A personal monitoring study of occupational RF exposure to the medical equipment used in physiotherapy centers: Diathermy is the top emission device

Maria Basiouka, Efthymios Karabetsos, George Gourzoulidis, heodoros C. Constantinidis, Athanassios Zissimopoulos


Purpose: In physiotherapy centers, equipment emitting electromagnetic fields (EMF) is used daily and diathermy is reported as the top emitting device used. The purpose of this work is the evaluation of the levels of radio frequency (RF) electric fields that can be reached and physiotherapists are exposed to, in relation to the action levels (ALs) of the 2013/35/EU Directive.

Material and Methods: Thirty five physiotherapists in 30 private physiotherapy centers participated in this study. RF personal monitors were used to record physiotherapists’ exposure during their normal working routine, while handling physiotherapy equipment.

Results: The recorded average exposure levels were found, in general, lower than the ALs of the Directive. Nevertheless, the recorded maximum exposure levels instantaneously exceeded the ALs, but these levels are actually very low when averaged over the 6 minute period provisioned in the Directive. Moreover, specific medical equipment and clinical practices are associated with higher measured values.

Conclusions: Compared to the occupational exposure ALs, as established in the Directive, the measurement results showed that high levels of RF electric fields were practically recorded only during the operation of diathermy equipment. On the contrary, when only the rest of the medical equipment of the physiotherapy centers was used, very low exposure values were recorded.


Occupational EMF exposure; physiotherapists; diathermy; RF electric fields.

Full Text:



Bauwens P, Scott BO. The value of measurements in diathermy. Ann Phys Med 1953; 1(6): 191-197.

Willett CS. An Introduction to Gas Lasers, Pergamon Press, 1974, pp 407–411.

Watson T. Ultrasound in contemporary physiotherapy practice. Ultrasonics 2008; 48(4): 321-329.

Wolfe WL, Zissis GJ (eds). The infrared handbook; prepared by the Infrared Information and Analysis (IRIA) Center, Environmental Research Institute of Michigan, for the Office of Naval Research, Department of the Navy Washington, DC, Government Printing Office, 1981.

Watson T. The role of electrotherapy in contemporary physiotherapy practice. Man Ther 2000; 5(3): 132-141.

Robinson AJ, Snyder-Mackler L (eds). Clinical Electrophysiology: Electrotherapy and Electrophysiologic Testing. Lippincott Williams & Wilkins, 2007, p. 68.

ICNIRP: International committee for non ionizing radiation protection guidelines for limiting exposure to time-varying electric, magnetic and electromagnetic fields (0-300 GHz). Health Physics 1998; 74(4): 494-552.

Directive 2004/40/EC of the European Parliament and of the Council of 29 April 2004 on the minimum health and safety requirements regarding the exposure of workers to the risks arising from physical agents (electromagnetic fields) (18th individual Directive within the meaning of article 16 (1) of Directive 89/391/EEC), OJ L 184/1. https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L: 2004:184:0001:0009:EN;2004.

Directive 2013/35/EU of the European Parliament and of the Council of 26 June 2013 on the minimum health and safety requirements regarding the exposure of workers to the risks arising from physical agents (electromagnetic fields) (20th individual Directive within the meaning of Article 16(1) of Directive 89/391/EEC) and repealing Directive 2004/40/EC, OJ L 179/1. https://eur-lex.europa.eu/LexUriServ/ LexUriServ.do?uri=OJ:L:2013:179:0001:0021:EN; 2013.

International commission on non-ionizing radiation protection (ICNIRP). Principles for non-ionizing radiation protection. Health Phys 2020; 118(5): 477-482.

SCENIHR – Scientific committee on emerging and newly identified health risks: opinion on potential health effects of exposure to electromagnetic fields (EMF), January 2015. https://ec.europa.eu/health/sites/health/files/scientific_committees/emerging/docs/scenihr_o_041; 2015.

CENELEC Standard EN 50499: Procedure for the assessment of the exposure of workers to electromagnetic fields, 2008. https://infostore.saiglobal.com/preview/ 98698679543.pdf?sku=860593_SAIG_NSAI_NSAI_2047418; 2008.

Karabetsos E, Basiouka M, Zissimopoulos A. Occupational exposure of physical therapists to radio frequency radiation-The situation in Greece. Proceedings of the 6th International Workshop on Biological Effects of Electromagnetic Fields, 10-14 October 2010, Bodrum, Turkey.

RadMan XT Operating Manual: Narda Safety Test Solutions, Germany. https://www.narda-sts.us/pdf_files/RadMan_Manual.pdf. Accessed April 17, 2020.

Skotte J. Reduction of radiofrequency exposure to the operator during short-wave diathermy treatments. J Med Eng Technol 1986; 10(1): 7-10.

