Treatment protocols for people affected by EMF
presented on behalf of the
MCS International Conference on „Misdiagnosed Illnesses - what you can do medically and legally“, September 2nd & 3rd 2003 in London
by
Jörg H. Reissenweber, M. D.; Ph. D.
Electropathological Research Center
Medical Faculty of Witten/Herdecke University
(Head: Prof. Eduard David, M. D.; Ph. D.)
Stockumer Straße 28
D-58453 Witten
Germany
Phone: 0049 2302 2825132
Fax: 0049 2302 2825135
Email:
Internet:
A) Preliminary remarks concerning EMF-hypersensitivity and its clinical portrait:
EMF-hypersensitivity or electromagnetic hypersensitivity (E. H.) is an increasing problem in modern industrial societies. Thus a new category of EMF-hypersensitivity-related health problems has been depicted in the literature often involving dermatologic symptoms like pain, tingling or heat sensations, itch, redness, papules, and pustules (Johansson and Liu 1994). More systemic complaints like dorsalgias, tiredness, headache, vomiting, cardiac pains, tachycardia, arterial hypertension, general undefined fear, aggression, and depression also have been described (Reißenweber et al. 1994 and 1995). States of illness attributed to E. H. comprise anything from neurological disturbances to severe health problems. Many E. H. persons report crawling sensations and other kinds of dysesthesias. In the field of research into the electromagnetic hypersensitivity issue provocation studies are performed and discussed to an increasing extent in the scientific community. The issue first arose in the 1980’s in the area of occupational health and medicine in Scandinavian countries. Provocation studies were and are performed foremost because they are believed to provide new insights into the development of the hypothetical phenomenon of electromagnetic hypersensitivity.
Although preexisting technical threshold values are beyond the limit of human sensibility, persons convinced that they are E.H. claim a perception far below thresholds.
Therefore, electrotechnical and medical experts as well as psychologists and even social scientists are confronted with the hypothetical effects of low and high frequency fields to a growing extent. Until now, E. H. has been defined as the capacity to perceive electric and magnetic fields causing bodily complaints. Thus E. H. is characterized by descriptions of the concerned persons themselves. Frequently E. H. persons suffer from the lack of comprehension by their relatives and/or colleagues and are often isolated from society. That is why the phenomenon of E. H. could not yet be investigated to a sufficient extent. Until now no objective screening test for self-reported E. H. and the correlated subjective symptoms could be established.
In this presentation treatment protocols in a broader sense for people affected by EMF shall be demonstrated. What we can do medically until now is rather poor because – to date - we must rely foremost on empirical data and not yet on a proven disease or disease entity. In this context we cannot really speak of electromagnetic hypersensitivity as a misdiagnosed illness in general. For - rather frequently – a cocktail of environmental factors might be involved in the development of this phenomenon including misdiagnosed health disorders and problems known from conventional medicine like hypertension, vegetative dystonia etc.
B) Diagnostic approaches
As an example for a diagnostic trial to identify an objective biological or medical or biomedical indicator „proving“ the existence of electromagnetic hypersensitivity the following attempt shall be presented:
As crawling sensations are frequently mentioned by E. H. patients we wondered whether alterations in cutaneous microcirculation possibly linked to exposure in magnetic fields might be involved in the development of crawling sensations and further dysesthesias. Therefore we investigated microcirculation of the thumb in seven healthy volunteers under and without exposure to weak circularly polarized 50 Hz magnetic flux densities of 96 T and compared the results with those obtained in three patients convinced to suffer from E. H. (see appendix 3)
C) Therapeutic approaches (= treatment protocols for people affected by EMF)
Therapeutic approaches are only just beginning in several countries. For example during the Second Copenhagen Conference on Electromagnetic Hypersensitivity in 1995 there was only one contribution dealing with therapeutic approaches in connection with electromagnetic hypersensitivity from Dr. Monro (UK).
