Abstract

Background

An Italian project aims to review the scientific literature on the possible carcinogenicity of radiofrequency (100 kHz–300 GHz) electromagnetic field (RF-EMF) exposure. The ENEA team has to carry out a systematic review of the in vivo studies on this topic.

Objectives

Development of a protocol for a systematic review (meta-analysis included) to investigate the potential carcinogenic risk following RF-EMF in vivo exposure to doses above or within legal limits. The aims of this review are (1) to provide a descriptive and, if possible, a quantitative summary of the results of the examined RF-EMF in vivo studies, together with an assessment of the consistency of observations and of the causes of heterogeneity, and (2) to assess the weight of evidence to support or refute the hypothesis of carcinogenic effects caused by RF-EMF exposure and to draw conclusions about the potential for carcinogenicity of RF-EMF exposure.

Methods

We will search for relevant studies in electronic academic databases and in the reference list of selected papers and reviews on the topic, including the descriptive reviews on RF-EMF carcinogenic effect carried out by international panels of experts since 2011. The following elements of the PECO question were defined: experimental studies on rodents of both sexes, all ages and species, all genetic backgrounds (Population) exposed to RF-EMF alone, or in combination with other physical or chemical agents (Exposure); only studies reporting outcome data in exposed and sham control groups (Comparison); and all types of cancer with all tumor-related outcome measures (Outcome) will be included.

Only peer-reviewed articles written in English will be considered without limit in the publication date.

Eligibility criteria were defined for papers to be included. A risk of bias assessment will be performed using a tool specifically developed for animal studies. A meta-analysis will be performed, if feasible, for all outcome measures; for subgroup analysis, a minimum of 3 studies per subgroup will be required. If meta-analysis will not be possible, a narrative synthesis of the results will be reported.

Systematic review registration

PROSPERO CRD42020191105

Highlights

• An Italian collaborative research agreement aims to review the scientific literature on the possible carcinogenicity of RF-EMF (100 kHz – 300 GHz).
• The ENEA team will systematically review and, if possible, meta-analyse estimates the effects of in vivo exposure to RF-EMF exposure on cancer.
• The ENEA group is a multidisciplinary team of researchers with a consolidated experience both in carcinogenicity experiments and radiofrequency dosimetric assessment.
• The proposed protocol uses the NTP OHAT Approach for Systematic Review as an organizing framework.
• The proposed protocol aims to lead to the first systematic review providing a strength of evidence assessment on this topic.

https://link.springer.com/article/10.1186/s13643-022-01898-4

PDF available at the link above.

The post Protocol for a systematic review of the in vivo studies on radiofrequency (100 kHz–300 GHz) electromagnetic field exposure and cancer appeared first on EMFSA.

Abstract

Background: Oxidative stress is conjectured to be related to many diseases. Furthermore, it is hypothesized that radiofrequency fields may induce oxidative stress in various cell types and thereby compromise human and animal health. This systematic review (SR) aims to summarize and evaluate the literature related to this hypothesis.

Objectives: The main objective of this SR is to evaluate the associations between the exposure to radiofrequency electromagnetic fields and oxidative stress in experimental models (in vivo and in vitro).

Methods: The SR framework has been developed following the guidelines established in the WHO Handbook for Guideline Development and the Handbook for Conducting a Literature-Based Health Assessment). We will include controlled in vivo and in vitro laboratory studies that assess the effects of an exposure to RF-EMF on valid markers for oxidative stress compared to no or sham exposure. The protocol is registered in PROSPERO. We will search the following databases: PubMed, Embase, Web of Science Core Collection, Scopus, and the EMF-Portal. The reference lists of included studies and retrieved review articles will also be manually searched.

Study appraisal and synthesis method: Data will be extracted according to a pre-defined set of forms developed in the DistillerSR online software and synthesized in a meta-analysis when studies are judged sufficiently similar to be combined. If a meta-analysis is not possible, we will describe the effects of the exposure in a narrative way.

Risk of bias: The risk of bias will be assessed with the NTP/OHAT risk of bias rating tool for human and animal studies. We will use GRADE to assess the certainty of the conclusions (high, moderate, low, or inadequate) regarding the association between radiofrequency electromagnetic fields and oxidative stress.

Funding: This work was funded by the World Health Organization (WHO).

Registration: The protocol was registered on the PROSPERO webpage on July 8, 2021.

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

https://pubmed.ncbi.nlm.nih.gov/34662800/

The post The effect of radiofrequency electromagnetic fields (RF-EMF) on biomarkers of oxidative stress in vivo and in vitro: A protocol for a systematic review appeared first on EMFSA.

Abstract

Exposure to radiofrequency (RF) electromagnetic fields (EMF) (frequencies of 100 kHz to 300 GHz) has been steadily increasing. In addition to heat-related effects of RF EMF, other yet-unspecified biological effects, might exist which could possibly lead to health effects. Given the large number of health endpoints that have been studied, we wanted to prioritize those that would merit systematic reviews.

We developed a survey listing of all health endpoints reported in the literature and we asked 300 RF EMF experts and researchers to prioritize these health effects for systematic review as critical, important or unimportant. We also asked the experts to provide the rationale for their prioritization.

Of the 300 RF EMF experts queried, 164 (54%) responded. They rated cancer, heat-related effects, adverse birth outcomes, electromagnetic hypersensitivity, cognitive impairment, adverse pregnancy outcomes and oxidative stress as outcomes most critical regarding RF EMF exposure. For these outcomes, systematic reviews are needed. For heat-related outcomes, the experts based their ranking of the critical outcomes on what is known from human or animal studies, and for cancer and other outcomes, they based their rating also on public concern.

To assess health risks of an exposure in a robust manner, it is important to prioritize the health outcomes that should be systematically reviewed. Here we have shown that it feasible to do so in an inclusive and transparent way.

Excerpt

4. Discussion

RF EMF experts rated cancer, heat-related effects, adverse birth outcomes, electromagnetic hypersensitivity, cognitive impairment, adverse pregnancy outcomes and oxidative stress as outcomes most critical regarding RF EMF exposure. For these outcomes, systematic reviews will be performed. For heat-related outcomes, the experts based their rating of the critical outcomes on their knowledge of human or animal studies, and for cancer and other outcomes, they based their rating also on public concern.

4.3. Implications

Given the many health outcomes studied in relation to RF EMF exposure, the survey showed that not all outcomes are considered equally important by RF experts. We decided at the outset of this survey that systematic reviews will be needed for those topics that are rated as critical by a large proportion of the RF experts. As part of the WHO health risk assessment on RF EMF exposure, WHO has recently commissioned those reviews through an open call for expressions of interest. A selection committee convened by WHO ranked the teams based on the criteria related to qualifications and skills mentioned in the calls, including expertise in systematic review methodology, RF EMF expertise and expertise in the outcome of interest. All team members were assessed for conflicts of interest, as per WHO’s requirements. The protocols for the systematic reviews will soon be published in Environment International.

To assess health risks of an exposure in a robust manner, it is important to prioritize the health outcomes that should be systematically reviewed. Here we have shown that it feasible to do so in an inclusive and transparent way.

Funding

This work was sponsored by the World Health Organization

The post Prioritizing health outcomes when assessing the effects of exposure to radiofrequency electromagnetic fields: A survey among experts appeared first on EMFSA.