Indoor transformer stations as predictors of residential ELF magnetic field exposure

Transformer stations in apartment buildings may offer a possibility to conduct epidemiological studies that involve high exposure to extremely low frequency magnetic fields (MF), avoid selection bias and minimize confounding factors. To validate exposure assessment based on transformer stations, measurements were performed in thirty buildings in three Finnish cities. In each building, spot measurements in all rooms and a 24-h recording in a bedroom were performed in one apartment above a transformer station (AAT), in one first floor (FF) reference apartment, and one reference apartment on upper floors (UF). The apartment mean of spot measurements was 0.62 microT in the AATs, 0.21 microT in the FF and 0.11 microT in the UF reference apartments The 24-h apartment mean (estimated from the spot measurements and the bedroom 24-h recording) was 0.2 microT or higher in 29 (97%) AATs, in 7 (25%) FF and in 3 (10 %) UF reference apartments. The corresponding numbers for the 0.4 microT cut-off point were 19 (63%), 4 (14%), and 1 (3.3%). The higher MF level in the FF reference apartments indicates that they should not be considered "unexposed" in epidemiological studies. If such apartments are excluded, a transformer station under the floor predicts 24-h apartment mean MF with a sensitivity of 0.41 (or 0.58) and a specificity of 0.997 (or 0.97), depending on the MF cut-off point (0.2 or 0.4 microT). The results indicate that apartments can be reliably classified as high and low MF field categories based on the known location of transformer stations.     

Survey of residential 50 Hz EMF exposure from transformer stations

In Hungary it is typical that 10/04 kV transformer stations are being installed in multistory residential and office buildings. Magnetic fields (MFs) up to several tens of microT have been measured in apartments close to transformers. The aim of the present study was to provide systematic assessment of MF exposure of residents living above transformer stations. Out of 41 addresses provided by the electricity supplier, current load of 21 transformers and MF in 21 apartments was measured. Spot MFs at 1 m height and time weighted average 24 h MF exposure at bed height was measured. All-day personal MF exposure was measured at waist and HOME exposure was calculated. BED exposure was measured at bed height. Participants kept a time-activity diary. The time-weighted average 24 h MF exposure (3.03 microT) exceeded the usual residential exposure (<0.2 microT). The mean HOME and BED personal exposure above transformers was 0.825 and 1.033 microT, respectively. Our study provides exposure assessment of a cohort with a wider exposure range, compared to power-line epidemiological studies.     

Occupational exposure to magnetic fields from transformer stations and electric enclosures in Turkey

We aimed to provide a systematic evaluation of magnetic field (MF) exposure of staff working in the offices located above or close to transformer stations (TS) and electric enclosures (EE). Occupational short-term “spot” measurements with Narda EFA-300 and isotropic magnetic field probe were carried out in two National Banks and one Industrial Company having more than 500 employees. Extremely low-frequency (ELF) MFs up to several tens of μT were measured in the mentioned working environments. 25% of the measured MFs were found less than 0.3 μT, the background exposure level that staff receive at home, 75% were above 0.3 μT with the highest value of 6.8 μT. The mean and median personal exposures were calculated to be 1.19 μT and 0.56 μT, respectively. Most of the staff (83%) is under risk based on epidemiological studies that reported a statistically significant association between risk of leukemia and averaged magnetic fields of 0.2 μT or over. Results showed that risk evaluation should be considered to minimize the possibility of the workers being harmed due to exposure to work-related electromagnetic sources.     

Extremely low-frequency magnetic fields of transformers and possible biological and health effects

Physiological processes in organisms can be influenced by extremely low-frequency (ELF) electromagnetic energy. Biological effect studies have great importance; as well as measurement studies since they provide information on the real exposure situations. In this study, the leakage magnetic fields around a transformer were measured in an apartment building in Küçükçekmece, Istanbul, and the measurement results were evaluated with respect to the international exposure standards. The transformer station was on the bottom floor of a three-floor building. It was found that people living and working in the building were exposed to ELF magnetic fields higher than the threshold magnetic field value of the International Agency for Research on Cancer (IARC). Many people living in this building reported health complaints such as immunological problems of their children. There were child-workers working in the textile factories located in the building. Safe distances or areas for these people should be recommended. Protective measures could be implemented to minimize these exposures. Further residential exposure studies are needed to demonstrate the exposure levels of ELF magnetic fields. Precautions should, therefore, be taken either to reduce leakage or minimize the exposed fields. Shielding techniques should be used to minimize the leakage magnetic fields in such cases.     

