Editorials

Mobile phones in hospitals

Are not as hazardous as believed and should be allowed at least in non-clinical areas

Mobile phones (cell phones) are a source of irritation for some but undeniably useful for many, and over 50% of the population of the United Kingdom possess one. Their use in hospitals, however, is mostly banned as they are considered potentially hazardous in medical environments. But the evidence for serious harm is flimsy, and the hysteria that surrounds the use of mobile phones in hospitals is unjustified.

So how dangerous are they? The evidence for harm is limited. Anecdotal reports exist of interference with medical electrical equipment, ^{1 2} which led to a study by the Medical Devices Agency in the United Kingdom.³ In this study, 4% of medical devices suffered from electromagnetic interference from digital mobile phones at a distance of 1 metre. This compared with 41% from emergency services' handsets and 35% from porters' handsets. Most of the interference related to disturbance of the signal on monitors, such as electrocardiographs, confirmed by data from the United States.⁴

Other effects were on pacemakers, with inappropriate inhibition or atrial oversensingor misinterpretation of the mobile phone signal as atrial activity with synchronous fast pacing of the ventriclewhich has been documented elsewhere in both permanent and temporary systems.^5-7 The effect on both devices is, however, transitory and can be avoided completely by taking the mobile phone away from the monitor or pacemaker. Moreover, the interference with the pacemaker occurred only with the mobile phone at a distance of up to 10 cm.⁵ These temporary and very localised effects do not seem to justify the outright ban on mobile phones and hostility towards users, particularly when greater effects occurred with porters' or emergency services' handsets, which are deemed essential and therefore permitted.

Many patients suffer significant isolation while in hospital and are unable to contact their relatives or businesses to inform them about their condition, or when they may be discharged. Relatives also need to contact others as clinical situations can change or important information needs to be relayed to family members. The provision of phones for patients and relatives on wards is often inadequate and goes only some way towards addressing the needs of patients.

It is time we took a more sensible and considered approach to the use of mobile phones in hospitals. The advice to patients with a permanent pacemaker who use mobile phones outside hospitals is based on evidence and is both sensible and practicalthey are advised to use the phone in the hand opposite to the site of implantation and to avoid placing the phone in a breast pocket over the pacemaker. A similarly practical solution could be found for hospitals.

So what might a more rational approach to mobile phone use in hospitals entail? It seems sensible to restrict their use in environments where monitoring of patients and pacemakers are commonunits providing coronary and intensive care. We also accept the argument about noise from mobile phones ringing on the ward and disturbing staff and patients, and it would be sensible to restrict their use here too. It might be possible, however, to allow the use of mobile phones in the day room of the ward, with minimal disturbance or risk to others. It would certainly be possible to allow their use in areas such as corridors, offices, entrance halls, and cafeterias without putting patients at risk. We think that outpatient waiting areas do not pose a risk, and the use of mobile phones could be allowed here too. The ringing of mobile phones during consultations would be disturbing, and it seems sensible to ask for phones to be turned off beforehandsomething that most patients would consider polite anyway.

We think that mobile phone use should be allowed in all non-clinical areas and outpatient waiting areas, but restricted to the day room, or other communal room, on wards and other clinical areas. One hospital already has such an enlightened approach to mobile phone usethe Chelsea and Westminster Hospital in London, and patients and relatives have told us that they find being able to use their mobile phones in selected areas invaluable.

We hope that hospital managers and clinical directors will consider the points raised here and adopt a more sensible and flexible policy towards mobile phones. A practical balance can be achieved, and it is hoped that this would remove the aggressive overreaction of some staff and members of the public to their use in hospitals.

Saul G Myerson, clinical lecturer. 

(saul.myerson{at}cardiov.ox.ac.uk)

Andrew R J Mitchell, specialist registrar. 

(mitcharj{at}doctors.org.uk), Department of Cardiology, John Radcliffe Hospital, Oxford OX4 3AU

Footnotes

Competing interests: SM and AM own mobile phones but have no financial interest in nor links to any mobile telecommunications company.