karpowicz j an assessment of hazards caused by

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Hindawi Publishing CorporationBioMed Research InternationalVolume , Article ID , pageshttp://dx.doi.org/.//

Research Article An Assessment of Hazards Caused by ElectromagneticInteraction on Humans Present near Short-WavePhysiotherapeutic Devices of Various Types Including Hazards for Users of Electronic Active ImplantableMedical Devices (AIMD)

Jolanta Karpowicz and Krzysztof Gryz Laboratory of Electromagnetic Hazards, Central Institute for Labour Protection-National Research Institute (CIOP-PIB),Ulica Czerniakowska , - Warszawa, Poland

Correspondence should be addressed to Jolanta Karpowicz; [email protected]

Received April ; Revised July ; Accepted August

Academic Editor: Martin G. Mack

Copyright © J. Karpowicz and K. Gryz. Tis is an open access article distributed under the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Leakage of electromagnetic elds (EMF) from short-wave radiofrequency physiotherapeutic diathermies (SWDs) may cause health

and safety hazards affecting unintentionally exposed workers (W) or general public (GP) members (assisting patient exposedduring treatment or presenting there for other reasons). Increasing use of electronic active implantable medical devices (AIMDs),by patients, attendants, and workers, needs attention because dysfunctions of these devices may be caused by electromagneticinteractions. EMF emitted by SWDs (with capacitive or inductive applicators) were assessed following international guidelineson protection against EMF exposure (International Commissionon Nonionizing RadiationProtection forGP and W, new Europeandirective //EU for W, European Recommendation for GP, and European Standard EN - for AIMD users). Direct EMFhazards for humans near inductive applicators were identied at a distance not exceeding cm for W or cm for GP, but forAIMD users up to cm (twice longer than that for W and % longer than that for GP because EMF is pulsed modulated). Nearcapacitive applicators emitting continuous wave, the corresponding distanceswere: cm for W or cm for both—GP or AIMDusers. Tis assessment does not cover patients who undergo SWD treatment (but it is usually recommended for AIMD users to becareful with EMF treatment).

1. Introduction

Electromagnetic elds (EMF) directly affecting living organ-isms cause an electric eld to be induced in the exposedbody. In the case of radiofrequency elds with a frequency exceeding MHz, the dominating direct exposure effect inhuman body is a thermal effect, which may cause an increasein tissuetemperature []. Tis effect may be used intentionally for physiotherapeutic treatment, including pain reductiontherapy []. It is also recognised as the main direct effectof exposure to high-frequency EMF, which creates healthhazards because of possible thermal damage to tissues in the

case of intentional or unintentional overexposure []. It may also be among the components of health hazards associatedwith long-term (many years) unintentional side exposure toradiofrequency (RF) EMF(e.g., at theworkplace or because of the use of wireless communication facilities), summarised by the IARC B classication of possible carcinogenic exposurefor humans and by reports regarding other possible healthdysfunctions increasing among exposed populations [–].

EMF affecting an electrically conductive object, forexam-ple, a metallic one, also directly induces an electric voltage init. When such an object includes electronic components, theEMF interactions may create dysfunctions in the electronic


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BioMed Research International

devices []. When humans are affected by the results of thefunction of the electronic devices, any uncontrolled inter-action may create health or safety hazards. Highly sensitiverelations between humans and electronic devices are estab-lished for example where any electronic active implantablemedical device (AIMD) is supporting a vital function of the

human body, such as in the use of cardiac peacemakers,implantable cardioverter debrillators, cochlear implants,implantable neurostimulators, implantable infusion pumpsor another type of implantable medical devices []. Variouspossible dysfunctions of AIMD reported in the researchpapers presenting observations of the results of exposure toRF EMF of various frequencies include, for example, thedestruction of cochlear implants when an electrosurgical unitis used for surgery on the user (usually related with exposureto RF EMF of .– MHz frequency); the recipient of acochlear implant hearing distorted sound when passing nearor through EAS (electronic article surveillance—emitting RFEMF from various frequency ranges, mostly from kHz upto MHz) and metal detection gates (emitting kHz or evenlower frequency EMF); an overdose of insulin from infusionpumps exposed to EMF from mobile phones or RFID (radiofrequency identication devices, usually emitting RF EMFof .–. GHz); changes in the operating rate of cardiacimplants; and dysfunctions of neurostimulators [–].

