Extremely Low-Frequency Magnetic Fields and Health Effects

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Extremely Low-Frequency Magnetic Fields and Health Effects Campos magnéticos de Resumo frequência extremamente baixa A partir da publicação, em 1979, dos resul� tados de um estudo que apontava para o e efeitos na saúde: revisão da aumento do risco de leucemia em crianças associado à exposição a campos magnéti� literatura cos, o interesse pelo tema vem aumentan� do, e diversos estudos foram publicados. O objetivo desta revisão é apresentar os Extremely low-frequency magnetic diferentes métodos utilizados na avaliação da exposição aos campos magnéticos de fields and health effects: literature frequência extremamente baixa, bem como as dificuldades enfrentadas na quantifi� review cação dessa exposição, além de relatar os resultados de estudos epidemiológicos pu� blicados nos últimos 10 anos. A falta de um modelo fisiopatológico que explique uma possível influência dos campos magnéticos na saúde e a dificuldade para quantificar a exposição têm sido os maiores obstáculos da pesquisa na área. Leucemia e tumores do sistema nervoso central têm sido os efeitos mais estudados. Leucemia em crianças é o desfecho mais consistentemente associado à exposição a campos magnéticos. Estudos mais recentes apontam a associação entre esclerose lateral amiotrófica e campos magnéticos. Palavras-chave: Campos magnéticos. Revisão de literatura. Leucemia. Doenças neurodegenerativas. Izabel Marcilio* Mateus Habermann Nelson Gouveia Departamento de Medicina Preventiva da Faculdade de Medicina, USP Este estudo foi financiado pela ANEEL – Agência Nacional de Energia Elétrica. Colaboradores: I. M. e M. H. realizaram a busca bibliográfica e revisão da literatura, escreveram e revisaram o manuscrito. N. G. coordenou o trabalho e revisou o manuscrito. Correspondência: Izabel Marcilio. Faculdade de Medicina da Universidade de São Paulo. Av. Dr. Arnaldo, 455 - São Paulo, SP - CEP 01246-903. E-mail: [email protected] 105 Rev Bras Epidemiol 2009; 12(2): 105-23 Abstract Introdução Since an epidemiologic report, in 1979, Os efeitos da exposição a campos mag� showed an association between childhood néticos na saúde têm sido alvo de preocupa� leukemia and exposure to magnetic fields, ção e suscitado a produção de estudos sobre concerns over the subject have grown, and o tema. O primeiro trabalho nesse sentido several other studies have been published. foi publicado na década de 1960 e focava a The main goal of this literature review is to exposição ocupacional1. Em 1979, o estudo present the methods of exposure assess� de Wertheimer e Leeper2 colocou o assunto ment and the main difficulties in measuring definitivamente em evidência ao apontar exposure, and also to report the results of uma relação entre o risco para leucemia epidemiological studies published along em crianças e a exposição a campos eletro� the past ten years. The lack of biophysical magnéticos. Desde então, observa�se uma mechanisms explaining the interaction vasta produção de trabalhos avaliando o between magnetic fields and health, and the possível risco à saúde advindo da exposição difficulties regarding exposure assessment a campos magnéticos (CM) e eletromagné� have been the main obstacles of research in ticos (CEM). this area. Leukemia and brain tumors are Campos magnéticos e campos elétri� the most evaluated outcomes. Childhood cos estão ambos associados à presença da leukemia has been the most consistently passagem de corrente elétrica e, portanto, é outcome associated with magnetic field comum o uso do termo CEM para se referir exposure. Recent studies have also shown às suas presenças. A avaliação de efeitos na an association between magnetic fields and saúde, no entanto, se refere mais frequen� amyotrophic lateral sclerosis. temente aos CM, uma vez que os materiais comuns de construção civil não bloqueiam Keywords: Magnetic fields. Literature a sua passagem, o que não ocorre com review. Leukemia. ��������������������eurodegenerative di� os campos elétricos3. CM são radiações seases. geradas por diferentes fontes, naturais e produzidas pelo homem. Por volta dos últimos cem anos, o homem passou a ser exposto artificialmente aos CM oriundos da transmissão de energia elétrica e esses campos constituem parte fundamental das sociedades industrializadas3,4. Os campos elétricos são gerados a par� tir de diferenças de voltagem, sendo tanto maiores quanto maior for a voltagem, e sua intensidade diminui com a distância da fonte. Os campos magnéticos acontecem quando há fluxo de corrente elétrica, e sua força é diretamente proporcional à grandeza da corrente5. Entre as fontes naturais de CM estão a radiação solar e a luz ultravioleta. São exemplos de CM gerados pelo homem as ondas de rádio e a energia elétrica. Os CM variam em relação à frequência, medida em Hertz (Hz), e ao tamanho das ondas. O extremo inferior do espectro de frequência (0 Hz) é representado pela cor� rente direta ou campos estáticos. O extremo Rev Bras Epidemiol 106 Campos magnéticos de frequência extremamente baixa e efeitos na saúde: revisão da literatura 