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一般人群中的非特异性躯体症状与电磁场暴露:能否更具体?系统综述。

Non-specific physical symptoms and electromagnetic field exposure in the general population: can we get more specific? A systematic review.

机构信息

Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.

出版信息

Environ Int. 2012 May;41:15-28. doi: 10.1016/j.envint.2011.12.002. Epub 2012 Jan 13.

Abstract

OBJECTIVE

A systematic review of observational studies was performed to address the strength of evidence for an association between actual and perceived exposure to electromagnetic fields (EMF) and non-specific physical symptoms (NSPS) in the general population. To gain more insight into the magnitude of a possible association, meta-analyses were conducted.

METHODS

Literature databases Medline, Embase, SciSearch, PsychInfo, Psyndex and Biosis and additional bibliographic sources such as reference sections of key publications were searched for the detection of studies published between January 2000 and April 2011.

RESULTS

Twenty-two studies met our inclusion criteria. Qualitative assessment of the epidemiological evidence showed either no association between symptoms and higher EMF exposure or contradictory results. To strengthen our conclusions, random effects meta-analyses were performed, which produced the following results for the association with actual EMF; for symptom severity: Headache odds ratio (OR)=1.65; 95% confidence interval (CI)=0.88-3.08, concentration problems OR=1.28; 95% CI=0.56-2.94, fatigue-related problems OR=1.15; 95% CI=0.59-2.27, dizziness-related problems OR=1.38; 95% CI=0.92-2.07. For symptom frequency: headache OR=1.01; 95% CI=0.66-1.53, fatigue OR=1.12; 95% CI=0.60-2.07 and sleep problems OR=1.18; 95% CI=0.80-1.74. Associations between perceived exposure and NSPS were more consistently observed but a meta-analysis was not performed due to considerable heterogeneity between the studies.

CONCLUSIONS

This systematic review and meta-analysis finds no evidence for a direct association between frequency and severity of NSPS and higher levels of EMF exposure. An association with perceived exposure seems to exist, but evidence is still limited because of differences in conceptualization and assessment methods.

摘要

目的

系统评价观察性研究,以评估实际和感知的电磁场(EMF)暴露与普通人群的非特异性躯体症状(NSPS)之间关联的证据强度。为了更深入地了解可能存在的关联程度,进行了荟萃分析。

方法

检索了 Medline、Embase、SciSearch、PsychInfo、Psyndex 和 Biosis 等文献数据库以及关键出版物的参考文献部分,以查找 2000 年 1 月至 2011 年 4 月期间发表的研究。

结果

符合纳入标准的研究有 22 项。对流行病学证据的定性评估表明,症状与较高的 EMF 暴露之间没有关联,或者结果相互矛盾。为了加强我们的结论,进行了随机效应荟萃分析,得出了以下与实际 EMF 相关的关联结果:症状严重程度:头痛比值比(OR)=1.65;95%置信区间(CI)=0.88-3.08,注意力问题 OR=1.28;95%CI=0.56-2.94,疲劳相关问题 OR=1.15;95%CI=0.59-2.27,头晕相关问题 OR=1.38;95%CI=0.92-2.07。症状频率:头痛 OR=1.01;95%CI=0.66-1.53,疲劳 OR=1.12;95%CI=0.60-2.07,睡眠问题 OR=1.18;95%CI=0.80-1.74。感知暴露与 NSPS 之间的关联更为一致,但由于研究之间存在很大的异质性,因此未进行荟萃分析。

结论

本系统评价和荟萃分析未发现 NSPS 的频率和严重程度与 EMF 暴露水平之间存在直接关联的证据。与感知暴露似乎存在关联,但由于概念化和评估方法的差异,证据仍然有限。

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