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					         INTERNATIONAL EMF PROJECT
       Workshop on Electrical Hypersensitivity
             Location: Prague, Czech Republic
 Monday 25 October & Tuesday 26 October 2004



Report to the IAC WHO meeting
                 June 13-14, 2005
                 Kjell Hansson Mild
           Nat l Inst Working Life
                    Umeå, Sweden
The WHO workshop on "Electrical hypersensitivity" in Prague,
Oct 25-26, 2004, over 150 participants. 18 invited talks, and
over 40 abstract were submitted, of which 14 were presented in
short oral presentations and another 15 presented as posters.
Speakers power point presentations can be found on the WHO
EMF project home page.
The third day working groups were organized:

       (i) Report on CHARACTERIZATION, DIAGNOSIS AND
       TREATMENT Rapporteur: Lena Hillert
       (ii) Report on RESEARCH NEEDS Rapporteur: N. Leitgeb

       (iii) Report on POLICY OPTIONS, COMMUNICATIONS
       WITH IEI INDIVIDUALS AND RECOMMENDATIONS TO
       NATIONAL AUTHORITIES Rapporteur: Jill Meara
Monday 25 October
09.00 Tutorial
- Characterizing EHS Prof B Stenberg
- Idiopathic Environmental Intolerance (IEI): a causation analysis Dr H Staudenmayer
10.30 EHS and the electromagnetic environment
- Prevalence of EHS in Populations of Different Countries Dr P Levallois
- Electromagnetic environment in EHS homes and workplaces Prof K Hansson Mild
11.30 Physiological Studies
- EMF Hypersensitivity and tissues generating electric current Dr J Bures
- Sensor reactivity and autonomic regulation in persons with perceived electrical hypersensitivity
Prof E Lyskov
14.00 Physiological Studies (cont'd)
- Electrohypersensitivity: Observations in the Human Skin of a Physical Impairment
Prof O Johansson
15.30 Provocation and Epidemiological Studies
- A review of EHS provocation and epidemiological studies Prof A Ahlbom
- Provocation study on subjects with self reported EHS: The NEMESIS Project Dr C Müller
- Provocation studies in electromagnetically hypersensitive persons Dr E David
           Tuesday 26 October
8.30 Upcoming Research
- Planned studies on EHS in the UK Prof L Challis
- Ongoing and planned EHS research Prof N Leitgeb
9.30 Clinical Studies / Treatment
- A Physician’s Approach to EMF Sensitive Patients Dr B Hocking
10.00 Coffee Break (Poster display in coffee area)
10.30 Clinical Studies / Treatment (cont'd)
- RF/ELF Human Studies in the UK Dr R Cox
- Cognitive therapy for patients who report electromagnetic hypersensitivity Dr L Hillert
- Discussion
AFTERNOON SESSION CHAIR: Dr E van Rongen
13.30 Discussion (short contributions from the floor)
14.30 Policy Options
- Review of current governmental responses Dr E van Deventer
- Possible policy options Dr J Meara
Characterizing EHS Prof B Stenberg
He has experience of over 350 patients.
Makes a distinction between two groups of patients in this area;
1.   those that experience facial skin symptoms in connection with work near a
     VDT display unit, has typically sensory sensation as stinging, itching,
     burning erythema, exzema, rosacea.
2.   those that besides skin symptoms also had general nervous system response
     when exposed to EMF from different electrical appliances, has the above
     symptom as well as fatigue, headache, sleep, dizziness, cardiac, cognitive.
Prognosis for group 1 is generally good and they improve over time and most
    can still be at work.
Group 2 with more general symptom have much in common with other
   environmental illnesses’ such as dental filling problems, MCS. The
   prognosis for this group is not as favourable as the other, and they do not
   generally heal over time as the VSS group.
Idiopathic Environmental Intolerance (IEI): a causation analysis
Dr H Staudenmayer
Argued that the name EHS would be changed to IEI. The term EHS is
misleading both in implying a causal relationship to EMF and the term
“hyper” has no medical support.
At a WHO meeting in 1996 in Berlin the IEI was defined as:
•An acquired disorder with multiple recurrent symptoms.
•Associated with diverse environmental factors tolerated by the majority of
people.
•Not explained by any know psychiatric or psychological disorder.
Sensor reactivity and autonomic regulation in persons with perceived
electrical hypersensitivity. Prof E Lyskov
Reported on neurophysiological studies on EHS patients. The patients had a
higher critical flicker frequency than normal, and the visual evoked potential,
VEP, was significantly higher than in controls, increased heart rate and decreased
HRV (heart rate variability), increased electrodermal reaction to sound stimuli.
Provocation 60 Hz, 10 T magnetic field had no effect on any of the
physiological parameters, in either group.
24 h ECG recording in EHS patients showed night time decrease in the ratio of
the low frequency/high frequency components of HRV, indicating an autonomic
imbalance and lack of normal circardian rhymes in EHS patients.
The findings of an hyperreactivity in the central nervous system and an
imbalance in the autonomic nervous system has been known under the name
vasoregulatory asthenia or neurocirculatory asthenia, and in the 50-ies and the
60-ies many patients were seeking for the same symptom as we now have in the
EHS groups, but today no one is coming to the clinical physiology departments
with these symptoms. Is EHS just another name for the neurocirculatory
asthenia?
Conclusions from the workshop

EHS is characterized by a variety of non-specific symptoms that differ
from individual to individual. The symptoms are certainly real and can
vary widely in their severity. For some individuals the symptoms can
change their lifestyle.

The term "Idiopathic Environmental Intolerance (IEI) with attribution
to EMF" was proposed by the working group to replace EHS since the
latter implies that a causal relationship has been established between
the reported symptoms and EMF.

The majority of studies indicate that IEI individuals cannot detect
EMF exposure any more accurately than non-IEI individuals. By and
large well controlled and conducted double-blind studies have shown
that symptoms do not seem to be correlated with EMF exposure.
  Recommendations for medical evaluation
Whatever its cause, IEI can be disabling for the affected individual. Treatment
should focus on the health symptoms and the clinical picture by performing:

• a medical evaluation to identify and treat any specific conditions that may be
responsible for the symptoms,

• an assessment of the workplace and home for factors that might contribute to the
presented symptoms. These could include indoor air pollution, excessive noise,
poor lighting (flickering light) or ergonomic factors. A reduction of stress and other
improvements in the work situation might be appropriate. EMF might be assessed
to ensure that levels of exposure meet existing standards and recommendations.

• a psychological evaluation to identify alternative psychiatric/psychological
conditions that may be responsible for the symptoms.

Some studies suggest that certain physiological responses of IEI individuals tend to
be outside the normal range. In particular, the findings of hyper reactivity in the
central nervous system and misbalance in the autonomic nervous system need to be
followed up in clinical investigations and the results for the individuals taken as
input for possible treatment.
   Research recommendations
Because EMF has not been established as a
causative factor for symptoms of IEI
individuals, the focus of research should be
on characterizing their physiological
responses.
Advice to national authorities

Governments should also note that IEI patients
have real symptoms, but that there is no
scientific evidence of causal link with EMF
exposure, and therefore no grounds to use IEI as
a diagnostic classification.

				
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