Environmental Radiofrequency Electromagnetic Fields Exposure at Home,Mobile and Cordless Phone Use,and Sleep Problems in 7-Year-Old Children

Background

We evaluated if exposure to RF-EMF was associated with reported quality of sleep in 2,361 children, aged 7 years.

Methods

This study was embedded in the Amsterdam Born Children and their Development (ABCD) birth cohort study. When children were about five years old, school and residential exposure to RF-EMF from base stations was assessed with a geospatial model (NISMap) and from indoor sources (cordless phone/WiFi) using parental self-reports. Parents also reported their children’s use of mobile or cordless phones. When children were seven years old, we evaluated sleep quality as measured with the Child Sleep Habits Questionnaire (CSHQ) filled in by parents. Of eight CSHQ subscales, we evaluated sleep onset delay, sleep duration, night wakenings, parasomnias and daytime sleepiness with logistic or negative binomial regression models, adjusting for child’s age and sex and indicators of socio-economic position of the parents. We evaluated the remaining three subscales (bedtime resistance, sleep anxiety, sleep disordered breathing) as unrelated outcomes (negative control) because these were a priori hypothesised not to be associated with RF-EMF.

Results

Sleep onset delay, night wakenings, parasomnias and daytime sleepiness were not associated with residential exposure to RF-EMF from base stations. Sleep duration scores were associated with RF-EMF levels from base stations. Higher use mobile phones was associated with less favourable sleep duration, night wakenings and parasomnias, and also with bedtime resistance. Cordless phone use was not related to any of the sleeping scores.

Conclusion

Given the different results across the evaluated RF-EMF exposure sources and the observed association between mobile phone use and the negative control sleep scale, our study does not support the hypothesis that it is the exposure to RF-EMF that is detrimental to sleep quality in 7-year old children, but potentially other factors that are related to mobile phone usage.     

Prevalence of subjective poor health symptoms associated with exposure to electromagnetic fields among university students

The number of people complaining about different symptoms that may be associated with exposure to electromagnetic fields (EMF) has increased rapidly during past years. Students use both mobile phones and video display terminals frequently. The purpose of this study was to investigate the association of mobile phone use and EMF health hazards. Basic demographic data and self-reported symptoms were sought using a questionnaire administered to all apparently healthy students at Rafsanjan University of Medical Sciences (RUMS) and Vali-e-Asr University (VAU). Questions about some major confounding factors such as age, gender, amount of video display terminal work were also included. Exact Fischer Test was used for data analysis. Among self-reported symptoms, headache (53.5%), fatigue (35.6%), difficulties in concentration (32.5%), vertigo/dizziness (30.4%), attention disorders (28.8%), nervousness (28.1%), palpitation (14.7%), low back pain (14.3%), myalgia (12.4%), and tinnitus (9.9%) were the main self-reported symptoms. No significant differences in the prevalence of these symptoms were found between CRT users and those who did not use CRTs. A significant association was found between cordless phone use and difficulties in concentration (P < .05) or attention disorders (P < .05). However, after correction of the gender role, these differences were not significant. No association was found between mobile phone use and the above-mentioned symptoms. No significantly higher prevalence of self-reported symptoms was found in individuals who had used mobile phones, video display terminals or cordless phones more frequently than others. Mass-media's lack of interest in the possible hazards of exposure to EMF in developing countries can explain the difference observed between the results of this study and those of other researchers in some developed countries who have shown an association between EMF exposure and the prevalence of self-reported subjective symptoms. This finding can confirm the results obtained in provocative studies which indicated the role of psychological factors in electromagnetic hypersensitivity. More research is needed to clarify whether daily environmental EMF may cause health problems.     

