ICNIRP GUIDELINES FOR LIMITING EXPOSURE TO ELECTROMAGNETIC FIELDS (100 KHZ TO 300 GHZ) PUBLISHED AHEAD OF PRINT IN: HEALTH PHYSICS

 
INTERNATIONAL COMMISSION ON NON‐IONIZING RADIATION PROTECTION

    ICNIRP GUIDELINES
    FOR LIMITING EXPOSURE TO
    ELECTROMAGNETIC FIELDS (100 KHZ TO 300 GHZ)

    PUBLISHED AHEAD OF PRINT IN: HEALTH PHYSICS

ICNIRP PUBLICATION – 2020
Special Submission

                                                                                                                                                                                                  GUIDELINES FOR LIMITING EXPOSURE TO ELECTROMAGNETIC
                                                                                                                                                                                                                  FIELDS (100 kHz to 300 GHz)

                                                                                                                                                                                                              International Commission on Non-Ionizing Radiation Protection (ICNIRP)1,2
Downloaded from https://journals.lww.com/health-physics by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3JhfpBaN+Hkz8a2fdl7wswh3aHLMZI+0uysu2qch7DtA= on 03/11/2020

                                                                                                                                                                                                                                                                       (EMFs) in the range 100 kHz to 300 GHz (hereafter “radiofre-
                                                                                                                                                                                        Abstract—Radiofrequency electromagnetic fields (EMFs) are used
                                                                                                                                                                                        to enable a number of modern devices, including mobile telecom-                quency”). This publication replaces the 100 kHz to 300 GHz
                                                                                                                                                                                        munications infrastructure and phones, Wi-Fi, and Bluetooth. As                part of the ICNIRP (1998) radiofrequency guidelines, as well
                                                                                                                                                                                        radiofrequency EMFs at sufficiently high power levels can ad-                  as the 100 kHz to 10 MHz part of the ICNIRP (2010) low-
                                                                                                                                                                                        versely affect health, ICNIRP published Guidelines in 1998 for hu-             frequency guidelines. Although these guidelines are based on
                                                                                                                                                                                        man exposure to time-varying EMFs up to 300 GHz, which
                                                                                                                                                                                        included the radiofrequency EMF spectrum. Since that time, there               the best science currently available, it is recognized that there
                                                                                                                                                                                        has been a considerable body of science further addressing the re-             may be limitations to this knowledge that could have implica-
                                                                                                                                                                                        lation between radiofrequency EMFs and adverse health outcomes,                tions for the exposure restrictions. Accordingly, the guidelines
                                                                                                                                                                                        as well as significant developments in the technologies that use ra-           will be periodically revised and updated as advances are made
                                                                                                                                                                                        diofrequency EMFs. Accordingly, ICNIRP has updated the radio-
                                                                                                                                                                                        frequency EMF part of the 1998 Guidelines. This document                       in the relevant scientific knowledge. The present document de-
                                                                                                                                                                                        presents these revised Guidelines, which provide protection for                scribes the guidelines and their rationale, with Appendix A
                                                                                                                                                                                        humans from exposure to EMFs from 100 kHz to 300 GHz.                          providing further detail concerning the relevant dosimetry
                                                                                                                                                                                        Health Phys. 00(00):00–00; 2020                                                and Appendix B providing further detail regarding the bio-
                                                                                                                                                                                                                                                                       logical and health effects reported in the literature.
                                                                                                                                                                                                                 INTRODUCTION
                                                                                                                                                                                        THE GUIDELINES described here are for the protection of
                                                                                                                                                                                        humans exposed to radiofrequency electromagnetic fields

                                                                                                                                                                                              1
                                                                                                                                                                                               ICNIRP, c/o BfS, Ingolstaedter Landstr. 1, 85764, Oberschleissheim,
                                                                                                                                                                                        Germany; 2Collaborators: Rodney Croft, ICNIRP and Australian Centre for              ICNIRP declares no conflict of interest. ICNIRP received annual
                                                                                                                                                                                        Electromagnetic bioeffects Research, Illawarra Health & Medical Research       support to carry out this work from the German Federal Ministry for the
                                                                                                                                                                                        Institute, University of Wollongong, Australia; Maria Feychting, ICNIRP        Environment (BMU), the European Union Programme for Employment
                                                                                                                                                                                        and Karolinska Institutet, Sweden; Adèle C Green, ICNIRP and QIMR              and Social Innovation "EaSI" (2014–2020), the International Radiation
                                                                                                                                                                                        Berghofer Medical Research Institute, Brisbane, Australia and CRUK             Protection Association (IRPA), the Australian Radiation Protection and
                                                                                                                                                                                        Manchester Institute, University of Manchester, Manchester, UK; Akimasa        Nuclear Safety Agency (ARPANSA), and the New Zealand Ministry
                                                                                                                                                                                        Hirata, ICNIRP and Nagoya Institute of Technology, Japan; Guglielmo            of Health. In regard to the EU funds, for further information please
                                                                                                                                                                                        d'Inzeo, ICNIRP and La Sapienza University, Rome, Italy; Kari Jokela†,         consult: http://ec.europa.eu/social/easi. The information contained in this
                                                                                                                                                                                        ICNIRP SEG and STUK – Radiation and Nuclear Safety Authority, Finland;         publication does not necessarily reflect the official position of the European
                                                                                                                                                                                        Sarah Loughran, ICNIRP SEG and Australian Centre for Electromag-               Commission or any other donors. ICNIRP receives funds from public
                                                                                                                                                                                        netic Bioeffects Research, Illawarra Health & Medical Research Institute,      and non-commercial bodies only. All information concerning the support
                                                                                                                                                                                        University of Wollongong, Australia; Carmela Marino, ICNIRP and Agency         received by ICNIRP throughout the years is available at http://www.icnirp.
                                                                                                                                                                                        for New Technologies, Energy and Sustainable Economic Development              org/en/about-icnirp/support-icnirp/index.html.
                                                                                                                                                                                        (ENEA), Italy; Sharon Miller, ICNIRP; Gunnhild Oftedal, ICNIRP and                   For correspondence contact: Gunde Ziegelberger, c/o Bfs,
                                                                                                                                                                                        Norwegian University of Science and Technology (NTNU); Tsutomu                 Ingolstaedter Landstr. 1, 85764 Oberschleissheim, Germany, or
                                                                                                                                                                                        Okuno, ICNIRP; Eric van Rongen, ICNIRP and Health Council, The                 email at info@icnirp.org.
                                                                                                                                                                                        Netherlands; Martin Röösli, ICNIRP and Swiss Tropical and Public Health              (Manuscript accepted 3 September 2019)
                                                                                                                                                                                        Institute, Switzerland; Zenon Sienkiewicz, ICNIRP; John Tattersall, ICNIRP           0017-9078/20/0
                                                                                                                                                                                        SEG; Soichi Watanabe, ICNIRP and National Institute of Information and               Copyright © 2020 The Author(s). Published by Wolters Kluwer
                                                                                                                                                                                        Communications Technology (NICT), Japan.                                       Health, Inc. on behalf of the Health Physics Society. This is an open-access
                                                                                                                                                                                              The views expressed by the collaborators in this publication do not      article distributed under the terms of the Creative Commons Attribution-
                                                                                                                                                                                        necessarily reflect the views or policies of the organizations they are pro-   Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it
                                                                                                                                                                                        fessionally affiliated with. The mention of commercial products, their         is permissible to download and share the work provided it is properly cited.
                                                                                                                                                                                        sources, or their use in connection with material reported herein is not to    The work cannot be changed in any way or used commercially without
                                                                                                                                                                                        be construed as either an actual or implied endorsement of such products       permission from the journal.
                                                                                                                                                                                        by ICNIRP or any of the organizations with which the ICNIRP members
                                                                                                                                                                                        are affiliated.                                                                DOI: 10.1097/HP.0000000000001210
                                                                                                                                                                                        www.health-physics.com                                                                                                                                     1
2                                                            Health Physics     Month 2020, Volume 00, Number 00

