Tuesday, January 25, 2022

Effect of Mobile Phones on Sperm Quality

Diagram representing various sources of RF EMF exposure effect on brain and testicular organ and deleterious outcomes (Kesari, Agarwal & Henkel, 2018)

Review Papers

Pusan National University scientists reveal links between sperm quality and cell phone use

The findings of their updated meta-analysis hint at the potential dangers of modern electronic gadgets

Pusan National University, News Release

An infographic depicting the key findings of the new meta-analysis

image: After examining a series of studies from 2012 to 2021, researchers have performed an updated meta-analysis that clearly indicates the connection between cell phone and decreased sperm quality. view more 

Credit: Pusan National University

Cell phones have succeeded in bringing the world closer, making life tolerable during a very trying time. But cellphones also have their downsides. They can have negative effects on health. This is because cell phones emit radiofrequency electromagnetic waves (RF-EMWs), which are absorbed by the body. According to a meta-analysis from 2011, data from previous studies indicate that RF-EMWs emitted by cell phones degrade sperm quality by reducing their motility, viability, and concentration. However, this meta-analysis had a few limitations, as it had low amounts of in vivo data and considered cell phone models that are now outdated.

In an effort to bring more up-to-date results to the table, a team of researchers led by Assistant Professor Yun Hak Kim from Pusan National University, Korea, conducted a new meta-analysis on the potential effects of cell phones on sperm quality. They screened 435 studies and records published between 2012 and 2021 and found 18—covering a total of 4280 samples—that were suitable for the statistical analyses. Their paper was made available online on July 30, 2021 and was published in Volume 202 of Environmental Research in November, 2021.

Overall, the results indicate that cell phone use is indeed associated with reduced sperm motility, viability, and concentration. These findings are more refined than those from the previous meta-analysis thanks to a better subgroup analysis of the data. Another important aspect that the researchers looked into was if higher exposure time to cell phones was correlated to lower sperm quality. However, they found out that the decrease in sperm quality was not significantly related to exposure time—just to exposure to mobile phones itself. Considering the results were consistent across both in vivo and in vitro (cultured sperm) data, Dr. Kim warns that “Male cell-phone users should strive to reduce mobile phone use to protect their sperm quality.”

Knowing that the number of cell phone users is most likely going to increase in the future, it’s high time we start considering exposure to RF-EMW as one of the underlying factors causing a reduction in sperm quality among the male population. Moreover, seeing how technologies evolve so quickly, Dr. Kim remarks that “additional studies will be needed to determine the effect of exposure to EMWs emitted from new mobile phone models in the present digital environment.” The bottom line is, if you’re worried about your fertility (and potentially other aspects of your health), it may be a good idea to limit your daily cell phone use.

https://www.eurekalert.org/news-releases/941005

Effects of mobile phone usage on sperm quality – No time-dependent relationship on usage: A systematic review and updated meta-analysis

Sungjoon Kim, Donghyun Han, Jiwoo Ryu, Kihun Kim, Yun Hak Kim. Effects of mobile phone usage on sperm quality – No time-dependent relationship on usage: A systematic review and updated meta-analysis. Environmental Research. 202:111784, 2021. doi:10.1016/j.envres.2021.111784.

Abstract

Background   Mobile phones emit radiofrequency (RF) electromagnetic waves (EMWs), a low-level RF that can be absorbed by the human body and exert potential adverse effects on the brain, heart, endocrine system, and reproductive function. Owing to the novel findings of numerous studies published since 2012 regarding the effect of mobile phone use on sperm quality, we conducted a systematic review and updated meta-analysis to determine whether the exposure to RF-EMWs affects human sperm quality.

Methods  This study was conducted in accordance with the PRISMA guidelines. The outcome measures depicting sperm quality were motility, viability, and concentration, which are the most frequently used parameters in clinical settings to assess fertility.

Results  We evaluated 18 studies that included 4280 samples. Exposure to mobile phones is associated with reduced sperm motility, viability, and concentration. The decrease in sperm quality after RF-EMW exposure was not significant, even when the mobile phone usage increased. This finding was consistent across experimental in vitro and observational in vivo studies.

