Monday, July 15, 2024

International Commission on the Biological Effects of Electromagnetic Fields (ICBE-EMF)



ICBE-EMF finds serious problems with WHO-Commissioned review of human observational studies 
on the effects of exposure to radio-frequency EMFs
TUCSON, AZ – July 15, 2024 – The International Commission on the Biological Effects of Electromagnetic Fields (ICBE-EMF) documented serious problems with a WHO-commissioned review of research on the effects of exposure to radio-frequency electromagnetic fields (RF-EMF) in a commentary published today in the journal Reviews on Environmental Health.
Our commentary, “A critical appraisal of the WHO 2024 systematic review of the effects of RF-EMF exposure on tinnitus, migraine/headache, and non-specific symptoms,” discusses major problems with a recent review of human observational studies on this topic by Röösli and colleagues (2024) that was published in the journal Environment International.
We call for a retraction of this paper. Contrary to the opinion of the authors, we conclude that the body of evidence reviewed for this paper is not adequate to either support or refute the safety of current exposure limits – largely due to the very small number and low methodological quality of the relevant primary studies to date, and the fundamental inappropriateness of meta-analysis for the handful of very heterogeneous primary studies identified for each of the analyzed exposure/outcome combinations.
Furthermore, the ICBE-EMF calls for an impartial international investigation, by unconflicted experts, of both the currently available evidence base on these issues, as well as related research priorities for the future.
The ICBE-EMF is made up of a multidisciplinary consortium of scientists, doctors and related professionals who are involved with research related to the biological and health effects of electromagnetic frequencies up to and including 300 GHz. The organization makes recommendations that include and go beyond establishing numerical exposure guidelines based on the best peer-reviewed scientific research publications.
Frank J, Melnick R, Moskowitz J, on behalf of the International Commission on the Biological Effects of Electromagnetic Fields (ICBE-EMF). A critical appraisal of the WHO 2024 systematic review of the effects of RF-EMF exposure on tinnitus, migraine/headache, and non-specific symptoms. Reviews on Environmental Health. 2024. doi: 10.1515/reveh-2024-0069. 


Also see: https://www.saferemr.com/2021/09/who-radiofrequency-emf-health-risk.html

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June 26, 2024

ICBE-EMF exposes major flaws in COSMOS cell phone brain tumor risk study in journal letter published today

Contacts:
Joel M. Moskowitz, PhD, jmm@berkeley.edu
Ronald Melnick, PhD, ronmelnick@gmail.com

New peer-reviewed letter presents 
scientific case for retraction of conclusions
of COSMOS brain tumor risk study.

TUCSON, AZ – June 26, 2024 – The International Commission on the Biological Effects of Electromagnetic Fields (ICBE-EMF) exposed major flaws with the COSMOS study of brain tumor risk from cell phone use in a letter to the editor published today in the journal Environment International"COSMOS: A methodologically-flawed cohort study of the health effects from exposure to radiofrequency radiation from mobile phone use."

The letter discusses serious problems with a recent COSMOS paper that provided interim results about brain tumor risk from mobile phone use. The letter calls for a retraction of the paper's conclusions and demands that the data set be made available to independent investigators who have no industry ties. Excerpts from the letter appear below.

The response to our letter by the authors of the COSMOS paper failed to adequately address our concerns.

COSMOS (“Cohort Study on Mobile Phone Use and Health”) is a 20-30-year cohort study investigating the possible health effects of long-term use of mobile phones and other wireless technologies. The study enrolled over 290,000 mobile phone users from six European countries (Denmark, Finland, France, Sweden, the Netherlands, and the United Kingdom). 

The ICBE-EMF is made up of a multidisciplinary consortium of scientists, doctors and related professionals who are involved with research related to the biological and health effects of electromagnetic frequencies up to and including 300 GHz. The organization makes recommendations that include and go beyond establishing numerical exposure guidelines based on the best peer-reviewed scientific research publications.

Also see: https://www.saferemr.com/2024/06/COSMOS.html


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Sep 6, 2023

"Radiofrequency Radiation from Wireless Communications Sources: 
Are Safety Limits Safe?

The recordings and slides from the following webinar are now available.


David Gee: “Wireless Radiation; An Emerging Hazard 1972-2003”

Dr. Erica Mallery-Blythe“Non-Ionizing Radiation Health Effects; Vulnerable Populations; Critical Role of Medical Doctor”

Dr. Kent Chamberlin:  "Towards the Better Protection of People and Planet from Wireless Radiation; Work of the New Hampshire Commission and the ICBE-EMF"

Dr. James C. Lin“A Critique of RF Exposure Limits and Recommendations for the Better Protection of Workers and the Public"

Dr. John Frank“Reflections and Key Questions”

​To view the videos and ​download the slides from this webinar: 


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April 4, 2023



NEWS RELEASE

Simple engineering fixes could dramatically reduce cellphone radiation, scientists say

Industry will now have to start competing on safety

ICBE-EMF, Tucson, AZ, April 4, 2023 -- Six simple engineering fixes could dramatically reduce radiation emitted by cellphones according to a group of scientists. The fixes are easy to implement, and in one case the fix relies on technology already patented by the industry.

The International Commission on the Biological Effects of Electromagnetic Fields (ICBE-EMF) reported its findings today in an open access, peer-reviewed article, "Cell Phone Radiation Exposure Limits and Engineering Solutions," published in the International Journal of Environmental Research and Public Health.

“Given the growing evidence of the health effects of radiation from cellphones and cell towers, I believe the wireless industry is going to have to start competing on safety,” said Joel Moskowitz, one of the authors who is also director of the Center for Family and Community Health at the University of California, Berkeley.

“With the proliferation of online advice and consultants helping people reduce their exposures, the concern about the safety of cellphones and other wireless devices has moved into the mainstream,” Moskowitz added.

“We will undoubtedly hear from many in the industry that a move toward safer cellphones and other wireless devices will be too costly and unnecessary,” Moskowitz said. “But carmakers said the same thing when the public demanded safer cars and the government required them. Today, those same carmakers compete on safety.”

“This competition for safety can move forward without a change in the current government standards,” Moskowitz explained. “Ultimately, I believe governments around the world will be playing catch-up with industry and consumers.”

“The six engineering solutions outlined in this paper provide a significant move forward in cellphone safety,” said Elizabeth Kelley, one of the authors of the paper and managing director of the International Commission on the Biological Effects of Electromagnetic Fields. “The scientists and engineers proposing them stand ready to assist the cellphone industry with implementing them as soon as is practical.”

Kelley added, “Some of the proposed solutions are just common sense. Using Wi-Fi to make cellphone calls whenever feasible dramatically reduces radiation emissions from the phone.” And, when a cellphone is sitting on the nightstand while the user is sleeping, it doesn’t need to communicate constantly with a cell tower to relay its location. “Why not shut down these transmissions—which cause frequent radiation emissions—when our phones are stationary such as when they sitting on a bedside table as we sleep or on our desk next to us as we work?”

Kelley said, “These common-sense changes can quickly and dramatically reduce radiation exposure from cellphones. Implementing them will create a healthier environment for all of us while still allowing us to stay connected to others and to the information we need daily.”

The paper also examines the history behind the current cellphone emissions standards and finds a trail of dated assumptions and poorly designed experiments and tests that don’t reflect how people use cellphones today.

Paul Héroux, the first author of this paper and a professor in the School of Population and Global Health at McGill University in Montreal, said the team of scientists and engineers who worked on the paper “identified seven blind spots in the methods and experiments upon which our current cellphone radiation emission standards and guidelines are based. These blind spots call into serious question the validity of those standards."


For example, tests to gauge the hazards of wireless radiation upon which our current standards rest only used exposures lasting between 40 and 60 minutes. Such exposures “can hardly be said to be representative of the 24/7 chronic exposures which all of us are and will be subject to for the rest of our lives.”

Héroux added, “Combined, these seven blind spots tell us that our current cellphone emissions standards cannot be trusted. We cannot and should not tell the public that we know cellphones are safe.”

In his written statement Héroux recommends that two things be done right away:

  • Test cellphones “using test designs that represent actual use and that rely on the growing body of research demonstrating biological effects from radiation emitted by cellphones.”
  • “Demand a quantitative health risk assessment of cellphone use and wireless infrastructure. This type of scientific assessment is routinely used by government agencies worldwide. In the United States the Environmental Protection Agency, the Food and Drug Administration, the Centers for Disease Control and Prevention, and the Occupational Safety and Health Administration all use quantitative health risk assessments to determine potential human health risks associated with exposure to hazardous agents or activities.”

To download the paper: https://www.mdpi.com/1660-4601/20/7/5398



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Oct 18, 2022 (Updated Nov 2, 2022)

Wireless Technology Not Adequately Assessed for Hazards to Human Health and Environment

New peer-reviewed paper presents scientific case for revision of limits

TUCSON, AZ – October 18, 2022 – The International Commission on the Biological Effects of Electromagnetic Fields (ICBE-EMF) is challenging the safety of current wireless exposure limits to radiofrequency radiation (RFR) and is calling for an independent evaluation.

Published today in the journal Environmental Health, “Scientific evidence invalidates health assumptions underlying the FCC and ICNIRP exposure limit determinations for radiofrequency radiation: implications for 5G,” demonstrates how the U.S. Federal Communications Commission (FCC) and the International Commission on Nonionizing Radiation Protection (ICNIRP) have ignored or inappropriately dismissed hundreds of scientific studies documenting adverse health effects at exposures below the threshold dose claimed by these agencies, which was used to establish human exposure limits. The authors argue that the threshold, based on science from the 1980s – before cell phones were ubiquitous -- is wrong, and these exposure limits based on this threshold do not adequately protect workers, children, people with electromagnetic hypersensitivity, and the public from exposure to the nonionizing radiation from wireless data transmission.

“Many studies have demonstrated oxidative effects associated with exposure to low-intensity RFR, and significant adverse effects including cardiomyopathy, carcinogenicity, DNA damage, neurological disorders, increased permeability of the blood-brain barrier, and sperm damage,” explains Dr. Ronald Melnick, Commission chair and a former senior toxicologist with the U.S. National Toxicology Program at the National Institute of Environmental Health Sciences. “These effects need to be addressed in revised and health-protective exposure guidelines. Furthermore, the assumption that 5G millimeter waves are safe because of limited penetration into the body does not dismiss the need for health effects studies.”


Dr. Lennart Hardell
, former professor at Örebro 
University Hospital in Sweden and author of  more than 100 papers on non-ionizing radiation, added, “Multiple robust human studies of cell phone radiation have found increased risks for brain tumors, and these are supported by clear evidence of carcinogenicity of the same cell types found in animal studies.”

The Commission believes that an independent evaluation based on the scientific evidence with attention to the knowledge gained over the past 25 years is needed to establish lower exposure limits. The Commission is also calling for health studies to be completed prior to any future deployment of 5G networks.