Terapeutic devices emitting a RF EMF at a frequency of MHz (recognised as short wave diathermia devices-SWDs) are widely used in physiotherapeutic medical centres,for treatments such as pain reduction. SWD may functionequipped with capacitive applicators or inductive applicator,supplied electrically by a continuous wave (CW) radiofre-quency signal or by a pulsed modulated one(PM). Te outputpower of SWD used to treat patients is regulated in therange from several watts to several hundreds of watts. Temodulation of the signal supplying applicator may be alsoregulated. SWDs with capacitive applicators are usually CWsupplied, but SWDs with inductive applicator are frequently PM supplied, sometimes it is regulated by the operator—CW or PM emission from applicators. During the patients’treatment, as a result of EMF leakage from the applicatorsandsupplying RF cables, not only the patient undergoing SWDtreatment is exposed to EMF (intentionally), but also humansand objects nearby, exposed unintentionally [, , , ].Trough the use of SWD, health care workers (SWD oper-ators) may be exposed to EMF produced by the active devicewhile changing settings of the treatment parameters and

changing the location of the applicator around the patient’sbody. In the course of regular treatment, usually operatorsmay stay away from the active applicator (even in the distanceof a several meters) where exposure level is signicantly reduced in the result of distance from the EMF source.Te distance between active EMF source and all workersemployed in the treatment centre (SWD operators, nurses,administrative personnel, masseurs, etc.) depends on thespatial organisation of the treatment room and other adjacentrooms. Tis distance may be even shorter than meter, when,for example, the administrative work space is situated just atthe opposite side of the light weightnonconductive wallof thetreatment box (e.g., made from the plaster-board modules,

which do not screen EMF). Sometimes also assisting todisabled patients may be needed and any health care workeror patient’s attendant (e.g., their relative) has to stay nearpatient and active SWD over the duration of the treatment.Te space which is accessible for patients waiting for any treatment, patients undergoing other treatments, or workers

doing such treatments, for example massage, may also belocated in the vicinity of active SWD. In the result, variousgroupsof humans, healthcare workers operating SWD(SWDoperators), other workers present in the treatment centre,any patients present near active SWDs or patient’s attendants(usually relatives), may be subjected unintentional exposureto RF EMF from active SWD being in the small distance fromthis devices, over the whole duration of treatment of an orderof – minutes or just passing by and being exposed overof fraction of minute only.

Tere is usually a warning note in SWD manuals thatthe application of RF EMF to patients who use AIMD isnot recommended or has to be consulted with responsiblemedical doctor. However, AIMD users may also be amongother patients who are present near SWD because of anothertreatment or waiting for treatment, as well as attendantswho assist patients and health care workers employed inthe medical centre, who are SWD operators or not. Tesafety data regarding their possible sensitivity to the AIMDdysfunctions caused by EMF exposure near SWD are scarce,but in the literature it is possible to nd already mentionedreports on the AIMD dysfunctions caused by RF EMFexposure of various frequencies (both, lower, and higherthan MHz emitted by SWD, as well as of electric, E-eld,or magnetic, H-eld, dominating component). Such reportsindicate that various AIMD functions may also be affectedby RF EMF emitted by SWD and such potential hazardsshould be covered by assessment of safety near SWD. Directeffects of EMF exposure should be also assessed because of the requirements of labour law or international guidelines.Scarce data regarding EMF from SWD which are availablein the research papers have got many limitations, such asthe assessment focused on direct effects of SWD operatorsEMF exposure only and only from the old models of SWDand nonsystematics methodology of reported measurementswithout attention to differences between CW and PM signalsmeasurements and assessment [, –].

Te New European Directive //EU on the pro-tection of workers against health and safety hazards causedby EMF exposure stresses the need to assess any direct

and indirect hazards from electromagnetic interaction onworkers, with special attention to the users of AIMD [].

(i) Direct effects are recognised as interaction with thehuman body, assessed by EMF at the workplace andinduced in the body, with respect to the thermaleffects of exposure (investigated by E- and H-eldmeasurements near SWD and assessed in accordancewith the exposure limits called action levels).

(ii) Indirect effects are recognised as interaction withobjects, for example, interference with AIMD, includ-ing cardiac pacemakers and other implants or contact


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currents in humans who are in contact with objectsexposed to EMF).

Proper identication of the location of the area wherepossible EMF hazards may exist near SWD of various typesis necessary for the safety of the people present in phys-

iotherapeutic centres. Te nature of indirect EMF hazardscaused near SWD by unintentional RF EMF exposure forAIMD users who are not workers is the same as for workers,and safety of both groups of AIMD users may be assessedfollowing unied rules.

