Evaluating alternative exposure indices in epidemiologic studies on extremely low-frequency magnetic fields

Choosing the right exposure index for epidemiological studies on 50–60 Hz magnetic fields is difficult due to the lack of knowledge about critical exposure parameters for the biological effects of magnetic fields. This paper uses data from a previously published epidemiological investigation on early pregnancy loss (EPL) to study the methods of evaluating the exposure-response relationship of 50 Hz magnetic fields. Two approaches were used. The first approach was to apply generalized additive modeling to suggest the functional form of the relationship between EPL and magnetic field strength. The second approach evaluated the goodness of fit of the EPL data with eight alternative exposure indices: the 24 h average of magnetic field strength, three indices measuring the proportion of time above specified thresholds, and four indices measuring the proportion of time within specified intensity windows. Because the original exposure data included only spot measurements, estimates for the selected exposure indices were calculated indirectly from the spot measurements using empirical nonlinear equations derived from 24 h recordings in 60 residences. The results did not support intensity windows, and a threshold-type dependence on field strength appeared to be more plausible than a linear relationship. In addition, the study produced data suggesting that spot measurements may be used as surrogates for other exposure indices besides the time average field strength. No final conclusions should be drawn from this study alone, but we hope that this exercise stimulates evaluation of alternative exposure indices in other planned and ongoing epidemiological studies. © 1996 Wiley-Liss, Inc.     

Effects of weak 16 3/2 Hz magnetic fields on growth parameters of young sunflower and wheat seedlings

Previous studies on effects of magnetic fields on plants focussed on the power frequencies (50-60 Hz), but in Austria and Germany electric railways are powered by a frequency of 16 2/3) Hz. In the present study, sunflower and wheat seedlings were exposed to 16 2/3 Hz sinusoidal 20 muT (rms) vertical magnetic fields. Seeds were germinated in a germination roll and grown for 12 days under continued exposure. Seven series with sunflower and six series with wheat were done over 2 years. Sunflower seedlings exposed to experimental magnetic field showed small, but significant increases in total fresh weights, shoot fresh weights, and root fresh weights, whereas dry weights and germination rates remained unaffected. Experimentally treated wheat exhibited marginally (but significantly) higher root fresh and dry weights, total fresh weights, and higher germination rates.     

The determinants of Canadian children's personal exposures to magnetic fields

Study of the health effects of magnetic fields often depends on identifying determinants and hence indicators of personal exposure. This study identified determinants of children's exposure to magnetic fields and constructed a prediction model for them. For 632 children participating in a case-control study of childhood leukemia, we made direct measures of exposure over 48 h using a portable device, together with observations on candidate determinants. A child's age and sex, the proportion of time spent in the home, and their parents' education or income were very weak predictors of (logged) mean 48 h magnetic field (R(2) < 1%). More important were province (R(2) = 8.0%) and type of residence (R(2) = 11.3%). Low temperatures at the time of measurement were associated with high fields (about 20% increase for each 10 degrees C below 14, R(2) = 4.9%). Several visible attributes of wiring around residences predicted exposure, mostly captured in the Wertheimer-Leeper wire code (R(2) = 13.5%). Stationary 24 h measurement in the bedroom (R(2) = 63.3%) and spot measurements outside the house (R(2) = 40.7%) predicted personal exposures best. Adding other minor predictors increased only slightly variance explained by 24 h stationary (R(2) = 66.2%) and spot (R(2) = 46.8%) measurements. Without spot or stationary measurements, the best model was much less powerful (R(2) = 29.0%). We conclude that spot measurements outside the residence provide a moderately effective basis for estimating exposure for children living there, but do not perform as well as 24 h stationary measurements in the child's bedroom. Although several other easily-observed variables were associated with personal exposure, they were weak determinants, either individually or in combination.     

Exposure assessment of ELF magnetic fields in urban environments in Extremadura (Spain)

We present the results of a study of the extremely low frequency (ELF) magnetic fields in urban environments of the Extremadura region (Spain). The study included a spectral analysis, an analysis of the temporal variation, and spot measurements in the streets of four cities. The spectral analysis showed that the main source of magnetic field exposure was that corresponding to the principal power frequency (50 Hz) and its third harmonic. The magnetic flux density measured at one point over 24 h presented rapid fluctuations in short time periods. Smoothing the time series eliminated these fluctuations, showing a temporal evolution associated with the differing levels of power consumption over the course of the day. The values of the spot measurements taken in the streets were all below the ICNIRP reference level, although 30% surpassed 0.2 microT, the value that some epidemiological studies take as the threshold above which there exist risks of effects that could be harmful to health. The values found for the magnetic flux density in these urban settings were generally greater than values reported in the literature for residential areas, and similar to, although in some cases less than those in workplace environments.     

