Tuesday, December 26, 2017

Thyroid Cancer & Mobile Phone Use








From: Carlberg et al. 2016 (see abstract below).
Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013

H Lim, SS Devesa, JA Sosa,et al D Check,CM Kitahara, Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013. JAMA. Published online March 31, 2017. doi:10.1001/jama.2017.2719

Key Points

Question  What have been the trends in US thyroid cancer incidence and mortality, and have they differed by tumor characteristics at diagnosis?

Findings  In this analysis of 77,276 thyroid cancer patients diagnosed during 1974-2013 and of 2,371 thyroid cancer deaths during 1994-2013, average annual increases in incidence and mortality rates, respectively, were 3.6% and 1.1% overall and 2.4% and 2.9% for patients diagnosed with advanced-stage papillary thyroid cancer.

Meaning  Thyroid cancer incidence and mortality rates have increased for patients diagnosed with advanced-stage papillary thyroid cancer in the United States since 1974, suggesting a true increase in the occurrence of thyroid cancer.

Abstract

Importance  Thyroid cancer incidence has increased substantially in the United States over the last 4 decades, driven largely by increases in papillary thyroid cancer. It is unclear whether the increasing incidence of papillary thyroid cancer has been related to thyroid cancer mortality trends.

Objective  To compare trends in thyroid cancer incidence and mortality by tumor characteristics at diagnosis.

Design, Setting, and Participants  Trends in thyroid cancer incidence and incidence-based mortality rates were evaluated using data from the Surveillance, Epidemiology, and End Results-9 (SEER-9) cancer registry program, and annual percent change in rates was calculated using log-linear regression.

Exposure  Tumor characteristics.

Main Outcomes and Measures  Annual percent changes in age-adjusted thyroid cancer incidence and incidence-based mortality rates by histologic type and SEER stage for cases diagnosed during 1974-2013.

Results  Among 77 276 patients (mean [SD] age at diagnosis, 48 [16] years; 58 213 [75%] women) diagnosed with thyroid cancer from 1974-2013, papillary thyroid cancer was the most common histologic type (64 625 cases), and 2371 deaths from thyroid cancer occurred during 1994-2013. Thyroid cancer incidence increased, on average, 3.6% per year (95% CI, 3.2%-3.9%) during 1974-2013 (from 4.56 per 100 000 person-years in 1974-1977 to 14.42 per 100 000 person-years in 2010-2013), primarily related to increases in papillary thyroid cancer (annual percent change, 4.4% [95% CI, 4.0%-4.7%]). Papillary thyroid cancer incidence increased for all SEER stages at diagnosis (4.6% per year for localized, 4.3% per year for regional, 2.4% per year for distant, 1.8% per year for unknown). During 1994-2013, incidence-based mortality increased 1.1% per year (95% CI, 0.6%-1.6%) (from 0.40 per 100 000 person-years in 1994-1997 to 0.46 per 100 000 person-years in 2010-2013) overall and 2.9% per year (95% CI, 1.1%-4.7%) for SEER distant stage papillary thyroid cancer.

Conclusions and Relevance  Among patients in the United States diagnosed with thyroid cancer from 1974-2013, the overall incidence of thyroid cancer increased 3% annually, with increases in the incidence rate and thyroid cancer mortality rate for advanced-stage papillary thyroid cancer. These findings are consistent with a true increase in the occurrence of thyroid cancer in the United States.




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Korea's Thyroid-Cancer “Epidemic” — Screening and Overdiagnosis (and wireless phone use?)

November 5, 2014

According to today's issue of the New England Journal of Medicine, South Korea has experienced a thyroid cancer epidemic in recent years (see paper and Figure below). 

"Thyroid cancer is now the most common type of cancer diagnosed in South Korea."
The authors of this paper attribute the "epidemic" to a government-sponsored cancer screening program. As evidence, they report,

"There was a strong correlation between the proportion of the population screened in a region in 2008 and 2009 and the regional incidence of thyroid cancer in 2009. Although the aggregate correlation could be vulnerable to the ecologic fallacy, the finding of significant positive correlations in each of eight age- and sex-based groups suggests that the finding is more robust."

That widespread screening identifies more cancer is not surprising. This could at least partly explain the increasing incidence of thyroid cancer observed in South Korea, and nine other countries including the U.S.

The authors argue that most of these cancers are not life-threatening and advise other countries against widespread screening for thyroid cancer:


"The experience with thyroid-cancer screening in South Korea should serve as a cautionary tale for the rest of the world. During the past two decades, multiple countries have had a substantial increase in thyroid-cancer incidence without a concomitant increase in mortality. According to the Cancer Incidence in Five Continents database maintained by the International Agency for Research on Cancer, the rate of thyroid-cancer detection has more than doubled in France, Italy, Croatia, the Czech Republic, Israel, China, Australia, Canada, and the United States. The South Korean experience suggests that these countries are seeing just the tip of the thyroid-cancer iceberg — and that if they want to prevent their own “epidemic,” they will need to discourage early thyroid-cancer detection."

I'm not sure the answer is to simply ignore these cancers, but I don't want to address that debate here.

Rather, I would like to focus on the question why has thyroid cancer become so prevalent in at least ten nations? According to the American Cancer Society, although some thyroid cancers are linked to exposure to ionizing radiation, "the exact cause of most thyroid cancers is not yet known."

Could exposure to the electromagnetic radiation (RF and ELF) emitted by cell phones and cordless phones be contributing to this worldwide thyroid cancer epidemic? Isn't time for our government to fund research on the risk factors underlying this epidemic?

Hyeong Sik Ahn, Hyun Jung Kim, H. Gilbert Welch. Korea's Thyroid-Cancer “Epidemic” — Screening and Overdiagnosis. N Engl J Med 2014; 371:1765-1767 November 6, 2014DOI: 10.1056/NEJMp1409841




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Is mobile phone use contributing to increased incidence of thyroid cancer?

July 9, 2014

The incidence of thyroid cancer has been increasing rapidly in recent years in many countries including the U.S., Canada, and Israel.

A headline in Haaretz a year ago March reads, "
Israeli scientists find possible link between cellphone use, thyroid cancer." 

In response to questions posed to me on this topic today from several individuals, I did a PubMed search. Although I did not find any epidemiologic studies that examined the association between mobile phone use and thyroid cancer in humans, I found almost a dozen published papers that have studied the effects of cell phone radiation on thyroid function. Apparently, case-control research on this topic is warranted.

The abstracts from 11 published papers that examined the effects of exposure to cell phone radiation on thyroid function appear below. Please let me know if you are aware of important studies that I missed, and I will supplement this list.  I did not include studies that examined exposure to power frequency radiation.

But first, here is the 2013 news article  ...

Israeli scientists find possible link between cellphone use, thyroid cancer

Dan Even, Haaretz, Mar 6, 2013

Israeli scientists have reported preliminary findings of a possible link between the radiation from cellphones and thyroid cancer. There has been a steep rise in rates of thyroid cancer in recent years in Western countries.

The Israeli research, conducted at Beilinson Hospital in Petah Tikva and at Tel Aviv University, identified evidence for the first time of the possible connection between the rise in thyroid cancer cases to the increased exposure to radiation emitted by cellphones.

In one experiment, human thyroid cells collected from healthy patients were subjected to radiation with a device, designed for the study, that simulates the electromagnetic radiation emitted by cellphones. The irradiated thyroid cells proliferated at a much higher, statistically significant rate than non-irradiated cells in the control group. A second experiment, using different methods and materials, gave similar results.

The research was conducted in the Felsenstein Medical Research Center, part of the Sackler Faculty of Medicine at Tel Aviv University and the Rabin Medical Center. Prof. Raphael Feinmesser, head of Beilinson’s Ear, Nose and Throat Department was the lead researcher. The findings will be presented for the first time this weekend at the annual conference of the Israeli Society of Otolaryngology, Head and Neck Surgery, in Eilat.

“The findings are the first evidence of changes in thyroid cells in response to electromagnetic radiation,” said Feinmesser. “But drawing sweeping conclusions as to a connection between cellphone radiation and thyroid cancer is still far off.”

The scientific community is divided as to the connection between cellular radiation and cancer. One opinion is that because cellular radiation is non-ionizing and incapable of causing changes in cellular DNA, it cannot cause cancer. But in recent years evidence has mounted from epidemiological studies indicating a relationship between increased exposure to cellular radiation and cancerous growths, especially in the brain and the salivary glands.

“The thyroid gland is located in the neck, but the area is located the same distance from the ear as the regions of the brain where [cancerous] growths have been diagnosed as being related to the use of the [cellular] devices. This is a region that is not far from the center of the device’s radiation,” said Feinmesser.

The incidence of thyroid cancer has been on the rise in Israel for more than a decade, which matches the rise in the use of cellphones. Thyroid cancer is three times more common in women than men. It is the fourth most common form of cancer among Jewish women in Israel, at 16.6 cases per 100,000 people. The three most common forms of cancer for women are cancer of the breast, colon and cervix. Among Israeli Arab women the rate of thyroid cancer is 11.6 cases per 100,000, and it is the third most common cancer. From 1990 to 2007 there was a 67-percent rise in thyroid cancer rates among Jewish women, and a 250 percent increase among Arab women, Health Ministry figures show. For men, the rise from 2000 is more moderate, but still shows a 41 percent increase in thyroid cancer rates for Jewish men.