Elizabeth Kelley, the Commission's managing director, noted that “ICBE-EMF was commissioned by the advisors to the International EMF Scientist Appeal, a petition signed by more than 240 scientists who have published over 2,000 papers on EMF, biology, and health, and that “The commissioners have endorsed the Appeal’s recommendations to protect public and environmental health.”

For background on the paper and its co-authors see:

Media contact: 
Joel M. Moskowitz, PhD
email to: media.inquiries@icbe-emf.org


Key points
  • ICBE-EMF scientists report that exposure limits for radiofrequency (or wireless) radiation set by ICNIRP and the FCC are based on invalid assumptions and outdated science, and are not protective of human health and wildlife.
  • ICBE-EMF calls for an independent assessment of the effects and risks of radiofrequency radiation based on scientific evidence from peer-reviewed studies conducted over the past 25 years. The aim of such assessment would be to establish health protective exposure standards for workers and the public.
  • The public should be informed of the health risks of wireless radiation and encouraged to take precautions to minimize exposures, especially for children, pregnant women and people who are electromagnetically hypersensitive.
  • ICBE-EMF calls for an immediate moratorium on further rollout of 5G wireless technologies until safety is demonstrated and not simply assumed.
--

International Commission on the Biological Effects of Electromagnetic Fields. Scientific evidence invalidates health assumptions underlying the FCC and ICNIRP exposure limit determinations for radiofrequency radiation: implications for 5G. Environmental Health. (2022) 21:92. doi.org:10.1186/s12940-022-00900-9.

Abstract


In the late-1990s, the FCC and ICNIRP adopted radiofrequency radiation (RFR) exposure limits to protect the public and workers from adverse effects of RFR. These limits were based on results from behavioral studies conducted in the 1980s involving 40–60-minute exposures in 5 monkeys and 8 rats, and then applying arbitrary safety factors to an apparent threshold specific absorption rate (SAR) of 4 W/kg. The limits were also based on two major assumptions: any biological effects were due to excessive tissue heating and no effects would occur below the putative threshold SAR, as well as twelve assumptions that were not specified by either the FCC or ICNIRP. 

In this paper, we show how the past 25 years of extensive research on RFR demonstrates that the assumptions underlying the FCC’s and ICNIRP’s exposure limits are invalid and continue to present a public health harm. Adverse effects observed at exposures below the assumed threshold SAR include non-thermal induction of reactive oxygen species, DNA damage, cardiomyopathy, carcinogenicity, sperm damage, and neurological effects, including electromagnetic hypersensitivity. Also, multiple human studies have found statistically significant associations between RFR exposure and increased brain and thyroid cancer risk. 

Yet, in 2020, and in light of the body of evidence reviewed in this article, the FCC and ICNIRP reaffirmed the same limits that were established in the 1990s. Consequently, these exposure limits, which are based on false suppositions, do not adequately protect workers, children, hypersensitive individuals, and the general population from short-term or long-term RFR exposures. 

Thus, urgently needed are health protective exposure limits for humans and the environment. These limits must be based on scientific evidence rather than on erroneous assumptions, especially given the increasing worldwide exposures of people and the environment to RFR, including novel forms of radiation from 5G telecommunications for which there are no adequate health effects studies.

Open access paper: 


Co-authors:

Ronald L. Melnick: National Toxicology Program, National Institute of Environmental Health Sciences (retired), Ron Melnick Consulting LLC, Logan, Utah, USA (corresponding author)
Igor Belyaev: Cancer Research Institute, Biomedical Research Center, Slovak Academy of Sciences, Slovakia
Carl Blackman: US Environmental Protection Agency (retired), North Carolina, USA
Kent Chamberlin: Department of Electrical and Computer Engineering, University of New Hampshire, USA
Suleyman Dasdag: Biophysics Department, Istanbul Medeniyet University, Medical School, Turkey
Alvaro DeSalles: Graduate Program on Electrical Engineering (PPGEE), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil 
Claudio Fernandez: Division of Electrical and Electronics Engineering, Federal Institute of Rio Grande do Sul (IFRS), Canoas, Brazil
Lennart Hardell: Department of Oncology, Orebro University Hospital (retired), The Environment and Cancer Research Foundation, Orebro, Sweden
Paul Héroux: Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Canada
Elizabeth Kelley: ICBE-EMF and International EMF Scientist Appeal, and Electromagnetic Safety Alliance, Arizona, USA
Kavindra Kesari: Department of Applied Physics, School of Science, Aalto, University, Espoo, Finland
Don Maisch: EMFacts Consultancy; The Oceanic Radiofrequency, Scientific Advisory Association, Tasmania, Australia
Erica Mallery-Blythe: Physicians’ Health Initiative for Radiation and Environment; British Society of Ecological Medicine; Oceania Radiofrequency Scientific Advisory Association, UK
Anthony Miller: Dalla Lana School of Public Health (Professor Emeritus), University of Toronto, Ontario, Canada
Joel M. Moskowitz: School of Public Health, University of California, Berkeley, California, USA
Wenjun Sun: School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
Igor Yakymenko: National University of Food Technology, Kyiv Medical University, Ukraine


About the International Commission 

on the Biological Effects of Electromagnetic Fields


Founded in 2021, ICBE-EMF was commissioned by the advisors to the International EMF Scientist Appeal. The Commission is dedicated to ensuring the protection of humans and other species from the harmful effects of non-ionizing radiation. Our primary purpose is to make recommendations, based on peer-reviewed scientific research, that includes and goes beyond establishing numerical exposure guidelines to ensure safety. ICBE-EMF is made up of a multidisciplinary consortium of scientists, doctors, and related professionals who are or have been, involved with research related to the biological and health effects of electromagnetic frequencies up to and including 300 GHz.


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Selected News Stories


"New Challenge to ICNIRP: Dissident Scientists Seek Tighter Health Limits. Will They Succeed Where Others Failed?" Microwave News, November 1, 2022. https://microwavenews.com/news-center/new-challenge-icnirp


André Fauteux."Hundreds of studies on wireless radiation toxicity 'inappropriately ignored or discounted'." La Maison du 21e Siecle, Oct 18, 2022. https://maisonsaine.ca/english?id=100353In French: https://maisonsaine.ca/article?id=100352



WHO Radiofrequency EMF Health Risk Assessment Monograph (EHC series)

ICBE-EMF finds serious problems with WHO-Commissioned review of human observational studies 
on the effects of exposure to radio-frequency EMFs
TUCSON, AZ – July 15, 2024 – The International Commission on the Biological Effects of Electromagnetic Fields (ICBE-EMF) documented serious problems with a WHO-commissioned review of research on the effects of exposure to radio-frequency electromagnetic fields (RF-EMF) in a commentary published today in the journal Reviews on Environmental Health.
Our commentary, “A critical appraisal of the WHO 2024 systematic review of the effects of RF-EMF exposure on tinnitus, migraine/headache, and non-specific symptoms,” discusses major problems with a recent review of human observational studies on this topic by Röösli and colleagues (2024) that was published in the journal Environment International.
We call for a retraction of this paper. Contrary to the opinion of the authors, we conclude that the body of evidence reviewed for this paper is not adequate to either support or refute the safety of current exposure limits – largely due to the very small number and low methodological quality of the relevant primary studies to date, and the fundamental inappropriateness of meta-analysis for the handful of very heterogeneous primary studies identified for each of the analyzed exposure/outcome combinations.
Furthermore, the ICBE-EMF calls for an impartial international investigation, by unconflicted experts, of both the currently available evidence base on these issues, as well as related research priorities for the future.
The ICBE-EMF is made up of a multidisciplinary consortium of scientists, doctors and related professionals who are involved with research related to the biological and health effects of electromagnetic frequencies up to and including 300 GHz. The organization makes recommendations that include and go beyond establishing numerical exposure guidelines based on the best peer-reviewed scientific research publications.
Frank J, Melnick R, Moskowitz J, on behalf of the International Commission on the Biological Effects of Electromagnetic Fields (ICBE-EMF). A critical appraisal of the WHO 2024 systematic review of the effects of RF-EMF exposure on tinnitus, migraine/headache, and non-specific symptoms. Reviews on Environmental Health. 2024. doi: 10.1515/reveh-2024-0069. Open access paper: 
Abstract
The World Health Organization (WHO) in 2012 initiated an expert consultation about research on the health effects of radio-frequency electromagnetic fields (RF-EMF) for a WHO monograph that was last updated in 1993. The project was abandoned over concerns about the quality of the commissioned review papers. The WHO restarted the project in 2019 by commissioning ten systematic reviews (SRs) of the research on RF-EMF exposure and adverse biological and health outcomes in laboratory animals, cell cultures, and human populations. The second of these SRs, published in 2024, addresses human observational studies of RF-EMF exposure and non-specific symptoms, including tinnitus, migraine/headache, and sleep disturbance. The present commentary is a critical appraisal of the scientific quality of this SR (SR7) employing criteria developed by the Oxford Centre for Evidence-Based Medicine. Based upon our review, we call for a retraction of SR7 and an impartial investigation by unconflicted experts of the currently available evidence and future research priorities.
Conclusion
To summarize, the way in which any epidemiologically unsophisticated reader is likely to be misled by this SR is clear. It appears to conclude unequivocally that the body of scientific evidence reviewed supports the safety of current (e.g. ICNIRP-based) population exposure limits for RF-EMF [10]. We reiterate that, on the contrary, this body of evidence is not adequate to either support or refute the safety of current exposure limits – largely due to the very small number and low methodological quality of the relevant primary studies to date, and the fundamental inappropriateness of meta-analysis for the handful of very heterogeneous primary studies identified by Röösli et al. [3] for each of the exposure/outcome combinations analysed.
We therefore call for a retraction of the SR by Röösli et al., and an impartial international investigation, by unconflicted experts, of both the currently available evidence base on these issues, as well as related research priorities for the future. That investigation should particularly address, above and beyond the topic of priority health outcomes to be researched (which was already assessed in the international expert consultation by WHO in 2018) [2], and the need for improved methods of accurately measuring RF-EMF exposures, suitable for large human observational studies in the general population – the Achilles heel of the current literature.
References cited above:
 2. Verbeek J, Oftedal G, Feychting M, van Rongen E, Rosaria Scarfì M, Mann S, Wong R, van Deventer E. Prioritizing health outcomes when assessing the effects of exposure to radiofrequency electromagnetic fields: A survey among experts. Environ Int. 2021 Jan;146:106300. doi: 10.1016/j.envint.2020.106300.
 3. Röösli M, Dongus S, Jalilian H, Eyers J, Esu E, Oringanje CM, Meremikwu M, Bosch-Capblanch X. The effects of radiofrequency electromagnetic fields exposure on tinnitus, migraine and non-specific symptoms in the general and working population: A systematic review and meta-analysis on human observational studies. Environ Int. 2024 Jan;183:108338. doi: 10.1016/j.envint.2023.108338.
10. ICNIRP – International Commission on Non-Ionizing Radiation Protection (website): https://www.icnirp.org/ (accessed Feb. 26, 2024).

