Hachulla, Caulier-Leleu, Fontaine, Mehianoui, Pelerin (12/7/02)

"Pseudo-iron deficiency in a French population living near high-voltage transmission lines: a dilemma for clinicians"

Tramès per Miguel Muntané

Estudio Francés que observa un extraño estado de la sangre (deficiencia pseudo-hierro) que fue aparentemente asociada con residencia prolongada a exposiciones de 2 miliGauss (= 0,2 uT) y más

---- Mensaje original -----
De: "Don Maisch" <yahoo@emfacts.com>
Para: <emfacts@yahoogroups.com.au>
Enviado: Jueves, 11 de Julio de 2002 02:57 a.m.
Asunto: [emfacts] (Message # 252) "Pseudo Iron Deficiency" as a possiblemarker for ELF/EMF exposure

The following is taken from a report I compiled last year about a French study that observed an unusual blood condition (pseudo iron
deficiency) that was apparently associated with prolonged residential exposures of 2 milliGauss (= 0.2 uT) and more.

I have given a copy of the report to a Melbourne diagnostic laboratory and they can easily test for the condition with a blood
sample. What is especially of interest is that the possibility exists that this condition may be a "marker" for ill health resulting from
prolonged EMF exposure.

Inquiries made as to why the people in question were being sent to the hospital revealed symptoms of CFS.

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"Pseudo-iron deficiency in a French population living near high-voltage transmission lines: a dilemma for clinicians"
by Eric Hachulla, Marie-ThÇräse Caulier-Leleu, Odile Fontaine, Lofti Mehianoui, Paul Pelerin

European Journal of Internal Medicine, Volume (issue): 11 (6) 2000 (pp 351 -- 352)

The observation during the years 1993-1994 of an unexplained iron deficiency in a number of patients from the same small, northern French village (Coutiches, 50 31' latitude north and 3 15' lontitude east, altitude 24-31m: a dormatory suburb of a large nearby conurbation) [1] prompted us to evaluate the iron profile and iron metabolism in subjects from this village who live in proximity to
high-voltage (2x400kV) 50-60 Hz transmission lines.

A Mag check 50+ and a matrix MX 52 multimeter were used to measure electromagnetic field (EMF) levels at 50 Hz. At 1.50 m overhead, EMF levels varied from 4.8 uT (48 mG) under the lines to 0.2 uT (2 mG) at 100m from the lines.

A total of 15/31 men (48.4%) (P<0.05 compared with controles), and 13/34 women (38.2%) had a low iron level but none had anemia. While none of the male subjects had a low ferritin level, 7/34 women (20.6%) did. Among the 13/34 women with a low iron level, only three had a low ferritin level (15/31 men (48.4%) and 10/34 women (29.4%) had a low iron level, but no anemia and normal ferritin level; P<0.05 compared with control, respectively). These results were much higher than those normally observed in the general population, i.e. the prevalence of iron deficiency is usually less than 25% in women and less than 5% in men [2-4].

Four male inhabitants with typical low iron levels and normal ferritin levels had a myelogram. Cell distribution was normal and the percentage of erythroblasts without iron granules was 56, 68, 73 and 87%, respectively. In two cases, iron in macrophage was absent.

Three of the males described above had isotopic explorations (more details of the method in Ref.[5] ). We found a high red cell 59Fe
incorporation in all cases (85, 85, and 95% respectively: normal 65-75%) with a fast injected plasma 59 Fe epuration in one case (T=65 min. normal:110-120 min). The red cell half-life was normal in all three cases (25, 26.5, and 28 days, respectively). Plasma iron clearance was normal in all cases ( 65, 80, and 115 min, respectively; normal: 60-140 min). In three cases (surface counting), a fast 59Fe bone marrow incorporation with a fast regression of radioactivity was observed. In one case, no liver radioactivity was found; in the two other cases, only a minute amount of radioactivity was observed in the liver. 59Fe uptake studies were similar to those of 'classic' iron deficiency but with normal ferritin levels, which is normally the first biological marker to decrease.

