Changes in Health Status in a Group of CFS and CF Patients Following Removal of Excessive 50 Hz Magnetic Field Exposure
Reprinted from. Journal of Australian College
of Nutritional & Environmental Medicine Vol. 21 No. 1; April 2002: pages
15-19
Don Maisch, AASc, John Podd, BA (Hons), MA, PhD Bruce Rapley, BSc, MPhil
ABSTRACT
In December 1998 a paper published in the ACNEM
Journal examined the hypothesis that prolonged exposure to excessive 50 Hz
(power line frequency) magnetic fields may act as an immune system stressor
giving rise to symptoms similar to those reported in Chronic Fatigue Syndrome
(CFS) or Chronic Fatigue (CF).1 This paper was based on a number of case
histories, most notably a well-documented Workcare Compensation case (Melbourne,
1991). Here, a group of female office workers developed CFS-like symptoms
when working in a room with strong 50 Hz magnetic fields emitted from an
electrical substation immediately below the floor.2
The present paper briefly reports the results of a small-scale pilot study
utilising 49 subjects suffering from CFS or ongoing CF, who were exposed
to varying strength magnetic fields in their home environment. Some subjects
were found to have prolonged exposure to magnetic fields >2 mG (milliGauss),
which was used as a benchmark level. These subjects (Group A) were provided
with advice and assistance regarding reducing their exposure level. The remainder
of the subjects (Group B: <2 mG exposure level) were given no such advice
or assistance. Changes in health status in both groups were recorded over
a 6-month period. Results from the data collected at the start of the study
showed no relationship between magnetic field strength and CFS/CF symptom
severity. However, the majority of Group A subjects reported an improvement
in symptoms and a marked improvement in sleep patterns, possibly due to the
decrease in exposure. These results are discussed in the context of previous
research showing disturbed sleep in the presence of magnetic fields. Such
disturbances may come about through the effect of magnetic fields on melatonin
secretion, a hormone involved in circadian functioning.
KEY WORDS
Chronic Fatigue Syndrome (CFS); electromagnetic fields (EMF); power line frequency; sleep changes; melatonin.
INTRODUCTION
Clinical CFS is characterised by incapacitating fatigue (experienced as exhaustion and extremely poor stamina) of at least 6 months duration, usually with an abrupt onset accompanied by an ”infectiouslike‘ illness. It can affect virtually every major system in the body as neurological, immunological, hormonal, gastro-intestinal, musculoskeletal, and psychological problems have been reported. Many patients with CFS are unable to work, whereas others continue to work at least part-time while drastically curtailing social activities.
Symptoms tend to wax and wane but are often severely debilitating and may
last for many months or years. All segments of the population (including
children) are at risk, but women under the age of 45 seem to be the most
susceptible. As with most diseases, CFS affects people differently. Not
everybody reaches the severe end of the CFS spectrum.
CFS is also referred to as CFIDS (Chronic Fatigue and Immune Dysfunction
Syndrome), CEBV (Chronic Epstein-Barr Virus), ME (Myalgic Encephalomyelitis),
as well as several other designations. It is a complex illness which has
been intensively studied for the past 40 years without firm conclusions as
to its cause. Diagnosis is largely by exclusion of other possible diseases.
In addition to persistent and extreme fatigue, other CFS symptoms identified
include the following: substantial impairment in short-term memory and
concentration, depression, sore throat, tender lymph nodes, muscle pain,
multi-joint pain without joint swelling or redness, unusual headaches,
unrefreshing sleep, cognitive function problems (such as spatial disorientation
and impairment of speech and/or reasoning), visual disturbances (blurring,
sensitivity to light, eye pain), chills and night sweats, dizziness and
balance problems, sensitivity to heat and cold, irregular heartbeat, abdominal
pain, diarrhoea, irritable bowel, low temperature, numbness or a burning
sensation in the face or extremities, dryness of the mouth and eyes (Sicca
syndrome), hearing disorders, menstrual problems including PMS and endometriosis,
hypersensitivity of the skin, chest pains, rashes, allergies and sensitivities
to odours (including chemicals and medications), weight changes without
changes in diet, hair loss, lightheadedness, fainting, muscle twitching,
and seizures.
