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Wilén, J., Olsrud, J., Frankel, J. & Hansson Mild, K. (2020). Valid Exposure Protocols Needed in Magnetic Resonance Imaging Genotoxic Research [Letter to the editor]. Bioelectromagnetics, 41(3), 247-257
Open this publication in new window or tab >>Valid Exposure Protocols Needed in Magnetic Resonance Imaging Genotoxic Research
2020 (English)In: Bioelectromagnetics, ISSN 0197-8462, E-ISSN 1521-186X, Vol. 41, no 3, p. 247-257Article in journal, Letter (Refereed) Published
Abstract [en]

Several in vitro and in vivo studies have investigated if a magnetic resonance imaging (MRI) examination can cause DNA damage in human blood cells. However, the electromagnetic field (EMF) exposure that the cells received in the MR scanner was not sufficiently described. The first studies looking into this could be regarded as hypothesis-generating studies. However, for further exploration into the role of MRI exposure on DNA integrity, the exposure itself cannot be ignored. The lack of sufficient method descriptions makes the early experiments difficult, if not impossible, to repeat. The golden rule in all experimental work is that a study should be repeatable by someone with the right knowledge and equipment, and this is simply not the case with many of the recent studies on MRI and genotoxicity. Here we discuss what is lacking in previous studies, and how we think the next generation of in vitro and in vivo studies on MRI and genotoxicity should be performed. Bioelectromagnetics.

Place, publisher, year, edition, pages
WILEY, 2020
Keywords
DNA, magnetic field, pulse sequence, isocenter, genotoxicity
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-169358 (URN)10.1002/bem.22257 (DOI)000519338000008 ()32157722 (PubMedID)
Available from: 2020-04-07 Created: 2020-04-07 Last updated: 2020-04-07Bibliographically approved
Lowden, A., Nagai, R., Åkerstedt, T., Hansson Mild, K. & Hillert, L. (2019). Effects of evening exposure to electromagnetic fields emitted by 3G mobile phones on health and night sleep EEG architecture. Journal of Sleep Research, 28(4), Article ID e12813.
Open this publication in new window or tab >>Effects of evening exposure to electromagnetic fields emitted by 3G mobile phones on health and night sleep EEG architecture
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2019 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 28, no 4, article id e12813Article in journal (Refereed) Published
Abstract [en]

Studies on sleep after exposure to radiofrequency electromagnetic fields have shown mixed results. We investigated the effects of double-blind radiofrequency exposure to 1,930-1,990 MHz, UMTS 3G signalling standard, time-averaged 10 g specific absorption rate of 1.6 W kg(-1) on self-evaluated sleepiness and objective electroencephalogram architecture during sleep. Eighteen subjects aged 18-19 years underwent 3.0 hr of controlled exposure on two consecutive days 19:45-23:00 hours (including 15-min break); active or sham prior to sleep, followed by full-night 7.5 hr polysomnographic recordings in a sleep laboratory. In a cross-over design, the procedure was repeated a week later with the second condition. The results for sleep electroencephalogram architecture showed no change after radiofrequency exposure in sleep stages compared with sham, but power spectrum analyses showed a reduction of activity within the slow spindle range (11.0-12.75 Hz). No differences were found for self-evaluated health symptoms, performance on the Stroop colour word test during exposure or for sleep quality. These results confirm previous findings that radiofrequency post-exposure in the evening has very little influence on electroencephalogram architecture but possible on spindle range activity.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
mobile phone-related symptoms, performance, slow-wave sleep
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-161983 (URN)10.1111/jsr.12813 (DOI)000476602100007 ()30648318 (PubMedID)
Available from: 2019-08-14 Created: 2019-08-14 Last updated: 2020-03-10Bibliographically approved
Frankel, J., Hansson Mild, K., Olsrud, J. & Wilén, J. (2019). EMF exposure variation among MRI sequences from pediatric examination protocols. Bioelectromagnetics, 40(1), 3-15
Open this publication in new window or tab >>EMF exposure variation among MRI sequences from pediatric examination protocols
2019 (English)In: Bioelectromagnetics, ISSN 0197-8462, E-ISSN 1521-186X, Vol. 40, no 1, p. 3-15Article in journal (Refereed) Published
Abstract [en]

