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Background In recent years, radiofrequency electromagnetic fields (RF-EMF) exposure has increased owing to new communication technologies. Simultaneously, increased exposure to RF-EMF has led to society's growing concern about the possible effects they may have on human health. Many studies have described personal RF-EMF exposure by using personal exposimeters to know a population's daily exposure to mobile phone base stations and to other sources whose installations tend to be permanent. Nonetheless during special events like concerts or fairs, where many people gather, permanent installations might not suffice to cover demand. So telephone companies install temporary stations for these events, and modify the exposure pattern of these areas or populations. Objective To study if installing temporary antennae for large events, and high concentrations of mobile phones, modify the exposure pattern compared to usual situations. Methods Personal RF-EMF exposure from mobile phones (uplink) and mobile phone base stations (downlink) installed at the 2017 Albacete Fair (Spain) was recorded. Between 7 and 17 September, more than 2,500,000 people visited this Fair. Measurements were taken by two Satimo EME SPY 140 personal exposimeters, placed one each side of a research team member's waist. These exposimeters were programmed to take measurements every 4 s at different time of day; morning, afternoon and night; and in several places, around the Fair Enclosure (zones Ejidos and Paseo) and inside the enclosure (Interior). These measurements were repeated on a weekday, at the weekend and the day after the Fair ended after temporary base stations had been removed. They were also taken for 1 h in all three zones, for each time of day; that is, 9 h were recorded for each study day. Results The mean RF-EMF recorded exposure from base stations (downlink-DL) on the days the Fair opened (morning, afternoon and night) for the three studied zones was 791.8 μW/m2, while the exposure produced by mobile phones (uplink-UL) was 59.0 μW/m2. These values were 391.2 μW/m2 (DL) and 10.3 μW/m2 (UL) a few days after the event ended. In study zones Ejidos and Paseo, both outside, the highest mean exposure was recorded at the weekend as 1494.1 and 848.1 μW/m2 respectively. For the Interior zone, the mean value recorded during the Fair was 354.8 μW/m2. These values contrast with those recorded in the three zones after the event ended: 556.37 (Ejidos), 144.1 (Paseo); 473.21 μW/m2 (Interior). The fact that the mean exposure recorded at Interior was slightly higher after the Fair could be due to signal shielding by so many people. The reduction in exposure in Paseo after the Fair was outstanding, probably due to the antennae being placed on low towers. Major differences were also found in the RF-EMF exposure from UL. In this case, the weekend values taken during the Fair were between 28.2 μW/m2 at Interior (weekday) and 98.1 μW/m2 at Ejidos (weekend), which dropped to 5.5 at Paseo after the Fair, to 11.7 μW/m2 at Interior and to 13.6 μW/m2 at Ejidos. Conclusions Installing mobile phone base stations, and a dense public using mobile phones, imply a significant increase in personal RF-EMF exposure compared to that recorded during normal periods in the same area. However, the recorded measurements were below legally established limits.

SARS-CoV-2 is a new coronavirus that has caused a worldwide pandemic. It causes severe acute respiratory syndrome (COVID-19), which is fatal in many cases, and is characterized by a cytokine release syndrome (CRS). Great efforts are currently being made to block the signal transduction pathway of pro-inflammatory cytokines in order to control this "cytokine storm" and rescue severely affected patients. Consequently, possible treatments for cytokine-mediated hyperinflammation, preferably within approved safe therapies, are urgently being researched to reduce rising mortality. One approach to inhibit proinflammatory cytokine release is to activate the cholinergic anti-inflammatory pathway through nicotinic acetylcholine receptors (α7nAchR). Nicotine, an exogenous α7nAchR agonist, is clinically used in ulcerative colitis to counteract inflammation. We have found epidemiological evidence, based on recent clinical SARS-CoV-2 studies in China, that suggest that smokers are statistically less likely to be hospitalized. In conclusion, our hypothesis proposes that nicotine could constitute a novel potential CRS therapy in severe SARS-CoV-2 patients.