Discussion  Accumulated data from in vivo studies show that mobile phone usage is harmful to sperm quality. Additional studies are needed to determine the effect of the exposure to EMWs from new mobile phone models used in the present digital environment.

Excerpts

"... 18 studies fulfilled all inclusion criteria and were included in the meta-analysis (Table 1 and Fig. 1) (Agarwal et al., 2008, 2009; Ahmad and Baig, 2011; Al-Bayyari, 2017b; De Iuliis et al., 2009; Ding et al., 2018a; Dkhil et al., 2011; Erogul et al., 2006; Falzone et al., 2008; Fejes et al., 2005; Kaya et al., 2020; Malini, 2017b; Rago et al., 2013; Sajeda and Al-Watter, 2011; Veerachari and Vasan, 2012; Wdowiak et al., 2018; Yildirim et al., 2015; Zalata et al., 2015). Nine studies from a previous meta-analysis and nine new studies that included 4280 samples were used for analysis. One conference paper included in the previous study was excluded. The sperm quality parameters established in each paper varied and were subjected to a meta-analysis; 16 papers provided data on sperm motility, 6 provided data on sperm viability, and 12 provided data on sperm concentration. All in vitro studies were experimental, whereas all in vivo studies were observational. We identified the MD values of the entire 4280 samples and analyzed the MD values of each group after classifying them according to four criteria: control group setting (non-exposure vs. less exposure), study design (in vivo and in vitro), participant group (fertility clinic and population), and storage location (trousers or not)."

Conclusion

"Mobile phone use decreased the overall sperm quality by affecting the motility, viability, and concentration. It was further reduced in the group with high mobile phone usage. In particular, the decrease was remarkable in in vivo studies with stronger clinical significance in subgroup analysis. Therefore, long-term cell phone use is a factor that must be considered as a cause of sperm quality reduction. Additional studies are needed to determine the effect of the exposure to EMWs emitted from new mobile phone models in the present digital environment."

https://www.sciencedirect.com/science/article/pii/S0013935121010781 

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Romualdo Sciorio, Luca Tramontano, Sandro C Esteves. Effects of mobile phone radiofrequency radiation on sperm quality. Zygote. 2021 Aug 13;1-10. doi: 10.1017/S096719942100037X

Abstract

In the last decades, the universal use of mobile phones has contributed to radiofrequency electromagnetic radiation environmental pollution. The steady growth in mobile phone usage has raised concerns about the effects of phone radiation on male reproductive health. Epidemiological studies report a sharp decline in sperm counts in developing countries, and worldwide with c. 14% of couples having difficulties to conceive, many of which are attributed to a male infertility factor. Environment and lifestyle factors are known to contribute to male infertility. Exposure to heat, radiation, or radioactivity might induce damage to biological tissue organs, including the testis. Given the ubiquitous use of mobile phones, the potential adverse effects of the resulting environmental radiation needs to be elucidated further. It seems to be an apparent relationship between the increased exposure to mobile phone radiofrequency and sperm quality decline, but the evidence is not conclusive. Our review summarizes the evidence concerning the possible adverse effects of cell phone radiation on the male reproductive system, with a focus on sperm quality. Also, we critically analyze the effects of elevated testicular temperature and oxidative stress on male fertility and how these factors could interfere with the physiological activities of the testis.


Future perspectives and conclusions

The rapid technological advances in personal computers and communication devices might pose a risk for human health. Cell phone devices emit radiofrequency electromagnetic waves that seem to affect male reproductive health and other body functions (McClelland 3rd and Jaboin, 2018; Sage and Burgio, 2018; Wall et al., 2019). Although the current data are not unequivocal, it seems sound to speculate that mobile phone exposure might be contributing to subfertility. However, the existing evidence primarily relates to adverse effects on sperm motility and morphology, which are limited endpoints for evaluating the male fertility potential.