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July 10, 2024 (updated July 15, 2024)

"WHO to build neglect of RF-EMF exposure hazards on flawed EHC reviews? 
Case study demonstrates how “no hazards” conclusion is drawn from data showing hazards"

To date, seven systematic reviews (covering SRs 3, 4, 5, 7, 8) commissioned by the WHO have been published in a special issue of Environment International, "WHO assessment of health effects of exposure to radiofrequency electromagnetic fields: systematic reviews." These biased SRs will serve as the basis for an upcoming WHO Environmental Health Criteria Monograph on this topic that may shape the field and influence policy debates over the next few decades.

All seven SRs suffer from major problems, many of which are discussed in the case study below of SR4 which critiques a systematic review and meta-analysis of experimental studies on pregnancy and birth outcomes in non-human mammals (Nordhagen and Flydal, 2024). This excellent critique did not did not even "question the selection of papers, nor the chosen statistical methods" which are problematic in many of these SRs

ICBE-EMF has prepared a critique of SR7 which will be published in Reviews on Environmental Health on July 15.

I encourage our international colleagues to analyse the shortcomings of each of the WHO SRs and publish their own critiques. For more information about how the WHO biased the process for the production of these SRs see my posts, "WHO Radiofrequency EMF Health Risk Assessment Monograph (EHC series)":

"Papers describing the protocols have been published for nine of the ten reviews (all but SR10). Nine current and former members of ICNIRP are involved in the nine reviews with four members involved in multiple reviews: Feychting (SR1, SR3, SR5, SR7), Roosli (SR1, SR7, SR8), Karipidis (SR1, SR5), Wood (SR2, SR4), Danker-Hopfe (SR6), Kuhne (SR9), Marino (SR4), Oftedal (SR8), and Pophof (SR6).

ICNIRP is a group of self-selected scientists who engage in "groupthink" and promote weak RF exposure guidelines that protect humans only from health risks due to acute heating. According to Investigate Europe, a team of investigative journalists, members of ICNIRP have a history of co-opting national health and international reviews of health effects to ensure support for their weak exposure limits. Hence, these scientists who have a vested interest in preserving weak RF exposure limits should not be allowed to participate in this official review of RF effects by the WHO."

Nordhagen E, Flydal E. WHO to build neglect of RF-EMF exposure hazards on flawed EHC reviews? Case study demonstrates how “no hazards” conclusion is drawn from data showing hazards. Reviews on Environmental Health. 2024. doi: 10.1515/reveh-2024-0089. 


​Abstract

We examined one of the first published of the several systematic reviews being part of WHO’s renewed initiative to assess the evidence of associations between man-made radiofrequency electromagnetic radiation (RF-EMF) and adverse health effects in humans. The examined review addresses experimental studies of pregnancy and birth outcomes in non-human mammals. The review claims that the analyzed data did not provide conclusions certain enough to inform decisions at a regulatory level. Our objective was to assess the quality of this systematic review and evaluate the relevance of its conclusions to pregnant women and their offspring. The quality and relevance were checked on the review’s own premises: e.g., we did not question the selection of papers, nor the chosen statistical methods. While the WHO systematic review presents itself as thorough, scientific, and relevant to human health, we identified numerous issues rendering the WHO review irrelevant and severely flawed. All flaws found skew the results in support of the review’s conclusion that there is no conclusive evidence for nonthermal effects. We show that the underlying data, when relevant studies are cited correctly, support the opposite conclusion: There are clear indications of detrimental nonthermal effects from RF-EMF exposure. The many identified flaws uncover a pattern of systematic skewedness aiming for uncertainty hidden behind complex scientific rigor. The skewed methodology and low quality of this review is highly concerning, as it threatens to undermine the trustworthiness and professionalism of the WHO in the area of human health hazards from man-made RF-EMF.

Excerpts

"In this paper, we present a thorough analysis of the quality, validity and conclusion of the first report of a series of reviews from a renewed World Health Organization (WHO) initiative to assess the evidence of associations between (human made) radiofrequency electromagnetic radiation (RF-EMF) and adverse health effects in the general and working population. This initiative will publish several reports in “the Environmental Health Criteria (EHC) series”. The report we analyzed [1], is the first in the row, hereinafter ‘EHC2023’, published in August 2023. A companion protocol was published in 2021 [2], below just termed “the protocol”. A monograph summing up the results of these EHC reports on individual adverse effects is planned as an update of the 1993 WHO monograph on radiofrequency fields [3].

EHC2023 is a systematic review, including meta-analyses as to 14 different endpoints related to pregnancy and birth outcomes, based on selected experimental laboratory studies on effects on pregnancy and birth from RF-EMF exposure of non-human mammals. EHC2023 is a massive work, carried out under the banner of objectivity, thoroughness and scientific rigor by the use of statistical refinement and technicalities, arguably in order to reach a sound and solid conclusion. The final conclusion of the report is (EHC2023, p. 31, bold added):

In spite of the large number of studies collected, our systematic review could only partly answer the PECO question and did not provide conclusions certain enough to inform decisions at a regulatory level, but it can be considered a solid starting point to direct future research on this topic.

Our objective with this paper is, contrary to this conclusion, to document as clearly as possible, that the conclusion of the EHC2023 review is far from supported, but contradicted, by the scientific literature analyzed by its authors. What seems to be supportive, appears so due to the many irrelevant studies included, to important methodological choices not being documented or discussed, and due to significant errors and flaws. By our stepwise testing, we found that with flaws corrected, the original data and the EHC2023 methodology led to an opposite conclusion: Evidence of hazard from subthermal exposure to RF-EMF is well underpinned by its reviewed literature."

"The authors of EHC2023 considered 88 papers to be relevant and of sufficient quality for their review. Parts of our analysis have been carried out using the data from all these 88 papers."

"For a detailed quality assessment of the performed calculations in EHC2023, we chose the procedure for doing calculations of the pooled effects size based on Cohen’s d and its confidence intervals used for nine of the 14 of the endpoints. To make the work manageable, we chose the endpoint with the most studies reviewed: the “fetal weight” endpoint (EHC2023 Figure 6), based on 44 papers, assuming this would be representative for the EHC2023 meta-analyses. The assessment was done by closely reviewing 43 of these papers and how they are handled in EHC2023."

"Our main result: many flaws in EHC2023, all contributing to the conclusion “no conclusion can be drawn”

"More than half the studies included in EHC2023 are irrelevant for humans protected by IEEE/ICES and ICNIRP guidelines, making the results irrelevant"

"For the EHC2023 review to be relevant for the assessment of hazards to pregnant women and their fetuses in everyday situations, the exposure conditions in the studies reviewed should mimic – or at least to a reasonable extent be transferable to – everyday situations pregnant women will encounter when in an environment with (manmade) RF-EMFs/wireless technology. This means that only studies with “Low nonthermal SAR” are relevant." ... "To be considered relevant, a study should therefore use subthermal exposure conditions, and over several days. We found that over half the studies selected for the EHC2023 review do not meet these criteria: They are experiments with irrelevant exposure conditions."

The Systematic Review (SR) used a "A pooled effect size open for interpretation" ... "The equations used for relative weighting of the studies have the potential of skewing the results in any direction, and are neither documented nor discussed"

"The Risk of Bias (RoB) assessment of EHC2023 is highly biased towards thermal studies" .... Hence, by favoring thermal studies, the RoB analysis is also skewed toward favoring old studies, while discrediting modern studies."... we see that of the total papers reviewed, the majority is published before 2001 (50 vs. 38 papers). Of papers published 1975–2000, 22 % were rated High Concern for Risk of Bias (HC), while 52 % of the newer studies (2001–2021) are rated HC. We also see that the newer papers are almost all nonthermal, and as much as more than half of them are rated (HC), while for older studies, published before 2001, a majority of the papers are thermal, and that more nonthermal than thermal are rated HC." ... " The overall conclusion from this analysis is that the RoB analysis is biased, in particular as it downgrades modern studies of nonthermal effects due to RoB questions unfit for quality assessment of such studies." ... The biased RoB analysis of the EHC2023 has the overall effect of increasing the number of thermal studies used in the meta-analysis – thereby reducing relevance, increasing heterogeneity and adding uncertainty, and is then further used in a biased and flawed line of logic to claim that the resulting small pooled effect sizes then found are uncertain."

"Our in-depth analysis of the “fetal weight” meta-analysis reveals misciting and miscalculation behind the pooled effect size" ... "

"We found, in total nine studies (27 %) cited erroneously or with unjustified divergences, and “cherry picking” experiments from 12 studies (36 %). In some cases, several flaws applied to the same study. In total we found flawed handling of 19 (58 %) of the 33 nonthermal studies analyzed in EHC2023 for the fetal weight endpoint....All of the flaws described skew the results in the direction of a lower pooled effect size and/or higher uncertainty. The flaws make the meta-analysis useless, unless for just that purpose."

"Misreporting of significant detrimental effects found in reviewed papers due to choice of endpoints not used in modern, nonthermal studies" ... we limited our analysis to the 28 relevant, nonthermal papers selected for the EHC2023 fetal weight meta-analysis. We found that significant detrimental effects were not reported, or misreported in various ways: Of the 28 papers, eight report no effects found. Of the remaining 20 papers, significant results are reported in 13 papers (65 %) but omitted in EHC2023 Table 3 (A very few of these omitted effects are superficially mentioned elsewhere in EHC2023)....Only for the remaining seven of the 28 nonthermal papers are all effects reported in EHC2023 Table 3, although they are still downplayed in most cases." ... "Using biochemical parameters as endpoints is part of modern approaches to assess health risks from subthermal exposure. Since such effects are relevant to all mammals, they offer better assessments also as to human health risks when experiments are carried out on animals. By disregarding findings at such endpoints and downgrading such modern approaches in their RoB assessment, the authors of EHC2023 favor old, irrelevant studies. Also, by their endpoints chosen, they effectively eliminate the huge majority of modern research observing physiological changes clearly caused from subthermal exposures [8]."

"Relevant correlated factors not taken into account" ... "EHC2023 checks for fetal weight reduction as an effect from RF-EMF exposure. However, the well-known inverse correlation between fetal weight and litter size has not been taken into account by the EHC2023 authors" ... " It Is alarming that the two single endpoints" [fetal weight and brain weight] "in EHC2023 that we checked, are so “saturated” with serious flaws, rendering the meta-analyses useless, although both endpoints should have been rather simple to evaluate."

"Sub-group analyses of non-thermal effects not made, although prescribed in protocol" ... "The protocol for EHC2023 specifies that sub-group analyses should be made for subthermal RF-EMF exposure – for parameters such as frequency, duration and modulation (the protocol, p. 9). EHC2023 deviates from its protocol by only doing sub-group analysis for animal species, SAR-values (SAR<0.1, 0.1≤SAR<5, SAR≥5 W/kg) and animal core temperature increase." ... "Leaving out sub-group analyses for frequency, duration and modulation means missed opportunities to spot effects on health from subthermal exposure and their possible causes, as such analyses would do so better than sub-groups for averaged SAR values from heterogeneous experiments."

