Thermal aspects of exposure to radiofrequency energy: report of a workshop.

This special issue contains papers presented at an international workshop entitled 'Thermal Aspects of Radio Frequency Exposure' convened in Gaithersburg, Maryland, USA on 11-12 January 2010, and co-sponsored by the Mobile Manufacturers Forum, the GSM Association, and the US Food and Drug Administration. The goals of the workshop were to (1) identify appropriate health endpoints associated with thermal hazards and their time-dependence thresholds, and (2) outline future directions for research that might lead to an improved understanding of health and safety implications of human exposure to radiofrequency energy and design of improved exposure limits for this energy. This present contribution summarises some of the major conclusions of the speakers, and offers comments by one of the present authors on proposed research priorities and the implications of the material presented at the workshop for setting improved thermally based limits for human exposure to RF energy.

Mild hyperthermia as a potential mechanism to locally enhance cell growth kinetics.

The effect of mild hyperthermia on growth kinetics of two human glioma and one mouse fibroblast cell line was evaluated over a 12 h (short-term) or 7 day (long-term) period. All cell lines showed growth enhancement at 38 degrees C, although the effect in C3H 10T (1/2) mouse fibroblasts was more pronounced and had a more rapid onset than in U87MG or LN71 glioma cells. At 39 degrees C, growth of C3H 10T (1/2) cells was slightly reduced and glioma cell lines similar to that of their respective 37 degrees C controls. At 40 degrees C, C3H 10T (1/2) cells showed a more rapid and dramatic growth reduction than glioma cell lines and accumulated in both G(0)/G(1) and G(2) checkpoint compartments. In contrast, U87MG cells accumulated only in G(2) and LN71 showed no checkpoint accumulation. The findings indicate that cell lines are differentially responsive to small temperature elevations. If similar differences exist between normal and diseased human tissues, local application of mild hyperthermia might offer a noninvasive and cost-effective method to achieve local enhancement of drugs that target proliferating tissue.

Electromagnetic compatibility management of wireless transceivers in electromagnetic-interference-sensitive medical environments.

The diffusion of wireless technology has caused concerns about interference in the hospital environment. Most hospitals have banned the use of cell phones on their premises although wireless technology can help in delivering time critical help to patients. We discuss some factors of radio frequency (RF) near field interference. These phenomena do not lend themselves easily to theoretical evaluation. It is possible to avert medical equipment interference by performing ad hoc tests. The method requires measurements of electromagnetic fields and the observation of interference events with increasing distance between equipment and RF transmitters. The results are applicable only to the specific testing environment. The ad hoc proposed method can be found in the draft document C63.18 of the American National Standard Institute.

Radio frequency exposure in mobile phone users: implications for exposure assessment in epidemiological studies.

The majority of epidemiological studies investigating correlations between long-term low-level radiofrequency (RF) exposure from mobile phones and health endpoints have followed a case-control design, requiring reconstruction of individual RF exposure. To date, these have employed 'time of use' as an exposure surrogate from questionnaire information or billing records. The present study demonstrates such an approach may not account for variability in mobile phone transmit power, which can be roughly correlated with RF exposure. This variability exists (a) during a single call, (b) between separate calls, (c) between averaged values from individuals within a local study group and (d) between average values from groups in different geographical locations. The present data also suggest an age-related influence on talk time, as well as significant inaccuracy (45-60%) in recalling 'time of use'. Evolving technology and changing use behaviours may add additional complexities. Collectively, these data suggest efforts to identify dose response and statistical correlations between mobile phone use and subtle health endpoints may be significantly challenged.

Safe use of cellular telephones in hospitals: fundamental principles and case studies.

Many industries and individuals have embraced cellular telephones. They provide mobile, synchronous communication, which could hypothetically increase the efficiency and safety of inpatient healthcare. However, reports of early analog cellular telephones interfering with critical life-support machines had led many hospitals to strictly prohibit cellular telephones. A literature search revealed that individual hospitals now are allowing cellular telephone use with various policies to prevent electromagnetic interference with medical devices. The fundamental principles underlying electromagnetic interference are immunity, frequency, modulation technology, distance, and power Electromagnetic interference risk mitigation methods based on these principles have been successfully implemented. In one case study, a minimum distance between cellular telephones and medical devices is maintained, with restrictions in critical areas. In another case study, cellular telephone coverage is augmented to automatically control the power of the cellular telephone. While no uniform safety standard yet exists, cellular telephones can be safely used in hospitals when their use is managed carefully.

Mobile phones in the hospital: improved mobile communication and mitigation of EMI concerns can lead to an overall benefit to healthcare.

There is a growing trend in hospitals throughout the world to incorporate mobile phones and other wireless technology to offer more efficient, cost effective, and higher quality healthcare. Misunderstanding of mobile phone systems, electromagnetic interference with medical devices, and available management solutions, however, has led to a wide range of inconsistent hospital policies. Recent reviews and commentaries on the subject have provided inconsistent and in some cases factually incorrect information that confuses the issue. At one extreme, unmanaged use of mobile phones in areas where life-critical medical devices are in operation can result in atypical situations that may place patients at risk. At the other extreme, overly-restrictive policies based upon speculation may deny benefits by acting as an obstacle to technology. Overly-restrictive policies may also not address growing and legitimate communication needs of patients and visitors in times of crisis. While it may not be feasible for hospitals to manage every mobile phone handset that is randomly brought into their facility without certain limits on use in areas where life-critical devices are commonly in operation, restrictions are not usually necessary throughout the entire facility. Restrictive policies are also better facilitated when easily accessible areas are designated where mobile phone use is encouraged. Controlled mobile phone systems for use by doctors and staff for hospital-specific communication, by contrast, can operate compatibly throughout the entire hospital facility with appropriate system design and management, even in sensitive areas, and such systems have already been deployed in a number of hospitals throughout the U.S.