The diminution of iron levels may have been due to the intensity of the EMFs but also to the cumulative dose and to the number of hours of exposure per day. We also observed individual susceptibility, as a low iron level was not observed in all of the members of the same family, and in the same individuals the iron level varied during this time. This is not unique to the Coutiches population. Since the beginning of this study we have seen other subjects who live in proximity to high-voltage lines (e.g. in Bolezeele, another northern French village) with sometimes the same iron profile in the population near the EMFs.

We speculate that EMFs may modify iron metabolism in populations subjected to 0.2 uT (2 mG) or more with a high bome marrow incorporation of the iron (that would explain the low iron level) and a rapid utilization for the metabolism of hemoglobin, sometimes with non-incorporation of 59Fe in the liver. There is currently no data about modification of iron metabolism in patients living near EMFs. These spurious results plead for a larger study to confirm our observations.

Acknowledgements

We are grateful to J.M. Provincial and the Comite' des Riverains SOS Environment of Coutiches for their technical assistence. We thank Dr. J.J. Huart for providing the control group, Dr. Th. Perez for statistical advice, Dr. J. Kerr-Conte of the Laboratoire de Culture Cellulaire, Faculte' de Medecine de Lille and R. Medeiros, English professor from the medical university of Rouen for the English translation and corrections, and M. Tomezak for typing the manuscript.

References

[1] Santini R. Presentation de cas particuliers. In: Notre sante face aux champs electriques et magnetiques. Des faits scientifiques aux conscils pratiques. Sully Eds. 1995. p. 81.

[2] Expert Scientific Working Group. Summary of a report on assessment of the iron nutritional status of the United States population. Am J Clin Nutr 1984; 42:1318.

[3] Galen P, Yoon HC, Preziosi P, Viteri F, Valeix P, Fietix B et al. Determining factors in the iron status of adult women in the SUVLMAX study. Supplementation en vitamines et mineraux antioxydants. Eur J Clin Nutr 1998; 52: 383-8.

[4] US Department of Health and Human Services. Hematological and nutritional biochemistry reference data for persons 6 months - 74 years of age: United States. 1976-80. Vital Health Series 1982; 232:173.

[5] Patterson KG, Richards JDM, The use of radioisotopes in haematology. Blood Rev 1992; 6:1-9.

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Dr. Hachulla's oral presentation at the conference,"Biological and medical effects of high tension electrical equipment", held at Assemblee Nationale (French Congress), Paris, March 26, 1999.

Transcript by Jean-Pierre Lentin

"Here are some basics in order to understand what we have found. Humans have approximately 30 grams of iron in their body. There are 2 methods for evaluating iron stocks in the organism. The indirect method measures seric iron (iron in blood). Many of you must have had a seric iron control. It is well known that seric iron is often diminished in women with abundant menstruation. This can be a direct sign of iron deficiency, but it's a crude indication, because there are many individual variations. There is another method that is more elegant and interesting for demonstrating an iron deficiency. Here we measure the increase of a protein that transports iron, called siderophilin or transferrin. And another method for measuring iron stocks more precisely is dosing ferritinemia. When you have diminished seric iron and an iron deficiency is suspected, one measures ferritinemia in order to know whether it's a real iron deficiency.

In the blood plasma, iron is transported on a protein called transferrin. The normal destiny of iron is to enter the haeme which will, in the blood marrow, permit the making of haemoglobin, which is a structure in the red cell that carries oxygen towards the tissues. The destiny of the red cells is that they get old and die in the reticulo-endothelial system, notably the macrophage system, and notably in the spleen. We have iron stocks because all our iron is not circulating. These stocks are located in several places, and they are notably evident through ferritinemia. In normal conditions iron is transported by transferrin and this transferrin is saturated by one third. When there is an iron deficiency, the organism increases hepatic production of transferrin, so there will be more transferrin, but there is not enough iron to transport. In the true deficiency transferrin is increased, and also transferrin's transport capacity, with more binding sites, but still we have decreased seric iron.