"EHC2023 claims the effects found stem from the thermal studies. But when corrected, the strongest effects are in the nonthermal" ... " This result shows that of all the nonthermal studies in the EHC2023 fetal weight analysis, those with the lowest SAR show the highest reductions of fetal weight and therefore contribute the most to the increase in pooled effect size for the “fetal weight” endpoint. It is also significantly higher than the pooled effect size presented in EHC2023 for the thermal, LSC studies (1.01 compared to 0.51)."

"Discussion: how may all the flaws in EHC2023 be explained?" ... "EHC2023’s many flaws strip the study of legitimacy and the results of any credibility or trustworthiness, even when evaluated on the premises of the so-called “thermal only tradition”....On the top of this, the authors of EHC2023 falsely claim that all effects found be caused by results of experiments with thermal exposure conditions and therefore, falsely inferring that realistic conditions are harmless....A substantial part of the flaws may well be explained as resulting from all the authors of the review belonging to “the thermal only tradition:"

"The WHO EHC undertaking is organized by a group of 21 experts selected by WHO’s office “The International EMF Project” (TIEP). All but three of these experts are either affiliated with the guidelines issuing foundation ICNIRP [9] or connected through co-authorships linked to a tiny self-referencing network of authors mainly affiliated with ICNIRP and IEEE/ICES or both [10]. Both ICNIRP and IEEE/ICES defend exposure limits based on tissue overheating as sufficient for EMF protection, the thermal only tradition. ICNIRP is closely connected to TIEP. IEEE/ICES issues guidelines for RF-EMF used in USA, in co-ordination with ICNIRP." // ... The 21 experts selected the authors for the protocol and EHC2023. All these experts are proponents of the thermal only view."

Conclusions

"The rigorous protocol and extensive analyses presented in EHC2023 and its protocol, convey an impression of serious science, credibility, and reliability. However, we have shown that this is not the case.

We found EHC2023 to be a massive work with a rigorous and complex protocol and extensive and complex statistical analyses. A consequence of the complexity is that it can be assumed that no average reader – not even professionals – will check the results of the review, if not for other reasons, because of the major effort needed. Thereby, scientific exchange, debate and control is impeded and reduced to a matter of trust.

We had the opportunity to spend time on an in-depth analysis of representative parts of EHC2023 to assess its quality based to the extent possible on the review’s own premises – that is, independent of our opinion about the professional premises chosen.

We cannot prove that the flaws and omissions are deliberately added to reach wanted conclusions, as we have next to no information about the authors, neither of the process behind the authoring EHC2023 or its protocol. Anyhow, and whatever the cause, the EHC2023 review is clearly of such a low quality, also when evaluated within the thermal only tradition, that its conclusions are without scientific value.

Our findings show that the conclusion of EHC2023 is not well-founded, and therefore the final conclusions of EHC2023 that no conclusion can be drawn that are (EHC2023, p. 31) “certain enough to inform decisions at a regulatory level” cannot be trusted. The errors, flaws and omissions are grave enough to render EHC2023 unscientific and unethical, and it should therefore be retracted.

As it now stands, the conclusion of ECH2023 stands out as what appears to be a manufactured argument for current regulations being adequate to protect the health of human mothers and their offspring. Manipulating and skewing research results in order to manufacture a wanted conclusion is a well-known strategy to avoid stricter regulations [11], [12], [13], [14], [15]. Further investigations and better sources would be needed to prove such an assault on humanity to be the case as to EHC2023.

EHC2023 is just one of several studies commissioned by the same organization (WHO EHC no. 137) and states clearly that consistency has been assured in the protocols for these studies. Our analysis of EHC2023 may in this view be seen as a case study of the results of the entire WHO EHC undertaking: Since many of our concerns are related to core elements of the protocol, there are good reasons also to question the quality of all present and forthcoming results being part of the WHO EHC undertaking unless a thorough revision of its course is made."

Open access paper: https://www.degruyter.com/document/doi/10.1515/reveh-2024-0089/html

==

Aug 1, 2023

WHO announces members of the Task Group 
on Radiofrequency Fields and Health Risks

The World Health Organization (WHO) announced the 21 experts selected for the Task Group on Radiofrequency Fields and Health Risks. These individuals are responsible for examining ten research reviews and making recommendations for the WHO Environmental Health Criteria (EHC) Monograph on Radio Frequency (RF) Fields and Health Risks to be published in 2023.

The list of 21 experts selected by the WHO for the Task Group on Radiofrequency Fields and Health Risks appears below along with information I compiled regarding task group members' EMF publications and affiliations with ICNIRP, the self-selected group that recommends RF exposure limits which are promoted by the WHO.

Eleven of the 21 individuals have current or past affiliations with ICNIRP. Most of the other individuals have published or presented papers defending ICNIRP's RF exposure limits. A recent study found that ICNIRP heavily cites its own members' research and that of their close colleagues to support the ICNIRP exposure limits (Nordhagen and Flydal, 2022).

Eight of the 21 experts have eight or fewer EMF articles listed in EMF-Portal's archive of 37,000 publications.

Not one of the 250 EMF scientists who signed the International EMF Scientist Appeal was selected by the WHO for the Task Group. Nor were any of these scientists selected to work on the ten research reviews that the Task Group will consider. Yet. signatories of the International EMF Scientist Appeal have more than 2,000 EMF publications listed in the EMF-Portal archive.

Apparently, the WHO has biased the selection of participants in the task group and the research reviews to ensure that the forthcoming WHO RF health risk monograph will support ICNIRP's weak RF exposure limits that fail to protect humans and other species from chronic exposure to low levels of radiofrequency radiation (ICBE-EMF, 2022). It's no wonder that much of the public distrusts the WHO if this is how the agency proceeds to "enhance its management of conflicts of interest as well as strengthen public trust and transparency."

Related posts:

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WHO PUBLIC NOTICE: Task Group on Radiofrequency Fields and Health Risks
World Health Organization, Dec 15, 2022

PUBLIC NOTICE: Task Group on Radiofrequency Fields and Health Risks

Overview

In order to enhance its management of conflicts of interest as well as strengthen public trust and transparency in connection with WHO meetings and activities involving the provision of technical/normative advice, the names and brief biographies of individuals (“Published Information”) being considered for participation in a WHO-convened Guideline Development Group are disclosed for public notice and comment.

The Published Information is provided by the experts themselves and is the sole responsibility of the individuals concerned. WHO is not responsible for the accuracy, veracity and completeness of the Published Information provided. Furthermore, in no event will WHO be responsible or liable for damages in relation to the use of, and reliance upon, the Published Information.

The comments received by WHO through the public notice and comment process are treated confidentially. Any comments should be sent to this e-mail address: emfproject@who.int. Comments brought to the attention of WHO through this process are an integral component of WHO’s conflict of interest assessment process and are carefully reviewed. WHO reserves the right to discuss information received through this process with the relevant expert and disclose to this expert the name and affiliation of the provider of such information. Upon review and assessment of the information received through this process, WHO, in its sole discretion, may take appropriate management action in accordance with its policies.

Guideline Development Groups provide technical and/or normative advice and recommendations to WHO. Participation in a Guideline Development Group convened by WHO does not necessarily mean that the views expressed by the expert concerned are shared by WHO and/or represent the decisions or stated policy of WHO.

The list of participating experts, a summary of relevant interests disclosed by such experts, and any appropriate mitigation measures taken by WHO relating to the management of conflicts of interests, will be reported publicly in accordance with WHO policies.

https://www.who.int/publications/m/item/task-group-on-radiofrequency-fields-and-health-risks

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Task Group on Radiofrequency Fields and Health Risks, 2023
WHO Headquarters, Geneva, Switzerland

Disclaimer

In order to enhance its management of conflicts of interest as well as strengthen public trust and transparency in connection with WHO meetings and activities involving the provision of technical/normative advice, the names and brief biographies of individuals (“Published Information”) being considered for participation in a WHO-convened Guideline Development Group are disclosed for public notice and comment.

The Published Information is provided by the experts themselves and is the sole responsibility of the individuals concerned. WHO is not responsible for the accuracy, veracity and completeness of the Published Information provided. Furthermore, in no event will WHO be responsible or liable for damages in relation to the use of, and reliance upon, the Published Information.

The comments received by WHO through the public notice and comment process are treated confidentially. Any comments should be sent to this e-mail address: emfproject@who.int. Comments brought to the attention of WHO through this process are an integral component of WHO’s conflict of interest assessment process and are carefully reviewed. WHO reserves the right to discuss information received through this process with the relevant expert and disclose to this expert the name and affiliation of the provider of such information. Upon review and assessment of the information received through this process, WHO, in its sole discretion, may take appropriate management action in accordance with its policies.

Guideline Development Groups provide technical and/or normative advice and recommendations to WHO. Participation in a Guideline Development Group convened by WHO does not necessarily mean that the views expressed by the expert concerned are shared by WHO and/or represent the decisions or stated policy of WHO.

The list of participating experts, a summary of relevant interests disclosed by such experts, and any appropriate mitigation measures taken by WHO relating to the management of conflicts of interests, will be reported publicly in accordance with WHO policies.

--

Following is a list of the 21 experts selected by the WHO for the Task Group on Radiofrequency Fields and Health Risks with some additional information appended. Download the document to see their biographies.

ZEEB Hajo (Chair)
Expertise: Epidemiologist
Qualifications: MSc, MD, PhD
Current position: Professor of Epidemiology
Institutional affiliation: Leibniz-Institute for Prevention Research and Epidemiology-BIPS (Bremen, Germany) and University of Bremen (Germany)
EMF-Portal: 1 EMF paper in 2010
Contributed to one of the review protocols for the WHO RF monograph with 3 ICNIRP co-authors

VERBEEK Jos (Methodologist)
Expertise: Occupational Physician by training, specialized in systematic reviews and guidelines of environmental and occupational health issues
Qualifications: MD, PhD
Current position: Senior Researcher
Institutional affiliation: University Medical Centers Amsterdam, Public and Occupational Health Department, Netherlands; Cochrane Work
EMF-Portal: 2 EMF papers in 2021-2022
Contributed to one of the review protocols for the WHO RF monograph with 3 ICNIRP co-authors

AHN Young Hwan
Expertise: Clinician - Neurosurgeon
Qualifications: MD, PhD
Current position: Professor of Neurosurgery
Institutional affiliation: Ajou University School of Medicine, Ajou University Hospital, Korea
EMF-Portal: 16 EMF papers from 2013-2022

AUVINEN Anssi
Qualifications: MD, PhD (epidemiology)
Current position: Professor of epidemiology
Institutional affiliation: Tampere University, Tampere, Finland
EMF-Portal: 41 EMF papers from 2013-2022
ICNIRP Scientific Expert Group (SEG): 2013 on

