Review Article Health Implications of …downloads.hindawi.com/archive/2014/198609.pdfReview Article...

Review ArticleHealth Implications of Electromagnetic Fields Mechanisms ofAction and Research Needs

Sarika Singh and Neeru Kapoor

Occupational Health Division Defence Institute of Physiology amp Allied Sciences DRDO Lucknow Road TimarpurDelhi 110054 India

Correspondence should be addressed to Neeru Kapoor neerukapoor0260yahoocom

Received 21 May 2014 Revised 26 August 2014 Accepted 1 September 2014 Published 23 September 2014

Academic Editor Byung-Cheon Lee

Copyright copy 2014 S Singh and N Kapoor This is an open access article distributed under the Creative Commons AttributionLicense which permits unrestricted use distribution and reproduction in any medium provided the original work is properlycited

Electromagnetic fields (EMF) have been implicated to influence a range of bodily functions Given their ubiquitous naturewidespread applications and capability to produce deleterious effects conclusive investigations of the health risks are criticalAccordingly this paper has been constructed to weigh the bioeffects possible biointeraction mechanisms and research areasin bioelectromagnetics seeking immediate attention The several gaps in the existing knowledge do not permit one to reach aconcrete conclusion but possibility for harmful effects cannot be underestimated in absence of consistent findings and causalmechanisms Several studies with appropriate methodologies reflect the capacity of electromagnetic radiations to cause adversehealth effects and there are several credible mechanisms that can account for the observed effects Hence need of the hour isto activate comprehensive well-coordinated blind scientific investigations overcoming all limitations and demerits of previousinvestigations especially replication studies to concretize the earlier findings Furthermore appropriate exposure assessment iscrucial for identification of dose-response relation if any and the elucidation of biological interaction mechanism For the timebeing the public should follow the precautionary principle and limit their exposure as much as possible

1 Introduction

The terrestrial electromagnetic environment has been and isbeing rapidly altered by humans as a result of technologicaladvancements This was well recognised very early in theseventies by Dr Robert O Becker (twice nominated forNobel Prize) who said ldquoI have no doubt in my mind thatat the present time the greatest polluting element in theearthrsquos environment is the proliferation of electromagneticfields (EMFs)rdquo On one hand these electromagnetic waves(EMW) provide immeasurable benefits on the other handthey may also create potential hazards through uncontrolledand excessive radiation emissions There are various typesof electromagnetic radiations (EMRs) and depending upontheir frequency and wavelength they are categorized intodifferent types Broadly the EMFs are categorized into twogroups namely extremely low frequency (ELF) EMF (gt3Hzndash3 kHz) and radiofrequency radiation (RFR) EMF (3 kHzndash300GHz) Scientific investigations concerning the interac-tion of EMF with living systems especially its health effects

are increasing in number There are arguments for bothpositive [1ndash3] and negative bioeffects [4ndash8] However thelack of sufficient knowledge on biological effects of the vastmajority of frequencies even below the safety limit leads toseveral apprehensions [9ndash11] The discussion is still ongoingespecially regarding the contentious nonthermal effects Itis considered that the energy absorbed calculated in termsof specific absorption rate (SAR) [12] is too low to producebiological effects [13] At the same time several studieshave demonstrated the influence of EMF by energies thatare much lower than those capable of producing tempera-ture changes in living tissues [10 14] The cell physiologyeither in vitro [14] or in vivo [15] can be affected by thesetemperature-insensitive reactions Whether this could resultin pathological alterations in higher life forms is a matterof debate [16] Despite the documentation of temperature-insensitive biological effects they have not been consideredin the existing EMF safety standard rather it is principallybased on heating effect of EMF [17] The current SAR values

Hindawi Publishing CorporationAdvances in BiologyVolume 2014 Article ID 198609 24 pageshttpdxdoiorg1011552014198609

2 Advances in Biology

Table 1 Showing the SAR values for general public and occupational groups laid by ICNIRP [18] International Commission on NonionisingRadiation Protection SAR stands for specific absorption rate expressed in Watts per kilogram (Wkg)

Frequency rangeGeneral public Occupational exposure

Whole body SAR Localized SAR-headand trunk

LocalizedSAR-limbs Whole body SAR Localized SAR-head

and trunkLocalizedSAR-limbs

100KHzndash10MHz 008 2 4 04 10 2010MHzndash10GHz 008 2 4 04 10 20

for general and occupational groups are presented in Table 1As a result current recommendations are established on thelowest exposure known to induce acute observable effects dueto heating [7]

In the past when much of the attention was centeredon certain EMW called ionizing radiation the others callednonionizing radiation (NIR) were generally assumed to beharmless However after World War II this assumption hasbeen reconsidered The overwhelming scientific investiga-tions concerning health effects of NIR have highlighted theirpotential to affect the well-being of biological organismSeveral researchers have raised questions regarding adequacyof current safety limits [17] and asserted for their revival sothat the newbiologically based exposure limits will be capableof eliminating the possibility of bioeffects [19]

Some of the documented bioeffects include changes inmelatonin levels [20ndash25] induction of heat shock protein(hsp) [26] effects on spatial memory [27 28] alteration ofintracellular calcium concentration [29] changes in blood-brain-barrier permeability (BBB) [30] enzyme activity [31]genotoxicity [32 33] nonspecific disabilities and subjectivesymptoms [34ndash37] to name a few Also radiation exposurefrom mobile phones (MPs) has been linked with tinnitusbrain tumours and acoustic neuroma [38ndash41] Additionallystudies at cellularmolecular level are important in illuminat-ing the actual primary injury produced by EMFs [17 27]

The field of bioelectromagnetics is surrounded withcontroversies because some studies are contradictory [11 42]and not always corroborated by independent researchers [35]The lack of any accepted causal mechanism further addsto the controversy As a result important details are simplynot comprehended and generate confusion in the generalpublic As uses expand the new situations are likely to furtherincrease the environmental EMF levels To cope with thesesituations and to promote life of biological organisms morecomfortably and efficiently achieving a scientific understand-ing of the biointeractions of these fields and evaluation ofhealth risks is highly desirableThis paper therefore has beenconstructed to weigh carefully the bioeffects biointeractionmechanisms and lacunae in EMF research areas seekingimmediate attention so that the public is not excessivelyexposed nor the technological advancements suffer a setbackby unjust fears that may or may not exist In this review weshall restrict our discussion to the health relevant effects ofELF-EMF and RFR-EMF

ELF and RFR-EMF related studies were identified bypeer-reviewed literature and data searched in electronicdatabase (PubMed) using a number of key words and their

combinations (electromagnetic field health effects electricmagnetic reproductive outcome and biointeraction mecha-nisms as examples) in order to find English-language reportsrelated to electromagnetic field health effects and theirprobable modes of action A number of papers were retrievedby hand searching several journals and few were obtainedthroughdirect correspondencewith the authorsUnlike otherreview papers no strict inclusion criteria were set Howevera rational explanation of the experimental design use ofcontrolsham population exposure conditions blinding ofthe research statistical assessment of the data and role ofartifacts could be reached for most but not all investigations

2 Health Effects of Electromagnetic Fields

21 Electromagnetic Hypersensitivity (EHS) EHS is a recentphenomenon of occurrence of subjective signs and symptomsin some sensitive individuals with EMF experience fromvaried electronic sources Despite lower levels of exposuressymptoms of ill health have been observed among thesubjects [34] According to WHO [43] about 1ndash3 of theworldrsquos population are affected by this EHS syndrome Theexposure to EMFs especially at lower levels and for longduration was originally reported among the East Europeanradar workers and linked with a number of subjective andobjective (skin and mucosa-related) symptoms Sufferersoften label EHS as lonerrsquos disease because of the consequentsocial isolation [9] Epidemiological investigations have beenconducted on people complaining about unpleasant symp-toms (Table 2) Complainants have related their symptomsmost frequently to exposure to MP base stations (74)followed by MPs (36) cordless phones (29) and powerlines (27) [36] Objective skin symptoms of EHS have beenrelated to increase in mast cell counts and their degranula-tion thereby causing the release of inflammatory substancessuch as histamine responsible for allergic hypersensitivitysensation of itch and pain edema local erythema and manykinds of dermatoses [19] With reference to effects of ELF-EMF Barsam et al [44] studied the effect of occupationalexposure on sleep quality in high voltage substation workersIn their case-control study they found poor sleep qual-ity among 905 of cases and 853 of controls Despitethe increased prevalence of poor sleep quality in exposedgroup no statistically significant difference was reachedSimilar occupational studies conducted in substation unitsof a petroleum complex also revealed higher percentage ofpoor sleep quality in addition to poor health condition in

Advances in Biology 3

Table 2 Subjective signs and symptoms of electromagnetic hypersensitivity (EHS) [34 36]

(1) Sleep disorders (2) Headaches (3) Palpitations (4) Hot flushes(5) Sweating (6) Tinnitus (7) Fatigue (8) Dizziness(9) Concentration difficulties (10) Limb pain (11) Heart disease (12) Nervousness(13) Arthropathy (14) Skin rash (15) Oculopathy (16) Depression(17) Back pain (18) Tremor (19) Nausea (20) Loss of energy(21) Circulatory disturbance (22) Loss of appetite (23) Breathing difficulties

exposed population when compared to control population[45] However the researchers in this group also couldnot reach any statistically significant correlation betweenthe ELF-EMF exposure level and poor quality of sleep andhealth status Another case-control study undertaken on theoccupational group of electric utility workers highlightedthe increased rate of suicide attempts in exposed groupas compared to controls [46] The authors also suggestedthat the occurrence of depression in the exposed workersmight be the plausible reason A study by Beale et al [47]demonstrated the occurrence of psychological symptoms likesuicide depression and unmanageable emotional conditionamongst the residents exposed to chronic 50HzMF exposureas a result of their residence in the vicinity of high-voltagesubstations and power transmission lines Case studies andanecdotal reports in this regard indicate that peoplersquos healthproblems like diabetes multiple sclerosis asthma and soforth could have some association with biologically activedirty electricity which has been found to improve when levelsare reduced [48] Dirty electricity present in the surroundingshas been shown to affect thewell-being of teachers and pupilsUse of filters ameliorated the effects thereby protectingsensitive individuals [49]

As regards RFR-EMF Navarro et al [37] carried outa health survey in the vicinity of a cellular phone basestation working in DCS-1800MHz frequency range withexposition time greater than 6 hoursday 7 daysweek in 95of the subjects Exposure assessment was done by measuringmicrowave power densities at residence of respondents Sta-tistical analysis revealed a significant correlation between thedeclared severity of symptoms and measured power densityThe study also showed an increase in the declared severityin groups with higher exposures Comparable studies havealso been performed reporting significant relation of somesymptoms to the measured exposures [34] Epidemiologicalstudies suggest that frequency and severity of symptoms tendto increase with duration of exposure and are reversible ifexposure is discontinued temporarily or permanently withsymptomatic and general supportive treatment and alsoseverity weakens for those residing far away from exposuresource For instance in one of the health surveys amongself-declared EHS individuals 90 of subjects reportedoccurrence of health symptomswhen present in the exposurearea and disappearance of the same after leaving the exposurearea [36] Studies have also highlighted the significant linkbetween longer duration of daily MP use and health effects[31 50 51] The MP use by children in this regard can be

deleterious as their nervous system is under developmentand greater amount of energy is absorbed because of theirthinner skull bones as compared to adults additionallylonger exposure duration increases their vulnerability to agreater extent [52] However to date quality double-blindstudies have not shown any correlation between subjectivehealth complaints and RF exposure [43] At the same timeepidemiological studies of EMF well-being are difficult toconduct because of imprecision in exposure assessment [53ndash56] and lack of objectivity in measuring health effects orcomplaints [35] In addition the symptoms are nonspecificand subjective based on self-reporting and hence difficultto prove clinically in absence of clear diagnostic criteria forthe condition [57] The subjective complaints of well-beingalso vary from individual to individual and are a function ofseveral variables like age sex social status anxiety currenthealth status and accompanying disease and personalitytraits [35] as well as the fear generated due to awarenessof adverse effects from EMF exposures [34] Psychologicalstress may be one of the consequences of EHS in patientsand incomplete understanding of pathophysiology of thesecomplex symptoms in absence of any single biomarker so farrecognized unique to EHS makes the diagnosis and medicaltreatment a complicate endeavour [9 35] It has also been sug-gested that subjective symptoms could be the consequenceof already prevailing psychiatric condition or stress responseresulting from EMF health concerns instead of the exposureitself [43] In todayrsquos modern world when we cannot partaway from electronic gadgets the EMF experiences are realand practically unavoidable resulting in disturbances whichcould be devastating for a few afflicted individuals In dearthof any visible causal mechanism and pathophysiologicalbiomarker its etiology is quite incomprehensibleThe pain ofEHS patients aggravates further when the majority of popu-lation do not experience any symptom with EMF exposuresThe increasing number of reports on EHS however warnsus to take this research promptly and locate the biomarkersthat could give some clue in ameliorating the problemsof such individuals More investigations are hence neededto completely delineate the pathophysiology of EHS alongwith the generation of clear diagnostic criteria to identifythe problem and develop strategies to limit the sufferingof afflicted individuals Besides investigations dissecting therelation between EHS manifestation in elderly children anddiseased persons (like neurodegenerative diseases mentallyand genetically unstable conditions) with EMF experiencesare crucial The lacunae in human studies with regard to


exposure assessment inclusion of suitable controls and datacollection and so forth need to be eliminated to reach fruitfulinsights For the time being individuals with EHS need to besupported by the family society and the government to leada normal and respectable life

22 Cytotoxic and Genotoxic Effects DNA alteration is con-sidered to instigate carcinogenesis [8 58] and change in DNAor micronuclei (MN) generation is an accepted indicationfor genotoxicity [59] Different cell types and organismshave been reported to react differently to differing exposurecharacteristics [26 32 60] Concerning this Ivancsits andcoworkers [61] have identified three responders (fibroblastand melanocytes from human granulosa cells from rat) andthree nonresponder cell types (lymphocytes monocytes andskeletal muscle cells from human) when exposed to inter-mittent ELF-EMF using alkaline and neutral comet assaysDelimaris et al [62] examined the effect of pulsed 50HzEFonhuman lymphocytes and showed significant DNA damage inexposed group in comparison to controls However Scarfı etal [58] could not detect any statistically significant genotoxicdifference in human fibroblasts exposed to intermittent 50HzEMFs A number of studies have demonstrated the potentialof ELF-EMF to cause DNA damage [33 63ndash66]

As regards RFR-EMF drsquoAmbrosio and coworkers [67]have documented significant micronuclei occurrence withphasemodulated RFR as against no effect by continuouswave(CW) Phillips et al [68] observed reduced and increasedSSB at least in some experiments at low and high SARsrespectively with RF-EMF exposures as opposed to shamcontrols IncreasedDNAdamage was reported in human lensepithelial cells exposed to 18 GHz at 3Wkg [69] Similarfindings were reached by Sun et al [70] on the same celltypes after two-hour exposure to 18 GHz at SARs of 3 and4Wkg DNA damage at 4Wkg was found to be irreversibleStudies on marine radar operators also registered significantincrease in MN frequency and comet parameters of ofDNA in tail and tail moment after EMF exposures [1] Adetailed summary of various studies have been tabulated(Table 3)The occurrence of aneuploidy is well acknowledgedto enhance the risk of tumour In this context linear and SARdependent aneuploidy rise for chromosome 17 detected byfluorescence in situ hybridization post RFR exposure furthersubstantiates their carcinogenic potential [67] SignificantDNA damage occurred after EMF exposure [71] whichdecreased with free radical scavenger treatment suggestingfree radical involvement in inducing damage [3 33] Fer-reira et al [72] found a significant increase in erythrocyteMN frequency in newborn pups from irradiated pregnantrats suggesting the genotoxic potential of EMF exposureSome investigations have shown the genotoxic potential ofEMFs only when coupled with some mutagen or carcino-genic or physical agents indicating their synergistic effect[13 64] Cell-culture studies by Luukkonen and coworkers[73] conducted on human SH-SY5Y neuroblastoma cells tostudy the combined effect of CW-RF (872MHz) and globalsystem for mobile communication (GSM) with menadionesuggested that 872MHz CW-RF radiations at 5Wkg mightenhance chemically induced reactive oxygen species (ROS)

production and thus cause secondary DNA damage Atthe same time enhancement of chemically induced DNAdamage observed in this study was associated only withthe CW-RF no effects were seen with GSM signal Amidthese positive effects Lagroye and coworkers [8] did not findany alkali-labile DNA damage DNA-DNA cross-links andDNA-protein cross-links in mouse fibroblast cells exposedto continuous 2450MHz at 19Wkg for two hours imply-ing their inability to produce genotoxic effects directly bydamaging theDNA Proteomic study on endothelial cell-linesshowed the manifestation and phosphorylation of variouschiefly unidentified proteins with RF-EMF exposure [14]Amid these proteins is Hsp 27 a biomarker for cellularstress Variation in the expression of cellular stress markerHsp 90 postirradiation suggests the complex cell defensemechanism and cell response to EMF [26] EMF interactionwith biological system is a very complex process and is afunction of several biological physical and environmentalfactors The exquisite sensitivity of biological systems toEMF experiences leads to intriguing results and regardlessof scientific evidences accumulated so far it is difficultto conclude about EMF toxic effects as the contradictoryfindings tangle the results confounding the true findingsThedifferences in experimental protocols in terms of frequencyapplied modulation intensity investigated endpoints celltype used sample size and so forth have also added tothe controversy [5 10 60] Evaluation of present data alsobecomes difficult due to relatively small number of replicationstudies because of want for funding However possibility ofgenetic hazard cannot be eliminated in view of conflictingscientific outcomes and lack of accepted causal mechanismsas the confusion has been generated by some commercialgroups in their own interest Therefore the need of the houris to critically analyse the differences and similarities in studyvariables with greater emphasis with regard to biologicalsystems used exposure characteristics study protocol usedfindings data interpretation and conclusions drawn alongwith recognising the source of funding rather than givingweight to the number of studies either observing or notobserving an effect Addition of statistically sound scientificinvestigations dissecting EMF biointeraction with respect tofield direction orientation polarization duration and timeof exposure and so forth needs to be elucidated to gainfruitful insights into cellular behaviours and their responsesHowever this province seems of least interest in bioelectro-magnetics research Further investigations investigating thelink between EMF exposures and the blue print that is theDNA of children aged and sick (neurodegenerative geneticor mental disease) are needed and will further substantiatethe earlier findings Given the inconspicuous nature ofEMF health effects even slight deviations in experimentalprotocols can head towards intriguing outcomes Thereforesound experimental designs with appropriate methodologiesare critical in order to reach firm grounds In light of theresearches done so far we conclude that the bulk of literatureon EMF and cytogenetic endpoints reflect both positive aswell as negative effects Hence for now precautions shouldbe taken to limit the exposures as much as possible


