The safe administration of medication within the electromagnetic scenarios of the Internet of Things (IoT): looking towards the future

This paper has focused on analyzing the impact of Information and Communication Technologies (ICTs) to prevent or reduce errors during therapeutic drug administration. The methodology used has included scientific literature and marketed appliances reviews and laboratory tests on radiant devices. The role of the patient has been analyzed, both in terms of compliance with the prescribed treatments and user of technical solutions designed for administering medication. In addition, it has taken into account, how a future characterized by multiple technologies designed to support our daily routines, including health care, might affect the current model of relationship between health professionals and patients. Particular attention has been given to safety risks of ICTs in environments characterized by concurrent electromagnetic emissions operating at different frequencies. Implications and new scenarios from Internet of Things or IoT, have been considered, in light of the approach taken jointly by the European Commission and the European Technology Platform on Intelligent Systems Integration – EPoSS, in their 2008 report Internet of Things in 2020: a roadmap for the future, and how the concept has evolved since then.Chapter 1. Adverse drug events. Chapter 2. ICTs in everyday life and healthcare. Chapter 3. the challenge of electromagnetic safety. Chapter 4. ICTs in health care and in the prevention of medication errors: IoT. Chapter 5. A more effective and safer alternative approach. Chapter 6. Technological proposal 7. Conclusions.N

Compatibilidad electromagnética y seguridad en aplicaciones de redes personales sin hilos para biotelemetría.

Esta tesis está centrada en el estudio electromagnético de los domicilios urbanos teniendo en cuenta el interés creciente en la implementación de sistemas de telemedicina para aplicaciones de atención domiciliaria para pacientes crónicos y población mayor. Una de las mejoras en la portabilidad de los sistemas de monitonzación ambulatoria es por medio de sensores acoplados al cuerpo con dispositivos de telemetría inalámbricos. Esto libera al usuario de la necesidad de transportar el dispositivos de almacenamiento de datos. En estos tipos de sistemas de telemetría, es probable que coexistan un gran número de dispositivos con enlaces inalámbricos en el mismo área compartiendo el espectro electromagnético. Las Interferencias Electromagnéticas (EMI) pueden ser un problema serio para cualquier dispositivo electrónico, pero en el caso de los dispositivos médicos, las consecuencias pueden ser vitales Se presentan una serie de normativas relativas a la exposición humana a campos electromagnéticos, a la compatibilidad electromagnética de dispositivos electromédicos y de equipos de radiocomunicaciones. Sin embargo, esta regulación no comprende los escenarios de las aplicaciones de telemedicina domiciliaria emergentes. Así mismo, es escasa la información sobre medidas de entomos electromagnéticos en domicilios y sobre temas de telemedicina. La investigación ha estado dirigida a la caracterización electromagnética presente en los domicilios urbanos con la finalidad de analizar el uso seguro de sistemas de telemedicina domiciliaria. Se han llevado a cabo medidas en 46 domicilios confonne a la norma ICNTRP-98 y 56registros en un mismo domicilio durante un largo período de tiempo. Así mismo, se han comprobado las características de radiación de los equipos domésticos electrónicos más frecuentes para analizar el potencial riesgo creado y los posibles fallos de funcionamiento conforme a las normas europeas existentes.Los trabajos desarrollados en esta Tesis han sido soportados por el Instituto de Salud Carlos III mediante la beca BISCIIH con número de Expediente 00/0011, así como por el Proyecto AIRMED2 en colaboración con la Fundación Vodafone, en el Área de Telemedicina y Sociedad de la Información, dirigida por el Dr. José Luís Monteagudo y perteneciente a la Unidad de Coordinación de Informática SanitariaS

Seguridad electromagnética en telemedicina

Precede al tít.: Área de Investigación en Telemedicina y Sociedad de la InformaciónUna de las mejoras en la portabilidad de los sistemas de monitorización ambulatoria es por medio de sensores acoplados al cuerpo con dispositivos de telemetría inalámbricos. Esto libera al usuario de la necesidad de transportar el dispositivos de almacenamiento de datos. En estos tipos de sistemas de telemetría, es probable que coexistan un gran número de dispositivos con enlaces inalámbricos en el mismo área compartiendo el espectro electromagnético. Las Interferencias Electromagnéticas (EMI) pueden ser un problema serio para cualquier dispositivo electrónico, pero en el caso de los dispositivos médicos, las consecuencias pueden ser vitales. Esta investigación está centrada en el estudio electromagnético de los domicilios urbanos teniendo en cuenta el interés creciente en la implementación de sistemas de telemedicina para aplicaciones de atención domiciliaria para pacientes crónicos y población mayor.JUSTIFICACIÓN Y OBJETIVOS: Objetivos, Antecedentes, Marco de la investigación, La Telemetría desde el hogar, La cuestión de las interferencias, Consideraciones previas, Proliferación de incidentes originados por ellas, Actividades reguladoras y normativa, Normativa relativa a la exposición del público, Normativa relativa a equipos de radiocomunicación ETSI e IEEE, Normativa relativa a equipos de radiocomunicación AENOR, Normativa relativa a productos sanitarios Disposiciones internacionales sobre biotelemetría, Normativa sobre seguridad y emisiones radioeléctricas de algunos, Ley 32/2003 General de Telecomunicaciones. MATERIAL Y MÉTODOS: Metodología de estudio, Configuración del ensayo, Relación entre los diferentes niveles y límites, Protocolo de medidas, Procedimiento para el análisis del entorno electromagnético de la Instrumentación, Elección del espacio muestral, Descripción de las medidas a realizar, Caracterización del entorno radioeléctrico de los domicilios, Medidas de niveles conforme a la norma ICNIRP-98, Medidas de niveles en dispositivos en condiciones de campo cercano. RESULTADOS: Niveles de exposición espaciales y temporales, Resultados obtenidos en los 46 domicilios, Resultados obtenidos en Ardemans, 41, Análisis de resultados, Análisis de los resultados obtenidos en los domicilios, Análisis de los resultados obtenidos en Ardemans, 41, Análisis de los niveles procedentes de los dispositivos domésticos, Resumen, Mapas, Resultados adicionales. DISCUSIÓN: Seguridad para pacientes y para la aplicación, Prevención Protección de la información, Perspectivas de investigación futuras. CONCLUSIONES. BIBLIOGRAFÍA / REFERENCIAS. APÉNDICE