                    PURPOSE AND SCOPE                                            radiofrequency EMF exposure. To determine these levels,
                                                                                 ICNIRP first identified published scientific literature con-
       The main objective of this publication is to establish
                                                                                 cerning effects of radiofrequency EMF exposure on biolog-
guidelines for limiting exposure to EMFs that will provide
                                                                                 ical systems, and established which of these were both
a high level of protection for all people against substantiated
                                                                                 harmful to human health3 and scientifically substantiated.
adverse health effects from exposures to both short- and
                                                                                 This latter point is important because ICNIRP considers
long-term, continuous and discontinuous radiofrequency
                                                                                 that, in general, reported adverse effects of radiofrequency
EMFs. However, some exposure scenarios are defined as
                                                                                 EMFs on health need to be independently verified, be of
outside the scope of these guidelines. Medical procedures
                                                                                 sufficient scientific quality and consistent with current sci-
may utilize EMFs, and metallic implants may alter or per-
                                                                                 entific understanding, in order to be taken as “evidence”
turb EMFs in the body, which in turn can affect the body
                                                                                 and used for setting exposure restrictions. Within the guide-
both directly (via direct interaction between field and tissue)
                                                                                 lines, “evidence” will be used within this context, and “sub-
and indirectly (via an intermediate conducting object). For
                                                                                 stantiated effect” used to describe reported effects that
example, radiofrequency ablation and hyperthermia are
                                                                                 satisfy this definition of evidence. The reliance on such ev-
both used as medical treatments, and radiofrequency EMFs
                                                                                 idence in determining adverse health effects is to ensure that
can indirectly cause harm by unintentionally interfering
                                                                                 the exposure restrictions are based on genuine effects, rather
with active implantable medical devices (see ISO 2012) or
                                                                                 than unsupported claims. However, these requirements may
altering EMFs due to the presence of conductive implants.
                                                                                 be relaxed if there is sufficient additional knowledge (such
As medical procedures rely on medical expertise to weigh po-
                                                                                 as understanding of the relevant biological interaction
tential harm against intended benefits, ICNIRP considers
                                                                                 mechanism) to confirm that adverse health effects are rea-
such exposure managed by qualified medical practitioners
                                                                                 sonably expected to occur.
(i.e., to patients, carers and comforters, including, where rele-
                                                                                       For each substantiated effect, ICNIRP then identified
vant, fetuses), as well as the utilization of conducting materials
                                                                                 the “adverse health effect threshold;” the lowest exposure
for medical procedures, as beyond the scope of these guide-
                                                                                 level known to cause the health effect. These thresholds
lines (for further information, see UNEP/WHO/IRPA 1993).
                                                                                 were derived to be strongly conservative for typical expo-
Similarly, volunteer research participants are deemed to be
                                                                                 sure situations and populations. Where no such threshold
outside the scope of these guidelines, providing that an insti-
                                                                                 could be explicitly obtained from the radiofrequency health
tutional ethics committee approves such participation follow-
                                                                                 literature, or where evidence that is independent from the ra-
ing consideration of potential harms and benefits. However,
                                                                                 diofrequency health literature has (indirectly) shown that
occupationally exposed individuals in both the clinical and re-
                                                                                 harm could occur at levels lower than the “EMF-derived
search scenarios are defined as within the scope of these
                                                                                 threshold,” ICNIRP set an “operational threshold.” These
guidelines. Cosmetic procedures may also utilize radiofre-
                                                                                 are based on additional knowledge of the relation between
quency EMFs. ICNIRP considers people exposed to radiofre-
                                                                                 the primary effect of exposure (e.g., heating) and health effect
quency EMFs as a result of cosmetic treatments without
                                                                                 (e.g., pain), to provide an operational level with which to de-
control by a qualified medical practitioner to be subject to
                                                                                 rive restriction values in order to attain an appropriate level
these guidelines; any decisions concerning potential exemp-
                                                                                 of protection. Consistent with previous guidelines from
tions are the role of national regulatory bodies. Radiofre-
                                                                                 ICNIRP, reduction factors were then applied to the resultant
quency EMFs may also interfere with electrical equipment
                                                                                 thresholds (or operational thresholds) to provide exposure re-
more generally (i.e., not only implantable medical equip-
                                                                                 striction values. Reduction factors account for biological vari-
ment), which can affect health indirectly by causing equip-
                                                                                 ability in the population (e.g., age, sex), variation in baseline
ment to malfunction. This is referred to as electromagnetic
                                                                                 conditions (e.g., tissue temperature), variation in environmen-
compatibility, and is outside the scope of these guidelines
                                                                                 tal factors (e.g., air temperature, humidity, clothing), dosi-
(for further information, see IEC 2014).
                                                                                 metric uncertainty associated with deriving exposure values,
                                                                                 uncertainty associated with the health science, and as a con-
              PRINCIPLES FOR LIMITING                                            servative measure more generally.
             RADIOFREQUENCY EXPOSURE                                                   These exposure restriction values are referred to as “ba-
                                                                                 sic restrictions.” They relate to physical quantities that are
     These guidelines specify quantitative EMF levels for                        closely related to radiofrequency-induced adverse health ef-
personal exposure. Adherence to these levels is intended                         fects. Some of these are physical quantities inside an exposed
to protect people from all substantiated harmful effects of                      body, which cannot be easily measured, so quantities that are
3
                                                                                 more easily evaluated, termed “reference levels,” have been
 Note that the World Health Organization (1948) definition of “health” is
used here. Specifically, “health is a state of complete physical, mental and     derived from the basic restrictions to provide a more-practical
social well-being and not merely the absence of disease or infirmity.”           means of demonstrating compliance with the guidelines.
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ICNIRP GUIDELINES                                                           3

