Antonio Sastre

Magnetic Field Exposure and Cardiovascular Disease Mortality among Electric Utility Workers

Laboratory studies suggest that electric and magnetic field exposure may affect heart rate and heart rate variability. Epidemiologic evidence indicates that depressed heart rate variability is associated with reduced survival from coronary heart disease as well as increased risk of developing coronary heart disease. The authors examined mortality from cardiovascular disease in relation to occupational magnetic field exposure among a cohort of 138,903 male electric utility workers from five US companies over the period 1950-1988. Cardiovascular disease deaths were categorized as arrhythmia related (n = 212), acute myocardial infarction (n = 4,238), atherosclerosis (n = 142), or chronic coronary heart disease (n = 2,210). Exposure was classified by duration of work in jobs with elevated magnetic field exposure and indices of cumulative magnetic field exposure. Adjusting for age, year, race, social class, and active work status, longer duration in jobs with elevated magnetic field exposure was associated with increased risk of death from arrhythmia-related conditions and acute myocardial infarction. Indices of magnetic field exposure were consistently related to mortality from arrhythmia and acute myocardial infarction, with mortality rate ratios of 1.5-3.3 in the uppermost categories. No gradients in risk were found for atherosclerosis or for chronic coronary heart disease. These data suggest a possible association between occupational magnetic fields and arrhythmia-related heart disease.

Prediction of nocturnal plasma melatonin from morning urinary measures

Abstract: A growing literature indicates that blood levels of the hormone melatonin may have important implications for human health and wellbeing. Melatonin is synthesized and released into the general circulation at night, however, and it is seldom feasible to draw blood samples at night in epidemiological studies. There is some evidence that levels of urinary melatonin and of 6‐sulfatoxymelatonin (aMT6s), the major metabolite of melatonin, accurately reflect nocturnal plasma melatonin. If this is the case, urinary assays could be powerful tools for epidemiological studies. A laboratory‐based study was performed to examine the relationships between nocturnal plasma melatonin, morning urinary melatonin, and morning urinary aMT6s levels in 78 men. The relationship between total nocturnal plasma melatonin and both urinary aMT6s corrected for creatinine and urinary melatonin is significant. Combining the two urinary measures accounts for 72% of the variance in total plasma melatonin. Peak nocturnal plasma melatonin also was significantly related to urinary melatonin and to aMT6s. The urinary measures show good sensitivity and specificity in identifying individual differences in nocturnal plasma melatonin levels. These results support the inclusion of morning urine samples to assess the contribution of the hormone melatonin in occupational or residential studies involving healthy, young men.

Nocturnal exposure to intermittent 60 Hz magnetic fields alters human cardiac rhythm

Heart rate variability (HRV) results from the action of neuronal and cardiovascular reflexes, including those involved in the control of temperature, blood pressure and respiration. Quantitative spectral analyses of alterations in HRV using the digital Fourier transform technique provide useful in vivo indicators of beat-to-beat variations in sympathetic and parasympathetic nerve activity. Recently, decreases in HRV have been shown to have clinical value in the prediction of cardiovascular morbidity and mortality. While previous studies have shown that exposure to power-frequency electric and magnetic fields alters mean heart rate, the studies reported here are the first to examine effects of exposure on HRV. This report describes three double-blind studies involving a total of 77 human volunteers. In the first two studies, nocturnal exposure to an intermittent, circularly polarized magnetic field at 200 mG significantly reduced HRV in the spectral band associated with temperature and blood pressure control mechanisms (P = 0.035 and P = 0.02), and increased variability in the spectral band associated with respiration (P = 0.06 and P = 0.008). In the third study the field was presented continuously rather than intermittently, and no significant effects on HRV were found. The changes seen as a function of intermittent magnetic field exposure are similar, but not identical, to those reported as predictive of cardiovascular morbidity and mortality. Furthermore, the changes resemble those reported during stage II sleep. Further research will be required to determine whether exposure to magnetic fields alters stage II sleep and to define further the anatomical structures where field-related interactions between magnetic fields and human physiology should be sought.

Multi-night exposure to 60 Hz magnetic fields: effects on melatonin and its enzymatic metabolite.

