台灣地區自覺電磁波敏感者：盛行率、風險感知、及精神科狀況的共病

Self-reported electric and magnetic field sensitivity in Taiwan: Prevalence, risk perception and psychiatric co-morbidity

曾美智(Mei-Chih Tseng)

指導教授 ： 鄭尊仁

國立臺灣大學/公共衛生學院/職業醫學與工業衛生研究所/博士(2012年)

https://doi.org/10.6342/NTU.2012.01414

摘要

背景/目的：人類對電磁波敏感的報導已經超過20年，但有關電磁波敏感者的盛行率和特徵卻知道得不多，特別是有關風險感知、精神疾病的罹病和電磁波過敏間的關係。在此研究中，我們的研究目的有三，一、調查台灣地區成年人口中，自稱電磁波敏感者的盛行率和其特徵；二、調查心理不適和電磁波敏感的嚴重度對這些特徵的影響；三、調查台灣地區民眾對電磁波的風險感知，及其和電磁波敏感和心理不適的關係。方法：這是一個針對全國民眾認為環境因子對健康影響的電話調查訪問，執行期間為2007年8月。參與者是成年人，經由電腦化的電話訪問系統，採兩階段地區分層系統性抽樣方法，每戶選出一位成年人接受訪談。總共1251人完成這次電話訪問，回覆率為17.76%，合作率為32.5%。訪談內容包括人口學資料，有無重大傷病、自覺健康狀況、自覺電磁波敏感，對環境因子的風險感知、職業功能障礙和醫療使用情形等。以簡短症狀量表(BSRS-5)大於6分者認為有精神科狀況。結果：台灣地區自覺電磁波敏感者的盛行率為13.3% (n = 170)。年齡65歲以上較少自覺對電磁波敏感，而自覺健康不佳，無工作，和有精神科狀況者有較高機會合併自覺電磁波敏感。自覺電磁波敏感和有精神科狀況者，均有無法工作和日常活動障礙等症狀。多變項分析發現心理不適愈嚴重會和自覺健康狀況不佳、增加醫療使用，無法工作和日常活動障礙有關，但是電磁波敏感的嚴重度祇和無法工作有關。男性比起女性較少關注電磁波對人體的健康危險，然而教育程度愈高、已婚、有重大疾病，對電磁波敏感程度愈高，以及有較高心理不適者，對電磁波和所有環境因子相關的健康風險，有較高的關注。結論：台灣地區自覺電磁波敏感者的盛行率比西方國家要高。除精神科狀況外，自覺電磁波敏感者還會合併自覺健康不佳和職業功能障礙。電磁波敏感者的特徵大多數是與心理不適的嚴重程度有關，而不是和電磁波敏感程度有關。心理不適的嚴重程度愈高對電磁波的風險感知愈高，但是精神科狀況和自覺電磁波敏感的相關不受電磁波的風險感知的影響。電磁波敏感程度愈高，其對電磁波的健康風險的感知愈高，但電磁波敏感程度和對電磁波的風險感知的關係也不受心理不適嚴重度的影響。精神科狀況和對電磁波的風險感知，兩者分別都和自覺電磁波敏感有獨立的相關。電磁波敏感者有其異質性，包含有認知、情緒和行為等面項的症狀。本研究的限制包括回覆率偏低，橫切面的調查無法推論因果關係，和用自填量表未使用精神科面談建立診斷。未來對電磁波敏感者的病因研究，可將重點放在聯繫功能不良性認知、情緒，以及身體症狀的神經生物機轉上。