Responses to Comments on Assessment of Polarization Dependence of Body Shadow Effect on Dosimetry Measurements in the 2.4 GHz Band

When the personal exposimeter (PEM) is worn by the user, in non-line of sight conditions, the electric field (E-field) measured has three contributions: (1) propagation through the human body; (2) contribution travelling around the human body; (3) and reflexions from the environment. Second, another component of the E-field measured by the PEM is the trapped surface wave signals around the body. Third, in indoor environments, electromagnetic waves are composed of specular and diffuse components.Sub-Directorate-General for Research Assessment and Promotion (Carlos III Health Institute) for the project “Electromagnetic Characterization in Smart Environments of Healthcare, and their involvement in Personal, Occupational, and Environmental Health”; grant number: DGPY-1285/15 (PI14CIII/ 00056); Human resources of the project “Assessment of Exposure to NonIonizing Radiation from Wireless Communication Technologies and its Relation to the Health of Humans”; grant number: DGPY-1064/13 (CA12/00038)S

An Evaluation of Electromagnetic Exposure While Using Ultra-High Frequency Radiofrequency Identification (UHF RFID) Guns

The aim is to evaluate specific absorption rate (SAR) values from exposure near handheld ultra-high frequency radiofrequency identification readers (UHF RFID guns-small electronic devices, or even portable computers with relevant accessories-emitting up to several watts of electromagnetic field (EMF) to search for RFID sensors (tags) attached to marked objects), in order to test the hypothesis that they have an insignificant environmental influence. Simulations of SAR in adult male and female models in seven exposure scenarios (gun near the head, arm, chest, hip/thigh of the operator searching for tags, or near to the chest and arm of the scanned person or a bystander). The results showed EMF exposure compliant with SAR limits for general public exposure (ICNIRP/European Recommendation 1999/519/EC) at emissions up to 1 W (reading range 3.5-11 m, depending on tag sensitivity). In the worst-case scenario, guns with a reading range exceeding 5 m (>2 W emission) may cause an SAR exceeding the general public limits in the palm of the user and the torso of the user, a bystander, or a scanned person; occupational exposure limits may be exceeded when emission >5 W. Users of electronic medical implants and pregnant women should be treated as individuals at particular risk in close proximity to guns, even at emissions of 1 W. Only UHF RFID guns emitting below 1 W may be considered as environmentally insignificant EMF sources.Results of a research task (II.N.18) carried out within the National Programme “Improvement of safety and working conditions” partly supported in Poland in 2017–2019—within the scope of research and development—by the Ministry of Science and Higher Education/National Centre for Research and Development (Central Institute for Labour Protection—National Research Institute was the Programme’s main co-ordinator) and by the project ‘Electromagnetic Characterisation in Smart Environments of Healthcare and their involvement in Personnel. Occupational and Environmental Health’ (PI14CIII/00056) funding from Sub-Directorate-General for Research Assessment and Promotion in Spain (Instituto de Salud Carlos III).S

Modelling and Evaluation of the Absorption of the 866 MHz Electromagnetic Field in Humans Exposed near to Fixed I-RFID Readers Used in Medical RTLS or to Monitor PPE

