5th Paris Appeal Congress, 18th of May, 2015 Royal Academy of Medicine, Belgium
IDIOPATHIC ENVIRONMENTAL INTOLERANCE: WHAT ROLE FOR ELECTROMAGNETIC FIELDS AND CHEMICALS?
Lennart Hardell, Epidemiologist, Professor at Örebro University Hospital, Orebro, Sweden
Already in 1970 a report from the Soviet Union described the Microwave syndrome as possible side effect from radar and radio radiation. Up to one fourth of the military personal working with such equipment with radiation emissions even under reference value could get symptoms like fatigue, dizziness, headache, problems with concentration and memory, and sleep disturbances. The suggested treatment was to change assignments and keep away from electromagnetic fields with rest, physical exercise and nutritional food.
The symptoms were similar as described some 40 years later in Finnish persons with electromagnetic hypersensitivity (EHS). Other used names are Idiopathic Environmental Intolerance attributed to electromagnetic fields (IEI-EMF), and Electromagnetic Field Intolerance Syndrome (EMFIS). There are different opinions if the symptoms are caused by electromagnetic fields or if it is anxiety for the new technology that is the cause. Provocation studies on electromagnetic fields have demonstrated divergent results on persons with EHS. Some cannot discriminate between an active microwave signal and a placebo signal; some observed objective symptoms are changes in reactions of the pupil, heart rhythm, damage to erythrocytes, and disturbed glucose metabolism in the brain after exposure to electromagnetic fields.
The reference value for radiofrequency electromagnetic fields from 1998 by ICNIRP protects from injuries caused by thermal effects exceeding one degree Celsius after short exposure observed in laboratories. Injuries and health effects caused by other biological mechanisms or from chronic exposure are not considered. The Austrian Medical Association has written a suggestion to a guideline for the diagnoses and treatment of EMF-related health problems and illnesses, but apart from that EHS is today not recognized as a specific diagnosis in the rest of the world. There are no diagnostic criteria and no treatment officially accepted. Instead persons with EHS are often offered cognitive therapy. In population based surveys the prevalence of EHS has ranged from 1.5 – 3.2 % in Sweden, 3.2 % in California, 5 % in Switzerland to 13.3 % in Taiwan.
Multiple chemical sensitivity (MCS) is part of IEI. The concept that MCS is a distinct entity that is caused by responses to chemicals originated in work in the 1950s. In the disease model MCS consists of an inability to adapt to chemicals and the development of responsiveness to extremely low concentrations after sensitization. The model postulates multiple symptoms that reflect involvement of multiple organ systems. Manifestation depends on: (1) the tissue or organ involved; (2) the chemical and pharmacologic nature of the toxin; (3) the individual susceptibility of the exposed person (genetic make-up, nutritional state, and total load at the time of exposure); (4) the length of time of the exposure; (5) amount and variety of other body stressors.
Controlled exposures to establish the presence of MCS have been used. Patients are placed in environments judged to eliminate deleterious agents and then exposed to suspect chemicals. This organization offers a definition of MCS which is also referred to as ecologic illness that is poly-symptomatic, a multi-system chronic disorder manifested by adverse reactions to environmental excitants. The excitants are present in air, water, drugs, and our habitats. Thus the patient with MCS can be discovered by removal from the suspected offending agents and by re-challenge, after an appropriate interval, under strictly controlled environmental conditions. Tests of the central nervous system, peripheral nervous system, nose and sinuses, pulmonary function, T-cell subsets, chemical antibodies and autoimmunity should be performed. If certain functions become abnormal or more abnormal after unintentional significant exposure, the diagnosis is confirmed. MCS is defined as an adverse reaction to ambient doses of toxic chemicals in our air, food, and water at levels which are generally accepted as subtoxic. Of the population 10-30 % have been reported to react to chemical substances with some type of sensitivity.