“One of the explanations is that the rise is related to better technical methods of early detection of these growths, which have been developed in recent years. But other research shows that even after neutralizing this influence a rise in these growths still remains,” said Feinmesser.

Just this week it was reported that mobile operator Partner Communications (Orange ) reached a settlement with a customer who claims he contracted cancer after using the company’s cellphones. The customer, who is in his 50s, sued Partner in May, claiming that intensive use of the device resulted in an aggressive lymphoma near his left ear. Partner agreed to pay NIS 400,000 in an out-of-court settlement.”

http://bit.ly/14rrWfA

Recent Studies

Baby NM, Koshy G, Mathew A. The Effect of Electromagnetic Radiation due to Mobile Phone Use on Thyroid Function in Medical Students Studying in a Medical College in South India. Indian J Endocrinol Metab. 2017 Nov-Dec;21(6):797-802.

Abstract


Background: Enormous increase in mobile phone use throughout the world raises widespread concerns about its possible detrimental effect on human health. Radiofrequency waves are emitted by cell phones. They are non-ionising and the effect on the thyroid gland is part of their non thermal effects. The thyroid gland may be particularly vulnerable to this effect because of its normal anatomical position.

Materials and Methods: The study was done to explore the association between radiation exposure and thyroid dysfunction among mobile phone users. It had an exploratory design and unit survey method to collect information from all medical students in a medical college in South India. Inclusion criteria included active use of mobile phone prior to and during the study period. Criteria for exclusion was presence of pre-existsting thyroid disease,thyroid nodule,thyroid goitre/nodule and altered thyroid function.

Results: The sample size was 83 undergraduate students. 71% of respondents had no family history of thyroid illness. Among the remainder,20.5% had a first degree relative with thyroid dysfunction,8.4% had a second degree relative affected. Clinical examination revealed that 79.5% of the respondents were normal,13.6% had thyroid swelling,3.6% had symptoms of thyroid dysfunction and 3.6% had both thyroid swelling and symptoms of thyroid dysfunction. 53% of the respondents spent 0.5 hrs on an average talking on the phone daily,28.9% spent 1.5 hrs daily and 10.8% of respondents spent over 3.5 hours. We found there was a significant correlation between total radiation exposure and an increase in TSH among both groups -in those with and without family history of thyroid illness.

Conclusion: In our study there was a significant correlation between total radiation exposure and increasing TSH values among both all respondents.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729662/


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Silva V, Hilly O, Strenov Y, Tzabari C, Hauptman Y, Feinmesser R. Effect of cell phone-like electromagnetic radiation on primary human thyroid cells. Int J Radiat Biol. 2016;92(2):107-15. Epub 2015 Dec 21.

Abstract

PURPOSE: To evaluate the potential carcinogenic effects of radiofrequency energy (RFE) emitted by cell phones on human thyroid primary cells.

MATERIALS AND METHODS: Primary thyroid cell culture was prepared from normal thyroid tissue obtained from patients who underwent surgery at our department. Subconfluent thyroid cells were irradiated under different conditions inside a cell incubator using a device that simulates cell phone-RFE. Proliferation of control and irradiated cells was assessed by the immunohistochemical staining of antigen Kiel clone-67 (Ki-67) and tumor suppressor p53 (p53) expression. DNA ploidy and the stress biomarkers heat shock protein 70 (HSP70) and reactive oxygen species (ROS) was evaluated by fluorescence-activated cell sorting (FACS).

RESULTS: Our cells highly expressed thyroglobulin (Tg) and sodium-iodide symporter (NIS) confirming the origin of the tissue. None of the irradiation conditions evaluated here had an effect neither on the proliferation marker Ki-67 nor on p53 expression. DNA ploidy was also not affected by RFE, as well as the expression of the biomarkers HSP70 and ROS.

CONCLUSION: Our conditions of RFE exposure seem to have no potential carcinogenic effect on human thyroid cells. Moreover, common biomarkers usually associated to environmental stress also remained unchanged. We failed to find an association between cell phone-RFE and thyroid cancer. Additional studies are recommended.


https://www.ncbi.nlm.nih.gov/pubmed/26689947

Note: This study did not expose the cell samples to cell phone radiation. The RFE exposure in this simulation did not resemble cell phone radiation.
"Subconfluent thyroid cells were irradiated ... using a device consisting of a Radio Frequency (RF) generator (Fluke 60602A, manufactured by Fluke, Everett, WA) and an RF power amplifier (EMPower 7044, Holbrook, NY). The RF generator, located outside the incubator, was set to the desired power and connected to the power amplifier, which was connected to a panel antenna that was fixed inside the incubator."

"... an antenna was placed inside the cell incubator and set at 900 or 895 MHz and 80 or 210 μW/cm2 to simulate the radiation emitted by mobile phones."

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International Agency for Research on Cancer. Overdiagnosis is a major driver of the thyroid cancer epidemic: Up to 50-90% of thyroid cancers in women in high-income countries estimated to be overdiagnoses. Press Release No. 246. August 18, 2016. http://www.iarc.fr/en/media-centre/pr/2016/pdfs/pr246_E.pdf

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Lu M, W XY. Study of specific absorption rate (SAR) induced in human endocrine glands for using mobile phones. IEEE Asia-Pacific International Symposium on Electromagnetic Compatibility (APEMC), 2016.: 1084-1086. (Journal not peer-reviewed)

Abstract

With the quick development and widespread use of mobile phones has led to a rising concern about the possible adverse health effects of radio frequency electromagnetic field exposure. This study aims to present the dosimetry analysis of the electromagnetic fields induced by mobile phone on human endocrine glands. A finite-difference time-domain (FDTD) method was employed to calculate the specific absorption rate (SAR) in a realistic human head-neck model from exposure to a generic handset at 1750 MHz. The results show that the locally induced SAR in thyroid gland is much larger than that in both hypophysis and hypothalamus glands. The induced SAR in thyroid for the mobile in short message service (SMS) position is much larger than that in the voice position. However, in all of the examined cases, the SAR values in endocrine glands are all below the IEEE safety standard.

Conclusion

In this work, SAR depositions in realistic human endocrine glands have been analysed when they were exposed to the electromagnetic radiation from a mobile phone. It was found the induced SAR in thyroid gland is much larger than that in hypophysis and hypothalamus glands when the mobile was placed in both voice and SMS positions. Although the induced SAR in the human endocrine glands are below the IEEE safety standard, long-term use of mobile with the higher level SAR absorption in thyroid gland may be a risk factor associated with several thyroid disorders.

http://ieeexplore.ieee.org/xpl/articleDetails.jsp?arnumber=7522951

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Carlberg M, Hedendahl L, Ahonen, Koppel T, Hardell L. Increasing incidence of thyroid cancer in the Nordic countries with main focus on Swedish data. BMC Cancer. 16:246. 2016.

Abstract

Background: Radiofrequency radiation in the frequency range 30 kHz–300 GHz was evaluated to be Group 2B, i.e. ‘possibly’ carcinogenic to humans, by the International Agency for Research on Cancer (IARC) at WHO in May 2011. Among the evaluated devices were mobile and cordless phones, since they emit radiofrequency electromagnetic fields (RF-EMF). In addition to the brain, another organ, the thyroid gland, also receives high exposure. The incidence of thyroid cancer is increasing in many countries, especially the papillary type that is the most radiosensitive type.

Methods: We used the Swedish Cancer Register to study the incidence of thyroid cancer during 1970–2013 using joinpoint regression analysis.

Results: In women, the incidence increased statistically significantly during the whole study period; average annual percentage change (AAPC) +1.19 % (95 % confidence interval (CI) +0.56, +1.83 %). Two joinpoints were detected, 1979 and 2001, with a high increase of the incidence during the last period 2001–2013 with an annual percentage change (APC) of +5.34 % (95 % CI +3.93, +6.77 %). AAPC for all men during 1970–2013 was +0.77 % (95 % CI −0.03, +1.58 %). One joinpoint was detected in 2005 with a statistically significant increase in incidence during 2005–2013; APC +7.56 % (95 % CI +3.34, +11.96 %). Based on NORDCAN data, there was a statistically significant increase in the incidence of thyroid cancer in the Nordic countries during the same time period. In both women and men a joinpoint was detected in 2006. The incidence increased during 2006–2013 in women; APC +6.16 % (95 % CI +3.94, +8.42 %) and in men; APC +6.84 % (95 % CI +3.69, +10.08 %), thus showing similar results as the Swedish Cancer Register. Analyses based on data from the Cancer Register showed that the increasing trend in Sweden was mainly caused by thyroid cancer of the papillary type.



Conclusions: We postulate that the whole increase cannot be attributed to better diagnostic procedures. Increasing exposure to ionizing radiation, e.g. medical computed tomography (CT) scans, and to RF-EMF (non-ionizing radiation) should be further studied. The design of our study does not permit conclusions regarding causality.

