Abstract
In the European Union, health surveillance (HS) of electromagnetic fields (EMF)-exposed workers is mandatory according to the Directive 2013/35/EU, aimed at the prevention of known direct biophysical effects and indirect EMF's effects. Long-term effects are not addressed in the Directive as the evidence of a causal relationship is considered inadequate. Objectives of HS are the prevention or early detection of EMF adverse effects, but scant evidence is hitherto available on the specific procedures. A first issue is that no specific laboratory tests or medical investigations have been demonstrated as useful for exposure monitoring and/or prevention of the effects. Another problem is the existence of workers at particular risk (WPR), i.e., subjects with specific conditions inducing an increased susceptibility to the EMF-related risk (e.g., workers with active medical devices or other conditions); exposures within the occupational exposure limit values (ELVs) are usually adequately protective against EMF's effects, but lower exposures can possibly induce a health risk in WPR. Consequently, the HS of EMF-exposed workers according to the EU Directive should be aimed at the early detection and monitoring of the recognized adverse effects, as well as an early identification of WPR for the adoption of adequate preventive measures.