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BioElectroMagnetics
BioElectroMagnetics
Human Safety and
Biomedical Applications
Second Edition

Riadh Habash
Second edition published 2020
by CRC Press
6000 Broken Sound Parkway NW, Suite 300, Boca Raton, FL 33487-2742

and by CRC Press

2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN

© 2020 Taylor & Francis Group, LLC

First edition published by CRC Press 2011

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Library of Congress Cataloging‑in‑Publication Data

Names: Habash, Riadh W. Y., author.
Title: BioElectroMagnetics : human safety and biomedical applications /
Riadh W.Y. Habash.
Description: Second edition. | Boca Raton, FL : CRC Press, 2020. | Includes
bibliographical references and index. | Summary: “This book is
characterized by extensive descriptions of fundamental physical concepts
and principals of EM fields and radiation and their relevance to human
health and therapeutic applications”-- Provided by publisher.
Identifiers: LCCN 2019058125 | ISBN 9781498779036 (hardback) | ISBN
9780429184093 (ebook)
Subjects: LCSH: Electromagnetic fields--Health aspects. | Electromagnetic
fields--Therapeutic use. | Electromagnetism--Physiological effect.
Classification: LCC RA569.3 .H328 2020 | DDC 612/.01442--dc23
LC record available at https://lccn.loc.gov/2019058125

ISBN: 978-1-4987-7903-6 (hbk)

ISBN: 978-0-429-18409-3 (ebk)

Typeset in Palatino
by Deanta Global Publishing Services, Chennai, India
If you want to find the secrets of the universe,
think in terms of energy, frequency and vibration.
Nicola Tesla
To my parents and family
Contents
Preface...............................................................................................................xxi
Acknowledgments .........................................................................................xxv
Author Bio .................................................................................................... xxvii
Abbreviations ................................................................................................xxix

Part I: Foundational Aspects of Bio + Electro + Magnetics

Chapter 1 Foundations of electromagnetism ........................................... 3

The hypothesis.................................................................................................... 3
1.1 Natural and artificial electromagnetic fields....................................... 3
1.1.1 Natural sources .......................................................................... 3
1.1.2 Artificial sources........................................................................ 4
1.2 Fields.......................................................................................................... 6
1.2.1 Electric fields .............................................................................. 6
1.2.2 Magnetic fields ........................................................................... 8
1.2.3 Signals, polarization, and harmonics ................................... 11
1.2.4 Theory of electromagnetic fields ........................................... 12
1.2.5 Electromagnetic waves ........................................................... 14
1.2.5.1 Wave propagation ................................................... 14
1.2.5.2 Wave–particle duality ............................................ 16
1.2.5.3 Near-, intermediate-, and far-field regions.......... 16
1.2.5.4 Electromagnetic fields............................................ 17
1.3 Electromagnetic induction ................................................................... 19
1.4 Electromagnetic energy ........................................................................ 21
1.5 Electromagnetic spectrum ................................................................... 22
1.6 Sources of electric and magnetic fields .............................................. 24
1.6.1 DC sources ............................................................................... 24
1.6.1.1 Magnetosphere........................................................ 25
1.6.1.2 Magnetic resonance imaging (MRI) .................... 26
1.6.1.3 DC power systems .................................................. 26
1.6.2 AC sources ............................................................................... 27
1.6.2.1 Single-conductor source......................................... 28
1.6.2.2 Dual-conductor source........................................... 28

ix
x Contents

1.6.2.3 Loop source ............................................................. 29

1.6.2.4 Three-phase source................................................. 29
1.7 Sources of radiofrequency radiation................................................... 30
1.7.1 Wireless frequency allocations .............................................. 30
1.7.2 Generators ............................................................................... 32
1.7.3 Transmission paths.................................................................. 32
1.7.3.1 Transmission lines .................................................. 32
1.7.3.2 Coaxial cables .......................................................... 33
1.7.3.3 Waveguides.............................................................. 34
1.7.4 Antennas ............................................................................... 34
1.7.4.1 Antenna properties................................................. 35
1.7.4.2 Types of antennas ................................................... 37
1.8 Fifth generation (5G) wireless systems............................................... 39
1.8.1 Millimeter wave (MMW) communications ......................... 40
1.8.2 State of knowledge................................................................... 42
1.8.3 Soft and green network .......................................................... 43
1.8.3.1 Radio Access Network (RAN) .............................. 43
1.8.3.2 5G core network ...................................................... 44
1.8.3.3 Beamforming........................................................... 45
1.8.4 Satellite and non-terrestrial networks .................................. 46
1.8.5 Internet of Things .................................................................... 47
1.8.6 The questions of electromagnetic constraint....................... 47
References.......................................................................................................... 48