The aim of this study was to model and evaluate the Specific Energy Absorption Rate (SAR) values in humans in proximity to fixed multi-antenna I-RFID readers of passive tags under various scenarios mimicking exposure when they are incorporated in Real-Time Location Systems (RTLS), or used to monitor Personal Protective Equipment (PPE). The sources of the electromagnetic field (EMF) in the modelled readers were rectangular microstrip antennas at a resonance frequency in free space of 866 MHz from the ultra-high frequency (UHF) RFID frequency range of 865-868 MHz. The obtained results of numerical modelling showed that the SAR values in the body 5 cm away from the UHF RFID readers need consideration with respect to exposure limits set by international guidelines to prevent adverse thermal effects of exposure to EMF: when the effective radiated power exceeds 5.5 W with respect to the general public/unrestricted environments exposure limits, and with respect to occupational/restricted environments exposure limits, when the effective radiated power exceeds 27.5 W.Results of a research tasks (II.PB.15, II.N.19) carried out within the National Programme “Improvement of safety and working conditions” partly supported in Poland in 2017–2019 and 2020–2022—within the scope of research and development—by the Ministry of Science and Higher Education/National Centre for Research and Development (Central Institute for Labour Protection—National Research Institute was the Programme’s main co-ordinator); grant ‘Architecture for Scalable, Self-human-centric, Intelligent, Secure, and Tactile next generation IoT’ (957258–ASSIST-IoT) funding from the European’s Union Horizon 2020 research innovation programme and the project ‘Electromagnetic Characterisation in Smart Environments of Healthcare and their involvement in Personnel. Occupational and Environmental Health’ (PI14CIII/00056) funding from Sub-Directorate-General for Research Assessment and Promotion in Spain (Instituto de Salud Carlos III).S

Modelling the Influence of the 2.4 GHz Electromagnetic Field on the User of a Wearable Internet of Things (IoT) Device for Monitoring Hazards in the Work Environment

The aim was to test the hypothesis that there is an insignificant influence on humans from the absorption of an 2.4 GHz electromagnetic field (EMF) emitted by wearable Internet of Things (IoT) devices (using Meandered Inverted-F Antenna (MIFA) for Wi-Fi and Bluetooth technologies) for monitoring hazards in the work environment. To quantify problem, the specific energy absorption rate (SAR) was calculated in a multi-layer ellipsoidal model of the IoT device user’s head exposed to EMF from MIFA attached to a headband or to a helmet. SAR values may be significant when a modelled IoT wearable device is attached to a headband, but not to a helmet.Results of a research tasks (II.PB.15, 2.G.04, 2.G.05) carried out within the National Programme “Improvement of safety and working conditions” partly supported in Poland in 2017–2022—within the scope of research and development—by the Ministry of Science and Higher Education/National Centre for Research and Development and within the scope of state services—by the Ministry of Family, Labour, and Social Policy (CIOPPIB is the Programme’s main co-ordinator) and the project ‘Electromagnetic Characterization in Smart Environments of Healthcare and their involvement in Personnel. Occupational and Environmental Health’ (PI14CIII/00056) funding from Sub-Directorate-General for Research Assessment and Promotion in Spain (Instituto de Salud Carlos III) and as part of the research activity of the Warsaw University of Technology.S

Investigación en tecnologías de inteligencia ambiental para la salud del futuro

El concepto de Inteligencia Ambiental que fue desarrollado en el documento ISTAG presenta una visión de la Sociedad de la Información futura enfatizando en la proximidad al usuario, eficiencia y soporte a servicios distribuidos, potenciación del usuario y en la facilidad de interacción humana con el entorno

Electromagnetic Assessment of UHF-RFID Devices in Healthcare Environment

In this work, the evaluation of electromagnetic effect of Ultra High Frequency Radio Frequency Identification (UHF-RFID) passive tags used in the healthcare environment is presented. In order to evaluate exposure levels caused by EM field (865–868 MHz) of UHF-RFID readers, EM measurements in an anechoic chamber and in a real medical environment (Hospital Universitario de Canarias), as well as simulations by 3D Ray Launching algorithm, and of biophysical exposure effects in human models are presented. The results obtained show that the EM exposure is localized, in close vicinity of RFID reader and inversely proportional to its reading range. The EM exposure levels detected are sufficient to cause EM immunity effects in electronic devices (malfunctions in medical equipment or implants). Moreover, more than negligible direct effects in humans (exceeding relevant SAR values) were found only next to the reader, up to approximately 30% of the reading range. As a consequence, the EM risk could be firstly evaluated based on RFID parameters, but should include an in situ exposure assessment. It requires attention and additional studies, as increased applications of monitoring systems are observed in the healthcare sector—specifically when any system is located close to the workplace that is permanently occupied.This work was supported by Instituto de Salud Carlos III project “Electromagnetic “Characterization in Smart Environments of Healthcare, and their involvement in Personal, Occupational, and Environmental Health” (PI14CIII/00056) https://portalfis.isciii.es/es/Paginas/DetalleProyecto. aspx?idProyecto=PI14CIII%2f00056 (accessed on 24 July 2022), and project “ (PI19CIII/00033) TMPY 508/19 “ Metrics development for electromagnetic safety assessment in healthcare centers in the context of 5G“ https://portalfis.isciii.es/es/Paginas/DetalleProyecto.aspx?idProyecto=PI19 CIII%2f00033, (accessed on 24 July 2022) from Sub-Directorate-General for Research Assessment and Promotion. The results of a research task (II.PB.15) carried out within the National Programme “Improvement of safety and working conditions” partly supported in Poland in 2020-2022-within the scope of research and development-by the National Centre for Research and Development were also included.S