23 EMF and Cancer Epidemiological investigations havefocused attention towards association between ELF-EMFexposures and incidence of tumours [6 40 41 77] Inves-tigations concerning military personnel also indicate thedevelopment of tumours [17] Amongst all cancer end-points weighed in epidemiological investigations childhoodleukemia in connection to postnatal exposure exceeding04 120583T gets the maximum support for an association [54]Recently a formal assessment for suggestion of carcinogene-sis from exposure to static and ELF fields by the InternationalAgency for Research onCancer [78] concluded that ELF-MFsare possibly carcinogenic to humans and grouped them in 2Bcategory

With regard to RFR-EMF Hardell et al [38] in their studysuggested that occurrence of vestibular schwannoma hasincreased in the decades after introduction of cell phones inSweden the country with the highest use of mobile technol-ogy [17] Hardell et al [38] conducted a cross-sectional studyin order to find the association between cell phone usageand vestibular schwannoma Self-administered questionnairewas used for exposure and symptom assessment Cases wereidentified from the Swedish cancer registries with age sexand geographical area matched control Histopathologicaland anatomical tumour localizationwas done byCT andMRIscans The authors reported risks for vestibular schwannomaamong cell phone users Significant rise in risk was reachedfor analogue phone users Elevated risks were also calculatedfor cordless and digital phones but these results could notreach statistical significance The researchers also reportedcases of unilateral tinnitus in some persons using cell phoneon ipsilateral side however a causal relation could notbe established on the basis of case report With regard toassociation between vestibular schwannoma and cordless andcellular phones another interesting finding was observedThe highest rising incidence was obtained for men and theage group of 50ndash59 years MP use has also been associatedwith ipsilateral cerebral brain tumours [77 79] astrocytomaand acoustic neuroma [40 41] and contralateral temporaltumours [79] Muscat et al [79] evaluated the risk of braintumour in relation to handheld cellular phone use Theyincluded the malignant brain tumour patients as cases (469)and hospital patients as controls (422) aftermatching for gen-der age race hospital and month of admission Structuredinterview was employed to gain information related to MPuse The mean duration of MP usage for cases and controlswas found to be 28 years and 27 years respectively Out ofthe 41 measurable tumours 26 appeared on the ipsilateralside while 15 appeared on the contralateral side The authorsdid not find any association between short-term handheldcellular phone use and cerebral brain tumour risk Anotherstudy by the same group [80] based on hospital derivedacoustic neuroma patients as cases (90) and patients withnonmalignant diseases as controls (86) reported an averagecell phone use of 41 and 22 years respectively Odds ratiowas found to increase from 05 for 1-2 years cell phone useto 17 for 3ndash6 years group however the relative risk did notdiffer significantly with regard to the frequency durationand lifetime hours of use The study by Muscat group wassurrounded with limitations like lack of data on long-term

users especially with regard to under-estimation of risksfor slow growing tumours Hepworth et al [81] found noassociation between increased glioma risk and MP use alongwith absence of any relation with time since first use years ofuse total hours of use or number of phone callsThe positiveassociation observed between glioma risk and ipsilateral MPuse in conjunction with the negative association as regardscontralateral MP use was attributed to recall bias as theglioma patients tend to overreport the use on the sameside of the tumour while under mentioning the same onthe opposed side This large case-control study was carriedout with cases identified from hospital records and cancerregistries whereas controls were selected randomly from thegeneral practitionerrsquos list aftermatching and personal contactThe details regarding the tumour site and laterality andtumour grade were judged from the pathology reports andscans Computer assisted personal interviews were used toextract the details pertaining to MP use number of callsmade and received start and stop year side of use modeland make of MP used network operator use of handsfreeusage in ruralurban area and so forth On the basis oftwo case-control studies on brain tumours with regard toMP and cordless phone use the Hardell group found anelevated risk for ipsilateral exposure with gt10 years latencyperiod and subjects started using MP and cordless phonebelow 20 years of age as regards both astrocytoma andacoustic neuroma [41] Questionnaire method was employedto evaluate the exposures and cases were identified fromthe cancer registries The tumour was assessed with regardto the anatomical region in the brain and was associatedwith the head side used during phone calls with ipsilateraluse defined as greater than 50 and contralateral as lessthan 50 of the calling time A review was undertakenwith an aim to assess the brain tumour risk in relation tolong-term use of mobile phones greater than 10 years andipsilateral exposure [40] The reviewers based their findingson the basis of 18 studies (2 cohort and 16 case-control) andfound an increased risk for acoustic neuroma and glioma Inaddition the chance of tumour was found to be the highestfor ipsilateral exposure in all the studies as reflected by theincreased odds ratio Another review by Levis et al [82]concluded that the risk for head tumours doubles with long-term MP use They also observed that methodological flawswith regard to nonblinding of experiments produce negativeresults and underestimate the risk for tumour developmentwhereas those studies which are free from errors biasesand financial interests therefore employing blind protocolsyield positive results indicating a cause-effect link betweenlog-term use of MPs and statistically significant rise in headtumour risk With increasing number of dynamic MP usersworldwide scientists consider this as the ldquolargest biophysicalhuman experimentationrdquo ever conducted in the past history[17] An interesting finding was reached in which incidenceof brain tumour was found to be higher in populations ofcell phone users in rural areas as compared to urban [39]Also average exposures have been observed to be slightlyhigher in rural areas compared to urban areas from MPbase stations [34] In this regard the connection betweenexposures and geographic area ethnicity nutritional status


Table 3 Studies on the cytotoxic and genotoxic effects of electromagnetic fields

EMF characteristics Study group Method Study outcome Reference

7mT 50HzMF for 3 h ferrouschloride (FeCl2 10 120583gmL)melatonin (05 or 10mM)

Rat peripheral bloodlymphocytes Alkaline comet assay

Significant DNA damage onlyafter simultaneous exposure toFeCl2 and MF melatoninameliorates the effect

[64]

1748GHz eitherCW or phase only modulatedwave GMSKlowast for 15minMaximum SAR = 5Wkg

Human peripheral bloodlymphocytes cultures

Cytokinesis block MN Assayand proliferation index

Statistically significant rise inMN frequency followingexposure to phase modulatedwave

[67]

60Hz MF at 001mT for 24 hand 48 h Male Sprague Dawley rats Microgel electrophoresis

assay

Significantly increased singleand double DNA strandbreaks prolonged 48-hourexposure resulted in a largerincrease

[33]

84774MHz CDMAdagger83562MHz FDMADagger81356MHz iDENpara 83655TDMAsect 24 h

Molt-4 T lymphoblastoid cells Single cell gel electrophoresisand annexin V affinity assay

No DNA damage or apoptosisat any frequency modulationor exposure time

[7]

MW frequency ranging from800 to 2000MHz

MP users and age sexmatched controls Comet assay amp MN assay

Significantly elevated comettail lengths and MN frequencyin MP users

[74]

980 950MHz 200KHzmodulation5 w and 500 ppm tolueneapplied for two weeks

Male bulbcmice MN assay on lymphocytes

MW radiation incombination with tolueneproduced significantcytogenetic effects but notalone

[13]

UHF||-EMF (600mWpeak834MHz 268ndash40Vmvertical polarization)Irradiation from 530 pm to200 am for 830 hday sinceday of sperm detection untiloffspring birth

Adult pregnantWistar rats only for irradiationand their offspring for study

MN assay activity ofantioxidant enzymesquantified total sulfhydrylcontent protein carbonylthiobarbituric acid reactivespecies and totalnonenzymatic antioxidantdefense

Significant rise in MNfrequency no difference inoxidative stress parameters inoffspring blood and liver

[72]

RF-EMF SAR = 13Wkg Small area of fore armrsquos skin in10 female volunteers

Collection of punch biopsiesfrom exposed andnonexposed areas of skinProtein extraction by 2-DEand protein expressionchanges analyzed usingPDQuest software

Radiation exposures fromMPs have also been suggestedto affect protein expression inhuman skin samples

[75]

MP radiation 85MP users and 24 nonusers MN assay on buccal mucosaepithelial cells

Significant rise in MNfrequency and positivecorrelation with duration ofuse

[76]

915MHz 1 hday for 2 weeksat 24Wm2 whole bodyaverage SAR-06Wkg

Wistar rats

Detection of DNA alterationin peripheral leukocytes bystandard and Fpg modifiedcomet assay

Oxidative stress could be thelikely cause of increased DNAdamage in exposed group

[71]

245GHz 2 hday for 35 daysto 034mWcm2 powerdensity whole body SAR =011WKg

Male wistar rats control andexposed group

Double strand DNA damageby microgel electrophoresisantioxidant enzymes andhistone kinase estimation inbrain cells

Significant elevation in comethead tail length and tailmovement decrease in GPx1SOD2 and histone kinase andincrease in catalase

[31]


Table 3 Continued


Pulsed MW from 3GHz55 GHz and 94GHz MarineRADAR

Marine RADAR operators Comet assay MN assay GSH3and MDA4 estimation

Significant changes found incomet and MN assayparameters indicatingcytogenetic disruptions withdropped GSH levels andincreased MDA levels inexposed groups

[1]

lowastGMSK Gaussian minimum shift keying daggerCDMA code division multiple access DaggerFDMA frequency division multiple access paraiDEN integrated digitalenhanced network sectTDMA time division multiple access ||UHF ultrahigh frequency Fpg formamidopyrimidine DNA-glycosylase 1GPx glutathioneperoxidise 2SOD superoxide dismutase 3GSH glutathione and 4MDA malondialdehyde

economic status and so forth may provide some remarkableinsights and further enhance our understanding Howeverassociation between brain cancer incidence and MP useremains unclear due to inconsistent findings Short-termand long-term cellular telephone use also did not reflectany connection with cancer risk [6] As far as cancer riskin animals is concerned lymphoma risk was found to besignificantly higher in experimental groups of mice exposedto pulsed RFR 900MHz coming from cellular phone than incontrols [83]

Study by Cho and Chung [59] suggested the role of lowdensity ELF-EMF as an enhancer in initiation process ofBenzopyrene rather than as an initiator of mutagenic effectsin human lymphocytes Most reviews however do not sup-port EMF exposures to be carcinogenic Lack of supportiveanimal data for carcinogenic potential of EMF also makesthe understanding of epidemiological outcomes a difficultenterprise along with faults in human experiments especiallywith respect to exposure assessment Majority of the reviewshave indicated lack of evidence for cancer initiation bymagnetic field (MF) alone however accumulating evidencesuggests that they could act as cocarcinogens if given incombinationwith knowngenotoxic or nongenotoxic carcino-gens showing their synergistic effect Additionally the DNAdamaging potential of EMFs by free radical generation andalso by increasing their lifespan coupled with alterations inDNA repair mechanisms is of concern However consideringthe information in hand on carcinogenesis cocarcinogenesiswith tangling results in the absence of established mecha-nisms strict limitations to exposures are suggested till thetime any firm conclusion is reached

24 Effects on Endocrine System Among the several hor-mones secreted by the body melatonin gained the focusof most of the EMF investigations Melatonin essentially atryptophan derivative produced chiefly from the pineal glandhas been documented to be affected by EMF in animals[25 84 85] as well as in humans [21 22 24] In additionthe enzyme machinery involved in melatonin biosynthesishas also been reported to be affected by EMF action [86 87]Recently Bellieni et al [88] investigated the effect of ELF-EMFs from incubators onmelatonin production in newbornswho had been kept in the incubators for at least 48 hours

In their study they found a transitory rise in melatoninsecretion almost immediately after the babies were takenout from the incubators highlighting the EMF potential toinfluence newborn melatonin production Significant mela-tonin depression was registered in an occupational clusterof electronic equipment repairers exposed to ELF-EMFs dueto their work in comparison to controls [89] Epidemiolog-ical studies performed on Swiss railway workers exposedto 167HzMFs exhibited statistically significant reductionsin mean evening 6-OHMS (6-hydroxymelatonin sulphate)concentrations after first and fifth days of exposure [24] Theresult of yet another occupational study conducted amongmale electric utility workers exposed to 60Hz yielded adecrease in postwork shift 6-OHMScreatinine excretionwith temporally stable MF exposures [21] However thereduction was found on second and third days of exposurewhereas no change was observed on the very first day asopposed to that by Pfluger and Minder [24] indicating therole of exposure duration and that exposure effect may bedelayed by several days Anyway the experiment of Woodet al [22] suggested that exposure of humans to 50Hzcircularly polarized 20120583TMF result in a delay in the onset ofrise of plasma melatonin concentrations As regards animalstudies Kumlin et al [20] found an interesting augmentingeffect on the circadian rhythm of melatonin synthesis infemale mice strain (CD

2F1) exposed to 50HzMF having

no or very low natural melatonin rhythm in contrast toprevious researches using rodents showing chiefly diminish-ing effects The findings do not corroborate the registeredmelatonin diminution in MF-exposed animals but do implyMF effects on pineal gland Another experiment showedstriking reduction in night-time melatonin concentrationsas a result of exposure to rapid onoff mode MFs duringthe day for several days [25] The authors pointed thatrapidly changing exposure conditions create difficulties inacclimatization as opposed to stable exposure characteristicsThe inadequacy in exposure characterization and the conductof investigation at different times for different exposuredurations and at different locations render the comparisonamong studies complicated [87]Melatonin is highly acceptedfor its antioxidant and tumour inhibiting properties henceif oxidative stress (OS) is accompanied by suppression ofmelatonin levels it may produce deleterious effects [87]Given the importance of melatonin for organisms further


studies with better EMF characterization and standardizationare crucial Hormone serotonin a tryptophan derivativeproduced chiefly from the pineal gland has also been doc-umented to be affected by EMF [85 90] However there arevery few studies investigating serotonin andEMFconnectionSerum cortisol and ACTH concentrations were found torise significantly in male guinea pigs exposed to 50Hz EMFreflecting the capacity to cause stress regardless of being alow frequency [91] Noticeable depression in melatonin andcorticosterone levels were reached in a study investigating theeffect of continuous EMF emission from video display unitsin exposed embryos and young chickens [92] In additionsignificant rise in fetal loss was also registered indicating theadverse effects of these EMF emissions Occupational studiesfocused on the effect of EMFs released frommagnetostrictivecavitrons used by dentists showed serum cortisol diminution[93] In the midst of all these studies reporting either anincrease or decrease in cortisol concentration another groupof researchers reported no significant change [94] reflectingthe inconsistency in this field With regard to adrenaline andnoradrenaline level significant suppression was registered inelectric utility workers exposed occupationally to 5060HzEMFs [95]

As regards RFR 900MHz with 217Hz pulse frequencyfrom digital wireless communication was reported to haveno significant effect on salivary melatonin in healthy malestudents [96] Cortisol which is a steroid hormone and oneof the key stress biomarkers released from adrenal glands hasbeen shown to be affected by RFR-EMF experience [96ndash99]It is assumed that RFR-EMF may act as a stressor evidentfrom the increased cortisol concentration documented inprevious investigations with animals [100 101] and humans[102ndash104] However the reports of cortisol increase arecontradicted by the results of cortisol diminution [97 98]and investigations reflecting no effect on adrenal cortisolsecretion [96 105] highlighting the disagreement in thisfield of investigation Given the relevance of cortisol anyimbalance can lead to health impairments in due course [103]More studies therefore in this connection are required toassess the course of action of the biological system in responseto EMF stress ACTH levels were reported to decrease [98]as well as not being affected [97] by RFR exposure Signifi-cantly higher levels of the stress biomarkers adrenaline andnoradrenaline have been reported in physiotherapists [103]Buchner and Eger [106] also assessed the catecholamines insubjects exposed to cell phone base station They examinedthe acute aswell as chronic effects of EMFexposure and founda significant increase in adrenaline and noradrenaline levelsafter EMF exposure following a drop but the normal levelswere not restored even at the end of the study (about oneand a half year) They also observed significant diminutionin dopamine levels Given the role of these catecholaminesin controlling BP heart rate (HR) and other biologicalfunctions the shift from baseline values due to stress hasimmense significance for health and well-being and hencetheir continual alteration may prove harmful in due courseDecreases in testosterone concentration with EMF exposurehave been stated by some research groups [98 105 107] withno effect as well in some reports [97] FSH levels have also

been found to reduce with EMF exposure at MP frequency[105] So far as effect on female reproductive hormones isconcerned there is limited number of studies The few inves-tigations on RFR from MPs and base stations have shownto mutate prolactin but not progesterone levels indicatingthe consequent effects on menstruation and pregnancy [98]Significant rise in serum progesterone concentration has alsobeen reported in pregnant rats after microwave exposure[108] In addition parallel studies investigating prolactinlevels have documented normal levels even after exposure toradio-cellular phones [97 109] As far as thyroid hormonesare concerned decrease in T3 [98 100] and T4 [98 110] andincrease in T4 [100] in parallel to no effect or retention ofnormal T3 levels [110] have all been documented with EMFcontact These findings when taken together reflect the vari-ation in EMF research and puzzle the understanding aboutEMF biointeraction and therefore urge for more studies Inlight of the above evidences it seems that EMF acts as astressor and has the potential to affect the various endocrinesecretions posing a significant health threat