Chapter 2 Foundations of bioelectromagnetics ..................................... 51

The hypothesis.................................................................................................. 51
2.1 Introduction............................................................................................ 51
2.2 Biophysical aspects of bioelectromagnetics....................................... 53
2.2.1 Interaction mechanisms for electric and magnetic
fields........................................................................................... 54
2.2.1.1 Induced fields and currents................................... 54
2.2.1.2 Electrostimulation .................................................. 56
2.2.1.3 Magnetic biosubstances ......................................... 57
2.2.1.4 Free radical............................................................... 58
2.2.2 Interaction mechanisms for radio frequency radiation ..... 58
2.2.2.1 Thermal mechanisms............................................. 58
2.2.2.2 Nonthermal/athermal mechanisms .................... 60
2.2.2.3 Thermal- or nonthermal-based exposure
limits?........................................................................ 61
2.2.3 Cell membrane and the chemical link.................................. 62
2.2.3.1 The role of cell membranes.................................... 62
2.2.3.2 Voltage-gated calcium channels (VGCCs)........... 63
2.3 Biological and health effects ................................................................ 64
2.3.1 Cells and membranes.............................................................. 65
Contents xi

2.3.2 Tissues ....................................................................................... 66

2.3.3 Changes in protein conformation ......................................... 67
2.3.4 Changes in binding probability ............................................ 67
2.3.5 Vibrational states of biological components ........................ 68
2.3.6 Genetic material....................................................................... 68
2.3.7 Carcinogenesis ......................................................................... 69
2.3.8 Hypothesis of melatonin ........................................................ 70
2.3.9 Cancer mechanisms ................................................................ 72
2.3.10 Brain and nervous system ...................................................... 72
2.3.10.1 Brain.......................................................................... 74
2.3.10.2 Neurological effects................................................ 75
2.4 Bioelectromagnetic dosimetry............................................................. 76
2.4.1 Macrodosimetry....................................................................... 77
2.4.1.1 Induced current density......................................... 77
2.4.1.2 Specific absorption rate.......................................... 78
2.4.1.3 Power density .......................................................... 80
2.4.1.4 Exposure-ratio metric............................................. 81
2.4.1.5 Dose .......................................................................... 81
2.4.1.6 Composite metric .................................................... 81
2.4.1.7 Thermal dosimetry................................................. 82
2.4.2 Microdosimetry ....................................................................... 84
2.4.3 Impact of frequency ................................................................ 85
2.4.4 Impact of dielectric constant .................................................. 86
2.5 Toward health-based safety standards............................................... 86
References.......................................................................................................... 87

Part II: Extremely Low Frequency Fields

Chapter 3 Extremely low frequency field safety ................................... 97

The hypothesis.................................................................................................. 97
3.1 Introduction............................................................................................ 97
3.2 Safety standards and guidelines ......................................................... 99
3.2.1 Standardization process ......................................................... 99
3.2.2 IEEE standard......................................................................... 101
3.2.3 ICNIRP guidelines................................................................. 102
3.2.4 Exposure limits ...................................................................... 104
3.2.5 Precautionary exposure models.......................................... 105
3.3 Potential sources .................................................................................. 108
3.3.1 Residential areas .................................................................... 108
3.3.2 Power systems ........................................................................ 109
3.3.3 Transportation systems..........................................................110
3.4 Dosimetry ..............................................................................................111
xii Contents

