Prospective cohort study on non-specific symptoms, cognitive, behavioral, sleep and mental health in relation to electronic media use and transportation noise among adolescents (HERMES): study protocol

<ns3:p> Electronic media (eMedia) devices along with exposure to transportation noise are integral to the daily routines of adolescents. The concerns associated with excessive eMedia usage extend beyond sleep deprivation to include the heightened exposure to radiofrequency electromagnetic fields (RF-EMF) emitted by these wireless devices. The aim of HERMES (Health Effects Related to Mobile PhonE Use in AdolescentS) study is to better understand biophysical and psychological pathways in relation to eMedia use, RF-EMF exposure and transportation noise that may affect cognitive, behavioral, sleep and mental health, as well as non-specific symptoms. Following two previous HERMES cohorts conducted between 2012 and 2015 we have initiated the third wave of HERMES study as a prospective cohort with intermediate (every four months) and one year follows-up. Eligible participants are adolescents attending 7 <ns3:sup>th</ns3:sup> or 8 <ns3:sup>th</ns3:sup> school grades in Northwest and Central Switzerland. Baseline examinations are a questionnaire on eMedia usage and selected health outcomes, as well as computerized cognitive tests. In addition, parents/guardians are asked to fill in a questionnaire about their child’s health and potential eMedia use determinants. Far-field RF-EMF exposure and transportation noise at the place of residence and school are predicted based on a propagation model. Cumulative RF-EMF brain dose is calculated based on self-reported eMedia use, mobile phone operator data, and RF-EMF modelling. A follow-up visit is conducted one year later, and two interim questionnaires are sent to adolescents to be completed at home. Between baseline and 1-year follow-up, a subsample of 150 study participants is invited to collect personal RF-EMF measurements as well as sleep and physical activity data using accelerometers. This new recruitment wave of HERMES study provides a greater understanding of causal pathways between eMedia, RF-EMF, and transportation noise exposure and their effects on health outcomes, with relevant implications for both governmental health policy and lay people alike. </ns3:p>