Direct EMF hazards consist of thermal effects of exposureand are assessed following different rules provided for expo-sure to the general public and workers. In both assessments,the procedure of the assessment is based on internationalguidelines provided by the International Commission onNonionizing Radiation Protection []. Tis assessment doesnot regard patients who undergo SWD treatment. Inter-national guidelines and legislation on workers and general

public EMF exposure advise also to limit the level of EMFexposure much more than exposure received by patientsundergoing SWD treatment.

Te aim of the work was to study the parameters of RF EMF near SWD therapeutic devices with respect torequirements for protection against the direct and indirecteffects of exposure. Te need for studies that focused onEMF from these medical devices was identied followinginternational advice. Medical devices intentionally emittingEMF are identied by European Standard EN amongdevices that, if used in the workplace, require an assessmentof occupational EMF hazards []. Short-wave diathermy isindicated as a source of possible high EMF exposure in areview by Hansson Mild et al. []. Te new important aspectof presented study was to distinguish between assessmentbased on limits provided to protect against direct hazards forworkers and general public (with regard to the time-averagedRF EMF exposure) and limits provided to protect againstindirect hazards for AIMD users (with regard to the exposurenot averaged in time). In consequences it was also neededto follow both types of limits in the analysis of measurementresults (by performing detailed analysis of RF EMF exposurepattern in the time domain and analysis of the consequencesof it for the “behaviour” of EMF measurement devices andtheir indications) and to assess RF EMF hazards with respectto the categories of exposed humans: workers (W), generalpublic (GP) members, and AIMD users.

Te scale of the public health attention that should berelated to the investigated problem may be exemplied by thefollowing. Based on public info on the health care services,in Poland (,, population) it was estimated that – thousand SWDs are in use in health care centres, whereat least a half of that number of workers are operating thesedevices. Implanted medical devices are spreading amongthe population, who may be present near SWD because of employment there or due to visiting the health care centrefor any treatment or any other reason. Te number of AIMDusers is growing each year. Te most popular today areimplants used by diabetics and people with cardiac dys-functions. Following the World Health Organization (WHO)

Y

X

F : Te scheme of measurements performed near SWDapplicators.

data, –% of diabetics need insulin, and % of them may

use insulin pumps (in Poland it is a population on the scaleof , patients). In Poland, over , cardiac implantsare implanted every year. Te use of cochlear implants isalso rising steadily; the current estimation is that over ,patients already have cochlear implants in Poland. Te useof AIMD in other European countries is at least on a similarscale in the proportion of the population and rising.

2. Materials and Methods

Following these recommendations, the presented study wasperformed near radiofrequency physiotherapeutic short-wave diathermies (SWDs). Te exposure assessment wascarried out with respect to requirements regarding thehealth and safety of workers (including SWD operators)and members of the general public (e.g., a patient whodoes not undergo radiofrequency treatment or attendantsassisting the disabled patient) against the harmful effectsof EMF exposure, as long as with requirements for theprotection of AIMD against dysfunctions caused by EMFinteractions, that is, to perform an EMFassessment regardingboth direct and indirect electromagnetic hazards caused by physiotherapeutic SWD [, , , ].

Te study performed near SWD concerned the distri-bution of electric and magnetic elds (E-eld expressed in

volts per meter (V/m) and H-eld expressed in amperes per

metre (A/m)) in the vicinity of applicators. Electric eldsinduced in the body and capacitive electric currents causedby EMF interaction in workers operating these devices werenot assessed.

Measurements of the root-mean-square (RMS) values(i.e., time-averaged exposure metrix) of H-eld and E-eldstrength were performed using a Narda EMR meterwith an H-eld probe (.– A/m; .– MHz) and an E-eld probe (– V/m; .–, MHz). Measurements wereperformed with a plastic container lled with . liter of %saline used as a patient’s phantom for SWD. Te reportedmeasurements were performed along orthogonal distancesfrom the cover of the applicators (Figure ).