Research suggests that CFS results from a dysfunction of the immune system,
involving a disruption of fundamental Central Nervous System (CNS) mechanisms,
such as the sleep-wake cycle and the hypothalamic-pituitary-adrenal axis.
One study found that more than a quarter of CFS patients had abnormal brain
scans and subtle changes were found in the levels of neuroendocrine hormones.3
Other research has found electrolyte disturbances which sometimes included
permanent changes in cell membranes‘ ability to pass electrolytes, permanent
biochemical changes in mitochondrial function, and disturbances of insulin
and T3-thyroid hormone functions.4
Unlike CFS, chronic fatigue (CF) is far more prevalent in the community and,
as its name suggests, is characterised mainly by an ongoing feeling of
fatigue and lack of energy that is not as debilitating as CFS. As there
is no clear dividing line between these two conditions, people suffering
chronic fatigue can be mistakenly diagnosed as having CFS.
We have hypothesised that exposure to power line frequency magnetic fields
in the home and in the work-place may be a co-factor to consider when treating
CFS/CF.3 The purpose of the present study was to begin the empirical investigation
of our hypothesis. We located a number of people currently being treated
by a medical practitioner for CFS/CF and then measured their exposure to
magnetic fields in their homes. Because field studies of this type are fraught
with difficulties and possible confounds, we thought it prudent to begin
with a small sample pilot study to better identify any problems and to develop
leads for a future, larger investigation.
METHOD
Subjects
All subjects were volunteers who initially heard about the pilot study through
doctors who are members of the Australasian College of Nutritional & Environmental
Medicine (ACNEM), through a notice placed in both the Victorian and South
Australian CFS Societies‘ newsletters, or from discussions with the Hobart
CFS group.
Subjects were drawn from Melbourne (Victoria), Adelaide (South Australia)
and Hobart (Tasmania). The mean age of the 49 subjects was 44 years, with
an age range from 17 to 72 years, consisting of 14 males and 35 females.
The inclusion criterion was that all subjects were currently being treated
by a medical practitioner for CFS or CF.
Questionnaire
The questionnaire consisted of two parts. First was a two-page questionnaire
(Bioscreen) that listed 86 symptoms, with a severity scale of 0 to 4. Examples
are: headaches, chest or heart pain, tinnitus or other noises in the ear,
unrefreshed or prolonged sleep, allergies, forgetfulness, dermatitis, stress
from work problems, symptoms of irritable bowel, etc.
The second part consisted of a further two pages that included questions
on: length of time living at present address, time since being diagnosed
by doctor, length of time with condition, brief description of symptoms
felt, was onset gradual or with an initial flu-like illness, any indications
from blood tests of low iron levels, trouble sleeping or dreaming, feelings
after waking, do symptoms lessen when staying elsewhere. There were also
questions on type of employment, if any, use of cordless and mobile phones
and time spent using a computer as well as any symptoms felt after the
extended use of a computer.
Approximately 180 questionnaires were sent out to doctors who had been previously
contacted and had expressed possible interest for some of their patients.
Fourteen were sent out to individuals who had contacted us as a result of
the notices placed in CFS newsletters or discussions with CFS groups. In
addition 8 were sent out as a result of a radio interview in Adelaide. Of
the total of approximately 202 questionnaires sent out, 49 responded with
no later drop-outs.
Magnetic Field Measurement
All measurements were taken with an F.W. Bell Triaxial ELF magnetic field
meter. Where there were indications that the fields may be changing over
time, a Trifield meter was left with subjects to check at different times
for any fluctuations that might be occurring. Only the measurements taken
with the F.W. Bell meter were used in the calculations.
For both Adelaide and Melbourne, two weeks were arranged in each city to
conduct the initial magnetic field surveys. Survey times were by spot measurements
taken at a pre-arranged time of the day according to each subject‘s availability.
At each home, measurements were taken first with most appliances and lights
off (low power configuration) and then with most appliances and lights
on (high power configuration). Measurements were taken in the centre of
all main rooms, one meter from the floor. Places where the subject may
spend some time, such as a chair, couch or bed were especially checked.
