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Electromagnetic hypersensitivity - anincreasing challenge to the medical profession
Article · September 2015
DOI: 10.1515/reveh-2015-0012

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Rev Environ Health 2015; aop

Lena Hedendahl*, Michael Carlberg and Lennart Hardell

Electromagnetic hypersensitivity – an increasing
challenge to the medical profession
DOI 10.1515/reveh-2015-0012
Received June 29, 2015; accepted August 17, 2015

Abstract
Background: In 1970, a report from the former Soviet
Union described the “microwave syndrome” among military personnel, working with radio and radar equipment,
who showed symptoms that included fatigue, dizziness,headaches, problems with concentration and memory,and sleep disturbances. Similar symptoms were found in
the 1980s among Swedes working in front of cathode ray
tube monitors, with symptoms such as flushing, burning,
and tingling of the skin, especially on the face, but alsoheadaches, dizziness, tiredness, and photosensitivity.
The same symptoms are reported in Finns, with electromagnetic hypersensitivity (EHS) being attributed to exposure to electromagnetic fields (EMF). Of special concern
is involuntary exposure to radiofrequency (RF)-EMF fromdifferent sources. Most people are unaware of this type of
exposure, which has no smell, color, or visibility. Thereis an increasing concern that wireless use of laptops andiPads in Swedish schools, where some have even abandoned textbooks, will exacerbate the exposure to EMF.
Methods: We have surveyed the literature on different
aspects of EHS and potential adverse health effects of
RF-EMF. This is exemplified by case reports from two students and one teacher who developed symptoms of EHS inschools using Wi-Fi.
Results: In population-based surveys, the prevalence of
EHS has ranged from 1.5% in Sweden to 13.3% in Taiwan.
Provocation studies on EMF have yielded different results,
ranging from where people with EHS cannot discriminate
between an active RF signal and placebo, to objectively
observed changes following exposure in reactions of thepupil, changes in heart rhythm, damage to erythrocytes,
and disturbed glucose metabolism in the brain. The two
students and the teacher from the case reports showed*Corresponding author: Lena Hedendahl, MD, Research andInnovation Unit, County Council of Norrbotten, SE-971 89 Luleå,Sweden, E-mail: lenahedendahl@telia.com
Michael Carlberg and Lennart Hardell: Department of Oncology,
University Hospital, Örebro, Sweden

similar symptoms, while in school environments, as thosementioned above.
Discussion: Austria is the only country with a written suggestion to guidelines on the diagnosis and treatment of
EMF-related health problems. Apart from this, EHS is notrecognized as a specific diagnosis in the rest of the world,and no established treatment exists.
Conclusion: It seems necessary to give an International
Classification of Diseases to EHS to get it accepted as
EMF-related health problems. The increasing exposure
to RF-EMF in schools is of great concern and needs better
attention. Longer-term health effects are unknown. Parents, teachers, and school boards have the responsibility
to protect children from unnecessary exposure.
Keywords: medical diagnosis; prevention; radiofrequency
electromagnetic fields (RF-EMF); school children; Wi-Fi.

BackgroundIn recent decades, human beings and other species havebeen increasingly exposed to radiofrequency electromagnetic fields (RF-EMF) (1, 2). Exposure is involuntary from,e.g. base stations and wireless fidelity (Wi-Fi) routers used
for wireless internet communication, but also voluntarythrough personal use of such devices as mobile phones,
cordless phones and wireless connected laptops, iPads,
etc. At homes and in offices, we now see a new development with wireless “talk” between different appliances
causing increased passive exposure to RF-EMF.
Many people are concerned about the potential
adverse health effects of RF-EMF. Of special concern is
exposure from sources that the individual cannot control,close out, or even reduce. However, most people areunaware of this type of exposure, which has no smell,color, or visibility. Cordless phones may be placed close
to the bed, whereby the sleeper is unnecessarily exposed
to RF-EMF from its base station. Many take their smart
phones everywhere and put them on the bedside table oreven under the pillow at night. Laptops and iPads are frequently used in schools, at work, and in the home. Schools
in Sweden usually have wireless networks reaching every

