PURPOSE: Electromagnetic fields (EMFs) are ubiquitous in modern environments, raising concerns about their potential influence on circadian rhythms and human health. This systematic review examines the biological mechanisms underlying EMF-circadian interactions to inform evidence-based public health policies.
METHODS: Following PRISMA 2020 guidelines, we systematically searched PubMed/MEDLINE, Web of Science, Scopus, and EMBASE for peer-reviewed studies published between 2010 and 2024. From 892 initial records, 55 studies met inclusion criteria after rigorous screening, comprising 22 in vitro studies, 21 animal studies, and 12 human studies.
RESULTS: EMF exposure can affect circadian regulation through multiple pathways including clock gene expression alterations, melatonin disruption, and cellular signaling modulation. The most robust evidence involves melatonin suppression (88% of high-quality animal studies) and sleep architecture changes. However, evidence quality varied considerably, with only 27% of studies meeting high methodological standards. Critical limitations include inadequate sham controls in 48% of animal studies, incomplete EMF exposure characterization in 33% of investigations, and minimal high-quality human research. The magnitude of melatonin suppression (20-50%) is substantially lower than light-induced effects (> 90%), raising questions about clinical significance. Translation from cellular effects to systemic circadian disruption remains incompletely established.
CONCLUSION: While EMFs can influence molecular and cellular circadian components, whether typical environmental exposures produce clinically meaningful circadian disruption in humans remains uncertain. The findings highlight critical evidence gaps and underscore the need for well-controlled studies with standardized protocols, rigorous designs, and comprehensive circadian assessment to clarify public health implications of chronic EMF exposure.