CARDIS Elisabeth
Expertise: Epidemiologist
Qualifications: PhD
Current position: Professor of Epidemiology, Head Radiation Programme
Institutional affiliation: Barcelona Institute of Global Health (ISGlobal), Spain
EMF-Portal: 79 EMF papers from 1997-2022
Corresponding member of ICNIRP; Standing Committee paper (2001)

DE SÈZE René
Expertise: researcher, background in physics and medicine; expertise in human and vivo studies, focused on the nervous and the endocrine system, and recently on thermal regulation and perception
Qualifications: MD, PhD, Docent
Current position: Senior scientist, end February 28th, 2023
Institutional affiliation: National Institute of Industrial Environment and Risks, under the umbrella of the Environment Ministry (Ecology), France
EMF-Portal: 54 EMF papers from 1991-2021

ELTITI Stacy
Expertise: Researcher
Qualifications: Ph.D.
Current position: Associate Professor of Psychology
Institutional affiliation: Rosemead School of Psychology, Biola University, USA
EMF-Portal: 8 EMF papers from 2007-2018

FIOCCHI Serena
Expertise: Bioelectromagnetics, EMF computational exposure assessment
Qualifications: PhD (Bioengineering)
Current position: Research Scientist
Institutional affiliation: CNR – National Research Council, Institute of Electronics, Information Engineering and Telecommunications (IEIIT), Italy
EMF-Portal: 62 EMF papers from 2011-2022

KAIJSER Magnus
Expertise: Clinician and Researcher
Qualifications: MD, PhD
Current positions: Senior Consultant in Neuroradiology, Professor of Epidemiology
Institutional affiliation: Department of Neuroradiology, Karolinska University Hospital, Institute of Environmental Medicine, Karolinska Institute, Sweden
EMF-Portal:  No EMF papers

KROMHOUT Hans
Expertise: Epidemiologist/exposure scientist
Qualifications: PhD, MSc
Current position: Full Professor
Institutional affiliation: Utrecht University, Institute for Risk Assessment Sciences, Netherlands
EMF-Portal:  92 EMF papers from 1991-2022

LAAKSO Ilkka
Expertise: Researcher
Qualifications: M.Sc.(Tech.), D.Sc.(Tech.)
Current position: Assistant Professor, Department of Electrical Engineering and Automation
Institutional affiliation: Aalto University, Finland
EMF-Portal: 82 EMF papers from 2097-2022
ICNIRP SEG: 2016 on

LEE Hae-June
Expertise: Researcher
Qualifications: DVM, PhD
Current position: Principal Researcher
Institutional affiliation: Korea Institute of Radiological & Medical Sciences
EMF-Portal: 35 EMF papers from 2006-2022

LOUGHRAN Sarah
Expertise: Research Scientist
Qualifications: PhD
Current position: Director, Radiation Research and Advice
Institutional affiliation: Australian Radiation Protection and Nuclear Safety Agency (ARPANSA)
EMF-Portal:  20 EMF papers from 2005-2021
ICNIRP SEG: 2013 on

MCGARR Gregory W.
Expertise: Thermal Physiology; Integrative Human Physiology
Qualifications: PhD
Current Position: Research Scientist; Adjunct Professor
Institutional Affiliation: Non-Ionizing Radiation Health Sciences Division, Consumer and Clinical Radiation
Protection Bureau, Health Canada; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa
EMF-Portal: 2 EMF papers from 2016-2022

MODENESE Alberto
Expertise: occupational medicine, occupational epidemiology
Qualifications: PhD, MD
Current position: Occupational Physician, Post-Doc Researcher, Secretary of the ICOH Scientific Committee “Radiation and Work”
Institutional affiliation: a) Department of biomedical, metabolic and Neural Science, University of Modena & Reggio emilia, Italy; b) International Commission on Occupational Health (ICOH) – Scientific Committee “Radiation and Work”
EMF-Portal: 5 EMF papers from 2020-2022

OKOKON Enembe Oku
Expertise: public health physician, clinical lecturer, environmental epidemiologist
Qualifications: MD, PhD
Current position: Chief consultant; senior lecturer; Caldwell Research Fellow, NCEPH, Australian National University.
Institutional affiliation: University of Calabar, Nigeria; National Centre for Epidemiology and Population Health, Australian National University.
EMF-Portal: 1 EMF paper in 2014

SAVITZ David A.
Expertise: Epidemiologist
Qualifications: PhD
Current position: Professor of Epidemiology
Institutional affiliation: Brown University School of Public Health, Rhode Island, USA
EMF-Portal:  74 EMF papers from 1985-2015

SCHMIDT Janine
Expertise: Biologist
Qualifications: Diploma, Dr. rer. nat. (PhD in Science)
Current position: Senior Scientist, Competence Center for Electromagnetic fields
Institutional affiliation: German Federal Office for Radiation Protection (BfS)
EMF-Portal:  3 EMF papers from 2020-2021
ICNIRP is supported and housed in the German Federal Office for Radiation Protection

USHIYAMA Akira
Expertise: in vivo experiment
Qualifications: PhD, MPH
Current position: Director
Institutional affiliation: National Institute of Public Health, Japan
EMF-Portal:  25 EMF papers from 2004-2021

WATANABE Soichi
Expertise: RF EMF exposure expert
Qualifications: Doctor of Engineering
Current position: Director
Institutional affiliation: Electromagnetic Compatibility Laboratory, Electromagnetic Standards Research Center, Radio Research Institute, National Institute of Information and Communications Technology, Japan
EMF-Portal:  154 EMF papers from 1996-2023
ICNIRP Standing Committee: 2004 on; Commission: 2013 on

WU Tongning
Expertise: Exposure expert
Qualifications: PhD
Current position: Professorate senior engineer
Institutional affiliation: China Academy of Information and Communications Technology
EMF-Portal: 51(?) EMF papers from 2004-2022
ICNIRP SEG: 2019 on

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September 1, 2021 (Updated August 28, 2023)

The World Health Organization (WHO) is undertaking a health risk assessment of radiofrequency (RF) electromagnetic fields (EMF) which will be published as a monograph in the Environmental Health Criteria (EHC) series. 

This monograph will update the 1993 monograph on radiofrequency fields (EHC #137).


According to Microwave News, the WHO originally began work on this monograph in January 2012 (WHO, 2016*) and planned to publish a new monograph by 2016. In 2014 the WHO released 11 chapters of a draft report for public comment, Comments on the draft report from the scientific community were highly critical. "After that the process stalled, and the RF EHC was stuck in limbo." 


Three years after the WHO planned to publish the formal risk assessment of all studied health outcomes, the WHO issued a call for ten systematic reviews of the RF effects research in October 2019 (see list below). This call had a short timeline to apply. "The lack of advance notice and the fast deadline have led some to question whether the WHO engineered the schedule to help ICNIRP stay in control." In 2020, WHO reissued the call for three of these reviews (SR2, SR4, SR10).
Although the WHO refused to state publicly whom they selected to conduct these reviews, most of the scientists' identities are now available since papers describing the research protocols for nine (all but SR10) of the forthcoming ten reviews have been published online (see abstracts below). 

Apparently, WHO only selected research groups whose members have not criticized ICNIRP's thermally-based exposure limits. Thus, no EMF scientists who signed the International EMF Scientist Appeal were selected. This biased selection process should be challenged by all who are concerned about protecting public or environmental health.

The ten research protocols are being published in a special issue of Environment International (see https://www.sciencedirect.com/journal/environment-international/special-issue/109J1SL7CXT).

To conduct the research reviews, the scientists will use a "tailored version" of the National Toxicology Program's OHAT risk of bias rating tool "for evaluating individual study risk of bias or internal validity – the assessment of whether the design and conduct of a study compromised the credibility of the link between exposure and outcome" (1-3). This tool has been recommended for assessing risk of bias in human environmental epidemiology studies (Eick et al., 2021; see abstract below). 

For the EHC monograph, "Confidence in evidence will be assessed in line with the GRADE approach."

A tool is only as good as the persons using it. Will the scientists that the WHO chose to conduct these reviews apply these tools in an unbiased manner? Or will they employ them to manufacture doubt about the validity of the thousands of peer-reviewed studies that assessed biologic and health effects from exposure to radio frequency fields?

Lagorio et al. (2021) while describing their research protocols forecast the conclusion of their review paper: "As systematic reviews cannot remedy limitations of the original studies, those (and our) syntheses are unlikely to produce conclusive evidence." So this review will likely call for more definitive research.

According to Chartres et al. (2022):

"A recent study found that tools that use an overall risk of bias rating may reduce the available evidence to evaluate the health effects of chemical exposures by excluding studies based on only one methodological or reporting limitation, leading to an inaccurate conclusion [136, 137]. These findings are consistent with the 2021 NAS report on the IRIS Program, which found, based on data from recent IRIS assessments that used such a risk of bias approach, that the proportion of human studies excluded from further consideration ranged from 0 to 50 percent for human epidemiological studies, and 0 to 41.5 percent for animal studies [70]. Recognizing this concern, two separate 2021 NAS reports recommended that “study evaluation ratings should not be used to exclude studies” [70], “Do not exclude studies based on risk of bias, study quality, or reporting quality” and “Do not use numeric scores to evaluate studies; replace them with domain-based scoring as is done in the tools used in the Navigation Guide and OHAT” [124].

To avoid discarding valuable information, risk of bias assessments should be performed for each individual study, and the evidence base should then be assessed in its entirety. This allows an exploration of the potential effects of various biases. The 2021 NAS report makes this point: “While there is inevitably variation in the internal validity and risk of bias across individual studies, it is standard practice to include all studies, even the studies with a high risk of bias into the evidence synthesis… Once a study is determined to be eligible, the study could be included in the synthesis and the risk-of-bias assessment and its limitations accounted for in any qualitative or quantitative synthesis… In the synthesis step, low-quality studies may be excluded as a sensitivity analysis, but it is inappropriate to leave them out of synthesis completely” [124]."  (4)

There has never been a perfect study--every study has either limited internal or construct validity and/or limited external validity or generalizability.

According to the National Research Council (2007):
"The extent to which particular scientific results constitute progress in knowledge or contribute to societal well-being is often contested. This is especially the case when scientific findings are uncertain or controversial and when they can be interpreted to support controversial policy choices....Assessing science, no matter how rigorous the methods that may be used, is ultimately a matter of interpretation. The possibility of competing interpretations of evidence is ever-present when using science indicators or applying any other analytic method for measuring the progress and impact of science." (5)
Papers describing the protocols have been published for nine of the ten reviews (all but SR10). Nine current and former members of ICNIRP are involved in the nine reviews with four members involved in multiple reviews: Feychting (SR1, SR3, SR5, SR7), Roosli (SR1, SR7, SR8), Karipidis (SR1, SR5), Wood (SR2, SR4), Danker-Hopfe (SR6), Kuhne (SR9), Marino (SR4), Oftedal (SR8), and Pophof (SR6).

ICNIRP is a group of self-selected scientists who engage in "groupthink" and promote weak RF exposure guidelines that protect humans only from health risks due to acute heating. According to Investigate Europe, a team of investigative journalists, members of ICNIRP have a history of coopting national health and international reviews of health effects to ensure support for their weak exposure limits. Hence, these scientists who have a vested interest in preserving weak RF exposure limits should not be allowed to participate in this official review of RF effects by the WHO.