25 Effects on Cardiovascular System An experiment onhuman head exposure to 37Hz EMF at a flux densityof 80120583T suggested that EMF could alter nociception andmay be associated with cardiovascular abnormalities [111]Hakansson et al [112] indicated a low level rise in AMIrisk in the highest exposure group and observed by meansof the synergy index of 27 in monozygotic twins that thegenetically predisposed subjects have an increased EMFinfluence for AMI possibly induced by reduced heart ratevariability (HRV) A cohort study on electric utility workerspointed towards an association between occupational 50HzELF-EMF exposure and arrhythmia related heart disorders[113] On the contrary a cohort study of railway workersexposed to 167Hz intermittent MF indicated no associationwith fatality from arrhythmia related heart diseases or acutemyocardial infarction (AMI) [4] Because of the electriccharacter the circulatory and the nervous system particularlythe autonomic nervous system is vulnerable to EMF effects[114] More explicit damage of neurovegetative regulationespecially a decreased parasympathetic function may resultwith high-intensity EMFs leading to cardiovascular malfunc-tioning [115] ELF-EMFs have been also implicated to affectthe HRV in newborns [116] and interfere with electronicmedical equipment like implanted pace makers but onlywhen kept close to chest [117] The detailed summary of var-ious investigations concerning cardiovascular system effectshave been listed (Table 4) Ali et al [118] has attributed thealterations in rat heart functions as a result of decreased RBCmembrane elasticity permeability and changes in molecularstructure of haemoglobin exposed to 50Hz 02mT MFs Yetanother study on rats linked the observed histopathologicalalterations like unclear cytoplasm polymorphic nucleusdisrupted fibrous tissue necrosis and bleeding in heartepithelial tissue with 50Hz EMF exposure [119]

As regards RFR-EMF Bortkiewicz et al [115] found moreimpairment in 24-hour and resting ECG in AM (amplitudemodulation) broadcast station workers when compared toradio-link station workers who are supposed to have less


Table 4 Studies concerning the effects of electromagnetic fields on the cardiovascular system

EMF characteristic Study group Method Study outcome Reference

Medium frequency EMF MF broadcast and radio linkstation workers

General medical examinationcardiological and familyhistory survey 24-hr ECGlowastLVPdagger HRV and ABPDaggermeasurement

EMF exposure is linked toabnormalities in theneurovegetative regulation ofcardiac function

[120]

EMF exposure fromMPInterference with medicalequipment like implantedpacemakers

[117]

MF exposure Electric utility workersCohort studyCause of death from deathcertificates

Association between elevatedMF exposure in electric utilityjobs and mortality fromarrhythmia related causes

[113]

50Hz 02mTMF for 15 and 30days Male albino rats

ECG osmotic fragility shapeof RBCsrsquopara membrane and Hbsectstructure tests dielectricrelaxation of Hb moleculesmeasured

Alterations in ECG RBCsmembrane elasticity andpermeability and changes inmolecular structure of Hb

[118]

BC|| 6ndash25MHz and TV stations66ndash900MHz

BC TV and radio relaystation operators

Arterial pressure lipid profileBMI waisthip ratio smokinghabits and family history forcardiovascular disease

RF EMR exposure contributedto a higher risk of becominghypertensive and dyslipidemic

[121]

Intermittent 167Hz MF75 hrsday and 240 workingdaysyear was assumed

Railway workers

Cohort studyCause of death from deathcertificatesaverage ELF-MF exposuredetermined by measurementsand modelling

No association betweenlong-term exposure to MFand death from arrhythmiarelated heart diseases or AMI

[4]

EMF from incubators Newborn babies15-minute HRV measurementin supine position at least 1hour after feeding

Alterations in HRV [116]

lowast

ECG electrocardiography daggerLVP late ventricular potential DaggerABP ambulatory blood pressure sectHb hemoglobin paraRBC red blood cell and ||BC broadcast

exposure A significantly higher frequency of irregularityidentified as conduction rhythm or repolarization distur-bances in resting and 24-hour ECG (electrocardiography)was noticed among subjects exposed to medium frequencywhen compared to control [120] Stress is considered toincrease BP (blood pressure) and exposure to EMFs has beenimplicated to cause stress [103 111] Vangelova and colleagues[121] found significantly higher systolic and diastolic BPtotal cholesterol and low-density lipoprotein cholesterol lev-els in radio operators exposed to RFR and confirmed strongerassociation between RFR-EMF exposure and the likelihoodof becoming hypertensive and dyslipidemicThe researchershowever noted that the results could be influenced by theextended shifts and monotonous work as well The study alsorevealed that majority of the hypertensives who were undermedication reached their normal BP only when stayed awayfrom the station Earlier findings have also reported increasedhypertension with RFR exposures [115] Significantly higherlevels of stress biomarkers like adrenaline noradrenalineand cortisol have been documented in medical staffs withRFR-EMF exposures which could also influence BP heart

rate (HR) and so forth [103] Recent findings have high-lighted the possibility of small short-term and medium-term effects on HR and cerebral blood flow to intermit-tent universal mobile telecommunication system (UMTS)exposures [122] Andrzejak and coworkers [123] reported anincreased parasympathetic tone and decreased sympathetictone duringMP usemeasured byHRV analysis and indicatedthe potential of MPs in affecting the autonomic balancein healthy individuals However the confounding effect oftalking during measurement of the parameters cannot beneglected Similar results of sympathetic domination andparasympathetic suppression were reached by Kodavanji etal [124] pointing towards the link between long-termMP useand adverse effects on HRV thereby affecting the autonomicbalance in healthy individuals However since the study wasundertaken on a small population without randomizationthe results need further confirmation To add a recentinvestigation with the intent to find the effect of RFR-EMFfromMP on the electrocardiographic parameters in ischemicheart disease patients taking into account the gender aspectreached some interesting resultsThey observed prolongation


of QT interval in male subjects with or without ischemicheart disease in addition to interferencewith voltage propertyof ECG records in myocardial ischemia patients excludingthe female counterparts from these effects [125] In themidst of studies reporting positive findings parallel studiesreporting absence of effects [126ndash128] create confusion andhampers our understanding Further long-term studies withbetter exposure characterization and health assessment areessential to depict the true picture in light of the prevailingcontroversy with the employment of the latest techniquesIn this connection EMF effect on newborns and patientswith electronic implants or on life supporting systems needsimmediate attention

26 Effects on Nervous System The inability of neuronalcells to divide and repair once damaged makes the organismsusceptible to develop several neurodegenerative diseasesThe occurrence of Parkinsonrsquos disease and so forth has beenlinked to cumulative DNA damage in brain tissues [60] Theincreased prevalence of Alzheimerrsquos disease reported amongworkers of textile factories exposed to ELF-MFs [129] couldbe one such instance Ahlbom and coworkers [54] in theirreview also indicated towards a possible relation betweenamyotrophic lateral sclerosis (ALS) and occupational ELF-EMF exposure However effect of confounders cannot beruled out Cognitive performances like attention perceptionand memory have been reported to diminish instantly by50Hz 1mT ELF-EMF exposure in human subjects [130] Inconcert authors have found significant alterations in learningand information acquisition in passive avoidance learningtask in both male and female mice exposed to 8mT 50HzELF-EMF [131] Authors have also found association betweenoccupational ELF-EMF exposures and problems like demen-tia and depression [132 133] Results from animal studiesin mice have also established the induction of depressionat ELF-EMF exposures due to increased nitric oxide levelsin cortex hippocampus and hypothalamus [134] Studieshave indicated that short-termELF-EMF exposuremay causesmall alterations in neurotransmitter metabolism and in cir-culating amino acids [90] as well as influencing monoaminemetabolism when exposure is in the same direction as themouse position [42] In connection Rajeswari et al [135]highlighted the importance of orientation of the field expo-sure with respect to the subject in human experiments Theyfound the subjects to be restless and aggressive when exposedto pulsations in north orientation and cholinesterase levelsin serum were significantly increased In east west andsouth orientations the subjects appeared to be calm andserum cholinesterase levels were normal which suggestedthe increase of cholinesterase due to MF stress Prato andcolleagues [136] have reported significant inhibitory effects ofa variety of ELF-MFs on endogenous opioid and exogenousopiate induced analgesia in snail Cepacea Zecca et al[137] found that higher field strength exposure may raisenorepinephrine levels in pineal gland of rats accompaniedwith key changes in brain involving opioid system in frontalcortex parietal cortex and hippocampus Pertaining to thisthe documented calcium ion efflux from brain tissue atRFR exposure can be an important neurochemical effect as

their significance in routine nervous system operation is wellknown for example neurotransmitter release for cellularinteraction [138]

With reference to RFR-EMF authors have reported thatRFR-EMFs interact with cognitive functions like shorteningof reaction times particularly during tasks that requireattention or manipulation of information in the workingmemory [27 143] In yet another study shorter latency inpassive avoidance taskwas registered inMPRF-EMFexposedrats reflecting significant impairments in memory retentionand retrieval [144] The authors suggested that the RFR-EMF exposure induced damage might lead to alterations inneuronal functioning of both hippocampus and amygdalaresulting in changed behaviour during task performanceA cross-sectional study meant to detect neurobehaviouraldeficits among residents living close to base stations found theprevalence of neuropsychiatric complaints such as memorychanges headache sleep disturbance depressive symptomsdizziness and tremors to be significantly higher amongexposed inhabitants than controls [145] The study outcomeswere based on a questionnaire survey clinical examinationneurobehavioural test battery (NBTB) and environmentalmeasures with age sex education level smoking habitoccupation and MP use matching The NBTB indicatedthat the exposed inhabitants exhibited a significantly lowerperformance than controls in one of the tests of attentionand short-term auditory memory The inhabitants oppositethe station showed a major reduction in performance inproblem-solving test than those under the station How-ever in the tests of visuomotor speed and one test ofattention the exposed individuals performed significantlywell as compared to controls A cross-sectional communitybased study conducted among hand-held cellular telephoneusers in Singapore found headache to be the most prevalentcentral nervous system symptom as compared to nonusersand the prevalence increased significantly with increasedduration of usage per day [146] The findings were furthersubstantiated by reduced prevalence by more than 20among those who used handsfree equipment as opposed tothose who never used themThe reduced exposure as a resultof using handsfree equipment could be possible becausethe antenna is kept farther away from the head Studieshave proved the sensitivity of brain cells towards RFR-EMFexposures [139 140] Significant increases in brain glucosemetabolism in regions closest to MP antenna have beenobserved with acute exposures [147] GSM-MP radiationshave been demonstrated to induce seizures in rats madeseizure prone by subconvulsive picrotoxin doses and toalter the cerebral activity reflected by significantly higherc-Fos levels in some brain regions which raises questionfor persons with epileptic disorders [15] MP-EMFs havebeen suggested to affect the normal neurophysiology throughalterations in cortical excitability as a result of demodulationor direct interference with membrane ionic changes whichresults in depolarisation and excitation of nerve cells [53]However no histopathological changes have been observedwith long-term MP exposures [148] Increased BBB perme-ability has also been documented not only immediately butalso after seven days of exposure to MPs [30] So far the


Table 5 Studies concerning the health effects of electromagnetic fields on the nervous system

EMF characteristics Study group Method Study outcome Reference1mT 50Hz EMF plus 45 dBSPL (expand) noise for 1 hrduration

66 subjects Double-blind studyDecreased cognitiveperformance in attentionperception and memory

[130]

Four different groups withdifferent durations daysorientation and levels of EMFexposure (60Hz 1 3310Gauss)

Male C57BL mice

Concentrations of DOPAClowastHVAdagger and 5-HIAADagger in braintissue were determined withHPLC-ECD

Monoamine levels are affectedonly by EMF when theexposure is in the samedirection as the mouseposition

[42]

700MHz continuousRF-EMF 252ndash710 Vm5ndash15min

Slices of rat hippocampus Evoked field potential Increases in the level ofneuronal excitability [139]

900MHz CWMP emissions 15 subjects two sessions for45min

Recording of motor evokedpotential using paired-pulseparadigm tympanictemperature

Influence on motor cortexexcitability [140]

ELF-MFs Mice Balbc Y-maze

Impairment in spatialrecognition memorydepending on field strengthand length of exposure

[141]

GSM 900MHz fromMP2 hdays for 4 days at SAR =041 to 098Wkg

16-week-old female rat Morris water mazeReduced ability to consolidateand retrieve the learnedspatial information

[27]

900MHzEMF (1 hday for 28days) SAR-0016 whole bodyand 2Wkg (locally in thehead)

Sham exposed group 16 ratsand four exposure groupseach with eight rats

Number of pyramidal cells inCApara region in hippocampusfollowing postnatal exposurehistopathological evaluationson sections of CA region

Significant reduction inpyramidal cell number in theCA of the EMF group

[142]

GSM 915MHz for 2 h inTEMsect cells at SARs of 0 01212 12 and 120mWkg

Forty-eight inbred male andfemale Fischer 344 rats

Histopathological assessmentof albumin extravasation overthe BBB neuronal albuminuptake and neuronal damage

Interruption of BBBpermeability as evidenced byenhanced albuminextravasation in exposed ratsafter seven-day recoveryperiod

[30]

lowast

DOPAC dihydroxyphenylacetic acid daggerHVA homovanillic acid Dagger5-HIAA 5-hydroxyindoleacetic acid paraCA cornu ammonis and sectTEM transverseelectromagnetic cell

most reliable findings have been reached regarding the brainelectrical activity [10] Impairment in spatial learning andmemory functions has been demonstrated in animal studies[27 143] Details of investigations with exposure character-istics have been tabulated (Table 5) Lai et al [28] pointedtowards 2450MHzMW induced short-termmemory deficitsin rats by the stimulation of endogenous opioids in brainresulting in depressed cholinergic activity responsible formemory functions The results of Xu et al [149] pointedtowards the connection between extended low intensity GSM1800MHz (24Wkg) exposure and synaptic activity evi-dent by decreased excitatory synaptic activity and excitatorysynapse number in cultured rat hippocampal neurons Astudy investigated the effect of GSMmodulated 900MHzRF-EMF at 1Wkg on neuron development in two different cellsystems by the assessment of morphological parameters andmRNA expression for 120573-thymosin and stress-related proteins[150] The authors found a diminution in neurite generationfrom the soma without any effect on branching and neurite

length in both the cellular systems which was also found tobe associated with 120573-thymosin mRNA overexpression Yuasaet al [151] conducted an investigation in order to study theacute effects of pulsed high frequency MP-EMF emissionsused for 30min on somatosensory evoked potentials (SEPs)in healthy individuals They demonstrated negative effectson SEPs as well as their recovery function indicating theabsence of immediate effects on the sensory cortex EMRsfrom MP base stations may expose residents to risk ofdeveloping neuropsychiatric difficulties and alterations inperformance of neurobehavioural functions either by inhibi-tion or facilitation [145] The comparative analysis of studiesrelating cognitive and nervous system performance withEMF experience gets complicated due to different assessmenttools employed and exposure situations and despite the bulkof scientific evidence the results turn into conflicting andunconvincing outcomes At present the precise mechanismof EMF ill effects on neurons lacks sound understandinghowever some investigations have indicated the role of lipid


peroxidation and free radical generation [2 152] To add thenervous system is chiefly helpless to ROS insults because ofits high metabolic rate inadequate oxidant protection andreduced cellular turnover [152]

27 Effects on Reproductive Functions Rising male infertilitycases in recent times have led to scientific investigationswhich indicate the involvement of EMRs as one of the possi-ble environmental factors [153] Understanding of EMF effecton reproductive functioning is also clouded by contradictoryfindings [154] despite several decades of research MPs ratherthan being a status symbol nowadays have become a part andparcel of everyonersquos life since the past decade and a half [155]As it is often carried in pockets in very close proximity tobody and the reproductive system effect of the same onmaleinfertility is an important issue which seeks immediate atten-tion Various studies have been undertaken to investigate thepotential of ELF field characteristics in inducing damage tothe reproductive system [156ndash160] In this regard intermit-tent 50Hz low frequency horizontal EF exposure has beenreported to cause significant histopathological alterations likefocal tubular atrophy necrosis and seminiferous epithelialerosion in rat testis [156] The serum testosterone levelshowever did not differ significantly between exposed andcontrol groups Toxic effects of 60Hz 1mT ELF-EMF werealso reported inmale rat offspring exposed fromgestation day13 to postnatal day 21 [159] The study found a reduction inthe count diameter area and volume of seminiferous tubulesand height of seminiferous epithelium along with leydig cellcount indicative of the harmful effects on testis developmentOn the contrary 60Hz 500120583T exposure for 21 hoursdayfrom gestation day 6 to postnatal day 21 in pregnant ratsdid not elicit any significant difference between the exposedand the controls with regard to spermatogenesis and fertilityin male offspring [160] With reference to investigations inmice 60Hz EMF was found to raise significantly the germcell death and defects in seminiferous tubules without anyeffect on the body or testes weights At the same time thesame frequency of EMF at 05mT was shown to induce DNAbreakage though cell survival was not significantly impaired[157] Another study at 60Hz 14120583T and 200120583T reported theinduction of apoptosis in mice testicular germ cells [158]

As regards RF-EMF exposure animal studies undertakenso far document higher levels of sperm head abnormalitiespositively correlated to RF-EMF exposures suggesting a dose-response effect [165] Aitken et al [166] reported alterationsin genome of epididymal spermatozoa in mice exposedto 900MHz RF-EMW 12 hday for 7 days Parallel studiesin rats have documented lower spermatocyte counts alongwith leydig cell hyperplasia and elevated testosterone levelsat 245GHz frequency [154] Significant decline in proteinkinase C and total sperm count together with increasedapoptosis was reported in male rats exposed to RF-EMF (2hoursdays 35 days 09Wkg) fromMPs [167]The investiga-tors indicated the possible role of ROS behind these findingsPrevious study on rats found major impairments in OS equi-librium in reproductive tissues along with modified semenparameters reflecting the fundamental connection between