Characterization of Levels of Extremely Low Frequency Magnetic Fields Emitted From Portable Hand‐Held Fans

This study aims to assess the levels of extremely low frequency magnetic fields (ELF‐MF) emitted from portable hand‐held fans (HHFs) and their principal frequency and to identify factors influencing these levels. We collected a total of eleven models of HHF and monitored the ELF‐MF as a function of fan speed and distance from the fan. EMDEX II was used to monitor the ELF‐MF. An SMP2 EMF‐meter equipped with a P400 field probe was used to determine the levels of ELF‐MF and the frequency spectrum. Ten of the fans, excluding only one bladeless‐fan model, emitted a high level of ELF‐MF near the source of the HHF direct‐current motor. The maximum measured level of ELF‐MF ranged from 14.07 to 218.7 µT. All measurements of the ELF‐MF taken within 10 cm from the HHFs showed values higher than 1.0 µT. ELF‐MF levels were found to decrease markedly with distance, regardless of the HHF product. The level of ELF‐MF rose noticeably with increased fan speed. The speed of and distance from the HHF significantly influenced the level of ELF‐MF. All principal frequencies ranged from 1 to 300 Hz, which falls in the typical range of ELF. Bioelectromagnetics. 2019;40:569–577. © 2019 Bioelectromagnetics Society.     

Occupational exposure to magnetic fields from transformer stations and electric enclosures in Turkey

We aimed to provide a systematic evaluation of magnetic field (MF) exposure of staff working in the offices located above or close to transformer stations (TS) and electric enclosures (EE). Occupational short-term "spot" measurements with Narda EFA-300 and isotropic magnetic field probe were carried out in two National Banks and one Industrial Company having more than 500 employees. Extremely low-frequency (ELF) MFs up to several tens of μT were measured in the mentioned working environments. 25% of the measured MFs were found less than 0.3?μT, the background exposure level that staff receive at home, 75% were above 0.3?μT with the highest value of 6.8?μT. The mean and median personal exposures were calculated to be 1.19?μT and 0.56?μT, respectively. Most of the staff (83%) is under risk based on epidemiological studies that reported a statistically significant association between risk of leukemia and averaged magnetic fields of 0.2?μT or over. Results showed that risk evaluation should be considered to minimize the possibility of the workers being harmed due to exposure to work-related electromagnetic sources.     

Chronic exposure to an extremely low‐frequency magnetic field induces depression‐like behavior and corticosterone secretion without enhancement of the hypothalamic–pituitary–adrenal axis in mice

An extremely low‐frequency magnetic field (ELF‐MF) is generated by power lines and household electrical devices. Many studies have suggested an association between chronic ELF‐MF exposure and anxiety and/or depression. The mechanism of these effects is assumed to be a stress response induced by ELF‐MF exposure. However, this mechanism remains controversial. In the present study, we investigated whether chronic ELF‐MF exposure (intensity, 3 mT; total exposure, 200 h) affected emotional behavior and corticosterone synthesis in mice. ELF‐MF‐treated mice showed a significant increase in total immobility time in a forced swim test and showed latency to enter the light box in a light–dark transition test, compared with sham‐treated (control) mice. Corticosterone secretion was significantly high in the ELF‐MF‐exposed mice; however, no changes were observed in the amount of the adrenocorticotropic hormone and the expression of genes related to stress response. Quantification of the mRNA levels of adrenal corticosteroid synthesis enzymes revealed a significant reduction in Cyp17a1 mRNA in the ELF‐MF‐exposed mice. Our findings suggest the possibility that high intensity and chronic exposure to ELF‐MF induces an increase in corticosterone secretion, along with depression‐ and/or anxiety‐like behavior, without enhancement of the hypothalamic–pituitary–adrenal axis. Bioelectromagnetics 34:43–51, 2013. © 2012 Wiley Periodicals, Inc.     