Examples for current therapies of electromagnetic hypersensitivity:
-Liden (Sweden): Psychological treatment: more than half of
the patients were able to return to work;
-Smith (UK): holistic nursing, complementary therapy;
-Monro (UK):
-Graded normal exposure
-Incremental injections
-Neutralising therapy
-Pulse steroid therapy
-Enzyme-potentiated desensitisation
-Hillert et al. (Sweden): intervention programs
-Andersson et al. (Sweden): cognitive-behavioral treatment;
- The preliminary therapy (in statu nascendi) at Witten/Herdecke University (Reissenweber, David, Wojtysiak) consists of the following items:
-Extensive narrative interviews with the patients including the Witten/Herdecke University QUESTIONNAIRE CONCERNING EMF-HYPERSENSITIVITY (see appendix) explicitly using the placebo effect („the doctor as a drug“);
-Special Witten test for electromagnetic hypersensitivity (see below)
-Taking people seriously - often for the first time after an Odyssey from one doctor to the next;
-Deflection;
-Distraction;
-Sports;
-Movement as far as compatible with health status like a walk in a park or in a forest, leaving the house or the building (= analogy to the Sick-Building-Syndrome (SBS) might be constructed here;
-Caring for patients by telephone often over long periods of time;
-Being present for them;
-Providing for them an atmosphere of understanding in order to prevent the feeling of being misunderstood by society;
(Individual remedies - sometimes seeming rather strange - are recommended by several patients like gargling with salad oil for about half an hour every morning. We are of course collecting and registering those empirical data)
D) Special Witten Test for E. H.
In addition, since medical or psychological questionnaires described in literature normally do not provide sound data concerning special sensitivities, we ask patients and healthy control persons (probands), to guess in several consecutive periods whether or not ELF (50 Hz) fields or perhaps even radiofrequency (RF) fields typically emitted by handheld mobile phones are switched on (duration: 5 minutes). The fields are switched on or off at random on a stochastic basis ten times during one session. The probability of fields being activated is 50 %. After a break this procedure is repeated once in order to obtain statistically more reliable data and average guess probabilities (scores of correct answers) will be calculated.
This method is normally used in sensory physiology in order to detect subliminal sensory excitations. Additionally patients and controls are asked to describe their individual subjective symptoms. Their social situation, internal and neurological status and behaviour are adequately documented. In this context questions about allergic reactions in connection with occupational or residential chemical loads or electromagnetic field exposures are carefully asked and answers evaluated.
In detail: Patients included in the preliminary studies have a documented sensitive nature, an enhanced reactivity to environmental stressors including electromagnetic fields. Electromagnetic fields may act as co-factors in causing health problems among the EMF-hypersensitive population. Our hypothesis that EMFs act in conjunction with other cellular stimuli to elicit a response is applicable here. However, in this context it must not be neglected that there might be a link between self-reported E. H. and chemical or environmental causes for symptoms. Accordingly, patients were prescreened for conditions such as multiple chemical sensitivity syndrome (MCS), idiopathic environmental intolerance (IEI), and sick building syndrome (SBS) through environmental medicine blood chemistry evaluation and medical interview. A thorough patient history was obtained with special detail in areas such as occupation, chemical or physical exposure to stressors, telephone and appliance use and exposure, patient and/or family history of depression, schizophrenia or neurosis. A thorough neurological and internal medicine examination also was made and where an organic cause for health problems was identified, some patients were excluded from the study. A questionnaire was used to generate a pool of information about each EMF-hypersensitive patient. Patients included in the study were found to have neither hypochondria nor to meet any criteria of psychiatric diagnoses.
Patients and controls underwent a screening test especially developed for detection of EMF-hypersensitivity by testing their capacity to detect a well-defined field situation: subjects were exposed to a series of field situations in which they were exposed to 50 Hz magnetic flux densities of 10 µT, generated by a coil or to a control (field off). The magnetic field was activated for 2 minutes or deactivated, and the succession of the intervals was determined on a stochastic basis by computer program (intermittent exposure). The probability of 50 Hz magnetic fields being switched on was 50 %. Hereafter patients were informed that fields were shut off for another 3 minutes. After that they were again confronted with the possibility that fields might be activated. The probability of fields being activated was 50 %. These 5-minute-experiments were repeated 10 times. Confronted with the possibility that fields were activated, subjects were invited to give their opinion on whether or not fields had been switched on. On the basis of the information obtained, hit frequency scores could be deduced for each person. This procedure was carried out twice.
Before the first set of exposures (real experiment) participants were acclimated to the test procedures by applying three times a field on/field off situation and telling participants simultaneously the status ”field on” or ”field off”.
The investigation was accompanied by an anamnesis and:
-clinical examinations,
-the above mentioned questionnaire concerning symptoms (WITTEN/HERDECKE UNIVERSITY QUESTIONNAIRE CONCERNING EMF-HYPERSENSITIVITY, see appendix 2) and another one Hypochondria-Hystery-Inventary (HHI) by Prof. Dr. Fritz Süllwold focussing on hypochondriac tendencies.
-In the framework of this procedure a blood sample was taken at 3:00 p.m. by antecubital venipuncture. Radioimmunoassay kits (IBL, Hamburg) were used to determine plasma melatonin levels.