The locations of meter boxes in relation to bedheads were noted as well
as magnetic fields on water pipes and proximity to power lines.
Out of the initial 14 subjects in group A, the nature of the individual exposure
sources made it possible to estimate that in 12 of the subjects their magnetic
exposure strength was likely to remain stable over time. For the remaining
two, additional measurements were made with the Trifield meter left with
them for this purpose.
In several cases where the services of an electrician and/or plumber were
required to fix the source of excessive magnetic fields, a later EMF survey
was conducted to ensure that the fields were lowered or eliminated.
RESULTS
A detailed statistical analysis of the questionnaire data, carried out at Massey University, New Zealand, found no relationships between the magnetic field strength and the severity of symptoms. In other words, there were no dose-response relationships (a not unusual finding in this type of research). Neither were any symptoms specific to magnetic field exposure identified. However, the later health changes, predominantly in quality of sleep, reported by the subjects did indicate unusual symptoms, such as night time tinnitus, that seemed to be related to excessive magnetic field exposure at night.
Of the 49 subjects, 14 had prolonged magnetic field exposures >2 mG (28%),
and of these 14, 9 were over 4 mG (18%). Interestingly, only 2 of the 14
exposure situations were due to proximity to power lines. This is in agreement
with the March 2001 British NRPB report that identified internal sources
within the home, not power lines, as being a significant source of exposure.5
Sources of exposure for the 14 subjects exposed to <2 mG (Group A):
• one was solely from proximity to power lines (3.6 mG);
• one was from proximity to power lines and conducting water
piping (2.4 mG). Four were from the bed head next to meter
box (4.4 / 2.9 / 8.3 / 3.0 mG);
• two were from electrical return currents on metal water pipes
(2.2 / 6.6 mG); • one was from a quartz halogen bedside light (6.2 mG);
• two were from sleeping with an energised electric blanket (8.7
/ 20.6 mG);
• one was from a waterbed heater (6.6 mG);
• one was from a phone charger by the bed head and water bed
heater (5.0 mG);
• one was from a chair against a wall with high magnetic fields
from kitchen appliances on the other side of the wall (9.6 mG).
Three of the above 14 subjects were excluded from all further analyses for
a variety of reasons (unable to reduce exposure due to power line proximity,
reduction in exposure confounded by introduction of a gluten-free diet,
a doubtful case of CFS/CF.) The removal of these 3 left 11 subjects in
group A, with a group average exposure of 7.1 mG.
Group B (exposure < 2 mG) consisted of 34 subjects, with a group average
exposure of 0.67 mG. One subject in Group B was excluded from further analysis
due to his just moving into new home; so previous EMF exposure was unknown.
At intervals up to 6 months subjects were contacted and asked about changes
in health/fatigue that may have occurred in the interim. These were classified
in three categories: no improvement (or worse), slight improvement, and
definite improvement.
Table 1: Percentage change in symptoms 6 months after initial contact.
Group A exposure >2mG, Group B < 2mG.
IMPROVEMENT
| None | Slight | Definite | |
| Group A | 45% | 0% | 55% |
| Group B | 68% | 18% | 14% |
Table 1 shows that 55% of the more highly exposed subjects (Group A) reported definite improvement in their symptoms. These were the subjects given advice and assistance on how to reduce their exposure. Group B subjects (< 2 mG exposure) received no such advice and only 14% reported a definite improvement in health 6 months after initial contact.
The greater improvement in group A is in agreement with recent Swedish research
that found in persons apparently hypersensitive to electricity, intensive
electrical environments intensified their symptoms, and that a reduction
of electromagnetic fields in the living and work-place environment seemed
to be highly positive as a means for rehabilitation.6, 7
Sleep changes
An unexpected change in this pilot study was a marked improvement in sleep
quality for the group A subjects: 64% reported an improvement in sleep while
only 12% reported a similar effect in Group B.
Interestingly, 4 subjects (36%) in Group A reported an end to tinnitus at
night after reduction of magnetic field levels. No Group B subjects reported
this.