References

(1) National Toxicology Program. Handbook for Conducting Systematic Reviews for Health Effects Evaluations. https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/handbook/index.html

(2) National Toxicology Program. Handbook for Conducting a Literature-Based Health Assessment Using OHAT Approach for Systematic Review and Evidence Integration (March 4, 2019): https://ntp.niehs.nih.gov/ntp/ohat/pubs/handbookmarch2019_508.pdf

(3) National Toxicology Program. 2019 OHAT Handbook Update and Clarification Summary Document (March 4, 2019). https://ntp.niehs.nih.gov/ntp/ohat/pubs/handbookclarificationmarch2019_508.pdf

(4) Chartres N, Sass JB, Gee D, Bălan SA, Birnbaum L, Cogliano VJ, Cooper C, Fedinick KP, Harrison RM, Kolossa-Gehring M, Mandrioli D, Mitchell MA, Norris SL, Portier CJ, Straif K, Vermeire T.​​ Conducting evaluations of evidence that are transparent, timely and can lead to health-protective actions. Environ Health. 2022 Dec 5;21(1):123. doi: 10.1186/s12940-022-00926-z. https://ehjournal.biomedcentral.com/articles/10.1186/s12940-022-00926-z 

(5) National Research Council. 2007. A Strategy for Assessing Science: Behavioral and Social Research on Aging. Washington, DC: The National Academies Press. https://doi.org/10.17226/11788.


Research Protocols for Radiofrequency EHC Reviews;


SR1: 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

Susanna Lagorio, Maria Blettner, Dan Baaken, Maria Feychting, Ken Karipidis, Tom Loney, Nicola Orsini, Martin Röösli, Marilia Silva Paulo, Mark Elwood. 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. Environ Int. 2021 Aug 22;157:106828. doi: 10.1016/j.envint.2021.106828.

Highlights

• 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.

Abstract

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.

Financial support 

This project is supported by the World Health Organization (grant numbers: RAD 2020/1031788–0; RAD 2020/994756–0). Co-financing was provided by the New Zealand Ministry of Health; the Istituto Superiore di Sanit`a in its capacity as a WHO Collaborating Centre for Radiation and Health; ARPANSA as a WHO Collaborating Centre for Radiation Protection.

Role of funders

A strict oversight was exercised by the WHO Secretariat to ensure that all commissioned systematic reviews were planned according to a harmonized and good practice standard. The other sponsors had no role in developing the protocol.

Open access paper: 
https://www.sciencedirect.com/science/article/pii/S0160412021004530?via%3Dihub

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SR2: Effects of radiofrequency electromagnetic fields (RF EMF) on cancer in laboratory animal studies

Meike Mevissen, Jerrold M. Ward, Annette Kopp-Schneider, James P. McNamee, Andrew W. Wood, Tania M. Rivero, Kristina Thayer, Kurt Straif. Effects of radiofrequency electromagnetic fields (RF EMF) on cancer in laboratory animal studies. Environment International. Volume 161, 2022. 107106. doi: 10.1016/j.envint.2022.107106.

Abstract

Background  The carcinogenicity of radiofrequency electromagnetic fields (RF EMF) has been evaluated by the International Agency for Research on Cancer (IARC) in 2011. Based on limited evidence of carcinogenicity in humans and in animals, RF EMF were classified as possibly carcinogenic to humans (Group 2B). In 2018, based on a survey amongst RF experts, WHO prioritized six major topics of potential RF EMF related human health effects for systematic reviews. In the current manuscript, we present the protocol for the systematic review of experimental laboratory animal studies (cancer bioassays) on exposure to RF fields on the outcome of cancer in laboratory animals.

Objective  In the framework of WHO’s Radiation Program, the aim of this work is to systematically evaluate effects of RF EMF exposure on cancer in laboratory animals.

Study eligibility and criteria  WHO's Handbook (2014) for guideline development will be followed with appropriate adaptation. The selection of eligible studies will be based on Population, Exposures, Comparators, and Outcomes (PECO) criteria. We will include peer-reviewed articles and publicly available reports from government agencies reporting original data about animal cancer bioassays on exposure to RF EMF. The studies are identified by searching the following databases: MEDLINE (PubMed), Science Citation Index Expanded and Emerging Sources Citation Indes (Web of Science), Scopus, and the EMF Portal. No language or year-of-publication restrictions are applied. The methods and results of eligible studies will be presented in accordance with the PRISMA 2020 guidelines.

Study appraisal method  Study evaluation of individual studies will be assessed using a risk of bias (RoB) tool developed by the Office of Health Assessment and Translation (OHAT) with appropriate considerations including sensitivity for evaluating RF EMF exposure in animal cancer bioassays. The final evaluation on the certainty of the evidence on a carcinogenic risk of RF EMF exposure in experimental animals will be performed using the OHAT Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach with appropriate considerations. The protocol has been registered in an open-source repository (PROSPERO).

Funding  The study is partly financially supported by the World Health Organization. No additional funding was provided outside author salaries through their places of employment.

Declaration of Competing Interest   

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: AWW directs a research group, which includes three technical associates who are telecommunications company employees. 

JM receives employment and research support from The government of Canada related to the topic. KS has been the Head of the IARC Monographs program until his regular retirement (11/2018). Since 10/2019, he is a member of the International Scientific Advisory Committee of the Ramazzini Institute. This involves one 3 h advisory group meeting per year. He does not receive remuneration for his advisory activity. 

MM is a member of the scientific advisory board of The Swiss Research Foundation for Electricity and Mobile Communication (FSM) that receives research money from commercial entities. She does not receive remuneration for his advisory activity. Her partner does consulting relating to cell phone safety. All remaining authors declare no conflict of interest.


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SR3: The effects of radiofrequency exposure on male fertility and adverse reproductive outcomes: A protocol for two systematic reviews of human observational studies with meta-analysis

Ryan P.W. Kenny, Evelyn Barron Millar, Adenike Adesanya, Catherine Richmond, Fiona Beyer, Carolina Calderon, Judith Rankin, Mireille Toledano, Maria Feychting, Mark S Pearce, Dawn Craig, Fiona Pearson. The effects of radiofrequency exposure on male fertility and adverse reproductive outcomes: A protocol for two systematic reviews of human observational studies with meta-analysis. Environ Int. 158, 2022, 106968. doi: 10.1016/j.envint.2021.106968.

Abstract

Background  The World Health Organization (WHO) is bringing together evidence on radiofrequency electromagnetic field (RF-EMF) exposure in relation to health outcomes, previously identified as priorities for evaluation by experts in the field, to inform exposure guidelines. A suite of systematic reviews are being undertaken by a network of topic experts and methodologists in order to collect, assess and synthesise data relevant to these guidelines. Here, we present the protocol for the systematic review on the effect of exposure to RF on adverse reproductive outcomes (human observational studies), also referred to as Systematic Review (SR) 3 within the series of systematic reviews currently being commissioned.

Objectives  Following the WHO handbook for guideline development and the COSTER conduct guidelines, we will systematically review the effect of RF-EMF exposure on both male fertility (SR3A) and adverse pregnancy outcomes (SR3B) in human observational studies. Herein we adhere to the PRISMA-P reporting guidelines.

Data sources  We will conduct a broad search for potentially relevant records relevant for both reviews within the following bibliographic databases: MEDLINE; Embase; and EMF Portal. We will also conduct searches of grey literature through relevant databases and organisational websites. RF-EMF experts will also be consulted. We will hand search citation and reference lists of included study records.

Study eligibility criteria  We will include quantitative human observational studies on the effect of RF-EMF exposure: (in SR3A) in adult male participants on infertility, sperm morphology, concentration or total sperm count or motility; and (in SR3B) in preconception adults or pregnant women on preterm birth, small for gestational age (associated with intrauterine growth restriction), miscarriage, stillbirth and congenital anomalies.

Study appraisal and synthesis methods  Titles, abstracts and then full texts will be screened in blinded duplicate against eligibility criteria with input from a third reviewer as required. Data extraction from included studies will be completed by two reviewers as will risk of bias assessment using the Office of Health Assessment and Translation (OHAT) tool. If appropriate we will undertake meta-analysis to pool effect measures and explore heterogeneity using sub-group analyses or meta-regression as feasible. We will conduct sensitivity analysis to assess the impact of any assumptions made throughout the review process. The OHAT methodology, based on the GRADE guidelines for evidence assessment, will be used to evaluate the certainty of evidence per outcome and to conclude the level of evidence of a health effect.

Conclusion  This manuscript details the protocols for two systematic reviews. The aims of publishing details of both protocols are to: pre-specify their scope and methods; reduce the impact of reviewer bias; promote transparency and replicability; and improve the review process.

Prospero registration CRD42021265401 (SR3A), CRD42021266268 (SR3B).

Declaration of Competing Interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Maria Feychting has a permanent position as Professor of Epidemiology at Karolinska Institutet, Stockholm Sweden since 2005. She has served as advisor to a number of national and international public advisory and research steering groups concerning the potential health effects of exposure to non-ionizing radiation, including the WHO (ongoing), Public Health England Advisory Group on Non-ionising Radiation - AGNIR (2009–2017), the Norwegian Public Health Institute (2010–2012), the Swedish Council for Working Life and Social Research (2003–2012), the Swedish Radiation Safety Authority’s independent scientific expert group on electromagnetic fields (2003–2011). She was member of the International Commission on Non-Ionizing Radiation Protection (ICNIRP), an independent body setting guidelines for non-ionizing radiation protection (2008–May 2020), and vice chairman of the Commission (May 2016–May 2020).

Mireille Toledano has been involved in funded research assessing mobile phone and other wireless technologies usage on health outcomes. The SCAMP (study cognition adolescents and mobile phones) prospective cohort study which is currently ongoing (2015–2021). The COSMOS (cohort study of mobile phone use and health) a longitudinal cohort study which is completed (2019).

Open access paper: https://www.sciencedirect.com/science/article/pii/S0160412021005936

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SR4: Effects of Radiofrequency Electromagnetic Field (RF-EMF) exposure on male fertility and pregnancy and birth outcomes: Protocols for a systematic review of experimental studies in non-human mammals and in human sperm exposed in vitro

Francesca Pacchierotti, Lucia Ardoino, Barbara Benassi, Claudia Consales, Eugenia Cordelli, Patrizia Eleuteri, Carmela Marino, Maurizio Sciortino, Martin H.Brinkworth, Guangdi Chen, James P. McNamee, Andrew William Wood, Carlijn R. Hooijmans. Rob B.M. de Vries. Effects of Radiofrequency Electromagnetic Field (RF-EMF) exposure on male fertility and pregnancy and birth outcomes: Protocols for a systematic review of experimental studies in non-human mammals and in human sperm exposed in vitro. Environment Int. Volume 157, December 2021, 106806.