RF-EMR exposures and mutations in semen quality [168] Incontradiction no difference in testicular function was foundat GSM-RF exposure from cellular phone in rats [169] An invitro study assessing the effect of 900MHz MP radiation at aSARof 20Wkg onhuman spermrsquos fertilizing potential foundno harmful effects on acrosome reaction [170] Howeverthe researchers did reach significant findings with regardto sperm morphometry and a measurable decline in spermbinding to hemizona was found thus indicating a significanteffect of RF-EMF on male fertilizing potential Interestingfindings were reached in a study evaluating the effects of RFRreleased from GSM multiband MP (9001900MHz at a SARof 14Wkg) in Drosophila melanogaster exposed during the10-day developmental period from egg laying through pupa-tion [171] The authors reported elevation in offspring countstress protein hsp70 concentration and binding activity ofserum response element (SRE) in conjunction with phos-phorylation of nuclear transcription factor ELK-1 indicativeof cellular stress which could further lead to critical alter-ations in the organism Observational studies conducted inconnection to RFR-EMF exposure reported diminution insemen quality by reduced sperm count motility viabilityand normal morphology which were also found to be afunction of duration ofMPuse [163]Wdowiak et al [172] alsodemonstrated an increase in the proportion of sperm cellswith abnormal morphology and a decrease in the proportionof rapid progressive sperms with the frequency of exposurefrom GSM-MPs Davoudi et al [161] also reported a decreasein rapid progressive motile sperm due to GSM-MPs Thedetails of investigations have been summarised in Table 6ExtendedMPuses have been reported to elicit harmful effectson sperm motility in previous researches as well [162 173]Studies show a possible relationship between occupationalexposure to radiofrequency equipment including radar andreduced fertility and sperm quality [164 174] Epidemio-logical investigations have indicated a link between maleinfertility andMPuse but themechanismof action is unclearThe role of hyperthermia in causing infertility is apparent butthe nonthermal effects are debatable [154] However it hasbeen speculated that the effect could be specific to EMReffecta thermal effect or due to the combination of both [168] Sofar motility or sperm movement is the only factor observedto be affected significantly [155] Reproductive functions likemeiosis fertilization and so forth are particularly vulnerableto toxic insults [154] De Iuliis et al [153] have highlightedthe occurrence of ROS and DNA fragmentation after RF-EMR exposure putting a question mark on the safety ofMP use especially in the context of fertility and childrenrsquoshealth Until now the malfunctioning porous cell membraneand disrupted calcium homeostasis along with OS can beaccounted for the damaging effects on testicular cells [12]Conclusive outcomes have not yet been reached despiteextensive researches So far long-term studies concerningEMF effects on male reproductive functions are lackingto substantiate the findings and give any clue regardingthe biointeraction mechanisms As far as effect on femalereproductive system is concerned there is limited number ofstudies RFR from MPs and base stations have been shownto mutate prolactin but not progesterone levels indicating


Table 6 Studies concerning the health effects of electromagnetic fields on the reproductive system


GSM-MP 6 hday for 5 days MP users Semen analysis Decrease in rapid progressivemotility of sperm [161]

MP MP users Semen analysis

Duration of use andtransmission time correlatedpositively and negatively withproportion of slow progressiveand rapid progressive motilesperm respectively

[162]

MP MP users with suitablecontrols

Sperm parameters likevolume liquefaction time pHviscosity sperm countmotility viability andmorphology

Statistically significantdecrease in semen qualitywhich was also a function ofduration of MP use

[163]

MP 1 h Human semen samples Semen analysis

Significant decline in semenmobility viability andROS-TAClowast score rise in ROSlevel

[164]

18 GHzRFEMR SAR(04Wkg to 275Wkg) Purified human spermatozoa

Vitality motility spermdensity DHEdagger assay MSRDaggerassay 8-OH-dGpara TUNELassay and flow cytometry

Significant decrease inmotility and vitality andincrease in ROS 8-OH-dGand DNA fragmentation withincreasing SAR

[153]

RF radiations from GSM basestation 6-month exposure Male miceMus musculus Sperm head abnormality assay

High level of sperm headinjury in exposed mice whichcorrelated positively withradiation levels

[165]

lowast

TAC total antioxidant count daggerDHE dihydroethidium DaggerMSR MitoSOX Red and para8-OH-dG 8-hydroxy-21015840-deoxyguanosine

the consequent effects on menstruation and pregnancy [98]Miscarriage risks have been shown to be higher in pregnantphysiotherapists due to their occupation [175] Han et al [176]found significant rise in risk of embryo growth cessation inthe first pregnancy trimester of pregnant women especiallywith the medical history of embryo growth terminationwith regard to increased exposures from television and MPsAnimal investigations also support the toxic effects of RFRIn this connection Gul et al [177] registered a fall in folliclescount in rat ovaries submitted to intrauterine RF exposureswhereas Xu et al [178] demonstrated toxic alterations in thereproductive organs Further studies in females are wantedwith special relevance for pregnant women who are alsocarrying the future generation Children form yet anothergroup of prime importance since their reproductive systemsare immature and exposures are prolonged hence they canbe the worst sufferers

28 Auditory and Ocular Effects A recent study [179] con-cluded that higher ELF-EMF exposure at 50Hz 10182 kVmcoupled to 445 pT MF may give rise to adverse auditoryeffects especially to the organ of Corti and outer hair cellsas a result of decreased distortion product auto acousticemission amplitudes in higher frequency region localized inbasal turn of cochlea in rabbits which have also resemblancewith humanrsquos frequency spectra As regards RFR-EMF MPuse has been associated with tinnitus and acoustic neuroma[38 41] Ear is the first biological structure to be hit by

EMFs from MP In addition relatively greater vulnerabilityof cochlear outer hair cells to injuries from a diversity ofexogenous and endogenous agents makes the system a victimof radiation emissions [179 180] These days about 50 ofworldrsquos population possesses a MP [30] and even greaterthan that are experiencing EMF emissions through ldquopassivemobile phoningrdquo [181] Hearing problems reported in fewobservational studies [50] have also been investigated tooccur in animals [179] with parallel contradictions [180182] Studies with ten minutes acute MP radiation exposureshave resulted in no immediate effect on hearing thresholdlevel of pure tone audiometry transient evoked otoacousticemissions [183] auditory brain stem response [184] andany depreciation in hearing in young human volunteersHowever regular long-term MP use has been linked toincreased relative risk of acoustic schwannoma [39] Despitethe interests in EMF effects due to MP there is lack ofsolid evidence regarding the ill effects on auditory systemand hence we are far from any conclusion and not able todevelop safe and sound communication devices necessary forsafeguarding one of the senses [11]

Heat-related skin injury and lens defects reported in eyesof man are the only undisputed harmful effects of MWexposure [56] Carpenter [185] in late seventies reportedthat microwaves have the capability to induce cataracts andaffect the eyes by reducing the ascorbic acid content ofthe lens coupled with the inhibition of DNA synthesis andmitosis in lens epithelium thereby slowing down the recovery


process In addition the lens becomes more vulnerable toEMF threats because of decreased water content and absenceof vasculature [12 56 186] Spector [187] suggested the roleof OS in cataract development due to extensive oxidation oflens protein and lipid at older age Nevertheless the databaseis yet deficient to decide regarding ocular defects includingcataracts in human subjects exposed for extended durations

29 Effects on Sleep Parameters Sleep insufficiency wasobserved to be more common in the occupational group ofelectronic equipment repairers exposed to ELF-EMF thoughnot statistically significant when compared to controls [89]Earlier studies have also documented diminished sleep andsleep efficiency with 60HzMF experience [188] So farstudies evaluating sleep quality in the context of ELF-EMFexposure in humans have not reached any statistical signifi-cance [44 45 89]

In connection to RFR-EMF Abelin et al [189] reportedthe prevalence of difficulties of falling asleep and in par-ticular maintaining sleep which increased with increasingRF-EMF exposure in the vicinity of short-wave broadcasttransmitter In addition sleep quality was found to improveafter interruption of the exposure A similar study foundan association of EMF exposure with sleep quality andmelatonin excretion but only in poor sleepers suggestingthe sensitivity of a group of people [190] The authorshighlighted that the absence of blinding in their investigationcould lead to such results Another study by Wiholm et al[191] indicated the negative influence on sleep componentduring laboratory exposure to 884MHz wireless signalsBesides volunteers with no self-reported symptoms relatedto MP use appear to have more headaches during actualRF exposure as compared to sham exposure Several studiesevaluating RF exposure effects on sleep parameters and sleepEEG are surrounded with contradictory outcomes owingto methodological limitations like small sample sizes andlack of replications of the previous findings According to aclinical review [192] sleep disturbances do not seem to bea predominant complaint under exposure to high frequencyEMF and with the present level of knowledge no finalconclusion can be drawn concerning any potential healthhazard Hutter et al [34] also reported no significant effecton sleep quality and pointed that it could be dominated bythe fear of negative health effects of EMF radiations as wellas age Sleep is an important component of the biologicalspecies to overcome the daily wear and tear Studies relatingEMF exposures to sleep do suggest some biological effectshowever these do not provide evidence for any adversehealth consequences Further research with well-designedprotocols is required with lessons from past experiments sothat valuable information is updated in bioelectromagneticsfield

3 Mechanisms of Action

31Thermal and Nonthermal Interactions Due to lack of suf-ficient energy required to break the molecular bonds in cellsby EMFs the elicited effects are assumed to be indirect andsecondary to other induced biochemical modifications [60

76] Ruediger [32] suggested the indirect role ofmicrothermalprocesses OS and altered DNA repair mechanisms behindthe observed effects However studies have also pointedtowards the involvement of resonance-like sensing mecha-nisms working only at specific combinations of frequencyand amplitude suggestive of a direct EMF effect [136] It isproposed that low frequency time varying electric fields (EFs)interact with the body by the induction of electric currentsformation of electric dipoles and reorientation of existingdipoles whereas interaction of time-varying MFs leads toinduced EFs and circulating electric currents Higher currentdensities and EFs have been shown to be induced when thedirection of external EF is parallel to the longer vertical axisof body (from head to feet) and the MFs are from front toback respectively due to better coupling with human bodycompared to other configurations [193] Additionally EMFeffects are dependent on a number of physical (frequencymodulation polarization wave characteristics near or farfield configuration duration and orientation of EF andMF exposure dielectric properties conductivity and watercontent of tissues and environmental factors like humiditytemperature etc) and biological variables (species shape andsize of the body weight geometry of the body and nutritionaland health status)

The possible effect of EMF irradiation is either thermalor nonthermal depending on frequency and strength Theelicited effects are assumed to be noticeable when notshrouded by thermal noise also termed as Brownian motionwhich is a virtue of all objectsmaterials above absolute zerotemperature The thermal effects are induced as a conse-quence of heat gained by water contained in body tissuesHence body tissues or organs like lens of eye and testes withless vasculature or deficient in water content are the mostvulnerable to even small rise in temperature Usually bodyparts with the smallest cross-section like hand feet fingersand toes gain the maximum values of current densities andEFs [193]

32 Oxidative Stress OS resulting from imbalance of reactiveoxygen species (ROS) and antioxidants leading to disruptionof cell functions has been proposed as one of the probablemodes of EMF action [2 5 60 71 196] EMFs have alsobeen implicated to lengthen life of free radicals particularlyby Fenton reaction [33] affect enzyme activity [31] andchange protein levels indicative of induction of cellular stressresponse pathways [14] Fenton reaction is a process inwhich hydroxy free radicals are generated from hydrogenperoxide produced during mitochondrial oxidative respira-tion in presence of transition metals like iron [60 64] EMFinteraction with free radicals and transitional metals has alsobeen linked to the observed genotoxic effects [33 64] In thisregard cells which are metabolically active or have highercellular concentrations of free iron and superparamagneticiron particles (magnetites) in body tissues like brain cellsare more vulnerable to EMFs [60] Several studies havedemonstratedOS inducing ability of EMF includingMP-RFRin different animalmodels [31 152 196ndash198] or in cell cultures[64 73] paralleledwith negative findings as well [5 7] Studies


Table 7 Studies showing the oxidative stress inducing ability of electromagnetic fields

EMF characteristics Study group Method Study outcome Reference2450MHz pulsed (2msecpulses 500 pps) 2mWcm2Avg SAR = 12Wkg 2 hmelatonin and PBNlowasttreatment before and afterexposure

Male Sprague Dawley rats Microgel electrophoresis assayin brain cells

Involvement of free radicals ininducing DNA damage inbrain cells and protectiveeffects of melatonin andPBNas free radical scavenger

[3]

01mT 60Hz 5 h and 30minafter LPSdagger administrationmice were administered withNODagger spin trap MGD-Fepara

MaleBALBC mice EPRsect measurement in liver EMF increased LPS induced

NO production but not alone [194]

900MHz 30minday 5dayswk for 2 weeks mel(10mgkg daily orally)

Male Sprague Dawley rats inthree groups

NO measurement in nasal andparanasal mucosa by Griessreaction

Increase in NO level in sinusand nasal mucosa beneficialeffect of melatonin inpreventing these changes

[195]

900MHzMW melatonin(100 120583gkg sc before dailyexposure)

Sprague Dawley rats in threegroups

Lipid peroxidation in cortexbrain and hippocampus tissue

Rise in MDA|| levelsmelatonin caused decline inhippocampal MDA levels withno decrease in cortex

[2]

900MHzRF CW amp GSMMPwaves for 10 or 30minSAR = 03 amp 1Wkg MX =500 120583M

Murine L929 fibrosarcomacells Measurement of ROS

No ROS generation eitheralone or in association withMX

[5]

MP 20 40 60 days SAR =0043minus0135Wkg) melatonin= 2mgkg body weight ip

Wistar rats in four groups

Biochemical estimation ofMDA carbonyl groups XO1

and CAT2 activity in braintissue

Significant rise in MDAcarbonyl groups XO activityand reduced CAT activity after40 and 60 days exposuremelatonin ameliorates OS

[152]

lowast

PBN N-tert-butyl-a-phenylnitrone daggerLPS lipopolysaccharide DaggerNO nitric oxide paraMGD-Fe ferrous N-methyl-D-glucamine dithiocarbamate sectEPR electronparamagnetic resonance ||MDAmalondialdehyde MX 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone 1XO xanthine oxidase and 2CAT catalase

demonstrating EMFrsquos ability to cause OS are summarisedin Table 7 Given the credence of free radicals in signaltransduction and EMF in boosting the free radical lifetimethere are chances of EMF influencing signalling [194]

33 Melatonin Diminution Several human and animal stud-ies conducted thus far have suggested decrease in melatoninafter EMF exposure [21 23 24 87] Like all other EMF effectsmelatonin diminution is also surrounded with conflictingresults [87] however the effects have been suggested to besomewhat constant at least in rodents [199] Some studieshave also supported the protective effect of melatonin againstoxidative damage induced by EMFs [2 3 64 152 195]pointing towards the OS mechanism involved in gener-ating negative health outcomes and melatoninrsquos beneficialproperties The hypothesised mechanism of EMF action onmelatonin concentration is through the imitation of light raysto the retina [22] To add Yaga et al [86] found significantsuppression of N-acetyltransferase (NAT) activity a rate-limiting enzyme in melatonin synthesis due to MF exposureThe melatonin forming enzyme hydroxyindole O-methyltransferase has also been documented to be affected [87]Melatoninrsquos shielding actions counter to EMF ill effects aresupposed to shoot from its direct free radical foraging andindirect antioxidant property of inhibiting free radical pro-duction at the power house of the cell and hence diminution

of pineal melatonin secretion could be proposed as a possiblemechanism of EMF interaction with living organisms

34 Calcium Flux Calcium ion effluxinflux has also beenproposed as the biological mechanism [200] and is depen-dent on ambient temperature geomagnetic field intensitydirection and signal strength [201ndash203] Calcium ions arecrucial for cAMP pathway as well as serotoninmelatoninconversion and their efflux from pinealocytes is supposedto cause melatonin suppression Besides calcium dependentsignal transduction systems also have been implicated in themediation of immune cell effects by low frequency EMF [29]However authors have indicated the occurrence of calciumeffluxinflux at some specific exposure combinations but notat other relatively closer exposure characteristics mainly dueto the ldquowindowrdquo effect or nonlinear nature of modulationfrequency and intensity effect

35 Molecular Mechanisms Similar to physiological stressresponse at the organ system level there are also cellular stressresponses at the cell level to impart protection to the cell fromexternal and internal stressors The cellular stress response ischaracterized by an elevation in stress protein concentration[204] in response to a stress causing damage to biomoleculeslike DNA and proteins [205] EMFs at ELF RF and amplitude


modulated RF have been demonstrated to stimulate the samestress response [204 206 207] Unlike the past assumption ofabsence of DNA-EMF interaction plausibility recent inves-tigations indicate the potential of EMF both ELF and RF tostimulate DNA and induce protein expression [14 171 208209] Various studies have highlighted the genotoxic abilityof EMF at both ELF and RF range as evidenced from DNAstrand break reports post-EMF experience [33 63ndash65 68]Recent investigations have further revealed the presence of anEMF reactive sequence in DNA [210] which acts particularlyin response to EMF stimulus These EMF reactive DNAsequences code for the production of the chief stress proteinhsp70 in response to the binding of transcription factor heatshock factor 1 (HSE-1) to heat shock element (HSE) in thepromoter region [210ndash213] Friedman et al [209] delineatedthemolecularmechanismbehind the stimulation of the ERKsin response to RFR exposure atMP frequenciesThe RF-EMFthrough its interaction with NADH oxidase in the plasmamembrane causes the formation of ROS which furtheractivate the MMPs (matrix metalloproteinases) Because ofactivation the MMPs break into Hb-EGF [heparin-bindingEGF (epidermal growth factor)] and stimulate the EGFreceptor which sequentially triggers the ERK cascade TheERK cascade is one of the four mitogen-activated proteinkinase (MAPK) signaling cascades that controls transcriptionand associated cellular processes like replication cell-cycleprogression apoptosis differentiation metabolism and soforth in reaction to extracellular stimuli The MP radiationinduced overexpressed protein transcription factors havebeen found to regulate the cellular processes such as apoptosis[214] and replication and cell cycle progression [14 215]The reported findings with regard to cellular stress responsepost-EMF experience give critical insights into connectionto harmful health-relevant potential of ELFs and RFRs inaddition to their role as cellular biomarkers