A NEW HYPOTHESIS
Our new hypothesis implies that E. H. patients show a tendency of increased susceptibility toward environmental stressors perhaps similar to patients suffering from allergies. If electromagnetic field exposure is added in addition to other allergic burden, the effect is a synergism between the hypersensitivity phenomena in those predisposed patients, triggering disease. Electromagnetic field exposure might cause E. H. patients to cross the threshold between health and disease or uneasiness.
E) CONCLUSIONS:
- The phenomenon of E. H. is very difficult to treat;
- Therapeutic outcomes are rater poor;
- Patients have a heavy burden of suffering;
- Authorities, the public and scientific bodies must be informed about the subject to an increasing extent;
- Interdisciplinary research must be strengthened;
APPENDIX 1: SELECTED PUBLICATIONS OF THE AUTHOR AND HIS GROUP AND FURTHER RELATED LITERATURE:
- David, E.; Reißenweber, J.; Kentner, S.:
The nature of electromagnetic hypersensitivity: Idiopathic Environmental Intolerance or specific perceptive faculty. Abstract Book of the Twentieth Annual Meeting of the Bioelectromagnetics Society; St. Petersburg, Florida, June 7-11, 1998, p. 211;
- David E, Reißenweber J. (1994):
Melatonin in humans. In: Electromagnetic compatibility of biological systems in weak 50 Hz magnetic fields. K. Brinkmann, H. C. Kärner, H Schaefer, eds. VDE-Verlag, Offenbach, pp. 155-183;
- Kentner, S.; David, E.; Reißenweber, J.; Pfotenhauer, M.; Ostermann, Th.:
An interdisciplinary approach to electromagnetic hypersensitivity. Abstract Book of the Twentieth Annual Meeting of the Bioelectromagnetics Society; St. Petersburg, Florida, June 7-11, 1998, p. 273-274;
- Reißenweber JH (1991):
Disorders of pulsatile hypophyseal gonadotropin secretion in patients suffering from pituitary adenomas. Doctoral Thesis, Medical Faculty of the University of Erlangen-Nuremberg;
- David, E.; Reißenweber, J.; Fachner, J.:
Dialog mit der Bevölkerung - eine Analyse schriftlicher und telefonischer Anfragen an die Forschungsstelle für Elektropathologie der Jahre 1988 bis 1995. In: Tagungsband des VDEW-Seminars „Niederfrequente elektrische und magnetische Felder“ am 09.06.1995 in Darmstadt-Neukranichstein;
- David, E.; J. Reißenweber; M. Pfotenhauer:
Experimente mit biologischen Substraten in elektromagnetischen Feldern. Das biologische System im elektromagnetischen Feld - Medizinische Universität zu Lübeck, Klinisch-experimentelle Forschungseinrichtung Lübeck - 25./26. 11.1988, S. 157 - 164;
- David, E.; J. Reißenweber:
Beeinflussung der Erregbarkeit biologischer Strukturen durch Magnetimpulse. Tagungsband "Nichtionisierende Strahlung" der 21. Jahrestagung des Fachverbandes für Strahlenschutz, Köln 7. - 9.11.1988, S. 115;
- David, E.; J. Reißenweber:
Umfrage unter in der Physikalischen Therapie tätigen Berufsgruppen die unterschiedliche Schmerzempfindlichkeit von Männern und Frauen betreffend. Physikalische Therapie, Heft Nr. 16/Okt. 1990, 11. Jahrgang, S. 650-652;
- David, E.; J. Reißenweber, M. Pfotenhauer:
Biologische Wirkung von Niederfrequenzfeldern. In: Sicherheit im elektromagnetischen Umfeld, S. 47 - 63 - Hans-Jürgen Haubrich – VDE-Verlag GmbH, Berlin/Offenbach - 1990;
- David, E.; W.-U. an der Heiden, J. Reißenweber, M. Pfotenhauer:
Epidemiologische Studien zu den Wirkungen elektrischer und magnetischer Felder auf den Menschen. Deutsches Ärzteblatt, 88. Jahrgang, Heft 10, A: S. 753-758; B: S. 528-531; C: S. 441-444 /
7. März 1991;
- Reißenweber, J.; E. David, M. Pfotenhauer:
Psychological aspects of perception of magnetophosphenes and electrophosphenes. Biomed Tech (Berl) (Germany), Mar 1992, 37(3) p42-5;
- David, E.; J. Reißenweber, D. Peier:
EMVU, die EMV für den Menschen - ¸ber die Wirkung elektrischer, magnetischer und elektromagnetischer Felder auf den Menschen. Elektrie, Berlin 48 (1994) 7 - S. 261 - 270;
- Reißenweber, J.:
Biologische Wirkungen von elektrischen und magnetischen Feldern im Nieder- und Hochfrequenzbereich. Hemmenhofener Gespräche 1994ì des Betriebsärztlichen Arbeitsmedizinischen Dienstes Böblingen (BAD) am 29.03.1994, S. 65 - 72;
- Fachner, J.; J. Reißenweber, E. David:
Is there Electromagnetic Hypersensivity? COST 244: Biomedical Effects of Electromagnetic Fields, Proceedings of the COST 244 meeting on Electromagnetic Hypersensitivity, Graz, 26.-27. September 1994, Editor: Dina Simunic, S. 30-40, XIII/72/95-EN;
- Reißenweber, J.; E. David, J. Fachner:
The Evaluation of Electrosensitivity/Magnetosensitivity in the Framework of the Analysis of Written and Telephone Questions Concerning the Electropathological Research Section, COST 244: Biomedical Effects of Electromagnetic Fields, Proceedings of the COST 24 meeting on Electromagnetic Hypersensitivity, Graz, 26.-27. September 1994, Editor: Dina Simunic, S. 81-87, XIII/72/95-EN;
- David, E.; J. Reißenweber:
Die Elektrosmog-Debatte aus Sicht der Schulmedizin. In: Strom des Lebens - Strom des Todes - Elektro- und Magnetosmog im Kreuzfeuer. Hrsg. P. C. Mayer-Tasch u. B. M. Malunat, Fischer-Taschenbuch-Verlag GmbH, Frankfurt am Main, M‰rz 1995, ISBN 3-596-12483-2;
- Reißenweber, J.:
Tagungsbericht zum Workshop Electromagnetic Hypersensitivity an der Technischen Universität Graz im September 1994 (europäisches Programm COST 244), Newsletter, Forschungsgemeinschaft Funk e. V., Bonn-Center HI 305, 53113 Bonn, 2. Jahrgang Nr. 4, S. 12-15 - November 1994;
- David, E.; J. Reißenweber:
Melatonin beim Menschen / Melatonin in Humans. In: Elektromagnetische Verträglichkeit biologischer Systeme/Electromagnetic Compatibility of Biological Systems, Band 4/Volume 4, dto. im schwachen 50-Hz-Magnetfeldern/ dto. In: weak 50 Hz Magnetic Fields, S. 154-183, Hrsg.: Brinkmann, Kärner, Schaefer, VDE-Verlag GmbH, Berlin - Offenbach, 1995;
- David, E.; J. Reißenweber, J. Fachner,:
Network Electromagnetic Hypersensitivity - Bio-Psycho-Social Dimensions of Information Processing. BEMS Abstract Book, Seventeenth Annual Meeting, Boston, 18.22.06.1995, S. 133-134;
- Fachner, J.; J. Reißenweber, E. David:
Electromagnetic Hypersensitivity as an Individual ability of selective perception and Information processing - A Biopsycho-social perspective. Electromagnetic Hypersensitivity, 2nd Copenhagen Conference, Copenhagen, Denmark, May 1995, Jyrki Katajainen, Bengt Knave (Eds.), S. 11-16;
- Reißenweber, J.; E. David, J. Fachner:
The evaluation and interpretation of the phenomenon of electrosensitivity/magnetosensitivity in the framework of the analysis of written andtelephone questions. Electromagnetic Hypersensitivity, 2nd Copenhagen Conference,
Copenhagen, Denmark, May 1995, Jyrki Katajainen, Bengt Knave (Eds.), S. 73-76;
- Reißenweber, J.; David, E.; Fachner, J.:
Elektrische und magnetische Felder und ihre biologischen Wirkungen im Nieder- und Hochfrequenzbereich. Zentralblatt für Arbeitsmedizin, Arbeitsschutz und Ergonomie mit Beiträgen zur Umweltmedizin 46 (1996) 206-219;
- Reißenweber, J.; David, E.:
Elektromagnetische Effekte auf biologische Systeme. Therapiewoche 14, 750-759 (1996);
- David, E.; Reißenweber, J.:
Difficulty of extrapolation of mutation results from 400 mT 50-Hz magnetic field studies to normal human field exposures. Mutation Research 4012 (1997);
- Reißenweber, J.; F. Wenzel; E. David; J. Grote:
Circularly polarized 50 Hz magnetic flux densities of 96 T do not influence cutaneous microcirculation of the thumb in healthy human volunteers and in persons suffering from self-reported electromagnetic hypersensitivity. Proceedings of the Millennium International Workshop on Biological Effects of Electromagnetic Fields, Heraklion, Greece, 17 – 20 October 2000, 442 – 453;
- Reißenweber, J., E. David, A. Wojtysiak & B. Grothus (2001):
Human Plasma Melatonin Levels are not Decreased under the Influence of Weak 50 Hz Magnetic Fields and Music whereas they are under the Influence of Light. IUPS, 34th International Congress of Physiological Sciences, 26.-31. Aug. 2001, Christchurch New Zealand;
- David, E., Reißenweber, J., Wojtysiak, A., Pfotenhauer, M. (2002): Das Phänomen der Elektrosensibilität. Umweltmed Forsch Prax 7 (1) 7-16 (2002);
- David E, Reißenweber J:
Ionisierende und nicht-ionisierende Strahlen, Elektromagnetische Felder. In: Arbeitsmedizin. Handbuch für Theorie und Praxis, hrsg. von Gerhard Triebig, Michael Kentner und Rainer Schiele, 1. Auflage, Gentner Verlag, Stuttgart 2003, ISBN 3-87247-598-3, S. 771-799;
- A theoretical model based upon mast cells and histamine to explain the recently
proclaimed sensitivity to electric and/or magnetic fields in humans.