The magnetic resonance imaging (MRI) exposure environment is unique due to the mixture and intensity of magnetic fields involved. Current safety regulations are based on well-known acute effects of heating and neuroexcitation while the scientific grounds for possible long-term effects from MRI exposure are lacking. Epidemiological research requires careful exposure characterization, and as a first step toward improved exposure assessment we set out to characterize the MRI-patient exposure environment. Seven MRI sequences were run on a 3-Tesla scanner while the radiofrequency and gradient magnetic fields were measured inside the scanner bore. The sequences were compared in terms of 14 different exposure parameters. To study within-sequence variability, we varied sequence settings such as flip angle and slice thickness one at a time, to determine if they had any impact on exposure endpoints. There were significant differences between two or more sequences for all fourteen exposure parameters. Within-sequence differences were up to 60% of the corresponding between-sequence differences, and a 5-8 fold exposure increase was caused by variations in flip angle, slice spacing, and field of view. MRI exposure is therefore not only sequence-specific but also patient- and examination occurrence-specific, a complexity that requires careful consideration for an MRI exposure assessment in epidemiological studies to be meaningful. 

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
children, electromagnetic field, epidemiology, exposure assessment, radiofrequency
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-155086 (URN)10.1002/bem.22159 (DOI)000453860500001 ()30500987 (PubMedID)
Funder
Swedish Research Council, 521-2013-2702
Available from: 2019-01-10 Created: 2019-01-10 Last updated: 2019-01-10Bibliographically approved
Hansson Mild, K., Lundström, R. & Wilén, J. (2019). Non-Ionizing Radiation in Swedish Health CareExposure and Safety Aspects. International Journal of Environmental Research and Public Health, 16(7), Article ID 1186.
Open this publication in new window or tab >>Non-Ionizing Radiation in Swedish Health CareExposure and Safety Aspects
2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 7, article id 1186Article in journal (Refereed) Published
Abstract [en]

The main aim of the study was to identify and describe methods using non-ionizing radiation (NIR) such as electromagnetic fields (EMF) and optical radiation in Swedish health care. By examining anticipated exposure levels and by identifying possible health hazards we also aimed to recognize knowledge gaps in the field. NIR is mainly used in health care for diagnosis and therapy. Three applications were identified where acute effects cannot be ruled out: magnetic resonance imaging (MRI), transcranial magnetic stimulation (TMS) and electrosurgery. When using optical radiation, such as class 3 and 4 lasers for therapy or surgical procedures and ultra-violet light for therapy, acute effects such as unintentional burns, photo reactions, erythema and effects on the eyes need to be avoided. There is a need for more knowledge regarding long-term effects of MRI as well as on the combination of different NIR exposures. Based on literature and after consulting staff we conclude that the health care professionals' knowledge about the risks and safety measures should be improved and that there is a need for clear, evidence-based information from reliable sources, and it should be obvious to the user which source to address.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
NIR, health care, exposure, safety, EMF, MRI, TMS, UV, Laser
National Category
Occupational Health and Environmental Health Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-159074 (URN)10.3390/ijerph16071186 (DOI)000465595800099 ()30987016 (PubMedID)
Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2019-05-20Bibliographically approved
Frankel, J., Wilén, J. & Hansson Mild, K. (2018). Assessing exposures to Magnetic resonance imaging's complex Mixture of Magnetic Fields for In Vivo, In Vitro, and epidemiologic studies of Health effects for staff and Patients. Frontiers In Public Health, 6, Article ID 66.
Open this publication in new window or tab >>Assessing exposures to Magnetic resonance imaging's complex Mixture of Magnetic Fields for In Vivo, In Vitro, and epidemiologic studies of Health effects for staff and Patients
2018 (English)In: Frontiers In Public Health, ISSN 2296-2565, Vol. 6, article id 66Article in journal (Refereed) Published
Abstract [en]

