Electromagnetic hypersensitivity (EHS) is a medical condition where exposure to artificial electromagnetic radiation cause a range of unpleasant symptoms. An estimated 15% of our population suffer from a degree of electromagnetic hypersensitivity, while about one percent are severely effected.
The condition is medically recognised in many countries, including Sweden, Germany, France and Spain. But in many places where EHS is not recognised, the cause of the symptoms are often misdiagnosed and patients continue to suffer, often taking medication and treatments that only mask the symptoms.
Daily we are exposed to potentially harmful levels of electromagnetic radiation (EMR) from mobile phones, cell towers, wireless devices and even electrical wiring and home appliances, the effects of which are long-term and cumulative.
This questionnaire can help you identify if EMR is affecting your health.
The questionnaire is a multi-purpose document that can be used:
This questionnaire was adapted from the EUROPAEM EMF guidelines 2016 questionnaire and retains the core questions and structure, but with some updates to make it more relevant to current times and devices. The format uses ‘multi-choice’ questions making the questionnaire easier to fill out and compare.
Download the EHS_Questionnaire and fill it out as best as you can. Take your time.
See EHS Questionnaire Help for explanations and examples if any part is unclear.
You can edit the pdf to fill it out, save and print it. Alternatively, you may print the questionnaire, fill it out on paper, then scan it. Keep it safe for your records.
If you wish to contribute to the research database, send the filled questionnaire to STinfoNZ@proton.me with the subject: EMR Questionnaire Complete.
If you wish to lower your exposure see the For Individuals section. There is a special section intended For Doctors however, individuals can take these steps themselves.
The EUROPAEM EMF guidelines 2016 provide a comprehensive understanding of Electrohypersensitivity (EHS) from a medical perspective. Below is a condensed guide.
Look for patients that display one or more of the common symptoms:
If a patient is having one or more of these symptoms regularly, have the patient fill out the questionnaire. The EHS Questionnaire Help provides further explanation on how to complete each page of the questionnaire with examples, if any part is unclear.
Suggest that the patient spend at least a week in a rural or natural area away from sources of electromagnetic radiation (cell sites, radio and TV stations, power lines, Wi-Fi) to undergo an 'electrical detox.' They should limit electronic device usage and turn off the circuit breakers to the bedroom and adjacent rooms to create an electricity quiet sleeping environment. The patient should keep a daily diary of their experience during this time.
Near the end of the electrical detox, before returning to their original environment, the patient should fill out a new questionnaire (sections A, B, and C only). This will help objectively assess any changes in symptoms and document the new environment.
Some patients with electromagnetic hypersensitivity (EHS) may not notice immediate improvements in symptoms during the detox, but may notice a worsening of symptoms when returning to a high EMR environment. It is recommended that patients continue keeping a daily diary after the detox and fill out a new questionnaire a third time (sections A and B only) a week after being re-exposed to their normal environment.
A comprehensive medical history – which should include all symptoms and their occurrences in spatial and temporal terms and in the context of EMR exposures – is the key to making the diagnosis. This questionnaire is designed specifically for this purpose. Compare the three questionnaires (Before the detox, During the detox and After re-exposure) to evaluate the potential impact of EMR on the patient’s health and symptoms.
The W.H.O. International Classification of Disease (ICD-10) codes:
Educate the patient on wireless hygiene (minimising exposure to personal wireless devices). Suggest to the patient to schedule a consultation with a Building Biologist or EMR specialist to evaluate their home and work environments for EMR exposure. The specialist can offer recommendations for reducing exposure. The patient can also use Section C of the questionnaire as a guide to start reducing personal exposure, see the ‘ForIndividuals’ section for details.
SaferTechNZ adhere to the NZ Privacy Act 2020. Your personal information will NOT be made publicly available. The results will be used for research proposes to help understand the widespread health effects of the ever-increasing levels of EMR in New Zealand.
Follow the guide in the ‘For Doctors’ section.
Fill out section C of the questionnaire to identify your sources of EMR exposure. See which sources are practical for you to address, by:
The questionnaire is a good tool to help objectively assess if your new environment has had an affect on your health. For example, if you move, or start a new job, or your street gets a new cell tower, and your symptoms change, you can fill out the questionnaire and compare the results with previous ones. fill out the questionnaire and compare the results with previous ones.
Hardell L, Nilsson M. Case Report: The Microwave Syndrome after installation of 5G emphasizes the need for protection from radiofrequency radiation. Ann Case Report. 2023; 8: 1112.
Nilsson M, Hardell L. Development of the microwave syndrome in two men shortly after installation of 5G on the roof above their office. Ann Clin Case Reports. 2023; 8: 2378.
Hardell L, Nilsson M. Case Report: A 52-Year Healthy Woman Developed Severe Microwave Syndrome Shortly After Installation of a 5G Base Station Close to Her Apartment. Ann Clin Med Case Rep. 2023; V10(16): 1-10