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In the case of assessing direct EMF hazards, all measure-ment results were analysed in order to obtain E-eld and H-eld values averaged over any six-minute period, that is, timeaveraged RMS value according to the requirements providedby ICNIRP, European EMF Directive //EU, and Coun-cil Recommendation //EC regarding hazards caused

by thermal effects [, , ]. Indirect EMF hazards wereassessed according to the opinion given by European Stan-dard No. EN-: that the electromagnetic immunity of AIMDs depends on the EMFvalues nonaveraged over time[]. It means that, in the case of PM EMF, the rules of anassessment of direct and indirect effects are different. Andalso the metrological properties of used EMF measurementdevices, calibrated in the sinusoidal time-varying EMF, aredifferent in the case of measurement of continues wave (CW)EMF and pulse modulated (PM) EMF.

Te international standard IEC EN --, concern-ing general safety requirements for medical life-supportingdevices, does notcover EMFemitted by the investigatedphys-iotherapeutic equipment (the immunity of medical devicesis tested in radiated EMF with the frequency range –,MHz, at the V/m level of E-eld, which coverscommon environmental exposures to EMF emitted by radioand television broadcasting and wireless communicationsystems facilities) [].

AIMDs intended for the European Union market haveto be compliant with the European Standard EN-,which requires that when EMF does not exceed the referencelevel for the general public given by ICNIRP requirementsand Council Recommendation regarding EMF of – GHzfrequency, then AIMD dysfunctions caused by EMF shouldnot be expected by users [, , ]. Tis meansthat, at MHz,the E-eld exposure of up to V/m level ( V/m RMS valuein the case of the sinusoidal CW eld orpeakin-time RMS inthe case of PM eld) and H-eld exposure of up to . A/mlevel canbe considered as safe forall AIMD users in Europeancountries. In the case of exposure exceeding such limits someAIMD may also function properly, but it needs individualassessment.

Workers’ protection against the thermal effects of EMFexposure is ensured by the European directive //EUand ICNIRP guidelines when the -minute averaged RMS

value of E-eld does not exceed V/m and of H-eld doesnot exceed . A/m at MHz [, ]. General public expo-sure limitations, expressed in a -minute averaged RMS valueprovided by ICNIRP guidelines and EU Recommendation,

are V/m and . A/m [, ].Following these rules, from all the results of RMS value

E-and H-eld measurements, the peak in-timeRMS values of pulsed (PM) or continuous wave (CW) emissions is derived,taking into account parameters of modulation identied by oscilloscopic observations and metrological properties of theused measurement devices. Te correction factor applied forPM EMF in the assessment of AIMD hazards is expressed by the formula

= 1

1/2, ()

where duty factor, , expressed the main parameter of PM—the duration of pulses () emitted by SWD divided by thepulse repetition time (), (Figure ).

For the CW exposures correction factor is “by deni-tion” equal to one and therefore can be omitted.

3. Results and Discussion

Investigations were performed near the following typicalphysiotherapeutic devices:

(i) short-wave diathermia equipped with a capacitiveapplicator (SWD-E), emitting a EMF continuoussinusoidal wave (CW) of MHz frequency and anoutput power of up to W;

(ii) short-wave diathermia equipped with an inductiveapplicator (SWD-H), emitting a pulse modulated(PM) EMF of MHz frequency, with a duty cycle = .–., an output power of up to W

peak, and averaged output power up to W.

Te main parameters of the investigated SWDs are givenin able . Te settings of SWDs are reported followingthe indications at the control panel of devices, but duty cycles were also controlled during measurements by theoscilloscopic observations.

Each applicator is characterised by a different distributionof theemitted EMF, but forthe purposeof identifying the haz-ards that may be caused by interaction with the human body or AIMD,it is important to understand the basic properties of this distribution. Te spatial distribution of EMF emitted by the SWD applicators is nonuniform: with increasing distance,the level of EMF decreases signicantly. Te normalised (tothe E- or H-eld measured at the cm distance from thecover of applicator) distribution of the E-eld and H-eldnear the applicators is characterised in Figures and by the statistical parameters of all measurement results. In thisway, the general characteristic of the EMF distribution ispresented.

Te results of measurements performed near each SWDapplicator were used to estimate the distance from theapplicator where the E-eld and H-eld exceed particularexposure limitations referred in Section (e.g., V/m -minute averaged RMS value (A) or V/m nonaveragedin-time value (M)). In this assessment, the measurementresults were counted including the measurement uncertainty

(∼% in the case of time averaged RMS value analysisdirectly following the measurement results but ∼% in thecase of non-averaged RMS values over the pulses of PM EMF,derived from the RMS measurement results and duty cycleanalysis).