Mobile phone ownership and use among school children in three Hungarian cities

In spite of rapid worldwide increase in mobile phone use and public concerns about associated potential health effects, little is known about patterns of mobile phone ownership and use in the general population and among children. In April 2005, we conducted a survey of mobile phone ownership and use among fourth grade school children in three Hungarian cities. From 24 schools, 1301 student filled out a short, self-administered questionnaire on basic demographics, mobile phone ownership, pattern of mobile phone use, and after-school activities. Overall, 989 students (76%) owned a mobile phone. Three hundred thirteen students (24%) used a mobile phone daily to make phone calls, and an additional 427 students (33%) used mobile phones for phone calls at least several times per week. Sixty-six students (5%) sent text messages daily and an additional 308 students (24%) sent text messages at least several times per week. Girls, children with no siblings, children who were members of a sport club, and children who played computer games daily were more likely to own and use mobile phones regularly. A higher number of socially disadvantaged children in a class predicted lower likelihood of regular mobile phone use among children. Our results suggest that mobile phone ownership and regular use is highly prevalent among school children in Hungary. Due to rapid changes in ownership patterns follow up surveys will be required to obtain information on temporal trends and changes in mobile phone ownership and pattern of use among school children.     

Use of wireless phones and serum β-trace protein in randomly recruited persons aged 18–65 years: a cross-sectional study

Background: There are studies suggesting effects on sleep from pulse-modulated radiofrequency fields used in mobile and cordless phones. So far, reports of adverse effects in observational studies are of limited value for risk assessment while effects from experimental studies seem to be more consistent but unclear as to their importance for health. The aim of this study was to investigate whether use of wireless phones is associated with lower concentrations of β-trace protein (lipocalin-type prostaglandin D synthase), a key enzyme in the synthesis of prostaglandin D₂, an endogenous sleep-promoting neurohormone.

Methods: Three hundred and fourteen people, aged 18–65 years and living in the municipality of Örebro, Sweden, were recruited randomly using the population registry. Total and age-specific linear regression analyses adjusted for known covariates were used to calculate associations between levels of β-trace protein and short- and long-term use of wireless phones.

Results: Overall, no statistically significant association between use of wireless phones and the serum concentration of β-trace protein was found, neither with respect to short-term nor long-term use. Age-specific analyses, however, yielded negative associations for long-term use (cumulative hours of use) and β-trace protein in the youngest age group (18–30 years). Conclusion: This study provided no overall evidence of an association between wireless phone use and serum concentrations of β-trace protein. While the findings in the 18–30 year age group indicating lower concentrations with more cumulative hours of use should be further investigated, no causal inferences can be made from the results of the present study.     

The Relationships between Sleep-Wake Cycle and Academic Performance in Medical Students

Survey and laboratory studies suggest that several factors, such as social and academic demands, part-time jobs and irregular school schedules, affect the sleep-wake cycle of college students. In this study, we examined the sleep-wake pattern and the role played by academic schedules and individual characteristics on the sleep-wake cycle and academic performance. The subjects were 36 medical students (male = 21 and female = 15), mean age = 20.7 years, SD = 2.2. All students attended the same school schedule, from Monday to Friday. The volunteers answered a morningness-eveningness questionnaire, the Pittsburgh Sleep Quality Index (PSQI) and kept a sleep-wake diary for two weeks. The relationships between sleep-wake cycle, PSQI, chronotypes and academic performance were analyzed by a multiple regression technique. The results showed that 38.9% of the students had a poor sleep quality according to the PSQI. When the medical students were evening type or moderate evening type the PSQI showed a tendency of poor sleep. The multiple regression analysis showed a correlation between sleep onset, sleep irregularity and sleep length with academic performance. These results suggest that chronotypes influence the quality of the sleep-wake cycle and that irregularity of the sleep-wake cycle, as well as sleep deprivation (average length was 6:52), influence the learning of college students.     

New predictors of sleep efficiency

Sleep efficiency is a commonly and widely used measure to objectively evaluate sleep quality. Monitoring sleep efficiency can provide significant information about health conditions. As an attempt to facilitate less cumbersome monitoring of sleep efficiency, our study aimed to suggest new predictors of sleep efficiency that enable reliable and unconstrained estimation of sleep efficiency during awake resting period. We hypothesized that the autonomic nervous system activity observed before falling asleep might be associated with sleep efficiency. To assess autonomic activity, heart rate variability and breathing parameters were analyzed for 5 min. Using the extracted parameters as explanatory variables, stepwise multiple linear regression analyses and k-fold cross-validation tests were performed with 240 electrocardiographic and thoracic volume change signal recordings to develop the sleep efficiency prediction model. The developed model’s sleep efficiency predictability was evaluated using 60 piezoelectric sensor signal recordings. The regression model, established using the ratio of the power of the low- and high-frequency bands of the heart rate variability signal and the average peak inspiratory flow value, provided an absolute error (mean ± SD) of 2.18% ± 1.61% and a Pearson’s correlation coefficient of 0.94 (p < 0.01) between the sleep efficiency predictive values and the reference values. Our study is the first to achieve reliable and unconstrained prediction of sleep efficiency without overnight recording. This method has the potential to be utilized for home-based, long-term monitoring of sleep efficiency and to support reasonable decision-making regarding the execution of sleep efficiency improvement strategies.     

