Auteurs

Berg-Beckhoff G, Heyer K, Kowall B, Breckenkamp J, Razum O (2010). The views of primary care physicians on health risks from electromagnetic fields. Dtsch Arztebl Int 107(46): 817–823

Introduction
Possible health risks from exposures to electromagnetic fields (EMFs) have been the subject of discussion since the introduction of mobile phones. Most reviews of scientific literature estimate these risks as low, while the media describe them as high. This leads to uncertainty and anxiety. In Germany, 27% of the population is concerned about possible health effects of mobile phones, and 9% attribute their health symptoms to EMF exposures. Such patients often consult primary care physicians and expect explanation of the risks and possible strategies for risk reduction.

Objective
The objective was to investigate “the physicians’ opinions and attitudes regarding this topic, and how these affect the doctor-patient relationship”.

Methods
A 7% sample of practicing primary care physicians was drawn using registries of the regional associations of statutory health insurance physicians in Germany. The sample included 2,795 physicians. Two thirds of the physicians received a four-page questionnaire, and one third received a one-page questionnaire that included 6 most important questions.
 
Results
The rate of response was 23.3% for the long questionnaire, and 49.1% for the short questionnaire. Sixty five percent of the physicians who completed the short questionnaire and 61% of those who answered the long questionnaire had discussed possible health risks associated with EMFs with at least one patient. In 73% of these discussions the concern about possible association between health symptoms and EMF exposure was expressed by the patient; only 24% of the physicians considered this association plausible. Forty three percent of the physicians knew that low-frequency EMFs could stimulate nerve or muscle cells. Fewer than 30% knew about specific absorption rate, temperature increase during a cell phone conversation or the depth of penetration of EMFs in tissues. The patients most frequently reported the following symptoms: headache (22%), sleep disorders (21%), weakness/dizziness (9.2%), fatigue (9%) and non-specific symptoms (8%). In most cases, the patients suspected that mobile phones and their base stations were the cause of their symptoms. In 46% of the consultations in which EMF was discussed, protective measures were recommended by the physician, even if in some of these cases only the patient, but not the doctor considered the connection between the health symptoms and EMF plausible. The most frequent recommendation was to remove electrical devises (25%), move to another house or to a different town (15.5%), and change position of bed or sleep in another room (12%).
 
Interpretation and Conclusion
The authors have concluded that primary care physicians frequently discuss possible health risks associated with EMF exposures. The knowledge of primary care physicians about EMFs is not very extensive. Their recommendations, some of which are drastic, are generally not evidence-based. Physicians would benefit from training courses on the subject. Limitations of this study include low response rate suggesting a self-selection process, and the use of a non-validated questionnaire.



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