Ambient 60-Hz magnetic flux density in an urban neighborhood

A residential neighborhood in Buffalo, NY, was surveyed with a magnetic field meter to evaluate whether or not spot measurements are reliable predictors of the 60-Hz fields at street corners and residences. The results of repeated measurements over 7 days at 33 street corners in this neighborhood indicate that day-to-day variation in power line magnetic fields is negligible (intraclass correlation coefficient = 0.94). Multivariate linear regression analysis of the data indicates that transmission lines and thick, three-phase primary wires near the field measurement site are strong predictors and account for the majority of the ambient magnetic field variance between locations (multiple correlation coefficient squared = 0.60; F ratio = 22.2, P less than .001). Magnetic fields measured at the front sidewalk were highly correlated with fields at the front doorsteps of 45 homes in this neighborhood (gamma = 0.81). These results suggest that ambient power line magnetic field levels at urban residences can be reliably characterized on a one-time site inspection using a hand-held magnetic field meter and a simple wiring classification system.     

Lack of a co-promotion effect of 60 Hz rotating magnetic fields on N-ethyl-N-nitrosourea induced neurogenic tumors in F344 rats

The present study was conducted to investigate the possible effect of 60 Hz magnetic fields as promoters of brain tumors initiated transplacentally by ethylnitrosourea (ENU) in F344 rats. One hundred twenty mated animals were divided into six different groups and exposed in utero on day 18 of gestation to a single intravenous dose of either Saline (vehicle control, Group I), or ENU 10 mg/kg (Groups II-VI). In the present study, a total of 480 offspring was used. The offspring in group II were given no further treatment while the offspring in Groups III-VI were exposed to four different intensities of magnetic fields. Animals received exposure to 60 Hz magnetic field at field strengths of 0 Tesla (sham control, T1, Group III), 5 muT (T2, Group IV), 83.3 muT (T3, Group V), or 500 muT (T4, Group VI), for 21 h/day from the age of 4 weeks to the age of 32 or 42 weeks. At histopathological examination, tumors of the nervous system were seen in all the ENU-treated groups. The tumor incidence of the ENU group at 32nd and 42nd week necropsy was higher than that of the vehicle control group. The incidence of glial tumors at 42nd week necropsy was higher than the 32nd week necropsy. However, there were no differences in the tumor incidence between the sham control (T1) and ENU + magnetic field exposure groups (T2-T4). In conclusion, there was no evidence that exposure of offspring to 60 Hz at magnetic field strengths up to 500 muT to the age of 32 or 42 weeks promoted ENU-initiated brain tumors in rats.     

Determinants of power-frequency magnetic fields in residences located away from overhead power lines.

The Wertheimer-Leeper wire code, originally developed as a surrogate for magnetic-field exposure, has been associated with childhood leukemia in several epidemiologic investigations. However, these and other studies indicate that most between-residence variability in measured magnetic fields remains unexplained by wire codes. To better understand this remaining variability, engineering and demographic data were examined for 333 underground (UG) and very-low current configuration (VLCC) single-family or duplex residences, selected from a database of nearly 1000 residences specifically because their magnetic fields are most likely affected negligibly by overhead power lines. Using linear regression techniques, four factors predictive of the log-transformed residential field were identified: the square-root of the 24-h average net service drop current (this current is equivalent to the current in the grounding system), the log of the number of service drops on the same secondary serving the residence, residence age (four categories), and area type (rural, suburban, or urban). Complete data on ground current and service drops, the two factors with the strongest individual relationships to measured fields, were available for only half of the residences in the sample. However, these data were determined to be "missing at random" according to established statistical criteria. The full-sample or "composite" models thus relied on a method similar to regression imputation, accounting for missing data with binary dummy variables. When applied to the samples from which they were derived, these models accounted for 25% of the variance of the log-spot-measured magnetic field values in the full sample, while models that considered only those residences with complete data (n = 167) explained about 35%. The model validated well against a sample of 201 ordinary low current configuration (OLCC) homes selected from the same database.     