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Hedendahl et al.: Electromagnetic hypersensitivity

room in the building. This makes it easy and convenient
to teach and keep in contact everywhere. In some schools,
almost all education is conducted through a personal computer given to each student. The same type of development
is going on in offices and other workplaces. Free Wi-Fi isalso available to everyone in some city centers in Sweden.
Electric light can be switched on all day during dark
winter months, and in our homes, we are dependent onelectricity and electric appliances for cooking, cleaning,
and washing clothes and dishes. Technical development
has accelerated rapidly during the last century. It has
made life easier and more convenient.
However, there are people who experience sideeffects from electrical and wireless equipment. They canexperience symptoms that include headaches, nausea,
dizziness, skin problems (itching, pricking, and heating),
heart arrhythmias, concentration and memory difficulties,
sleep problems, aches in muscles and joints, etc. (3). They
present different symptoms depending on the frequencyof the EMF. It can also vary widely which symptoms aperson gets depending on his or her individual sensitivity
and weaknesses. The intensity of the symptoms can varyfrom weak to strong within seconds and last from minutes
to several days. The symptoms can make everyday life
very disabling and difficult to manage.

a similarity between skin biopsies from these womenand those from heavily UV-­radiated skin. He compared
it with elastosis solaris, seen in elderly people after long­sun-bathing or working out in the sun. The term “screen
dermatitis” was suggested. If the affected office workers
went on working in front of CRT screens, they could
develop more symptoms – headaches, dizziness, tiredness, and light and noise sensitivity. Both at work and at
home, they could become sensitive to fluorescent light,
the stove, TV, and other electric devices (5).
The Swedish Confederation of Professional Employees, Tjänstemännens Centralorganisation (TCO), succeeded in making their recommendation of 0.2 μT thelimit for the extremely low frequency (ELF) magnetic
fields from the CRT screens internationally accepted. It
might not only have been the high magnetic fields fromearlier screens but also chemicals like brominated flame
retardants in the materials in the screen and the computer that caused these reactions. When the devices were
heated, new chemicals were vaporized in the electronics(5). Polybrominated diphenylether, a flame retardant usedin electronics, was later found s­ ignificantly elevated in agroup of patients with EHS compared to a healthy control
group (6).

Reference values

Historical aspects
As early as in the 1970, a report from the former Soviet Union
described the “microwave syndrome”. The Soviet military
recognized early on the possible side-effects from radar andradio radiation. The microwave syndrome was seen in up toa quarter of the military personnel working with radio andradar equipment, even though the EMF were below today’sreference value. They showed symptoms such as fatigue,dizziness, headaches, problems with concentration andmemory, sleep disturbances, and being hot tempered. The
treatment suggested was a change of assignments and tokeep away from EMF. Rest, physical exercise, and nutritious food were offered (4). The symptoms described are thesame as those found 40 years later in Finnish people withelectromagnetic hypersensitivity (EHS) (3).
In the 1980s, symptoms from cathode ray tube (CRT)
computer screens appeared among office workers, mostof whom were women. They showed symptoms that
included flushing, burning, and tingling in the skin, especially on the face. When it worsened, they could develop
eczema and swollen faces, with dilated blood vessels andvesicles, which was usually diagnosed as Rosacea. Björn
Lagerholm, a Swedish dermatologist, histologically foundThe reference values for RF-EMF were recommended in1998 by the International Commission on Non-­Ionizing
Radiation Protection to 2–10 W/m2 for frequencies between
10 MHz and 300 GHz. Up to 400 MHz, the ­recommendationis 2 W/m2. The formula: frequency/2 × 108 is used for frequencies between 400 and 2000 MHz. Above 2000 MHz up
to 300 GHZ, the recommended reference value is 10 W/m2
(7). These reference values protect against injuries caused
by a heating effect over 1°C after an exposure of 30 min,and with a safety factor of 50 for general public. Injuriescaused by other biological mechanisms than heating orfrom chronic effects of EMF exposure are not believed toexist. Sweden and many other countries apply these reference values. Other countries, like Russia, Poland, Italy,
and India have chosen lower reference values down to
0.1 W/m2. Some of the researchers behind the BioInitiative Report in 2012 suggest 3 μW/m2 as a reference value,
because research work on biological effects has shown
some influence of RF-EMF down to 30 μW/m2 (8).
Measurements of outdoor exposure in Sweden in 2013
showed a median power density for RF fields between
30 MHz and 3 GHz to be 16 μW/m2 in rural areas, 270 μW/m2
in urban areas, and 2400 μW/m2 in city areas (9).

