Jörg Schröttner

Does “electromagnetic pollution” cause illness?

SummaryMore and more self-declared electromagnetic hypersensitive patients are entering physicians’ practices seeking help. To assess the prevalence of cases and the opinion of Austrian physicians regarding the potential health-relevance of environmental electromagnetic fields (“electromagnetic pollution”), a statistical investigation among general practitioners was undertaken, with surprising results. Only one-third report on never having been asked about the health impact of electromagnetic pollution by patients. An overwhelming percentage of general practitioners (up to 96%) to some degree, or totally, believe in a health-relevant role of environmental electromagnetic fields, and only 39% have never associated health symptoms with “electromagnetic pollution”. Two-thirds are consulted occasionally or even frequently by self-declared electromagnetic hypersensitive patients. However, sound information seems to be lacking. Knowledge on existing electromagnetic exposure limits and on environmental field levels in relation to them is poor. It is remarkable that authorities play a marginal role in informing physicians. Only 4% mention having received information on “electromagnetic pollution” from such a source. It is rather remarkable that there is such a widespread contradiction between physicians’ opinions and established national and international health risk assessment. With respect to the frequency with which doctors are confronted with this issue, the results demonstrate an urgent need for action.ZusammenfassungImmer mehr von ihrer elektromagnetischen Überempfindlichkeit überzeugte Patienten suchen ärztliche Hilfe. Um das Vorkommen dieser Fälle und die Meinung der österreichischen Ärzte über die potentielle Gesundheitsrelevanz elektromagnetischer Felder im Alltag (Elektrosmog) zu erfassen, wurde eine statistische Untersuchung unter den Allgemeinmedizinern Österreichs durchgeführt, die zu überraschenden Ergebnissen geführt hat. Nur ein Drittel der befragten Ärzte berichtet, niemals von Patienten über die gesundheitliche Bedeutung von Elektrosmog befragt zu werden, zwei Drittel geben an, gelegentlich oder häufig von Patienten konsultiert zu werden, die von ihrer elektromagnetischen Überempfindlichkeit überzeugt sind. Ein überwältigender Prozentsatz von bis zu 96 % schließt einen gesundheitsrelevanten Einfluss von Elektrosmog nicht aus und nur 39 % diagnostizieren niemals einen Zusammenhang zwischen Gesundheitsbeschwerden und Elektrosmog. Allerdings scheint ein großer Informationsmangel zu herrschen. Das Wissen über Elektrosmog, die bestehenden Grenzwerte und die Größe der elektromagnetischen Umgebungsfelder im Vergleich zu ihnen ist gering, und 99 % der Ärzte empfinden die Informationen über elektromagnetische Überempfindlichkeit als nicht ausreichend. Es ist bemerkenswert, dass die Behörden eine marginale Rolle bei der Information spielen. Nur 4 % der Ärzte geben an, von ihnen Informationen über Elektrosmog zu erhalten. Es ist eher einzigartig, dass es einen derartig weit verbreiteten Widerspruch zwischen den Meinungen von Ärzten und der anerkannten nationalen und internationalen Risikobewertung gibt. Angesichts der Häufigkeit der Begegnung mit dieser Thematik zeigen die Ergebnisse einen dringenden Handlungsbedarf auf.

Untersuchung von Bildqualität und Genauigkeit der Dosisberechnung bei cone-beam-CT-Aufnahmen mit reduziertem Projektionsdatensatz (half scan, half fan) im Hinblick auf die Verwendbarkeit für die adaptive Bestrahlungsplanung

UNLABELLED Subject of this study is the question of whether cone beam CT (CBCT) images with reduced projection data are suitable for use in adaptive radiation therapy (ART) treatment planning. For this purpose image quality and dose calculation accuracy depending on imaging modality were analysed. In this context, two CBCT-methods will be indicated having reduced projection data sets: Scans acquired with 200° rotation angle in order to accelerate the CBCT process (half scan), or scans with an asymmetric cone beam and detector offset, used to enlarge the field-of-view (half fan). METHODS For three different CBCT-modes (On-Board-Imaging, Varian Medical Systems), two of them based on reduced projection data, and a conventional multidetector CT system, the main image quality parameters were studied. Treatment plans for two phantoms were transferred to all datasets and re-computed to analyse dose calculation accuracy. Furthermore imaging dose was measured for all modalities. RESULTS All three CBCT-modes showed similar results with regard to image quality. It was found, that a reduction in projection data does not necessarily involve deterioration in image quality parameters. For dose calculation based on CBCT images, a good agreement with the reference plan was found, with a maximum deviation for the mean dose in regions of interest of 1.1%. Imaging dose was found to be 2.5 cGy and 2.9 cGy for the large-FOV mode and the partial rotation mode, respectively, and 5.4 cGy for the 360°-full fan mode.