Development of a protocol for assessing time-weighted-average exposures of young children to power-frequency magnetic fields

A study was carried out in 1990 to guide the development of a protocol for assessing residential exposures of children to time-weighted-average (TWA) power-frequency magnetic fields. The principal goal of this dosimetry study was to determine whether area (i.e., spot and/or 24 h) measurements of power-frequency magnetic fields in the residences and in the schools and daycare centers of 29 children (4 months through 8 years of age) could be used to predict their measured personal 24-h exposures. TWA personal exposures, measured with AMEX-3D meters worn by subjects, were approximately log-normally distributed with both residential and nonresidential geometric means of 0.10 μT (1.0 mG). Between-subjects variability in residential personal exposure levels (geometric standard deviation of 2.4) was substantially greater than that observed for nonresidential personal exposure levels (1.4). The correlation between log-transformed residential and total personal exposure levels was 0.97. Time-weighted averages of the magnetic fields measured in children's bedrooms, family rooms, living rooms, and kitchens were highly correlated with residential personal exposure levels (r = 0.90). In general, magnetic field levels measured in schools and daycare centers attended by subjects were smaller and less variable than measured residential fields and were only weakly correlated with measured nonresidential personal exposures. The final measurement protocol, which will be used in a large US study examining the relationship between childhood leukemia and exposure to magnetic fields, contains the following elements: normal- and low-power spot magnetic field measurements in bedrooms occupied by subjects during the 5 years prior to the date of diagnosis for cases or the corresponding date for controls; spot measurements under normal and low power-usage conditions at the centers of the kitchen and the family room; 24-h magnetic-field recordings near subjects' beds; and wire coding using the Wertheimer-Leeper method. © 1994 Wiley-Liss, Inc.

1 This article is a US Government work and, as such, is in the public domain in the United States of America.

     

Maternal exposure to magnetic fields from high-voltage power lines and the risk of birth defects

The issue of adverse human health effects due to exposure to electromagnetic fields is still unclear, and congenital anomalies are among the outcomes that have been inconsistently associated with such exposure. We conducted a population-based, case-control study to examine the risk of congenital anomalies associated with maternal exposure to magnetic fields (MF) from high-voltage power lines during pregnancy in a community in northern Italy. We identified 228 cases of congenital malformations diagnosed in live births, stillbirths, and induced abortions among women living in the municipality of Reggio Emilia during the period 1998-2006, and a reference group of healthy newborns was matched for year of birth, maternal age, and hospital of birth. We identified maternal residence during early pregnancy and used Geographic Information System to determine whether the residences were within geocoded corridors with MF ≥0.1 μT near high-voltage power lines, then calculated the relative risk (RR) of congenital anomalies associated with maternal exposure. One case and 5 control mothers were classified as exposed, and the RR associated with MF ≥0.1 μT was 0.2 (95% CI: 0.0-2.0) after adjusting for maternal education. While small or moderate effects may have gone undetected due to low statistical power, the results of this study overall do not provide support for major effects of a teratogenic risk due to exposure to MF during early pregnancy.     

Effects of extremely low-frequency magnetic fields on L-glutamic acid aqueous solutions at 20, 40, and 60 microT static magnetic fields

Current peaks have been observed and measured in electrolytic ionic current of L-glutamic acid aqueous solutions at room temperature, in static magnetic fields of 20, 40, and 60 muT flux densities, with a superimposed extremely low-frequency, (1/10) Hz, alternating magnetic field flux density of 40 nT. The distributions of the peaks have mean values centered at the cyclotron resonance frequency of the singly charged L-glutamic acid ion molecular mass in the corresponding static field. Amplitudes and widths of the peaks are compared and analyzed to extract their correlation. The results can be considered a contribution to the understanding of the experimental phenomenology in low-frequency electromagnetic fields on ionic currents of L-glutamic amino acid aqueous solutions. The results can be of interest in the studies on the interaction of the electromagnetic fields with some structural neurotransmitters in cellular medium.     