Sinusoidal ELF magnetic fields affect acetylcholinesterase activity in cerebellum synaptosomal membranes

The effects of extremely low frequency magnetic fields (ELF‐MF) on acetylcholinesterase (AChE) activity of synaptosomal membranes were investigated. Sinusoidal fields with 50 Hz frequency and different amplitudes caused AChE activity to decrease about 27% with a threshold of about 0.74 mT. The decrease in enzymatic activity was independent of the time of permanence in the field and was completely reversible. Identical results were obtained with exposure to static MF of the same amplitudes. Moreover, the inhibitory effects on enzymatic activity are spread over frequency windows with different maximal values at 60, 200, 350, and 475 Hz. When synaptosomal membranes were solubilized with Triton, ELF‐MF did not affect AChE activity, suggesting the crucial role of the membrane, as well as the lipid linkage of the enzyme, in determining the conditions for inactivation. The results are discussed in order to give an interpretation at molecular level of the macroscopic effects produced by ELF‐MF on biological systems, in particular the alterations of embryo development in many organisms due to acetylcholine accumulation. Bioelectromagnetics 31:270–276, 2010. © 2009 Wiley‐Liss, Inc.     

Melatonin Levels and Low‐Frequency Magnetic Fields in Humans and Rats: New Insights From a Bayesian Logistic Regression

The present analysis revisits the impact of extremely low‐frequency magnetic fields (ELF‐MF) on melatonin (MLT) levels in human and rat subjects using both a parametric and non‐parametric approach. In this analysis, we use 62 studies from review articles. The parametric approach consists of a Bayesian logistic regression (LR) analysis and the non‐parametric approach consists of a Support Vector analysis, both of which are robust against spurious/false results. Both approaches reveal a unique well‐ordered pattern, and show that human and rat studies are consistent with each other once the MF strength is restricted to cover the same range (with B ? 50 μT). In addition, the data reveal that chronic exposure (longer than ～22 days) to ELF‐MF appears to decrease MLT levels only when the MF strength is below a threshold of ~30 μT (), i.e., when the man‐made ELF‐MF intensity is below that of the static geomagnetic field. Studies reporting an association between ELF‐MF and changes to MLT levels and the opposite (no association with ELF‐MF) can be reconciled under a single framework. Bioelectromagnetics. 2019;40:539–552. © 2019 Bioelectromagnetics Society.     

Combined effects of 60 Hz electromagnetic field exposure with various stress factors on cellular transformation in NIH3T3 cells

Epidemiological studies have suggested that extremely low‐frequency magnetic fields (ELF‐MF) are associated with an increased incidence of cancer. Studies using in vitro systems have reported mixed results for the effects of ELF‐MF alone, and the World Health Organization (WHO) Research Agenda published in 2007 suggested that high priority research should include an evaluation of the co‐carcinogenic effects of ELF‐MF exposure using in vitro models. Here, the carcinogenic potential of ELF‐MF exposure alone and in combination with various stress factors was investigated in NIH3T3 mouse fibroblasts using an in vitro cellular transformation assay. NIH3T3 cells were exposed to a 60 Hz ELF‐MF (1 mT) alone or in combination with ionizing radiation (IR), hydrogen peroxide (H₂O₂), or c‐Myc overexpression, and the resulting number of anchorage‐independent colonies was counted. A 4 h exposure of NIH3T3 cells to ELF‐MF alone produced no cell transformation. Moreover, ELF exposure did not influence the transformation activity of IR, H₂O₂, or activated c‐Myc in our in vitro assay system, suggesting that 1 mT ELF‐MF did not affect any additive or synergistic transformation activities in combination with stress factors such as IR, H₂O₂, or activated c‐Myc in NIH3T3 cells. Bioelectromagnetics 33:207–214, 2012. © 2011 Wiley Periodicals, Inc.     

Survey of electromagnetic field exposure in bedrooms of residences in lower Austria