I am a clinician in internal medicine and I was astonished, in 1996 - 1997, by the arrival to my consultation of several people who had strange seric assays, that were done in other labs in town and confirmed by our own lab, with perturbations that I could not explain. The first one was a little girl. At first I did not take it seriously, I thought it was a lab error or an individual variation. Then there were 4 men, with decreased seric iron, which is rare in men, and they had no anaemia, haemoglobin rate was normal, iron stocks were normal, ferritinemia was normal. But these 4 patients had also increased levels of transferrin, so they appeared to have iron deficiency, but really there was no deficiency, and this corresponded to nothing known.

As I am curious as a clinician, I wondered why they had this biological profile, and I found they were all living in the same village, Coutiches. So I went there. It's close to Douai, not very far from Lille. Since 1991 there are high tension lines, of 2 x 400 000 volts. The village has approximately 2000 inhabitants, altitude varies from 24 to 31 meters. Some houses are right under the lines. Measures of EM fields have been done repeatedly. Here are the measures taken on 15th of July, 1996, at 11 PM. Right under the line we have 50 mG (milliGauss), at 100 m from the line it goes down to 2 mG. These levels vary very little from day to day, we have 20 % variations - we know that thanks to measures done regularly by the association Environnement-Coutiches.

In order to try to understand, we took biological samples, with their consent, from 31 men, 34 women and 26 children, all living in
Coutiches, less than 200 m from the lines. No woman was pregnant, nobody took iron supplementation, no one had an inflammatory syndrome - those are interference causes. Each person was living at least 8 hours in this perimeter. Then we made up a control population, with the help of Lille blood transfusion center, people who were recent blood donors, matched in age and gender.

Here are the first results. People with decreased seric iron : men, 48,4 %, women, 38,2 %, children, 34 %. In the control population, it was 20 % for women and 15 % for men. Nobody had anaemia, according to haemoglobin levels. Seric iron rates in men varied from 33 to 82, where the normal rate is above 90. For women rates were 40 to 63, normal rate being above 70. The normal rate of transferrin in our lab is 350. But here this rate was increased, both in men and women. It was as if the organism sought to compensate a lack by increasing hepatic synthesis of this iron-carrying protein. Ferritinemia was normal for average values, and even for extreme values, no man had a low ferritinemia, so no man had true iron deficiency. 3 women out of 13 had low ferritinemia, and 1 child out of 9. So we found, on a larger scale, what we had found with the first 4 patients. Even if it is a small population sample, we see a distinct tendancy. I tried to figure if these modifications might be linked to intensity of EM fields. I separated the people living less than 60 m from the line, from those living farther. At less than 60 m, iron level, in the global population, is slightly lower, and so is ferritinemia. Binding capacity of the protein is slightly higher. There is no increase of haemoglobin levels. These variations are not statistically significant, the sample is too small, we need a bigger sample. On haemoglobin levels, there is a trend towards inverse correlation with distance from the line. Nearer to the line, levels appear higher. You will understand why later.

Levels of seric iron, in the adult population of Coutiches, compared to control population, have very significant differences. Average is 85 for Coutiches residents and 107 for control population. Also the proportion : 15 out of 31 men had decreased levels in Coutiches, 5 out of 31 for controls. For women the difference is not significant, but it exists : 13 women out of 34 in Coutiches, 7 out of 34 in controls. For a decreased seric iron level with normal ferritinemia, we have 15 men out of 31 in Coutiches, 2 out of 31 in controls. This is highly significant, and it's also significant for women. We have here a typical profile of people exposed to EM fields. Why does it also appear in a small number of controls? Maybe because they are also exposed to one of the many EM sources in the environment.