Residential magnetic and electric fields

A magnetic flux density (MFD) and electric-field (E-field) data-acquisition system was built for characterizing extremely low-frequency fields in residences. Every 2 min during 24-h periods, MFD and E-field measurements were made in 43 homes in King, Pierce, and Snohomish counties of Washington State. The total electrical energy used in each residence during the 24-h measurement period was also recorded, and maps were drawn to scale of the distribution wiring within 43 m (140 ft) of these homes. Finally, on a separate date, field measurements were made in each home during an epidemiological interview. The results of this study can be summarized as follows: 1) 24-h-average MFD measured at two separate points in the family room were correlated, as were a 24-h-average bedroom measurement and the mean of the two family-room measurements. 2) The 24-h-average family-room MFD and E-field measurements were uncorrelated. 3) The 24-h-average total harmonic distortions of family-room MFD and E-fields were less than about 24% and 7%, respectively. 4) Residential MFD exhibited a definite 24-h (diurnal) cycle. 5) The 24-h-average and interviewer-measured MFD were correlated. 6) Residential 24-h-average MFD were correlated with the wiring code developed by Wertheimer and Leeper. 7) An improved prediction of 24-h-average residential MFD was obtained using the total number of service drops, the distance to neighboring transmission lines, and the number of primary phase conductors.     

Residential exposure to magnetic fields generated by 110-400 kV power lines in Finland

In a specific case, the magnetic field generated in a building by a nearby power line is usually easy to calculate, although the accuracy of these calculations is sensitive to the quality of source information. To be able to study public health dimensions of magnetic field exposure (e.g., risk of cancer), it is necessary to evaluate the size and exposure of the population at risk. Relatively little quantitative information on public exposure to power-frequency magnetic fields of high-voltage power lines is available. This report describes residential exposure to magnetic fields from 110 kV, 220 kV, and 400 kV power lines in Finland at the national level, including 90% of the total line length in 1989. A geographical information system (GIS) was used to identify the buildings located near the power lines. After determining the distances between the lines and the buildings, historical data on load currents of these lines were used to calculate the magnetic fields. The residential magnetic field histories were then linked to the residents by means of a computerized central population register. The data obtained on personal exposure have also been utilized in a nationwide epidemiological study on magnetic field exposure of power lines and risk of cancer. The methods of exposure assessment and results of the number of buildings near 110 kV, 220 kV, and 400 kV power lines, their average annual magnetic fields, and personal exposure to magnetic fields from these lines are described. We found that 15,600 residents lived in an average residential magnetic field ≥0.1 μT caused by power lines in 1989. The number of these residents increased fivefold during 1970-1989. We estimated that 0.3% of the population was exposed in their residences to an annual average magnetic flux density from 110 kV, 220 kV, and 400 kV power lines higher than 0.1 μT, the level that the background magnetic flux density in general does not exceed in Finnish homes. Thus, the problem of magnetic field exposure generated by high-voltage lines concerns only a relatively small fraction of the total population in Finland. However, the size and exposure of the population at risk remain somewhat arbitrary in practical multisource situations, as the biological interaction mechanism, the concept of harmful dose, and, in particular, the significance of the duration of exposure are unknown. © 1995 Wiley-Liss, Inc.     

Use of wiring configuration and wiring codes for estimating externally generated electric and magnetic fields

The relative locations and characteristics of the distribution lines feeding 434 residences in the Denver metropolitan area were recorded and classified according to the Wertheimer-Leeper code (WL code) as a part of an epidemiological study of the incidence of childhood cancer. The WL code was found to place the mean values of the fields in rank order. However, the standard deviations were approximately the same size as the means. Theoretical calculations indicate that a significant fraction of the low-power magnetic fields can be generated by the distribution lines, especially in the cases where the distribution lines are within 50 feet of the residence. Thus, the wiring code was shown to be a useful method for making a first-order approximation to predict long-term, low-level magnetic fields in residences.     

Do ELF magnetic fields affect human reaction time?

Two double-blind studies were run in an attempt to confirm the finding that a 0.2 Hz magnetic field affects simple reaction time (RT) in humans, whereas a 0.1 Hz field does not. In the first experiment, 12 volunteer subjects were exposed to a continuous 0.2 Hz, 0.1 Hz, or sham field in a fully counter-balanced, within-subjects design. Subjects were run singly for one condition each day over 3 consecutive days with a field strength of 1.1 mT and a daily exposure duration of 5 min. Neither magnetic field had any effect on RT at any time during the exposure. One condition of a second study, using a new group of 24 volunteer subjects, also failed to find any field effects at 0.2 Hz. Additionally, the second study failed to show any effects when the frequency, flux density, and field orientation were set according to parametric resonance theory. It is suggested that, although ELF magnetic field effects on human behaviour may be elusive, future research can improve detection rates by paying greater attention to reducing error variance and increasing statistical power. © 1995 Wiley-Liss, Inc.     