Te level of the E-eld exceeding the ICNIRP’s referencelevel on occupational exposure ( V/m and . A/m @ MHz, min averaged RMS value) was found at a followingdistances: E-eld at a distance up to cm and H-eld up to/ cm (max/median values resp.)—for inductive applica-tors (SWD-H); but E-eld at a distance up to / cm andH-eld up to / cm—for the capacitive applicators (SWD-E), (Figure ).


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T

0.5 ms/div 20 ns/div

T1 = 36.8 ns (f = 27.12 MHz)

F : Oscillogram of pulse modulated EMF emitted by SWD-E (duty cycle = / = 0.30).

PM

20 30 40 50 60 70

Median25%–75%

Min-max

Distance from applicator (cm)

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

E / E ( 1 0 c m )

(a)

CW

Median25%–75%

Min-max

20 40 60 80 100 120 140


0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

E / E ( 1 0 c m )

(b)

F : Te normalised distribution of the E-eld (to the E-eld measured at a distance of cm from the cover of applicator) near theapplicators. Te statistical parameters of all measurement results: (a) SWD-H emitting PM EMF (no. = ); (b) SWD-E emitting CW EMF(no. = ).

Te distance from the EMF source where the specicexposure limit is fullledmay be called the “safety distance”—in the case of assessing the workers’ exposure limits, the

distances mentioned previously may be taken as the “safety distances for workers’ exposure.” When workers are presentat a closer distance from the active applicator or whenthe human body is in contact with the EMF source, thepreviously-mentioned induced electric eld and capacitivecurrents in the body need assessing, which involves numeri-cal calculations or measurements of limb currents [, ].

Te area where people who not undergoing treatmentshould not be present (where the ICNIRP’s reference levelson general public exposure exceeded-E-eld >V/mandH-eld >.A/m at MHz, min averaged RMS value) canreach a distance of up to / cm (with regard to the E-eld)and / cm (with regard to the H-eld) from the inductive

applicators of SWD-H. In the case of capacitive applicatorsof SWD-E, the EMF of levels exceeding the ICNIRP’s generalpublic reference level may be found up to / cm (with

regard to the E-eld) and / cm (with regard to the H-eld) from the applicators.

In the assessment of safety of AIMD users, it is nec-essary to follow modied rules—the limit is based on thenonaveraged in-time RMS value of E- and H-eld strengths( V/m and .A/m at MHz, RMS values nonaveragedin-time). As a result, for the continuous wave EMF emitted by the capacitive applicators of SWD-E-the “safety distance forAIMD users” from the applicators is the same as previously-mentioned distance where EMF are compliant with thegeneral public ICNIRP’s exposure limitations. But in the caseof PM EMF emitted by inductive applicators of SWD-H,the safety distance for AIMD users is signicantly longer


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Median

25%–75%Min-max

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

20 30 40 50 60 70


PM

H / H

( 1 0 c m )

(a)

CW

Median

25%–75%Min-max


20 30 40 50 60 70 800

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

H / H

( 1 0 c m )

(b)

F : Te normalised distribution of the H-eld (to the H-eld measured at a distance of cm from the cover of applicator) near theapplicators. Te statistical parameters of all measurement results: (a) SWD-H emitting PM EMF (no. = ); (b) SWD-E emitting CW EMF(no. = ).

: Te main parameters of investigated short-wave diathermia (SWD).

SWD type

echnical parameters of SWD Settings of technical parameters

during measurements

Te type of applicator

Te averaged output powerregulation range (W)

Duty cycleregulation range,

Averaged outputpower (W)

Duty cycle,

PhyactionPerforma+

Termoplode,Ø cm/H

.– .–. .

Curapuls Circuplode,

Ø cm/H .– .–. .

Termo Termoplode,

Ø cm/H – .–. .

Curapuls Circuplode-E,

30 × 10 cm/H .– .–. .


Ø cm/H .– .–. .


Ø cm/H .– .–. .

erapuls GS Ø cm/H .– .–. .

PhyactionPerforma+

Termoplode,Ø cm/H

.– .–. .

Termatur Circular plates,

Ø cm/E –

Continuous wave(CW)

CW

CosmogammaSW

Circular plates,Ø cm/E

– Continuous wave

(CW) CW

Termopulse Circular plates,

Ø cm/E –

Continuous wave(CW)

CW

Te type of applicators: H: inductive, E: capacitive.