Martin CJ, McCallum HM, Heaton B. An evaluation of radiofrequency exposure from therapeutic diathermy equipment in the light of current recommendations. Clin Phys Physiol Meas 1990; 11: 53–63.

Li CY, Feng CK. An evaluation of radiofrequency exposure from therapeutic diathermy equipment. Ind Health 1999; 37(4): 465-468.

Berlana Llorente T, Diego Segura B. Occupational Exposure to High Frequency EMF in Physiotherapy Facilities. Part I (preliminary study) & Part II (measurements and results). 6th International NIR Workshop of ICNIRP, Rio de Janeiro, Brazil, 2008, pp 14-17.

Koutsojannis C. Measurement and simulation of electromagnetic radiation distribution in physiotherapy units. Proceedings of 7th International NIR Workshop, Edinburgh, UK, May 2012.

Israel M, Tschobanoff P. Exposure to non-Ionizing radiation of personnel in physiotherapy. In: Ayropetyan SN, Markov MS (Eds). Bioelectromagnetics Current Concepts. Springer 2006, pp. 367–376.

Vesselinova L. Electromagnetic fields in clinical practice of physical and rehabilitation medicine: a health hazard assessment of personnel. Environmentalist 2012; 32: 249–255.

Tzima E, Martin CJ. An evaluation of safe practices to restrict exposure to electric and magnetic fields from therapeutic and surgical diathermy equipment. Physiol Meas 1994; 15: pp 201–216.

Scandurra G. [Levels of the electromagnetic field in the vicinity of therapeutic devices using radiofrequency and microwaves] [Article in Italian]. Med Lav 1989; 80(4): 335–340.

Martin CJ, McCallum HM, Strelley S, et al. Electromagnetic fields from therapeutic diathermy equipment: a review of hazards and precautions. Physiotherapy 1991; 77: 3–7.

Bolte JFB, Pruppers MJM. Electromagnetic fields in the working environment, Ministry of Social Affairs and Employment (SZW) and National Institute for Public Health and the Environment RIVM 2006, no. 610015001. https://www.rivm.nl/bibliotheek/rapporten/6610015001;2006.

Casciardi S, Rossi P, Campanella F. Inquinamento elettromagnetico nei reparti di terapia fisica: rilievi sperimentali e interventi di bonifica “dBA ’98 – Dal rumore ai rischi fisici. Valutazione, prevenzione e bonifica in ambiente di lavoro”. Modena 17–19 September 1998, pp 917–926.

Grandi C, Iavicoli S, Molinaro V, et al. Problematiche di particolare interesse riguardanti la tutela dei lavoratori esposti a rischi di tipo fisico in ambiente sanitario. Prevenzione Oggi 2001; 13: 3–44.

Shields N, O’ Hare N, Gormely J. An evaluation of safety guidelines to restrict exposure to stray radiofrequency radiation from short-wave diathermy units. Phys Med Biol 2004; 49: 2999–3015.

Macca I, Scapellato ML, Carrieri M, et al. Occupational exposure to electromagnetic fields in physiotherapy departments. Radiat Prot Dosimetry 2008; 128(2): 180-190.

Di Nallo AM, Strigari L, Giliberti C, et al. Monitoring of people and workers exposure to the electric, magnetic and electromagnetic fields in an Italian national cancer Institute. J Exp Clin Cancer Res 2008; 27(1): 16.

Anguera M, Gianini R. Prevalence of fatigue reported by physiotherapists operating diathermy equipment for microwave. Rev Bras Epidemiol 2014;17(3): 577-581.

Andrikopoulos A, Adamopoulos A, Seimenis I, et al. Microwave diathermy in physiotherapy units: a survey on spatial and time heterogeneity of the electromagnetic field. J Radiol Prot 2017; 37(2): N27-N41.

Sarwar Shah SG, Farrow A. Assessment of physiotherapists’ occupational exposure to radiofrequency electromagnetic fields from shortwave and microwave diathermy devices: A literature review. J Occup Environ Hyg 2013; 10(6): 312-327.

Karpowicz J, Gryz K. An assessment of hazards caused by electromagnetic interaction on humans present near short-wave physiotherapeutic devices of various types including hazards for users of Electronic Active Implantable Medical Devices (AIMD). Biomed Res Int 2013; 2013:150143.

Iskra S, McKenzie R, Cosic I. Factors influencing uncertainty in measurement of electric fields close to the body in personal RF dosimetry. Radiat Prot Dosimetry 2010; 140(1): 25-33.

DOI: http://dx.doi.org/10.36162/hjr.v5i2.334


  • There are currently no refbacks.