The exact mechanisms of how RF-EMR might affect the testis, epididymis, and sperm have not yet been fully understood. Additional studies are warranted, particularly prospective studies assessing sperm functional markers, such as sperm DNA integrity and OS, in fertile and subfertile men. Equally important will be to analyze whether the decreased sperm quality associated with mobile phone exposure translates into impaired pregnancy chances. The effects of short-term and long-term exposure and energy intensity should be also investigated in more detail, taking into account relevant confounders. Only then will scientific societies and regulatory bodies be able to provide users with transparent information concerning the risks and guidance for proper use.

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Gang Yu, Zhiming Bai, Song Chao, Qing Cheng, Gang Wang, Zeping Tang, Sixing Yang. Current progress on the effect of mobile phone radiation on sperm quality: an updated systematic review and meta-analysis of human and animal studies. Environmental Pollution. Published online: 30 March 2021. https://doi.org/10.1016/j.envpol.2021.116952.

Highlights

• Mobile phone use was related to sperm quality decline of men in some areas.
• Mobile phone RF-EMR directly impaired mature sperm of men in vitro.
• Mobile phone RF-EMR affected some parameters of sperm quality in experiment animals.
• Experiment conditions affected pooled results of animal experiments.
• More studies should be conducted to investigate this issue in new era.

Abstract

Potential suppression of fertility due to mobile phone radiation remains a focus of researchers. We conducted meta-analyses on the effects of mobile phone radiation on sperm quality using recent evidence and propose some perspectives on this issue. Using the MEDLINE/PubMed, Embase, WOS, CENTRAL, and ClinicalTrials.gov databases, we retrieved and screened studies published before December 2020 on the effects of mobile phone use/mobile phone RF-EMR on sperm quality. 

Thirty-nine studies were included. Data quality and general information of the studies were evaluated and recorded. Sperm quality data (density, motility, viability, morphology, and DFI) were compiled for further analyses, and we conducted subgroup, sensitivity, and publication bias analyses. 

The pooled results of human cross-sectional studies did not support an association of mobile phone use and a decline in sperm quality. Different study areas contributed to the heterogeneity of the studies. In East Europe and West Asia, mobile phone use was correlated with a decline in sperm density and motility. Mobile phone RF-EMR exposure could decrease the motility and viability of mature human sperm in vitro. 

The pooled results of animal studies showed that mobile phone RF-EMR exposure could suppress sperm motility and viability. Furthermore, it reduced sperm density in mice, in rats older than 10 weeks, and in rats restrained during exposure. Differences regarding age, modeling method, exposure device, and exposure time contributed to the heterogeneity of animal studies. Previous studies have extensively investigated and demonstrated the adverse effects of mobile phone radiation on sperm. 

In the future, new standardized criteria should be applied to evaluate potential effects of mobile phone RF-EMR dosages. Further sperm-related parameters at the functional and molecular levels as well as changes in biological characteristics of germ cells should be evaluated. Moreover, the impact of mobile phone RF-EMR on individual organs should also be examined.

Conclusion

The results of our meta-analysis indicated that in East Europe and West Asia, mobile phone use is associated with a decline in human sperm density and motility. Mobile phone RF-EMR can reduce motility and viability of mature human sperm in vitro, and it can also reduce sperm motility and viability in male animals and decrease sperm density of sexually mature restrained rats. Some important factors that affect the results of animal experiments are study setup and radiation device as well as age and exposure time. Our study is an extension of previous studies and has scientific value for future studies on effects of mobile phone RF-EMR associated with sperm quality.

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Pooja Negi, Rajeev Singh. Association between reproductive health and nonionizing radiation exposure.  Electromagnetic Biology and Medicine. Published online: 20 Jan 2021. DOI: 10.1080/15368378.2021.1874973.
 