Previous investigations of exposure to electric, magnetic, or electromagnetic fields (EMF) in households were either about electricity supply EMFs or radio frequency EMFs (RF‐EMFs). We report results from spot measurements at the bedside that comprise electrostatic fields, extremely low‐frequency electric fields (ELF‐EFs), extremely low‐frequency magnetic fields (ELF‐MFs), and RF‐EMFs. Measurements were taken in 226 households throughout Lower Austria. In addition, effects of simple reduction measures (e.g., removal of clock radios or increasing their distance from the bed, turning off Digital Enhanced Cordless Telecommunication (DECT) telephone base stations) were assessed. All measurements were well below International Commission on Non‐Ionizing Radiation Protection (ICNIRP) guideline levels. Average night‐time ELF‐MFs (long‐term measurement from 10 pm to 6 am, geometric mean over households) above 100 nT were obtained in 2.3%, and RF‐EMFs above 1000 µW/m² in 7.1% of households. Highest ELF‐EFs were primarily due to lamps beside the bed (max = 166 V/m), and highest ELF‐MFs because of transformers of devices (max = 1030 nT) or high current of power lines (max = 380 nT). The highest values of RF‐EMFs were caused by DECT telephone base stations (max = 28979 µW/m²) and mobile phone base stations (max = 4872 µW/m²). Simple reduction measures resulted in an average decrease of 23 nT for ELF‐MFs, 23 V/m for ELF‐EFs, and 246 µW/m² for RF‐EMFs. A small but statistically significant correlation between ELF‐MF exposure and overall RF‐EMF levels of R = 0.16 (P = 0.008) was computed that was independent of type (flat, single family) and location (urban, rural) of houses. Bioelectromagnetics 31:200–208, 2010. © 2009 Wiley‐Liss, Inc.     

Human cognitive performance in a 3 mT power-line frequency magnetic field

Extremely low frequency (ELF, <300 Hz) magnetic fields (MF) have been reported to modulate cognitive performance in humans. However, little research exists with MF exposures comparable to the highest levels experienced in occupations like power line workers and industrial welders. This research aims to evaluate the impact of a 60 Hz, 3 mT MF on human cognitive performance. Ninety‐nine participants completed the double‐blind protocol, performing a selection of psychometric tests under two consecutive MF exposure conditions dictated by assignment to one of three groups (sham/sham, MF exposure/sham, or sham/MF exposure). Data were analyzed using a 3 × 2 mixed model analysis of variance. Performance between repetitions improved in 11 of 15 psychometric parameters (practice effect). A significant interaction effect on the digit span forward test (F = 5.21, P < 0.05) revealed an absence of practice effects for both exposure groups but not the control group. This memory test indicates MF‐induced abolition of the improvement associated with practice. Overall, this study does not establish any clear MF effect on human cognition. It is speculated that an ELF MF may interfere with the neuropsychological processes responsible for this short‐term learning effect supported by brain synaptic plasticity. Bioelectromagnetics. Bioelectromagnetics 32:620–633, 2011. © 2011 Wiley Periodicals, Inc.     

Electromagnetic fields and epidemiology: An overview inspired by the fourth course at the International School of Bioelectromagnetics

The fourth course at the International School of Bioelectromagnetics addressed various aspects of the epidemiology of exposure to electromagnetic fields (EMF). In this overview, inspired by the lectures and the discussions among participants, we summarize current knowledge on exposure to EMF and disease risk, with emphasis on studies of use of mobile phones and brain tumours and exposure to power lines and childhood leukaemia. Sources of bias and error hamper straightforward conclusions in some areas and, in order to move forward, improvements in study design and exposure assessment are necessary. The scientific evidence available to date on possible long‐term effects from exposure to ELF and RF fields is not strong enough to revise current protection limits based on the known acute effects of such exposures. Precautionary measures may be considered to reduce ELF exposure of children or exposure to RF during mobile phone use, keeping in mind that it is unclear whether they involve any preventive benefit. Possible health effects from mobile phone use in adults and in children should be investigated further by prospective epidemiological studies with improved exposure assessment and brain tumour incidence rates should be monitored. Further studies on the relation between childhood leukaemia and ELF magnetic fields would be worthwhile if they focus on heavily exposed groups and attempt to minimize possible selection bias. In conclusion, epidemiological studies conducted with appropriate diligence can play a key role in finding the answers. Bioelectromagnetics 30:511–524, 2009. © 2009 Wiley‐Liss, Inc.     