In light of several credible biointeraction processes theOS mechanism appears to gain the maximum support Thehypothesised EMF biointeraction pathmay involve ROS gen-eration leading to diminished antioxidant capacity affectingthe antioxidantprooxidant equilibrium and causing OSthereby instigating adverse health effects This sequence maybe paralleled by calcium efflux which alters serotonin con-version intomelatonin thus triggeringmelatonin diminutionwhich further substantiates OS At the same time ROS maylead to the activation of signal transduction pathway triggingthe ERK cascade The cellular stress response mediated byhsp70 overexpression can also be considered but this effectis limited to certain group of cells while other cell types arebeing nonresponsive [216] The exact mode of biointeractionmechanism still needs to be elucidated

4 Research Needs

The limited quality of research works in bioelectromagneticsand methodological problems is an important concern [57155] Until now epidemiological investigations have failedto get the SAR value which is the most direct dosimetricmeasure of an individualrsquos exposure at the tissue or organlevel under study [217] Moreover lack of an appropriate

exposure assessment method [55] and reliable equipmentfor calculation of energy absorbed in the body and theintricate relation with species frequency power EMF sourceand modulation dosimetry has inhibited the utilization oflaboratory results to human conditions [53] and the conductof epidemiological studies [56] Hutter et al [34] suggestedthe usage of personal ldquoexposimeterrdquo or long-term exposuremonitoring as the best way for exposure assessment Sofar errors in exposure assessment due to lack of long-termexposure monitoring by EMF dosimeters exposure has beenassessed by crude methods in most studies such as wiringcodes occupation or residence in relation to proximity to asource spot measurements time-weighted average and self-reports and hence results in underestimation of actual riskand clouds the true relationship Absence of suitable controlpopulation for comparison as all of us are exposed to EMFsevery day coming from varied sources with different degreesfurther complicates the understanding of literature on humanEMF exposure [52 55]

Furthermore clear understanding is hampered by themultipart interactions of different EMF exposure factors[12 53] and shape size mass orientation and electricalcharacteristics of body and individual characteristics like agegender activity level incapacitation or illness [218] Environ-mental parameters like ambient temperature wind velocityhumidity and body insulation also affect the communicationbetween body and the EMF vector Anatomical differencesamong humans and animal models as regards size shapereproductive tract variations and so forth further complicatethe understanding of observed results [12]

As far as studies investigating exposure of humans to MPradiations are concerned they have followed the standardmethod of EMF exposure assessment by retrospective inter-views or obtaining information or self-reports of subjectson total duration of use or number of calls number ofyears of use side of use ipsilateral or contralateral alongwith exposure duration estimates and billing records fromservice providers [52 79] However these parameters havebeen questioned for recall bias [52] Animal experimentationespecially using primates or species closely related to humanswould eliminate the chances of recall bias regarding MP useand give meaningful directions Besides the duration basedexposure assessment is built on the postulation of equivalentpower emissions per minute from all phones which maynot be correct with expanding use of GSM based phoneswith variable power outputs ending in miscalculation of trueexposure in spite of recall accuracy [217] Besides geographicarea physical environment user location rural or urbandistance between user and base station antenna handsfreeuse individual characteristics of phone handset and its useas well as technical features of provider network all have someeffect on EMF emissions and consequent exposure to theindividuals [12 34 52 219]

A research carried out by Erdreich et al [217] to increasethe accuracy of exposure estimation in epidemiological stud-ies of GSM-MPs found that the average power output rate inGSM phones varies with several characteristics of phone usethe largest being the site of investigation followed by usermovement and location (indoor or outdoor) use of handsfree


device and urbanicity The understanding is complicatedfurther by factors like distance to the phone holding positionposition of antenna pinna size elasticity of ear thickness ofskull bone type of tissue tissue type distribution and soforth governing the actual amount of power absorbed [220]In addition lack of long-term studies also restricts our under-standing Apart from this role of media finds significancein focusing the attention on the potential adverse healtheffects caused by MP radiations This may give rise to fearor awareness forcing MP users to report more symptomsthan nonusers even if the prevalence of symptoms were equal[146]

Animal and cell culture studies are surrounded withconflicting results as a consequence of the heterogeneousexposure conditions (type of EMF- RF MW CW Pulsed andso forth SAR value exposure duration) [5 7] and differingassay protocols [53] At the same time vested interestsof sponsors also influence the study outcome with qualitystudies havingmixed funding and hence sponsorship shouldbe taken into consideration while interpreting the findings[221] We strongly advocate that with mere swelling numberof studies no fruitful conclusions can be reached If we do notaddress the limitations of past investigations we may not beable to truly contribute to the domain of bioelectromagneticsTherefore need of the hour is to do innovative research withsound designs and appropriate methodologies rising abovethe demerits of past researches

5 Conclusion

Given the ubiquitous nature of EMFs their widespread appli-cations and their capability to produce deleterious effectsconclusive investigations of the health risks are critical Withthe published literature on EMF it is still not sufficientenough to reach a concrete conclusion But the possibilityof negative consequences cannot be excluded Several studieswith appropriate methodologies reflect the capacity of EMFsto cause adverse health effects However the absence ofany established biointeraction mechanism does not diminishthe reliability of these studies as there are several crediblemechanisms likeOS that can account for the observed effects

Therefore need of the hour is to restrict the swellingnumbers of scientific investigations and in place activatecomprehensive well-coordinated blind scientific investiga-tions especially long-term studies overcoming all limitationsand demerits of previous findings with suitable replicationstudies and follow-up There is a need for standardizedresearchmethodology alongwith the inclusion of appropriateexposure assessment technique which is crucial for identifi-cation of dose response relation if any and the elucidationof mechanism for biological interaction If we do not workupon the demerits of previous findings we may remain farfrom any concrete conclusion At the same time it is criticalto analyse the EMF investigations giving more weight tothe similarities and dissimilarities rather than giving moreimportance to the endpoints reached

For the time being since it is difficult to protect oneselffrom EMFs the only practical way to check exposures is to

distance oneself from the source Together the precautionaryapproach and ALARA (as low as reasonably achievable)principle can also be applied to save us from substantialexposures and the possible ill effects if any The objective isto minimize EMF exposures to the greatest degree possiblewithout significant economic cost and disturbance

Conflict of Interests

The authors declare that there is no conflict of interestsregarding the publication of this paper

Acknowledgments

The authors are very thankful to Dr M P K Reddy and DrS N Singh DIPAS DRDO for their valuable inputs in thepreparation of the paper

References

[1] V Garaj-Vrhovac G Gajski S Pazanin et al ldquoAssessment ofcytogenetic damage and oxidative stress in personnel occupa-tionally exposed to the pulsed microwave radiation of marineradar equipmentrdquo International Journal of Hygiene and Environ-mental Health vol 214 no 1 pp 59ndash65 2011

[2] H Koylu H Mollaoglu F Ozguner M Naziroglu and NDelibas ldquoMelatonin modulates 900MHz microwave-inducedlipid peroxidation changes in rat brainrdquo Toxicology and Indus-trial Health vol 22 pp 211ndash216 2006

[3] H Lai and N P Singh ldquoMelatonin and a spin-trap compoundblock radio-frequency electromagnetic radiation-inducedDNA strand breaks in rat brain cellsrdquo Bioelectromagnetics vol18 no 6 pp 446ndash454 1997

[4] M Roosli M Egger D Pfluger and CMinder ldquoCardiovascularmortality and exposure to extremely low frequency magneticfields a cohort study of Swiss railway workersrdquo EnvironmentalHealth vol 7 article 35 2008

[5] O Zeni R di Pietro G dAmbrosio et al ldquoFormationof reactive oxygen species in L929 cells after exposure to900MHz RF radiation with and without co-exposure to 3-chloro-4-(dichloromethyl)-5- hydroxy-2(5H)-furanonerdquo Radi-ation Research vol 167 no 3 pp 306ndash311 2007

[6] J Schuz R Jacobsen J H Olsen J D Boice Jr J K McLaugh-lin and C Johansen ldquoCellular telephone use and cancer riskupdate of a nationwide Danish cohortrdquo Journal of the NationalCancer Institute vol 98 no 23 pp 1707ndash1713 2006

[7] G J Hook D R Spitz J E Sim et al ldquoEvaluation of parametersof oxidative stress after in vitro exposure to FMCW- andCDMA-modulated radiofrequency radiation fieldsrdquo RadiationResearch vol 162 no 5 pp 497ndash504 2004

[8] I Lagroye G J Hook B A Wettring et al ldquoMeasurements ofalkali-labile DNA damage and protein-DNA cross links after2450 MHz microwave and low-dose gamma irradiation invitrordquo Radiation Research vol 161 no 2 pp 201ndash214 2004

[9] S J Genuis and C T Lipp ldquoElectromagnetic hypersensitivityFact or fictionrdquo Science of the Total Environment vol 414 pp103ndash112 2012

[10] S J Regel and P Achermann ldquoCognitive performancemeasuresin bioelectromagnetic research critical evaluation and recom-mendationsrdquo Environmental Health vol 10 article 10 2011


[11] A E Kaprana A D Karatzanis E P Prokopakis et al ldquoStudy-ing the effects of mobile phone use on the auditory system andthe central nervous system a review of the literature and futuredirectionsrdquo European Archives of Oto-Rhino-Laryngology vol265 no 9 pp 1011ndash1019 2008

[12] A J Hamada A Singh and A Agarwal ldquoCell phones and theirimpact on male fertility fact or fictionrdquoThe Open ReproductiveScience Journal vol 5 pp 125ndash137 2011

[13] S B Mortazavi A Safari A Khavanin A Kazemnejad S MMoazzeni and R Abbas ldquoInduction of micronuclei in micelymphocytes exposed to microwave and toluenerdquo AmericanJournal of Applied Science vol 2 pp 1321ndash1324 2005

[14] D Leszczynski S Joenvaara J Reivinen and R Kuokka ldquoNon-thermal activation of the hsp27p38MAPK stress pathway bymobile phone radiation in human endothelial cells molecularmechanism for cancer- and blood-brain barrier-related effectsrdquoDifferentiation vol 70 no 2-3 pp 120ndash129 2002

[15] E Lopez-Martın J L Relova-Quinteiro R Gallego-GomezM Peleteiro-Fernandez F J Jorge-Barreiro and F J Ares-Pena ldquoGSM radiation triggers seizures and increases cerebralc-Fos positivity in rats pretreated with subconvulsive doses ofpicrotoxinrdquo Neuroscience Letters vol 398 no 1-2 pp 139ndash1442006

[16] M Kundi ldquoMobile phone use and cancerrdquo Occupational andEnvironmental Medicine vol 61 no 6 pp 560ndash570 2004

[17] I Yakymenko and E Sidorik ldquoRisks of carcinogenesis fromelectromagnetic radiation of mobile telephony devicesrdquo Exper-imental Oncology vol 32 no 2 pp 54ndash60 2010

[18] ldquoGuidelines for limiting exposure to time-varying electricmag-netic and electromagnetic fields (up to 300GHz) InternationalCommission on Non-Ionizing Radiation Protectionrdquo HealthPhysics vol 74 pp 494ndash522 1998

[19] O Johansson ldquoDisturbance of the immune system by elec-tromagnetic fieldsmdasha potentially underlying cause for cellulardamage and tissue repair reduction which could lead to diseaseand impairmentrdquo Pathophysiology vol 16 no 2-3 pp 157ndash1772009

[20] T Kumlin P Heikkinen J T Laitinen and J JuutilainenldquoExposure to a 50Hzmagnetic field induces a circadian rhythmin 6-hydroxymelatonin sulfate excretion in micerdquo Journal ofRadiation Research vol 46 no 3 pp 313ndash318 2005

[21] J B Burch J S Reif M G Yost T J Keefe and C APitrat ldquoReduced excretion of amelatoninmetabolite in workersexposed to 60Hzmagnetic fieldsrdquoAmerican Journal of Epidemi-ology vol 150 no 1 pp 27ndash36 1999

[22] A W Wood S M Armstrong M L Sait L Devine and MJ Martin ldquoChanges in human plasma melatonin profiles inresponse to 50 Hz magnetic field exposurerdquo Journal of PinealResearch vol 25 no 2 pp 116ndash127 1998

[23] R G Stevens and S Davis ldquoThe melatonin hypothesis electricpower and breast cancerrdquo Environmental Health Perspectivesvol 104 no 1 pp 135ndash140 1996

[24] D H Pfluger and C E Minder ldquoEffects of exposure to 167Hz magnetic fields on urinary 6-hydroxymelatonin sulfateexcretion of Swiss railway workersrdquo Journal of Pineal Researchvol 21 no 2 pp 91ndash100 1996

[25] W R Rogers R J Reiter H D Smith and L Barlow-WaldenldquoRapid-onsetoffset variably scheduled 60Hz electric andmagnetic field exposure reduces nocturnal serum melatoninconcentration in nonhuman primatesrdquo Bioelectromagneticssupplement 3 pp 119ndash122 1995

[26] T Jorge-Mora M Alvarez-Folgueiras J Leiro F J Jorge-Barreiro F J Ares-Pena and E Lopez-Martın ldquoExposure to245 GHz microwave radiation provokes cerebral changes ininduction of HSP-90 120572120573 heat shock protein in ratrdquo Progress inElectromagnetics Research vol 100 pp 351ndash379 2010

[27] A F Fragopoulou P Miltiadous A Stamatakis FStylianopoulou S L Koussoulakos and L H MargaritisldquoWhole body exposure with GSM 900MHz affects spatialmemory in micerdquo Pathophysiology vol 17 no 3 pp 179ndash1872010

[28] H Lai A Horita and AW Guy ldquoMicrowave irradiation affectsradial-arm maze performance in the ratrdquo Bioelectromagneticsvol 15 no 2 pp 95ndash104 1994

[29] J Walleczek ldquoElectromagnetic field effects on cells of theimmune system the role of calcium signalingrdquo The FASEBJournal vol 6 no 13 pp 3177ndash3185 1992

[30] H Nittby A Brun J Eberhardt L Malmgren B R R Perssonand L G Salford ldquoIncreased blood-brain barrier permeabilityin mammalian brain 7 days after exposure to the radiation froma GSM-900 mobile phonerdquo Pathophysiology vol 16 no 2-3 pp103ndash112 2009

[31] K K Kesari J Behari and S Kumar ldquoMutagenic response of245GHz radiation exposure on rat brainrdquo International Journalof Radiation Biology vol 86 no 4 pp 334ndash343 2010

[32] H W Ruediger ldquoGenotoxic effects of radiofrequency electro-magnetic fieldsrdquo Pathophysiology vol 16 no 2-3 pp 89ndash1022009

[33] H Lai and N P Singh ldquoMagnetic field-induced DNA strandbreaks in brain cells of the ratrdquo Environmental Health Perspec-tives vol 112 no 6 pp 687ndash694 2004

[34] H P Hutter H Moshammer P Wallner and M KundildquoSubjective symptoms sleeping problems and cognitive per-formance in subjects living near mobile phone base stationsrdquoOccupational and Environmental Medicine vol 63 no 5 pp307ndash313 2006

[35] H Seitz D Stinner T Eikmann C Herr and M RooslildquoElectromagnetic hypersensitivity (EHS) and subjective healthcomplaints associated with electromagnetic fields of mobilephone communicationmdasha literature review published between2000 and 2004rdquo Science of the Total Environment vol 349 no1ndash3 pp 45ndash55 2005

[36] M Roosli M Moser Y Baldinini M Meier and C Braun-Fahrlander ldquoSymptoms of ill health ascribed to electromagneticfield exposuremdasha questionnaire surveyrdquo International Journal ofHygiene and Environmental Health vol 207 no 2 pp 141ndash1502004

[37] E A Navarro J Segura M Portoles and C Gomez-PerrettaldquoThe microwave syndrome a preliminary study in SpainrdquoElectromagnetic Biology and Medicine vol 22 no 2-3 pp 161ndash169 2003

[38] L Hardell K Hansson Mild M Sandstrom M Carlberg AHallquist and A Pahlson ldquoVestibular schwannoma tinnitusand cellular telephonesrdquo Neuroepidemiology vol 22 no 2 pp124ndash129 2003

[39] L Hardell M Carlberg and K Hansson Mild ldquoUse of cellulartelephones and brain tumour risk in urban and rural areasrdquoOccupational and Environmental Medicine vol 62 no 6 pp390ndash394 2005

[40] L Hardell M Carlberg F Soderqvist K H Mild and L LMorgan ldquoLong-term use of cellular phones and brain tumoursincreased risk associated with use for gt10 yearsrdquo Occupationaland Environmental Medicine vol 64 no 9 pp 626ndash632 2007


[41] L Hardell and M Carlberg ldquoMobile phones cordless phonesand the risk for brain tumoursrdquo International Journal of Oncol-ogy vol 35 no 1 pp 5ndash17 2009

[42] H Kabuto I Yokoi A Mori and N Ogawa ldquoEffects of an invivo 60Hzmagnetic field onmonoamine levels inmouse brainrdquoPathophysiology vol 7 no 2 pp 115ndash119 2000

[43] WHO (World Health Organisation) ldquoElectromagnetic hyper-sensitivityrdquo inProceedings of the InternationalWorkshop onEMFHypersensitivity Prague Czech Republic 2004

[44] T Barsam M R Monazzam A A Haghdoost M R Ghotbiand S F Dehghan ldquoEffect of extremely low frequency elec-tromagnetic field exposure on sleep quality in high voltagesubstationsrdquo Iranian Journal of Environmental Health Scienceand Engineering vol 9 no 15 2012