Recently, a decreasing rate of fertility has to be credited to an array of factors such as environmental, health and lifestyle. Male infertility is likely to be affected by the strong exposure to heat and radiations. The most common sources of nonionizing radiations are cell phones, laptops, Wi-Fi and microwave ovens, which may participate to the cause of male infertility. One of the major sources of daily exposure to non-ionizing radiation is mobile phones. A mobile phone is now basically dominating our daily life through better services such as connectivity, smartphone devices. However, the health consequences are linked with their usage are frequently ignored. Constant exposure to non-ionizing radiations produced from a cell phone is one of the possible reasons for growing male infertility. Recently, several studies have shown that cell phone users have altered sperm parameters causing declining reproductive health. Cell phone radiation harms male fertility by affecting the different parameters like sperm motility, sperm count, sperm morphology, semen concentration, morphometric abnormalities, increased oxidative stress along with some hormonal changes. This review is focusing on the prevailing literature from in vitro and in vivo studies suggesting that non-ionizing exposure negatively affects human male infertility.


Negi & Singh, 2021

Conclusion

Generally, the outcome of the studies has indicated that mobile phone usage changes different sperm parameters in both ways in-vitro (human) and in-vivo (animals). Several studies disclose that the exposure to cell phones produces harmful effects on the testes, which may affect sperm motility, sperm number, sperm concentration, and morphology and an increased DNA damage, causing micronuclei formation and reactive oxygen species within the cell. So many evidences showed that exposure from cell phones results in elevated oxidative stress with disintegrated DNA and it is directly and indirectly dependent on the time of cell phone use. Further researches are required to provide strong evidence that the use of mobile phones may disturb sperm and testicular activity. Several evidences suggest that the irregularities reported due to RF-EMF-exposure depend on physical parameters such as utilized RF wavelength, penetration range into the object, and transmission length of the radiation. Unfortunately, existing studies are not able to suggest a true mechanism between the harmful effects of RF-EMF radiation and the male reproductive system. To conclude all of the above, government bodies and agencies should form strong guidelines against cell phone exposure and take preventive actions such as in the usage of mobile phones, preventing chatting, reducing the overall contact time, and holding the gadget away from the groin may be of significant help to people pursuing fertility. Moreover, very limited studies are available on protective actions so far so a large-scale analysis is also required to determine the reproductive parameters.


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Chidiebere Emmanuel Okechukwu. Does the Use of Mobile Phone Affect Male Fertility? A Mini-Review. J Hum Reprod Sci. Jul-Sep 2020;13(3):174-183. doi: 10.4103/jhrs.JHRS_126_19.  

Abstract

Presently, there is a rise in the use of mobile phones, laptops, and wireless internet technologies such as Wi-Fi and 5G routers/modems across the globe; these devices emit a considerable amount of electromagnetic radiation (EMR) which could interact with the male reproductive system either by thermal or nonthermal mechanisms. The aim of this review was to examine the effects of mobile phone use on male fertility. Related studies that reported on the effects of EMR from mobile phones on male fertility from 2003 to 2020 were evaluated. PubMed database was used. The Medical Subject Heading system was used to extract relevant research studies from PubMed. Based on the outcomes of both human and animal studies analyzed in this review, animal and human spermatozoa exposed to EMR emitted by mobile phones had reduced motility, structural anomalies, and increased oxidative stress due to overproduction of reactive oxygen species. Scrotal hyperthermia and increased oxidative stress might be the key mechanisms through which EMR affects male fertility. However, these negative effects appear to be associated with the duration of mobile phone use.

Conclusion

Based on the outcomes of both human and animal studies examined in this review, animal and human spermatozoa exposed to EMR emitted by mobile phones had reduced motility, structural anomalies, and increased oxidative stress due to the production of ROS. Scrotal hyperthermia and increased oxidative stress might be the key mechanisms by which EMR affects male fertility. However, these negative effects appear to be associated with the duration of mobile phone use.


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Jaffar FHF, Osman K, Ismail NH, Chin KY, Ibrahim SF. Adverse Effects of Wi-Fi Radiation on Male Reproductive System: A Systematic Review. Tohoku J Exp Med. 2019;248(3): 169-179. doi: 10.1620/tjem.248.169. (Note: Smartphones emit Wi-Fi, Bluetooth and various types of cellular radiation.)