Involvement of eddy currents in the mutagenicity of ELF magnetic fields

Possible carcinogenic and/or mutagenic activity of extremely low frequency magnetic fields was examined using somatic mutation and recombination test system of Drosophila melanogaster. An X-linked semi-dominant DNA repair defective mutation mei-41(D5) was introduced into the conventional mwh/flr test system to enhance mutant spot frequency. Virgin females of w mei-41(D5)/FM6; flr/TM6 were crossed with w mei-41(D5)/Y; mwh jv; spa(pol) males. The F(1) third instar larvae were exposed to a 50Hz, 20mT sinusoidal AC magnetic field for 24h. After moulting from pupal cases, their wings were examined under a bright field microscope to detect hair spots with mwh or flr mutant morphology. The exposure caused a statistically significant enhancement in somatic recombination spot frequency. Mutant spots arising due to chromosomal non-disjunction or terminal deletion also increased but the frequency of spots resulting from point mutation was not altered. The enhancement in the recombination spot frequency was suppressed to the control level when a culture medium without electrolytes was used during exposure. When larvae were exposed to a magnetic field in an annular dish, flies from the outer ring showed more mutant spots compared to those from the inner ring. These results suggest that the detected mutagenic activity was that of the induced eddy current, rather than that of the magnetic field itself.     

Relative contribution of residential and occupational magnetic field exposure over twenty-four hours among people living close to and far from a power line

This study sought to estimate the relative contribution of exposure to 50 Hz magnetic fields experienced at home, at work/school, or elsewhere to the total exposure over 24 hr. Personal exposure meters were carried by 97 adults and children in the Stockholm area. About half of the subjects lived close (<50 m) to a transmission line and half far (>100 m) away. Spot measurements and calculations for the residential exposure were also made. For subjects living<50 m from the line, the exposure at home contributed about 80% of the total magnetic field exposure, measured in mT-hours. Adults living far away experienced only 38% of the total exposure at home, but children still received 55%. Subjects with low time-weighted average (TWA) exposure both at home and at work spent 84% of their time in fields <0.1 microT, and those with high TWA at both locations spent 69% of their time in fields > or = 0.2 microT. This contrast was diluted if only exposure at one location was considered. For spot measurements and calculations of the residential exposure, both sensitivity and specificity was good. However, the intermediate field exposure category (0.1-0.19 microT) showed poor correlation to the 24 hr personal measurements.     

Influence of weak static and 50 Hz magnetic fields on the redox activity of cytochrome-C oxidase

The effects of static and 50 Hz magnetic fields on cytochrome-C oxidase activity were investigated in vitro by strictly controlled, simultaneous polarographic measurements of the enzyme's high- and low-affinity redox reaction. Cytochrome-C oxidase was isolated from beef heart. Control experiments were carried out in the ambient geomagnetic and 50 Hz magnetic fields at respective flux densities of 45 and 1.8 μT. The experimentally applied fields, static and time-varying, were generated by Helmholtz coils at flux densities between 50 μT and 100 mT. Exposures were timed to act either on the combined enzyme-substrate interchange or directly on the enzyme's electron and proton translo-cations. Significant changes as high as 90% of the overall cytochrome-C oxidase activity resulted during exposure (1) to a static magnetic field at 300 μT or 10 mT in the high-affinity range, and (2) to a 50 Hz magnetic field at 10 or 50 mT in the low-affinity range. No changes were observed at other flux densities. After exposure to a change-inducing, static or time-varying field, normal activity returned. © 1993 Wiley-Liss. Inc.     

Effects of 50 Hz magnetic fields on gap junctional intercellular communication.