Assessment of inhomogeneous ELF magnetic field exposures

In daily life as well as at workplaces, exposures to inhomogeneous magnetic fields become very frequent. This makes easily applicable compliance assessment methods increasingly important. Reference levels have been defined linking basic restrictions to levels of homogeneous fields at worst-case exposure conditions. If reference levels are met, compliance with basic restrictions can be assumed. If not, further investigations could still prove compliance. Because of the lower induction efficiency, inhomogeneous magnetic fields such as from electric appliances could be allowed exceeding reference levels. To easily assess inhomogeneous magnetic fields, a quick and flexible multi-step assessment procedure is proposed. On the basis of simulations with numerical, anatomical human models reference factors were calculated elevating reference levels to link hot-spot values measured at source surfaces to basic limits and allowing accounting for different source distance, size, orientation and position. Compliance rules are proposed minimising assessment efforts.

Untersuchung von Schlafstörungen um Hochfrequenz-Sendeanlagen / Investigation of Sleep Disorders in the Vicinity of RF Transmitters

Abstract Zur Untersuchung eines potentiellen Einflusses von hochfrequenten elektromagnetischen Feldern von Sendeanlagen auf die Schlafqualität von elektrosensiblen Anrainern wird ein neuartiges Studiendesign vorgestellt. In einer Doppelblind-Crossover-Feldstudie wird die Auswirkung einer Vor-Ort-Abschirmung statt einer zusätzlichen Exposition untersucht. Zur zuverlässigeren Differenzierung der Schlafqualität werden Polysomnographie-Parameter durch zusätzliche Meßgrößen ergänzt. Die Machbarkeitsstudie zeigte, daß die Überprüfung der Rohdaten der Schlafaufzeichnung und eine Korrektur der Ergebnisse der Auswertungssoftware durch visuelle Befundung der Polysomnographie-Aufzeichnungen unverzichtbar sind. Die Langzeit-frequenzselektive Messung der HF-Immissionen ergab, daß die Exposition sowohl während einer Nacht als auch zwischen den Nächten sehr stark variieren kann. Die Variationen können größer als die Größe des vom Mobilfunk stammenden Immissionsanteils sein. Es dominierten meist die Anteile im UKW-Radiofrequenzband im Vergleich zu den Mobilfunkanteilen. Für eine zuverlässige Interpretation der Ergebnisse insbesonders in Hinblick auf eine Beurteilung der Mobilfunk-Immission ist daher eine kontinuierliche breitbandige Erfassung der HF-Immission unverzichtbar. Die Ergebnisse zeigen, daß einfache Schlaferfassungssysteme, die nur auf der Einkanal-EEG-Auswertung beruhen und keine Kontrolle der Rohdaten zulassen, für Schlafstudien ungeeignet sind. To investigate the potential impact of RF electromagnetic fields of transmitters on the sleep quality of nearby residents, a new study design is presented. In a double- blind crossover field study the effect of on-site shielding, rather than of additional exposure, is investigated. For improved sleep quality differentiation the polysomnographic parameters are expanded by additional parameters. The feasibility study showed that checking the raw data and correcting the software-generated results by visual reading of the polysomnographic recordings is essential. Long-term RF measurement showed that exposure may vary considerably throughout the night, as well as from one night to the next. This variation may be greater than the GSM contribution itself. Mostly, the contributions of USW radio frequency fields dominated over GSM. Thus, continuous broadband RF recording is required for reliable interpretation of the results, in particular with regard to the potential role of mobile telephony emissions. Results show that simple sleep monitoring systems based on single-channel EEG analysis without acces to original biosignals are not adequate for sleep studies.

