mobile phones and health: an interim report
Sociological implications
Mobile telecommunication technology has been embraced by society at an astounding rate. The current uncertainty over possible adverse health effects has been discussed, but as with all new developments in society, there are also sociological implications, both positive and negative, that need to be addressed.
Negative implications
Electromagnetic compatibility problems
Interference with medical devices
The Medical Devices Agency(43, 44) has investigated a range of mobile communications including mobile phones to determine whether they may cause any electromagnetic interference (EMI). Medical devices suffered EMI in 23% of tests, of which 43% would have had a direct impact on patient care. Some categories of devices had high susceptibility to interference, with the most severely affected being physiological monitors, or devices incorporating them, such as defibrillators or external pace makers, while some makes of infusion pumps were also affected. However, the type of radio handset made a large difference to the likelihood of EMI, with mobile phones (both analogue and digital) at a distance of 1m causing interference to only 4% of devices, with less than 0.1% being serious. It was also concluded that EMI from base stations was unlikely unless the medical devices were particularly sensitive.
In light of these findings a number of recommendations regarding mobile phones were made:(43)
- Mobile phones should always be switched off in operating theatres and treatment areas where sensitive devices may be used; by the patients’ bedsides when the patient is connected to any electromedical device; and in other designated areas where there is a perceived risk.
- Since the handset communicates periodically with the base station to signal its location, mobile phones should not be left in standby mode in the designated areas.
- Users, patients, and visitors should be informed of restrictions on use, restricted areas should be clearly signed, and staff should be aware of the possibility of EMI from mobile phones affecting medical devices.
The Stewart Report(3) stated that health authorities and health boards should issue guidance for the use of mobile phones, and ensure that all hospitals comply with them. This guidance should include the placing of visible warning signs at entrances to buildings to indicate that mobile phones should be switched off.
Pacemakers and hearing aids – mobile phones used close to these devices may possibly cause interference.(5) If there is any concern, technical specifications of both the mobile phone and the device (hearing aid or pacemaker) should be obtained from the product literature, and advice sought from the Medical Devices Agency.
Mobile phones on aircraft
The Civil Aviation Authority (CAA), in response to anecdotal evidence of interference with aircraft instrumentation from mobile phones, conducted their own research(45) which found evidence of false cockpit warnings, aircraft system malfunction, interference in pilots’ headsets, and the crew making mistakes due to distraction by the phones. Therefore, the ban on mobile phones in UK-regulated aircraft that has been implemented since mobile phone technology was introduced, remains. Research is planned by the CAA for later this year (2001) into how the aircraft instruments are affected, and which are the most susceptible.
Environmental issues
Perhaps one of the most common complaints made about the use of mobile phones after health concerns, is the amount of noise pollution they generate; on public transport, in restaurants, theatres, cinemas and other public places. In May 2000 a House of Commons Early Day Motion with 45 signatures was passed deploring the “willingness with which many mobile phone users on trains divulge intimate details of their domestic and business affairs to their fellow passengers”. A train company was congratulated on its introduction of Quiet Zones on its trains for passengers who wish to work and/or travel in peace. The Government was called upon to encourage the rail operators to designate mobile phone free zones on all trains, “following the precedent established by smoking and non-smoking sections”. As mobile phone technology evolves and becomes even more widespread, the BMA recommends that the Government consider issuing guidelines for establishing ‘quiet zones’ in public places.
Base stations have an environmental impact: wherever possible operators locate them on existing buildings, but otherwise, purpose-built structures usually over 15m high are erected that are painted, or if appropriate, disguised as windmills or trees, to limit their impact. Mast sharing is encouraged between operators where that is the optimum solution in the individual circumstances, although this may result in taller structures to accommodate the antennas. With the emergence of 3G phones, the number of masts required for full coverage will increase significantly.
The current planning procedure for masts was criticised in the Stewart Report,(3) particularly since masts below 15 metres are not subject to full planning procedure. The DETR has recently announced changes to this situation that will be implemented at the ‘earliest opportunity’.(35) This includes strengthening public consultation requirements on mast proposals of 15 metres and below so that they are exactly the same as applications for planning permission. The operators have simultaneously launched their own initiative, comprising ten commitments that they expect to achieve by early 2002, to address public concerns in relation to the siting of base stations.
Crime
Recorded Crime Statistics in England and Wales (1999-2000)(46) shows an increase in robberies of 26.1%. The majority of these robberies were of personal property, mainly muggings which have increased by 28%. It has been suggested in the media that this rise might be due to an increase in theft of mobile phones. Metropolitan Police figures indicate an increase in street crimes since 1998 in which only mobile phones were stolen (suggesting they were actively targeted). The suspects and victims of these possibly targeted thefts are younger than other street crime suspects and victims; over 20% of the victims are aged 14 or 15, and the peak suspect age is 16, compared to 20 for other street crimes. As many as 10,000 mobile phones are stolen each month in London.
Positive action that mobile phone owners can take is to note their handsets’ electronic security number (ESN), which can be found by typing in *#06#. A 15 digit code, unique to that handset, will appear on the screen. Should the phone be stolen, the service provider can be given this code to block the handset. Even if the thief changes the SIM card, the phone will remain useless, and hence impossible to use in future. In addition, owners should use their phone’s security lock code if it has one, and put their postcode on the phone and battery to help police identify stolen ones.(47)
Children’s use
In schools, theft of mobile phones and bullying via text messaging is an area of concern. The Department for Education and Employment (DfEE) is working with the Home Office to produce a strategy document for tackling crime for both schools and the police,(48) which will touch on the issue of theft of mobile phones. Schools will be advised that through dialogue with local education authorities, school governors, parents and the police, protocols can be devised for controlling mobile phone use in the school environment, and also for raising awareness among parents. Balance needs to be achieved between the benefits of children being able to contact their parents with the consequences of bullying and theft in the playground, and possible disruption in the classroom. In terms of health effects, the DfEE has recommended that each school should bear in mind the advice from the Stewart Report when considering their policies on the use of mobile phones in the schools.(49)
Positive implications
Benefits to the medical profession
In 1999 the NHS Executive launched its 'Zero Tolerance Zone' nationwide campaign(50) to stop violence against staff working in the NHS. Part of this campaign involved an assessment of risk of violence and aggression faced by staff; those judged to be at such risk may be issued communication devices to help reduce it, such as mobile phones. Such a method to minimise any risk to their safety can only be a benefit.
The possible future inclusion of email and video cameras on third generation mobile phone systems may assist in diagnosis or rapid treatment of patients who, for example, are in transit to a hospital, or who have been injured in a remote location. If clinical information from a patient in an ambulance can be transferred to a doctor at a hospital, valuable time in assessment of the condition may be saved.
Use of mobile phones to make calls to emergency services
Research in Australia has shown that there appears to be widespread use of mobile phones in rapidly reporting emergencies.(51) If this results in ambulances arriving more quickly at the scene of a car accident for example, this must be viewed as a positive application of the technology. With the advent of the new generation of mobile phones with location technology, the benefits of a handset in an emergency will increase.
Personal safety
Data from 2000 showed that nearly two thirds of all UK mobile phone users considered their mobile phones to be a necessity, rising to 71% for the over 65s(52) indicating that they may provide an added sense of security to vulnerable sectors of the population. In terms of child safety, parents and guardians are often reassured that they can be contacted by their children if they are in a difficult situation.