It is instructive to examine the comments made by Group A subjects who experienced
an improved sleep quality, in a little more detail:
Subject #4: No real change to fatigue but noticed better sleep, less time
awake while in bed, sleeps more soundly, easier to get back to sleep. (Bed
head was by meter box, 4.4 mG.)
Subject #5: No longer suffers from tinnitus, or ”buzzing‘ in body at night,
better sleep (deeper) and wake in the morning easier. Very sure of an improvement.
Not much difference in fatigue though. (Used heated water bed, 6.6 mG.)
Subject #7: Sleeping much better, deeper, waking more refreshed, more energy,
headaches less frequent, tinnitus at night ended. (Transformer was by bed
head and used heated water bed, 5.0 mG.)
Subject #9: Excellent - back to normal, no longer lying awake at night trying
to get back to sleep, no longer has ear-ringing at night, energy returned.
(Bed head was by meter box, 8.3 mG.)
Subject #28: Sleeping really well now, longer, dreaming, with less anxiety,
less vivid, less fatigue, now sleeps 10 hours a night without waking, hasn‘t
been sick for quite a time now. (Electric blanket left on at night, 20.6
mG.)
Subject #41: Dramatic improvement, feeling better with slight improvement
in sleep (more, deeper and longer), energy levels better, slow and steady
improvement, overall 70-80% improvement. (Bed head by meter box, 3.3 mG.)
Subject #47: Sleeping better, having vivid dreams, never before remember
dreaming, thinking more focused and clear, buzzing and tingling at night
gone, no head noises, no foggy feeling, no longer trying to think through
cotton wool, do not need to struggle in order to be clear-headed, still
have tiredness, fatigue. (Electrical return currents on water pipes, 6.6
mG.)
These changes would seem to be a direct consequence of removal of previous
night-time magnetic fields; they do not appear to be directly related to
fatigue. In other words, a marked improvement in sleep does not necessarily
mean an improvement in fatigue, at least in the short term.
DISCUSSION
The present investigation did not find any dose-response relationships between severity of CFS/CF symptoms and magnetic field strength. Nor were any particular symptoms linked to exposure level. In future studies, attention must be given not only to point exposure levels in the home, but to how long residents are exposed and what other sources of exposure there might be (e.g. the workplace). It is notoriously difficult to establish dose-response relationships in magnetic field research with humans, but before accepting that such relationships are nonexistent, we must be sure of the quality of our exposure measurements.
The most interesting result to come out of this pilot study was the apparent
effect of reducing magnetic field exposure on sleep, though it is possible
that Group A‘s improvement might have been due in part to the fact that
they knew that they were being ”treated‘ (i.e. fields reduced). Sleep is
not a matter of simply switching off the brain; it is a complex process
that involves stages of deep and light sleep that occur over a full sleep
cycle of about 8 hours for most adults. The later stages of this cycle
are crucial for physical recovery and psychological wellbeing. Any factor
that interrupts the cycle can cause physical and physiological effects
such as fatigue, dizziness, inability to concentrate, perceptual changes,
mood changes, etc.8
The question of whether power line magnetic fields can affect sleep was specifically
examined in a paper titled: —A 50-Hz electromagnetic field impairs sleep“,
published in the Journal of Sleep Research in 1999. The researchers took
18 healthy adults (8 females, 10 males, age range 18-50 years) who were
good sleepers and compared their sleep with and without exposure to a 10
mG magnetic field (one night on - one night off). The results clearly showed
a significant reduction in total sleep time, sleep efficiency, stages 3
and 4 slow wave sleep, and slow wave activity. Circulating levels of melatonin,
growth hormone, prolactin, testosterone and cortisol were not affected.
The authors concluded that —commonly occurring low frequency electromagnetic
fields may interfere with sleep“.