關鍵字

電磁場 ； 電磁波敏感 ； 盛行率 ； 心理不適 ； 風險感知 ； 電話調查

並列摘要

Background/purpose: Hypersensitivity of human subjects to environmental electric and magnetic fields (EMFs) has been reported for more than 20 years. Little was known regarding the relationships between psychiatric morbidity, risk perception, and electromagnetic hypersensitivity. In this study, we aimed, first, to investigate the prevalence and characteristics of people with self-reported electromagnetic field sensitivity (SREMFS) in a sample of adult population in Taiwan; second, to examine the differential effects of elevated psychopathology and the degree of electrosensitivity on the common characteristics of SREMFS (or Idiopathic Environmental Intolerance with attribution to EMF, IEI-EMF); and third, to examine the risk perception of EMFs in Taiwanese people and its relationships with elevated psychopathology and degree of sensitive to EMFs. Methods: Questions regarding hypersensitivity to EMF were included in a telephone survey for environmental agents on health and well-being. Participants were adults selected from nation-wide households registered in the database of the computer-assisted Telephone Interviewing system via two-stage geographically stratified systematic sampling. A total of 1251 persons successfully completed telephone interviews administered by trained interviewers (response rate = 17.76% and cooperation rate = 32.5%). The interview content consists of questions regarding demographic variables, presence of catastrophic illness, self-reported health condition, self-reported electric and magnetic field sensitivity, risk perception of 13 kinds of environmental agents, impairment of functioning, as well as medical utilization. People with psychiatric morbidity were identified by a screening questionnaire, the Brief Symptom Rating Scale-5 (BSRS-5), with a cutoff score at 6. Results: The estimated prevalence of people with SREMFS was 13.3 % (n = 170). People aged above 65-years-old were associated with a lower risk of reporting sensitivity to EMFs, while people with a very poor self-reported health status, those who were unable to work, and those who had psychiatric morbidity were associated with a higher risk of having SREMFS. Individuals with IEI-EMF shared features with those having psychiatric conditions including inability to work and impairment of daily activities. The severer degree of psychopathology was associated with poorer subjective health, increased medical utilization, and functional incapacities whereas the severer degree of electrosensitivity was associated with non-employment only. More than half of the survey population showed very concerned about the effects of power lines and mobile phone base stations on human health in Taiwanese people. Male gender was negatively associated with perception of health risks concerning EMF and overall environmental agents, whereas higher educational level, being married, having catastrophic illness, higher degree of sensitivity to EMFs, and the elevated psychopathology were positively associated with higher levels of concerns toward EMFs and all environmental agents. Conclusions: The prevalence of SREMFS (or IEI-EMF) in general population of Taiwan was higher than that reported in Western countries. In addition to psychiatric conditions, people with SREMFS (or IEI-EMF) were associated with very poor subjective health conditions and inability to work. The commonly reported features in people with IEI-EMF were mostly associated with degree of psychopathology instead of degree of sensitivity to EMFs. The elevated psychopathology was associated with a higher level of perceived health risks regarding EMFs, but the relationship between psychiatric conditions and IEI-EMF was independent from the effect of risk perception concerning base stations. The higher degree of electrosensitivity was associated with a higher level of perceived health risks regarding EMFs, and their relationship was also independent from the effect of psychopathology. This study suggested that people with IEI-EMF comprised heterogeneous group and had symptoms in independent constructs of cognitions, emotions, and behaviors. This study had several limitations including low response rate, cross-sectional design, and using self-administered questionnaire without interview for psychiatric morbidity. Future research on the etiology of IEI-EMF may focus on the neurobiological mechanisms linking between dysfunctional cognitions, emotion, and somatic symptoms.

並列關鍵字

electromagnetic fields ； electromagnetic sensitivity ； prevalence ； psychopathology ； risk perception ； telephone survey

參考文獻

91. Lee M-B, Lee Y-J, Yen L-L, et al. Reliability and validity of using a Brief Psychiatric Symptom Rating Scale in clinical practice. J Formos Med Assoc 1990;89:1081-1087.

87. Hung YT, Huang YC. Telephone sampling: Random digit dialing in Taiwan. Election Research 2001;7:173-84 (Text in Chinese).

1. Roosli M. Radiofrequency electromagnetic field exposure and non-specific symptoms of ill health: a systematic review. Environ Res 2008;107:277-287.

2. Liden C, Wahlberg JE. Work with video display terminals among office employees. V. Dermatologic factors. Scand J Work Environ Health 1985;11:489-493.

3. Koh D, Goh CL, Jeyaratnam J, et al. Dermatological symptoms among visual display unit operators using plasma display and cathode ray tube screens. Ann Acad Med Singapore 1990;19:617-620.