3.5 Measurement techniques ....................................................................113

3.5.1 Electric field measurements ..................................................114
3.5.2 Magnetic field measurements...............................................115
3.5.3 Test and survey protocol........................................................117
3.6 Exposure assessments and exposimetry...........................................119
3.6.1 Outdoor and indoor environmental surveys .....................119
3.6.2 Residential exposure ............................................................. 120
3.6.3 Transport systems exposure ................................................ 121
3.6.4 Personal exposimetry............................................................ 122
3.7 Field management ............................................................................... 123
3.7.1 Mitigation techniques ........................................................... 123
3.7.1.1 Buildings ................................................................ 123
3.7.1.2 Power systems ....................................................... 123
3.7.1.3 Electric vehicles..................................................... 125
3.7.2 Shielding techniques............................................................. 125
3.7.2.1 Active shielding .................................................... 126
3.7.2.2 Passive shielding by conductive
materials................................................................. 127
3.7.2.3 Passive shielding by ferromagnetic
materials................................................................. 128
3.7.2.4 Shielding design.................................................... 129
3.7.3 Reduction procedures ........................................................... 130
3.7.3.1 General ................................................................... 130
3.7.3.2 Computers.............................................................. 131
References........................................................................................................ 132

Chapter 4 Health effects of exposure to extremely low

frequency fields....................................................................... 139
The hypothesis................................................................................................ 139
4.1 Introduction.......................................................................................... 139
4.2 Epidemiological studies...................................................................... 140
4.2.1 Occupational environments................................................. 142
4.2.2 General public environments .............................................. 143
4.2.2.1 Childhood cancer and leukemia ........................ 144
4.2.2.2 Adult cancer........................................................... 145
4.2.2.3 Neurodegenerative diseases ............................... 147
4.2.2.4 Reproductive health effects ................................. 147
4.2.3 Summary of epidemiological studies ................................. 149
4.3 Experimental studies .......................................................................... 149
4.3.1 Genotoxicity and carcinogenicity ....................................... 149
4.3.2 Cell functions ......................................................................... 151
4.3.3 Animal studies....................................................................... 152
4.4 Clinical studies..................................................................................... 154
4.4.1 Perception ............................................................................. 155
Contents xiii

4.4.2 Brain and behavior ................................................................ 155

4.4.3 Cardiovascular system.......................................................... 156
4.4.4 Melatonin release................................................................... 157
4.4.5 Reproductive and development effect................................ 158
4.5 Concluding remarks............................................................................ 159
4.5.1 Review studies ....................................................................... 160
4.5.2 Future research .......................................................................161
References.........................................................................................................161

Part III: Radio Frequency Radiation

Chapter 5 Radio frequency radiation safety ........................................ 177

The hypothesis................................................................................................ 177
5.1 Introduction.......................................................................................... 177
5.2 Safety standards .................................................................................. 178
5.2.1 Process of standardization ................................................... 178
5.2.2 IEEE C95.1 standard .............................................................. 180
5.2.3 Federal Communication Commission (FCC)
guidelines ............................................................................... 182
5.2.4 ICNIRP guidelines................................................................. 183
5.2.5 Compliances and restrictions .............................................. 185
5.2.6 Precautionary exposure models.......................................... 187
5.3 Dosimetry ............................................................................................. 189
5.3.1 Whole-body assessments...................................................... 189
5.3.2 In-head assessments.............................................................. 191
5.3.2.1 Sources of local RFR ............................................. 192
5.3.2.2 Adult size heads.................................................... 194
5.3.2.3 Child size heads .................................................... 195
5.3.3 Tissue and skin dosimetry ................................................... 196
5.4 Exposure assessment and exposimetry ........................................... 198
5.4.1 Exposure assessment approaches ....................................... 198
5.4.1.1 Assessment techniques ........................................ 199
5.4.1.2 Assessment units .................................................. 200
5.4.2 Sources of environmental RFR ............................................ 200
5.4.2.1 Cellular base stations ........................................... 200
5.4.2.2 Broadcast antennas............................................... 203
5.4.2.3 Wireless internet ................................................... 204
5.4.2.4 Bluetooth devices .................................................. 204
5.4.2.5 Smart electricity meters ....................................... 205
5.4.2.6 Baby monitoring systems .................................... 205
5.4.2.7 Microwave ovens, heaters, and dryers............... 205
5.4.2.8 Medical equipment............................................... 206
5.4.2.9 Other sources......................................................... 206
xiv Contents