Open access paper: https://bmccancer.biomedcentral.com/articles/10.1186/s12885-016-2429-4

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Silva V, Hilly O, Strenov Y, Tzabari C, Hauptman Y, Feinmesser R. Effect of cell phone-like electromagnetic radiation on primary human thyroid cells. Int J Radiat Biol. 92(2):107-115. 2016.

My comments: The exposures in this study were rather low as the maximum SAR was 0.170 W/kg.  The exposures in the three experimental conditions ranged from 895 to 900 Mhz, 80 to 210 μW/cm2 power density, and 0.082 to 0.170 W/kg SAR. 

Abstract

Purpose To evaluate the potential carcinogenic effects of radiofrequency energy (RFE) emitted by cell phones on human thyroid primary cells.

Materials and methods Primary thyroid cell culture was prepared from normal thyroid tissue obtained from patients who underwent surgery at our department. Subconfluent thyroid cells were irradiated under different conditions inside a cell incubator using a device that simulates cell phone-RFE. Proliferation of control and irradiated cells was assessed by the immunohistochemical staining of antigen Kiel clone-67 (Ki-67) and tumor suppressor p53 (p53) expression. DNA ploidy and the stress biomarkers heat shock protein 70 (HSP70) and reactive oxygen species (ROS) was evaluated by fluorescence-activated cell sorting (FACS).

Results Our cells highly expressed thyroglobulin (Tg) and sodium-iodide symporter (NIS) confirming the origin of the tissue. None of the irradiation conditions evaluated here had an effect neither on the proliferation marker Ki-67 nor on p53 expression. DNA ploidy was also not affected by RFE, as well as the expression of the biomarkers HSP70 and ROS.

Conclusion Our conditions of RFE exposure seem to have no potential carcinogenic effect on human thyroid cells. Moreover, common biomarkers usually associated to environmental stress also remained unchanged. We failed to find an association between cell phone-RFE and thyroid cancer. Additional studies are recommended.

Conclusions

We here report that different evaluated RFE exposure conditions have no potential carcinogenic effect on thyroid cells. Proliferation and cellular DNA integrity, two major players in cancer development and progression were not affected in our conditions. Moreover, common biomarkers that are usually associated with environmental stress also remained unchanged after RFE irradiation. Among the limitations of our work we consider that even though measurements of extremely low frequency interference were considerably low, the stray magnetic fields emitted by the instruments used in the study may have had a confounder effect on our results. On the other hand, different conditions of time and frequencies of exposure should be further explored in order to completely cross out a deleterious effect of RFE on thyroid cells. In summary, the increase of both, thyroid cancer and cellular phone use calls the attention to further investigate the potential effects that chronic use of mobile phones might have on the thyroid gland.

http://1.usa.gov/1QKkvx9

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Hilly, Ohad; Silva, Verónica; Mizrachi, Aviram; Ariel, Ortal; Raiter, Annat; Hauptman, Yirmi; Hardy, Britta; Feinmesser, Raphael. EFFECT OF NON-IONIZING ELECTROMAGNETIC RADIATION AT MOBILE PHONE FREQUENCY ON HUMAN THYROID CELLS. Abstract from the World Thyroid Cancer Congress in Toronto 2013.

Background/Purpose: The aim of this study was to examine the effect of non-ionizing electromagnetic radiation (NIER) at mobile phone frequency on human thyroid cells.

Methods: We cultured samples of normal thyroid tissue and subsequently exposed the cultured thyrocytes to NIER for 3 hours. NIER effects were evaluated in terms of proliferation using a cell viability assay and immunohistochemistry.

Results: We found that NIER exposure for 3 hours has lead to an increased proliferation of thyrocytes in cell viability assay (p=0.007). This result was confirmed by immunohistochemistry with antibodies against Ki67.

Discussion & Conclusion: In this study we present for the first time an in vitro evaluation of NIER  effects on human thyroid cells. Our results suggest a proliferative effect of NIER on human thyrocytes, an effect that may link NIER exposure with potential carcinogenesis.

http://thyroidworldcongress.com/wp-content/uploads/2013/07/O022_Mizrachi.pdf


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Exposure to non-ionizing radiation provokes changes in rat thyroid morphology and expression of HSP-90

Misa-Agustiño MJ, Jorge-Mora T, Jorge-Barreiro FJ, Suarez-Quintanilla J, Moreno-Piquero E, Ares-Pena FJ, López-Martín E.Exposure to non-ionizing radiation provokes changes in rat thyroid morphology and expression of HSP-90. Exp Biol Med (Maywood). 2015 Feb 2.


Abstract

Non-ionizing radiation at 2.45 GHz may modify the morphology and expression of genes that codify heat shock proteins (HSP) in the thyroid gland. Diathermy is the therapeutic application of non-ionizing radiation to humans for its beneficial effects in rheumatological and musculo-skeletal pain processes.

We used a diathermy model on laboratory rats subjected to maximum exposure in the left front leg, in order to study the effects of radiation on the nearby thyroid tissue. Fifty-six rats were individually exposed once or repeatedly (10 times in two weeks) for 30 min to 2.45 GHz radiation in a commercial chamber at different non-thermal specific absorption rates (SARs), which were calculated using the finite difference time domain technique. We used immunohistochemistry methods to study the expression of HSP-90 and morphological changes in thyroid gland tissues.

Ninety minutes after radiation with the highest SAR, the central and peripheral follicles presented increased size and the thickness of the peripheral septa had decreased. Twenty-four hours after radiation, only peripheral follicles radiated at 12 W were found to be smaller. Peripheral follicles increased in size with repeated exposure at 3 W power.

Morphological changes in the thyroid tissue may indicate a glandular response to acute or repeated stress from radiation in the hypothalamic-pituitary-thyroid axis. Further research is needed to determine if the effect of this physical agent over time may cause disease in the human thyroid gland.

http://1.usa.gov/1Fb1Ykz



Excerpts
The thyroid gland is one of the most superficial vital organs and possibly more vulnerable to EMFs.7 Chronic exposure to microwaves at a RF of 2.45 GHz has been shown to significantly affect the hypothalamus–pituitary–thyroid (HPT) axis, provoking changes in body temperature, behavior, and thyroid hormone concentrations.8 Alterations in human and animal levels of thyroid stimulating hormone and other thyroid hormones have also been reported with chronic exposure to frequencies used in mobile telephones, such as 900 MHz.
Heat shock protein (HSP) 90 is a chaperone protein regulating several client proteins involved in thyroid cancer development and the level of expression is higher than in normal tissues. This chaperone has emerged as an exciting target in the development of cancer chemotherapeutics.11,12 Recently, we discovered that repeated, acute subthermal radiation for 30 min at 2.45 GHz can alter cellular stress levels in rat hypothalamus13 and thyroid gland,14 without initially altering apoptotic capacity. Surprisingly, in spite of frequent direct and indirect exposure to non-ionizing radiation in human environments and indications that radiation provokes a degree of stress in thyroid cells, there is very little research describing morphological changes that point to precocious re-adjustments of the mammalian thyroid gland after close-range exposure to non-ionizing radiation at 2.45 GHz.
Group A: single exposure and studied after 90 min (n = 18): The rats were divided into three subgroups (n = 6); each rat was exposed to 30 mina of microwave radiation at three levels: 0 (control), 3, and 12 W.b The rats were kept alive for 90 minc and then euthanized and perfused with fixative.
Group B: single exposure and studied after 24 h (n = 18): The rats were divided into three subgroups (n = 6); each rat was exposed to 30 min of microwave radiation at three levels: 0 (control), 3, and 12 W.b The rats were kept alive for 24 hc and then euthanized and perfused with fixative.
Group C: repeated exposure and studied after 90 min (n = 20): Rats in this group were irradiated at 3 W for 30 min/day, for a total of 10 times in a two-week period. On the last day of exposure, the rats were irradiated and after 90 min were euthanized and perfused with fixative. They were then tested for HSP-90 expression. In the non-irradiated control group (n = 10), rats were immobilized for each of the 10 sessions and euthanized on the last day, following the same protocol as the irradiated animals.
... we found that the interaction of non-ionizing radiation at a frequency of 2.45 GHz caused modifications in the morphology of the thyroid gland tissue and in the distribution of the constituent cellular stress protein known as HSP-90. The morphology of the thyroid gland underwent the following changes due to radiation:
The size of central and peripheral follicles increased and the thickness of the peripheral septa decreased 90 min after single exposure. After 24 h, central follicles had decreased in size, but hypertrophy was still present in the peripheral follicles of thyroid gland exposed to the higher SAR level.
Repeated stimulus of the thyroid gland at the lower SAR level triggered adaptation and an increase in the size of peripheral follicles.
The observed localization of the expression of this protein in the supportive tissue of the septa, specifically in the fibers and in the capsular and lobular membranes suggests that this stress protein constitutes an important component of glandular architecture and is probably dedicated to maintaining glandular structure and morphology. The distribution of HSP-90 in thyroid membranes and cells was diminished after single (if the SAR and time after radiation increased) and repeated exposure to radiation.
Our work describes for the first time the effects of single and repeated exposure to 2.45 GHz RF on the morphology of Sprague-Dawley rat thyroid gland. Published studies to date have described histopathological alterations in thyroid tissue of experimental animals exposed to extremely low frequency (ELF) (50 Hz) or in thyroid hormone levels in humans or animals exposed at ELF or RF.
We chose to experimentally examine small animals at 2.45 GHz RF because of the wide range of potential applications, from therapeutics to tissue diathermy (this frequency resonates with H2O, facilitating greater penetration) to telecommunications involving WIFI, UMTS, or Bluetooth. We used subthermal SAR levels of 0.102 ± 12.10–3 and 0.429 ± 12.10–3 W/kg at 2.45 GHz in the right front leg, near the thyroid, to ensure that the non-ionizing radiation would not cause direct thermal effects to the gland.  Research of this type requires immobilization of the animal, which itself has been found to generate a certain amount of stress. It must also be noted that radiation can catalyze single or repetitive activation of different neuron populations in rat hypothalamus, which intervene in the HPT axis. We cannot therefore assume that the effects of non-ionizing radiation to the thyroid are limited to its tissues; it must be treated as part of a system with multiple, interacting entry points. Other studies have described how microwave radiation at 2.45 GHz affects brain physiopathology and provokes changes in cerebral functioning and behavior. In the present study, the thyroid system is directly or indirectly affected by alterations in the HPT axis as well as by biochemical changes in the thyroid itself due to exposure to microwaves.
Recent research has described how EMFs can constitute external sources for the formation of free radicals in blood cells, the brain, spermatozoids,and myocardial tissue. The thyroid gland is by nature an oxidative organ, and when additional oxidative abuse is caused by exogenous pro-oxidants (ionizing radiation would be the most significant), damage to the macromolecules in the gland increases, possibly leading to thyroid pathology or cancer. In spite of this, a direct relation between thyroid cancer and exposure to EMFs has not yet been established. However, the search is ongoing for biomarkers in thyroid diseases that would make early detection, diagnosis, and intervention possible. HSP-90 is physiologically essential in cellular processes such as hormone signaling and control, proliferation, and differentiation of the cellular cycle. In prior studies, we described a decrease in HSP-90 and 70 due to acute radiation at 2.45 GHz in the thyroid gland, with no apparent effect in the apoptotic activity of thyroid cells. HSP-90 is known to play a modulatory role against thyroid cancer due to its primarily antiapoptotic function. In the present work, we have observed how, after 30 min exposure, the immunoreactivity of HSP-90 is histologically distributed throughout the thyroid gland in places where kinase proteins had previously been activated, between the capsular and lobular membranes and in the follicular and parafollicular cells.