To explore whether the extremely low frequency (ELF) electromagnetic fields (EMFs) may act as cancer promoters or be synergistic with 12-O-tetradecanoylphorbol-13-acetate (TPA) in cancer promotion, an experiment was conducted on the effects of 50 Hz magnetic fields (MFs) on gap junctional intercellular communication (GJIC) of Chinese hamster lung (CHL) cells. Lucifer dye was loaded into CHL cells by iontophoretic injection, and the number of dye-coupled cells (DCC) 5 min after the injection was adopted as the index of GJIC. The effects of TPA at different concentrations and magnetic fields at different intensities, combined with 5 ng/ml TPA, were studied. The results showed that the suppression of TPA on GJIC was dependent on TPA concentration; the threshold concentration of TPA for CHL cells was between 1 and 5 ng/ml. After exposure to 0.8 mT magnetic field for 24 h, the number of DCC decreased to 6.08 +/- 1.59, whereas the number of DCC in the control group was 9.84 +/- 2.27 (P < .05). When the cells were exposed at 0.2, 0.4, and 0.8 mT for 24 h, combined with 5 ng/ml TPA treatment during the last 1 h, the number of DCC decreased to 5.52 +/- 1.53, 5.00 +/- 1.22, and 4.00 +/- 1.29, respectively, which were significantly lower than the values for the group treated with 5 ng/ml TPA alone (6.38 +/- 1.39). It is suggested that certain intensities of 50 Hz magnetic field might act as cancer promoters, be additive with other promoters in cancer promotion, or both.     

Measurement of the individual exposure to 50 and 16 2/3 Hz magnetic fields within the Bavarian population.

This study investigates the individual magnetic field exposures at 16 2/3 and 50 Hz of 1952 people, selected from the Bavarian population. Personal flux density meters ("Field Watcher FW2A") were worn by the participants for 24 h. Every second, the flux density was recorded for both frequencies and for the three spatial axes (dynamic range per axis: several nT up to 100 microT at 50 Hz, 150 microT at 16 2/3 Hz). For 50 Hz fields, the mean of the 1,952 individual means was 0.101 microT and that of the individual medians was 0.047 microT. High level exposures occurred mainly during working hours. Only 2.4% of the subjects showed individual medians higher than 0.2 microT. About 53% of all volunteers were working on the day of recording. Levels for craftsmen (n = 148; mean individual mean: 0.166 microT) were generally higher than those for office workers (n = 624; mean individual mean: 0.107 microT). Flux densities exceeding 100 microT at 50 Hz were measured in 31 persons. The total time with such extreme exposures amounts to nearly 21 min, less than 0.001% of the total time for all measurements (5.3 years). To our knowledge, this is the first exposure study where 16 2/3 Hz magnetic fields (caused by electrified railways) have additionally been monitored over 24 h. For persons living next to railway lines, the mean individual mean (0.156 microT) and mean individual median (0.102 microT) were calculated. Over all, the mean exposures are only 0.1% of the magnetic flux density limit for 50 Hz (100 microT) and about 0.05% of the limit (300 microT) for 16 2/3 Hz recommended by the International Commission on Non-Ionizing Radiation Protection.     

Association of residential magnetic fields with contact voltage

The US National Electrical Code's (NEC) requirement to ground a home's electrical service to the residential water line results in a voltage between the water line and earth, V W-E. The voltage may result from ground return current that flows into the earth via the water line or from inductive effects from other sources of magnetic fields, such as transmission lines. This voltage can, in turn, serve as a source for Vbath, the voltage between the water fixtures and conductive drain pipes sunk into the earth beneath a residence. Vbath can be a source of contact current exposure to a child touching a water fixture while bathing. Previous research has suggested that exposure to these currents could be the basis for the association between power-frequency magnetic fields and childhood leukemia. In this study, we assessed the association between measured Vbath and VW-E with the average spot-measured magnetic field, Bavg, in a sample of 191 single-family residences in the Denver metropolitan area. This area was the source of cases and controls for previous studies of electric and magnetic field (EMF) and childhood cancer. The association of both Vbath and VW-E with Bavg had upward trends across magnetic field strata (<0.1 microT (reference); 0.1-<0.3 microT; and > or = 0.3 microT). In addition, VW-E was associated with Vbath. Without further study, these results cannot be applied to multi-dwelling residences or to electrical systems prevalent in other nations. Nonetheless, when combined with the finding that contact current is a far more plausible candidate than the residential magnetic field for mediating biological effects on the basis of comparative dose to bone marrow, these associations indicate that contact current exposure deserves further study.