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

• Published in: Environment international Vol. 157; p. 106828
• Main Authors: Lagorio, Susanna, Blettner, Maria, Baaken, Dan, Feychting, Maria, Karipidis, Ken, Loney, Tom, Orsini, Nicola, Röösli, Martin, Paulo, Marilia Silva, Elwood, Mark
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.12.2021; Elsevier Science; Elsevier
• Subjects: Acoustic neuroma; Base stations; Brain cancer; Broadcast transmitters; Case-control studies; Childhood leukaemia; Cohort studies; Cordless phones; Epidemiology; Glioma; Leukaemia; Medicin och hälsovetenskap; Meningioma; Microwaves; Mobile phones; Neoplasms; Occupational exposure; Pituitary tumours; Radiofrequency electromagnetic fields; Salivary gland tumours; Systematic review protocol; Base stations; Pituitary tumours; Salivary gland tumours; Brain cancer; Mobile phones; Cordless phones; Occupational exposure; Childhood leukaemia; Epidemiology; Systematic review protocol; Neoplasms; Leukaemia; Radiofrequency electromagnetic fields; Glioma; Acoustic neuroma; Cohort studies; Case-control studies; Broadcast transmitters; Microwaves; Meningioma
• ISSN: 0160-4120; 1873-6750; 1873-6750
• DOI: 10.1016/j.envint.2021.106828

•RF-EMF was classified by IARC as possibly carcinogenic to humans (2B) in May 2011•A systematic review of all subject-relevant epidemiological studies is now needed.•A detailed protocol ensures the review's transparency, utility and credibility.•Original study validity will be evaluated with a customized OHAT risk of bias tool.•Internal coherence and external plausibility will inform conclusions. 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. 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. 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). Eligible studies will be identified through Medline, Embase, and EMF-Portal. We will use a tailored version of the OHAT's tool to evaluate the study's internal validity. 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. Confidence in evidence will be assessed in line with the GRADE approach. 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. PROSPERO CRD42021236798.