Synergic effect of retinoic acid and extremely low frequency magnetic field exposure on human neuroblastoma cell line BE(2)C

The aim of the present study was to assess whether exposure to a sinusoidal extremely low frequency magnetic field (ELF‐MF; 50 Hz, 1 mT) can affect proliferation and differentiation in the human neuroblastoma cell line BE(2)C, which is representative of high risk neuroblastomas. Cells were subjected to ELF‐MF exposure in the presence or absence of a neuronal differentiating agent (all‐trans‐retinoic acid, ATRA) for 24–72 h. In each experiment, ELF‐MF‐exposed samples were compared to sham‐exposed samples. Cells exposed to ELF‐MF combined with retinoic treatment showed a decreased cellular proliferation and an increased proportion of G₀/G₁ phase cells compared to cells exposed to either treatment alone. Moreover, ELF‐MF‐ and ATRA‐treated cells showed more differentiated morphological traits (a higher neurite number/cell, an increased neurite length), together with a significant increase of mRNA levels of p21^WAF1/CIP1 and cdk5 genes, both involved in neuronal differentiation. In addition, the expression of cyp19 gene, which is involved both in neuronal differentiation and stress response, was evaluated; cyp19 gene expression was enhanced by ATRA treatment and significantly enhanced further by ELF‐MF exposure combined with ATRA. In conclusion, our data suggest that ELF‐MF exposure can strengthen ATRA effects on neuroblastoma cells. Bioelectromagnetics 31:425–433, 2010. © 2010 Wiley‐Liss, Inc.     

Effects of exposure to a 50 Hz sinusoidal magnetic field during the early adolescent period on spatial memory in mice

Adolescence is a critical developmental stage during which substantial remodeling occurs in brain areas involved in emotional and learning processes. Although a robust literature on the biological effects of extremely low frequency magnetic fields (ELF‐MFs) has been documented, data on the effects of ELF‐MF exposure during this period on cognitive functions remain scarce. In this study, early adolescent male mice were exposed from postnatal day (P) 23–35 to a 50 Hz MF at 2 mT for 60 min/day. On P36–45, the potential effects of the MF exposure on spatial memory performance were examined using the Y‐maze and Morris water maze tasks. The results showed that the MF exposure did not affect Y‐maze performance but improved spatial learning acquisition and memory retention in the water maze task under the present experimental conditions. Bioelectromagnetics 34:275–284, 2013. © 2012 Wiley Periodicals, Inc.     

Pilot study of extremely low frequency magnetic fields emitted by transformers in dwellings. Social aspects

A large number of epidemiologic studies examining the potential effect of residential exposure to extremely-low frequency (ELF) magnetic fields and childhood leukemia have been published. Two pooled analyses [Ahlbom A, Day N, Feychting M, Roman E, Skinner J, Dockerty J, Linet M, et al. (2000). A pooled analysis of magnetic fields and childhood leukaemia. Br J Cancer. 83(5):692–698; Greenland S, Sheppard AR, Kaune WT, Poole C, Kelsh AM (2000). A pooled analysis of magnetic fields, wire codes, and childhood leukemia. Epidemiology. 11(6):624–634], which included the major epidemiologic studies on ELF magnetic fields and childhood leukemia showed twofold increase in childhood leukemia risk in association with residential ELF exposure above 0.3–0.4 μT. Based on “limited” epidemiologic evidence linking ELF exposure to childhood leukemia and “inadequate evidence” for carcinogenicity of ELF in rodent bioassays, the International Agency for Research on Cancer (IARC) classified ELF magnetic fields as a possible human carcinogen (2B classification) [International Agency for Research on Cancer (IARC) (2002). Non-ionizing radiation, Part 1: Static and extremely low-frequency (ELF) electric and magnetic fields. IARC monographs on the evaluation of carcinogenic risks to humans. Vol. 80. IARC Press: Lyon], confirmed by WHO on the basis of studies published after 2000 [World Health Organization. Extremely low frequency fields. In: 238 Environmental health criteria, Geneva: WHO; 2007]. The analysis of more recent studies of ELF magnetic fields and childhood leukemia had small findings and propose methodological improvements concerning the uncertainties in epidemiological approaches and exposure assessment, bias in selection of controls [Kheifets L, Oksuzyan S (2008). Exposure assessment and other challenges in non-ionizing radiation studies of childhood leukaemia. Radiat Prot Dosimetry. 132(2):139–147]. By the end of 2010, 37 countries had been identified for possible participation in the International study TRANSEXPO. The pilot work has been completed in five countries (Finland, Hungary, Israel, Switzerland and Bulgaria). In 2008, Bulgaria through the National Centre of Public Health Protection joined with pilot study in TRANSEXPO Project. At this first stage of the project our investigation was directed to performing measurements in dwellings with built-in transformer stations, collecting data of population and cancer registry and choosing the epidemiology design feasible for continuing the project. Taking into account the available sources of information in Bulgaria (different registers of the population) needed for epidemiological approach, it was found that the most appropriate epidemiology design would be the nested case-control study. Control group could be collected in accordance with the international requirements for such epidemiological studies. This approach could be modified in the course of the further study in order to ensure achievement of the purposes of the main international requirements of the study.     