2009; 12(2): 105-23 Marcílio, I. et al. superior, com frequência acima de 1016 Hz, melatonina15�17. A melatonina é produzida compreende as radiações ionizantes – raios� principalmente pela glândula pineal. Sua X, raios Gama e luz ultravioleta6. secreção está diretamente relacionada ao ci� Os campos de baixa frequência ocupam clo circadiano, influenciada pela percepção a faixa de 3 a 3.000 Hz, com um longo com� de ausência da luz por células sensíveis no primento de onda. As redes de geração e olho. Alguns trabalhos demonstraram que transmissão de energia elétrica são campos os CM reduzem diferentes parâmetros da de frequência extremamente baixa, compre� produção de melatonina na glândula pineal endendo as faixas de 50 a 60 Hz. de mamíferos17. Da revisão de literatura rela� A intensidade do CM é medida em Am� cionada ao tema conclui�se que, apesar dos pères por metro (A/m). Para fins de pesquisa resultados obtidos em alguns experimentos e comunicação de risco, no entanto, tem�se com animais, não há evidências suficientes usado a unidade de medida da indução de alterações na fisiologia da melatonina magnética, descrita em Gauss (G) e, mais em seres humanos em relação à exposição a comumente, em Tesla (T) ou micro�Tesla CM de frequência extremamente baixa18�20. (µT). O sistema nervoso funciona através da estimulação elétrica e é considerado parti� Mecanismos Biológicos cularmente vulnerável aos efeitos dos CM e às correntes elétricas por eles induzidas15. A interação conhecida entre os CM de Embora os CM de frequência extremamente frequência extremamente baixa e o corpo baixa provoquem correntes menores dos humano é a indução de correntes elétricas que aquelas fisiologicamente presentes e fracas. Esses campos não são capazes de capazes de estimular o tecido nervoso pe� quebrar ligações químicas e são conhecidos riférico, evidências sugerem que os mesmos como “radiações não ionizantes”3,7. podem modular a atividade elétrica funcio� A despeito das muitas pesquisas realiza� nal no sistema nervoso central (S�C)13,15. das, até o momento não existe concordância Os estudos experimentais avaliando os sobre efeitos adversos à saúde gerados por efeitos dos CM na saúde apresentam algu� campos de frequência extremamente baixa, mas limitações. Grande parte deles utiliza já que estes parecem possuir energia insufi� exposições muito acima dos níveis que em ciente para romper ligações entre as cadeias geral estão presentes no ambiente domici� de D�A e desencadear um processo de car� liar16,21. É o caso do estudo de Iorio et al.22, cinogênese8,9, com exceção das exposições que encontrou aumento na mobilidade de agudas iguais ou superiores a 100 µT10. A espermatozoides expostos a campos a partir tendência atual, portanto, é de se considerar da intensidade mínima de 2,5 mT, e do es� os CM de frequência extremamente baixa tudo de Tokalov e Gutzeit23, que encontrou como um fator de promoção tumoral ou de diferenças na expressão de proteínas de cocarcinogênese11,12. estresse com a estimulação das células por Evidências experimentais sugerem que CM de 10 a 140 µT. os CM podem influenciar algumas funções A não identificação de um órgão�alvo celulares, como a proliferação das células (ou mecanismo alvo) dos CM representa e a comunicação intercelular11�13. A expo� um desafio para as pesquisas experimen� sição a níveis elevados de CM pode levar à tais acerca de seus efeitos na saúde23. A promoção tumoral ou outros tipos de danos falta de replicação independente também é celulares através da produção de radicais li� frequente nesses estudos, o que dificulta o vres endógenos, ou através da interferência estabelecimento de uma associação causal nos canais de cálcio11,13�15. entre a exposição aos CM e seus efeitos na Uma outra hipótese para explicar a asso� saúde16. ciação de leucemia e câncer de mama com Assim, os estudos experimentais até o os CM é a influência destes no sistema de momento não foram capazes de estabele� Campos magnéticos de frequência extremamente baixa e efeitos na saúde: revisão da literatura 107 Rev Bras Epidemiol Marcílio, I. et al. 2009; 12(2): 105-23 cer um mecanismo biofísico que justifique somar o efeito das diversas fontes de CM15. uma resposta biológica induzida pelos CM. A falta de um modelo dose�resposta ou Ressalta�se, no entanto, que, uma vez que os de um mecanismo de ação, além da difi� estudos epidemiológicos demonstram que a culdade em se definir o período necessário exposição a CM pode trazer danos à saúde, para a indução de efeitos nocivos, é um um mecanismo de interação deve existir, obstáculo para o estabelecimento de pa� ainda que no momento esse mecanismo râmetros relevantes a serem quantificados não possa ser demonstrado, ou mesmo para a avaliação do risco9,15. parecer implausível15. A despeito da dificuldade para se ca� racterizar a exposição aos CM, não parece Objetivo haver uma tendência viciada de erros. Presume�se que há a mesma probabilida� O objetivo desta revisão é apresentar de de erro na classificação dos sujeitos em os diferentes métodos utilizados na ava� expostos e não expostos10.
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