Effect of exposure to RF on cancer risk: A systematic review of human observational studies - Part I: Most researched outcomes (WHO SR 1A)

Authors: Karipidis K, Baaken D, Loney T, Blettner M, Brzozek C, Elwood M, Narh C, Orsini N, Röösli M, Paulo MS, Lagorio S

Year: 2024

Category: Epidemiology

Journal: Environment International

Institution: World Health Organization (WHO)

DOI: 10.1016/j.envint.2024.108983

URL: https://doi.org/10.1016/j.envint.2024.108983

Abstract

Overview

The objective of this review was to assess the quality and strength of the evidence provided by human observational studies for a causal association between exposure to radiofrequency electromagnetic fields (RF-EMF) and risk of the most investigated neoplastic diseases.

Methods

  • Included cohort and case-control studies examining neoplasia risks in relation to three types of RF-EMF exposure: near-field, head-localized exposure from wireless phone use; far-field, whole-body, environmental exposure from fixed-site transmitters; and occupational exposures to RF-emitting equipment.
  • Focused on studies investigating specific neoplasms (e.g., brain, meninges, pituitary gland, acoustic nerve, salivary gland, leukaemias) in relation to specific RF exposure sources.
  • Studies identified through Medline, Embase, and EMF-Portal.
  • Risk-of-bias was assessed using a tailored OHAT tool and confidence in evidence using GRADE.
  • Meta-analyses and data syntheses performed using random and mixed effects models.

Findings

  • Included 63 articles published between 1994 and 2022, reporting on 119 exposure-outcome pairs from 22 countries.
  • No association found between RF-EMF exposure from mobile or cordless phones and risk of glioma, meningioma, acoustic neuroma, pituitary tumors, salivary gland tumors, pediatric brain tumors, or childhood leukemia.
  • No observable increased risk for neoplasms with increasing cumulative exposure from mobile phone use (duration, call time, number of calls).
  • No increase in glioma risk with occupational RF exposure.
  • No association between exposure from fixed-site transmitters and childhood leukemia or pediatric brain tumors, regardless of exposure level.
  • Bias analysis showed low to moderate risk of bias across studies, and exclusion of certain studies reduced heterogeneity and effect size.

Conclusion

  • Moderate certainty evidence suggests near-field RF-EMF exposure to the head from mobile phones likely does not increase risk for glioma, meningioma, acoustic neuroma, pituitary, or salivary gland tumors in adults, or pediatric brain tumors.
  • Low certainty evidence for cordless phone use and for occupational exposures indicates possible lack of increased risk, but interpretive caution is recommended due to study limitations and small sample sizes for certain outcomes.
  • The evidence rating for environmental RF exposure from transmitters and pediatric brain tumors should be interpreted carefully due to limited data.
Other: This project was commissioned and partially funded by the World Health Organization (WHO). Co-financing provided by several international health organizations. Registration: PROSPERO CRD42021236798.
radiofrequency electromagnetic fields cancer risk systematic review glioma mobile phone use occupational exposure childhood leukemia
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