60 F . Forster et al .: Radioprotection 2024 , 59 ( 1 ), 55 – 64
Nevertheless , also among the German GPs most participants stated their wish to receive more information on health consequences as well as general information on EMF ( Berg- Beckhoff et al ., 2009 , 2010 ). Similarly , in the French study , 89 % of the GPs reported they did not have enough information on EMF , whereas in the Dutch study 72 % of the participants said they felt insufficiently informed ( Slottje et al ., 2017 ).
3.3.5 . Determinants
In addition to the above-mentioned descriptive measures , all included studies also aimed to identify potential determinants of the knowledge levels , attitude and risk perception of GPs towards EMF . In this context , the most investigated factors were age , sex , alternative medical training , subjective level of information and location of the practice ( urban vs . rural ).
3.3.5.1 Age
In the German study , participants aged 45 to 54 yr mainly believed that there are people with health problems caused by EMF ( Berg-Beckhoff et al ., 2009 ) while in the Swiss study predominantly younger GPs believed that exposure to EMF occurring under everyday conditions can cause symptoms ( Huss and Röösli , 2006 ). The same trend was seen when being asked whether GPs had ever been consulted regarding EMF . However , in both the Swiss and the Dutch study , age was not associated with GPs ’ assessment at the last consultation whether a link between symptoms and EMF was plausible or not ( Huss and Röösli , 2006 ; Slottje et al ., 2017 ).
3.3.5.2 Sex
In the German study , there were slightly more women than men believing there are people with health problems caused by EMF ( Berg-Beckhoff et al ., 2009 ). The proportion of male GPs was highest in the group , with mostly correct answers to the knowledge questions identified by the latent class analysis ( Berg-Beckhoff et al ., 2014 ). Likewise , the French study also reported that knowledge of EMF sources was higher among male GPs than among their female counterparts ( Lambrozo et al ., 2013 ).
Furthermore , in the Swiss study there were also more women believing that everyday exposure to EMF can cause symptoms . On the other hand , there was no evidence that sex had an influence on the assessment of GPs at the last consultation whether a link between symptoms and EMF was plausible or not ( Huss und Röösli , 2006 ). The latter also applies to the Dutch study ( Slottje et al ., 2017 )
3.3.5.3 Alternative medical training
In the Austrian study , GPs who had alternative medical training precluded a relation between EMF , other environmental factors and health issues less common than GPs who usually used conventional medicine ( Leitgeb et al ., 2005 ). Similarly , German GPs with an alternative medical training believed more often than GPs without an additional alternative education that there are people who get health-related problems because of EMF . Furthermore , GPs with alternative medical training knew less about EMF exposure in the population regarding legal limits and brain-temperature rises due to EMF . Additionally , they reported more frequently about EMF consultations and agreed less often that health issues attributed to EMF are predominantly psychosomatic . Stratification by type of alternative medical training yielded evidence that these associations were strongest in GPs with homeopathic medical training but nonetheless also existed in GPs with acupuncture and naturopathy education ( Berg-Beckhoff et al ., 2009 , Berg-Beckhoff et al ., 2014 , Kowall et al ., 2015 ). In line with those findings , also in the Swiss study GPs with alternative medical training had more consultations regarding EMF . They reported more often that , in their opinion , EMF can cause symptoms in everyday conditions and more frequently evaluated a connection between these two variables as possible ( Huss und Röösli , 2006 ). The results in the Dutch study were similar ( Slottje et al ., 2017 ).
3.3.5.4 Subjective level of information
Altogether , the studies report mixed or even conflicting results concerning the question if physicians ’ subjective level of information is associated with their level of concern about EMF-related health effects . In detail , Swiss GPs with a higher level of subjective information reported a higher count of EMF-related consultations . Moreover , the number of GPs who believed that EMF can cause symptoms under everyday conditions was highest among the group with a medium subjective information level . In contrast , the number of GPs who did not believe in EMF-related health issues was slightly lower in the group with rather good or bad subjective level of information ( Huss und Röösli , 2006 ). In contrast , Dutch GPs who thought they were informed sufficiently evaluated the relation between EMF and symptoms during the latest consultation as rather less plausible ( Slottje et al ., 2017 ). In Germany , a few more GPs with higher subjective information level thought that there are people who develop health problems because of EMF ( Berg-Beckhoff et al ., 2009 ). However , there is another publication from the same data that reported an opposite association ( Kowall et al ., 2010 ).
3.3.5.5 Localisation of the physicians ’ practice
The Austrian study reported no difference between GPs whose practices were located in a rural compared to an urban setting with respect to the question if EMF can cause health problems ( Leitgeb et al ., 2005 ). In the Swiss study , more GPs whose patients predominantly came from rural areas believed that EMF can lead to symptoms under everyday exposure levels . These GPs also reported more often that they had at least one consultation related to EMF ( Huss und Röösli , 2006 ). The German study found no relation between the location of the practice ( rather rural , rather urban or mixed ) and the belief of GPs that there are individuals whose health complaints are caused by EMF exposure ( Berg-Beckhoff et al ., 2009 ).
In addition , there were additional factors that were each investigated by just one study , such as general environmental concern ( Berg-Beckhoff et al ., 2009 ), level of trust in authorities ( Berg-Beckhoff et al ., 2009 ), work experience ( Slottje et al ., 2017 ) or temporal trends ( Huss und Röösli , 2006 ). None of them was reported to play a major role in the attitudes of GPs towards EMF and associated health risks .