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H M T

=

0 . 0

7 3 A / m

H T A

=

0 . 0

7 3 A / m

H T A

=

0 . 1

6 A / m

E M T

=

2 8 V / m

E T A

=

2 8 V / m

E T A

=

6 1 V / m

H T A = M T

=

0 . 0

7 3 A / m

H T A

=

0 . 1

6 A / m

E T A = M T

=

2 8 V / m

E T A

=

6 1 V / m

E-eld and H-eld of particular limit values

0

20

40

60

80

100

120

140

160

E (CW) H (CW) E (PM) H (PM)

Median25%–75%

Min-max

D i s t a n c e f r o

m a p p l i c a t o r ( c m )

F : Distance from the SWD applicators, where continueswave (CW) or pulsed modulated (PM) E-eld or H-eld does notexceed particular exposure limits regarding general public, workers,or AIMD users; E

TA, H

TA: electric or magnetic eld strength RMS

value time averaged over minute; EMT

, HMT

: electric or magneticeld strength maximum in-time RMS value.

than the one regarding the exposure for the general public,

because the correctionfactor and elevated uncertainty haveto be counted (following the formula ): a distance of upto / cm (with regard to the E-eld) and / cm (withregard to the H-eld) from the inductive applicators of SWD.

With respect to the provisions of the new European EMFdirective //EU regarding the protection of workers’safety and health against direct and indirect hazards nearEMF sources, in the process of health surveillance, whichshould be provided by employers to all workers, the indirecthazards related to EMF emitted by SWD should be managedfor workers using AIMD. Informing about such hazardsis also an important element of worker information onworkplace safety issues. Information on the possible hazards

for the AIMD users is also important for every patient andtheir attendants visiting health care centres, where SWDs arein use.

4. Conclusions

Direct and indirect electromagnetic hazards were found nearSWD devices in the distance from applicators not exceeding cm—similar to previous reports from the literature [,, ]. Direct EMF hazards for humans near inductiveapplicators were identied at a distance not exceeding cm(W) or cm (GP), but for AIMD users up to cm(twice longer than that for W and % longer than that

for GP—because EMF is pulsed modulated). Near capacitiveapplicators emitting continuous wave it is cm (W) or cm (GPor AIMD users). Te exposure of physiotherapistsand other workers present in the therapeutic centre to EMFdepends on the workspace spatial organisation and theirlocation while treating patients.

Te results of the investigations indicate that there is aneed for organisational measures to protect workers againstexcessive exposure to EMF (e.g., the position of the workernot closer than cm from the SWD applicators whiletreating patients; the adjustment of the location of applicatorsby a patient only when EMF is switched off).

Workersand other AIMD users shouldbe aware that theirpresence closer than cm from the SWD is not recom-mended because of a possible implant dysfunction. Warningsigns are also recommended to indicate such hazards withrespect to the privacy of interested AIMD users [, ]. Telocation of SWD in the electromagnetically shielded boxesmay be also recommended to reduce the volume of the spaceaffected by EMF near the active SWD.

In the EU directive //EU it is advised the individualanalysis of EMF hazards for each AIMD user because of many factors inuencing the results of EMF exposure, likethe type and model of AIMD, the settings of its operation,the duration and spatial distribution of exposure of theuser, and so forth. In the case of well-documented statusof AIMD of particular user, it may be achievable for theemployer to get supporting data from the AIMD manufac-turer. In the result of the technology progress, many modernAIMDs from leading manufacturers are less sensitive to EMFinteraction than EN -: indications, but AIMDs of

various designs including old models are stil l in use, whichcause very big variations of the sensitivity level []. Ingeneral case, individual data for EMF hazards assessmentmay not be achievable, especially regarding the personswho are not permanently employed in the physiotherapy centre (including patients and attendants). Because of that,for the employer and for a body in charge of the safety of visitors in the physiotherapy centre, it is important topresent in this paper general data related to the direct andindirect EMF hazards for workers,patients,and otherpersonspresent near active SWD, including AIMD users safety. Itis also important to update the safety data, because SWDsand AIMDs design are changing, and becouse the range of EMF which need supervision near SWD may signicantly changed over decades. Because of that aspect, further exten-

sive investigations of presented aspect of environmental EMFare suggested.

Acknowledgments

Tis paper has been based on the results of a research task .A. carried out within the scope of thesecond stage of thenational programme “Improvement of Safety and WorkingConditions” partly supported in –—within the scopeof state services—by the Ministry of Labour and SocialPolicy. Te Central Institute for Labour Protection-NationalResearch Institute is the programme’s main coordinator.


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