Reference levels have been derived to provide an equivalent                     SCIENTIFIC BASIS FOR LIMITING
degree of protection to the basic restrictions, and thus an ex-                  RADIOFREQUENCY EXPOSURE
posure is taken to be compliant with the guidelines if it is
                                                                     100 kHz to 10 MHz EMF Frequency Range: Relation
shown to be below either the relevant basic restrictions or          Between the Present and Other ICNIRP Guidelines
relevant reference levels. Note that the relative concordance             Although the present guidelines replace the 100 kHz to
between exposures resulting from basic restrictions and ref-         10 MHz EMF frequency range of the ICNIRP (2010) guide-
erence levels may vary depending on a range of factors. As           lines, the science pertaining to direct radiofrequency EMF ef-
a conservative step, reference levels have been derived such         fects on nerve stimulation and associated restrictions within
that under worst-case exposure conditions (which are highly          the ICNIRP (2010) guidelines has not been reconsidered here.
unlikely to occur in practice) they will result in similar           Instead, the present process evaluated and set restrictions for
exposures to those specified by the basic restrictions. It           adverse health effects other than direct effects on nerve
follows that in the vast majority of cases, observing the            stimulation from 100 kHz to 10 MHz, and for all adverse
reference levels will result in substantially lower exposures        health effects from 10 MHz to 300 GHz. The restrictions re-
than the corresponding basic restrictions allow. See “Refer-         lating to direct effects of nerve stimulation from the 2010
ence Levels” section for further details.                            guidelines were then added to those derived in the present
     The guidelines differentiate between occupationally-            guidelines to form the final set of restrictions. Health and
exposed individuals and members of the general public.               dosimetry considerations related to direct effects on nerve
Occupationally-exposed individuals are defined as adults             stimulation are therefore not provided here [see ICNIRP
who are exposed under controlled conditions associated               (2010) for further information].
with their occupational duties, trained to be aware of po-
tential radiofrequency EMF risks and to employ appropri-             Quantities, Units and Interaction Mechanisms
ate harm-mitigation measures, and who have the sensory                     A brief overview of the electromagnetic quantities and
and behavioral capacity for such awareness and harm-                 units employed in this document, as well as the mechanisms
mitigation response. An occupationally-exposed worker                of interaction of these with the body, is provided here. A more
must also be subject to an appropriate health and safety             detailed description of the dosimetry relevant to the guidelines
program that provides the above information and protec-              is provided in Appendix A, “Quantities and Units” section.
tion. The general public is defined as individuals of all ages             Radiofrequency EMFs consist of oscillating electric and
and of differing health statuses, which includes more vulner-        magnetic fields; the number of oscillations per second is re-
able groups or individuals, and who may have no knowledge            ferred to as “frequency,” and is described in units of hertz
of or control over their exposure to EMFs. These differences         (Hz). As the field propagates away from a source, it transfers
suggest the need to include more stringent restrictions for the      power from its source, described in units of watt (W), which
general public, as members of the general public would not           is equivalent to joule (J, a measure of energy) per unit of time
be suitably trained to mitigate harm, or may not have                (t). When the field impacts upon material, it interacts with the
the capacity to do so. Occupationally-exposed individuals            atoms and molecules in that material. When a biological
are not deemed to be at greater risk than the general pub-           body is exposed to radiofrequency EMFs, some of the power
lic, providing that appropriate screening and training is            is reflected away from the body, and some is absorbed by it.
provided to account for all known risks. Note that a fetus           This results in complex patterns of electromagnetic fields in-
is here defined as a member of the general public, regard-           side the body that are heavily dependent on the EMF charac-
less of exposure scenario, and is subject to the general             teristics as well as the physical properties and dimensions of
public restrictions.                                                 the body. The main component of the radiofrequency EMF
     As can be seen above, there are a number of steps in-           that affects the body is the electric field. Electric fields inside
volved in deriving ICNIRP’s guidelines. ICNIRP adopts a              the body are referred to as induced electric fields (Eind, mea-
conservative approach to each of these steps in order to en-         sured in volt per meter; V m−1), and they can affect the body
sure that its limits would remain protective even if exceeded        in different ways that are potentially relevant to health.
by a substantial margin. For example, the choice of adverse                Firstly, the induced electric field in the body exerts a
health effects, presumed exposure scenarios, application of          force on both polar molecules (mainly water molecules)
reduction factors and derivation of reference levels are all         and free moving charged particles such as electrons and
conducted conservatively. The degree of protection in the            ions. In both cases a portion of the EMF energy is converted
exposure levels is thus greater than may be suggested by             to kinetic energy, forcing the polar molecules to rotate and
considering only the reduction factors, which represent only         charged particles to move as a current. As the polar mole-
one conservative element of the guidelines. There is no ev-          cules rotate and charged particles move, they typically inter-
idence that additional precautionary measures will result in         act with other polar molecules and charged particles,
a benefit to the health of the population.                           causing the kinetic energy to be converted to heat. This heat
                                                       www.health-physics.com
4                                                                  Health Physics            Month 2020, Volume 00, Number 00

can adversely affect health in a range of ways. Secondly, if                                  SA, Uab, and Eind are the quantities used in these guidelines
the induced electric field is below about 10 MHz and strong                                   to specify the basic restrictions.
enough, it can exert electrical forces that are sufficient to                                       As the quantities used to specify basic restrictions can
stimulate nerves, and if the induced electric field is strong                                 be difficult to measure, quantities that are more easily eval-
and brief enough (as can be the case for pulsed low frequency                                 uated are also specified, as reference levels. The reference
EMFs), it can exert electrical forces that are sufficient to                                  level quantities relevant to these guidelines are incident elec-
cause dielectric breakdown of biological membranes, as oc-                                    tric field strength (Einc) and incident magnetic field strength
curs during direct current (DC) electroporation (Mir 2008).                                   (Hinc), incident power density (Sinc), plane-wave equivalent
     From a health risk perspective, we are generally inter-                                  incident power density (Seq), incident energy density (Uinc),
ested in how much EMF power is absorbed by biological                                         and plane-wave equivalent incident energy density (Ueq), all
tissues, as this is largely responsible for the heating effects                               measured outside the body, and electric current inside the
described above. This is typically described as a function                                    body, I, described in units of ampere (A). Basic restriction
of a relevant dosimetric quantity. For example, below about                                   and reference level units are shown in Table 1, and definitions
6 GHz, where EMFs penetrate deep into tissue (and thus re-                                    of all relevant terms provided in Appendix A, in the “Quanti-
quire depth to be considered), it is useful to describe this in                               ties and Units” section.
terms of “specific energy absorption rate” (SAR), which is
the power absorbed per unit mass (W kg−1). Conversely,                                        Radiofrequency EMF Health Research
above 6 GHz, where EMFs are absorbed more superficially                                             In order to set safe exposure levels, ICNIRP first de-
(making depth less relevant), it is useful to describe expo-                                  cided whether there was evidence that radiofrequency
sure in terms of the density of absorbed power over area                                      EMFs impair health, and for each adverse effect that was
(W m−2), which we refer to as “absorbed power density”                                        substantiated, both the mechanism of interaction and the
(Sab). In these guidelines, SAR is specified over different                                   minimum exposure required to cause harm were determined
masses to better match particular adverse health effects;                                     (where available). This information was obtained primarily
SAR10g represents the power absorbed (per kg) over a 10-g                                     from major international reviews of the literature on radiofre-
cubical mass, and whole-body average SAR represents                                           quency EMFs and health. This included an in-depth review
power absorbed (per kg) over the entire body. Similarly, ab-                                  from the World Health Organization on radiofrequency
sorbed power density is specified over different areas as a                                   EMF exposure and health that was released as a draft Techni-
function of EMF frequency. In some situations, the rate of en-                                cal Document (WHO 2014), and reports by the Scientific
ergy deposition (power) is less relevant than the total energy                                Committee on Emerging and Newly Identified Health Risks
deposition. This may be the case for brief exposures where                                    (SCENIHR 2015) and the Swedish Radiation Safety Author-
there is not sufficient time for heat diffusion to occur. In                                  ity (SSM 2015, 2016, 2018). These reports have reviewed an
such situations, specific energy absorption (SA, in J kg−1)                                   extensive body of literature, ranging from experimental re-
and absorbed energy density (Uab, in J m−2) are used, for                                     search to epidemiology, and include consideration of health
EMFs below and above 6 GHz, respectively. SAR, Sab,                                           in children and those individuals thought to be sensitive to

         Table 1. Quantities and corresponding SI units used in these guidelines.
             Quantity                                                                         Symbola                                 Unit

             Absorbed energy density                                                            Uab                                   joule per square meter (J m−2)
             Incident energy density                                                            Uinc                                  joule per square meter (J m−2)
             Plane-wave equivalent incident energy density                                      Ueq                                   joule per square meter (J m−2)
             Absorbed power density                                                              Sab                                  watt per square meter (W m−2)
             Incident power density                                                             Sinc                                  watt per square meter (W m−2)
             Plane-wave equivalent incident power density                                        Seq                                  watt per square meter (W m−2)
             Induced electric field strength                                                    Eind                                      volt per meter (V m−1)
             Incident electric field strength                                                   Einc                                      volt per meter (V m−1)
             Incident electric field strength                                                   Eind                                      volt per meter (V m−1)
             Incident magnetic field strength                                                   Hinc                                    ampere per meter (A m−1)
             Specific energy absorption                                                          SA                                     joule per kilogram (J kg−1)
             Specific energy absorption rate                                                    SAR                                     watt per kilogram (W kg−1)
             Electric current                                                                     I                                             ampere (A)
             Frequency                                                                            f                                              hertz (Hz)
             Time                                                                                 t                                              second (s)
         a
         Italicized symbols represent variables; quantities are described in scalar form because direction is not used to derive the basic restrictions or reference levels.

