62 F . Forster et al .: Radioprotection 2024 , 59 ( 1 ), 55 – 64
measures , future studies that shed further light on physicians ’ knowledge levels and attitudes by closing research gaps and overcoming limitations of the existing studies would be helpful .
Regarding those limitations , apart from the lack of a communication studies perspective , it is striking that , except for the Dutch survey , all studies were conducted more than 10 yr ago . During this period , there have been significant changes in the media usage patterns of the general population . The use of mobile internet and services such as WhatsApp instead of SMS for communication purposes ( Langer et al ., 2017 ) ( Südwest , 2021 ) has drastically increased and technical standards have evolved by new developments like 5G . Additionally , the results of today ’ s most popular and relevant studies on health effects of EMF were published after the surveys included in this review had been conducted ( Interphone Study Group , 2010 , Interphone Study Group , 2011 , Auvinen et al ., 2019 , Tettamanti et al ., 2020 , Castaño- Vinyals et al ., 2021 ). In the meantime , a different state of scientific evidence concerning EMF and health exists . To what extent GPs are familiar with these studies and the latest state of scientific evidence ( including current risk assessment provided by authorities like ICNIRP ) has not yet been elucidated .
In addition , all studies were conducted exclusively among GPs in the field of adult medicine , while there are no scientific findings on the attitudes of paediatricians with regard to EMF and health . Children and adolescents could , however , play a special role in the question of potentially harmful effects of EMF exposure as they are possibly particularly vulnerable to such effects ( Kheifets et al ., 2005 ). For example , children and adolescents do not only show clearly different patterns in the use of mobile communication technologies than their parents ’ generation ( Eeftens et al ., 2018 ) but also accumulate a higher lifetime exposure than many of today ’ s adults due to the increasingly early onset of smartphone and tablet use ( Eeftens et al ., 2023 ). Due to this possible special vulnerability of children and adolescents , as well as the fact that some of the outcomes discussed in connection with EMF ( e . g ., behavioural problems or ADHD ) relate specifically to childhood , it appears conceivable that the attitudes of paediatricians may differ from their colleagues in the field of adult medicine .
What is also lacking is a qualitative research approach since all studies solely used quantitative methods . Qualitative interviews such as focus groups are particularly suitable for investigating attitudes , opinions and behaviours because it is often challenging to articulate habituated actions as well as complex and unconscious perceptions or to scale agreement or disagreement ( Meyen et al ., 2011 , Flick , 2018 ). Lastly , since all studies so far were conducted in Central / Western European countries , it may be hard to extrapolate their findings to other regions of the world .
Limitations of this review itself include the sole use of one electronic database . While we are confident that PubMed is by far the most relevant source for searching for any kind of research on EMF and health , we may have missed relevant publications , especially reports published in languages other than English and German . In fact , we identified one study whose abstract was available in English but the full text was provided only in French . Even though we are confident that we were able to extract the relevant data from this manuscript correctly , we cannot preclude that there are some misinterpretations due to the lack of a native speaker among the authors . Lastly , the fact that we retrieved only a small number of eligible studies leads our conclusions to be drawn on a relatively weak basis of evidence .
Nevertheless , a variety of implications can be derived from this review . First , there is a practical need to improve the fulfilment of GPs ’ information needs . Furthermore , further research is necessary for a mere update of the scientific knowledge about general practitioners ’ risk perception , subjective and objective information level and information needs regarding potential health effects of EMF . On top of that , the scientific state of evidence concerning physicians ’ EMF risk perception should not only be refreshed but also deepened through the inclusion of novel aspects like media health literacy or conspiracy beliefs and methods not used by previous research such as qualitative methods .
5 Conclusion
In summary , the results from our review point towards considerable levels of concern regarding potential health effects of EMF among general practitioners . At the same time , their information needs concerning EMF and health seem to be insufficiently fulfilled . Thus far , it remains unclear what factors determine their concern . Likewise , there is little data on the actual level of knowledge on EMF and health among GPs . To gain better understanding , future studies may take new perspectives like concepts and theories from communication science and use additional methods such as qualitative techniques . Such research may help responsible bodies and authorities to find better ways to transfer and communicate scientific evidence about EMF and health towards general practitioners . This is particularly important in order to ensure that patients receive counselling on EMF and health that is rigorously based on the current state of scientific evidence .
Conflict of interest The authors declare that they have no conflict of interest .
Funding
The research project ( project number : 3621EMF110 ) on which this report is based was carried out on behalf of the Federal Ministry for the Environment , Nature Conservation , Nuclear Safety and Consumer Protection and was technically supervised by the Federal Office for Radiation Protection . The responsibility for the content of this publication lies with the authors .
Ethical approval
The present work forms part of the study ‘ Risiken elektromagnetischer Felder aus Sicht von Allgemeinmediziner * innen und Kinderärzt * innen in Deutschland II ‘ which was approved by the Ethical Committee at the Medical Faculty of LMU Munich , Munich , Germany ( project number 22-0655 ).