Non-specific physical symptoms and electromagnetic field exposure in the general population: Can we get more specific? A systematic review

Baliatsas, Christos; Kamp, Irene van; Bolte, John; Schipper, Maarten; Yzermans, Joris; Lebret, Erik

doi:10.1016/j.envint.2011.12.002

Cited by 67 publications

(36 citation statements)

References 70 publications

(90 reference statements)

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“…Such concerns are often justified, considering the well-documented harmful effects of a number of pollutants [3][4][5]. Nevertheless, people's worries about a given source can also be in conflict with what research evidence suggests, as in the case of attribution of non-specific physical symptoms (NSPS) to everyday life electromagnetic fields (EMF) [6][7][8].…”

Section: Introductionmentioning

confidence: 94%

The relationship of modern health worries to non-specific physical symptoms and perceived environmental sensitivity: A study combining self-reported and general practice data

Baliatsas

Kamp

Hooiveld

et al. 2015

Journal of Psychosomatic Research

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a b s t r a c t a r t i c l e i n f oObjective: The present study investigates the association of modern health worries (MHW) with self-reported as well as general practitioner (GP)-registered non-specific physical symptoms (NSPS), medication use, alternative therapy consultations, sleep quality and quality of life. The interrelation between MHW, general environmental sensitivity and the aforementioned outcomes is also explored. Methods: Self-reported questionnaires and data from electronic medical records from 21 general practices in The Netherlands were combined in a sample of 5933 adult participants. Results: The majority of the participants reported increased worries about potential health effects from environmental exposures. The highest worry scores were reported by people who perceived themselves as more vulnerable to environmental stressors. After adjustment for socio-demographic characteristics and diagnosed psychiatric morbidity, higher MHW were significantly associated with increased self-reported prevalence and duration of NSPS, symptom-related healthcare utilization, GP-registered NSPS, alternative therapy consultations and lower sleep quality and quality of life. These associations were statistically mediated by perceived environmental sensitivity. No association was observed between worries and GP-registered medication prescriptions. Conclusion: Modern health worries are very common in the general population. They are associated with self-reported as well as clinically defined NSPS and as such might play a key role in the process of developing and maintaining environmental sensitivities and related symptoms. A large cross-cultural longitudinal study would help to determine important aspects such as temporal precedence and stability of MHW and the relevant psychosocial context within which symptomatic conditions occur.

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Section: Introductionmentioning

confidence: 94%

The relationship of modern health worries to non-specific physical symptoms and perceived environmental sensitivity: A study combining self-reported and general practice data

Baliatsas

Kamp

Hooiveld

et al. 2015

Journal of Psychosomatic Research

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“…It is thought a nocebo effect may play a role in the formation of other apparent side effects (Barsky, Saintfort, Rogers, & Borus, 2002). As well as medication side effects, nocebo effects have been implicated in symptoms attributed to technological exposures such as electro-magnetic fields (EMF) from mobile phones and Wi-Fi (Baliatsas et al, 2012; Rubin, Cleare, & Wessely, 2008). A nocebo effect is the experience of negative symptoms following exposure to an inert substance, which are triggered or exacerbated by psychological mechanisms such as expectations (Kennedy, 1961).…”

Section: Introductionmentioning

confidence: 99%

A systematic review of factors that contribute to nocebo effects.

Webster¹,

Weinman²,

Rubin³

2016

Health Psychology

128

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Objectives: Medication side effects are common, often leading to reduced quality of life, nonadherence and financial costs for health services. Many side effects are the result of a psychologically-mediated 'nocebo effect'. This review identifies the risk factors involved in the development of nocebo effects.Methods: Web of Science, Scopus, Medline, PsychINFO, Journals @ Ovid full text, and Global health were searched using the terms "nocebo" and "placebo effect". To be included, studies must have exposed people to an inert substance and have assessed one or more baseline or experimental factor(s) on its ability to predict symptom development in response to the inert exposure.Results: 89 studies were included, 70 used an experimental design and 19 used a prospective design, identifying 14 different categories of risk factor. The strongest predictors of nocebo effects were a higher perceived dose of exposure, explicit suggestions that the exposure triggers arousal or symptoms, observing people experiencing symptoms from the exposure, and higher expectations of symptoms.Conclusions: In order to reduce nocebo induced symptoms associated with medication or other interventions clinicians could: reduce expectations of symptoms, limit suggestions of symptoms, correct unrealistic dose perceptions, and reduce exposure to people experiencing side effects. There is some evidence that we should do this especially for persons with at-risk personality types, though exactly which personality types these are requires further research.These suggestions have a downside in terms of consent and paternalism, but there is scope to develop innovative ways to reduce nocebo effects without withholding information.Key words: nocebo effect, predictors, symptoms, inert exposure, review 3 Adverse drug reactions (ADRs) are common (Davies et al., 2009), and can have serious implications in terms of patient well-being and adherence (Ammassari et al., 2001) as well as significant financial costs for health services (Monguio, Otero, & Rovira, 2003; NICE, 2009). However, ADRs are not always related to the physiological action of the medication (Faasse & Petrie, 2013). Only 10.9% of reported ADRs to commonly prescribed drugs are clearly attributable to the medication (de Frutos Hernansanz et al., 1994). It is thought a nocebo effect may play a role in the formation of other apparent side effects (Barsky, Saintfort, Rogers, & Borus, 2002). As well as medication side effects, nocebo effects have been implicated in symptoms attributed to technological exposures such as electro-magnetic fields (EMF) from mobile phones and Wi-Fi (Baliatsas et al., 2012; Rubin, Cleare, & Wessely, 2008). A nocebo effect is the experience of negative symptoms following exposure to an inert substance, which are triggered or exacerbated by psychological mechanisms such as expectations (Kennedy, 1961). The name 'nocebo' was created to distinguish between the desirable ('placebo') and undesirable effects of an inert exposure (Hauser, Hansen, & Enck, 2012), alth...

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“…Recent reviews have concluded that a causal relationship between subjective health complaints and non-occupational exposure to RF-EMF cannot be adequately and consistently supported, either in experimental or in observational studies (Augner et al, 2012;Baliatsas et al, 2012;R€ o€ osli et al, 2010;Rubin et al, 2010). Only three studies in the past 20 years have investigated the association of NSPS and exposure to ELF MF for women, suggesting associations with subjective complaints (McMahan and Meyer, 1995) and self-reported sleep quality (Li et al, 2002).…”

Section: Introductionmentioning

confidence: 93%

“…This is the case for both extremely low frequency magnetic fields (ELF MF) and radiofrequency electromagnetic fields (RF EMF). In some cases this worry appears related to non-specific physical symptoms (NSPS) such as fatigue, headache, dizziness, sleep problems, heart palpitations and skin problems (Baliatsas et al, 2012;Schreier et al, 2006;WHO, 2005). However, it is less clear whether also the actual exposure to EMF is associated with NSPS.…”

Section: Introductionmentioning

confidence: 98%

Everyday exposure to power frequency magnetic fields and associations with non-specific physical symptoms

Bolte¹,

Baliatsas²,

Eikelboom³

et al. 2015

Environmental Pollution

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Non-specific physical symptoms and electromagnetic field exposure in the general population: Can we get more specific? A systematic review

Cited by 67 publications

References 70 publications

The relationship of modern health worries to non-specific physical symptoms and perceived environmental sensitivity: A study combining self-reported and general practice data

The relationship of modern health worries to non-specific physical symptoms and perceived environmental sensitivity: A study combining self-reported and general practice data

A systematic review of factors that contribute to nocebo effects.

Everyday exposure to power frequency magnetic fields and associations with non-specific physical symptoms

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