5.4.3 Indoor environmental RFR .................................................. 206

5.4.3.1 Exposure in public places .................................... 207
5.4.3.2 Exposures in residential places........................... 208
5.4.3.3 Exposures in transportation facilities................ 209
5.4.3.4 Summary of results .............................................. 209
5.4.4 Outdoor environmental RFR ............................................... 210
5.5 Mitigation approaches .........................................................................211
5.5.1 Exposure from common sources..........................................211
5.5.2 Exposure reduction ................................................................211
5.6 Future development ............................................................................ 213
5.6.1 Harmonizing exposure limits ............................................. 213
5.6.2 5G deployment policies ........................................................ 215
5.6.3 Dosimetry knowledge gap ................................................... 215
References........................................................................................................ 217

Chapter 6 Health effects of exposure to radio frequency

radiation.................................................................................... 225
The hypothesis................................................................................................ 225
6.1 Introduction.......................................................................................... 225
6.2 Epidemiological studies...................................................................... 226
6.2.1 Occupational exposure studies ........................................... 226
6.2.2 Public exposure studies ........................................................ 227
6.2.3 INTERPHONE study ............................................................ 228
6.2.4 IARC statement ...................................................................... 229
6.2.5 COSMOS ............................................................................. 230
6.3 Cellular and animal studies............................................................... 230
6.3.1 Genetic toxicology ................................................................. 230
6.3.2 Cellular functions .................................................................. 232
6.3.3 Animal studies....................................................................... 233
6.4 Clinical studies..................................................................................... 234
6.4.1 Perception and auditory response ...................................... 234
6.4.2 Ocular effects ......................................................................... 235
6.4.3 Brain function ........................................................................ 236
6.4.4 Cardiac functions .................................................................. 237
6.4.5 Melatonin ............................................................................. 237
6.5 Reproductive system and male fertility ........................................... 237
6.5.1 State of the art review ........................................................... 238
6.5.2 Protective measures .............................................................. 238
6.6 Electromagnetic hypersensitivity (EHS) .......................................... 239
6.6.1 Sensitivity of children........................................................... 239
6.6.2 Hypersensitivity of adults.................................................... 240
6.7 Concluding remarks............................................................................ 243
6.7.1 International and national expert group
evaluations .............................................................................. 243
Contents xv

6.7.1.1 International Agency for Research on

Cancer (IARC) ....................................................... 243
6.7.1.2 Bio-Initiatives Working Group............................ 244
6.7.1.3 Committee on Man and Radiation
(COMAR)................................................................ 244
6.7.1.4 World Health Organization (WHO)................... 244
6.7.1.5 French Agency for Food, Environmental
and Occupational Health and Safety
(ANSES) .................................................................. 245
6.7.1.6 Advisory Group on Non-ionizing Radiation
(AGNIR).................................................................. 245
6.7.1.7 Norwegian Institute of Public Health................ 245
6.7.1.8 Swedish Council for Working Life and
Social Research (SCWLSR) .................................. 245
6.7.1.9 Institute of Engineering and
Technology (IET)................................................... 246
6.7.1.10 Expert Panel report on a review of Safety
Code 6 ..................................................................... 246
6.7.1.11 Australian Radiation Protection and
Nuclear Safety Agency (ARPANSA) .................. 247
6.7.1.12 Scientific Committee on Emerging and
Newly Identified Health Risks (SCENIHR) ...... 247
6.7.1.13 National Toxicology Program (NTP) ................. 248
6.7.2 Future research ...................................................................... 248
References........................................................................................................ 249

Part IV: Therapeutic Applications

Chapter 7 Diathermy therapy.................................................................. 269

The hypothesis................................................................................................ 269
7.1 Introduction.......................................................................................... 269
7.1.1 Historical perspective ........................................................... 269
7.1.2 Literature review ................................................................... 272
7.2 Thermal mechanisms.......................................................................... 273
7.2.1 Heat stress ............................................................................. 273
7.2.2 Thermal injury ........................................................................274
7.2.3 Thermotolerance .................................................................... 275
7.3 Therapeutic categories ........................................................................ 277
7.4 Diathermy modalities ......................................................................... 279
7.4.1 Short-wave diathermy........................................................... 279
7.4.2 Microwave diathermy ........................................................... 280
7.4.3 MMW and THz therapy ....................................................... 281
xvi Contents

