The effect of exposure to radiofrequency fields on cancer risk in the general and working population: A protocol for a systematic review of human observational studies

Aug 25, 2021Environment international

Radiofrequency exposure and cancer risk in the general and working population: plan for a review of human studies

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Abstract

A systematic review protocol aims to assess the evidence linking exposure to radiofrequency electromagnetic fields (RF-EMF) with cancer risk in humans.

The review will focus on observational studies, specifically cohort and case-control studies, investigating neoplasia risks associated with RF-EMF exposure.
Three types of RF-EMF exposure will be considered: near-field from wireless phone use, far-field from fixed-site transmitters, and occupational exposure from RF-emitting equipment.
Selected neoplasms of interest include central nervous system tumours and salivary gland tumours for near-field exposure, and brain tumours and leukaemias for far-field and occupational exposures.
The review will evaluate the internal validity of included studies using a tailored risk-of-bias assessment tool.
A meta-analysis may be conducted to assess the strength of the association and the exposure-response relationship if sufficient data is available.

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BACKGROUND: The World Health Organization (WHO) has an ongoing project to assess potential health effects of exposure to radiofrequency electromagnetic fields (RF-EMF) in the general and working population. Here we present the protocol for a systematic review of the scientific literature on cancer hazards from exposure to RF-EMF in humans, commissioned by the WHO as part of that project.

OBJECTIVE: To assess the quality and strength of the evidence provided by human observational studies for a causal association between exposure to RF-EMF and risk of neoplastic diseases.

ELIGIBILITY CRITERIA: We will include cohort and case-control studies investigating neoplasia risks in relation to three types of exposure to RF-EMF: near-field, head-localized, exposure from wireless phone use (SR-A); far-field, whole body, environmental exposure from fixed-site transmitters (SR-B); near/far-field occupational exposures from use of handheld transceivers or RF-emitting equipment in the workplace (SR-C). While no restriction on tumour type will be applied, we will focus on selected neoplasms of the central nervous system (brain, meninges, pituitary gland, acoustic nerve) and salivary gland tumours (SR-A); brain tumours and leukaemias (SR-B, SR-C).

INFORMATION SOURCES: Eligible studies will be identified through Medline, Embase, and EMF-Portal.

RISK-OF-BIAS ASSESSMENT: We will use a tailored version of the OHAT's tool to evaluate the study's internal validity.

DATA SYNTHESIS: We will consider separately studies on different tumours, neoplasm-specific risks from different exposure sources, and a given exposure-outcome pair in adults and children. When a quantitative synthesis of findings can be envisaged, the main aims of the meta-analysis will be to assess the strength of association and the shape of the exposure-response relationship; to quantify the degree of heterogeneity across studies; and explore the sources of inconsistency (if any). When a meta-analysis is judged inappropriate, we will perform a narrative synthesis, complemented by a structured tabulation of results and appropriate visual displays.

EVIDENCE ASSESSMENT: Confidence in evidence will be assessed in line with the GRADE approach.

FUNDING: This project is supported by the World Health Organization. Co-financing was provided by the New Zealand Ministry of Health; the Istituto Superiore di Sanità in its capacity as a WHO Collaborating Centre for Radiation and Health; ARPANSA as a WHO Collaborating Centre for Radiation Protection.

REGISTRATION: PROSPERO CRD42021236798.

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The effect of exposure to radiofrequency fields on cancer risk in the general and working population: A protocol for a systematic review of human observational studies

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