Magnetic field‐induced suppression of nocturnal melatonin in humans has been reported in occupational and residential studies, but not in laboratory‐based exposure studies. The present study examined whether this contrasting pattern of results might be related to associated differences in exposure duration or to field‐induced measurement instability over time. Thirty healthy young men were evaluated using a randomized, double‐blind test protocol. Statistical analysis indicated that 4 consecutive nights of exposure to power‐frequency magnetic fields at occupational intensity (resultant flux density=28.3 microtesla, μT, [283 milligauss, mG]) had no differential effect on concentrations of melatonin or its major enzymatic metabolite (6‐hydroxymelatonin sulfate, 6‐OHMS) in daily morning urine samples, compared to equivalent no‐exposure sham control conditions. The consistency of intra‐individual urinary measurements over the 4 test nights also was quite high (P<0.01) in the sham control condition. In contrast, repeated nightly exposure to the magnetic field was associated with reduced consistency. Morning urinary measures obtained after exposure on night 4 differed (P<0.01) from similar measures obtained after the second and third exposure night. Thus, while the overall results of this study do not support the melatonin hypothesis, there is some suggestion of a possible cumulative effect of magnetic field exposure on the stability of individual melatonin measurements over time. Additional research with longer periods of controlled exposure may be warranted.

Complex Factors in the Etiology of Gulf War Illness: Wartime Exposures and Risk Factors in Veteran Subgroups

Background: At least one-fourth of U.S. veterans who served in the 1990–1991 Gulf War are affected by the chronic symptomatic illness known as Gulf War illness (GWI). Clear determination of the causes of GWI has been hindered by many factors, including limitations in how epidemiologic studies have assessed the impact of the complex deployment environment on veterans’ health. Objective: We sought to address GWI etiologic questions by evaluating the association of symptomatic illness with characteristics of veterans’ deployment. Methods: We compared veteran-reported wartime experiences in a population-based sample of 304 Gulf War veterans: 144 cases who met preestablished criteria for GWI and 160 controls. Veteran subgroups and confounding among deployment variables were considered in the analyses. Results: Deployment experiences and the prevalence of GWI differed significantly by veterans’ location in theater. Among personnel who were in Iraq or Kuwait, where all battles took place, GWI was most strongly associated with using pyridostigmine bromide pills [odds ratio (OR) = 3.5; 95% confidence interval (CI): 1.7, 7.4] and being within 1 mile of an exploding SCUD missile (OR = 3.1; 95% CI: 1.5, 6.1). For veterans who remained in support areas, GWI was significantly associated only with personal pesticide use, with increased prevalence (OR = 12.7; 95% CI: 2.6, 61.5) in the relatively small subgroup that wore pesticide-treated uniforms, nearly all of whom also used skin pesticides. Combat service was not significantly associated with GWI. Conclusions: Findings support a role for a limited number of wartime exposures in the etiology of GWI, which differed in importance with the deployment milieu in which veterans served.

Pacemaker interference by magnetic fields at power line frequencies

Human exposure to external 50/60-Hz electric and magnetic fields induces electric fields within the body. These induced fields can cause interference with implanted pacemakers. In the case of exposure to magnetic fields, the pacemaker leads are subject to induced electromotive forces, with current return paths being provided by the conducting body tissues. Modern computing resources used in conjunction with millimeter-scale human body conductivity models make numerical modeling a viable technique for examining any such interference. In this paper, an existing well-verified scalar-potential finite-difference frequency-domain code is modified to handle thin conducting wires embedded in the body. The effects of each wire can be included numerically by a simple modification to the existing code. Results are computed for two pacemaker lead insertion paths, terminating at either atrial or ventricular electrodes in the heart. Computations are performed for three orthogonal 60-Hz magnetic field orientations. Comparison with simplified estimates from Faradays law applied directly to extracorporeal loops representing unipolar leads underscores problems associated with this simplified approach. Numerically estimated electromagnetic interference (EMI) levels under the worst case scenarios are about 40 /spl mu/T for atrial electrodes, and 140 /spl mu/T for ventricular electrodes. These methods could also be applied to studying EMI with other implanted devices such as cardiac defibrillators.