We live in a global pandemic caused by the COVID-19 disease where severe social distancing measures are necessary. Some of these measures have been taken into account by the administrative boundaries within cities (neighborhoods, postal districts, etc.). However, considering only administrative boundaries in decision making can prove imprecise, and could have consequences when it comes to taking effective measures. To solve the described problems, we present an epidemiological study that proposes using spatial point patterns to delimit spatial units of analysis based on the highest local incidence of hospitalisations instead of administrative limits during the first COVID-19 wave. For this purpose, the 579 addresses of the cases hospitalised between March 3 and April 6, 2020, in Albacete (Spain), and the addresses of the random sample of 383 controls from the Inhabitants Register of the city of Albacete, were georeferenced. The risk ratio in those hospitalised for COVID-19 was compatible with the constant risk ratio in Albacete (p = 0.49), but areas with a significantly higher risk were found and coincided with those with greater economic inequality (Gini Index). Moreover, two districts had areas with a significantly high incidence that were masked by others with a significantly low incidence. In conclusion, taking measures conditioned exclusively by administrative limits in a pandemic can cause problems caused by managing entire districts with lax measures despite having interior areas with high significant incidences. In a pandemic context, georeferencing disease cases in real time and spatially comparing them to updated random population controls to automatically and accurately detect areas with significant incidences are suggested. This would facilitate decision making, which must be fast and accurate in these situations.

Simultaneously with the increase of Radiofrequency Electromagnetic Fields (RF-EMF) in recent decades, there has been increasing concern about their potential relation with the etiology of several tumors. At this time, the techniques of spatial data analysis jointly with the study of the personal exposure to these fields offer a new approach to the problem. This paper presents the results of a preliminary epidemiological study, combining Epidemiology, Statistics and Geographical Information Systems (GIS), in which we analyzed the correlation between exposure to RF-EMF in the city of Albacete (166,000 inhabitants, southeast Spain) and the incidence of several cancers with unspecific causes (lymphomas, and brain tumors). We used statistical tools to analyze the spatial point patterns and aggregate data with the aim to study the spatial randomness and to determine the zones with the highest incidence from 95 tumors studied (65 lymphomas, 12 gliomas and 18 meningiomas). We also perform a correlation (Spearman) study between the personal exposure to RF-EMF in 14 frequency bands, recorded by an EME Spy 140 (Satimo) exposimeter in the city's administrative regions, and the incidence of the tumors registered from January 2012 to May 2015. The studied cancer cases have a random spatial distribution inside the city. On the other hand, and by means of an ecological study, we verified that the exposure to RF-EMF registered in the city of Albacete shows little correlation with the incidence of the studied tumors (gliomas (ρ = 0.15), meningiomas (ρ = 0.19) and lymphomas (ρ = − 0.03)). The proposed methodology inaugurates an unexplored analysis path in this field.

Several studies have characterized personal exposure to RF-EMF, which allows possible effects on health to be studied. All equipment has a detection limit, below which we obtain nondetects or censored data. This problem is a challenge for researchers as it makes the analysis of such data complex. We suggest reconsidering the statistical protocols of the nondetects analysis by comparing four different methods. Three of them substitute censored data using different approaches: regression on order of statistics (ROS) to simulate data below the detection limit (Method 1), substituting nondetect values by the detection limit divided by 2 (Method 2), a naïve calculation (Method 3) using the detection limit as a valid measurement. The fourth method consists of considering censored data to be missing values (Method 4). This article examines how these methods affect the quantification of personal exposure. We considered data from 14 frequency bands from FM to WiMax measured in Albacete (Spain) for 76 days every 10 s by a personal exposimeter (PEM) Satimo EME Spy 140.Methods 3 and 2 gave similar mean and median values to Method 1, but both underestimated the mean values when high nondetects records occurred, which conditioned the physical description of the real situation. The mean values calculated by Method 4 differed from those obtained by Method 1 but were similar when the percentage of nondetects was below 20%.Our comparison suggests that nondetects can be neglected when the percentage of censored data is low to provide a more realistic physical situation.

In recent years, numerous epidemiological studies, which deal with the potential effects of mobile phone antennas on health, have almost exclusively focused on their distance to mobile phone base stations. Although it is known that this is not the best approach to the problem, this situation occurs due to the numerous difficulties when determining the personal exposure to the radiofrequency electromagnetic fields (RF-EMF). However, due to the rise of personal exposimeters, the evolution of spatial statistics, the development of geographical information systems and the use of powerful software, new alternatives are available to deal with these epidemiological studies and thus overcome the aforementioned difficulties. Using these tools, this paper presents a lattice map of personal RF-EMF exposure from exterior mobile phone base stations, covering the entire 110 administrative regions in the city of Albacete (Spain). For this purpose, we used a personal exposimeter, Satimo EME Spy 140 model, performing measurements every 4s The exposimeter was located inside the plastic basket of a bicycle, whose versatility permitted the access to all the zones of the city. Once the exposure map was prepared, its relation with the known antenna locations was studied. The 64 mobile telephone antennas of the city were also georeferenced; the randomness of both variables (exposure and antennas) were studied by means of the Moran's I test. Results showed that the distribution of the antennas follows a grouped pattern (p

This is a reply to the comment by Ivan Berlin and Daniel Thomas on our recently published work [...]