7.5 Diathermy therapeutic applications.................................................. 281

7.5.1 Pain management .................................................................. 281
7.5.2 Rehabilitation practice .......................................................... 283
7.5.3 Bone and tissue healing........................................................ 284
7.6 Possible side effects of EM energy and heat .................................... 285
7.6.1 Tissue physiology and response to heat............................. 285
7.6.2 Cellular responses ................................................................. 286
7.6.3 Immunological effects........................................................... 287
7.6.4 Cardiovascular responses .................................................... 288
7.6.5 Nervous system responses................................................... 289
7.6.6 Carcinogenic effects .............................................................. 291
7.7 Concluding remarks............................................................................ 292
7.7.1 Risk assessment ..................................................................... 292
7.7.2 Trends in equipment development ..................................... 293
7.7.3 Future research ...................................................................... 294
References........................................................................................................ 294

Chapter 8 Hyperthermia therapy............................................................ 305

The hypothesis................................................................................................ 305
8.1 Introduction.......................................................................................... 305
8.1.1 Historical perspective ........................................................... 305
8.1.2 Early research work............................................................... 306
8.1.3 Modern hyperthermia .......................................................... 307
8.1.4 Practical challenges ............................................................... 309
8.1.5 A wealth of literature .............................................................310
8.2 Biophysical and practical rationale ....................................................311
8.2.1 Heat alone ..............................................................................311
8.2.2 Heat and radiation................................................................. 313
8.2.3 Heat and drugs .......................................................................314
8.3 Hyperthermia in oncology..................................................................314
8.3.1 Local hyperthermia............................................................... 315
8.3.1.1 External local hyperthermia ................................316
8.3.1.2 Intraluminal local hyperthermia.........................316
8.3.1.3 Interstitial local hyperthermia ............................ 317
8.3.2 Regional hyperthermia..........................................................318
8.3.2.1 Deep regional hyperthermia................................318
8.3.2.2 Regional perfusion hyperthermia...................... 319
8.3.2.3 Local regional hyperthermia or oncothermia .. 319
8.3.3 Whole-Body Hyperthermia (WBH) .................................... 320
8.3.4 Extracellular hyperthermia.................................................. 321
8.4 Hyperthermia techniques and equipment ...................................... 322
8.4.1 Techniques ............................................................................. 322
8.4.1.1 Radio frequency (RF) ........................................... 322
8.4.1.2 Microwaves............................................................ 323
Contents xvii

8.4.2 External RF applicators......................................................... 324

8.4.2.1 Capacitive heating ................................................ 324
8.4.2.2 Inductive heating .................................................. 325
8.4.2.3 Hybrid heating systems ....................................... 326
8.4.3 External radiative EM devices ............................................. 326
8.4.3.1 Single applicators .................................................. 327
8.4.3.2 Multielement array applicators........................... 328
8.4.4 Interstitial and intracavitary devices.................................. 330
8.4.5 Nanotechnology-based sources........................................... 331
8.5 Hyperthermia with other modalities ............................................... 332
8.5.1 Hyperthermia and radiation................................................ 333
8.5.2 Hyperthermia and chemotherapy ...................................... 334
8.5.3 Hyperthermia and radiochemotherapy ............................. 335
8.6 Status and trends ................................................................................. 335
8.6.1 Technical and clinical challenges........................................ 335
8.6.2 Standardization...................................................................... 337
8.7 Conclusion ............................................................................................ 337
References........................................................................................................ 338

Chapter 9 Ablation therapy...................................................................... 357

