title: Context-sensitive ecological momentary assessments; integrating real-time exposure measurements, data-analytics and health assessment using a smartphone application.
abstract: Modern sensor technology makes it possible to collect vast amounts of environmental, behavioural and health data. These data are often linked to contextual information on for example exposure sources which is separately collected with considerable lag time, leading to complications in assessing transient and/or highly spatially variable environmental exposures. Context-Sensitive Ecological Momentary Assessments1(CS-EMAs) could be used to address this. We present a case study using radiofrequency-electromagnetic fields (RF-EMF) exposure as an example for implementing CS-EMA in environmental research.
  
  
  
  Participants were asked to install a custom application on their own smartphone and to wear an RF-EMF exposimeter for 48h. Questionnaires were triggered by the application based on a continuous data stream from the exposimeter. Triggers were divided into four categories: relative and absolute exposure levels, phone calls, and control condition. After the two days of use participants filled in an evaluation questionnaire.
  
  
  
  74% of all CS-EMAs were completed, with an average time of 31s to complete a questionnaire once it was opened. Participants reported minimal influence on daily activities. There were no significant differences found between well-being and type of RF-EMF exposure.
  
  
  
  We show that a CS-EMA based method could be used in environmental research. Using several examples involving environmental stressors, we discuss both current and future applications of this methodology in studying potential health effects of environmental factors.
authors.affiliation: Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands. Electronic address: L.vanWel@uu.nl.
authors.forename: Luuk
authors.initials: L
authors.lastname: van Wel
authors.affiliation: Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Anke
authors.initials: A
authors.lastname: Huss
authors.affiliation: Fields at Work GmbH, Zurich, Switzerland.
authors.forename: Philipp
authors.initials: P
authors.lastname: Bachmann
authors.affiliation: Fields at Work GmbH, Zurich, Switzerland; Institute of Electromagnetic Fields (IEF), ETH Zurich, Switzerland.
authors.forename: Marco
authors.initials: M
authors.lastname: Zahner
authors.affiliation: Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.affiliation: Fields at Work GmbH, Zurich, Switzerland.
authors.forename: Jürg
authors.initials: J
authors.lastname: Fröhlich
authors.affiliation: Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
mesh_terms: D000293:Adolescent; D000328:Adult; D000072860:Ecological Momentary Assessment; D004574:Electromagnetic Fields; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011846:Radio Waves; D012107:Research Design; D000068997:Smartphone; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Ecological momentary assessments; Feasibility; RF-EMF