Supplementary file 1_Chicken or egg? Attribution hypothesis and nocebo hypothesis to explain somatization associated to perceived RF-EMF exposure.docx

IntroductionThe aim of this study is to understand the temporal relationship between the somatization usually attributed to RF-EMFs, and to evaluate the attribution hypothesis and the nocebo hypothesis in this context.
MethodIn this longitudinal study, data from the Dutch Occupational and Environmental Health Cohort Study (AMIGO) was analyzed, consisting of a baseline questionnaire collected in 2011 (14,829 participants) and a follow-up questionnaire collected in 2015 (7,904 participants). Participants completed a questionnaire providing information on their health status, perceived environmental exposures, and demographics. Two sets of multiple regressions were conducted to evaluate the two hypotheses.
ResultsResults show that the attribution hypothesis overall explained symptom reporting in association to perceived RF-EMF base station exposure and perceived electricity exposure more frequently than the nocebo hypothesis.
DiscussionThis finding stands out from most of the existing literature, which primarily points to the nocebo effect as the main explanation for somatization in response to RF-EMF exposure. While this does not exclude, in absolute terms, the existence of a nocebo effect, potentially at other time scales, this finding has relevant consequences at the policy making level. The emerging relevance of the attribution hypothesis moves the focus on the discomfort of people with unexplained symptoms and their need to find a plausible explanation for their discomfort.

引言
本研究旨在明确通常归因于射频电磁场（RF-EMF）的躯体化（somatization）症状的时间关联，并在此背景下评估归因假说与反安慰剂假说。
方法
本项纵向研究对荷兰职业与环境健康队列研究（AMIGO）的数据进行了分析。该数据集包含2011年收集的基线调查问卷（共14829名参与者）与2015年收集的随访调查问卷（共7904名参与者）。参与者需填写问卷，以提供其健康状况、感知到的环境暴露情况以及人口统计学信息。研究开展了两组多元回归分析，以验证上述两项假说。
结果
结果显示，相较于反安慰剂假说，归因假说整体上更能解释与感知到的射频基站暴露及感知到的电力暴露相关的症状报告。
讨论
本研究结果与绝大多数现有文献结论相悖，后者普遍认为反安慰剂效应是射频电磁场暴露引发躯体化症状的核心解释。尽管本研究并未完全排除其他时间尺度下反安慰剂效应存在的可能性，但该发现对政策制定具有重要参考价值。归因假说的重要性日益凸显，这使得研究焦点转向存在不明原因症状人群的不适体验，以及他们为自身不适寻求合理解释的需求。