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Hedendahl et al.: Electromagnetic hypersensitivity

Wi-Fi in schools
Over the last few years, while all public schools and mostprivate schools in Sweden have installed wireless accessto the Internet (Wi-Fi), there have been reports in newspapers of teachers and children experiencing symptomsof EHS (10, 11). In classes with one laptop per student,
exposure to EMF can be especially high. Symptoms often
include tiredness, headaches, dizziness, and difficulties
with concentration and memory. Some recover at home,whereas others have problems sleeping at night. Palpitation of the heart is another reported symptom.
A debate has started in Sweden as to whether students
should be allowed to use their mobile phones during
school time. It is usually not exposure to EMF from thephone that is the issue of this debate, but rather the time,energy, and attention it takes away from school work.

Methods
Following a short literature review of different aspects on EHS, we
will discuss the increasing use of Wi-Fi in schools. This is of special concern regarding EHS and other potential health effects. Two­students and one teacher from the Nordic countries with healthproblems exacerbated by such a school environment are presented
as case reports.

Results
There are different names for the medical condition
called the microwave syndrome, which some now call
EHS (3, 12). Other names are idiopathic environmental
intolerance attributed to electromagnetic fields (IEI-EMF)(13) and electromagnetic field intolerance syndrome. As
the different names point out, opinions are divided onwhether the symptoms are caused by EMF (14, 15) or if
there is anxiety about new technology that could be thecause of the symptoms (16). In population-based surveys,
the prevalence of EHS has ranged from 1.5% in Sweden(17), 3.2% in California (18), 5% in Switzerland (19), up to
13.3% in Taiwan (20).

Provocation studies
Provocation studies with exposure to EMF have produced
divergent results. Some studies have shown how people
with EHS cannot discriminate between an active microwave

3

signal and a placebo signal, or do not get more symptoms
from active exposure compared to sham exposure (21–23).
Other studies on healthy or EHS people have shown objectively observed changes in the reactions of the pupil (14),changes in heart rhythm (15, 24, 25), damage to erythrocytes(26), and disturbed glucose metabolism in the brain (27)following exposure to EMF. Several studies indicate someinfluence on electrical activity in the brain seen in electroencephalograms after exposure to RF-EMF during both sleep
and active memory tests (28, 29). An increased activity in thesympathetic nervous system and hyperreactivity to sensor
stimulation has been found in patients with EHS (30).
Some reviews on provocation studies on EHS and
IEI-EMF conclude that it is difficult, under blind conditions, to show that exposure to EMF can trigger thesymptoms described by people with EHS or support theexistence of a biophysical hypersensitivity to EMF (31, 32).
Another review points to the sparse literature on thiscondition and discusses the controversy surrounding thelegitimacy of the EHS diagnosis (33).
Provocation studies where the subject is supposed
to tell whether an EMF is on, or has to report subjective
symptoms can be difficult to conduct and have manysources of error. For people with EHS, the backgroundenvironment of EMF can have a considerable influence on
the test results. The best situation would be a test roomwith very low EMF both from ELF and RF.
Rea et al. did a provocation study in an environmentally controlled area with porcelain-on-steel walls tominimize airborne chemical pollution and external EMF,
which might interfere with the testing procedure (14).
Their provocation study had an alternating magnetic fieldwith 21 active challenges frequencies from 0.1 Hz to 5 MHz
and tested 100 subjects with self-reported EHS. Sixteen
subjects reacted to active challenges but not to blanks.
The subjects’ health and well-being on the test day
may also influence the results. If the journey from hometo the test room is long, it may find the EHS subject in aworse condition and more hypersensitive to EMF. This canmake them react even to the lower power of EMF.
In the study by Rubin et al. on self-reported EHS, subjects were exposed to a pulsing 900 MHz global system formobile communication (GSM) signal from a mobile phone
as an active signal, which produced a targeted specificabsorption rate of 1.4 W/kg (21). The sham signal, a continuous wave, was supposed to have a minimal leakageof < 2 mW/kg. This low, but not negligible, signal may
account for some of the positive reactions from the sham
exposure. Of the EMF-sensitive participants, 60% believedthat a signal was present during exposure to GSM, whereas
63% reported an active signal on the sham exposure.