... cellular damage in the thyroid gland was directly related to the SAR level and/or number of exposures applied to the tissue.

... In the present experiment, exposure of rat thyroid gland to RF at 2.45 GHz and 0.102 ± 12.10–3 SAR increased HSP-90 marking in the parafollicular cells. However, HSP-90 stress immunomarking decreased in the parafollicular cells at 0.429 ± 12.10–3 SAR or with repeated exposure (see Figure 7). HSP-90 in the parafollicular cell is sensitive to the nature and intensity of radiation stimulus, which can modify cellular function and serve as a biomarker for cellular damage.

Thyroid gland exposed to 2.45 GHz radiation in this experimental model of diathermy in rats presented the following visible morphological effects: (a) glandular hypertrophy in relation to the SAR and/or number of exposures; (b) modification of the distribution of HSP-90 associated with membranes and parafollicular cells. These effects might not be exclusively or directly produced by radiation and can be included with other indirect effects from the hypothalamus. However, further research is needed to ascertain whether the continued effect of this physical agent could provoke pathology in the thyroid gland.                             
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 K, Sechman A, Nieckarz Z. Plasma thyroid hormones and corticosterone levels in blood of chicken embryos and post hatch chickens exposed during incubation to 1800 MHz electromagnetic field. Int J Occup Med Environ Health. 2014 Jan 31.

Abstract

INTRODUCTION: This study attempted to determine the effect of a 1800 MHz electromagnetic field (EMF) (only carrier frequency) on thyroxine (T4), triiodothyronine (T3) and corticosterone (CORT) concentrations in the blood plasma of chick embryos, and to investigate the effect of electromagnetic field (EMF) exposure during embryogenesis on the level of these hormones in birds that are ready for slaughter.

MATERIAL AND METHODS:  Throughout the incubation period, embryos from the experimental group were exposed to a 1800 MHz EMF with power density of 0.1 W/m2, 10 times during 24 h for 4 min. Blood samples were collected to determine T4, T3 and CORT concentrations on the 12th (E12) and 18th (E18) day of incubation, from newly hatched chicks (D1) and from birds ready for slaughter (D42).

RESULTS:  The experiment showed that T4 and T3 concentrations decreased markedly and CORT levels increased in the embryos and in the newly hatched chicks exposed to EMF during embryogenesis. However, no changes were found in the level of the analyzed hormones in the birds ready for slaughter. Differences in T4 and T3 plasma concentrations between the EMF-exposed group and the embryos incubated without additional EMF were the highest in the newly hatched chicks, which may be indicative of the cumulative effect of electromagnetic field on the hypothalamo-pituitary-thyroid axis (HPT).

DISCUSSION:  The obtained results suggest that additional 1800 MHz radio frequency electromagnetic field inhibits function of HPT axis, however, it stimulates hypothalamo-pituitary-adrenal axis by inducing adrenal steroidogenic cells to synthesize corticosterone. Further investigations are needed to elucidate the mechanisms by which radio EMFs affect HPT and HPA axis function in the chicken embryos.

http://1.usa.gov/1e4do9w

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Jin YB, Choi HD, Kim BC, Pack JK, Kim N, Lee YS.Effects of simultaneous combined exposure to CDMA and WCDMA electromagnetic fields on serum hormone levels in rats. J Radiat Res. 2013 May;54(3):430-7. doi: 10.1093/jrr/rrs120.

Abstract

Despite more than a decade of research on the endocrine system, there have been no published studies about the effects of concurrent exposure of radiofrequency electromagnetic fields (RF-EMF) on this system. The present study investigated the several parameters of the endocrine system including melatonin, thyroid stimulating hormone, stress hormone and sex hormone after code division multiple access (CDMA, 849 MHz) and wideband code division multiple access (WCDMA, 1.95 GHz) signals for simultaneous exposure in rats. Sprague-Dawley rats were exposed to RF-EMF signals for 45 min/day, 5 days/week for up to 8 weeks. The whole-body average specific absorption rate (SAR) of CDMA or WCDMA was 2.0 W/kg (total 4.0 W/kg). At 4 and 8 weeks after the experiment began, each experimental group's 40 rats (male 20, female 20) were autopsied. Exposure for 8 weeks to simultaneous CDMA and WCDMA RF did not affect serum levels in rats of melatonin, thyroid stimulating hormone (TSH), triiodothyronine (T3) and thyroxin (T4), adrenocorticotropic hormone (ACTH) and sex hormones (testosterone and estrogen) as assessed by the ELISA method.

http://www.ncbi.nlm.nih.gov/pubmed/23239176

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Dimida A, Ferrarini E, Agretti P, De Marco G, Grasso L, Martinelli M, Longo I, Giulietti D, Ricci A, Galimberti M, Siervo B, Licitra G, Francia F, Pinchera A, Vitti P, Tonacchera M. Electric and magnetic fields do not modify the biochemical properties of FRTL-5 cells. J Endocrinol Invest. 2011 Mar;34(3):185-9. doi: 10.3275/7107.

Abstract

BACKGROUND: Electric and magnetic fields (EMF) might be involved in human disease and numerous research and scientific reviews have been conducted to address this question. In particular thyroid structural and functional alterations caused by various forms of non-ionizing radiation have been described.

AIM: The aim of this study was to analyze the possible effects of EMF on thyroid, in particular we analyzed the effects caused by a GSM (Global System for Mobile Communications) signal (900 MHz) on cultured thyroid cells (FRTL- 5).

MATERIAL AND METHODS:  The experimental setup was designed in order to expose samples to a radiofrequency wave in well-controlled conditions. We used the FRTL-5 cell line, an epithelial monoclonal continuous cell line derived from Fisher rat thyroid tissue growing as monolayer, expressing the TSH receptor and the sodium-iodide symporter (NIS). FRTL-5 were subsequently irradiate for 24, 48, and 96 h with EMF (800-900 MHz, power-frequency of mobile communication systems) and iodide uptake and cAMP production were measured.

RESULTS:  The irradiation of cells with EMF at 900 Mhz for 24, 48, and 96 h did not influence the level of cAMP production and was not able to modify iodide accumulation in FRTL- 5 cells with respect to basal conditions.

CONCLUSIONS: In conclusion, EMF do not seem to be able to interfere with the biochemical properties of FRTL-5 cells in vitro.

http://www.ncbi.nlm.nih.gov/pubmed/20543553

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Esmekaya MA, Seyhan N, Ömeroglu S. Pulse modulated 900 MHz radiation induces hypothyroidism and apoptosis in thyroid cells: a light, electron microscopy and immunohistochemical study. Int J Radiat Biol. 2010 Dec;86(12):1106-16.

Abstract

PURPOSE: In the present study we investigated the possible histopathological effects of pulse modulated Radiofrequency (RF) fields on the thyroid gland using light microscopy, electron microscopy and immunohistochemical methods.