The Relationships between Sleep-Wake Cycle and Academic Performance in Medical Students

Survey and laboratory studies suggest that several factors, such as social and academic demands, part-time jobs and irregular school schedules, affect the sleep-wake cycle of college students. In this study, we examined the sleep-wake pattern and the role played by academic schedules and individual characteristics on the sleep-wake cycle and academic performance. The subjects were 36 medical students (male = 21 and female = 15), mean age = 20.7 years, SD = 2.2. All students attended the same school schedule, from Monday to Friday. The volunteers answered a morningness-eveningness questionnaire, the Pittsburgh Sleep Quality Index (PSQI) and kept a sleep-wake diary for two weeks. The relationships between sleep-wake cycle, PSQI, chronotypes and academic performance were analyzed by a multiple regression technique. The results showed that 38.9% of the students had a poor sleep quality according to the PSQI. When the medical students were evening type or moderate evening type the PSQI showed a tendency of poor sleep. The multiple regression analysis showed a correlation between sleep onset, sleep irregularity and sleep length with academic performance. These results suggest that chronotypes influence the quality of the sleep-wake cycle and that irregularity of the sleep-wake cycle, as well as sleep deprivation (average length was 6:52), influence the learning of college students.     

Fatigue in Type 2 Diabetes: Impact on Quality of Life and Predictors

Fatigue is a persistent symptom, impacting quality of life (QoL) and functional status in people with type 2 diabetes, yet the symptom of fatigue has not been fully explored. The purpose of this study was to explore the relationship between fatigue, QoL functional status and to investigate the predictors of fatigue. These possible predictors included body mass index (BMI), Hemoglobin A1C (HbA1C), sleep quality, pain, number of complications from diabetes, years since diagnosis and depression. Forty-eight individuals with type 2 diabetes (22 females, 26 males; 59.66±7.24 years of age; 10.45 ±7.38 years since diagnosis) participated in the study. Fatigue was assessed by using Multidimensional Fatigue Inventory (MFI-20). Other outcomes included: QoL (Audit of Diabetes Dependent QoL), and functional status (6 minute walk test), BMI, HbA1c, sleep (Pittsburg sleep quality index, PSQI), pain (Visual Analog Scale), number of complications, years since diagnosis, and depression (Beck’s depression Inventory-2). The Pearson correlation analysis followed by multivariable linear regression model was used. Fatigue was negatively related to quality of life and functional status. Multivariable linear regression analysis revealed sleep, pain and BMI as the independent predictors of fatigue signaling the presence of physiological (sleep, pain, BMI) phenomenon that could undermine health outcomes.     

Prevalence of Mobile Phones and Factors Influencing Usage by Caregivers of Young Children in Daily Life and for Health Care in Rural China: A Mixed Methods Study

Introduction

To capitalise on mHealth, we need to understand the use of mobile phones both in daily life and for health care.

Objective

To assess the prevalence and factors that influence usage of mobile phones by caregivers of young children.

Materials and Methods

A mixed methods approach was used, whereby a survey (N=1854) and semi-structured interviews (N=17) were conducted concurrently. The quantitative and qualitative data obtained were compared and integrated. Participants were caregivers of young children in Zhao County, Hebei Province, China.