[45] M R Monazzam M Hosseini L F Matin H A AghaeiH Khosroabadi and A Hesami ldquoSleep quality and generalhealth status of employees exposed to extremely low frequencymagnetic fields in a petrochemical complexrdquo Journal of Envi-ronmental Health Science amp Engineering vol 12 article 78 2014

[46] E van Wijngaarden D A Savitz R C Kleckner J Cai andD Loomis ldquoExposure to electromagnetic fields and suicideamong electric utility workers a nested case-control studyrdquoOccupational and Environmental Medicine vol 57 no 4 pp258ndash263 2000

[47] I L Beale N E Pearce D M Conroy M A Henning andK A Murrell ldquoPsychological effects of chronic exposure to50Hz magnetic fields in humans living near extra-high-voltagetransmission linesrdquo Bioelectromagnetics vol 18 no 8 pp 584ndash594 1997

[48] M Havas ldquoElectromagnetic hypersensitivity biological effectsof dirty electricity with emphasis on diabetes and multiplesclerosisrdquo Electromagnetic Biology and Medicine vol 25 no 4pp 259ndash268 2006

[49] M Havas and A Olstad ldquoPower quality affects teacher wellbe-ing and student behavior in three Minnesota Schoolsrdquo Scienceof the Total Environment vol 402 no 2-3 pp 157ndash162 2008

[50] M M Khan ldquoAdverse effects of excessive mobile phone userdquoInternational Journal of Occupational Medicine and Environ-mental Health vol 21 no 4 pp 289ndash293 2008

[51] T Al-Khlaiwi and S A Meo ldquoAssociation of mobile phoneradiation with fatigue headache dizziness tension and sleepdisturbance in Saudi populationrdquo SaudiMedical Journal vol 25no 6 pp 732ndash736 2004

[52] D R Kohli A Sachdev andH S Vats ldquoCell phones and tumorstill in no man1015840s landrdquo Indian Journal of Cancer vol 46 no 1pp 5ndash12 2009

[53] E Valentini G Curcio F Moroni M Ferrara L de Gennaroand M Bertini ldquoNeurophysiological effects of mobile phoneelectromagnetic fields on humans a comprehensive reviewrdquoBioelectromagnetics vol 28 no 6 pp 415ndash432 2007

[54] A Ahlbom E Cardis A Green M Linet D Savitz and ASwerdlow ldquoReview of the epidemiologic literature on EMF andhealthrdquo Environmental Health Perspectives vol 109 no 6 pp911ndash933 2001

[55] D O Carpenter ldquoPossible effects of electromagnetic fieldson the nervous system and developmentrdquo MRDD ResearchReviews vol 3 pp 270ndash274 1997

[56] C Silverman ldquoNervous and behavioral effects of microwaveradiation in humansrdquo The American Journal of Epidemiologyvol 97 no 4 pp 219ndash224 1973

[57] P Levallois ldquoHypersensitivity of human subjects to environ-mental electric and magnetic field exposure a review of theliteraturerdquo Environmental Health Perspectives vol 110 pp 613ndash618 2002

[58] M R Scarfı A Sannino A Perrotta M Sarti P Mesirca and FBersani ldquoEvaluation of genotoxic effects in human fibroblastsafter intermittent exposure to 50 Hz electromagnetic fields aconfirmatory studyrdquoRadiation Research vol 164 no 3 pp 270ndash276 2005

[59] Y H Cho and H W Chung ldquoThe effect of extremely lowfrequency electromagnetic fields (ELF-EMF) on the frequencyof micronuclei and sister chromatid exchange in human lym-phocytes induced by benzo(a)pyrenerdquo Toxicology Letters vol143 no 1 pp 37ndash44 2003

[60] J L Phillips N P Singh andH Lai ldquoElectromagnetic fields andDNAdamagerdquo Pathophysiology vol 16 no 2-3 pp 79ndash88 2009

[61] S Ivancsits A Pilger E DiemO Jahn andHW Rudiger ldquoCelltype-specific genotoxic effects of intermittent extremely low-frequency electromagnetic fieldsrdquo Mutation ResearchmdashGeneticToxicology and Environmental Mutagenesis vol 583 no 2 pp184ndash188 2005

[62] J Delimaris S Tsilimigaki N Messini-Nicolaki E Ziros andS M Piperakis ldquoEffects of pulsed electric fields on DNA ofhuman lymphocytesrdquo Cell Biology and Toxicology vol 22 no6 pp 409ndash415 2006

[63] H Lai and N P Singh ldquoMelatonin and N-tert-butyl-120572-phenylnitrone block 60-Hzmagnetic field-induced DNA singleand double strand breaks in rat brain cellsrdquo Journal of PinealResearch vol 22 no 3 pp 152ndash162 1997

[64] J Jajte M Zmyslony J Palus E Dziubałtowska and ERaikowska ldquoProtective effect of melatonin against in vitro ironions and 7mT 50Hz magnetic field-induced DNA damage inrat lymphocytesrdquo Mutation Research vol 483 no 1-2 pp 57ndash64 2001

[65] B Yokus D U Cakir M Z Akdag C Sert and N MeteldquoOxidative DNA damage in rats exposed to extremely lowfrequency electro magnetic fieldsrdquo Free Radical Research vol39 no 3 pp 317ndash323 2005

[66] M Zmyslony J Palus J Jajte E Dziubaltowska and ERajkowska ldquoDNA damage in rat lymphocytes treated in vitrowith iron cations and exposed to 7mT magnetic fields (staticor 50Hz)rdquo Mutation ResearchFundamental and MolecularMechanisms of Mutagenesis vol 453 no 1 pp 89ndash96 2000

[67] G drsquoAmbrosio RMassaM R Scarfl andO Zeni ldquoCytogeneticdamage in human lymphocytes following GMSK phase modu-lated microwave exposurerdquo Bioelectromagnetics vol 23 no 1pp 7ndash13 2002

[68] J L Phillips O Ivaschuk T Ishida-Jones R A Jones MCampbell-Beachler and W Haggren ldquoDNA damage in molt-4T-lymphoblastoid cells exposed to cellular telephone radiofre-quency fields in vitrordquo Bioelectrochemistry and Bioenergeticsvol 45 no 1 pp 103ndash110 1998

[69] S Lixia K Yao W Kaijun et al ldquoEffects of 18 GHz radiofre-quency field on DNA damage and expression of heat shockprotein 70 in human lens epithelial cellsrdquo Mutation Researchvol 602 no 1-2 pp 135ndash142 2006

[70] L-X Sun K Yao J-L He D-Q Lu K-J Wang and H-W LildquoEffect of acute exposure to microwave from mobile phone onDNA damage and repair of cultured human lens epithelial cellsin vitrordquo Zhonghua Lao DongWei Sheng Zhi Ye Bing Za Zhi vol24 no 8 pp 465ndash467 2006 (Chinese)


[71] V Garaj-Vrhovac G Gajski I Trosic and I Pavicic ldquoEvaluationof basal DNA damage and oxidative stress in Wistar ratleukocytes after exposure to microwave radiationrdquo Toxicologyvol 259 no 3 pp 107ndash112 2009

[72] A R Ferreira T Knakievicz M A de Bittencourt Pasquali etal ldquoUltra high frequency-electromagnetic field irradiation dur-ing pregnancy leads to an increase in erythrocytes micronucleiincidence in rat offspringrdquo Life Sciences vol 80 no 1 pp 43ndash502006

[73] J Luukkonen P Hakulinen J Maki-Paakkanen J Juutilainenand J Naarala ldquoEnhancement of chemically induced reactiveoxygen species production and DNA damage in human SH-SY5Y neuroblastoma cells by 872 MHz radiofrequency radia-tionrdquoMutation Research vol 662 no 1-2 pp 54ndash58 2009

[74] A G Gandhi ldquoGenetic damage in mobile phone users somepreliminary findingsrdquo Indian Journal of Human Genetics vol11 no 2 pp 99ndash104 2005

[75] A Karinen S Heinavaara R Nylund and D LeszczynskildquoMobile phone radiation might alter protein expression inhuman skinrdquo BMC Genomics vol 9 article 77 2008

[76] A S Yadav and M K Sharma ldquoIncreased frequency ofmicronucleated exfoliated cells among humans exposed in vivotomobile telephone radiationsrdquoMutation Research vol 650 no2 pp 175ndash180 2008

[77] V G Khurana C Teo M Kundi L Hardell and M CarlbergldquoCell phones and brain tumors a review including the long-term epidemiologic datardquo Surgical Neurology vol 72 no 3 pp205ndash214 2009

[78] IARC (International Agency for Research on Cancer) Non-Ionizing Radiation Part 1 Static and Extremely Low-Frequency(ELF) Electric and Magnetic Fields vol 80 of IARCMonographson the Evaluation of Carcinogenic Risks to Humans IARC PressLyon France 2002

[79] J E Muscat M G Malkin S Thompson et al ldquoHandheldcellular telephone use and risk of brain cancerrdquo Journal of theAmerican Medical Association vol 284 no 23 pp 3001ndash30072000

[80] J E Muscat M GMalkin R E Shore et al ldquoHandheld cellulartelephones and risk of acoustic neuromardquoNeurology vol 58 no8 pp 1304ndash1306 2002

[81] S J HepworthM J Schoemaker K RMuir A J SwerdlowMJ A van Tongeren and P A McKinney ldquoMobile phone use andrisk of glioma in adults case-control studyrdquoThe British MedicalJournal vol 332 no 7546 pp 883ndash887 2006

[82] A G Levis N Minicuci P Ricci V Gennaro and S GarbisaldquoMobile phones and head tumours the discrepancies in cause-effect relationships in the epidemiological studies how do theyariserdquo Environmental Health vol 10 article no 59 2011

[83] MH Repacholi A Basten V Gebski D Noonan J Finnie andAWHarris ldquoLymphomas in E120583-Pim1 transgenicmice exposedto pulsed 900 MHz electromagnetic fieldsrdquo Radiation Researchvol 147 no 5 pp 631ndash640 1997

[84] B W Wilson L E Anderson D I Hilton and R D PhillipsldquoChronic exposure to 60 Hz electric fields effects on pinealfunction in the ratrdquo Bioelectromagnetics vol 2 no 4 pp 371ndash380 1981

[85] A Lerchl K O Nonaka K-A Stokkan and R J ReiterldquoMarked rapid alterations in nocturnal pineal serotoninmetabolism in mice and rats exposed to weak intermittentmagnetic fieldsrdquo Biochemical and Biophysical Research Commu-nications vol 169 no 1 pp 102ndash108 1990

[86] K Yaga R J Reiter L C Manchester H Nieves S Jih-Hsingand C Li-Dun ldquoPineal sensitivity to pulsed static magneticfields changes during the photoperiodrdquo Brain Research Bulletinvol 30 no 1-2 pp 153ndash156 1993

[87] D L Henshaw and R J Reiter ldquoDo magnetic fields causeincreased risk of childhood leukemia via melatonin disrup-tionrdquo Bioelectromagnetics vol 26 no 7 pp S86ndashS97 2005

[88] C V Bellieni M Tei F Iacoponi et al ldquoIs newborn melatoninproduction influenced by magnetic fields produced by incuba-torsrdquo Early Human Development vol 88 no 8 pp 707ndash7102012

[89] M El-Helaly and E Abu-Hashem ldquoOxidative stress melatoninlevel and sleep insufficiency among electronic equipmentrepairersrdquo Indian Journal of Occupational and EnvironmentalMedicine vol 14 no 3 pp 66ndash70 2010

[90] W T Chance C J Grossman R Newrock et al ldquoEffects ofelectromagnetic fields and gender on neurotransmitters andamino acids in ratsrdquo Physiology and Behavior vol 58 no 4 pp743ndash748 1995

[91] H Sedghi S Zare H Hayatgeibi S Alivandi and A GEbadi ldquoEffects of 50Hz magnetic field on some factors ofimmune system in the male guinea pigsrdquo American Journal ofImmunology vol 1 no 1 pp 37ndash41 2005

[92] B J Youbicier-Simo F Boudard C Cabaner and M BastideldquoBiological effects of continuous exposure of embryos andyoung chickens to electromagnetic fields emitted by videodisplay unitsrdquo Bioelectromagnetics vol 18 no 7 pp 514ndash5231997

[93] SM JMortazavi S Vazife-DoostM Yaghooti SMehdizadehand A Rajaie-Far ldquoOccupational exposure of dentists toelectromagnetic fields produced by magnetostrictive cavitronsalters the serum cortisol levelrdquo Journal of Natural ScienceBiology and Medicine vol 3 no 1 pp 60ndash64 2012

[94] J M Thompson F Stormshak J M Lee Jr D L Hessand L Painter ldquoCortisol secretion and growth in ewe lambschronically exposed to electric andmagnetic fields of a 60-Hertz500-kilovolt AC transmission linerdquo Journal of Animal Sciencevol 73 no 11 pp 3274ndash3280 1995

[95] J Batanjac and E A Pauncu ldquoRisk of 5060 hertz electro-magnetic fields in electric utility workersrdquo Facta UniversitatisMedicine and Biology vol 10 no 2 pp 99ndash100 2003

[96] K Radon D Parera D-M Rose D Jung and L VollrathldquoNo effects of pulsed radio frequency electromagnetic fields onmelatonin cortisol and selectedmarkers of the immune systemin manrdquo Bioelectromagnetics vol 22 no 4 pp 280ndash287 2001

[97] Y Djeridane Y Touitou and R de Seze ldquoInfluence of electro-magnetic fields emitted by GSM-900 cellular telephones on thecircadian patterns of gonadal adrenal and pituitary hormonesin menrdquo Radiation Research vol 169 no 3 pp 337ndash343 2008

[98] E F Eskander S F Estefan and A A Abd-Rabou ldquoHow doeslong term exposure to base stations and mobile phones affecthuman hormone profilesrdquo Clinical Biochemistry vol 45 no 1-2 pp 157ndash161 2012

[99] C Augner G W Hacker G Oberfeld et al ldquoEffects ofexposure to GSMmobile phone base station signals on salivarycortisol alpha-amylase and immunoglobulin Ardquo Biomedicaland Environmental Sciences vol 23 no 3 pp 199ndash207 2010

[100] H A Shahryar A Lotfi M B Ghodsi and A R KaramiBonary ldquoEffects of 900 MHz electromagnetic fields emittedfrom a cellular phone on the T3 T4 and cortisol levels in Syrianhamstersrdquo Bulletin of the Veterinary Institute in Pulawy vol 53no 2 pp 233ndash236 2009


[101] H A Shahryar A R Lotfi M Bahojb and A R KaramildquoEffects of electromagnetic fields of cellular phone on cortisoland testosterone hormones rate in Syrian Hamsters (Mesocrice-tus auratus)rdquo International Journal of Zoological Research vol4 no 4 pp 230ndash233 2008

[102] K Mann P Wagner G Brunn F Hassan C Hiemke andJ Roschke ldquoEffects of pulsed high-frequency electromagneticfields on the neuroendocrine systemrdquo Neuroendocrinology vol67 no 2 pp 139ndash144 1998

[103] K Vangelova M Israel D Velkova and M Ivanova ldquoChangesin excretion rates of stress hormones inmedical staff exposed toelectromagnetic radiationrdquo Environmentalist vol 27 no 4 pp551ndash555 2007

[104] K VangelovaM Israel and SMihaylov ldquoThe effect of low levelradiofrequency electromagnetic radiation on the excretion ratesof stress hormones in operators during 24-hour shiftsrdquo CentralEuropean Journal of Public Health vol 10 no 1-2 pp 23ndash272002

[105] M R Sarookhani R M Asiabanha A Safari V Zaroushaniand M Ziaeiha ldquoThe influence of 950MHz magnetic field(mobile phone radiation) on sex organ and adrenal functionsof male rabbitsrdquo African Journal of Biochemistry Research vol5 no 2 pp 65ndash68 2011

[106] K Buchner and H Eger ldquoChanges of clinically importantneurotransmitters under the influence ofmodulated RF fieldsmdasha long-term study under real-life conditionsrdquoUmwelt-Medizin-Gesellschaft vol 24 no 1 pp 44ndash57 2011

[107] S A Meo A M Al-Drees S Husain M M Khan andM B Imran ldquoEffects of mobile phone radiation on serumtestosterone in Wistar albino ratsrdquo Saudi Medical Journal vol31 no 8 pp 869ndash873 2010

[108] H Nakamura H Nagase K Ogino K Hatta and I Mat-suzaki ldquoUteroplacental circulatory disturbance mediated byprostaglandin F(2120572) in rats exposed to microwavesrdquo Reproduc-tive Toxicology vol 14 no 3 pp 235ndash240 2000

[109] R De Seze P Fabbro-Peray and L Miro ldquoGSM radiocellulartelephones do not disturb the secretion of antepituitary hor-mones in humansrdquo Bioelectromagnetics vol 19 no 5 pp 271ndash278 1998

[110] S Mortavazi A Habib A Ganj-Karami R Samimi-Doost APour-Abedi and A Babaie ldquoAlterations in TSH and thyroidhormones following mobile phone userdquoOmanMedical Journalvol 24 no 4 pp 274ndash278 2009

[111] S Ghione C Del Seppia L Mezzasalma M Emdin and PLuschi ldquoHuman head exposure to a 37 Hz electromagneticfield effects on blood pressure somatosensory perception andrelated parametersrdquo Bioelectromagnetics vol 25 no 3 pp 167ndash175 2004

[112] N Hakansson P Gustavsson A Sastre and B FloderusldquoOccupational exposure to extremely low frequency magneticfields andmortality from cardiovascular diseaserdquoTheAmericanJournal of Epidemiology vol 158 no 6 pp 534ndash542 2003

[113] D A Savitz D Liao A Sastre R C Kleckner and R KavetldquoMagnetic field exposure and cardiovascular disease mortalityamong electric utility workersrdquo American Journal of Epidemiol-ogy vol 149 no 2 pp 135ndash142 1999