MATERIALS AND METHODS: Two months old male Wistar rats were exposed to a 900 MHz pulse-modulated RF radiation at a specific absorption rate (SAR) of 1.35 Watt/kg for 20 min/day for three weeks. The RF signals were pulse modulated by rectangular pulses with a repetition frequency of 217 Hz and a duty cycle of 1:8 (pulse width 0.576 ms). To assess thyroid endocrine disruption and estimate the degree of the pathology of the gland, we analysed structural alterations in follicular and colloidal diameters and areas, colloid content of the follicles, and height of the follicular epithelium. Apoptosis was confirmed by Transmission Electron Microscopy and assessing the activites of an initiator (caspase-9) and an effector (caspase-3) caspases that are important markers of cells undergoing apoptosis.

RESULTS: Morphological analyses revealed hypothyrophy of the gland in the 900 MHz RF exposure group. The results indicated that thyroid hormone secretion was inhibited by the RF radiation. In addition, we also observed formation of apoptotic bodies and increased caspase-3 and caspase-9 activities in thyroid cells of the rats that were exposed to modulated RF fields.

CONCLUSION: The overall findings indicated that whole body exposure to pulse-modulated RF radiation that is similar to that emitted by global system for mobile communications (GSM) mobile phones can cause pathological changes in the thyroid gland by altering the gland structure and enhancing caspase-dependent pathways of apoptosis.

http://www.ncbi.nlm.nih.gov/pubmed/20807179

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Milham S. Most cancer in firefighters is due to radio-frequency radiation exposure not inhaled carcinogens. Med Hypotheses. 2009 Nov;73(5):788-9. doi: 10.1016/j.mehy.2009.04.020.

Abstract


Recent reviews and reports of cancer incidence and mortality in firefighters conclude that they are at an increased risk of a number of cancers. These include leukemia, multiple myeloma, non-Hodgkin's lymphoma, male breast cancer, malignant melanoma, and cancers of the brain, stomach, colon, rectum, prostate, urinary bladder, testes, and thyroid. Firefighters are exposed to a long list of recognized or probable carcinogens in combustion products and the presumed route of exposure to these carcinogens is by inhalation. Curiously, respiratory system cancers and diseases are usually not increased in firefighters as they are in workers exposed to known inhaled carcinogens. The list of cancers with increased risk in firefighters strongly overlaps the list of cancers at increased risk in workers exposed to electromagnetic fields (EMF) and radiofrequency radiation (RFR). Firefighters have increased exposure to RFR in the course of their work, from the mobile two-way radio communications devices which they routinely use while fighting fires, and at times from firehouse and fire vehicle radio transmitters. I suggest that some of the increased cancer risk in firefighters is caused by RFR exposure, and is therefore preventable. The precautionary principle should be applied to reduce the risk of cancer in firefighters, and workman's compensation rules will necessarily need to be modified.

http://www.ncbi.nlm.nih.gov/pubmed/19464814

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Mortavazi S, Habib A, Ganj-Karami A, Samimi-Doost R, Pour-Abedi A, Babaie A. Alterations in TSH and Thyroid Hormones following Mobile Phone Use. Oman Med J. 2009 Oct;24(4):274-8. doi: 10.5001/omj.2009.56.

Abstract


OBJECTIVES: In recent years, the widespread use of mobile phones has lead to a public debate about possible detrimental effects on human health. In spite of years of research, there is still a great controversy regarding the possibility of induction of any significant physiological effects in humans by microwave radiations emitted by mobile phones. This study aims to investigate the effects of electromagnetic fields induced by the Global System for Mobile communications (GSM) mobile phones on the Thyroid Stimulating Hormone (TSH) and thyroid hormones in humans.

METHODS: 77 healthy university students participated in this study. The levels of T3, T4 and TSH were measured by using appropriate enzyme-linked immunosorbent assay (ELISA) kits (Human, Germany).

RESULTS: The average levels of T3, T4 and TSH in students who moderately used mobile phones were 1.25±0.27 ng/ml, 7.76±1.73 µg/dl and 4.25±2.12 µu/l respectively. The levels in the students who severely used mobile phones were 1.18±0.30, 7.75±1.14 and 3.75±2.05 respectively. In non-users, the levels were 1.15±0.27, 8.42±2.72 and 2.70±1.75, respectively. The difference among the levels of TSH in these 3 groups was statistically significant (P<0.05).

CONCLUSION: As far as the study is concerned, this is the first human study to assess the associations between mobile phone use and alterations in the levels of TSH and thyroid hormones. Based on the findings, a higher than normal TSH level, low mean T4 and normal T3 concentrations in mobile users were observed. It seems that minor degrees of thyroid dysfunction with a compensatory rise in TSH may occur following excessive use of mobile phones. It may be concluded that possible deleterious effects of mobile microwaves on hypothalamic-pituitary-thyroid axis affects the levels of these hormones.

http://www.ncbi.nlm.nih.gov/pubmed/22216380

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Sinha RK. Chronic non-thermal exposure of modulated 2450 MHz microwave radiation alters thyroid hormones and behavior of male rats. Int J Radiat Biol. 2008 Jun;84(6):505-13. doi: 10.1080/09553000802085441.

Abstract

PURPOSE: The purpose of this investigation was to analyze the effects of leakage microwave (2450 MHz) irradiation on thyroid hormones and behavior of male rats.

MATERIALS AND METHODS: Experiments were carried out on two groups of male rats (exposure and control, respectively). Radio-immuno assay (RIA) methods were used for estimation of 3,5,3'-triiodothyronine (T3), thyroxine (T4) and thyrotrophin or thyroid stimulating hormone (TSH). The assessments of behavioral changes were performed in Open-Field (OF) and Elevated Plus-Maze (EPM) apparatuses.

RESULTS: Following chronic microwave exposure, rats were found hyperactive and aggressive on the 16th and 21st days. Behavioral changes in OF were analyzed and found to be significantly changed from controls (p < 0.05) for immobilization, rearing and ambulation behavior. In EPM, rats showed increased activity with decreased time spent in the open arm and more time spent in the center on the 11th (p < 0.05), 16th (p < 0.05) and 21st day (p < 0.01) after irradiation. Changes in behavioral parameters are also correlated with the trend of changes, compared to control animals, in hormonal blood levels of T3 (decreased on the 16th day, p < 0.05 and 21st day, p < 0.01) and T4 (increased on the 21st day, p < 0.05).

CONCLUSION: Low energy microwave irradiation may be harmful as it is sufficient to alter the levels of thyroid hormones as well as the emotional reactivity of the irradiated compared to control animals.

https://www.ncbi.nlm.nih.gov/pubmed/18470749

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Djeridane Y, Touitou Y, de Seze R. Influence of electromagnetic fields emitted by GSM-900 cellular telephones on the circadian patterns of gonadal, adrenal and pituitary hormones in men. Radiat Res. 2008 Mar;169(3):337-43.

Abstract

The potential health risks of radiofrequency electromagnetic fields (RF EMFs) emitted by mobile phones are currently of considerable public interest. The present study investigated the effect of exposure to 900 MHz GSM radiofrequency radiation on steroid (cortisol and testosterone) and pituitary (thyroid-stimulating hormone, growth hormone, prolactin and adrenocorticotropin) hormone levels in 20 healthy male volunteers. Each subject was exposed to RF EMFs through the use of a cellular phone for 2 h/day, 5 days/ week, for 4 weeks. Blood samples were collected hourly during the night and every 3 h during the day. Four sampling sessions were performed at 15-day intervals: before the beginning of the exposure period, at the middle and the end of the exposure period, and 15 days later. Parameters evaluated included the maximum serum concentration, the time of this maximum, and the area under the curve for hormone circadian patterns. Each individual's pre-exposure hormone concentration was used as his control. All hormone concentrations remained within normal physiological ranges. The circadian profiles of prolactin, thyroid-stimulating hormone, adrenocorticotropin and testosterone were not disrupted by RF EMFs emitted by mobile phones. For growth hormone and cortisol, there were significant decreases of about 28% and 12%, respectively, in the maximum levels when comparing the 2-week (for growth hormone and cortisol) and 4-week (for growth hormone) exposure periods to the pre-exposure period, but no difference persisted in the postexposure period. Our data show that the 900 MHz EMF exposure, at least under our experimental conditions, does not appear to affect endocrine functions in men.

http://www.ncbi.nlm.nih.gov/pubmed/18302481

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Koyu A, Cesur G, Ozguner F, Akdogan M, Mollaoglu H, Ozen S. Effects of 900 MHz electromagnetic field on TSH and thyroid hormones in rats. Toxicol Lett. 2005 Jul 4;157(3):257-62.

