Exposure of laboratory animals to small air ions: a systematic review of biological and behavioral studies.

BACKGROUND: Air ions are molecules of air that have become ionized-that is, they have either lost or gained an electrical charge. Past speculation has suggested that exposure to positive air ions may be harmful to one's health, while exposure to negative air ions may be associated with beneficial health effects. Air ions arise from natural sources as well as direct-current transmission lines and commercial ionizers. Several recent clinical studies have suggested therapeutic effects of air ions on various types of depression at exposure levels 10- to 1000-fold higher than most previous human studies. The aim of this study was to assess the evidence from studies of laboratory animals for beneficial or adverse effects of air ions on health. METHODS: Sixty-two studies (1935-2015) in nine topics areas were evaluated for quality and potential systematic bias by ARRIVE guidelines. Standardized mean differences or proportional differences between exposed and control groups were computed for 44 studies to quantitatively assess the strength of the evidence for exposure-related effects. RESULTS: Many of the studies were conducted before 1990 and exhibited various reporting and methodological deficiencies, including small sample size, failure to control for the influence of potential confounding variables, lack of randomized assignment to treatment groups and blinded analyses, and statistical errors relating to treating group-exposed animals as individuals. The highest quality studies consistently reported no effects of exposure on any of the endpoints examined. There were no evident dose-response relationships within or across studies. CONCLUSIONS: Experimental studies of laboratory animals exposed to positive and negative air ions for minutes to years over a five-log unit range of intensities did not suggest any consistent or reliable effects on measures of behavior, learning and memory, neurotransmitters, tracheal function, respiratory infection, cardiovascular function, reproduction and growth, carcinogenesis, or other health endpoints. These data do not provide evidence of adverse or beneficial effects of air ion exposure on health, and did not suggest any biological mechanism of interaction, except perhaps for mechanosensory stimulation of body surfaces by static electric fields at high air ion concentrations.

Systematic review of biological effects of exposure to static electric fields. Part II: Invertebrates and plants.

BACKGROUND: The construction of high-voltage direct current (HVDC) lines for the long-distance transport of energy is becoming increasingly popular. This has raised public concern about potential environmental impacts of the static electric fields (EF) produced under and near HVDC power lines. As the second part of a comprehensive literature analysis, the aim of this systematic review was to assess the effects of static EF exposure on biological functions in invertebrates and plants and to provide the basis for an environmental impact assessment of such exposures. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to guide the methodological conduct and reporting. RESULTS: Thirty-three studies - 14 invertebrate and 19 plant studies - met the eligibility criteria and were included in this review. The reported behavioral responses of insects and planarians upon exposure strongly suggest that invertebrates are able to perceive the presence of a static EF. Many other studies reported effects on physiological functions that were expressed as, for example, altered metabolic activity or delayed reproductive and developmental stages in invertebrates. In plants, leaf damage, alterations in germination rates, growth and yield, or variations in the concentration of essential elements, for example, have been reported. However, these physiological responses and changes in plant morphology appear to be secondary to surface stimulation by the static EF or caused by concomitant parameters of the electrostatic environment. Furthermore, all of the included studies suffered from methodological flaws, which lowered credibility in the results. CONCLUSION: At field levels encountered from natural sources or HVDC lines (< 35kV/m), the available data provide reliable evidence that static EF can trigger behavioral responses in invertebrates, but they do not provide evidence for adverse effects of static EF on other biological functions in invertebrates and plants. At far higher field levels (> 35kV/m), adverse effects on physiology and morphology, presumably caused by corona-action, appear to be more likely. Higher quality studies are needed to unravel the role of air ions, ozone, nitric oxide and corona current on alterations in physiological functions and morphology.

Biological effects of exposure to static electric fields in humans and vertebrates: a systematic review.

BACKGROUND: High-voltage direct current (HVDC) lines are the technology of choice for the transport of large amounts of energy over long distances. The operation of these lines produces static electric fields (EF), but the data reviewed in previous assessments were not sufficient to assess the need for any environmental limit. The aim of this systematic review was to update the current state of research and to evaluate biological effects of static EF. METHODS: Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations, we collected and evaluated experimental and epidemiological studies examining biological effects of exposure to static EF in humans (n = 8) and vertebrates (n = 40). RESULTS: There is good evidence that humans and animals are able to perceive the presence of static EF at sufficiently high levels. Hair movements caused by electrostatic forces may play a major role in this perception. A large number of studies reported responses of animals (e.g., altered metabolic, immunologic or developmental parameters) to a broad range of static EF strengths as well, but these responses are likely secondary physiological responses to sensory stimulation. Furthermore, the quality of many of the studies reporting physiological responses is poor, which raises concerns about confounding. CONCLUSION: The weight of the evidence from the literature reviewed did not indicate that static EF have adverse biological effects in humans or animals. The evidence strongly supported the role of superficial sensory stimulation of hair and skin as the basis for perception of the field, as well as reported indirect behavioral and physiological responses. Physical considerations also preclude any direct effect of static EF on internal physiology, and reports that some physiological processes are affected in minor ways may be explained by other factors. While this literature does not support a level of concern about biological effects of exposure to static EF, the conditions that affect thresholds for human detection and possible annoyance at suprathreshold levels should be investigated.