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Hedendahl et al.: Electromagnetic hypersensitivity

Another difficulty with provocation studies is thatEHS subjects may be sensitive to many different frequencies, but not all. Some react mostly to ELF-EMF and somemostly to RF-EMF (14). Furthermore, the symptoms canbe very different between two subjects with EHS depending on their sensitivity and other illnesses, where somemainly get dermatological symptoms whereas others getheart effects (3). The time from exposure to appearanceof symptoms may also differ from seconds to days (15, 26).

Case reports
Case 1A previously healthy boy aged 15. Starting at the age of 5,
he frequently played computer games, which often madehim angry. He disliked the mobile phone he got when hewas 7 and therefore seldom used it. In the fall of 2013, hestarted eighth grade, and his class moved to a building
with mold problems. He started to have headaches, getvery tired, and had difficulties concentrating at school.
It seemed that he was in his own world and had trouble
hearing what other people said. He became increasingly
sensitive to light and sounds, experienced itching aroundhis mouth and nose, and had palpitations of his heartwith increasing rhythm, for which acute medical care wassought. In the hospital, he had tachycardia with a heart
rhythm of above 200 beats per minute, which was treatedwith intravenous drug injections and only returned tonormal after about 2 h. He started to sleep very badly, andbecame sad and depressed.
Except from offering allergy and psychiatric medicines, the doctors seemed helpless. In the spring of 2014,a friend recommended that the parents seek help from analternative medicine therapist. The therapist made somemuscle tests and found the boy’s muscles very tense. After
turning off the main power switch in the house, the boy’smuscles and body relaxed. The therapist suggested hecould be hypersensitive to EMF.
At home, the family turned off their Wi-Fi, electric
devices, and lights. The boy got a lot better, especiallyduring the summer of 2014 when he was outside and often
at the seaside. Presently (2015), during his last year in
primary school, he has increasingly been missing school
and gets help to study at home. He develops symptoms
soon after entering the school building, even in a smallbuilding without mold. The parents have not had any
success in making the school authorities turn off the Wi-Fi.
Mobile phones are supposed to be switched off when heis in class, but few teachers enforce this. Outdoors and at

home, he feels better and can now use the cabled computer for a while. He is concerned about his future andwhether there is any school he can go to next year.