Results

Four main themes were found: (i) trends in mobile phone ownership; (ii) usage of mobile phone functions; (iii) factors influencing replying to text messages; and (iv) uses of mobile phones for health care. The majority of 1,854 survey participants (1,620; 87.4%) used mobile phones, but usage was much higher among mothers (1,433; 92.6%) and fathers (41; 100.0%) compared to grandparents (142; 54.6%). Parents were able to send text messages, grandparents often not. Factors influencing the decision to reply to text messages in daily life were checking the mobile phone, trusting the sender, emotion or feeling when receiving a text message, the importance of replying and ease of use of text messages. Of 1,620 survey participants who used a mobile phone, about one in four (432; 26.7%) had used it for health care in the past three months and most (1,110; 93.5%) of 1,187 who had not wished to use their phone to receive health information.

Conclusion

We found that usage of mobile phones is high, several factors influencing usage and an interest of caregivers to use phones for health care in Zhao County, rural China, which can be used to inform studies in settings with similar characteristics. Future work needs to assess factors influencing mobile phone usage in-depth to optimize experiences of users for specific mHealth-based interventions.     

Sleep Duration and Quality among Different Occupations--China National Study

Objective

To examine the associations between occupation, sleep duration and sleep quality.

Methods

The data for this study was extracted from data collected from the 2008 Chinese Sub-optimal Health Study. Our study sample consisted of 18,316 Chinese subjects aged 18-65. Occupation and other relevant characteristics to sleep were collected. We used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and multiple logistic regression models to examine the association of occupation with shortened sleep duration and poor sleep quality.

Results

Farmers had the longest sleep duration (mean=8.22 hours) while the civil servants had the shortest sleep duration (mean=7.85 hours). Farmers also had the best sleep quality (mean score=3.74) while professional workers had the worst sleep quality (mean score=4.87). Compared to civil servants, the OR of shortened sleep duration and poor sleep quality for blue collar workers is 1.39 (95%CI: 1.11-1.73) and 1.28 (95%-CI: 1.15-1.42), respectively, after adjusting for age, sex, marital status, education, area, smoking, drinking, pain, and health status.

Conclusion

sleep duration and quality varied among different Chinese occupation populations. The blue collar workers are more likely to have shortened sleep duration and poor sleep quality.     

Sleep Disturbances Among Female Nurses: Comparing Shift to Day Work

Recently, attention has focused in Israel on the possible legal and health consequences of shift work. We decided to study sleep disorders among female nursing personnel working a shift schedule, in comparison with day nurses, in a large metropolitan general hospital. The study population was composed of 131 female certified nurses working shifts and 44 working days only. Inclusion criteria for the survey was at least 1 year of shift work alternating between day, evening, and night shifts, or at least 1 year of day work. All participants completed a self-report sleep questionnaire encompassing (a) demographic data, (b) sleep survey, and (c) employment details. Statistical analysis was performed using the Pearson correlation test and analysis of variance multiple range test (according to Scheffe's procedure). No significant correlation was found between sleep disorders and age of subjects. No sleep disorders were reported by 19.8% of shift workers versus 76.5% of day workers. Statistically significant findings were that the number of shifts per week >4.1 (p = 0.001) and duration of shift work >13.6 years (p = 0.007) correlated with the presence of sleep disorders. An additional significant finding (p = 0.014) was the impact of evening shifts on sleep disorders. The present small study confined to women supports the growing body of data on sleep complaints among shift workers.     

Construct Validity and Factor Structure of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale in a Multi-National Study of African,South East Asian and South American College Students

Background

The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) are questionnaires used to assess sleep quality and excessive daytime sleepiness in clinical and population-based studies. The present study aimed to evaluate the construct validity and factor structure of the PSQI and ESS questionnaires among young adults in four countries (Chile, Ethiopia, Peru and Thailand).

Methods

A cross-sectional study was conducted among 8,481 undergraduate students. Students were invited to complete a self-administered questionnaire that collected information about lifestyle, demographic, and sleep characteristics. In each country, the construct validity and factorial structures of PSQI and ESS questionnaires were tested through exploratory and confirmatory factor analyses (EFA and CFA).