Highlights

• Male infertility and adverse pregnancy outcomes are relevant human health problems.
• Radiofrequency electromagnetic fields are widespread in the human environment.
• A link between radiofrequency and adverse reproductive outcomes is controversial.
• This is the protocol of WHO-funded systematic review and meta-analysis on this issue.

Abstract

Background  Radiofrequency Electromagnetic Fields (RF-EMF) at environmental level have been reported to induce adverse effects on the male reproductive system and developing embryos. However, despite the number of experiments conducted since the 1970s, the diversity of testing approaches and exposure conditions, inconsistencies among results, and dosimetric flaws have not yet permitted a solid assessment of the relationship between RF-EMF exposure and such effects, warranting a more systematic and methodologically rigorous approach to the evaluation of available data.

Objectives  This study aims at evaluating the effects of RF-EMF exposure on male fertility and pregnancy outcomes by a systematic review (SR) of experimental studies, conducted in compliance with international guidelines. The evidence will be organized into three streams: 1) Studies evaluating the impact of RF-EMF on the male reproductive system of experimental mammals; 2) studies evaluating the impact of RF-EMF on human sperm exposed in vitro; 3) studies evaluating the impact of RF-EMF on adverse pregnancy, birth outcomes and delayed effects in experimental mammals exposed in utero.

Study eligibility and criteria  Eligible studies will include peer-reviewed articles reporting of original results about effects of controlled exposures to RF-EMF in the frequency range 100 kHz–300 GHz on the selected outcomes without any language or year-of-publication restrictions. Eligible studies will be retrieved by calibrated search strings applied to three electronic databases, PubMed, Scopus and EMF Portal and by manual search of the list of references of included papers and published reviews.

Study appraisal and synthesis method  The internal validity of the studies will be evaluated using the Risk of Bias (RoB) Rating Tool developed by National Toxicology Program/Office of Health Assessment and Translation (NTP/OHAT) integrated with input from the SYRCLE RoB tool. Given sufficient commensurate data, meta-analyses will be performed, otherwise narrative syntheses will be produced. Finally, the certainty of the effects of RF-EMF exposure on male fertility and pregnancy and birth outcomes will be established following GRADE.

Funding  The study is financially supported by the World Health Organization.

Registration  OSF Registration DOI https://doi.org/10.17605/OSF.IO/7MUS3; PROSPERO CRD42021227729, CRD42021227746.

Financial support   This project is partially funded by the World Health Organization (contract 2020/1026306-0). Additional in-kind funds are provided by ENEA, Health Canada and Swinburne University of Technology.

Declaration of Competing Interest

AWW directs a research group, which includes three technical associates who are telecommunications company employees. The group is also providing advice for a local government authority and a utility on electric and magnetic field exposure issues on a fee-for-service basis. AWW has been member of the ICNIRP Scientific Expert Group (SEG) from 2013 until 2021 and collaborates with the Australian Radiation Protection and Nuclear Safety Agency. 

JPM was a member for IARC Monograph 102 Working Group assessing the carcinogenicity of RF-EMF (Mechanistic Studies sub-group), a co-author of Canada’s Safety Code 6 (which are the de facto national human exposure limits applied in Canada) and a member of the WHO EMF Project International Advisory Committee (Canadian representative). Health Canada financially contributed to the WHO EMF Project to support the completion of the systematic reviews on RF-EMF. 

CM has been member of Technical Consultation on the WHO RF Research Agenda (2010), member of ICNIRP main commission since May 2012, confirmed in 2016 and 2020, Italian delegate for the European Cost Actions BM0704 and BM1309 “EMF-MED”. 

All other authors declare that they have no known conflicts of interest.

Open access paper: 

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SR5: The effect of long-term radiofrequency exposure on cognition in human observational studies: A protocol for a systematic review

Geza Benke, Michael J Abramson, B M Zeleke, Jordy Kaufman, Ken Karipidis, Helen Kelsall, Steve McDonald, Chris Brzozek, Maria Feychting, Sue Brennan. The effect of long-term radiofrequency exposure on cognition in human observational studies: A protocol for a systematic review. Environ Int. 158, 2022. doi: 10.1016/j.envint.2021.106972.

Highlights

• This protocol outlines the steps required for a systematic review of the effect of long-term radiofrequency exposure on cognition in human observational studies.
• The protocol allows for an assessment of possible cognitive effects due to RF-EMFs from personal, environmental and occupational exposure.
• The protocol follows the best methodology for synthesis and risk of bias assessment for RF-EMF exposure and cognition in human observational studies.

Abstract

Background: The long term effects of exposure to radiofrequency (RF) electromagnetic fields (EMF) for frequencies from 100 kHz to 300 GHz on cognitive performance are best assessed using observational studies. In recent years, the use of mobile (cell) phones has been the main source of RF EMF exposure to the brain, although other sources of exposure may be significant. Cognitive function includes various mental and psychological abilities, which can be measured in a range of domains, such as learning, memory, reasoning, problem solving, decision making and attention. Although effects on cognitive function may be most evident later in life, in the experimental setting acute and immediate effects can only be studied. Observational studies are needed when effects are observed after months or years following short or long-term exposure. The importance of the effects of exposure on children has also been recently identified.

Objectives: To assess the long-term effects of RF EMF local and whole-body exposure compared to no or a lower level of exposure on indicators of cognition, including complex attention, executive function, learning and memory, perceptual motor ability and social cognition, but excluding cognitive effects caused by neurodegenerative diseases or neurodevelopmental disorders, and to assess if there is evidence of a dose response relationship.

Study eligibility and criteria: We will include observational studies that have evaluated cognitive effects of RF energy including a comparator group with a different level of exposure. Studies must report at least one validated measure of cognitive function, including global or domain specific measures, or cognitive impairment, with a minimum follow-up of 6 months. Cohort or case-control studies published in the peer review literature in any language are eligible. We will exclude cross-sectional studies and any that only report brain structure or biomarkers.

Study appraisal and synthesis method: We will conduct searches of PubMed, Embase, PsycINFO and the EMF-Portal. At least two authors will independently screen the titles/abstracts of all records, with any conflicts resolved by a third reviewer. Full-text screening will also be conducted independently by two authors with conflicts resolved by consensus. Data will be extracted from the studies included, such as identifiers and characteristics of the study design, exposure and comparator groups, participants, outcomes assessed and results. Risk of bias will be assessed with the Office of Health Assessment and Translation (OHAT) tool. We will conduct a meta-analysis of similar studies with a random effects model in STATA or similar software, if two or more studies are available for a given exposure-outcome combination. Confidence in the body evidence will be judged using GRADE methods as adapted by OHAT for reviews of environmental exposures.

Funding  This project is funded by the World Health Organization. Co-financing was provided by ARPANSA in its capacity as a WHO Collaborating Centre for Radiation Protection.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Open access paper:
 
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SR6: The effect of exposure to radiofrequency electromagnetic fields on cognitive performance in human experimental studies: A protocol for a systematic review

Blanka Pophof, Jacob Burns, Heidi Danker-Hopfe, Hans Dorn, Cornelia Egblomassé-Roidl, Torsten Eggert, Kateryna Fuks, Bernd Henschenmacher, Jens Kuhne, Cornelia Sauter, Gernot Schmid. The effect of exposure to radiofrequency electromagnetic fields on cognitive performance in human experimental studies: A protocol for a systematic review. Environ Int. 2021 Jul 29;157:106783. doi: 10.1016/j.envint.2021.106783.

Abstract

Background: The World Health Organization (WHO) is currently assessing the potential health effects of exposure to radiofrequency electromagnetic fields (RF-EMFs) in the general and working population. Related to one such health effect, there is a concern that RF-EMFs may affect cognitive performance in humans. The systematic review (SR) aims to identify, summarize and synthesize the evidence base related to this question. Here, we present the protocol for the planned SR.

Objectives: The main objective is to present a protocol for a SR which will evaluate the associations between short-term exposure to RF-EMFs and cognitive performance in human experimental studies.

Data sources: We will search the following databases: PubMed, Embase, Web of Science, Scopus, and the EMF-Portal. The reference lists of included studies and retrieved review articles will be manually searched.

Study eligibility and criteria: We will include randomized human experimental studies that assess the effects of RF-EMFs on cognitive performance compared to no exposure or lower exposure. We will include peer-reviewed articles of any publication date in any language that report primary data.

Data extraction and analysis: Data will be extracted according to a pre-defined set of forms developed and piloted by the review author team. To assess the risk of bias, we will apply the Rating Tool for Human and Animal Studies developed by NTP/OHAT, supplemented with additional questions relevant for cross-over studies. Where sufficiently similar studies are identified (e.g. the heterogeneity concerning population, exposure and outcome is low and the studies can be combined), we will conduct random-effects meta-analysis; otherwise, we will conduct a narrative synthesis.

Assessment of certainty of evidence: The certainty of evidence for each identified outcome will be assessed according to Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Performing the review according to this protocol will allow the identification of possible effects of RF-EMFs on cognitive performance in humans. The protocol has been registered in PROSPERO, an open-source protocol registration system, to foster transparency.

Financial support  This project is funded by the World Health Organization.

Registration  PROSPERO CRD42021236168.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Open access paper

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SR7: The effects of radiofrequency electromagnetic fields exposure on tinnitus, migraine and non-specific symptoms in the general and working population: A protocol for a systematic review on human observational studies

Martin Röösli, Stefan Dongus, Hamed Jalilian, Maria Feychting, John Eyers, Ekpereonne Esu, Chioma Moses Oringanje, Martin Meremikwu, Xavier Bosch-Capblanch. The effects of radiofrequency electromagnetic fields exposure on tinnitus, migraine and non-specific symptoms in the general and working population: A protocol for a systematic review on human observational studies. Environ Int, Volume 157, 2021. doi: 10.1016/j.envint.2021.106852.

Highlights

• There is public concern to develop non-specific symptoms from EMF.
• No up to date comprehensive systematic review is available.
• Priority outcomes for head exposure are tinnitus, migraine, and headaches.
• Further priority outcomes are sleep disturbances and composite symptom scores.

Abstract

Background  Applications emitting radiofrequency electromagnetic fields (RF-EMF; 100 kHz to 300 GHz) are widely used for communication (e.g. mobile phones), in medicine (diathermy) and in industry (RF heaters). Concern has been raised that RF-EMF exposure affects health related quality of life, because a part of the population reports to experience a variety of symptoms related to low exposure levels below regulatory limits.

Objectives  To systematically review the effects of longer-term or repeated local and whole human body RF-EMF exposure on the occurrence of symptoms evaluating migraine, tinnitus, headaches, sleep disturbances and composite symptom scores as primary outcomes.

Methods  We will follow the WHO handbook for guideline development. For the development of the systematic review protocol we considered handbook for conducting systematic reviews for health effects evaluations from the National Toxicology Program-Office of Health Assessment and Translation (NTP-OHAT) and COSTER (Recommendations for the conduct of systematic reviews in toxicology and environmental health research).