Increased vascular permeability in the circumventricular organs of adult rat brain due to stimulation by extremely low frequency magnetic fields

It has been demonstrated that the exposure of biological systems to magnetic fields (MFs) can produce several beneficial effects: tissue recovery in chronic wounds, re‐establishment of blood circulation after tissue ischemia or in necrotic tissues, improvement after epileptic episodes, angiogenesis, etc. In the current study, the effects of extremely low frequency (ELF) MF on the capillaries of some circumventricular organs (CVOs) are demonstrated; a vasodilator effect is reported as well as an increase in their permeability to non‐liposoluble substances. For this study, 96 Wistar male rats (250 g body mass) were used and divided into three groups of 32 rats each: a control group (no treatment); a sham ELF‐MF group; and an experimental group subjected to ELF‐MF (120 Hz harmonic waves and 0.66 mT, root mean square) by the use of Helmholtz coils. All animals were administered colloidal carbon (CC) intravenously to study, through optical and transmission electron microscopy, the capillary permeability in CVOs and the blood–brain barrier (BBB) in brain areas. An increase in capillary permeability to CC was detected in the ELF‐MF‐exposed group as well as a significant increase in vascular area (capillary vasodilation); none of these effects were observed in individuals of the control and sham ELF‐MF groups. It is important to investigate the mechanisms involved in the phenomena reported here in order to explain the effects of ELF‐MF on brain vasculature. Bioelectromagnetics 34:145–155, 2013. © 2012 Wiley Periodicals, Inc.     

Effects of 50‐Hz magnetic field exposure on hormone secretion and apoptosis‐related gene expression in human first trimester villous trophoblasts in vitro

Evidence from epidemiological and animal studies showed that exposure to extremely low frequency magnetic fields (ELF‐MF) could produce deleterious effects on reproduction. In order to investigate the possible mechanism of MF exposure on reproductive effects, first trimester human chorionic villi at 8–10 weeks' gestation were obtained, and trophoblasts were isolated, cultured, and exposed to a 50‐Hz MF for different durations. The human chorionic gonadotropin (hCG) and progesterone in the culture medium was measured by electrochemiluminescence immunoassay. The mRNA levels of apoptosis‐related genes bcl‐2, bax, caspase‐3, p53, and fas in trophoblasts were analyzed using real‐time RT‐PCR. The results showed that exposure of trophoblasts to MF at 0.2 mT for 72 h did not affect secretion of hCG and progesterone from these cells. There was also no significant change in secretion of these hormones when trophoblasts were exposed to a 0.4 mT MF for 48 h. However, MF significantly inhibited hCG and progesterone secretion of trophoblasts after exposure for 72 h at 0.4 mT. Results of apoptosis‐related gene expression analysis showed that, within 72 h of exposure at 0.4 mT, there was no significant difference between MF exposure and control on the expression pattern of each gene. Based on results of the present experiment, it is suggested that exposure to MF for a longer duration (72 h) could inhibit secretion of hCG and progesterone by human first trimester villous trophoblasts, however, the effect might not be related to trophoblast apoptosis. Bioelectromagnetics 31:566–572, 2010. © 2010 Wiley‐Liss, Inc.     

Feasibility of future epidemiological studies on possible health effects of mobile phone base stations

The increasing deployment of mobile communication base stations led to an increasing demand for epidemiological studies on possible health effects of radio frequency emissions. The methodological challenges of such studies have been critically evaluated by a panel of scientists in the fields of radiofrequency engineering/dosimetry and epidemiology. Strengths and weaknesses of previous studies have been identified. Dosimetric concepts and crucial aspects in exposure assessment were evaluated in terms of epidemiological studies on different types of outcomes. We conclude that in principle base station epidemiological studies are feasible. However, the exposure contributions from all relevant radio frequency sources have to be taken into account. The applied exposure assessment method should be piloted and validated. Short to medium term effects on physiology or health related quality of life are best investigated by cohort studies. For long term effects, groups with a potential for high exposure need to first be identified; for immediate effect, human laboratory studies are the preferred approach.