Abstract


In this study, the effects of exposure to a 900 megahertz (MHz) electromagnetic field (EMF) on serum thyroid stimulating hormone (TSH) and triiodothronine-thyroxin (T3-T4) hormones levels of adult male Sprague-Dawley rats were studied. Thirty rats were used in three independent groups, 10 of which were control (without stress and EMF), 10 of which were exposed to 900 MHz EMF and 10 of which were sham-exposed. The exposures were performed 30 min/day, for 5 days/week for 4 weeks to 900 MHz EMF. Sham-exposed animals were kept under the same environmental conditions as the study groups except with no EMF exposure. The concentration of TSH and T3-T4 hormones in the rat serum was measured by using an immunoradiometric assay (IRMA) method for TSH and a radio-immunoassay (RIA) method for T3 and T4 hormones. TSH values and T3-T4 at the 900 MHz EMF group were significantly lower than the sham-exposed group (p<0.01). There were no statistically significant differences in serum TSH values and T3-T4 hormone concentrations between the control and the sham-exposed group (p>0.05). These results indicate that 900 MHz EMF emitted by cellular telephones decrease serum TSH and T3-T4 levels.

http://www.ncbi.nlm.nih.gov/pubmed/15917150

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Wakeford R. The cancer epidemiology of radiation. Oncogene. 2004 Aug 23;23(38):6404-28.

Abstract


Ionizing radiation has been the subject of intense epidemiological investigation. Studies have demonstrated that exposure to moderate-to-high levels can cause most forms of cancer, leukaemia and cancers of the breast, lung and thyroid being particularly sensitive to induction by radiation, especially at young ages at exposure. Predominant among these studies is the Life Span Study of the cohort of survivors of the atomic bombings of Japan in 1945, but substantial evidence is derived from groups exposed for medical reasons, occupationally or environmentally. Notable among these other groups are underground hard rock miners who inhaled radioactive radon gas and its decay products, large numbers of patients irradiated therapeutically and workers who received high doses in the nuclear weapons programme of the former USSR. The degree of carcinogenic risk arising from low levels of exposure is more contentious, but the available evidence points to an increased risk that is approximately proportional to the dose received. Epidemiological investigations of nonionizing radiation have established ultraviolet radiation as a cause of skin cancer. However, the evidence for a carcinogenic effect of other forms of nonionizing radiation, such as those associated with mobile telephones or electricity transmission lines, is not convincing, although the possibility of a link between childhood leukaemia and extremely low-frequency electromagnetic fields cannot be dismissed entirely.

http://www.ncbi.nlm.nih.gov/pubmed/15322514

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Bergamaschi A, Magrini A, Ales G, Coppeta L, Somma G. Are thyroid dysfunctions related to stress or microwave exposure (900 MHz)? Int J Immunopathol Pharmacol. 2004 May-Aug;17(2 Suppl):31-6.

Abstract


In the last decade, numerous scientific evidence suggested possible adverse health effects from exposure to electromagnetic fields (EMF'S) and the use of mobile phones. According to some studies EMF induced changes of trans-membrane Ca++ flux may lead to altered metabolism and/or secretion of neurohormones including TSH, ACTH, GH, prolactin and melatonin. The aim of this research was to analyse the effects of mobile phone use on thyroid function and to evaluate the possible role of occupational stress. 2598 employees (1355 men and 1243 women) with different duties (vendors, operators and network technicians) were included in the study. Exposure to EMF'S, generated by mobile phones, was assessed both by submitting a questionnaire directly to the employees and acquiring data regarding conversation times. The workers were divided into three groups on the basis of their personal mobile phone use. Moreover, a group of 160 workers with TSH values below 0.4 UI/l was characterized. No statistically significant difference regarding TSH values below 0.4 UI/l was observed among workers with different duties but there was a greater prevalence of subjects with low SH values among 192 employees with more than 33 hrs./month conversation time; this difference was statistically significant (p<0.05). On the basis of our data, it is not possible to establish whether this result is determined by exposure to EMF'S from mobile phones of by the stress of using these instruments.

http://www.ncbi.nlm.nih.gov/pubmed/15345189

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Black DR, Heynick LN. Radiofrequency (RF) effects on blood cells, cardiac, endocrine, and immunological functions. Bioelectromagnetics. 2003;Suppl 6:S187-95.

Abstract

Effects of radiofrequency electromagnetic fields (RFEMF) on the pituitary adrenocortical (ACTH), growth (GH), and thyroid (TSH) hormones have been extensively studied, and there is coherent research on reproductive hormones (FSH and LH). Those effects which have been identified are clearly caused by heating. The exposure thresholds for these effects in living mammals, including primates, have been established. There is limited evidence that indicates no interaction between RFEMF and the pineal gland or an effect on prolactin from the pituitary gland. Studies of RFEMF exposed blood cells have shown that changes or damage do not occur unless the cells are heated. White cells (leukocytes) are much more sensitive than red cells (erythrocytes) but white cell effects remain consistent with normal physiological responses to systemic temperature fluctuation. Lifetime studies of RFEMF exposed animals show no cumulative adverse effects in their endocrine, hematological, or immune systems. Cardiovascular tissue is not directly affected adversely in the absence of significant RFEMF heating or electric currents. The regulation of blood pressure is not influenced by ultra high frequency (UHF) RFEMF at levels commonly encountered in the use of mobile communication devices.

http://www.ncbi.nlm.nih.gov/pubmed/14628314

Friday, December 22, 2017

Research on Smart Phone and Internet Addiction

Recent Studies on Smart Phone Addiction and Nomophobia

Zou Z, Wang H, d'Oleire Uquillas F, Wang X, Ding J, Chen H. Definition of Substance and Non-substance Addiction. Adv Exp Med Biol. 2017;1010:21-41.

Abstract

Substance addiction (or drug addiction) is a neuropsychiatric disorder characterized by a recurring desire to continue taking the drug despite harmful consequences. Non-substance addiction (or behavioral addiction) covers pathological gambling, food addiction, internet addiction, and mobile phone addiction. Their definition is similar to drug addiction but they differ from each other in specific domains. This review aims to provide a brief overview of past and current definitions of substance and non-substance addiction, and also touches on the topic of diagnosing drug addiction and non-drug addiction, ultimately aiming to further the understanding of the key concepts needed for a foundation to study the biological and psychological underpinnings of addiction disorders.


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Gao T, Xiang YT, Zhang H, Zhang Z, Mei S. Neuroticism and quality of life: Multiple mediating effects of smartphone addiction and depression. Psychiatry Res. 2017 Dec;258:457-461. doi: 10.1016/j.psychres.2017.08.074.

Abstract

The purposes of this study were to investigate the mediating effect of smartphone addiction and depression on neuroticism and quality of life. Self-reported measures of neuroticism, smart-phone addiction, depression, and quality of life were administered to 722 Chinese university students. Results showed smartphone addiction and depression were both significantly affected neuroticism and quality of life. The direct effect of neuroticism on quality of life was significant, and the chain-mediating effect of smartphone addiction and depression was also significant. In conclusion, neuroticism, smartphone addiction, and depression are important variables that worsen quality of life.


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Kim HJ, Min JY, Kim HJ, Min KB. Accident risk associated with smartphone addiction: A study on university students in Korea. J Behav Addict. 2017 Nov 3:1-9. doi: 10.1556/2006.6.2017.070.

Abstract

Background and aims: The smartphone is one of the most popular devices, with the average smartphone usage at 162 min/day and the average length of phone usage at 15.79 hr/week. Although significant concerns have been made about the health effects of smartphone addiction, the relationship between smartphone addiction and accidents has rarely been studied. We examined the association between smartphone addiction and accidents among South Korean university students.
Methods: A total of 608 college students completed an online survey that included their experience of accidents (total number; traffic accidents; falls/slips; bumps/collisions; being trapped in the subway, impalement, cuts, and exit wounds; and burns or electric shocks), their use of smartphone, the type of smartphone content they most frequently used, and other variables of interests. Smartphone addiction was estimated using Smartphone Addiction Proneness Scale, a standardized measure developed by the National Institution in Korea.
Results: Compared with normal users, participants who were addicted to smartphones were more likely to have experienced any accidents (OR = 1.90, 95% CI: 1.26-2.86), falling from height/slipping (OR = 2.08, 95% CI: 1.10-3.91), and bumps/collisions (OR = 1.83, 95% CI: 1.16-2.87). The proportion of participants who used their smartphones mainly for entertainment was significantly high in both the accident (38.76%) and smartphone addiction (36.40%) groups.
Discussion and conclusions: We suggest that smartphone addiction was significantly associated with total accident, falling/slipping, and bumps/collisions. This finding highlighted the need for increased awareness of the risk of accidents with smartphone addiction.


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Wolniewicz CA, Tiamiyu MF, Weeks JW, Elhai JD. Problematic smartphone use and relations with negative affect, fear of missing out, and fear of negative and positive evaluation. Psychiatry Res. 2017 Sep 25. pii: S0165-1781(17)30901-0. doi: 10.1016/j.psychres.2017.09.058.

Abstract

For many individuals, excessive smartphone use interferes with everyday life. In the present study, we recruited a non-clinical sample of 296 participants for a cross-sectional survey of problematic smartphone use, social and non-social smartphone use, and psychopathology-related constructs including negative affect, fear of negative and positive evaluation, and fear of missing out (FoMO). Results demonstrated that FoMO was most strongly related to both problematic smartphone use and social smartphone use relative to negative affect and fears of negative and positive evaluation, and these relations held when controlling for age and gender. Furthermore, FoMO (cross-sectionally) mediated relations between both fear of negative and positive evaluation with both problematic and social smartphone use. Theoretical implications are considered with regard to developing problematic smartphone use.