Case 2
A boy aged 15. Before starting school and during his
first school years, the boy was healthy. In his first school,
where he went from grades 1 to 7, he started to get headaches, especially when his friends brought their smart
phones to school. Later, he also started to be more tired
and had problems with memory, concentration, andsleep. In grade 9, in August 2014, all classes moved into a
newly built school building with Wi-Fi already installed.
Here, his symptoms got a lot worse. During this school
year he has often been very tired when he returned home.
Sometimes he slept from five in the afternoon to seven in
the morning the next day, complaining that he slept badly.
He also complains of severe headaches, poor memory, dizziness, and problems with his balance. He began to havestomach problems. He recovers during weekends, but still
has symptoms. He lives near a base station and has neighbors using Wi-Fi. The school board and the local government refuse to turn off the Wi-Fi in the boy’s classroom,
but other students are supposed to turn off their smart
phones during school hours.
In his earlier school, where he went from grades 1 to 7,
measurements of RF-EMF were made in March 2012. With
the RF-Analysator Gigahertz Solutions HF 59B, Isotrop
antenna UBB27_G3, and frequency filter FFGE with therange of 27 MHz–3.3 GHz, measurements showed values
from 41 to 10,000 μW/m2. Most of the measured RF-EMF
came from UMTS (3G). Wi-Fi was not installed in thisschool in 2012. In October 2011, measurements were madein the school yard and showed a maximum of 6200 μW/m2(average 470) increasing to 10,800 μW/m2 (average 1300) in
February 2015 (www.EMF-consult.no). In the area aroundthis school, the number of mobile base stations increased
between 2011 and 2015 from 12 to 22.
The school board at the school the boy is attending
since 2014 has refused to do any measurements because theexposure of RF-EMF is thought to be well under the country’s reference value of 10 W/m2 for RF-EMF > 2000 MHz.

Case 3A previously healthy female teacher aged 47. Wi-Fi wasinstalled in her school in the spring of 2011, and all students in grades 7–9 got their own laptop in the fall. All theBereitgestellt von | De Gruyter / TCS
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Hedendahl et al.: Electromagnetic hypersensitivity

teachers were encouraged to use the computers in every
lesson. The school did not buy any textbooks for any of theclasses starting that year. The fall semester started withdownloading several programs to each student’s laptop
for the different school subjects. After 3 weeks, the teacher
started to feel heart palpitations, with both a very fast
and uneven rhythm, when working in school. This disappeared when she went on a 2-week planned education
trip to another country. Back at home, the palpitations
returned after a week’s work and got steadily worse. She
consulted the hospital as an emergency patient, but herheart calmed down on her way to the clinic, and she had
a normal rhythm at medical examination. She was on sickleave at home for a week, recovered, and felt well again.
Back at work she started to get palpitations within 3 days
and felt dizzy as though she was about to faint. She wasnow sure about the association between her palpitations
and her work with Wi-Fi and all the laptops being usedduring the school day. This time she also became hypersensitive to ELF-EMF at home, from the television monitor,
the induction stove, and the corded computer.
During the first 2 years, the school authorities did notrecognize her EHS or make arrangements for it, but she
finally got help with the support of her labor union. Now,
4 years later (June 2015), she remains sensitive to Wi-Fi
and wireless equipment, but tolerates regular electricity
and electronic devices. She still works as a teacher, but
in another school in a classroom without Wi-Fi and has
all her school meetings there. The students can use theirlaptops and smart phones in her classroom, but they haveto be off-line in flight mode. She can use her own mobile
phone, but does so sparingly. She feels well and has noheart problems as long as she avoids excessive use andexposure to wireless devices.

Discussion
The two students and the teacher report similar symptoms as the military radio and radar workers in theformer Soviet Union, the Swedish office workers who got
symptoms in front of the CRT monitors, and the electromagnetic hypersensitive Finns (3–5). They experienced
symptoms such as headaches, tiredness, dizziness, heartarrhythmias, problems with concentration and memory,
sleep disturbances, hypersensitivity to light and sounds,
and flushing, burning and tingling of the skin, etc. These
people attribute their symptoms to different EMF, bothfrom ELF-EMF from our household electricity and/or from
RF-EMF from wireless devices.