The hypothesis................................................................................................ 357
9.1 Introduction.......................................................................................... 357
9.2 Procedures and techniques ................................................................ 358
9.2.1 Minimally invasive procedures........................................... 358
9.2.2 Ablation techniques .............................................................. 359
9.3 Clinical applications............................................................................ 360
9.3.1 Liver ......................................................................................... 361
9.3.2 Lung ......................................................................................... 361
9.3.3 Prostate .................................................................................... 362
9.3.4 Kidney ..................................................................................... 362
9.3.5 Breast ....................................................................................... 363
9.3.6 Bone ......................................................................................... 363
9.3.7 Cardiac diseases .................................................................... 363
9.4 Radio frequency ablation (RFA) ........................................................ 364
9.4.1 Technical considerations....................................................... 364
9.4.1.1 Mechanisms........................................................... 364
9.4.1.2 Electrodes and approaches.................................. 365
9.4.1.3 Multiple applicators.............................................. 366
9.4.1.4 Localization ........................................................... 367
9.4.1.5 Thermal–electrical modeling .............................. 368
9.4.2 Clinical advantages and applications ................................. 368
9.4.2.1 Cancer treatment................................................... 369
9.4.2.2 Cardiac diseases.................................................... 371
9.4.2.3 Snoring and obstructive sleep apnea (OSA)...... 372
xviii Contents

9.4.3 Limitations ............................................................................. 373

9.4.4 Complications..........................................................................374
9.5 Microwave ablation (MWA) ............................................................... 375
9.5.1 Technical considerations....................................................... 376
9.5.1.1 Mechanisms........................................................... 376
9.5.1.2 Antenna designs ................................................... 377
9.5.1.3 Multiple insertions and multiple antennas....... 378
9.5.2 Clinical advantages and applications ................................. 379
9.5.2.1 Treating cancer ...................................................... 379
9.5.2.2 Cardiac diseases.................................................... 380
9.5.2.3 Microwave endometrial ablation (MEA) ........... 381
9.5.3 Limitations ............................................................................. 383
9.5.4 Complications......................................................................... 384
9.6 Trends and future research................................................................ 384
9.6.1 Improved techniques ............................................................ 384
9.6.2 Ablation in clinical practice ................................................. 386
9.6.3 Future research ...................................................................... 386
References........................................................................................................ 387

Part V: Dosimetry, Thermometry, and Medical Imaging

Chapter 10 Electromagnetic-thermal dosimetry ................................... 409

The hypothesis................................................................................................ 409
10.1 Introduction.......................................................................................... 409
10.2 Power deposition modeling ............................................................... 410
10.2.1 Techniques for low frequencies ........................................... 410
10.2.2 Techniques for radiofrequency radiation............................411
10.2.2.1 Analytical techniques ...........................................411
10.2.2.2 Numerical techniques ...........................................411
10.3 Thermoregulatory modeling ............................................................. 412
10.3.1 Thermal dose.......................................................................... 412
10.3.2 Thermal measurements ........................................................ 413
10.4 Bioheat transfer models .......................................................................414
10.4.1 Pennes model ......................................................................... 415
10.4.2 Wissler model......................................................................... 417
10.4.3 Stolwijik model....................................................................... 418
10.4.4 Weinbaum–Jiji model ............................................................ 418
10.4.5 Baish model ............................................................................ 420
10.4.6 Applications of bioheat transfer models ............................ 420
10.5 Thermal therapy planning system (TTPS)....................................... 421
10.5.1 Objectives and requirements ............................................... 421
10.5.2 Developments in TTPS.......................................................... 423
10.5.3 Software packages ................................................................. 423
10.6 Status and trends ................................................................................. 424
References........................................................................................................ 425
Contents xix

Chapter 11 Thermometry and medical imaging ................................... 433

The hypothesis................................................................................................ 433
11.1 Introduction.......................................................................................... 433
11.2 Historical perspective ......................................................................... 434
11.3 Invasive thermometry......................................................................... 435
11.3.1 Thermoelectric thermometry............................................... 436
11.3.2 Thermistor ............................................................................. 437
11.3.3 Thermometer.......................................................................... 437
11.3.4 Thermography........................................................................ 438
11.4 Non-invasive thermometry and imaging techniques.................... 438
11.4.1 Ultrasound imaging .............................................................. 440
11.4.1.1 Apparatus .............................................................. 440
11.4.1.2 Advantages and limitations ................................ 441
11.4.1.3 Two- to three-dimensional
ultrasonography.................................................... 442
11.4.2 Magnetic resonance imaging (MRI) ................................... 443
11.4.2.1 Operation ............................................................... 443
11.4.2.2 Advantages and limitations ................................ 445
11.4.3 Microwave imaging............................................................... 446
11.4.4 THz imaging .......................................................................... 448
11.4.4.1 Characteristics of THz radiation......................... 448
11.4.4.2 THz-ray system ..................................................... 449
11.4.4.3 Challenges.............................................................. 451
11.4.4.4 THz-ray computed tomography (CT) ................ 451
11.4.5 IR thermography.................................................................... 452
11.4.6 X-ray computed tomography ............................................... 453
11.4.6.1 Conventional CT scanners................................... 454
11.4.6.2 Spiral (helical) CT scanners................................. 454
11.4.6.3 Multislice CT scanners ......................................... 455
11.5 Status and trends ................................................................................. 455
References........................................................................................................ 456