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ICNIRP GUIDELINES                                                            5

radiofrequency EMFs. To complement those reports, ICNIRP               and it is typically reported as a “tingling” sensation for frequen-
also considered research published since those reviews. A              cies around 100 kHz. As frequency increases, heating effects
brief summary of this literature is provided in Appendix B,            predominate and the likelihood of nerve stimulation decreases;
with the main conclusions provided below.                              at 10 MHz the effect of the electric field is typically described
      As described in Appendix B, in addition to nerve stim-           as “warmth.” Nerve stimulation by induced electric fields is de-
ulation (described in ICNIRP 2010), radiofrequency EMFs                tailed in the ICNIRP low frequency guidelines (2010).
can affect the body via two primary biological effects:
                                                                             Changes to permeability of cell membranes. When
changes in the permeability of membranes and temperature
                                                                       (low frequency) EMFs are pulsed, the power is distributed
rise. Knowledge concerning relations between thermal ef-
                                                                       across a range of frequencies, which can include radiofrequency
fects and health, independent of the radiofrequency EMF
                                                                       EMFs (Joshi and Schoenbach 2010). If the pulse is sufficiently
literature, is also important and is described below. ICNIRP
                                                                       intense and brief, exposure to the resultant EMFs may cause
considers this appropriate given that the vast majority of ra-
                                                                       cell membranes to become permeable, which in turn can lead
diofrequency EMF health research has been conducted
                                                                       to other cellular changes. However, there is no evidence that
using exposures substantially lower than those shown to
                                                                       the radiofrequency spectral component from an EMF pulse
produce adverse health effects, with relatively little research
                                                                       (without the low-frequency component) is sufficient to cause
addressing adverse health effect thresholds from known in-
                                                                       changes in the permeability of cell membranes. The restric-
teraction mechanisms themselves. Thus, it is possible that
                                                                       tions on nerve stimulation in the ICNIRP (2010) guidelines
the radiofrequency health literature may not be sufficiently
                                                                       (and used here) are sufficient to ensure that permeability
comprehensive to ascertain precise thresholds. Conversely,
                                                                       changes do not occur, so additional protection from the resul-
where a more extensive literature is available that clarifies
                                                                       tant radiofrequency EMFs is not necessary. Membrane perme-
the relation between health and the primary biological ef-
                                                                       ability changes have also been shown to occur with 18 GHz
fects, this can be useful for setting guidelines. For example,
                                                                       continuous wave exposure (e.g., Nguyen et al. 2015). This
if the thermal physiology literature demonstrated that local
                                                                       has only been demonstrated in vitro, and the effect requires
temperature elevations of a particular magnitude caused
                                                                       very high exposure levels (circa 5 kW kg−1, over many mi-
harm, but radiofrequency exposure known to produce a
                                                                       nutes) that far exceed those required to cause thermally-
similar temperature elevation had not been evaluated for
                                                                       induced harm (see “Temperature rise” section). Therefore,
harm, then it would be reasonable to also consider this ther-
                                                                       there is also no need to specifically set restrictions to protect
mal physiology literature. ICNIRP refers to thresholds de-
                                                                       against this effect, as the restrictions designed to protect
rived from such additional literature as operational adverse
                                                                       against smaller temperature rises described in the “Temper-
health effect thresholds.
                                                                       ature Rise” section will also provide protection against this.
      It is important to note that ICNIRP only uses operational
thresholds to set restrictions where they are lower (more con-               Temperature rise. Radiofrequency EMFs can generate
servative) than those demonstrated to adversely affect health          heat in the body and it is important that this heat is kept to a
in the radiofrequency literature, or where the radiofrequency          safe level. However, as can be seen from Appendix B, there
literature does not provide sufficient evidence to deduce an           is a dearth of radiofrequency exposure research using suffi-
adverse health effect threshold. For the purpose of determin-          cient power to cause heat-induced health effects. Of particular
ing thresholds, evidence of adverse health effects arising from        note is that although exposures (and resultant temperature
all radiofrequency EMF exposures is considered, including              rises) have occasionally been shown to cause severe harm,
those referred to as ‘low-level’ and ‘non-thermal’, and includ-        the literature lacks concomitant evidence of the lowest expo-
ing those where mechanisms have not been elucidated. Simi-             sures required to cause harm. For very low exposure levels
larly, as there is no evidence that continuous (e.g., sinusoidal)      (such as within the ICNIRP (1998) basic restrictions) there is
and discontinuous (e.g., pulsed) EMFs result in different bio-         extensive evidence that the amount of heat generated is not
logical effects (Kowalczuk et al. 2010; Juutilainen et al. 2011),      sufficient to cause harm, but for exposure levels above those
no theoretical distinction has been made between these types           of the ICNIRP (1998) basic restriction levels, there is limited
of exposure (all exposures have been considered empirically            research. Where there is good reason to expect health impair-
in terms of whether they adversely affect health).                     ment at temperatures lower than those shown to impair health
                                                                       via radiofrequency EMF exposure, ICNIRP uses those lower
Thresholds for Radiofrequency EMF-Induced                              temperatures as a basis for its restrictions (see “Radiofre-
Health Effects                                                         quency EMF health research” section).
      Nerve stimulation. Exposure to EMFs can induce                         It is important to note that these guidelines restrict ra-
electric fields within the body, which for frequencies up to           diofrequency EMF exposure to limit temperature rise rather
10 MHz can stimulate nerves (Saunders and Jeffreys 2007).              than absolute temperature, whereas health effects are pri-
The effect of this stimulation varies as a function of frequency,      marily related to absolute temperature. This strategy is used
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6                                                         Health Physics     Month 2020, Volume 00, Number 00

