title: Absence of acute ocular damage in humans after prolonged exposure to intense RF EMF.
abstract: The eye is considered to be a critical organ when determining safety standards for radio frequency (RF) radiation. Experimental data obtained using animals showed that RF heating of the eye, particularly over a specific threshold, can induce cataracts. During the treatment of cancer in the head and neck by hyperthermia, the eyes receive a considerable dose of RF radiation due to stray radiation from the prolonged (60 min) and intense exposure at 434 MHz of this region. In the current study, we verified the exposure guidelines for humans by determining the association between the electromagnetic and thermal dose in the eyes with the reported ocular effects. We performed a simulation study to retrospectively assess the specific absorption rate (SAR) and temperature increase in the eyes of 16 selected patients (encompassing a total of 74 treatment sessions) whose treatment involved high power delivery as well as a minimal distance between the tumor site and the eye. Our results show that the basic restrictions on the peak 10 g spatial-averaged SAR (10 W kg(-1)) and peak tissue temperature increase (1 °C) are exceeded by up to 10.4 and 4.6 times, on average, and by at least 6.2 and 1.8 times when considering the lower limit of the 95% confidence interval. Evaluation of the acute effects according to patients' feedback (all patients), the common toxicity criteria scores (all patients) and an ophthalmology investigation (one patient with the highest exposure) revealed no indication of any serious acute ocular effect, even though the eyes were exposed to high electromagnetic fields, leading to a high thermal dose. We also found that, although there is a strong correlation (R (2) =  0.88) between the predicted induced SAR and temperature in the eye, there are large uncertainties regarding the temperature-SAR relationship. Given this large uncertainty (129%) compared with the uncertainty of 3D temperature simulations (61%), we recommend using temperature simulations as a dosimetric measure in electromagnetic exposure risk assessments.
authors.affiliation: Department of Radiation Oncology, Erasmus MC: Daniel den Hoed Cancer Center, Hyperthermia Unit, 3015 CE Rotterdam, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Adibzadeh
authors.forename: G C
authors.initials: GC
authors.lastname: van Rhoon
authors.forename: G M
authors.initials: GM
authors.lastname: Verduijn
authors.forename: N C
authors.initials: NC
authors.lastname: Naus-Postema
authors.forename: M M
authors.initials: MM
authors.lastname: Paulides
mesh_terms: D000328:Adult; D004574:Electromagnetic Fields / Q000009:adverse effects*; D005123:Eye / Q000528:radiation effects*; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D011846:Radio Waves / Q000009:adverse effects*; D011879:Radiotherapy Dosage