Citation: Modenese, A.; Gobba, F. Occupational Exposure to Electromagnetic Fields and Health Surveillance According to the European Directive 2013/35/EU. Int. J. Environ. Res. Public Health 2021, 18, 1730. https://doi.org/10.3390/ijerph18041730
(This article belongs to the Special Issue Occupational and General Public Exposure to Electromagnetic Fields)
In the European Union, health surveillance (HS) of electromagnetic fields (EMF)-exposed workers is mandatory according to the Directive 2013/35/EU, aimed at the prevention of known direct biophysical effects and indirect EMF’s effects. Long-term effects are not addressed in the Directive as the evidence of a causal relationship is considered inadequate. Objectives of HS are the prevention or early detection of EMF adverse effects, but scant evidence is hitherto available on the specific procedures. A first issue is that no specific laboratory tests or medical investigations have been demonstrated as useful for exposure monitoring and/or prevention of the effects. Another problem is the existence of workers at particular risk (WPR), i.e., subjects with specific conditions inducing an increased susceptibility to the EMF-related risk (e.g., workers with active medical devices or other conditions); exposures within the occupational exposure limit values (ELVs) are usually adequately protective against EMF’s effects, but lower exposures can possibly induce a health risk in WPR. Consequently, the HS of EMF-exposed workers according to the EU Directive should be aimed at the early detection and monitoring of the recognized adverse effects, as well as an early identification of WPR for the adoption of adequate preventive measures.
The occupational exposure to EMF is a recognized and diffused occupational risk factor, potentially involving a very huge number of workers.
Accordingly, as for other occupational risks, the opportunity to implement an appropriate HS of these workers must be considered. As we have seen, in European Union, HS of EMF-exposed workers is mandatory according to a specific directive (2013/35/EU). This directive is aimed at the prevention of known direct biophysical effects caused by electromagnetic fields—such as the stimulation of muscles, nerves or sensory organs, and limb currents—and thermal effects, as well as of the indirect effects, while long-term effects are not addressed as scientific evidence of a causal relationship is considered inadequate. The objectives of HS are clear: the prevention and early detection of EMF’s adverse effects, in the case of both usual working exposure conditions and overexposure (i.e., accidental exposures or extraordinary situations where an exceeding of the occupational limit values are allowed), but to date there is still scant available data on the specific details of the HS. Further research is needed to evaluate the effectiveness of HS programs for the prevention of EMF risk in workers. A first issue is that no specific laboratory tests or other medical investigations have been demonstrated as useful for the prevention and early detection of the abovementioned EMF-related adverse effects; these points still represent important open questions that we hope can be solved soon, based on upcoming scientific evidence. Another problem is the existence of the workers at particular risk, i.e., subjects with specific pathological or physiological conditions possibly inducing an increased susceptibility to the EMF-related risk, as is the case of active implanted medical devices (but other pathological or also physiological conditions, such as pregnancy, are also possible, and currently no recognized exhaustive list of these conditions is available according to the scientific literature). An exposure below the proposed occupational exposure limit values (ELVs) is usually adequately protective against the direct and indirect EMFs effects, but in these workers, relatively low exposure, possibly similar to the levels of the general population, can induce a health risk. Consequently, the main goals of a HS of EMFs-exposed workers according to the EU directive should be the early detection and monitoring of any of the described adverse effects, as well as the early identification of the workers at particular risk. Providing adequate information to workers about the risk, the exposure levels, and the EMF-related effects, including the conditions possibly inducing a particular susceptibility, is also a fundamental part of appropriate prevention for EMF-exposed workers.
Finally, the collective results of the HS should be adequately collected and preserved, as they may represent an important source with which to further develop scientific knowledge of possible EMF-related effects, on the conditions of particular susceptibility to the risk, and, eventually, on the possible thresholds.