Chapter 12 Electromagnetic risk paradigm ............................................ 467

The hypothesis................................................................................................ 467
12.1 Introduction.......................................................................................... 467
12.2 Risk assessment ................................................................................... 469
12.2.1 Scientific evidence ................................................................. 470
12.2.2 Safety standard programs.................................................... 472
12.2.3 Structured risk assessment .................................................. 473
12.3 Risk perception .....................................................................................474
12.3.1 Public perception of risk........................................................474
12.3.2 Factors relevant to electromagnetic fields.......................... 475
12.3.3 Health consequences of risk perception............................. 476
12.4 Risk management ................................................................................ 477
12.4.1 Anticipatory ethics ................................................................ 477
xx Contents

12.4.2 Involving the public .............................................................. 478

12.4.3 Public meetings...................................................................... 479
12.4.4 Precautionary approaches .................................................... 479
12.4.5 Public understanding of precautionary actions................ 482
12.5 Risk communication............................................................................ 482
12.5.1 Role of communication in risk assessment........................ 484
12.5.2 Media coverage ...................................................................... 485
12.5.3 Role of industry...................................................................... 485
12.5.4 Role of the internet ................................................................ 486
12.5.5 Communication with children ............................................ 487
12.6 Trends and future research................................................................ 487
12.6.1 Challenges and implications................................................ 487
12.6.2 Research and policy .............................................................. 488
12.6.3 Concluding remarks.............................................................. 490
References........................................................................................................ 491

Index ................................................................................................................ 495

Preface
Many of today’s inventions, ranging from electrification and smart grid,
wireless electromagnetic (EM) communications, and consumer products
to biomedical applications including therapeutic and diagnostic technolo­
gies, are so important and advantageous that we wonder how we ever
lived without them. These inventions have become an integral part of our
modern life. Sure, they are valuable; however, it is significant to know they
are safe! With all above, “bioelectromagnetics” becomes a public good that
everyone should have access to and right to know. It is essentially about
life and health and so should be limitless in its supply to public, especially
to students. To realize this timely fact, bioelectromagnetics should be
facilitated and learned effectively throughout the education system. This
book simplifies the above process by first exploring the two basic founda­
tions, electromagnetics and bioelectromagnetics, in order to provide the
learners with a deeper, more meaningful glimpse into the impact of EM
fields on human health and safety. The two opposites of bioelectromag­
netics’s yin-yang of health care and health scare are extensively discussed
along the landscape of the book content. Unique on this landscape is to
empower learners to develop transdisciplinary knowledge acquisition
skills in a wide range of topics including EM safety standards and protec­
tion guidelines, dosimetry and exposure assessment, observational and
experimental evaluation studies, and risk science. Such a wide range of
topics gives the reader the opportunity to treat the process of learning as
a design task and makes learners more innovative in investigating health
and safety problems, developing proper solutions, and creating new clus­
ters of knowledge. The ultimate goal of the book is to bring the above
knowledge creation process from a classic scientific research niche into
reader experience reach.

Objectives
This book is an educational resource of evolving scientific knowledge in
the area of bioelectromagnetics that may serve the interests of students
and decision-makers, as well as society as a whole. It is distinguished by

xxi
xxii Preface

extensive descriptions of fundamental biophysical concepts and their rel­

evance to human health. Reflecting the transdisciplinary approach from
several different intellectual streams including physics, biology, epidemi­
ology, medicine, environment, risk science, and engineering, the book is
quite a venture into the battling studies to assess latest research on health
effects and biomedical applications of EM energy. This new edition of
the book particularly looks at the potential threats from the emerging
5G wireless networks, which will deploy large numbers of low-powered
smartphones, notebooks, tablets, radio access networks, and Internet of
Things (IoT) technologies.