A complex mixture of electromagnetic fields is used in magnetic resonance imaging (MRI): static, low-frequency, and radio frequency magnetic fields. Commonly, the static magnetic field ranges from one to three Tesla. The low-frequency field can reach several millitesla and with a time derivative of the order of some Tesla per second. The radiofrequency (RF) field has a magnitude in the microtesla range giving rise to specific absorption rate values of a few Watts per kilogram. Very little attention has been paid to the case where there is a combined exposure to several different fields at the same time. Some studies have shown genotoxic effects in cells after exposure to an MRI scan while others have not demonstrated any effects. A typical MRI exam includes muliple imaging sequences of varying length and intensity, to produce different types of images. Each sequence is designed with a particular purpose in mind, so one sequence can, for example, be optimized for clearly showing fat water contrast, while another is optimized for high-resolution detail. It is of the utmost importance that future experimental studies give a thorough description of the exposure they are using, and not just a statement such as "An ordinary MRI sequence was used." Even if the sequence is specified, it can differ substantially between manufacturers on, e.g., RF pulse height, width, and duty cycle. In the latest SCENIHR opinion, it is stated that there is very little information regarding the health effects of occupational exposure to MRI fields, and long-term prospective or retrospective cohort studies on workers are recommended as a high priority. They also state that MRI is increasingly used in pediatric diagnostic imaging, and a cohort study into the effects of MRI exposure on children is recommended as a high priority. For the exposure assessment in epidemiological studies, there is a clear difference between patients and staff and further work is needed on this. Studies that explore the possible differences between MRI scan sequences and compare them in terms of exposure level are warranted.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2018
Keywords
electromagnetic field, occupational exposure, switched gradient field, diagnostic imaging, asurement
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-147347 (URN)10.3389/fpubh.2018.00066 (DOI)000429555100001 ()29594090 (PubMedID)
Available from: 2018-05-11 Created: 2018-05-11 Last updated: 2018-06-09Bibliographically approved
Hansson Mild, K. & Greenebaum, B. (2018). Environmental and occupational DC and low frequency electromagnetic fields. (4ed.). In: Ben Greenebaum and Frank Barnes (Ed.), Bioengineering and Biophysical Aspects of Electromagnetic Fields, Fourth Edition: (pp. 55-72). Boca Raton: Taylor & Francis Group
Open this publication in new window or tab >>Environmental and occupational DC and low frequency electromagnetic fields.
2018 (English)In: Bioengineering and Biophysical Aspects of Electromagnetic Fields, Fourth Edition / [ed] Ben Greenebaum and Frank Barnes, Boca Raton: Taylor & Francis Group, 2018, 4, p. 55-72Chapter in book (Other academic)
Place, publisher, year, edition, pages
Boca Raton: Taylor & Francis Group, 2018 Edition: 4
Series
Handbook of Biological Effects of Electromagnetic Fields
National Category
Biophysics
Identifiers
urn:nbn:se:umu:diva-171049 (URN)9781138735309 (ISBN)
Available from: 2020-05-25 Created: 2020-05-25 Last updated: 2020-05-25
Wilén, J., Hansson Mild, K. & Lundström, R. (2018). Non-Ionising Radiation in Swedish Health Care. Stockholm: Strålsäkerhetsmyndigheten
Open this publication in new window or tab >>Non-Ionising Radiation in Swedish Health Care
2018 (English)Report (Other academic)
Abstract [sv]

Bakgrund

Inom sjukvården används alltmera teknik som exponerar patienter för icke-joniserande strålning vid diagnostik och terapi. Ofta används sådan teknik som ett alternativ till och ibland i kombination med metoder som exponerar för joniserande strålning.

Huvudsyftet med studien var att identifiera och beskriva hur icke-joniserande strålning används inom hälso- och sjukvård, samt att undersöka förväntade exponeringsnivåer, identifiera eventuella hälsorisker och identifiera kunskapsluckor inom området. Icke-joniserande strålning refererar här till icke-joniserande elektromagnetisk strålning med frekvenser från 0 Hz upp till 3,0 PHz, inkluderande elektromagnetiska fält, optisk strålning och mekaniska vågor såsom ultraljud.

SSM har saknat en samlad kunskap kring de metoder och exponeringsnivåer som använder icke-joniserande strålning inom sjukvården. Bland annat EU:s vetenskapliga råd SCENIHR (har numera bytt namn till SCHEER) har pekat på behovet av forskning om potentiella hälsoeffekter inom detta område. Studien var alltså viktig för att få ett underlag för att bedöma behovet av ytterligare säkerhetsåtgärder inom området, identifiera kunskapsluckor och också för att få ett bättre underlag för att besvara frågor angående säkerhet och eventuella risker.

Resultat

Inga hälsorisker eller allvarliga säkerhetsbrister har identifierats. Däremot är de exponeringsnivåer som används många gånger på en nivå där det finns en tydlig biologisk påverkan och ibland kan även akuta symtom upplevas, detta är dock ofta helt avsiktligt för att få önskad effekt och av övergående natur.

Författarna har identifierat ett behov av att förbättra hälsovårdspersonalens kunskap om risker och säkerhet vid användning av icke-joniserande strålning samt pekar på vikten av tydlighet när det gäller vilken organisation/myndighet som ska tillhandahålla sådan information.

Rapporten indikerar också att ett robust forskningsunderlag för närvarande saknas för att bedöma möjliga långsiktiga hälsorisker med användning av exempelvis MRI, TMS och ultraljud. Den kunskap och forskning som finns tillgänglig tyder dock inte på några betydande hälsorisker med nu aktuella exponeringsnivåer.

