title: Actual and perceived exposure to electromagnetic fields and non-specific physical symptoms: an epidemiological study based on self-reported data and electronic medical records.
abstract: BACKGROUND
  There is continuing scientific debate and increasing public concern regarding the possible effects of electromagnetic fields (EMF) on general population's health. To date, no epidemiological study has investigated the possible association between actual and perceived EMF exposure and non-specific physical symptoms (NSPS) and sleep quality, using both self-reported and general practice (GP)-registered data.
  
  
  METHODS
  A health survey of adult (≥ 18) participants (n=5933) in the Netherlands was combined with the electronic medical records (EMRs) of NSPS as registered by general practitioners. Characterization of actual exposure was based on several proxies, such as prediction models of radiofrequency (RF)-EMF exposure, geo-coded distance to high-voltage overhead power lines and self-reported use/distance of/to indoor electrical appliances. Perceived exposure and the role of psychological variables were also examined.
  
  
  RESULTS
  Perceived exposure had a poor correlation with the actual exposure estimates. No significant association was found between modeled RF-EMF exposure and the investigated outcomes. Associations with NSPS were observed for use of an electric blanket and close distance to an electric charger during sleep. Perceived exposure, perceived control and avoidance behavior were associated with the examined outcomes. The association between perceived exposure was stronger for self-reported than for GP-registered NSPS. There was some indication, but no consistent pattern for an interaction between idiopathic environmental intolerance (IEI-EMF) and the association between actual exposure and NSPS.
  
  
  CONCLUSIONS
  In conclusion, there is no convincing evidence for an association between everyday life RF-EMF exposure and NSPS and sleep quality in the population. Better exposure characterization, in particular with respect to sources of extremely low frequency magnetic fields (ELF-MF) is needed to draw more solid conclusions. We argue that perceived exposure is an independent determinant of NSPS.
authors.affiliation: Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands; National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Electronic address: Christos.Baliatsas@rivm.nl.
authors.forename: Christos
authors.initials: C
authors.lastname: Baliatsas
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: John
authors.initials: J
authors.lastname: Bolte
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Joris
authors.initials: J
authors.lastname: Yzermans
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Gert
authors.initials: G
authors.lastname: Kelfkens
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Mariette
authors.initials: M
authors.lastname: Hooiveld
authors.affiliation: Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands; National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: Lebret
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
authors.forename: Irene
authors.initials: I
authors.lastname: van Kamp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004574:Electromagnetic Fields / Q000009:adverse effects; D057286:Electronic Health Records; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D018876:Environmental Illness / Q000209:etiology* / Q000523:psychology; D016021:Epidemiologic Studies; D005260:Female; D058006:General Practice; D006262:Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010465:Perception; D057566:Self Report; D012890:Sleep; D055815:Young Adult
keywords: Electromagnetic fields; Epidemiological studies; IEI-EMF; Non-ionizing radiation; Non-specific physical symptoms