What evidence do we have of the causal role of EMFs in EMFIS

Operators along with some scientists and physicians with strong financial bias to their objectivity are not well minded of the current scientific data. Most have no clinical experience of EMFIS patients and argue, on the basis of negative epidemiological studies and provocation tests, that there is little evidence and so no significant concern; or ven allege that EMFs have no effect on health. Hence the current thoughtless profit-driven rush into wireless technologies is supported by administrative and political authorities. The huge medical bills and suffering that we are already paying may explode, given the apparent scale of the phenomenon.

Negative epidemiologic and provocation findings are in fact very subjective. Negative EMF epidemiologic findings have no scientific value for three following reasons:

1 Because the data are usually provided by questionnaires insufficiently validated;

2 Because the interviews are most often by telephone, without a patient clinical examination nor an appropriate biologic investigation;

3 Because most often patients have severe cognitive impairment and thus may not correctly answer the questions so much more during interviews questions are mostly dealing with retrospective evaluation.

So despite all the precautions taken, these studies are affected by many biases. The example here is the Interphone study whose apparently negative results were greatly contested by many independent specialized researchers and scientists.

Moreover as underlined by the Paris Appeal, we stress that a negative epidemiological study by no means establishes no risk.

Similarly, the negative results obtained from provocation tests, as currently performed, have no scientific value, mainly for the following reasons:

1. Crucially, most of these tests used healthy volunteers, i.e. subjects with no EHS, likely to show no signs of intolerance at clinico-biologic levels when exposed to EMFs. Since EHS is associated with very strong emotions (see the reasons below) and with cognitive impairment with short-memory loss, subjects may answer wrong under stress effect induced by the experiment or the delayed occurrence of symptoms. By contrast the few provocation studies on EHS subjects showed most often positive results.
2. The tests are usually very short - often around 20 minutes! - and therefore do not consider the effects of chronic or multiple exposure over months or years.
3. The inconsistency of responses in case of "ghost" stimulationsimilarly has no value either.

Again, negative results do not enable to exclude the possibility of a causal link.

There are actually three main scientific questions which ARTAC and now ECERI studies attempt to answer; leading to three sets of questions raised:
• Are patients who claim to be EHS true patients ?

• Are electromagnetic fields really involved?

• What are the most frequently sources involved?

The answer is clearly yes. The fact that functional symptoms are qualified as" subjective" by skeptics, who state that these people are 'hypochondriacs or simulators’ is not an acceptable scientific argument. In fact it questions the very foundation of medicine, since all diseases or pathological disorders, including the organic ones that show functional symptoms, which by definition are subjective.

Indeed for patients claiming to be intolerant to EMF, the question is whether there are somatic objective detectable signs associated with functional symptoms. Here again, if patients are carefully clinically examined and investigated, the answer is obviously yes. Notably, this response cannot be given by those who claim EMF safety, because most of them have never examined EHS patients. At physical examination electro-hypersensitive patients may indeed show cutaneous lesions, especially on the face and hands (but also in other parts such as the chest), similar to a first degree "sunburn " or even, more rarely, a second degree burn. Most rashes are fleeting within a few days to several weeks, and disappear after weaning from electromagnetic sources. So it may be impossible for the physician to evidence such cutaneous lesions at the time of clinical examination. But photographs provided by the patient are usually sufficiently informative. Similarly "screen dermatitis" syndrome has been described and proved to be causally related to exposure to cathode-ray computer monitors. More rarely, skin lesions are pruriginous suggesting a possible local cutaneous histamine release.

Patients may also exhibit joint stiffness and/ or deformities of fingers which do not evoke rheumatoid arthritis nor osteoarthritis symptoms. Also, in our series, approximately 5-10 % of patients had troubled equilibrium while waking. At clinical examination, several of them were found to exhibit a Romberg sign at eye occlusion, suggesting involvement of the deep sensitivity network.