[114] M Zmyslony A Bortkiewicz and H Aniołczyk ldquoEvaluation ofselected parameters of circulatory system function in variousoccupational groups of workers exposed to high frequencyelectromagnetic fieldsrdquoMedycyna Pracy vol 47 no 1 pp 9ndash141996

[115] A BortkiewiczM Zmyslony E Gadzicka C Pałczynski and SSzmigielski ldquoAmbulatory ECG monitoring in workers exposedto electromagnetic fieldsrdquo Journal of Medical Engineering andTechnology vol 21 no 2 pp 41ndash46 1997

[116] C V Bellieni M Acampa M Maffei et al ldquoElectromagneticfields produced by incubators influence heart rate variability innewbornsrdquoArchives of Disease in Childhood Fetal and NeonatalEdition vol 93 no 4 pp F298ndashF301 2008

[117] D L Hayes P J Wang DW Reynolds et al ldquoInterference withcardiac pacemakers by cellular telephonesrdquo The New EnglandJournal of Medicine vol 336 no 21 pp 1473ndash1479 1997

[118] FMAliW SMohamed andMRMohamed ldquoEffect of 50Hz02mT magnetic fields on RBC properties and heart functionsof albino ratsrdquo Bioelectromagnetics vol 24 no 8 pp 535ndash5452003

[119] S Shadfar S H Zamzam M B Zendeh and V TabatabaieldquoThe examination of the effects of electromagnetic fields onheart tissue of rat using optical microscoperdquo Advances inEnvironmental Biology vol 6 no 7 pp 1916ndash1921 2012

[120] A Bortkiewicz E Gadzicka and M Zmyslony ldquoHeart ratevariability in workers exposed to medium-frequency electro-magnetic fieldsrdquo Journal of the Autonomic Nervous System vol59 no 3 pp 91ndash97 1996

[121] K Vangelova C Deyanov and M Israel ldquoCardiovascular riskin operators under radiofrequency electromagnetic radiationrdquoInternational Journal of Hygiene and Environmental Health vol209 no 2 pp 133ndash138 2006

[122] S Spichtig F Scholkmann L Chin H Lehmann andMWolfldquoAssessment of intermittent UMTS electromagnetic field effectson blood circulation in the human auditory region using a near-infrared systemrdquo Bioelectromagnetics vol 33 no 1 pp 40ndash542012

[123] R Andrzejak R Poreba M Poreba et al ldquoThe influence of thecall with a mobile phone on heart rate variability parameters inhealthy volunteersrdquo IndustrialHealth vol 46 no 4 pp 409ndash4172008

[124] B Kodavanji V S Mantur N A Kumar and S R Pai ldquoA pilotstudy on long-term effects of mobile phone usage on heart ratevariability in healthy young adult malesrdquo Journal of Clinical andDiagnostic Research vol 6 no 3 pp 346ndash349 2012

[125] A H Alhusseiny M S Al-Nimer and A D Majeed ldquoElec-tromagnetic energy radiated from mobile phone alters electro-cardiographic records of patients with ischemic heart diseaserdquoAnnals of Medical and Health Sciences Research vol 2 pp 146ndash151 2012

[126] K C Nam S W Kim S C Kim and D W Kim ldquoEffects of RFexposure of teenagers and adults by CDMA cellular phonesrdquoBioelectromagnetics vol 27 no 7 pp 509ndash514 2006

[127] A T Barker P R Jackson H Parry L A Coulton G GCook and S MWood ldquoThe effect of GSM and TETRAmobilehandset signals on blood pressure catechol levels and heart ratevariabilityrdquoBioelectromagnetics vol 28 no 6 pp 433ndash438 2007

[128] K D Thorat and V Shelke ldquoEffects of mobile phone radiationon heart rate variation in healthy volunteersrdquo Research Journalof Pharmaceutical Biological and Chemical Sciences vol 4 no1 pp 840ndash845 2013

[129] E Sobel Z Davanipour R Sulkava et al ldquoOccupations withexposure to electromagnetic fields a possible risk factor forAlzheimerrsquos diseaserdquo American Journal of Epidemiology vol142 no 5 pp 515ndash524 1995

[130] M Trimmel and E Schweiger ldquoEffects of an ELF (50Hz1mT) electromagnetic field (EMF) on concentration in visual


attention perception and memory including effects of EMFsensitivityrdquo Toxicology Letters vol 96-97 pp 377ndash382 1998

[131] E Foroozandeh H Ahadi P Askari and M S Naeini ldquoEffectsof single brief exposure to an 8 mT electromagnetic field onavoidance learning in male and female micerdquo Psychology andNeuroscience vol 4 no 1 2011

[132] R Andel M Crowe M Feychting et al ldquoWork-related expo-sure to extremely low-frequency magnetic fields and dementiaresults from the population-based study of dementia in swedishtwinsrdquo The Journals of Gerontology A Biological Sciences andMedical Sciences vol 65 no 11 pp 1220ndash1227 2010

[133] D Baris B G Armstrong J Deadman andGTheriault ldquoA casecohort study of suicide in relation to exposure to electric andmagnetic fields among electrical utility workersrdquo Occupationaland Environmental Medicine vol 53 no 1 pp 17ndash24 1996

[134] B P Salunke S N Umathe and J G Chavan ldquoLow frequencymagnetic field induces depression by rising nitric oxide levelsin the mouse brainrdquo International Journal of Research andDevelopment in Pharmacy and Life Sciences vol 2 pp 439ndash4502013

[135] K R Rajeswari M Satyanarayana P V Narayan and SSubrahmanyam ldquoEffect of extremely low frequency magneticfield on serum cholinesterase in humans and animalsrdquo IndianJournal of Experimental Biology vol 23 no 4 pp 194ndash197 1985

[136] F S Prato J J L Carson K-P Ossenkopp and M KavaliersldquoPossible mechanisms by which extremely low frequency mag-netic fields affect opioid functionrdquo FASEB Journal vol 9 no 9pp 807ndash814 1995

[137] L Zecca C Mantegazza V Margonato et al ldquoBiological Effectsof Prolonged Exposure to ELF Electromagnetic Fields in RatsIII 50 Hz Electromagnetic Fieldsrdquo Bioelectromagnetics vol 19no 1 pp 57ndash66 1998

[138] S K Dutta B Ghosh and C F Blackman ldquoRadiofre-quency radiation-induced calcium ion efflux enhancementfrom human and other neuroblastoma cells in culturerdquo Bioelec-tromagnetics vol 10 no 2 pp 197ndash202 1989

[139] J E H Tattersall I R Scott S J Wood et al ldquoEffects of lowintensity radiofrequency electromagnetic fields on electricalactivity in rat hippocampal slicesrdquo Brain Research vol 904 no1 pp 43ndash53 2001

[140] F Ferreri G Curcio P Pasqualetti L De Gennaro R Finiand P M Rossini ldquoMobile phone emissions and human brainexcitabilityrdquo Annals of Neurology vol 60 no 2 pp 188ndash1962006

[141] Y Fu C Wang J Wang Y Lei and Y Ma ldquoLong-termexposure to extremely low-frequency magnetic fields impairsspatial recognitionmemory inmicerdquo Clinical and ExperimentalPharmacology and Physiology vol 35 no 7 pp 797ndash800 2008

[142] O Bas E Odaci S Kaplan N Acer K Ucok and S Colakogluldquo900 MHz electromagnetic field exposure affects qualitativeand quantitative features of hippocampal pyramidal cells in theadult female ratrdquo Brain Research vol 1265 pp 178ndash185 2009

[143] B Wang and H Lai ldquoAcute exposure to pulsed 2450-MHzmicrowaves affects water-maze performance of ratsrdquo Bioelectro-magnetics vol 21 no 1 pp 52ndash56 2000

[144] S N Narayanan R S Kumar B K Potu S Nayak P G Bhatand M Mailankot ldquoEffect of radio-frequency electromagneticradiations (RF-EMR) on passive avoidance behaviour andhippocampal morphology in Wistar ratsrdquo Upsala Journal ofMedical Sciences vol 115 no 2 pp 91ndash96 2010

[145] G Abdel-Rassoul O A El-Fateh M A Salem et al ldquoNeurobe-havioral effects among inhabitants around mobile phone basestationsrdquo NeuroToxicology vol 28 no 2 pp 434ndash440 2007

[146] S-E Chia H-P Chia and J-S Tan ldquoPrevalence of headacheamong handheld cellular telephone users in Singapore a com-munity studyrdquo Environmental Health Perspectives vol 108 no11 pp 1059ndash1062 2000

[147] N D Volkow D Tomasi G-JWang et al ldquoEffects of cell phoneradiofrequency signal exposure on brain glucose metabolismrdquoThe Journal of the American Medical Association vol 305 no 8pp 808ndash813 2011

[148] G Grafstrom H Nittby A Brun et al ldquoHistopathologicalexaminations of rat brains after long-term exposure to GSM-900 mobile phone radiationrdquo Brain Research Bulletin vol 77no 5 pp 257ndash263 2008

[149] S Xu W Ning Z Xu S Zhou H Chiang and J LuoldquoChronic exposure to GSM 1800-MHz microwaves reducesexcitatory synaptic activity in cultured hippocampal neuronsrdquoNeuroscience Letters vol 398 no 3 pp 253ndash257 2006

[150] G Del Vecchio A Giuliani M Fernandez et al ldquoContinuousexposure to 900MHzGSM-modulated EMF alters morpholog-ical maturation of neural cellsrdquo Neuroscience Letters vol 455no 3 pp 173ndash177 2009

[151] K Yuasa N Arai S Okabe et al ldquoEffects of thirty minutesmobile phone use on the human sensory cortexrdquo ClinicalNeurophysiology vol 117 no 4 pp 900ndash905 2006

[152] D Sokolovic B Djindjic J Nikolic et al ldquoMelatonin reducesoxidative stress induced by chronic exposure of microwaveradiation frommobile phones in rat brainrdquo Journal of RadiationResearch vol 49 no 6 pp 579ndash586 2008

[153] G N De Iuliis R J Newey B V King and R J Aitken ldquoMobilephone radiation induces reactive oxygen species productionand DNA damage in human spermatozoa In vitrordquo PLoS ONEvol 4 no 7 Article ID e6446 2009

[154] J Y Kim H T Kim K H Moon and H J Shin ldquoLong-termexposure of rats to a 245GHz electromagnetic field effects onreproductive functionrdquo Korean Journal of Urology vol 48 no12 pp 1308ndash1314 2007

[155] K Makker A Varghese N R Desai R Mouradi and AAgarwal ldquoCell phones modern manrsquos nemesisrdquo ReproductiveBioMedicine Online vol 18 no 1 pp 148ndash157 2009

[156] S Erpek M D Bilgin E Dikicioglu and A Karul ldquoThe effectsof low frequency electric field in rat testisrdquo Revue de MedecineVeterinaire vol 158 no 4 pp 206ndash212 2007

[157] J S Lee S S Ahn K C Jung Y-W Kim and S K Lee ldquoEffectsof 60Hz electro magnetic field exposure on testicular germ cellapoptosis in micerdquo Asian Journal of Andrology vol 6 no 1 pp29ndash34 2004

[158] Y-W Kim H-S Kim J-S Lee et al ldquoEffects of 60Hz 14120583Tmagnetic field on the apoptosis of testicular germ cell in micerdquoBioelectromagnetics vol 30 no 1 pp 66ndash72 2009

[159] B M Tenorio G C Jimenez R N Morais S M TorresR Albuquerque Nogueira and V A Silva Jr ldquoTesticulardevelopment evaluation in rats exposed to 60 Hz and 1 mTelectromagnetic fieldrdquo Journal of Applied Toxicology vol 31 no3 pp 223ndash230 2011

[160] M K Chung S J Lee Y B Kim et al ldquoEvaluation ofspermatogenesis and fertility in F1 male rats after in utero andneonatal exposure to extremely low frequency electromagneticfieldsrdquo Asian Journal of Andrology vol 7 no 2 pp 189ndash1942005


[161] M Davoudi C Brossner and W Kuber ldquoThe influence ofelectromagnetic waves on sperm motilityrdquo Journal fur Urologieund Urogynakologie vol 19 pp 18ndash22 2002

[162] I Fejes Z Zavaczki J Szollosi et al ldquoIs there a relationshipbetween cell phone use and semen qualityrdquoArchives of Androl-ogy vol 51 no 5 pp 385ndash393 2005

[163] A Agarwal F Deepinder R K Sharma G Ranga and J LildquoEffect of cell phone usage on semen analysis in men attendinginfertility clinic an observational studyrdquo Fertility and Sterilityvol 89 no 1 pp 124ndash128 2008

[164] A Agarwal N R Desai K Makker et al ldquoEffects of radiofre-quency electromagneticwaves (RF-EMW) fromcellular phonesonhuman ejaculated semen an in vitro pilot studyrdquoFertility andSterility vol 92 no 4 pp 1318ndash1325 2009

[165] A A Otitoloju I A Obe O A Adewale O A Otubanjoand V O Osunkalu ldquoPreliminary study on the induction ofsperm head abnormalities in mice mus musculus exposedto radiofrequency radiations from global system for mobilecommunication base stationsrdquo Bulletin of Environmental Con-tamination and Toxicology vol 84 no 1 pp 51ndash54 2010

[166] R J Aitken L E Bennetts D Sawyer A M Wiklendt and BV King ldquoImpact of radio frequency electromagnetic radiationon DNA integrity in the male germlinerdquo International Journalof Andrology vol 28 no 3 pp 171ndash179 2005

[167] K K Kesari S Kumar and J Behari ldquoMobile phone usage andmale infertility in wistar ratsrdquo Indian Journal of ExperimentalBiology vol 48 no 10 pp 987ndash992 2010

[168] M Mailankot A P Kunnath H Jayalekshmi B Koduruand R Valsalan ldquoRadio frequency electromagnetic radiation(RF-EMR) from GSM (0918GHZ) mobile phones inducesoxidative stress and reduces spermmotility in ratsrdquo Clinics vol64 no 6 pp 561ndash565 2009

[169] E P Ribeiro E L Rhoden M M Horn C Rhoden L PLima and L Toniolo ldquoEffects of subchronic exposure to radiofrequency from a conventional cellular telephone on testicularfunction in adult ratsrdquo Journal of Urology vol 177 no 1 pp 395ndash399 2007

[170] N Falzone C Huyser P Becker D Leszczynski and D RFranken ldquoThe effect of pulsed 900-MHz GSM mobile phoneradiation on the acrosome reaction head morphometry andzona binding of human spermatozoardquo International Journal ofAndrology vol 34 no 1 pp 20ndash26 2011

[171] D Weisbrot H Lin L Ye M Blank and R Goodman ldquoEffectsof mobile phone radiation on reproduction and development inDrosophila melanogasterrdquo Journal of Cellular Biochemistry vol89 no 1 pp 48ndash55 2003

[172] A Wdowiak L Wdowiak and H Wiktor ldquoEvaluation of theeffect of using mobile phones on male fertilityrdquo Annals ofAgricultural and Environmental Medicine vol 14 no 1 pp 169ndash172 2007

[173] O Erogul E Oztas I Yildirim et al ldquoEffects of electromagneticradiation from a cellular phone on human spermmotility an invitro studyrdquo Archives of Medical Research vol 37 no 7 pp 840ndash843 2006

[174] O J Moslashllerloslashkken and B E Moen ldquoIs fertility reduced amongmen exposed to radiofrequency fields in the Norwegian NavyrdquoBioelectromagnetics vol 29 no 5 pp 345ndash352 2008

[175] R Ouellet-Hellstrom and W F Stewart ldquoMiscarriages amongfemale physical therapists who report using radio- andmicrowave-frequency electromagnetic radiationrdquo AmericanJournal of Epidemiology vol 138 no 10 pp 775ndash786 1993

[176] J Han Z Cao X Liu W Zhang and S Zhang ldquoEffect of earlypregnancy electromagnetic field exposure on embryo growthceasingrdquo Journal of hygiene research vol 39 no 3 pp 349ndash3522010

[177] A Gul H Celebi and S Ugras ldquoThe effects of microwaveemitted by cellular phones on ovarian follicles in ratsrdquo Archivesof Gynecology and Obstetrics vol 280 no 5 pp 729ndash733 2009

[178] Y-Q Xu N-X Zheng B-H Li et al ldquoFemale genital toxicitiesof high-frequency electromagnetic field on ratsrdquo Chinese jour-nal of industrial hygiene and occupational diseases vol 27 no 9pp 544ndash548 2009

[179] B Budak G G Budak G G Ozturk N BMuluk A Apan andN Seyhan ldquoEffects of extremely low frequency electromagneticfields on distortion product otoacoustic emissions in rabbitsrdquoAuris Nasus Larynx vol 36 no 3 pp 255ndash262 2009

[180] M Parazzini A R Brazzale A Paglialonga et al ldquoEffects ofGSM cellular phones on human hearing the European projectlsquoGUARDrsquordquo Radiation Research vol 168 no 5 pp 608ndash613 2007

[181] L G Salford B Persson L Malmgren and A BrunldquoTelephonie mobilemdasheffects potentiels sur la sante des ondeselectromagnetiques de haute frequencerdquo in Telephonie Mobileet Barriere Sang-Cerveau P Marco Ed pp 141ndash152 Emburg2001

[182] M Parazzini P Galloni M Piscitelli et al ldquoPossible combinedeffects of 900MHZcontinuous-wave electromagnetic fields andgentamicin on the auditory system of ratsrdquo Radiation Researchvol 167 no 5 pp 600ndash605 2007

[183] I Uloziene V Uloza E Gradauskiene and V Saferis ldquoAssess-ment of potential effects of the electromagnetic fields of mobilephones on hearingrdquo BMC Public Health vol 5 article 39 2005

[184] G Stefanics L Kellenyi FMolnar G Kubinyi GThuroczy andI Hernadi ldquoShort GSM mobile phone exposure does not alterhuman auditory brainstem responserdquo BMC Public Health vol7 p 325 2007