Validity of geographically modeled environmental exposure estimates.

Geographic modeling is increasingly being used to estimate long-term environmental exposures in epidemiologic studies of chronic disease outcomes. However, without validation against measured environmental concentrations, personal exposure levels, or biologic doses, these models cannot be assumed a priori to be accurate. This article discusses three examples of epidemiologic associations involving exposures estimated using geographic modeling, and identifies important issues that affect geographically modeled exposure assessment in these areas. In air pollution epidemiology, geographic models of fine particulate matter levels have frequently been validated against measured environmental levels, but comparisons between ambient and personal exposure levels have shown only moderate correlations. Estimating exposure to magnetic fields by using geographically modeled distances is problematic because the error is larger at short distances, where field levels can vary substantially. Geographic models of environmental exposure to pesticides, including paraquat, have seldom been validated against environmental or personal levels, and validation studies have yielded inconsistent and typically modest results. In general, the exposure misclassification resulting from geographic models of environmental exposures can be differential and can result in bias away from the null even if non-differential. Therefore, geographic exposure models must be rigorously constructed and validated if they are to be relied upon to produce credible scientific results to inform epidemiologic research. To our knowledge, such models have not yet successfully predicted an association between an environmental exposure and a chronic disease outcome that has eventually been established as causal, and may not be capable of doing so in the absence of thorough validation.

Air ions and respiratory function outcomes: a comprehensive review.

BACKGROUND: From a mechanistic or physical perspective there is no basis to suspect that electric charges on clusters of air molecules (air ions) would have beneficial or deleterious effects on respiratory function. Yet, there is a large lay and scientific literature spanning 80 years that asserts exposure to air ions affects the respiratory system and has other biological effects. AIMS: This review evaluates the scientific evidence in published human experimental studies regarding the effects of exposure to air ions on respiratory performance and symptoms. METHODS: We identified 23 studies (published 1933-1993) that met our inclusion criteria. Relevant data pertaining to study population characteristics, study design, experimental methods, statistical techniques, and study results were assessed. Where relevant, random effects meta-analysis models were utilized to quantify similar exposure and outcome groupings. RESULTS: The included studies examined the therapeutic benefits of exposure to negative air ions on respiratory outcomes, such as ventilatory function and asthmatic symptoms. Study specific sample sizes ranged between 7 and 23, and studies varied considerably by subject characteristics (e.g., infants with asthma, adults with emphysema), experimental method, outcomes measured (e.g., subjective symptoms, sensitivity, clinical pulmonary function), analytical design, and statistical reporting. CONCLUSIONS: Despite numerous experimental and analytical differences across studies, the literature does not clearly support a beneficial role in exposure to negative air ions and respiratory function or asthmatic symptom alleviation. Further, collectively, the human experimental studies do not indicate a significant detrimental effect of exposure to positive air ions on respiratory measures. Exposure to negative or positive air ions does not appear to play an appreciable role in respiratory function.

Air ions and mood outcomes: a review and meta-analysis.

BACKGROUND: Psychological effects of air ions have been reported for more than 80 years in the media and scientific literature. This study summarizes a qualitative literature review and quantitative meta-analysis, where applicable, that examines the potential effects of exposure to negative and positive air ions on psychological measures of mood and emotional state. METHODS: A structured literature review was conducted to identify human experimental studies published through August, 2012. Thirty-three studies (1957-2012) evaluating the effects of air ionization on depression, anxiety, mood states, and subjective feelings of mental well-being in humans were included. Five studies on negative ionization and depression (measured using a structured interview guide) were evaluated by level of exposure intensity (high vs. low) using meta-analysis. RESULTS: Consistent ionization effects were not observed for anxiety, mood, relaxation/sleep, and personal comfort. In contrast, meta-analysis results showed that negative ionization, overall, was significantly associated with lower depression ratings, with a stronger association observed at high levels of negative ion exposure (mean summary effect and 95% confidence interval (CI) following high- and low-density exposure: 14.28 (95% CI: 12.93-15.62) and 7.23 (95% CI: 2.62-11.83), respectively). The response to high-density ionization was observed in patients with seasonal or chronic depression, but an effect of low-density ionization was observed only in patients with seasonal depression. However, no relationship between the duration or frequency of ionization treatment on depression ratings was evident. CONCLUSIONS: No consistent influence of positive or negative air ionization on anxiety, mood, relaxation, sleep, and personal comfort measures was observed. Negative air ionization was associated with lower depression scores particularly at the highest exposure level. Future research is needed to evaluate the biological plausibility of this association.

Recent advances in research relevant to electric and magnetic field exposure guidelines.