Relevans

Rapporten stöder Strålsäkerhetsmyndighetens tidigare uppfattning att de tillämpningar med icke-joniserande strålning som används i sjukvården inte utgör några kända hälsorisker. När metoder som bygger på icke-joniserande strålning ersätter metoder som bygger på joniserande strålning ökar patientsäkerheten, under förutsättning att syftet med undersökningen eller behandlingen uppnås.

Place, publisher, year, edition, pages
Stockholm: Strålsäkerhetsmyndigheten, 2018. p. 94
Series
SSM, ISSN 2000-0456 ; 2017:37
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-158401 (URN)
Projects
SSM 2016-498 / 7030054-00
Available from: 2019-04-26 Created: 2019-04-26 Last updated: 2019-04-26Bibliographically approved
Hansson Mild, K. & Møllerløkken, O. J. (2018). Occupational Exposure to Magnetic Field inTranscranial Magnetic Stimulation Treatment. In: Ustohal, Libor (Ed.), Transcranial Magnetic Stimulation in Neuropsychiatry: (pp. 143-149). IntechOpen
Open this publication in new window or tab >>Occupational Exposure to Magnetic Field inTranscranial Magnetic Stimulation Treatment
2018 (English)In: Transcranial Magnetic Stimulation in Neuropsychiatry / [ed] Ustohal, Libor, IntechOpen , 2018, p. 143-149Chapter in book (Refereed)
Abstract [en]

Transcranial magnetic stimulation (TMS) is used both as a diagnostic instrument and for therapy, available only at some psychiatric clinics for treatment of depression and at clinical neurophysiology where TMS is used for diagnosis of nerve damage. The Swedish National Board of Health and Welfare issued a referral edition about the use of repetitive TMS as an alternative treatment for depression. This may lead to a major increase in the application of TMS to treat depression. TMS is based on induction of an electric (E) field inside the brain by application of an external magnetic field with rapid rise and fall time. The E field in the brain has been calculated when different coils were used for the treatment. The reported E fields are of the order of tens to hundreds of volts per meter and the induced current density is estimated at tens of A/m2. This field can depolarize neurons or modulate cortical excitability by selecting the appropriate parameters for stimulation and the duration of the treatment session. The mechanisms of action of neurostimulation still remain incompletely understood.

Place, publisher, year, edition, pages
IntechOpen, 2018
Keywords
staff, EU directive, health risk, precautionary principle
National Category
Neurosciences
Identifiers
urn:nbn:se:umu:diva-158399 (URN)10.5772/intechopen.73224 (DOI)978-1-78923-651-4 (ISBN)978-1-78923-650-7 (ISBN)
Available from: 2019-04-26 Created: 2019-04-26 Last updated: 2019-04-26Bibliographically approved
Hansson Mild, K. & Mattsson, M.-O. (2017). Dose and exposure in bioelectromagnetics. In: Marko Markov (Ed.), Dosimetry in bioelectromagnetics: (pp. 101-117). Boca Raton: CRC Press
Open this publication in new window or tab >>Dose and exposure in bioelectromagnetics
2017 (English)In: Dosimetry in bioelectromagnetics / [ed] Marko Markov, Boca Raton: CRC Press , 2017, p. 101-117Chapter in book (Refereed)
Place, publisher, year, edition, pages
Boca Raton: CRC Press, 2017
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-147081 (URN)10.1201/9781315154572-6 (DOI)978-1-4987-7413-0 (ISBN)978-1-4987-7414-7 (ISBN)
Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-09-28Bibliographically approved
Mild, K. H., Friberg, S., Frankel, J. & Wilen, J. (2017). Exposure to the magnetic field from an induction loop pad for a hearing aid system. International Journal of Occupational Safety and Ergonomics, 23(1), 143-145
Open this publication in new window or tab >>Exposure to the magnetic field from an induction loop pad for a hearing aid system
2017 (English)In: International Journal of Occupational Safety and Ergonomics, ISSN 1080-3548, E-ISSN 2376-9130, Vol. 23, no 1, p. 143-145Article in journal (Refereed) Published
Abstract [en]

As a case study we have measured the magnetic field from an induction loop pad designed for hearing aid assistance. The magnitude of the field was high, although well below international guidelines. We recorded values up to 70% of the recommended standard in some instances. However, in view of the many reports indicating health effects of low-level exposure, we recommend that the precautionary principle is applied when such pads are given to people who might be especially vulnerable, such as children, pregnant women and women on breast cancer medication.

Keywords
hearing aid, cancer, reproduction, tamoxifen
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-132622 (URN)10.1080/10803548.2016.1226597 (DOI)000393712900016 ()
Available from: 2017-08-14 Created: 2017-08-14 Last updated: 2018-06-09Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7260-6819

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