Results

The largest component-total correlation coefficient for sleep quality as assessed using PSQI was noted in Chile (r = 0.71) while the smallest component-total correlation coefficient was noted for sleep medication use in Peru (r = 0.28). The largest component-total correlation coefficient for excessive daytime sleepiness as assessed using ESS was found for item 1 (sitting/reading) in Chile (r = 0.65) while the lowest item-total correlation was observed for item 6 (sitting and talking to someone) in Thailand (r = 0.35). Using both EFA and CFA a two-factor model was found for PSQI questionnaire in Chile, Ethiopia and Thailand while a three-factor model was found for Peru. For the ESS questionnaire, we noted two factors for all four countries

Conclusion

Overall, we documented cross-cultural comparability of sleep quality and excessive daytime sleepiness measures using the PSQI and ESS questionnaires among Asian, South American and African young adults. Although both the PSQI and ESS were originally developed as single-factor questionnaires, the results of our EFA and CFA revealed the multi- dimensionality of the scales suggesting limited usefulness of the global PSQI and ESS scores to assess sleep quality and excessive daytime sleepiness.     

THE VALIDITY OF THE FATIGUE AND RISK INDEX FOR PREDICTING IMPAIRMENTS OF HEALTH AND SAFETY UNDER DIFFERENT SHIFT SCHEDULES IN THE CONTEXT OF RISK ASSESSMENTS

In Germany, risk assessment of the working time arrangement is legally required, and within this context the authors assessed the usefulness of the fatigue and risk index (FRI) to predict any detrimental effects to health and safety. This assessment was made using data from two different surveys. Each contained records of working hours over a 4-wk period plus information on occupational accidents and health complaints. The independent variables drawn from the FRI parameters included the maxima, means, variances, and index factor scores. Phi-correlations between the FRI (dichotomized to the index of the reference system) and the incidence of an occupational accident were rather moderate, with a maximum correlation of .22 using the mean fatigue index (FI). Correlations between the two index factor scores and health complaints (sleep problems, stomach pain, eructation/heartburn) revealed the FI component, but not the risk index (RI) component, was related to those health complaints. Forward stepwise logistic regression analysis indicated the FI (but not the RI) predicted occupational accidents (FI_factor odds ratio [OR]?=?1.90, confidence interval [CI] 1.23–2.93). When using multiple regression analyses, the FI was able to predict sleep problems and other circadian related-problems, but the regression coefficients were moderate. In general, the results were not considered sufficient to justify a mandatory use of the FRI. (Author correspondence: jana.greubel@gawo-ev.de)     

Mobile phones and children: Is precaution warranted?

Are there health related arguments to recommend that children limit their use of mobile telephones? The International Expert Group on Mobile Phones from the UK concluded so, but did not come up with convincing scientific data to back this statement. The Health Council of the Netherlands approached the problem by considering whether developmental arguments might be found, i.e., asking if there reason to believe that the heads of children are more susceptible to the electromagnetic fields emitted by mobile telephones than those of adults. It concluded that no major changes in head development occur after the second year of life that might point at a difference in electromagnetic susceptibility between children and adults. The Health Council therefore sees no reason to recommend limiting the use of mobile phones by children. Bioelectromagnetics 25:142–144, 2004. © 2004 Wiley‐Liss, Inc.     

糖尿病足患者睡眠质量与疲劳程度的调查研究

目的:调查糖尿病足(diabetic foot,DF)患者的睡眠质量与疲劳程度,并分析其相关性。方法:选取105例糖尿病足患者,采用人口数据统计表调查患者的一般情况,匹兹堡睡眠质量指数量(PSQI)评估患者的睡眠质量,Piper疲劳量表(PFS)评估患者的疲劳程度,并通过pearson检测分析其相关性。结果:人口统计数据显示,56%的DF患者年龄在41岁以上,64.8%女性,82.9%已婚,48.6%小学学历,39%病程3年或更长的时间。PSQI的平均总得分为(8.17±3.02),PFS量表总分为(6.38±2.18),睡眠质量与疲劳度总得分之间呈显著正相关,相关系数r=0.622(P0.05)。结论:DF患者的睡眠质量较差,大多出现中度疲劳,二者之间呈正相关,应加强对DF患者的睡眠质量与疲劳的护理。     

Microfungal Contaminants on Mobile Phones of Health Services Vocational School Students in Marmaris,Turkey