Features
• Introduces necessary biophysical principles of EM fields in the con­
text of their interaction with living systems.
• Discusses and analyzes the results of various experimental and epi­
demiological studies on the effects of nonionizing EM fields on cells
and organs, including adverse effects of exposure to low and high
frequencies.
• Presents safety standards and guidelines for human exposure to EM
fields.
• Apart from adverse health effects, the therapeutic potential of EM
fields for clinical use in various pathologies is also investigated.
• Discusses techniques that have been developed to ensure adequate
EM-thermal dosimetry required for both health effects and biomedi­
cal applications.
• Provides insight into the determinants of EM health risk assessment
and public concerns.
• Includes extensive reference list at the end of each chapter to enhance
further study.

Scope
This book extensively describes the two sides of the core notion “biologi­
cal effects of nonionizing EM fields” including five parts (11 chapters) and
one stand-alone chapter (Chapter 12). The introductory Part I (Chapters
1 and 2) facilitates the foundational aspects of bioelectromagnetics that
integrates biophysics, biomedical, and bioengineering in the study of EM
pathophysiology. In the adverse health effects and human safety aspect
(Parts II and III), EM fields are investigated for their biological and health
implications. Part II (Chapters 3 and 4) deals with safety standards,
dosimetry and exposure assessment, and health implications of extremely
low frequency (ELF) fields. Part III (Chapters 5 and 6) deals with safety
standards, dosimetry and exposure assessment, and health implications
Preface xxiii

of radio frequency radiation (RFR). In the emerging biomedical applica­

tions side, EM energy is investigated for its therapeutic and diagnostic
benefits. Part IV (Chapters 7, 8, and 9) deals with EM therapeutic tech­
niques including diathermy, hyperthermia, and ablation for treatment of
various disorders, including cancer. Part V (Chapters 10 and 11) focuses
on EM diagnostic applications including dosimetry, thermometry, and
imaging. At the end, the stand-alone Chapter 12 discusses issues related
to EM health risk assessment including risk perception and communica­
tion, public concerns, and public health policies.

Audience
Developing a useful and usable transdisciplinary knowledge resource
encompasses complex challenges that require inputs from multiple disci­
plines and sectors. In preparing this learning resource for a wide range of
audiences or as a textbook for a related course in universities, the author
strived to show that the subject matter is quite understandable to anyone
interested in the details of the health effects, human safety, and medical
applications of EM energy. Because of its comprehensive coverage and the
large number of detailed subjects, this book is useful as a primary refer­
ence for various related topics. The only prerequisite for understanding
the material in this book is a basic knowledge of physics and biology.
Acknowledgments
I gratefully acknowledge the collaboration and numerous conversations
I had over the years with Professor D. Krewski, Director, McLaughlin
Centre for Population Health Risk Assessment, Institute of Population
Health, University of Ottawa, Canada, on various related issues. I also
acknowledge and appreciate the support of my wife (Najat) and our chil­
dren (Gandhi, Mara, Marina, and Mikeli) during the completion of this
work.

xxv
Author Bio
Dr. Riadh Habash is a special appointment professor at the School of
Electrical Engineering and Computer Science and McLaughlin Research
Chair in Electromagnetic Fields and Health at the University of Ottawa,
Canada. He has also taught at many other universities. Dr. Habash has
a proven professional, teaching, and research expertise in several areas
including bioelectromagnetics, power and energy systems, mechatronics,
and engineering education. During his academic career, Dr. Habash has
been involved in various institutional- and industrial-funded projects and
collaborative research programs. He has authored or co-authored over 90
research articles, six books, five book chapters, and two conference pro­
ceedings. In recognition of his professional standing and educational suc­
cess, Dr. Habash received the Canadian National Wighton Fellowship in
Engineering (2014) and several university initiative awards. He currently
serves as a member of the Committee on Man and Radiation (COMAR) of
the Engineering in Medicine and Biology Society (EMBS) of the IEEE. He
also serves as a reviewer for several academic journals and funding insti­
tutions. In addition, Dr. Habash has delivered a large number of special
lectures, invited talks, workshops, and tutorials in various universities,
institutions, and conferences.

xxvii
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