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Han S, Kim KJ, Kim JH. Understanding Nomophobia: Structural Equation Modeling and Semantic Network Analysis of Smartphone Separation Anxiety. Cyberpsychol Behav Soc Netw. 2017 Jul;20(7):419-427. doi: 10.1089/cyber.2017.0113.

Abstract

This study explicates nomophobia by developing a research model that identifies several determinants of smartphone separation anxiety and by conducting semantic network analyses on smartphone users' verbal descriptions of the meaning of their smartphones. Structural equation modeling of the proposed model indicates that personal memories evoked by smartphones encourage users to extend their identity onto their devices. When users perceive smartphones as their extended selves, they are more likely to get attached to the devices, which, in turn, leads to nomophobia by heightening the phone proximity-seeking tendency. This finding is also supplemented by the results of the semantic network analyses revealing that the words related to memory, self, and proximity-seeking are indeed more frequently used in the high, compared with low, nomophobia group.


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Lee H, Kim JW, Choi TY. Risk Factors for Smartphone Addiction in Korean Adolescents: Smartphone Use Patterns. J Korean Med Sci. 2017 Oct;32(10):1674-1679. doi: 10.3346/jkms.2017.32.10.1674.
Abstract
With widespread use of the smartphone, clinical evidence for smartphone addiction remains unclear. Against this background, we analyzed the effect of smartphone use patterns on smartphone addiction in Korean adolescents. A total of 370 middle school students participated. The severity of smartphone addiction was measured through clinical interviews and the Korean Smartphone Addiction Proneness Scale. As a result, 50 (13.5%) were in the smartphone addiction group and 320 (86.5%) were in the healthy group. To investigate the effect of smartphone use patterns on smartphone addiction, we performed self-report questionnaires that assessed the following items: smartphone functions mostly used, purpose of use, problematic use, and parental attitude regarding smartphone use. For smartphone functions mostly used, the addiction group showed significantly higher scores in "Online chat." For the purpose of use, the addiction group showed significantly higher "habitual use," "pleasure," "communication," "games," "stress relief," "ubiquitous trait," and "not to be left out." For problematic use, the addiction group showed significantly higher scores on "preoccupation," "tolerance," "lack of control," "withdrawal," "mood modification," "conflict," "lies," "excessive use," and "loss of interest." For parental attitude regarding children's smartphone use, the addiction group showed significantly higher scores in "parental punishment." Binary logistic regression analysis indicated that "female," "use for learning," "use for ubiquitous trait," "preoccupation," and "conflict" were significantly correlated with smartphone addiction. This study demonstrated that the risk factors for smartphone addiction were being female, preoccupation, conflict, and use for ubiquitous trait; the protective factor was use for learning. Future studies will be required to reveal the additional clinical evidence of the disease entity for smartphone addiction.
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Kuss DJ, Griffiths MD. Social Networking Sites and Addiction: Ten Lessons Learned. Int J Environ Res Public Health. 2017 Mar 17;14(3). pii: E311. doi: 10.3390/ijerph14030311.
Abstract
Online social networking sites (SNSs) have gained increasing popularity in the last decade, with individuals engaging in SNSs to connect with others who share similar interests. The perceived need to be online may result in compulsive use of SNSs, which in extreme cases may result in symptoms and consequences traditionally associated with substance-related addictions. In order to present new insights into online social networking and addiction, in this paper, 10 lessons learned concerning online social networking sites and addiction based on the insights derived from recent empirical research will be presented. These are: (i) social networking and social media use are not the same; (ii) social networking is eclectic; (iii) social networking is a way of being; (iv) individuals can become addicted to using social networking sites; (v) Facebook addiction is only one example of SNS addiction; (vi) fear of missing out (FOMO) may be part of SNS addiction; (vii) smartphone addiction may be part of SNS addiction; (viii) nomophobia may be part of SNS addiction; (ix) there are sociodemographic differences in SNS addiction; and (x) there are methodological problems with research to date. These are discussed in turn. Recommendations for research and clinical applications are provided.

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De-Sola Gutiérrez J, Rodríguez de Fonseca F, Rubio G. Cell-Phone Addiction: A Review. Front Psychiatry. 2016 Oct 24;7:175.

Abstract

We present a review of the studies that have been published about addiction to cell phones. We analyze the concept of cell-phone addiction as well as its prevalence, study methodologies, psychological features, and associated psychiatric comorbidities. Research in this field has generally evolved from a global view of the cell phone as a device to its analysis via applications and contents. The diversity of criteria and methodological approaches that have been used is notable, as is a certain lack of conceptual delimitation that has resulted in a broad spread of prevalent data. There is a consensus about the existence of cell-phone addiction, but the delimitation and criteria used by various researchers vary. Cell-phone addiction shows a distinct user profile that differentiates it from Internet addiction. Without evidence pointing to the influence of cultural level and socioeconomic status, the pattern of abuse is greatest among young people, primarily females. Intercultural and geographical differences have not been sufficiently studied. The problematic use of cell phones has been associated with personality variables, such as extraversion, neuroticism, self-esteem, impulsivity, self-identity, and self-image. Similarly, sleep disturbance, anxiety, stress, and, to a lesser extent, depression, which are also associated with Internet abuse, have been associated with problematic cell-phone use. In addition, the present review reveals the coexistence relationship between problematic cell-phone use and substance use such as tobacco and alcohol.

https://www.ncbi.nlm.nih.gov/pubmed/27822187

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Bragazzi NL, Del Puente G. A proposal for including nomophobia in the new DSM-V. Psychol Res Behav Manag. 2014 May 16;7:155-60. doi: 10.2147/PRBM.S41386.

Abstract

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is considered to be the gold standard manual for assessing the psychiatric diseases and is currently in its fourth version (DSM-IV), while a fifth (DSM-V) has just been released in May 2013. The DSM-V Anxiety Work Group has put forward recommendations to modify the criteria for diagnosing specific phobias. In this manuscript, we propose to consider the inclusion of nomophobia in the DSM-V, and we make a comprehensive overview of the existing literature, discussing the clinical relevance of this pathology, its epidemiological features, the available psychometric scales, and the proposed treatment. Even though nomophobia has not been included in the DSM-V, much more attention is paid to the psychopathological effects of the new media, and the interest in this topic will increase in the near future, together with the attention and caution not to hypercodify as pathological normal behaviors.

Open source paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4036142/

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Hussain Z. Smartphone Use, Addiction, Narcissism, and Personality: A Mixed Methods Investigation.International Journal of Cyber Behavior, Psychology and Learning. 5(1):17-32. 2015.

Abstract

There are increasing numbers of people who are now using smartphones. Consequently, there is a risk of addiction to certain web applications such as social networking sites (SNSs) which are easily accessible via smartphones. There is also the risk of an increase in narcissism amongst users of SNSs. 
The present study set out to investigate the relationship between smartphone use, narcissistic tendencies and personality as predictors of smartphone addiction. The study also aimed to investigate the distinction between addiction specificity and co-occurrence in smartphone addiction via qualitative data and discover why people continue to use smartphones in banned areas. A self-selected sample of 256 smartphone users (Mean age = 29.2, SD = 9.49) completed an online survey. The results revealed that 13.3% of the sample was classified as addicted to smartphones. Higher narcissism scores and neuroticism levels were linked to addiction. Three themes of; social relations, smartphone dependence and self-serving personalities emerged from the qualitative data. Interpretation of qualitative data supports addiction specificity of the smartphone. It is suggested smartphones encourage narcissism, even in non-narcissistic users. In turn, this increased use in banned areas. Future research needs to gather more in-depth qualitative data, addiction scale comparisons and comparison of use with and without SNS access. It is advised that prospective buyers of smartphones be pre-warned of the potential addictive properties of new technology.


Recent Study on Social Networking Site Disorder

Pontes HM. Investigating the differential effects of social networking site addiction and Internet gaming disorder on psychological health. J Behav Addict. 2017 Nov 13:1-10. doi: 10.1556/2006.6.2017.075.

Abstract

Background and aims: Previous studies focused on examining the interrelationships between social networking site (SNS) addiction and Internet gaming disorder (IGD) in isolation. Moreover, little is known about the potential simultaneous differential effects of SNS addiction and IGD on psychological health. This study investigated the interplay between these two technological addictions and ascertained how they can uniquely and distinctively contribute to increasing psychiatric distress when accounting for potential effects stemming from sociodemographic and technology-related variables.
Methods: A sample of 509 adolescents (53.5% males) aged 10-18 years (mean = 13.02, SD = 1.64) were recruited.
Results: It was found that key demographic variables can play a distinct role in explaining SNS addiction and IGD. Furthermore, it was found that SNS addiction and IGD can augment the symptoms of each other, and simultaneously contribute to deterioration of overall psychological health in a similar fashion, further highlighting potentially common etiological and clinical course between these two phenomena. Finally, the detrimental effects of IGD on psychological health were found to be slightly more pronounced than those produced by SNS addiction, a finding that warrants additional scientific scrutiny.
Discussion and conclusion: The implications of these results are further discussed in light of the existing evidence and debates regarding the status of technological addictions as primary and secondary disorders.