because it is not feasible to limit absolute temperature,                     results in harm is only seen where temperature increases
which is dependent on many factors that are outside the                       more than +1°C, with no clear evidence of a specific thresh-
scope of these guidelines, such as environmental tempera-                     old for adverse health effects. Due to the limited literature
ture, clothing and work rate. This means that if exposure                     available, ICNIRP has adopted a conservative temperature
caused a given temperature rise, this could improve, not af-                  rise value as the operational adverse health effect threshold
fect, or impair health depending on a person’s initial tem-                   (the 1°C rise of ACGIH 2017). It is important to note that
perature. For example, mild heating can be pleasant if a                      significant physiological changes can occur when body core
person is cold, but unpleasant if they are already very hot.                  temperature increases by 1°C. Such changes are part of the
The restrictions are therefore set to avoid significant in-                   body’s normal thermoregulatory response (e.g., Van den
crease in temperature, where “significant” is considered in                   Heuvel et al. 2017), and thus do not in themselves represent
light of both potential harm and normal physiological tem-                    an adverse health effect.
perature variation. These guidelines differentiate between                          Recent theoretical modeling and generalization from
steady-state temperature rises (where temperature increases                   experimental research across a range of species predicts that
slowly, allowing time for heat to dissipate over a larger tis-                exposures resulting in a whole-body average SAR of approx-
sue mass and for thermoregulatory processes to counter                        imately 6 W kg−1, within the 100 kHz to 6 GHz range, over at
temperature rise), and brief temperature rises (where there                   least a 1-hour interval under thermoneutral conditions5 (28°C,
may not be sufficient time for heat to dissipate, which can                   naked, at rest), is required to induce a 1°C body core temper-
result in larger temperature rises in small regions given the                 ature rise in human adults. A higher SAR is required to reach
same absorbed radiofrequency energy). This distinction                        this temperature rise in children due to their more-efficient
suggests the need to account for steady-state and brief expo-                 heat dissipation (Hirata et al. 2013). However, given the
sure durations separately.                                                    limited measurement data available, ICNIRP has adopted
                                                                              a conservative position and uses 4 W kg−1 averaged over
Steady-state temperature rise
                                                                              30 min as the radiofrequency EMF exposure level corre-
Body core temperature. Body core temperature refers to
                                                                              sponding to a body core temperature rise of 1°C. An averag-
the temperature deep within the body, such as in the abdo-
                                                                              ing time of 30 min is used to take into account the time it
men and brain, and varies substantially as a function of such
                                                                              takes to reach a steady-state temperature (for more details,
factors as sex, age, time of day, work rate, environmental
                                                                              see Appendix A, “Temporal averaging considerations” sec-
conditions and thermoregulation. For example, although
                                                                              tion). As a comparison, a human adult generates a total of ap-
the mean body core temperature is approximately 37°C
                                                                              proximately 1 W kg−1 at rest (Weyand et al. 2009), nearly 2 W
(and within the “normothermic” range4), this typically varies
                                                                              kg−1 standing, and 12 W kg−1 running (Teunissen et al. 2007).
over a 24-h period to meet physiological needs, with the mag-
                                                                                    As EMF frequency increases, exposure of the body and
nitude of the variation as large as 1°C (Reilly et al. 2007). As
                                                                              the resultant heating becomes more superficial, and above
thermal load increases, thermoregulatory functions such as va-
                                                                              about 6 GHz this heating occurs predominantly within the
sodilation and sweating can be engaged to restrict body core
                                                                              skin. For example, 86% of the power at 6 and 300 GHz is
temperature rise. This is important because a variety of health
                                                                              absorbed within 8 and 0.2 mm of the surface respectively
effects can occur once body core temperature has increased
                                                                              (Sasaki et al. 2017). Compared to heat in deep tissues, heat
by more than approximately 1°C (termed “hyperthermia”).
                                                                              in superficial tissues is more easily removed from the body
For example, risk of accident increases with hyperthermia
                                                                              because it is easier for the thermal energy to transfer to the
(Ramsey et al. 1983), and at body core temperatures >40°C
                                                                              environment. This is why basic restrictions to protect
it can lead to heat stroke, which can be fatal (Cheshire 2016).
                                                                              against body core temperature rise have traditionally been
      Detailed guidelines are available for minimizing ad-
                                                                              limited to frequencies below 10 GHz (e.g., ICNIRP 1998).
verse health risk associated with hyperthermia within the
                                                                              However, research has shown that EMF frequencies above
occupational setting (ACGIH 2017). These aim to modify
                                                                              300 GHz (e.g., infrared radiation) can increase body core
work environments in order to keep body core temperature
                                                                              temperature beyond the 1°C operational adverse health ef-
within +1°C of normothermia, and require substantial
                                                                              fect threshold described above (Brockow et al. 2007). This
knowledge of each particular situation due to the range of
                                                                              is because infrared radiation, as well as lower frequencies
variables that can affect it. As described in Appendix B,
                                                                              within the scope of the present guidelines, cause heating
body core temperature rise due to radiofrequency EMFs that
                                                                              within the dermis, and the extensive vascular network
                                                                              within the dermis can transport this heat deep within the
4
 Normothermia refers to the thermal state within the body whereby active      body. It is therefore appropriate to also protect against body
thermoregulatory processes are not engaged to either increase or decrease     core temperature rise above 6 GHz.
body core temperature.
5
 Thermoneutral refers to environmental conditions that allow body core              ICNIRP is not aware of research that has assessed the
temperature to be maintained solely by altering skin blood flow.              effect of 6 to 300 GHz EMFs on body core temperature,
                                                                www.health-physics.com
ICNIRP GUIDELINES                                                          7

nor of research that has demonstrated that it is harmful.            define operational thresholds for local heat-induced health
However, as a conservative measure, ICNIRP uses the                  effects; adopting 41 °C as potentially harmful, the present
4 W kg−1 corresponding to the operational adverse health effect      guidelines take a conservative approach and treat radiofre-
threshold for frequencies up to 6 GHz, for the >6 to 300 GHz         quency EMF-induced temperature rises of 5°C and 2°C,
range also. In support of this being a conservative value, it        within Type-1 and Type-2 tissue, respectively, as opera-
has been shown that 1260 W m−2 (incident power density)              tional adverse health effect thresholds for local exposure.
infrared radiation exposure to one side of the body results               It is difficult to set exposure restrictions as a function of
in a 1°C body core temperature rise (Brockow et al.,                 the above tissue-type classification. ICNIRP thus defines
2007). If we related this to the exposure of a 70 kg adult           two regions and sets separate exposure restrictions, where
with an exposed surface area of 1 m2 and no skin reflectance,        relevant, for these regions: “Head and Torso,” comprising
this would result in a whole-body exposure of approximately          the head, eye, pinna, abdomen, back, thorax and pelvis,
18 W kg−1; this is far higher than the 4 W kg−1 exposure level       which includes both Type-1 and Type-2 tissue, and the
for EMFs below 6 GHz that is taken to represent a 1°C body           “Limbs,” comprising the upper arm, forearm, hand, thigh,
core temperature rise. This is viewed as additionally conser-        leg and foot, which only includes Type-1 tissue. Exposure
vative given that the Brockow et al. study reduced heat dissi-       levels have been determined for each of these regions such
pation using a thermal blanket, which would underestimate            that they do not result in temperature rises of more than
the exposure required to increase body core temperature              5°C and 2°C, in Type-1 and Type-2 tissue, respectively.
under typical conditions.                                            As the Limbs, by definition, do not contain any Type-2
                                                                     tissue, the operational adverse health effect threshold for
Local temperature. In addition to body core temperature,             the Limbs is always 5°C.
excessive localized heating can cause pain and thermal                    The testes can be viewed as representing a special case,
damage. There is an extensive literature showing that skin           whereby reversible, graded, functional change can occur
contact with temperatures below 42°C for extended periods            within normal physiological temperature variation if main-
will not cause pain or damage cells (e.g., Defrin et al. 2006).      tained over extended periods, with no apparent threshold.
As described in Appendix B, this is consistent with the lim-         For example, spermatogenesis is reversibly reduced as a re-
ited data available for radiofrequency EMF heating of the            sult of the up to 2°C increase caused by normal activities
skin [e.g., Walters et al. (2000) reported a pain threshold          such as sitting (relative to standing; Mieusset and Bujan
of 43°C using 94 GHz exposure], but fewer data are avail-            1995). Thus, it is possible that the operational adverse
able for heat sources that penetrate beyond the protective           health effect threshold for Type-2 tissue may result in re-
epidermis and to the heat-sensitive epidermis/dermis inter-          versible changes to sperm function. However, there is cur-
face. However, there is also a substantial body of literature        rently no evidence that such effects are sufficient to impair
assessing thresholds for tissue damage which shows that              health. Accordingly, ICNIRP views the operational adverse
damage can occur at tissue temperatures >41–43°C, with               health effect threshold of 2°C for Type-2 tissue, which is
damage likelihood and severity increasing as a function              within the normal physiological range for the testes, as ap-
of time at such temperatures (e.g., Dewhirst et al. 2003;            propriate for them also. Note that the operational adverse
Yarmolenko et al. 2011; Van Rhoon et al. 2013).                      health effect threshold for Type-2 tissue, which includes
      The present guidelines treat radiofrequency EMF expo-          the abdomen and thus potentially the fetus, is also consistent
sure that results in local temperatures of 41°C or greater as        with protecting against the fetal temperature rise threshold
potentially harmful. As body temperature varies as a function        of 2°C for teratogenic effects in animals (Edwards et al.
of body region, ICNIRP treats exposure to different regions          2003; Ziskin and Morrissey 2011).
separately. Corresponding to these regions, the present guide-            Within the 100 kHz to 6 GHz EMF range, average
lines define two tissue types which, based on their tempera-         SAR over 10 g provides an appropriate measure of the ra-
ture under normothermal conditions, are assigned different           diofrequency EMF-induced steady-state temperature rise
operational adverse health effect thresholds; “Type-1” tissue        within tissue. A 10-g mass is used because, although there
(all tissues in the upper arm, forearm, hand, thigh, leg, foot,      can initially be EMF-induced temperature heterogeneity
pinna and the cornea, anterior chamber and iris of the eye,          within that mass, heat diffusion rapidly distributes the ther-
epidermal, dermal, fat, muscle, and bone tissue), and                mal energy to a much larger volume that is well-represented
“Type-2” tissue (all tissues in the head, eye, abdomen, back,        by a 10-g cubic mass (Hirata and Fujiwara 2009). In speci-
thorax, and pelvis, excluding those defined as Type-1 tis-           fying exposures that correspond to the operational adverse
sue). The normothermal temperature of Type 1 tissue is typ-          health effect thresholds, ICNIRP thus specifies an average
ically
8                                                Health Physics     Month 2020, Volume 00, Number 00

