Effects of radiofrequency electromagnetic field exposure on sleep quality

The use of wireless communication devices, which emit radiofrequency electromagnetic fields (RF-EMF), has increased in the past decades. According to the World Health Organization (WHO) mobile phone use is ubiquitous with an estimated 4.6 billion subscriptions globally. The missing knowledge about a biological mechanism and the attribution of non-specific symptoms of ill health to RF-EMF has led to an increased public concern about possible adverse health effects from this radiation. One of the most often reported symptoms due to RF-EMF exposure are sleep disturbances. In several randomised double-blind human laboratory studies, changes in the sleep electroencephalogram (EEG) after exposure to RF-EMF were observed. The impact of these small changes on sleep quality and therefore on general well-being is unclear. Previous epidemiological studies have used a cross-sectional design, which is not appropriate for establishing causal relationships between exposure and outcome. Studies with a cohort design are therefore needed. Additionally, exposure assessment was mostly inadequate or only parts of the real exposure situation were taken into account. Personal measurement devices (exposimeters) have become available a few years age. In large epidemiological studies, it is very time-consuming and costly to use such devices. Other exposure assessment methods are therefore needed.
The main aim of this thesis was to investigate the association between personal RF-EMF exposure and sleep quality by using objective as well as subjective data. To predict personal exposure to RF-EMF a comprehensive exposure assessment method was applied. This thesis was part of the QUALIFEX project (a prospective cohort study on radiofrequency electromagnetic field exposure and health related quality of life) which is embedded in the National Research Program 57 (NRP-57) about non-ionising radiation.
The health effect of RF-EMF exposure was investigated in a cohort study which consisted of a baseline survey in May 2008 and a follow-up survey one year later. Questionnaires entitled „Environment and Health“ were sent out to 1375 randomly selected study participants in the region of Basel (Switzerland). Information on sleep quality, on exposure relevant factors and on various confounding factors was collected. By means of a pre-study, which was not part of this thesis, a comprehensive exposure assessment method was developed. To predict personal exposure to far-field RF-EMF (e.g mobile phone base stations or radio transmitters), a validated full exposure prediction model was used which was developed based personal exposure measurements of 166 study participants who took part in a pre-study. Exposure to close to body sources was assessed using self-reported data on mobile phone and cordless phone use. Objective data of mobile phone use from network operators for participants who gave informed consent were additionally collected. For a nested sleep study, 120 participants out of the baseline survey took part in a nested sleep study to verify our previous results. Sleep quality and sleep behavior was assessed using actigraphy and exposure to RF-EMF was measured by means of personal exposimeters.
For the baseline survey, mean calculated RF-EMF exposure to all relevant sources of all 1375 study participants was 0.12 mW/m2 (0.21 V/m). Exposure at the follow-up survey was 0.13 mW/m2 (0.22 V/m) and therefore comparable with the baseline exposure. No consistent association between RF-EMF exposure and self-reported sleep quality neither in the baseline analysis (cross-sectional analysis) nor in the cohort analysis (longitudinal analysis) was observed. In the nested sleep study, objective data on exposure and sleep quality did not yield any association between exposure and sleep quality.
The QUALIFEX project was the first study which applied a cohort design to investigate the association between RF-EMF exposure and sleep quality. Additionally, we were able to verify our results of the cohort study with objective data obtained in a nested sleep study. Overall, we found no consistent association between self-reported as well as objectively measured sleep quality and exposure to relevant RF-EMF sources in everyday life. Our results increase the evidence for a true absence of an effect of RF-EMF exposure on sleep quality. Our study used a very comprehensive exposure assessment method which included far-field sources as well as close to body sources. In general, exposure levels were very small and changes between the baseline and the follow-up survey were marginal. Hence, with our study no conclusions can be drawn regarding potential health effects of higher exposure levels. In future studies, more data on long-term effects have to be collected. Additionally, the exposure situation in everyday life should be monitored because new technologies operating with RF-EMF are continuously arising.