5

There can be a combination effect between chemicals
and allergens, such as mold, together with EMF, which
may aggravate the EHS. The office workers in front of new
CRT monitors and elevated levels of flame retardants inthe blood of a group of EHS people point to this combination effect (5, 6). The boy from case 1 above exemplifies this with his symptoms exacerbating when his class
moved into a building with mold problems.
The Austrian Medical Association has made suggestions as to guidelines for the diagnoses and treatment
of EMF-related health problems and illnesses (34), but
apart from this, EHS is not recognized by the rest of theworld today as a specific diagnosis. There are no diagnostic criteria and no treatment has been officially accepted.
Instead, persons with EHS are often offered cognitive
therapy because some studies have shown a reductionin perceived hypersensitivity after its use (35, 36). Efforts
to raise the question of a medical diagnosis for EHS havebeen made several times in the European Parliament andits committees, but every time these have been rejected.
Provocation studies under double-blind conditions,where EHS cases are supposed to tell whether they are
exposed to EMF or report which symptoms they get, canbe difficult to conduct as we have discussed above. Thus,
it would be useful to do provocation studies with exposure to EMF and objectively observe and register changes
in body reactions beyond voluntary control, such as heart
rhythm and electric skin potentials (25), adverse effects on
blood cells (26), and saliva (37). The discussed difficulties
with provocation studies seem to be the same for assessing diagnostic criteria for EHS, because symptoms andsensitivity can differ considerably among EHS persons.
This would require further research.
People with EHS report that they can be sensitive andget symptoms to RF-EMF down to a few μW/m2. Residential areas with low RF-EMF exposure can be the best wayof reducing the symptoms of EHS. Activist and non-governmental organizations in several countries are working
on this, but because governments do not recognize EHS asa real medical illness and impairment, they usually do notgive any support. Avoiding wireless devices and choosing
cabled connections to the Internet are important. In thehome and office, electricity, lights, and machines can beshielded from ELF-EMF with special equipment that can
improve living and working conditions.
Both ELF- and RF-EMF have been evaluated by theInternational Agency for Research on Cancer (IARC) at theWorld Health Organization to be “possible” human carcinogens, Group 2B (38, 39), but these conclusions seem tohave had little or no impact on regulating human exposure.
Those people who are not actively seeking information,

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Hedendahl et al.: Electromagnetic hypersensitivity

especially children, are uninformed of the IARC evaluation,
because, at least in Sweden, governmental agencies do not
actively inform people about the problem. The situationin schools with increasing exposure to RF-EMF is of major
concern and hard to understand and defend for medical
reasons, not least because a wired solution gives equal oreven better internet access. Longer-term health effects are
unknown. Parents and school boards are responsible forprotecting children who are at a vulnerable age to toxins
and obliged by law to attend school.

Conclusions
The prevalence of EHS seems to be increasing today, andmany people get symptoms when exposed to ELF- and/or
RF-EMF. With the ever more extensive use of wireless technologies, nobody can avoid being exposed. It is important
to work toward getting objective diagnostic criteria for EHS,
and have it recognized and officially accepted as hypersensitivity, an illness caused by exposure to EMF. Thus, it is necessary to give an International Classification of Diseases to
EHS. If and when EHS is accepted as a diagnosis by society
and the medical profession, measures can be taken especially in consideration for this group of people with EHS
regarding healthcare, accommodation, school, and work.
Measurements of exposure to EMF should be performed in classrooms and in school yards during a typicalschool week. The results must be evaluated in relation to
current knowledge of biological effects from EMF exposure. This should lead to a precautionary approach using
wired solution of the internet connection, but also reduction of other sources of EMF exposure. This approachshould be similar as for control of exposure to other toxic
agents such as asbestos and radon emissions. It is time toconsider ELF-EMF and RF-EMF as environmental pollutants that need to be controlled.
Acknowledgments: General support by grants from
­Cancer-och Allergifonden, Cancerhjälpen, Pandora-Foundation for Independent Research, Berlin, Germany, Kone
Foundation, Helsinki, Finland, and Mr. Brian Stein is
acknowledged.

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Article note: From: The Fifth Congress of the Paris Appeal:
Environmental idiopathic intolerance: what role for EMFs andmultiple chemicals? 18 May 2015, Brussels, Belgium.

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