realistic exposures (exposure scenarios that people may en-          power density value for local heating, averaged over 6 min
counter in daily life, including occupationally), such as from       and a square 4-cm2 region, at 200 W m−2; this will also re-
EMFs from radio-communications sources. This method                  strict temperature rise in Type-2 tissue to below the opera-
provides for higher exposures in the Limbs than in the Head          tional adverse health effect threshold of 2°C. An additional
and Torso. A SAR10g of at least 20 W kg−1 is required to ex-         specification of 400 W m−2 has been set for spatial averages
ceed the operational adverse health effect thresholds in the         of square 1-cm2 regions, for frequencies >30 GHz.
Head and Torso, and 40 W kg−1 in the Limbs, over an inter-
val sufficient to produce a steady-state temperature (from a
few minutes to 30 min). This time interval is operationalized        Rapid temperature rise
as a 6-min average as it closely matches the thermal time                  For some types of exposure, rapid temperature rise
constant for local exposure.                                         can result in “hot spots,” heterogeneous temperature dis-
      Within the >6 to 300 GHz range, EMF energy is depos-           tribution over tissue mass (Foster et al. 2016; Morimoto
ited predominantly in superficial tissues; this makes SAR10g,        et al. 2017; Laakso et al. 2017; Kodera et al. 2018). This
which includes deeper tissues, less relevant to this frequency       suggests the need to consider averaging over smaller time-
range. Conversely, absorbed power density (Sab) provides a           intervals for certain types of exposure. Hot spots can occur
measure of the power absorbed in tissue that closely approx-         for short duration exposures because there is not sufficient
imates the superficial temperature rise (Funahashi et al.            time for heat to dissipate (or average out) over tissue. This
2018). From 6 to 10 GHz there may still be significant ab-           effect is more pronounced as frequency increases due to
sorption in the subcutaneous tissue. However, the maxi-              the smaller penetration depth.
mum and thus worst-case temperature rise from 6 to                         To account for such heterogeneous temperature distri-
300 GHz is close to the skin surface, and exposure that will         butions, an adjustment to the steady-state exposure level is
restrict temperature rise to below the operational adverse           required. This can be achieved by specifying the maximum
health effect threshold for Type-1 tissue (5°C) will also re-        exposure level allowed, as a function of time, in order to re-
strict temperature rise to below the operational adverse             strict temperature rise to below the operational adverse
health effect threshold for Type-2 tissue (2°C). Note that           health effect thresholds.
there is uncertainty with regard to the precise frequency                  From 400 MHz to 6 GHz, ICNIRP specifies the re-
for the change from SAR to absorbed power density. Six               striction in terms of specific energy absorption (SA) of
GHz was chosen because at that frequency, most of the ab-            any 10-g cubic mass, where SA is restricted to 7.2[0.05
sorbed power is within the cutaneous tissue, which is within         +0.95(t/360)0.5] kJ kg−1 for Head and Torso, and 14.4
the upper half of a 10-g SAR cubic volume (that is, it can be        [0.025+0.975(t/360)0.5] kJ kg−1 for Limb exposure,
represented by the 2.15 cm  2.15 cm surface of the cube).           where t is exposure interval in seconds (Kodera et al.
Recent thermal modeling and analytical solutions suggest             2018). Note that for this specification, exposure from any
that for EMF frequencies between 6 and 30 GHz, the expo-             pulse, group of pulses, or subgroup of pulses in a train, as
sure over a square averaging area of 4 cm2 provides a good           well as from the total (sum) of exposures (including non-
estimate of local maximum temperature rise (Hashimoto et al.         pulsed EMF), delivered in t seconds, must not exceed the
2017; Foster et al. 2017). As frequency increases further, the       below formulae (in order to ensure that the temperature
averaging area needs to be reduced to account for the possi-         thresholds are not exceeded).
bility of smaller beam diameters, such that it is 1 cm2 from               There is no brief-interval exposure level specified be-
approximately 30 GHz to 300 GHz. Although the averaging              low 400 MHz because, due to the large penetration depth,
area that best corresponds to temperature rise would therefore       the total SA resulting from the 6-minute local SAR average
gradually change from 4 cm2 to 1 cm2 as frequency increases          cannot increase temperature by more than the operational
from 6 to 300 GHz, ICNIRP uses a square averaging area of            adverse health effect threshold (regardless of the particular
4 cm2 for >6 to 300 GHz as a practical protection specifica-         pattern of pulses or brief exposures).
tion. Moreover, from >30 to 300 GHz (where focal beam ex-                  Above 6 GHz, ICNIRP specifies the exposure level for
posure can occur), an additional spatial average of 1 cm2 is         both Head and Torso, and Limbs, in terms of absorbed energy
used to ensure that the operational adverse health effect            density (Uab) over any square averaging area of 4 cm2, such
thresholds are not exceeded over smaller regions.                    that Uab is specified as 72[0.05+0.95(t/360)0.5] kJ m−2,
      As 6 minutes is an appropriate averaging interval              where t is the exposure interval in seconds (extension of
(Morimoto et al. 2017), and as an absorbed power density             Kodera et al. 2018).
of approximately 200 W m−2 is required to produce the                      An additional exposure level for square 1-cm2 averag-
Type-1 tissue operational adverse health effect threshold            ing areas is applicable for EMFs with frequencies of >30 to
of a 5°C local temperature rise for frequencies of >6 to             300 GHz to account for focused beam exposure and is given
300 GHz (Sasaki et al. 2017), ICNIRP has set the absorbed            by 144[0.025+0.975(t/360)0.5] kJ m−2.
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ICNIRP GUIDELINES                                                                       9
        Table 2. Basic restrictions for electromagnetic field exposure from 100 kHz to 300 GHz, for averaging intervals ≥6 min.                          a