[185] R L Carpenter ldquoOcular effects of microwave radiationrdquo Bul-letin of the New York Academy of Medicine vol 55 no 11 pp1048ndash1057 1979

[186] O Goldwein and D J Aframian ldquoThe influence of handheldmobile phones on human parotid gland secretionrdquo Oral Dis-eases vol 16 no 2 pp 146ndash150 2010

[187] A Spector ldquoOxidative stress-induced cataract mechanism ofactionrdquo FASEB Journal vol 9 no 12 pp 1173ndash1182 1995

[188] C Graham and M R Cook ldquoHuman sleep in 60Hz magneticfieldsrdquo Bioelectromagnetics vol 20 pp 277ndash283 1999

[189] T Abelin E Altpeter and M Roosli ldquoSleep disturbances inthe vicinity of the short-wave broadcast transmitter Schwarzen-burgrdquo Somnologie vol 9 no 4 pp 203ndash209 2005

[190] E-S Altpeter M Roosli M Battaglia D Pfluger C E Minderand T Abelin ldquoEffect of short-wave (6ndash22 MHz) magneticfields on sleep quality and melatonin cycle in humans theSchwarzenburg shut-down studyrdquo Bioelectromagnetics vol 27no 2 pp 142ndash150 2006

[191] C Wiholm A Lowden L Hillert et al ldquoThe effects of 884MHz GSM wireless communication signals on spatial memoryperformancemdashan experimental provocation studyrdquo in Proceed-ings of the Progress in Electromagnetics Research Symposium(PIERS rsquo07) pp 526ndash529 Beijing China August 2007

[192] K Mann and J Roschke ldquoSleep under exposure to high-frequency electromagnetic fieldsrdquo Sleep Medicine Reviews vol8 no 2 pp 95ndash107 2004


[193] N M Maalej and C A Belhadj ldquoExternal and internal electro-magnetic exposures of workers near high voltage power linesrdquoProgress in Electromagnetics Research C vol 19 pp 191ndash2052011

[194] T Yoshikawa M Tanigawa T Tanigawa A Imai H HongoandM Kondo ldquoEnhancement of nitric oxide generation by lowfrequency electromagnetic fieldrdquo Pathophysiology vol 7 no 2pp 131ndash135 2000

[195] M Yariktas F Doner F Ozguner O Gokalp H Dogru and NDelibas ldquoNitric oxide level in the nasal and sinus mucosa afterexposure to electromagnetic fieldrdquo OtolaryngologymdashHead andNeck Surgery vol 132 no 5 pp 713ndash716 2005

[196] I Meral H Mert N Mert et al ldquoEffects of 900-MHz electro-magnetic field emitted from cellular phone on brain oxidativestress and some vitamin levels of guinea pigsrdquo Brain Researchvol 1169 no 1 pp 120ndash124 2007

[197] M K Irmak E Fadillioglu M Gulec H Erdogan MYagmurca and O Akyol ldquoEffects of electromagnetic radiationfrom a cellular telephone on the oxidant and antioxidant levelsin rabbitsrdquo Cell Biochemistry and Function vol 20 no 4 pp279ndash283 2002

[198] G Guler N Seyhan and A Aricioglu ldquoEffects of static and 50Hz alternating electric fields on superoxide dismutase activityand TBARS levels in guinea pigsrdquo General Physiology andBiophysics vol 25 no 2 pp 177ndash193 2006

[199] R J Reiter ldquoStatic and extremely low frequency electromagneticfield exposure reported effects on the circadian production ofmelatoninrdquo Journal of Cellular Biochemistry vol 51 no 4 pp394ndash404 1993

[200] C F Blackman ldquoELF effects on calcium homeostasisrdquo inExtremely Low Frequency Electromagnetic Fields The Questionof Cancer BWWilson R G Stevens and L E Anderson Edspp 187ndash208 Battelle Press Columbus Ohio USA 1990

[201] C F Blackman S G Benane D J Elliott D E House andM M Pollock ldquoInfluence of electromagnetic fields on theefflux of calcium ions from brain tissue in vitro a three-modelanalysis consistent with the frequency response up to 510HzrdquoBioelectromagnetics vol 9 no 3 pp 215ndash227 1988

[202] C F Blackman L S Kinney D E House and W T JoinesldquoMultiple power-density windows and their possible originrdquoBioelectromagnetics vol 10 no 2 pp 115ndash128 1989

[203] C F Blackman S G Benane and D E House ldquoThe influenceof temperature during electric- and magnetic-field-inducedalteration of calcium-ion release from in vitro brain tissuerdquoBioelectromagnetics vol 12 no 3 pp 173ndash182 1991

[204] R Goodman and M Blank ldquoMagnetic field stress inducesexpression of hsp70rdquo Cell Stress Chaperones vol 3 pp 79ndash881998

[205] D Kultz ldquoMolecular and evolutionary basis of the cellular stressresponserdquo Annual Review of Physiology vol 67 pp 225ndash2572005

[206] D de Pomerai C Daniells H David et al ldquoNon-thermal heat-shock response to microwavesrdquo Nature vol 405 no 6785 pp417ndash418 2000

[207] J Czyz K Guan Q Zeng et al ldquoHigh frequency electromag-netic fields (GSM signals) affect gene expression levels in tumorsuppressor p53-deficient embryonic stem cellsrdquo Bioelectromag-netics vol 25 no 4 pp 296ndash307 2004

[208] R Goodman M Blank H Lin et al ldquoIncreased levels of hsp70transcripts induced when cells are exposed to low frequencyelectromagnetic fieldsrdquo Bioelectrochemistry and Bioenergeticsvol 33 no 2 pp 115ndash120 1994

[209] J Friedman S Kraus Y Hauptman Y Schiff and R SegerldquoMechanism of short-term ERK activation by electromagneticfields at mobile phone frequenciesrdquo Biochemical Journal vol405 no 3 pp 559ndash568 2007

[210] H Lin M Blank and R Goodman ldquoA magnetic field respon-sive domain in the human HSP70 promoterrdquo Journal of CellularBiochemistry vol 75 pp 170ndash176 1999

[211] H Lin M Blank K Rossol-Haseroth and R GoodmanldquoRegulating genes with electromagnetic response elementsrdquoJournal of Cellular Biochemistry vol 81 pp 143ndash148 2001

[212] T Taira Y Negishi F Kihara S M M Iguchi-Ariga and HAriga ldquoc-myc protein complex binds to two sites in humanhsp70 promoter regionrdquoBiochimica et BiophysicaActa vol 1130no 2 pp 166ndash174 1992

[213] J Topol D M Ruden and C S Parker ldquoSequences required forin vitro transcriptional activation of a Drosophila hsp 70 generdquoCell vol 42 no 2 pp 527ndash537 1985

[214] G J Hook P Zhang I Lagroye et al ldquoMeasurement of DNAdamage and apoptosis in Molt-4 cells after in vitro exposure toradio frequency radiationrdquo Radiation Research vol 161 no 2pp 193ndash200 2004

[215] D Leszczynski R Nylund S Joenvaara and J Reivinen ldquoAppli-cability of discovery science approach to determine biologicaleffects of mobile phone radiationrdquo Proteomics vol 4 no 2 pp426ndash431 2004

[216] M Jin H Lin L Han et al ldquoBiological and technical variablesin myc expression in HL60 cells exposed to 60Hz electromag-netic fieldsrdquo Bioelectrochemistry and Bioenergetics vol 44 no 1pp 111ndash120 1997

[217] L S Erdreich M D van Kerkhove C G Scrafford et alldquoFactors that influence the radiofrequency power output ofGSM mobile phonesrdquo Radiation Research vol 168 no 2 pp253ndash261 2007

[218] S Sarkar K Chandra R C Sawhney and P K Banerjee ldquoEffectof radiofrequency radiation on biological systemrdquo in Topicsin Electromagnetic Waves Devices Effects and Applications JBehari Ed pp 42ndash73 Anamaya Publishers New Delhi India2005

[219] S Lonn U Forssen P Vecchia A Ahlbom and M FeychtingldquoOutput power levels from mobile phones in different geo-graphical areas implications for exposure assessmentrdquoOccupa-tional and Environmental Medicine vol 61 no 9 pp 769ndash7722004

[220] A Christ and N Kuster ldquoDifferences in RF energy absorptionin the heads of adults and childrenrdquo Bioelectromagnetics vol 26no 7 pp S31ndashS44 2005

[221] A Huss M Egger K Hug K Huwiler-Muntener and MRoosli ldquoSource of funding and results of studies of health effectsofmobile phone use systematic reviewof experimental studiesrdquoEnvironmental Health Perspectives vol 115 no 1 pp 1ndash4 2007

Submit your manuscripts athttpwwwhindawicom

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Anatomy Research International

PeptidesInternational Journal of


Hindawi Publishing Corporation httpwwwhindawicom

International Journal of

Volume 2014

Zoology


Molecular Biology International

GenomicsInternational Journal of


The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014


BioinformaticsAdvances in

Marine BiologyJournal of



Signal TransductionJournal of


BioMed Research International

Evolutionary BiologyInternational Journal of



Biochemistry Research International

ArchaeaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014


Genetics Research International


Advances in

Virolog y

Hindawi Publishing Corporationhttpwwwhindawicom

Nucleic AcidsJournal of

Volume 2014

Stem CellsInternational



Enzyme Research



Microbiology


Table 1 Showing the SAR values for general public and occupational groups laid by ICNIRP [18] International Commission on NonionisingRadiation Protection SAR stands for specific absorption rate expressed in Watts per kilogram (Wkg)

Frequency rangeGeneral public Occupational exposure

Whole body SAR Localized SAR-headand trunk

LocalizedSAR-limbs Whole body SAR Localized SAR-head

and trunkLocalizedSAR-limbs

100KHzndash10MHz 008 2 4 04 10 2010MHzndash10GHz 008 2 4 04 10 20

for general and occupational groups are presented in Table 1As a result current recommendations are established on thelowest exposure known to induce acute observable effects dueto heating [7]

In the past when much of the attention was centeredon certain EMW called ionizing radiation the others callednonionizing radiation (NIR) were generally assumed to beharmless However after World War II this assumption hasbeen reconsidered The overwhelming scientific investiga-tions concerning health effects of NIR have highlighted theirpotential to affect the well-being of biological organismSeveral researchers have raised questions regarding adequacyof current safety limits [17] and asserted for their revival sothat the newbiologically based exposure limits will be capableof eliminating the possibility of bioeffects [19]

Some of the documented bioeffects include changes inmelatonin levels [20ndash25] induction of heat shock protein(hsp) [26] effects on spatial memory [27 28] alteration ofintracellular calcium concentration [29] changes in blood-brain-barrier permeability (BBB) [30] enzyme activity [31]genotoxicity [32 33] nonspecific disabilities and subjectivesymptoms [34ndash37] to name a few Also radiation exposurefrom mobile phones (MPs) has been linked with tinnitusbrain tumours and acoustic neuroma [38ndash41] Additionallystudies at cellularmolecular level are important in illuminat-ing the actual primary injury produced by EMFs [17 27]

The field of bioelectromagnetics is surrounded withcontroversies because some studies are contradictory [11 42]and not always corroborated by independent researchers [35]The lack of any accepted causal mechanism further addsto the controversy As a result important details are simplynot comprehended and generate confusion in the generalpublic As uses expand the new situations are likely to furtherincrease the environmental EMF levels To cope with thesesituations and to promote life of biological organisms morecomfortably and efficiently achieving a scientific understand-ing of the biointeractions of these fields and evaluation ofhealth risks is highly desirableThis paper therefore has beenconstructed to weigh carefully the bioeffects biointeractionmechanisms and lacunae in EMF research areas seekingimmediate attention so that the public is not excessivelyexposed nor the technological advancements suffer a setbackby unjust fears that may or may not exist In this review weshall restrict our discussion to the health relevant effects ofELF-EMF and RFR-EMF

ELF and RFR-EMF related studies were identified bypeer-reviewed literature and data searched in electronicdatabase (PubMed) using a number of key words and their

combinations (electromagnetic field health effects electricmagnetic reproductive outcome and biointeraction mecha-nisms as examples) in order to find English-language reportsrelated to electromagnetic field health effects and theirprobable modes of action A number of papers were retrievedby hand searching several journals and few were obtainedthroughdirect correspondencewith the authorsUnlike otherreview papers no strict inclusion criteria were set Howevera rational explanation of the experimental design use ofcontrolsham population exposure conditions blinding ofthe research statistical assessment of the data and role ofartifacts could be reached for most but not all investigations

2 Health Effects of Electromagnetic Fields

21 Electromagnetic Hypersensitivity (EHS) EHS is a recentphenomenon of occurrence of subjective signs and symptomsin some sensitive individuals with EMF experience fromvaried electronic sources Despite lower levels of exposuressymptoms of ill health have been observed among thesubjects [34] According to WHO [43] about 1ndash3 of theworldrsquos population are affected by this EHS syndrome Theexposure to EMFs especially at lower levels and for longduration was originally reported among the East Europeanradar workers and linked with a number of subjective andobjective (skin and mucosa-related) symptoms Sufferersoften label EHS as lonerrsquos disease because of the consequentsocial isolation [9] Epidemiological investigations have beenconducted on people complaining about unpleasant symp-toms (Table 2) Complainants have related their symptomsmost frequently to exposure to MP base stations (74)followed by MPs (36) cordless phones (29) and powerlines (27) [36] Objective skin symptoms of EHS have beenrelated to increase in mast cell counts and their degranula-tion thereby causing the release of inflammatory substancessuch as histamine responsible for allergic hypersensitivitysensation of itch and pain edema local erythema and manykinds of dermatoses [19] With reference to effects of ELF-EMF Barsam et al [44] studied the effect of occupationalexposure on sleep quality in high voltage substation workersIn their case-control study they found poor sleep qual-ity among 905 of cases and 853 of controls Despitethe increased prevalence of poor sleep quality in exposedgroup no statistically significant difference was reachedSimilar occupational studies conducted in substation unitsof a petroleum complex also revealed higher percentage ofpoor sleep quality in addition to poor health condition in






















[64]





[67]


assay


[33]




[7]




[74]




[13]





[72]




[75]



[76]


Wistar rats



[71]





[31]


Table 3 Continued





[1]




















[120]


[117]



[113]




[118]





[121]


Railway workers



[4]



lowast













[130]


Male C57BL mice



[42]








[141]



[27]





[142]





[30]

lowast















[162]




[163]



[164]




[153]



[165]

lowast




















[3]








[195]





[2]




[5]






[152]

lowast










4 Research Needs









5 Conclusion







Acknowledgments


References













































































































































































































































Volume 2014

Zoology






















Advances in

Virolog y



Volume 2014




Enzyme Research



Microbiology






















[64]





[67]


assay


[33]




[7]




[74]




[13]





[72]




[75]



[76]


Wistar rats



[71]





[31]


Table 3 Continued





[1]




















[120]


[117]



[113]




[118]





[121]


Railway workers



[4]



lowast













[130]


Male C57BL mice



[42]








[141]



[27]





[142]





[30]

lowast















[162]




[163]



[164]




[153]



[165]

lowast




















[3]








[195]





[2]




[5]






[152]

lowast










4 Research Needs









5 Conclusion







Acknowledgments


References













































































































































































































































Volume 2014

Zoology






















Advances in

Virolog y



Volume 2014




Enzyme Research



Microbiology


Table 3 Continued





[1]




















[120]


[117]



[113]




[118]





[121]


Railway workers



[4]



lowast













[130]


Male C57BL mice



[42]








[141]



[27]





[142]





[30]

lowast















[162]




[163]



[164]




[153]



[165]

lowast




















[3]








[195]





[2]




[5]






[152]

lowast










4 Research Needs









5 Conclusion







Acknowledgments


References













































































































































































































































Volume 2014

Zoology






















Advances in

Virolog y



Volume 2014




Enzyme Research



Microbiology













[120]


[117]



[113]




[118]





[121]


Railway workers



[4]



lowast













[130]


Male C57BL mice



[42]








[141]



[27]





[142]





[30]

lowast















[162]




[163]



[164]




[153]



[165]

lowast




















[3]








[195]





[2]




[5]






[152]

lowast










4 Research Needs









5 Conclusion







Acknowledgments


References













































































































































































































































Volume 2014

Zoology






















Advances in

Virolog y



Volume 2014




Enzyme Research



Microbiology










[130]


Male C57BL mice



[42]








[141]



[27]





[142]





[30]

lowast















[162]




[163]



[164]




[153]



[165]

lowast




















[3]








[195]





[2]




[5]






[152]

lowast










4 Research Needs









5 Conclusion







Acknowledgments


References













































































































































































































































Volume 2014

Zoology






















Advances in

Virolog y



Volume 2014




Enzyme Research



Microbiology












[162]




[163]



[164]




[153]



[165]

lowast




















[3]








[195]





[2]




[5]






[152]

lowast










4 Research Needs









5 Conclusion







Acknowledgments


References













































































































































































































































Volume 2014

Zoology






















Advances in

Virolog y



Volume 2014




Enzyme Research



Microbiology















[3]








[195]





[2]




[5]






[152]

lowast










4 Research Needs









5 Conclusion







Acknowledgments


References













































































































































































































































Volume 2014

Zoology






















Advances in

Virolog y



Volume 2014




Enzyme Research



Microbiology




4 Research Needs









5 Conclusion







Acknowledgments


References













































































































































































































































Volume 2014

Zoology






















Advances in

Virolog y



Volume 2014




Enzyme Research



Microbiology




5 Conclusion







Acknowledgments


References













































































































































































































































Volume 2014

Zoology






















Advances in

Virolog y



Volume 2014




Enzyme Research



Microbiology



































































































































































































































Volume 2014

Zoology






















Advances in

Virolog y



Volume 2014




Enzyme Research



Microbiology

Review Article Health Implications of …downloads.hindawi.com/archive/2014/198609.pdfReview Article...

Documents

Transcript of Review Article Health Implications of …downloads.hindawi.com/archive/2014/198609.pdfReview Article...