Overall one could argue that physical symptoms are also not specific clinically. In fact the stereotypical clinical picture that results from physical symptom’s association with functional symptoms makes EMFIS easily recognized and diagnosed clinically, however without proving that they are causally related to EMF. We emphasized that the observed symptoms obviously demonstrate that EMFIS patients are true patients.
Moreover various medical imaging and laboratory techniques that were developed in our laboratory provide definitive proof that EMFIS is a true new somatic clinico-biologic pathological entity. We found the following objective biologic abnormalities:

1. At cerebral Doppler, patients  show a general blood hypo-perfusion (exceptions are very rare) in one cerebral hemisphere, more frequently the right one, sometimes both; more particularly in one or both temporal lobes, more precisely in the areas corresponding to the limbic system and / or the thalamus.
2. Many patients have a minimal vitamin D blood level.
3. Approximately 40% of the patients have high histamine circulating blood levels.
4. In nearly half of patients high levels of anti- Hsp70, anti- Hsp27 and / or anti -O- myelin antibodies are detected in the blood, suggesting that EMFIS, perhaps at a certain stage may be associated with an autoimmune disorder, a finding which has been recently featured in published experimental studies.
5. Approximately 15 % of the patients exhibit a high blood level of the S100B protein, which according to the recent scientific literature may reflect brain hypoxia and/or opening of the blood-brain barrier.
6. Almost 15% have a rise in blood nitro-tyrosamine - a marker of oxidative stress - a finding which suggests, again recently reported in the scientific literature, opening of the BBB patients exhibit a deficit in their antioxidant defenses.
7. And nearly a third of the patients have  24-hour urinary melatonin decreased rate while unexpectedly another third of have significantly increased 24-hour urinary melatonin excretion.

In sum, these various biochemistry abnormalities show objectively that EMFIS patients are real patients, and so EMFIS should be recognized nosologically as a new pathological disorder.

Although the absolute scientific proof hasn’t been found yet, diverse lines of evidence strongly suggest that EMFIS is caused by EMF exposure and that it evolves progressively towards a state of EHS. The arguments are as follows:

1 Appearance and disappearance of clinical and biologic signs according to EMF exposure.

In the ARTAC series, all the patients diagnosed as suffering from EMFIS clearly reported that their clinical symptoms do appear when they are in the presence of EMFs (whatever the source) but regress, even disappear when they get away from EMFs, especially when staying in so-called “white zones”, i.e. in zones devoid of any EMFs. This observation was unanimously among the patients of our series who were clinically and biologically diagnosed as suffering from EMFIS, and their claim cannot be questioned as they provided verifiable examples. Moreover we were able to show the existence of a correlation between the presence or absence of exposure to EMFs and the results obtained from biochemistry and echodoppler tests in many patients. Indeed normalization of echodoppler and biochemistry tests did occur after the patients stayed in “white zone”, and altered again when patients were re-exposed to EMFs. This dose-response relationship is a strong argument for causation, and an essential criterion for EMFIS diagnosis.

2 Clinical symptom association

The association of symptoms described above is largely identical from one patient to the next (stereotypical symptoms). Furthermore, the clinical picture does not match to any other known diseases, except MCS, making EMFIS a new pathological disorder. Given the most often sporadic (non-hereditary) nature of the disorder, scientific research should be primarily devoted to the search of environmental factors; and, on the basis of previous findings, electromagnetic track should be first to be investigated. In our series of patients so far diagnosed as suffering from EMFIS (including extensive histories) we have never found an environmental cause other than EMFs that could account for EMFIS occurrence.

3. Patho-physiologic mechanisms.

Results of biologic and imaging tests are key elements for the diagnosis of EMFIS. Arguments are the following:

3.1 In order to search for other pathology, all patients in our series underwent a systematic assessment based on a battery of classical imaging investigations : brain scan and/or MRI, carotid and vertebral artery ultrasound scan, and in some cases, electroencephalogram and / or brain scintigraphy, more rarely angiograph scans. Patients also underwent a battery of blood and urine tests looking for an infectious, microbial / viral, or metabolic causes or markers of their symptoms. In addition, when needed, some of these patients benefited from psychological or psychiatric expertise.