              Exposure                                       Whole-body average            Local Head/Torso            Local Limb                Local
              scenario            Frequency range             SAR (W kg−1)                  SAR (W kg−1)              SAR (W kg−1)            Sab (W m−2)

            Occupational         100 kHz to 6 GHz                    0.4                           10                       20                    NA
                                  >6 to 300 GHz                      0.4                           NA                       NA                    100
            General public       100 kHz to 6 GHz                    0.08                           2                        4                    NA
                                  >6 to 300 GHz                      0.08                          NA                       NA                    20
        a
         Note:
        1. “NA” signifies “not applicable” and does not need to be taken into account when determining compliance.
        2. Whole-body average SAR is to be averaged over 30 min.
        3. Local SAR and Sab exposures are to be averaged over 6 min.
        4. Local SAR is to be averaged over a 10-g cubic mass.
        5. Local Sab is to be averaged over a square 4-cm2 surface area of the body. Above 30 GHz, an additional constraint is imposed, such that
        exposure averaged over a square 1-cm2 surface area of the body is restricted to two times that of the 4-cm2 restriction.

     The SA and Uab values are conservative in that they are                          frequency fields in terms of the restrictions in the “Simulta-
not sufficient to raise Type 1 or Type 2 tissue temperatures                          neous Exposure to Multiple Frequency Fields” section.
by 5 or 2°C, respectively.                                                            Contact current guidance is provided in the “Guidance for
                                                                                      Contact Currents”, and health considerations for occupa-
                                                                                      tional exposure are described in the “Risk Mitigations Con-
          GUIDELINES FOR LIMITING
       RADIOFREQUENCY EMF EXPOSURE                                                    siderations for Occupational Exposure” section. To be
                                                                                      compliant with the present guidelines, for each exposure
     As described in the “Scientific Basis for Limiting Ra-                           quantity (e.g., E-field, H-field, SAR), and temporal and spatial
diofrequency Exposure” section, radiofrequency EMF                                    averaging condition, either the basic restriction or corre-
levels corresponding to operational adverse health effects                            sponding reference level must be adhered to; compliance
were identified. Basic restrictions have been derived from                            with both is not required. Note that where restrictions
these and are described in the “Basic Restrictions” section                           specify particular averaging intervals, ‘all’ such averaging
below. The basic restrictions related to nerve stimulation                            intervals must comply with the restrictions.
for EMF frequencies 100 kHz to 10 MHz, from ICNIRP
(2010), were then added to the present set of basic restric-                          Basic Restrictions
tions, with the final set of basic restrictions given in                                   Basic restriction values are provided in Tables 2-4 with
Tables 2–4. Reference levels were derived from those final                            an overview of their derivation described below. As de-
basic restrictions and are described in the “Reference                                scribed above, the basic restrictions from ICNIRP (2010)
Levels” section, with details of how to treat multiple                                for the frequency range 100 kHz to 10 MHz have not been

        Table 3. Basic restrictions for electromagnetic field exposure from 100 kHz to 300 GHz, for integrating intervals >0 to 400 MHz to 6 GHz           3.6[0.05+0.95(t/360)0.5]       7.2[0.025+0.975(t/360)0.5]                   NA
                                     >6 to 300 GHz                      NA                              NA                       36[0.05+0.95(t/360)0.5]
            General public        100 kHz to 400 MHz                    NA                              NA                                NA
                                  >400 MHz to 6 GHz           0.72[0.05+0.95(t/360)0.5]      1.44[0.025+0.975(t/360)0.5]                  NA
                                     >6 to 300 GHz                      NA                              NA                       7.2[0.05+0.95(t/360)0.5]
        a
         Note:
        1. “NA” signifies “not applicable” and does not need to be taken into account when determining compliance.
        2. t is time in seconds, and restrictions must be satisfied for all values of t between >0 and
10                                                               Health Physics     Month 2020, Volume 00, Number 00

Table 4. Basic restrictions for electromagnetic field exposure from                  of 50 was applied for the general public, making the
100 kHz to 10 MHz, for peak spatial values.a                                         whole-body average SAR restriction for the general public
                                                              Induced electric       0.08 W kg−1, averaged over 30 min.
  Exposure scenario            Frequency range              field; Eind (V m−1)
                                                                                           It is noteworthy that the scientific uncertainty pertaining
  Occupational               100 kHz to 10 MHz                2.70  10−4f           to both dosimetry and potential health consequences of
  General public             100 kHz to 10 MHz                1.35  10−4f           whole-body radiofrequency exposure have reduced sub-
a
 Note:                                                                               stantially since the ICNIRP (1998) guidelines. This would
1. f is frequency in Hz.                                                             justify less conservative reduction factors, but as ICNIRP
2. Restriction values relate to any region of the body, and are to be averaged as    considers that the benefits of maintaining stable basic restric-
root mean square (rms) values over 2 mm  2 mm  2 mm contiguous tissue              tions outweighs any benefits that subtle changes to them
(as specified in ICNIRP 2010).
                                                                                     would provide, ICNIRP has retained the same reduction fac-
                                                                                     tors as before for the whole-body average basic restrictions.
re-evaluated here; these are described in Table 4. A more de-                        Similarly, although temperature rise is more superficial as
tailed description of issues pertinent to the basic restrictions                     frequency increases (and thus it is easier for the resultant heat
is provided in Appendix A, in the “Relevant Biophysical                              to be lost to the environment), the whole-body average SAR
Mechanisms” section. Note that for the basic restrictions                            restrictions above 6 GHz have been conservatively set the
described below, a pregnant woman is treated as a member                             same as those ≤6 GHz.
of the general public. This is because recent modeling sug-
gests that for both whole-body and local exposure scenar-                                 Local SAR (100 kHz to 6 GHz)
ios, exposure of the mother at the occupational basic                                Head and Torso
restrictions can lead to fetal exposures that exceed the gen-                              As described in the “Local temperature” section within
eral public basic restrictions.                                                      the 100 kHz to 6 GHz range, the guidelines take a SAR of
                                                                                     20 W kg−1, averaged over a 10-g cubic mass and 6-min inter-
      Whole-body average SAR (100 kHz to 300 GHz). As                                val, as the local exposure level corresponding to the operational
described in the “Body core temperature” section, the                                adverse health effect threshold for the Head and Torso (5°C in
guidelines take a whole-body average SAR of 4 W kg−1, av-                            Type-1 tissue and 2°C in Type-2 tissue). A reduction factor of 2
eraged over the entire body mass and a 30-minute interval,                           was applied to this for occupational exposure to account for sci-
as the exposure level corresponding to the operational ad-                           entific uncertainty, as well as differences in thermal physiology
verse health effect threshold for an increase in body core                           across the population and variability in environmental condi-
temperature of 1°C. A reduction factor of 10 was applied                             tions and physical activity levels. Reduction factors for local ex-
to this threshold for occupational exposure to account for sci-                      posure are smaller than for whole-body exposure because the
entific uncertainty, as well as differences in thermal physiol-                      associated health effect threshold is less dependent on environ-
ogy across the population and variability in environmental                           mental conditions and the highly variable centrally-mediated
conditions and physical activity levels. Variability in an indi-                     thermoregulatory processes, and because the associated
vidual’s ability to regulate their body core temperature is par-                     health effect is less serious medically. Thus, the basic restric-
ticularly important as it is dependent on a range of factors that                    tion for occupational exposure becomes a SAR10g of 10 W
the guidelines cannot control. These include central and pe-                         kg−1, averaged over a 6-min interval. As the general public
ripherally-mediated changes to blood perfusion and sweat rate                        cannot be expected to be aware of exposures and thus to
(which are in turn affected by a range of other factors, includ-                     mitigate risk, and also recognizing greater differences in
ing age and certain medical conditions), as well as behavior                         thermal physiology in the general population, a reduction
and environmental conditions.                                                        factor of 10 was applied for the general public, reducing
      Thus the basic restriction for occupational exposure be-                       the general public basic restriction to a SAR10g of 2 W
comes a whole-body average SAR of 0.4 W kg−1, averaged                               kg−1 averaged over a 6-min interval.
over 30 min. Although this means that SAR can be larger for
smaller time intervals, this will not affect body core temperature                   Limbs
rise appreciably because the temperature will be “averaged-out”                           As described in the “Local temperature” section,
within the body over the 30-min interval, and it is this time-                       within the 100 kHz to 6 GHz range, the guidelines take a
averaged temperature rise that is relevant here. Further, as both                    SAR of 40 W kg−1, averaged over a 10-g cubic mass and
whole-body and local restrictions must be met simultaneously,                        6-min interval, as the local exposure level corresponding
exposures sufficiently high to be hazardous locally will be                          to the operational adverse health effect threshold for the
protected against by the local restrictions described below.                         Limbs of a 5°C rise in local temperature. As with the Head
      As the general public cannot be expected to be aware                           and Torso restrictions, a reduction factor of 2 was applied to
of exposures and thus to mitigate risk, a reduction factor                           this threshold for occupational exposure to account for
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ICNIRP GUIDELINES                                                       11