In order to explain that, we had to search if there was a modification in iron metabolism. So we had to study bone marrow. We took sternal samples from 4 people, and we did an isotopic exploration of radioactive iron, in order to follow the iron metabolism and the path of iron through the organism. 3 people took this test, which is very long, they had to go daily at the hospital. On myograms, their marrow is normally rich, but, astonishingly, poor in iron. Incorporation of radioactive iron injected through the veins in the marrow is rapid and almost complete - in a normal person, incorporation is rarely more than 60 or 80 %. And we did an external count of radioactivity of Fe59 injected in the organism, we sawthat iron is very rapidly incorporated in bone, where haemoglobin synthesis takes place, then very quickly evacuated from the bone. Also, probably, red cells are rapidly ejected by the bone marrow. Iron, which is normally stocked in the liver and spleen, is depleted and rapidly evacuated by normal stocking organs. And after 6 days there is nothing left. This kind of profile is exactly the profile of iron deficiency, But there is no deficiency, since ferritinemia is normal.

Our working hypothesis is that there is probably a displacement of iron from some part of the organism to others, in order to have a
rapid synthesis of haeme and haemoglobin, and this may explain that, nearer to the HT line, there is higher haemoglobin levels. This is probably linked to EM fields intensity and cumulative doses. Clearly, there are individual susceptibilities. We also observed that the iron parameters would return to normal when people moved from the exposed residence, and it took several months. And this is not a "Coutiches effect", because we observed the same thing with residents of Bolezeele. "

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Summary by Jean-Pierre Lentin < jplentin@club-internet.fr >

Coutiches is a village near Lille, in the North of France, situated right under a big HT line (2 x 400 kV). It was a famous case in the early 1990s, with lots of citizen protests, media reports, court cases, some medical studies - all to no avail. No health risk was acknowledged, most inhabitants eventually left, EDF (Electricite de France, the national grid company) bought the houses, many of them are empty now...

In 1991, an agreement was reached with EDF (Electricite de France), the national power company. A regular medical follow-up of residents would be financed by EDF, on 117 residents, having a check-up and blood analysis every 6 months. Pr Paul Pelerin, from Lille General Hospital, headed the medical team.

Initial findings:

The first findings were presented at Assemblee Nationale in 1994. Along with the symptoms below, iron deficiency (ferritinemia) was
found from regular blood analysis. ( Now the new research, with more precise and thorough analysis, shows it's a "pseudo-deficiency").

Reported symptoms were :

- general tiredness (chronic fatigue)
- headaches
- insomnia, especially in children
- hypernervosity
- hypotension
- iron deficiency ( since identified as pseudo iron deficiency)
- 2 cases of severe anxiety /depression
- one resident died from bone marrow cancer in September 1992
- nausea and dizziness
- vision / ocular troubles

It was also noted that insomnia would disappear when the power was lower than usual, and return when the power got back to full level. The children often could not sleep at all, so often they were sent to grandparents' or relatives' homes, where they would sleep normally.

Current findings:

Dr Hachulla originally got involved by "chance" in 1994-95. Working in a big hospital in Lille, he noticed that several patients who came for blood analysis had very unusual parameters - and they were all living in Coutiches under the lines. Eventually a thorough follow up study was financed, on 15 men and 13 women, plus 31 male and 34 female controls (people also living in Coutiches but farther from the HT lines). There was repeated blood analysis, myelograms, isotopic explorations (and of course meausurements of fields levels). The results, despite individual variations, show clearly that most of the people living under the line have a "iron pseudo-deficiency". I.e. they have low iron levels in the blood, but no symptoms of anemia and no decrease of ferritin, which normally goes with iron deficiency.

Conclusion: "We speculate that EMFs may modify iron metabolism in populations subjected to 0,2 microTeslas (2 mG) or more, with a high bone marrow incorporation of the iron (that would explain the low iron level) and a rapid utilization for the metabolism of hemoglobin, sometimes with non-incorporation of (39)Fe in the liver."

At the symposium, Dr Hachulla commented that this peculiar syndrome is unknown in medical records, and that one does not know at this point what are the consequences on health and whether this effect could be detrimental or lead to other symptoms linked with EMF. But it is apparently the first time that an "objective", measurable bio-chemical effect is clearly and unmistakably shown in people living under HT lines.

In a private conversation, Dr Hachulla also told me that he expects his results will be severely criticized by EDF-appointed experts... But he is convinced his data are very robust and will stand the future trials.