Recent Studies on Internet Gaming Disorder

Wang HR, Cho H, Kim DJ. Prevalence and correlates of comorbid depression in a nonclinical online sample with DSM-5 internet gaming disorder. J Affect Disord. 2018 Jan 15;226:1-5. doi: 10.1016/j.jad.2017.08.005.

Abstract

BACKGROUND: We investigated the prevalence and correlates of comorbid depression among patients with internet gaming disorder using the Internet Gaming Disorder scale (IGD-9) and the Patient Health Questionnaire-9 (PHQ-9) among nonclinical online survey respondents.
METHODS: Korean adolescents and adults from 14 to 39 years of age were selected. We compared internet gaming use patterns and sociodemographic and clinical variables between patients with internet gaming disorder who had depression and those without depression.
RESULTS: In 2016, 7200 people participated in an online survey. Respondents with internet gaming disorder that was comorbid with depression were older, more often female, had greater Internet Addiction Test total scores, Alcohol Use Disorder Identification Test total scores, Generalized Anxiety Disorder Scale-7 total scores, Fagerstrom Test for Nicotine Dependence total scores, and higher Dickman Dysfunctional Impulsivity Instrument dysfunctional subscale scores than those without depression. The binary logistic regression analysis revealed that female gender, problematic alcohol use, anxiety, and a past history of psychiatric counseling or treatment due to internet gaming use were significant predictors for comorbid depression among participants with internet gaming disorder.
CONCLUSION: Depression was a common comorbidity of internet gaming disorder. Internet gaming disorder with comorbid depression was related to more serious psychiatric phenomenology and a greater psychiatric burden.


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Stockdale L, Coyne SM. Video game addiction in emerging adulthood: Cross-sectional evidence of pathology in video game addicts as compared to matched healthy controls. J Affect Disord. 2018 Jan 1;225:265-272. doi: 10.1016/j.jad.2017.08.045.

Abstract

BACKGROUND: The Internet Gaming Disorder Scale (IGDS) is a widely used measure of video game addiction, a pathology affecting a small percentage of all people who play video games. Emerging adult males are significantly more likely to be video game addicts. Few researchers have examined how people who qualify as video game addicts based on the IGDS compared to matched controls based on age, gender, race, and marital status.
METHOD: The current study compared IGDS video game addicts to matched non-addicts in terms of their mental, physical, social-emotional health using self-report, survey methods.
RESULTS: Addicts had poorer mental health and cognitive functioning including poorer impulse control and ADHD symptoms compared to controls. Additionally, addicts displayed increased emotional difficulties including increased depression and anxiety, felt more socially isolated, and were more likely to display internet pornography pathological use symptoms. Female video game addicts were at unique risk for negative outcomes.
LIMITATIONS: The sample for this study was undergraduate college students and self-report measures were used.
CONCLUSIONS: Participants who met the IGDS criteria for video game addiction displayed poorer emotional, physical, mental, and social health, adding to the growing evidence that video game addictions are a valid phenomenon.


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Paik SH, Cho H, Chun JW, Jeong JE, Kim DJ. Gaming Device Usage Patterns Predict Internet Gaming Disorder: Comparison across Different Gaming Device Usage Patterns. Int J Environ Res Public Health. 2017 Dec 5;14(12). pii: E1512. doi: 10.3390/ijerph14121512.

Abstract

Gaming behaviors have been significantly influenced by smartphones. This study was designed to explore gaming behaviors and clinical characteristics across different gaming device usage patterns and the role of the patterns on Internet gaming disorder (IGD). Responders of an online survey regarding smartphone and online game usage were classified by different gaming device usage patterns: (1) individuals who played only computer games; (2) individuals who played computer games more than smartphone games; (3) individuals who played computer and smartphone games evenly; (4) individuals who played smartphone games more than computer games; (5) individuals who played only smartphone games. Data on demographics, gaming-related behaviors, and scales for Internet and smartphone addiction, depression, anxiety disorder, and substance use were collected. Combined users, especially those who played computer and smartphone games evenly, had higher prevalence of IGD, depression, anxiety disorder, and substance use disorder. These subjects were more prone to develop IGD than reference group (computer only gamers) (B = 0.457, odds ratio = 1.579). Smartphone only gamers had the lowest prevalence of IGD, spent the least time and money on gaming, and showed lowest scores of Internet and smartphone addiction. Our findings suggest that gaming device usage patterns may be associated with the occurrence, course, and prognosis of IGD.


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Du X, Yang Y, Gao P, Qi X, Du G, et al. Compensatory increase of functional connectivity density in adolescents with internet gaming disorder. Brain Imaging Behav. 2017 Dec;11(6):1901-1909. doi: 10.1007/s11682-016-9655-x.

Abstract

Behavioral studies have demonstrated visual attention bias and working memory deficits in individuals with internet gaming disorder (IGD). Neuroimaging studies demonstrated that individuals with IGD presented abnormalities in brain structures and functions including resting-state functional connectivity (rsFC) disturbance. However, most previous studies investigated IGD-related rsFC alterations by using hypothesis-driven methods with priori selection of a region of interest, which cannot provide a full picture of the rsFC changes in IGD individuals. In this study, we recruited 27 male IGD adolescents and 35 demographically matched healthy controls (HCs) to investigate abnormal connective property of each voxel within whole brain of IGD adolescents using resting-state functional connectivity density (rsFCD) method, and further to evaluate the relationship between altered rsFCD and behavioral performances of visual attention and working memory. The results exhibited no significant intergroup difference in behavioral performance (visual working memory and attention). The IGD adolescents exhibited higher global/long-range rsFCD in the bilateral dorsal lateral prefrontal cortex (DLPFC) and the right inferior temporal cortex (ITC)/fusiform compared with the HCs. Although no significant correlation survived after Bonferroni correction, higher global/long-range rsFCD of the bilateral DLPFC was correlated with the Young's internet addiction test (IAT) score and/or behavioral performance in IGD adolescents using an uncorrected threshold of P < 0.05. In conclusion, IGD adolescents demonstrated increased rsFCD in the brain regions involved in working memory, spatial orientation and attention processing, which indicated that increased rsFCD may reflect a compensatory mechanism for maintaining the normal behavioral performance in IGD adolescents compared with the HCs.


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Zhai J, Luo L, Qiu L, Kang Y, Liu B, et al. The topological organization of white matter network in internet gaming disorder individuals. Brain Imaging Behav. 2017 Dec;11(6):1769-1778. doi: 10.1007/s11682-016-9652-0.

Abstract

White matter (WM) integrity abnormalities had been reported in Internet gaming disorder (IGD). Diffusion tensor imaging (DTI) tractography allows identification of WM tracts, potentially providing information about the integrity and organization of relevant underlying WM fiber tracts' architectures, which has been used to investigate the connectivity of cortical and subcortical structures in several brain disorders. Unfortunately, relatively little is known about the thoroughly circuit-level characterization of topological property changes of WM network with IGD. Sixteen right-hand adolescents with IGD participated in our study, according to the diagnostic criteria of IGD in DSM-5. Meanwhile, 16 age and gender-matched healthy controls were also enrolled. DTI tractography was employed to generate brain WM networks in IGD individuals and healthy controls. The 90 cortical and subcortical regions derived from AAL template were chosen as the nodes. The network parameters (i.e., Network strength, clustering coefficient, shortest path length, global efficiency, local efficiency, regional efficiency) were calculated and then correlated with the Internet addiction test (IAT) scores in IGD. IGD group showed decreased global efficiency, local efficiency and increased shortest path length. Further analysis revealed the reduced nodal efficiency in frontal cortex, anterior cingulate cortex and pallidium in IGD. In addition, the global efficiency of WM network was correlated with the IAT scores in IGD (r = -0.5927; p = 0.0155). We reported the abnormal topological organization of WM network in IGD and the association with the severity of IGD, which may provide new insights into the neural mechanism of IGD from WM network level.

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Zajac K, Ginley MK, Chang R, Petry NM. Treatments for Internet gaming disorder and Internet addiction: A systematic review. Psychol Addict Behav. 2017 Dec;31(8):979-994. doi: 10.1037/adb0000315. Epub 2017 Sep 18.

Abstract

Problems related to excessive use of the Internet and video games have recently captured the interests of both researchers and clinicians. The goals of this review are to summarize the literature on treatment effectiveness for these problems and to determine whether any treatments meet the minimum requirement of an evidence-based treatment as defined by Chambless et al. (1998). Studies of treatments for Internet gaming disorder (IGD) and Internet addiction were examined separately, as past studies have linked IGD to more severe outcomes. The systematic review identified 26 studies meeting predefined criteria; 13 focused on treatments for IGD and 13 on Internet addiction. The results highlighted a paucity of well-designed treatment outcome studies and limited evidence for the effectiveness of any treatment modality. Studies were limited by methodological flaws, including small sample sizes, lack of control groups, and little information on treatment adherence, among other problems. In addition, the field is beset by a lack of consistent definitions of and established instruments to measure IGD and Internet addiction. The results of this review highlight the need for additional work in the area of treatment development and evaluation for IGD and Internet addiction. Attention to methodological concerns identified within this review should improve subsequent research related to treating these conditions, and ultimately outcomes of patients suffering from them.