The authors point out that, as this study was conducted with healthy volunteers
using only one night of exposure, patient groups exposed over a longer
period might be more sensitive. Furthermore, it is conceivable that increased
intensity of the field or of duration of exposure might yield larger effects.9
The fact that hormone levels were unaffected after the one night‘s exposure
is in agreement with the findings of Wilson, Stevens and co-workers at
the Pacific Northwest National Laboratory, in Washington, USA. Their research,
mainly on electromagnetic field effects on melatonin in the home and workplace,
indicates that melatonin levels are generally affected over the longer
term (30 days or longer) by magnetic field exposure, suggesting effects
may be cumulative.10
Sleep problems were also reported in a study published in the European Journal
of Internal Medicine in 2000. Here, it was found that many people living
near twin 400 kV transmission lines in Coutiches, France, and exposed to
a magnetic field >2 mG, had a modified iron metabolism, which they termed
—pseudo-iron deficiency“. The authors propose a high bone marrow uptake
of iron, explaining the apparent low iron levels in the blood.11 It was
noted that after several months the iron parameters would return to normal
when people moved away from the exposed residences.12 Besides tiredness/fatigue,
one of the symptoms commonly reported by subjects (especially children)
was an inability to sleep. It was especially noted that the insomnia would
disappear when the power level was lower than usual, and return when the
level normalised. The children slept normally when sent to grandparents‘
or relatives‘ homes.13
If indications are that only one night‘s exposure to a 50 Hz magnetic field
can cause observable sleep impairment in healthy people, what might be
the effects from prolonged exposure (years) on people with compromised
immune systems, such as with CFS?
Melatonin
One possible way a magnetic field could affect sleep is by affecting the
production of melatonin, a hormone produced by the pineal gland. The pineal
gland is the major control gland over this cycle, with melatonin production
controlled by signals from the postganglionic sympathetic fibres (neurons)
connected to the hormone-producing cells of the pineal gland. The firing
rate of the incoming neurons varies according to the phase of the light/dark
cycle. At night, these neurons exhibit an increased rate of firing, inducing
the release of the neurotransmitter norepinephrine, leading to a rise in
melatonin production.14, 15
During the day, light falling on photoreceptor cells in the retina produces
signals that quell the firing rate of the sympathetic neurons and, as a
result, melatonin production and secretion remain low. The differential
firing of the neurons between the day and night accounts for the circadian
rhythm in melatonin production. The day/night variation in pineal melatonin
synthesis is characteristic of all [diurnal] mammalian species, including
man.16
Shortly after its production, melatonin quickly enters the bloodstream and
gains access to all bodily fluids and therefore every cell, and cell nucleus,
in the body.17 The ability to enter every cell in the body is important
for melatonin‘s function as an antioxidant, scavenging highly toxic, oxygen-based
free radicals produced as a consequence of the utilization of oxygen by
all organisms.18, 19, 20 Unchecked, free radicals can damage macromolecules
such as DNA, proteins and lipids, through a process referred to as oxidative
stress.
Besides its role as an anti-oxidant, melatonin is also known for its sleep-enhancing
property.21 This may explain the phenomenon of jet-lag, where individuals
fly through several time zones to end up at a place in which the body‘s
circadian rhythms are temporarily out of phase with the new location‘s
day/night cycle. During the readjustment time, humans experience several
signs, among them difficulty sleeping, and it is believed that the disturbance
of the melatonin rhythm is partially responsible for this.22
In a paper on melatonin suppression by static and extremely low-frequency
electromagnetic fields, Reiter states: —Epidemiologists should look for
other possible changes, including psychological depression, fatigue, sleep
inefficiency, chronic feelings of jet lag, endocrine disturbances and other
symptoms; all these may result from a chronically low melatonin rhythm“.23
Thus, magnetic field effects might be implicated in a wide range of disorders
through their effect on melatonin. There are now several studies which
strongly suggest that these very low frequency fields can indeed suppress
melatonin.
At a workshop on electromagnetic fields, light-at-night, and human breast
cancer (1997), Dr. Scott Davis of the Fred Hutchinson Cancer Research Centre,
presented evidence that higher magnetic field levels at night were associated
with significantly lower melatonin levels during the same night.24 This
research was published in the American Journal of Epidemiology (2001),
where the authors concluded that: —These results suggest that exposure
to night-time residential 60-Hz magnetic fields can depress the normal
nocturnal rise in melatonin“.25
At the Second World Congress for Electricity and Magnetism in Biology and
Medicine (1997), Japanese researchers from the Faculty of Medicine, University
of Tokyo, presented research that specifically looked at melatonin levels
and electric blanket use. This study set out to determine whether the effects
of comparably long-term power line frequency exposure (from electric blanket
use) on suppression of the melatonin rhythm in humans, could be replicated.