Med Hypotheses 2000 Apr;54(4):663-71 (ISSN: 0306-9877)
Gangi S; Johansson O
Experimental Dermatology Unit, Department of Neuroscience, Karolinska Institute, Stockholm, Sweden.
- Study of self-reported hypersensitivity to electromagnetic fields in California.
Environ Health Perspect 2002 Aug;110 Suppl 4:619-23 (ISSN: 0091-6765)
Levallois P; Neutra R; Lee G; Hristova L
Unite de Recherche en Sante Publique, Centre Hospitalier Universitaire de Quebec, Beauport, Canada.
.
- Nursing the electrically-sensitive patient.
Complement Ther Nurs Midwifery 1997 Aug;3(4):111-6 (ISSN: 1353-6117)
Smith CW
Department of Electronic and Electrical Engineering, University of Salford, UK.
- A cognitive-behavioral treatment of patients suffering from "electric hypersensitivity".
Subjective effects and reactions in a double-blind provocation study.
J Occup Environ Med 1996 Aug;38(8):752-8 (ISSN: 1076-2752)
Andersson B; Berg M; Arnetz BB; Melin L; Langlet I; Liden S
Department of Clinical Psychology, University of Uppsala, Sweden.
- Magnetic fields, brain and immunity: effect on humoral and cell-mediated immune
responses.
Int J Neurosci 1991 Jul;59(1-3):25-43 (ISSN: 0020-7454)
Jankovic BD; Maric D; Ranin J; Veljic J
Immunology Research Center, Belgrade, Yugoslavia.
- Electrosensibility and electromagnetic hypersensitivity [In Process Citation]
Bioelectromagnetics 2003 Sep;24(6):387-94 (ISSN: 0197-8462)
Leitgeb N; Schrottner J
Department of Clinical Engineering, Institute of Biomedical Engineering, Graz University of Technology, Graz,
Austria.
- Cognitive behavioural therapy for patients with electric sensitivity - a multidisciplinary
approach in a controlled study.
Psychother Psychosom 1998;67(6):302-10 (ISSN: 0033-3190)
Hillert L; Kolmodin Hedman B; Dolling BF; Arnetz BB
Environmental Illness Research Centre, Southern Division of Community Health, Huddinge, Sweden. Email: .
APPENDIX 2: WITTEN/HERDECKE UNIVERSITY QUESTIONNAIRE CONCERNING EMF-HYPERSENSITIVITY
- Name:...... ; Address:...... ; Phone:......
- Date:...... Proband PatientPatient-Number......
(Please tick the corresponding boxes)
1. Family and social anamnesis------
- Sex: male female
- Date of birth......
- Children: yes, number of children:...... no
- Number of inhabitants of residence:
0 to 99inhabitants
100 to 999inhabitants
1 000 to 9 999inhabitants
10 000 to 99 999inhabitants
100 000 to 499 999inhabitants
500 000 to 999 999inhabitants
more than 1 000 000inhabitants
- grown up in: rural area municipal area
- own job/profession:......
- parents´ job/profession:......
2. Occupational anamnesis------
- Electromagnetic fields at the workplace: yes no
if yes, please specify which field strength:......
- daily work at VDT/VDU: up to 1 hour
1 to 5 hours
more than 5 hours
- daily use of other electric equipment/appliances yes no
if yes, please specify which......
......
-bad work climate (mobbing,
few contact among colleagues) yes no
3. EMF-hypersensitivity------
- Are you EMF-hypersensitive to your own opinion? yes no
if yes, please specify since when:......