Limits on exposures to extremely low-frequency electric fields, magnetic fields and contact currents, designated as voluntary guidelines or standards by several organizations worldwide, are specified so as to minimize the possibility of neural stimulation. The limits, which we refer to as guidelines, derive from "basic restrictions" either on electric fields or current density within tissue, or on avoidance of annoying or startling interactions that may be experienced with spark discharge or contact current. Further, the guidelines specify more conservative permissible doses and exposure levels for the general public than for exposures in controlled environments, which most typically involve occupational settings. In 2001 we published an update on guideline science. This paper covers more recent developments that are relevant to the formulation and implementation of the next generation of guidelines. The paper deals with neurostimulation thresholds and the relevance of magnetophosphenes to setting guideline levels; dosimetry associated with contact current benchmarked against basic restrictions; tissue and cellular dosimetry from spark discharge; assessment of exposures to high electric fields in realistic situations (e.g., line worker in a transmission tower); a simplified approach to magnetic field assessment in non-uniform magnetic fields; and a quantitative approach to sampling workplace exposure for assessing compliance.

Accounting for human variability and sensitivity in setting standards for electromagnetic fields.

Biological sensitivity and variability are key issues for risk assessment and standard setting. Variability encompasses general inter-individual variations in population responses, while sensitivity relates to unusual or extreme responses based on genetic, congenital, medical, or environmental conditions. For risk assessment and standard setting, these factors affect estimates of thresholds for effects and dose-response relationships and inform efforts to protect the more sensitive members of the population, not just the typical or average person. While issues of variability and sensitivity can be addressed by experimental and clinical studies of electromagnetic fields, investigators have paid little attention to these important issues. This paper provides examples that illustrate how default assumptions regarding variability can be incorporated into estimates of 60-Hz magnetic field exposures with no risk of cardiac stimulation and how population thresholds and variability of peripheral nerve stimulation responses at 60-Hz can be estimated from studies of pulsed gradient magnetic fields in magnetic resonance imaging studies. In the setting of standards for radiofrequency exposures, the International Commission for Non-Ionizing Radiation Protection uses inter-individual differences in thermal sensitivity as one of the considerations in the development of "safety factors." However, neither the range of sensitivity nor the sufficiency or excess of the 10-fold and the additional 5-fold safety factors have been assessed quantitatively. Data on the range of responses between median and sensitive individuals regarding heat stress and cognitive function should be evaluated to inform a reassessment of these safety factors and to identify data gaps.

Thresholds for 60 Hz magnetic field stimulation of peripheral nerves in human subjects.

The goal of the research reported here is to narrow the range of uncertainty about peripheral nerve stimulation (PNS) thresholds associated with whole body magnetic field exposures at 50/60 Hz. This involved combining PNS thresholds measured in human subjects exposed to pulsed magnetic gradient fields with calculations of electric fields induced in detailed anatomical models of the body by that same exposure system. PNS thresholds at power frequencies (50/60 Hz) can be predicted from these data due to the wide range of pulse durations (70 mus to 1 ms), the length of the pulse trains (several tens of ms), and the exposure of a large part of the body to the magnetic field. These data together with the calculations of the rheobase electric field exceeded in 1% (E(1%)) of two anatomical body models, lead to a median PNS detection threshold of 47.9 +/- 4.4 mT for a uniform 60 Hz magnetic field exposure coronal to the body. The threshold for the most sensitive 1% of the population is about 27.8 mT. These values are lower than PNS thresholds produced by magnetic fields with sagittal and vertical orientations or nonuniform exposures.

Health effects relevant to the setting of EMF exposure limits.

To date, electric and magnetic exposure limits for frequencies below 100 kHz have been based on vaguely defined neurobiological responses to electric fields induced in tissues in vivo by magnetic fields and on perceptual responses to external electric fields. Advances in tissue dosimetry, risk assessment methods, and biological research on stimulation thresholds and mechanisms are providing new bases for exposure limits. This paper reviews the historical basis for current electric and magnetic exposure limits in preparation for the development of the "next generation" of electric and magnetic occupational and public exposure guidelines. This is followed by an overview of reported neurobiological effects of electric and magnetic stimulation that should be considered in new exposure guidelines. For magnetic fields, there is stronger evidence for setting exposure limits to protect against adverse effects of nerve stimulation than for protecting against visual magnetophosphenes. Magnetophosphenes are not adverse, and the evidence that these perceptual responses of the eye are a precursor or surrogate for other adverse neurologic responses is weak. Rather than relying just on theoretical models to set exposure limits, data from human subjects exposed to pulsed magnetic fields should be used to estimate nerve stimulation thresholds. Such data can provide a solid basis for setting magnetic field exposure limits if uncertainties in the data and inter-individual variability are addressed. Research on sensory perception, spontaneous and evoked potentials, and epidemiologic studies of neuropsychiatric conditions in electric and magnetic exposed populations does not suggest a need for lower exposure limits. However, a report that a 60-mT magnetic field (below the threshold for peripheral nerve stimulation) produces prolonged alterations of brain excitability and "indisposure" of subjects should be investigated in future research.