The participants were 9 healthy male volunteers, aged between 23 and 37.
It was found that exposure to magnetic fields, of the intensity generated
by the electric blanket, suppressed peak value and/or delayed melatonin
rhythm in 7 out of 8 subjects. They concluded that: —The present findings
may suggest a possibility that exposure to ELF-EMF [extremely low frequency
electromagnetic fields] by electric blankets, if magnitude and duration
are sufficient, could lead to changes in melatonin production and its rhythm,
at least in highly sensitive individuals“.26
A preliminary study of 60 workers at a Finnish garment factory found —a highly
significant effect“ of electromagnetic fields in reducing nocturnal melatonin
levels. Magnetic field measurements were taken for the two types of machines
used in the factory and operators were assigned to high or low exposure
groups, based on the type of machine they were using, with average exposures
either above or below 10 mG. Non-exposed non-industrial workers were used
as controls. The results showed strong effects of both magnetic field exposure
and smoking on night-time levels of melatonin. No difference was found
in melatonin levels on week nights and Sunday nights, indicating —that
the possible suppression caused by magnetic field exposure is chronic,
with little recovery during the weekend“.27
Finally, in a study of 192 electric utility workers, Reif and Burch, from
Colorado State University, found that some electromagnetic field exposures
are associated with lower levels of melatonin. They found a significant
association between magnetic field exposures and lower daytime melatonin
levels on the second and third of three days of measurement. The lack of
an effect on the first day (following a weekend or equivalent) may indicate
a cumulative effect of exposure. Some studies have suggested that electromagnetic
effects on melatonin may depend on whether the field is continuous or intermittent.
Reif and Burch found that magnetic fields in the home that were —temporally
coherent“ (less intermittent) had a very significant association with lower
melatonin levels at night. They concluded that: —The intensity and temporal
characteristics of magnetic fields appear to be involved in melatonin suppression“.28
In the concluding remarks of the book, The Melatonin Hypothesis: Breast Cancer
and Use of Electric power (1997) the authors wrote: —The electromagnetic
spectrum, particularly in the visible range,
suppresses melatonin synthesis in the pineal gland of all vertebrates, including
man. Thus, electromagnetic energy has an important function in controlling
the internal milieu of vertebrates… A major challenge of future research
is to define the health effects of changes in melatonin production, and to
determine whether wavelengths outside the visible range reproducibly alter
the circadian synthesis of this important chemical mediator.“29
In summary, our findings of improved sleep patterns when relatively strong
magnetic fields were reduced in the home at night, can be accounted for
in terms of an increase in melatonin secretion, which enabled better quality
sleep. Of course, at this juncture, such a conclusion is speculative. We
hope to incorporate melatonin assays in our future work. Melatonin levels
should correlate positively with sleep duration and quality and be negatively
correlated with magnetic field intensity and/or duration.
CONCLUSIONS
The present study had quite limited aims, being a pilot for a more ambitious future investigation. That we found no relationship between exposure level and symptom severity was not entirely surprising. Clearly, our method of assessing exposure level and duration of exposure to magnetic fields must encompass more than an assessment of average exposure based on one or two readings. If possible, the full-scale investigation being planned will use meters that can be carried by subjects and which can store many readings across the course of a day. Only then can we be sure that there is no dose-response relationship between CFS symptoms and field levels.
Undoubtedly, the most interesting and exciting finding was that relatively
strong magnetic fields may impair sleep. Although caution is required in
drawing conclusions from such a limited sample, the results suggest that
it may be worthwhile to directly assess circulating melatonin levels in
future studies.
The effects of magnetic fields on the human body and central nervous system
are likely to be subtle. Thus, any study in this area must be mindful of
sample size. Large samples are required to provide sufficient statistical
power to detect what are probably very small effects. That said, even small
effects operating as co-factors in a severe illness may be enough to have
a devastating impact. Therefore, it seems to us that a carefully controlled,
large-scale investigation of magnetic field exposure as a co-factor in
CFS and other related disorders is warranted.
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