Development of a System Dynamics Model for Cost Estimation for the Implantation and Revision of Hip Joint Endoprosthesis

The increasing population, particularly regarding the proportion of people over the age of 60 causes new challenges to public health care systems. Simulations of existing health care models indicate that especially orthopedic and arthritic conditions show a considerable impact of population aging on total health care costs. To demonstrate the estimated total amount of costs, a model was developed in this work, which allows simulating the costs regarding hip joint endoprosthesis. The benefit of this model will be the chance to compare the results of different simulation scenarios to each other, with regard to their economic effectiveness. The model simulates the number of implantations as well as revisions of total and part hip endoprosthesis and the incurred costs, based on real statistical data, until the year 2040. For modeling the system dynamic technique was used. To calculate the distribution of the population with a hip implant the parameters rate of implantation, type of implant, mortality and the rate of revision have been considered. The model incorporates 898 elements of which 133 represent adjustable variables. As a result of these properties, a wide range of different simulation scenarios can be investigated, such as scenarios based on capacity limits, changes in implantation and revision times, variations in implant costs, expense-related costs or changes in the allocation of cemented and un-cemented implants as well as bearing combinations. Therefore the model can be enhanced by adapting it for future developments. The model presented in this paper represents a comprehensive tool, which for the first time enables a lot of possibilities for different simulation scenarios in the medical area of hip arthroplasty regarding cost estimations and resource management.

Current Status of Biomedical Engineering Education Programs in Austria

The situation of education programs in the area of “Biomedical Engineering” in Austria changed considerably since the European initiative, the Bologna Process. Beside the classic education sector at universities additional new education programs are offered at universities of applied science, private universities and in terms of advanced training courses. To get an overview of all these education programs a working group inside the Austrian society for Biomedical Engineering has been established. In this paper a summery of different study programs in Austria in the area of Biomedical Engineering is presented. The overview includes detailed information of all Bachelor and Master Curricula offered at Austrians universities. Additional information is given regarding duration, degrees, accreditation status and in-depth topics of the education programs.

Standards and Regulations for (Bio)Medical Software

This chapter provides an introduction to the basic legal regulations and harmonized standards for the development and release of biomedical software, which is treated by law as a medical product. The authors will primarily focus on the regulations and recommendations within the European Union, and also delineate and discuss the legal situation exemplarily in selected countries such as the United States, Canada and Australia. In summary, this survey will provide a guideline for researchers and practitioners dealing with software development as a medical product according to the Medical Devices Act.

Usability evaluation of a locomotor therapy device considering different strategies

Abstract Usability of medical devices is one of the main determining factors in preventing use errors in treatment and strongly correlates to patient safety and quality of treatment. This thesis demonstrates the usability testing and evaluation of a prototype for locomotor therapy of infants. Therefore, based on the normative requirements of the EN 62366, a concept combined of evaluation procedures and assessing methods was created to enable extensive testing and analysis of the different aspects of usability. On the basis of gathered information weak points were identified and appropriate measures were presented to increase the usability and operating safety of the locomotor prototype. The overall outcome showed an usability value of 77.4% and an evaluation score of 6.99, which can be interpreted as “satisfactory”.

Medication process in Styrian hospitals

Abstract The aim of this work was to analyse the medication process and the potential for errors during the process steps. For this purpose, a literature review was conducted and a questionnaire was developed to compare the results from the literature with the current medication process in Styrian hospitals. The questionnaire was divided into four different parts with a total of 29 questions. For the survey all 37 Styrian hospitals were contacted whereas 11 filled out the questionnaire. The survey showed that there is no standardized medication process defined and that the rate of medication errors is generally underestimated. In addition, technical solutions may help to reduce errors but are expected to be hardly used in clinical practice.

Investigation of noise levels in intensive care units.

To investigate noise levels in intensive care units sound level measurements were carried out for several weeks both in patient’s areas as well as in staff working and monitoring areas. The time course of the sound pressure level was investigated and the characteristics in terms of minimum, maximum and rating levels were determined and assessed. Preliminary results show that the noise level is very high for patients at any given time. Furthermore, the legal noise limit for intellectual activities (50dB) at the workplace was exceeded at all times, although the limit for simple office work (70dB) was not exceeded. Solutions should be developed to minimize the noise disturbance to staff and patients.