Brain frequency magnetic fields alter cardiac autonomic control mechanisms

OBJECTIVE Heart rate variability (HRV) is a noninvasive indicator of sympathetic and vagal cardiovascular control known to be tightly correlated with sleep stages. Recent studies indicate that HRV in humans is altered by nocturnal exposure to power-frequency (60 Hz) magnetic fields. Given the central origin of autonomic cardiac control, we determined if field exposure in the beta(1) EEG/MEG frequency range was a more effective stimulus for HRV alteration than 60 Hz fields, and explored the mechanisms involved. METHODS Healthy young men were exposed (n=9) overnight to an intermittent magnetic field (16 Hz, 28.3 microTesla, microT), or sham exposed (n=9), under blind test conditions in a laboratory exposure facility. RESULTS Field exposure was associated (P<0.05) with reduced power in the low band of the HRV frequency spectrum, and with decreases in mean heart rate. Analysis of the timing of the R waves surrounding each on-off transition of the intermittent field revealed no evidence for a direct effect on the cardiac pacemaker. CONCLUSIONS Magnetic field exposure in the EEG/MEG beta(1) frequency range alters HRV via a CNS effect. Phase-resetting experiments rule out a direct effect on the cardiac pacemaker. Biophysical calculations of the intensity of the electric fields induced in brain versus heart under the present exposure conditions are also consistent with and support a central rather than a peripheral site of action.

Pacemaker interference and low-frequency electric induction in humans by external fields and electrodes

The possibility of interference by low-frequency external electric fields with cardiac pacemakers is a matter of practical concern. For pragmatic reasons, experimental investigations into such interference have used contact electrode current sources. However, the applicability to the external electric field problem remains unclear. The recent development of anatomically based electromagnetic models of the human body, together with progress in computational electromagnetics, enable the use of numerical modeling to quantify the relationship between external field and contact electrode excitation. This paper presents a comparison between the computed fields induced in a 3.6-mm-resolution conductivity model of the human body by an external electric field and by several electrode source configurations involving the feet and either the head or shoulders. The application to cardiac pacemaker interference is also indicated.

Exposure to strong ELF magnetic fields does not alter cardiac autonomic control mechanisms

Clinical and epidemiological studies attest that alterations in heart rate variability (HRV) are predictive of specific types of cardiovascular morbidity and mortality in otherwise healthy persons. Recent reports also suggest that changes in HRV may be associated with exposure to intermittent magnetic fields (60 Hz, 28.3 microT) in the laboratory and that mortality is increased in cardiac disease categories related to altered HRV for utility workers whose jobs involve longer exposure to elevated magnetic fields. This study combined three approaches to learn more about the specific exposure circumstances under which changes in HRV occur. First, cardiac autonomic control, as indexed by HRV spectral analysis measures, was measured in 24 men during exposure to a much higher intensity field than any previously examined (resultant flux density = 127.3 microT [1273 milliGauss, mG]). Second, HRV measures from the same individual were compared across three relevant test conditions: intermittent and continuous field exposure and during a no-exposure, control condition. Third, electrocardiographic data were analyzed to determine if the precise timing of when the magnetic field switched on or off in relation to the cardiac cycle results in phase-resetting of the human cardiac rhythm. HRV measures were not altered by either field exposure condition compared to the control condition, and no evidence for a phase-resetting mechanism was found. Further research is needed to resolve the differences between the present and the earlier laboratory-based studies of HRV and to determine if cardiac rhythm disturbances are associated with exposure to the more complex magnetic fields found in the man-made environment.

All‐night exposure to EMF does not alter urinary melatonin, 6‐OHMS or immune measures in older men and women

Healthy men (n=22) and women (n=24), 40–60 years of age, were exposed all‐night (23:00–07:00 hr) to 60‐Hz magnetic fields at an intensity (resultant flux density=28.3 microTesla [μT]) well within the occupational‐exposure range, or sham exposed under equivalent, counter‐balanced, no‐exposure (≤0.2 μT) control conditions. Concentrations of melatonin, and the major metabolite of melatonin, 6‐hydroxymelatonin‐sulfate (6‐OHMS), in first‐void morning urine were not altered in either gender by exposure to the magnetic field, compared to control conditions. Statistical analysis also failed to reveal any evidence for exposure‐related alterations in blood concentrations of multiple hematologic and immune system parameters (CD3, CD4, CD8, natural killer [NK] cells). The present results replicate and extend earlier negative findings based on the exposure of young men to power‐frequency magnetic fields.