECT and WLAN.

d The lower end of this range (0.21% of the ICNIRP limit) corresponds to 0.123 V/m at a frequency of 1800 MHz.

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