scientific uncertainty, as well as differences in thermal physi-      exposure to account for scientific uncertainty, as well as dif-
ology across the population and variability in environmental          ferences in thermal physiology across the population and
conditions and physical activity levels. This results in a basic      variability in environmental conditions and physical activity
restriction for occupational exposure of a SAR10g of 20 W             levels. This results in a basic restriction for occupational ex-
kg−1. As the general public cannot be expected to be aware            posure of 100 W m−2, averaged over 6 min and a square
of exposures and thus to mitigate risk, and also to recognize         4-cm2 surface area of the body.
greater differences in thermal physiology in the general popu-             As the general public cannot be expected to be aware of
lation, a reduction factor of 10 was applied for the general          these exposures and thus to mitigate risk, and to recognize
public, reducing the general public restriction to 4 W kg−1           greater differences in thermal physiology in the general pop-
averaged over a 6-min interval.                                       ulation, a reduction factor of 10 was applied, which reduces
                                                                      the general public basic restriction to 20 W m−2, averaged
      Local SA (400 MHz to 6 GHz). As described in the                over 6 min and a square 4-cm2 surface area of the body.
“Rapid temperature rise” section, within the >400 MHz to                   Further, to account for focal beam exposure from >30
6 GHz range, an additional constraint is required to ensure           to 300 GHz, absorbed power density averaged over a
that the cumulative energy permitted by the 6-minute aver-            square 1-cm2 surface area of the body must not exceed
age SAR10g basic restriction is not absorbed by tissues too           2 times that of the 4-cm2 basic restrictions for workers
rapidly. Accordingly, ICNIRP sets an SA level for exposure            or the general public.
intervals of less than 6 min, as a function of time, to limit
temperature rise to below the operational adverse health ef-                Local absorbed energy density (>6 GHz to 300
fect thresholds. This SA level, averaged over a 10-g cubic            GHz). As described in the “Rapid temperature rise” section,
mass, is given by 7.2[0.05+0.95(t/360)0.5] kJ kg−1 for the            within the >6 to 300 GHz range, an additional constraint is
Head and Torso, and 14.4[0.025+0.975(t/360)0.5] kJ kg−1               required to ensure that the cumulative energy permitted by
for the Limbs, where t is exposure duration in seconds.               the 6-min average absorbed power density basic restriction
      As with the SAR10g basic restrictions, a reduction factor       is not absorbed by tissue too rapidly. Accordingly, for both
of 2 was applied to these exposure levels for occupational            the Head and Torso, and Limbs, ICNIRP set a maximum ab-
exposure to account for scientific uncertainty, as well as dif-       sorbed energy density level for exposure intervals of less
ferences in thermal physiology across the population and              than 6 minutes, as a function of time, to limit temperature
variability in environmental conditions and physical activity         rise to below the operational adverse health effect thresholds
levels. This results in a basic restriction for the Head and          for both Type-1 and Type-2 tissues. This absorbed energy
Torso of 3.6[0.05+0.95(t/360)0.5] kJ kg−1, and for the Limbs          density level, averaged over any square 4-cm2 surface area
of 7.2[0.025+0.975(t/360)0.5] kJ kg−1. As the general public          of the body, is given by 72[0.05+0.95(t/360)0.5] kJ m−2,
cannot be expected to be aware of exposures and thus to               where t is exposure duration in seconds. To account for fo-
mitigate risk, and to recognize greater differences in ther-          cal beam exposure from >30 to 300 GHz, the absorbed
mal physiology in the general population, a reduction fac-            energy density level corresponding to the operational
tor of 10 was applied for the general public. This makes              adverse health effect threshold, averaged over a square 1-cm2
the general public restriction 0.72[0.05+0.95(t/360)0.5] kJ kg−1      surface area of the body, is given by 144[0.025+0.975(t/360)0.5]
for the Head and Torso, and 1.44[0.025+0.975(t/360)0.5]               kJ m−2. Note that for these basic restrictions for brief expo-
kJ kg−1 for the Limbs.                                                sures, the exposure from any pulse, group of pulses, or sub-
      Note that for these brief exposure basic restrictions, the      group of pulses in a train, as well as from the summation of
exposure from any pulse, group of pulses, or subgroup of              exposures (including non-pulsed EMFs), delivered in t sec-
pulses in a train, as well as from the summation of exposures         onds, must be used to satisfy this formula.
(including non-pulsed EMFs), delivered in t seconds, must                   As with the absorbed power density basic restrictions, a
not exceed these local SA values.                                     reduction factor of 2 was applied to this exposure level for
     Local absorbed power density (>6 GHz to 300 GHz).                occupational exposure to account for scientific uncertainty,
As described in the “Local temperature” section, within the           as well as differences in thermal physiology across the pop-
>6 to 300 GHz range, the guidelines take an absorbed power            ulation and variability in environmental conditions and
density of 200 W m−2, averaged over 6 min and a square                physical activity levels. This results in a basic restriction
4-cm2 surface area of the body, as the local exposure corre-          for occupational exposure of 36[0.05+0.95(t/360)0.5] kJ
sponding to the operational adverse health effect threshold           m−2, over any square 4-cm2 surface area of the body. From
for both the Head and Torso, and Limb regions (5 and 2°C              >30 to 300 GHz, an additional basic restriction for occupa-
local temperature rise in Type-1 and Type-2 tissue, respec-           tional exposure is 72[0.025+0.975(t/360)0.5] kJ m−2, aver-
tively). As with the local SAR restrictions, a reduction fac-         aged over any square 1-cm2 surface area of the body. As
tor of 2 was applied to this exposure level for occupational          the general public cannot be expected to be aware of
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