F . Forster et al .: Radioprotection 2024 , 59 ( 1 ), 55 – 64 61
4 Discussion
The present work aimed to summarise the current evidence regarding the knowledge , risk perception , information needs of GPs as well as the relevance of questions around EMF in their occupational practice . In total , we identified a small number of studies that investigated these topics . The results of these studies indicate that among GPs , on the one hand , there is a considerable concern about possible negative health effects caused by EMF and , on the other hand , information needs are covered insufficiently and knowledge levels are rather low . Moreover , a considerable part of the GPs already has been consulted concerning potential health effects of EMF .
The most striking and consistent findings are the high proportions of GPs who considered it , at least to some extent , as plausible that EMF can have detrimental effects on health in most of the studies , especially in the surveys among Austrian , German and Swiss physicians and the considerable numbers of GPs who regarded their information needs as unmet . On the one hand , the observed risk perception among the GPs is in line with the relatively high concern regarding health effects of EMF in the general population ( as observed , for instance , by surveys in Germany ( Götte und Ludewig , 2019 )). On the other hand , such high levels of concern stand in contrast to the rather limited scientific evidence for an association between EMF exposure and various health outcomes .
When trying to interpret the high levels of concern among GPs , one may argue that the numbers reported by at least some of the studies may be biased by selective ( non- ) participation . This view is supported by the low response rates of less than 50 per cent in all studies . One top of that , in the German survey , the proportion of GPs who stated that , in their view , EMF can have detrimental health effects was markedly higher among those participants who completed the full questionnaire compared to those who answered the short version of the questionnaire ( Berg-Beckhoff et al ., 2009 ). This can be interpreted as an indication that GPs who are more skeptical about EMF had a higher interest in joining the study than their less concerned peers .
Nevertheless , if one assumes that the high levels of concern cannot not only be explained by bias , the question arises which other factors may account for the attitudes of GPs towards EMF . All studies included in our review tried to elucidate the role of at least some explanatory factors . The only variable with relatively consistent evidence was alternative medical training as physicians having received such training indicated higher levels of concern than their peers . Besides , there is barely any scientific knowledge on what determines the views of GPs on EMF and health .
When aiming to close this research gap , we consider it especially interesting and promising to include the perspective of communication studies . In fact , EMF research touches on an interface between health and communication studies . The latter investigates , among other things , media use and related effects and , in this context , which factors influence the use and effects of media on an individual level . These include attitudes towards media ( e . g ., the individual acceptance of media and their technologies ) as well as users ’ ( health-related ) media literacy , in this case , the competent use of media for professional ( information seeking ) and private purposes among physicians .
Specifically , various research questions that are typically investigated by communication scholars could make substantial contributions to a better understanding of GPs ’ attitudes towards EMF and underlying determinants . Physician-patient communication may be worthwhile to be explored in the context of physicians ’ counselling on EMF since there is evidence that a good relationship between physician and patient goes along with improved information brokering ( Riedl and Schüßler , 2017 ). With respect to EMF , GPs ’ media health literacy ( Levin-Zamir et al ., 2011 ) may be a crucial determinant of their risk perception . The concept constitutes an interplay between media literacy ( defined as the ability to reflect on the advantages and disadvantages of media consumption and use opportunities that media offer , e . g ., with regard to individual health behaviour ) and health literacy , which includes numerous factors that determine how people find , understand and deal with information relevant for health ( Parker et al ., 1995 , Baker et al ., 1999 ). While there are first results on how media health literacy is associated with patients ’ individual self-management of chronic diseases ( Rossmann et al ., 2019 ), there is no data yet on physicians ’ media health literacy . Furthermore , future studies may collect information on the technology acceptance of GPs as this may be a determinant of their attitudes towards the use of phones and other devices and as health-related information is increasingly searched online ( Jia et al ., 2021 ).
Another intriguing aspect are conspiracy beliefs . Numerous conspiracy theories are circulating in the media about the link between EMF exposure and adverse health effects , such as an increased risk of cancer [ 28 ]. In the context of the COVID- 19 pandemic , exposure to 5G radiation was particularly addressed in non-science-based theories [ 29 ]. These include assumptions that EMF exposure could weaken the immune system or that 5G was the direct cause of a COVID-19 infection [ 30 ]. Hence , it would be interesting to scrutinise the extent to which GPs are influenced by such conspiracy theories .
The second major finding from our synthesis , that high proportions of GPs do not feel satisfactorily informed about EMF and potential health effects , bears the danger that , at least in some instances , patients may receive counselling that is not solely based on scientific evidence . This concern is highlighted by the low levels of knowledge concerning health risks in association with EMF reported by the German and French studies and the significant proportions of GPs across several studies reporting to use non-scientific sources like mass media when seeking information on EMF . To overcome this danger , appropriate institutions like governmental bodies , radiation protection authorities or occupational associations must find ways to cover GPs ’ information needs better . One approach may be to address potential health effects of EMF more extensively in medical curricula . Of course , in many cases , this would be a complex undertaking as universities and medical faculties would have to adapt their entire curricula . Another approach would be to improve informing GPs who are already practising via advanced training , workshops or information events . For appropriate authorities to plan and implement such