It is noteworthy that all the patients in whom EMFs were considered as a potential cause of EMFIS were entirely normal when considering the above mentioned classical medical imaging investigations and common biologic tests. This means that all the patients in our series presumed to be intolerant to EMF, and even already being EHS showed no other known pathologic disorder likely to explain their clinico-biologic symptoms.

3.2 Moreover the biologic abnormalities we did find in patients with EMFIS : hyper-histaminemia, S100B protein increase, anti- Hsp 27, anti- Hsp 70 and anti-O myelin auto-antibodies increase, 24h-urinary melatonin perturbation) are consistent with the biologic mechanisms and effects of EMF, usually observed in animal or in ex vivo models.

3.3 In patients claiming to be EHS and who were clinically and biologically confirmed to bear a true somatic disorder, cerebral hypo-perfusion, were also evidenced to change according to EMF exposure: tests normalized (after several weeks) when patients took advise to stay away from EMFs, in particular when they ceased to be exposed at their workplace or changed their living place; while these tests confirmed a reversion to pathologic EHS upon re-exposure to EMFs.

3.4 Provocation tests in EHS patients considered to be EHS also confirmed EMF as a potential cause: when they recently come from a white zone, patients were free of many clinical symptoms at the time of the test. We therefore have shown that exposure to calibrated EMFs (either RF, microwave, or low or extremely low frequencies) could trigger some of the clinic symptoms usually observed in suffering patients as well as a modification of several of their biologic parameters. Although our convenience sample results must be considered as preliminary, we hypothesize that provocation tests in EHS patients, unlike results in healthy volunteers, could give largely positive results favoring a direct effects of EMFs, confirming also some results observed in animals; therefore standardized provocation tests could be used in the future as diagnostic tool in cases for which the diagnosis of EMFIS might be not clinically and biologically be evident.

3.5 In sum, the above clinico-biologic data argue in favor of a causal effect of EMFs, because of their consistency, robustness and (in some tests) reverse causation confirmation; and because of the plausible patho-physiologic mechanisms they can offer.

Preliminary analysis of our series of EMFIS patients indicates that the following are causally involved in EMFIS occurrence:

4.1.In about half of the patients the use of a mobile phone, GSM or cordless phone, over one hour or more per day for several years. This may concern particularly the use of mobiles characterized by a high Specific Absorption Rate (SAR), indicating strong EMF fields.

4.2. About 20-30% of people use a computer over 8 hours per day, including some who may be genetically susceptible. In this case, the use of CRT screens (TVs, computers) and WiFi (or WiMax) may promote significantly the genesis of the pathological disorder and its evolution towards EHS.

4.3. 5-10% of people appeared to have prolonged exposure (several years or more) to EMFs emitted by an electric transformer, a high voltage power line, or military radars.

4.4. No more than 10% of people have a prolonged exposure to EMFs emitted by a multiple antennas mast (mobile telephony, television) or by wind turbine.

This analysis may appear different from that experienced by patients claiming to be EHS, including non-ascertained claims from certain patient associations, who believe that the role of antennas in causing EHS is much higher.

But we should note that EMFIS-inducing causes and more particularly EHS-inducing causes should be distinguished from the consequences of EHS itself, i.e. when EMFIS patients have evolved to intolerance to very low EMF intensity, a characteristic of EHS.

So, the effect of antenna as an inducing cause of EHS should be clearly distinguished since at that time patients are highly sensitive to any form of electromagnetic sources, whatever the electromagnetic source which has caused the hypersensitivity, from its consequence once the electro-hypersensitivity is installed.

Indeed, once people have become EHS, they show intolerance to all kinds of electromagnetic sources and for very low EMF intensities, thus surrounded by innumerable EMF sources, including antennas whatever their power. We believe this explains why in our study, the antenna-associated EMF intolerance was found to be more frequently associated with EHS as a consequence, but more rarely as a cause involved in the genesis of EHS.

This clearly means in terms of public health, that the causes of EMF intolerance and EHS are mainly due to individual exposure to mobile or cordless phones and computers; and collectively to the ubiquity of Wifi and Wimax.

These data have therefore several public health implications: they stress the need for a reduction of the excessive use of wireless telephony - a medical and societo-political priority.

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