Eligibility criteria  Peer-reviewed epidemiological studies in the general population or workers aiming to investigate the association between local or whole-body RF-EMF exposure for at least one week and symptoms are eligible for inclusion. Only cohort, case-control and panel studies will be included.

Information sources  We will search the scientific literature databases Medline, Web of Science, PsycInfo, Cochrane Library, Epistemonikos and Embase, using a predefined search strategy. This search will be supplemented by a search in the EMF-Portal and checks of reference lists of relevant papers and reviews.

Study appraisal and synthesis method  Data from included papers will be extracted according to predefined forms. Findings will be summarized in tables, graphical displays and in a narrative synthesis of the available evidence, complemented with meta-analyses. We will separately review effects of local, far field and occupational exposure.

Risk of bias The internal validity of included studies will be assessed using the NTP-OHAT Risk of Bias Rating Tool for Human and Animal Studies, elaborated to observational RF-EMF studies.

Evidence appraisal  To rate certainty of the evidence, we will use the OHAT GRADE-based approach for epidemiological studies.

Framework and funding  This protocol concerns one of the ten different systematic reviews considered in a larger systematic review of the World Health Organization to assess potential health effects of exposure to RF-EMF in the general and working population.

Registration PROSPERO CRD42021239432.

Open access paper: https://www.sciencedirect.com/science/article/pii/S0160412021004773?via%3Dihub

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SR8: The effects of radiofrequency electromagnetic fields exposure on human self-reported symptoms: A protocol for a systematic review of human experimental studies

Xavier Bosch-Capblanch, Ekpereonne Esu, Stefan Dongus, Chioma Moses Oringanje, Hamed Jalilian, John Eyers, Gunnhild Oftedal, Martin Meremikwu, Martin Röösli. The effects of radiofrequency electromagnetic fields exposure on human self-reported symptoms: A protocol for a systematic review of human experimental studies. Environ Int. 158, 2022, 106953. doi: 10.1016/j.envint.2021.106953.

Abstract

Background  The technological applications of radiofrequency electromagnetic fields (RF-EMF) have been steadily increasing since the 1950s across multiple sectors exposing large proportions of the population. This fact has raised concerns related to the potential consequences to people’s health. The World Health Organization (WHO) is assessing the potential health effects of exposure to RF-EMF and has carried out an international survey amongst experts, who have identified six priority topics to be further addressed through systematic reviews, whereof the effects on symptoms is one of them. We report here the systematic review protocol of experimental studies in humans assessing the effects of RF-EMF on symptoms.

Objective  Our objectives are to assess the effects of exposure to electromagnetic fields (compared to no or lower exposure levels) on symptoms in human subjects. We will also assess the accuracy of perception of presence of exposure in volunteers with and without idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF).

Eligibility criteria  We will search relevant literature sources (e.g. the Web of Science, Medline, Embase, Epistemonikos) for randomized trials (comparing at least two arms) and randomised crossover trials of RF-EMF exposure that have assessed the effects on symptoms. We will also include studies that have measured the accuracy of the perception of the presence or absence of exposure. We will include studies in any language.

Study appraisal and synthesis  Studies will be assessed against inclusion criteria by two independent reviewers. Data on study characteristics, participants, exposure, comparators and effects will be extracted using a specific template for this review, by two independent reviewers. Discrepancies will be solved by consensus. Risk of bias (ROB) will be assessed using the ROB Rating Tool for Human and Animal Studies and the level of confidence in the evidence of the exposure-outcome relations will be assessed using the GRADE approach. For the perception studies, we will use adapted versions of the ROB tool and GRADE assessment. Where appropriate, data will be combined using meta-analytical techniques.


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SR9: The effect of radiofrequency electromagnetic fields (RF-EMF) on biomarkers of oxidative stress in vivo and in vitro: A protocol for a systematic review

Bernd Henschenmacher, Annette Bitsch, Tonia de las Heras Gala, Henry Jay Forman, Athanassios Fragoulis, Pietro Ghezzi, Rupert Kellner, Wolfgang Koch, Jens Kuhne, Dmitrij Sachno, Gernot Schmid, Katya Tsaioun, Jos Verbeek, Robert Wright. The effect of radiofrequency electromagnetic fields (RF-EMF) on biomarkers of oxidative stress in vivo and in vitro: A protocol for a systematic review. Environ Int. 158, 2022, 106932. doi: 10.1016/j.envint.2021.106932.

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.

Open access paper: https://www.sciencedirect.com/science/article/pii/S0160412021005572

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Prioritizing health outcomes when assessing the effects of exposure to radiofrequency electromagnetic fields: A survey among experts

Jos Verbeek, Gunnhild Oftedal, Maria Feychting, Eric van Rongen, Maria Rosaria Scarfì, Simon Mann, Rachel Wong, Emilie van Deventer. Prioritizing health outcomes when assessing the effects of exposure to radiofrequency electromagnetic fields: A survey among experts. Environ Int. 146, 2021. 106300. 
doi:10.1016/j.envint.2020.106300.

Highlights

• RF EMF may lead to other than heat-related health effects by yet unknown mechanisms
• Prioritizing health effects is needed for review utility and resource efficiency.
• RF EMF experts prioritized all peer-reviewed published biological and health outcomes.
• Cancer, heat-related effects, and adverse birth outcomes were rated most critical.
• WHO commissioned ten systematic reviews of the most critical health outcomes.

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.

Excerpts

Given the limited resources available for systematic reviews, it was decided to include male fertility but not brain electrical function. The ratings of these two outcomes as critical were similar, but more experts rated male fertility as important....

Declaration of Competing Interest

MF was vice chairman (May 2016 – May 2020) of the International Commission on Non-Ionizing Radiation Protection, an independent body setting guidelines for non-ionizing radiation protection. She has served as advisor to several national and international public advisory and research steering groups concerning the potential health effects of exposure to non-ionizing radiation.

MRS is in the Scientific Council of the Swedish Radiation Safety Authority for preparing reports on the evaluation of the scientific literature related to electromagnetic fields and health.

GO is member of the International Commission on Non-Ionizing Radiation Protection. She has been member of groups appointed by Norwegian authorities to evaluate potential health effects of non-ionizing electromagnetic fields.

EvR was chairman (May 2016 – May 2020) of the International Commission on Non-Ionizing Radiation Protection and is currently vice-chairman. He is also member of the Scientific Council of the Swedish Radiation Safety Authority.

SM is a member of the International Commission on Non-Ionizing Radiation Protection’s Scientific Expert Group. Within the UK, he is Secretary to the Committee on Medical Aspects of Radiation in the Environment and he was Secretary (until 2017) to the Advisory Group on Non-Ionising Radiation.

All other authors have declared no conflict of interest.


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Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools

Stephanie M. Eick, Dana E. Goin, Nicholas Chartres, Juleen Lam, Tracey J. Woodruff. Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools. Syst Rev 9, 249 (2020). doi: 10.1186/s13643-020-01490-8.

Abstract

Background  Systematic reviews are increasingly prevalent in environmental health due to their ability to synthesize evidence while reducing bias. Different systematic review methods have been developed by the US National Toxicology Program’s Office of Health Assessment and Translation (OHAT), the US Environmental Protection Agency’s (EPA) Integrated Risk Information System (IRIS), and by the US EPA under the Toxic Substances Control Act (TSCA), including the approach to assess risk of bias (ROB), one of the most vital steps which is used to evaluate internal validity of the studies. Our objective was to compare the performance of three tools (OHAT, IRIS, TSCA) in assessing ROB.

Methods  We selected a systematic review on polybrominated diphenyl ethers and intelligence quotient and/or attention deficit hyperactivity disorder because it had been endorsed by the National Academy of Sciences. Two reviewers followed verbatim instructions from the tools and independently applied each tool to assess ROB in 15 studies previously identified. We documented the time to apply each tool and the impact the ROB ratings for each tool had on the final rating of the quality of the overall body of evidence.

Results  The time to complete the ROB assessments varied widely (mean = 20, 32, and 40 min per study for the OHAT, IRIS, and TSCA tools, respectively). All studies were rated overall “low” or “uninformative” using IRIS, due to “deficient” or “critically deficient” ratings in one or two domains. Similarly, all studies were rated “unacceptable” using the TSCA tool because of one “unacceptable” rating in a metric related to statistical power. Approximately half of the studies had “low” or “probably low ROB” ratings across all domains with the OHAT and Navigation Guide tools.

Conclusions  Tools that use overall ROB or study quality ratings, such as IRIS and TSCA, may reduce the available evidence to assess the harms of environmental exposures by erroneously excluding studies, which leads to inaccurate conclusions about the quality of the body of evidence. We recommend using ROB tools that circumvent these issues, such as OHAT and Navigation Guide.


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EHC on Radiofrequency fields* (WHO, 2016)

Excerpt from: 

World Health Organization. The International EMF Project Progress Report. June 2015-2016. page 10. https://cdn.who.int/media/docs/default-source/radiation-international-emf-project-reports/emf-iac-2016-progress-report.pdf?sfvrsn=7b2836c0_2. Accessed 01/17/2022.
"Following on the publication of the INTERPHONE study (May 2010) and the IARC classification of RF fields (May 2011), the health risk assessment of radiofrequency fields by WHO was started with a kick-off meeting in January 2012. A core group of 6 experts has been gathered to help with the development of the monograph. They, in turn, have enlisted the help of close to 30 experts to develop different sections of the first draft. Monthly conference calls have been held over the past year. A face-to-face meeting was convened in Istanbul in May 2015.

A number of systematic reviews have been performed based on published peer-reviewed data. Search strategies, inclusion/exclusion criteria and quality criteria have been developed for the different types of studies. A first draft was uploaded on the WHO website in the Fall of 2014. Over 90 entries were filed electronically through the consultation providing around 700 comments to different chapters and section of the draft. Over 300 missing papers were identified through this useful step. Each submission has been carefully considered by the Core Group and the draft has been revised to take account of relevant comments and of papers published since December 2012. As a result of the consultation, a new chapter on biochemical and biological effects was added.

The drawing of conclusions from the literature and the drafting of these chapters is the remit of a formal Task Group that will be convened by WHO following due process. The meeting of the Task Group is currently slated to be held in the Fall of 2016."

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In March 1993, almost 30 years ago, the WHO published the last EHC monograph on radiofrequency radiation:


Electromagnetic fields (‎300 Hz to 300 GHz)

Environmental Health Criteria Monograph No.137

Overview

"WHO's assessment of any health risks produced by EMF emitting technologies falls within the responsibilities of the International EMF Project. One of the goals of the International EMF Project is therefore to carry out health risk assessments of RF, ELF and static fields, published in the Environmental Health Criteria.

The health risk assessments are the result of in-depth critical reviews conducted through independent, scientific peer-review groups. The are usually undertaken if new data are available that would substantially change the evaluation, if there is public concern for health or environmental effects of the agent because of greater exposure, or if an appreciable time period has elapsed since the last evaluation."

https://www.who.int/publications/i/item/9241571373