In this study, it was aimed to determine microfungi on mobile phones. Totally, 50 mobile phones were used belonging to Health Services Vocational School students. The samples were taken by swabbing the screen and keys of mobile phones using moistened sterile swab sticks. A total of 24 different microfungal species were obtained belonging to Alternaria, Aspergillus, Cladosporium, Geotrichum, Penicillium, Phoma, Rhinocladiella, Scopulariopsis, Trichoderma, and Trichophyton genera. The genera of microfungi most abundant in terms of the number of species on the mobile phones were Aspergillus, Cladosporium, and Penicillium. Numerically, Cladosporium was found as the most abundant on the mobile phones. Cladosporium herbarum colonies were highest in number, followed by Cladosporium sphaerospermum, and Penicillium verrucosum var. cyclopium. When percentages of each species present on the mobile phones were considered, C. herbarum and C. sphaerospermum were the most common. There was a great similarity between the dominant microfungi isolated from mobile phones and dominant microfungi obtained from studies of atmospheric microfungi in Turkey.     

The electromagnetic fields of cellular phones and the health of children and of teenagers (the situation requiring to take an urgent measure)

The problem of the influence of electromagnetic fields (EMF) of cellular phones (CP) on the health of children and teenagers is considered in this article. The results of the researchs indicate the increased sensitivity of the children and of the teenagers to this kind of radiation. Direct indicators of electromagnetic influence can be infringement of sleep, decrease of the memory, fatigue, breach of a blood-brain barrier permeability, changes in nervous cells of a brain. As the remote consequences the development of tumors of a brain and acoustic nerve are predicted. However all these results require the realization of independent repeated researches. WHO (World Health Organization) recommends to use "Precautionary principle" with the purposes of decreasing of the risk. Russian National Committee of Non-Ionizing Radiation Protection recommended to limit the use of CP by children and teenagers under 16 years old (2002, February 2004). The corresponding recommendations were included into SunPin H2.1.8/2.2.4.1190-03/(2003).     

食管癌术后患者癌因性疲乏现状调查及与社会支持和生存质量的相关性分析

摘要 目的：调查食管癌术后患者癌因性疲乏现状,分析其影响因素,同时观察癌因性疲乏与社会支持和生存质量的相关性。方法：选取2019年7月~2021年4月期间在我院住院治疗的食管癌术后患者180例,统计并整理所有患者的临床资料,采用社会支持评定量表（SSRS）评价所有患者的社会支持情况,采用世界卫生组织生存质量测定量表简表（WHOQOL-BREF）评价所有患者的生存质量,采用Piper疲乏量表（PFS）评价所有患者癌因性疲乏情况。应用Pearson检验分析PFS评分与SSRS评分和WHOQOL-BREF评分的相关性,采用单因素及多因素Logistic回归分析癌因性疲乏的影响因素。结果：180例食管癌术后患者共有141例发生癌因性疲乏,发生率为78.33%。根据食管癌患者术后是否发生癌因性疲乏分为两组：癌因性疲乏组（n=141）和无癌因性疲乏组（n=39）。其中癌因性疲乏组PFS评分为（6.37±1.29）分。单因素分析结果显示,食管癌术后患者癌因性疲乏与与年龄、睡眠、营养状况、疼痛程度、社会支持度、简明心境量表（POMS-SF）评分有关（P<0.05）。多因素Logistic回归分析结果显示：年龄、睡眠、营养状况、疼痛程度、社会支持度、POMS-SF评分均是食管癌术后患者癌因性疲乏的影响因素(P＜0.05)。无癌因性疲乏组SSRS各维度评分及总分和WHOQOL-BREF各维度评分及总分均高于癌因性疲乏组（P<0.05）。Pearson相关分析结果显示,PFS评分与SSRS评分和WHOQOL-BREF评分均呈负相关（P<0.05）。结论：食管癌术后患者癌因性疲乏发生率较高,且受到年龄、睡眠、营养状况、疼痛程度、社会支持度、POMS-SF评分的影响,同时还与生存质量及社会支持度具有一定联系,临床应重视相关影响因素,给予及时的干预,以预防癌因性疲乏的发生或减轻癌因性疲乏程度。