Abstract

Extensive use of Wi-Fi has contributed to radiofrequency electromagnetic radiation (RF-EMR) pollution in environment. Various studies have been conducted to evaluate the effect of RF-EMR emitted by Wi-Fi transmitter on male reproduction health. However, there are conflicting findings between studies. Thus, this review aims to elucidate the possible effects of 2.45 GHz Wi-Fi exposure on both animal and human male reproductive system. A computerized database search performed through MEDLINE via Ovid and PUBMED with the following set of keywords: 'Wi-Fi or WiFi or wireless fidelity or Wi-Fi router or WiFi router or electromagnetic or radiofrequency radiation' AND 'sperm or spermatozoa or spermatogenesis or semen or seminal plasma or testes or testis or testosterone or male reproduction' had returned 526 articles. Only 17 studies conformed to pre-set inclusion criterion. Additional records identified through Google Scholar and reviewed article further revealed six eligible articles. A total of 23 articles were used for data extraction, including 15 studies on rats, three studies on mice, and five studies on human health. Sperm count, motility and DNA integrity were the most affected parameters when exposed to RF-EMR emitted by Wi-Fi transmitter. Unfortunately, sperm viability and morphology were inconclusive. Structural and/or physiological analyses of the testes showed degenerative changes, reduced testosterone level, increased apoptotic cells, and DNA damage. These effects were mainly due to the elevation of testicular temperature and oxidative stress activity. In conclusion, exposure towards 2.45 GHz RF-EMR emitted by Wi-Fi transmitter is hazardous on the male reproductive system.

Open access paper: https://www.jstage.jst.go.jp/article/tjem/248/3/248_169/_article

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Kesari KK, Agarwal A, Henkel R. Radiation and male fertility. Reprod Biol Endocrinol. 2018 Dec 9;16(1):118. doi: 10.1186/s12958-018-0431-1.

Abstract
During recent years, an increasing percentage of male infertility has to be attributed to an array of environmental, health and lifestyle factors. Male infertility is likely to be affected by the intense exposure to heat and extreme exposure to pesticides, radiation, radioactivity and other hazardous substances. We are surrounded by several types of ionizing and non-ionizing radiations and both have recognized causative effects on spermatogenesis. Since it is impossible to cover all types of radiation sources and their biological effects under a single title, this review is focusing on radiation deriving from cell phones, laptops, Wi-Fi and microwave ovens, as these are the most common sources of non-ionizing radiation, which may contribute to the cause of infertility by exploring the effect of exposure to radiofrequency radiation on the male fertility pattern. From currently available studies it is clear that radiofrequency electromagnetic fields (RF-EMF) have deleterious effects on sperm parameters (like sperm count, morphology, motility), affects the role of kinases in cellular metabolism and the endocrine system, and produces genotoxicity, genomic instability and oxidative stress. This is followed with protective measures for these radiations and future recommendations. The study concludes that the RF-EMF may induce oxidative stress with an increased level of reactive oxygen species, which may lead to infertility. This has been concluded based on available evidence from in vitro and in vivo studies suggesting that RF-EMF exposure negatively affects sperm quality. 
Ford-Glanton BS, Melendez DA. Male reproductive toxicants: Electromagnetic radiation and heat. Reference Module in Biomedical Sciences, 2018.

Abstract

Human population in today's world lives surrounded by radiofrequency fields (RF) and electromagnetic radiation (EM) fields, transmitting almost all forms of electronic communication and data that humans produce every second. Mobile devices and laptop computers are EMR-emitting devices. The effect of mobile phone emitted radiation and heat on fertility is the subject of recent interest and investigations. Many studies have found a decrease in semen quality which has increased the focus on male reproductive health. Infertility affects approximately 15% of couples of reproductive age, and nearly half of these cases are linked to male fertility (Sharlip et al., 2002). Different harmful environmental influences have led to changes in semen analysis standards by reducing the lower limits of normal ranges, which were declared by the World Health Organization (2010). The possible negative impact of mobile phone radiation on sperm quality has been well established. While no certain conclusions can be drawn from current evidence, a growing number of studies indicate a decrease in male fertility associated with increased cellular phone usage (Agarwal et al., 2011) and laptop computers using Wi-Fi (Avendaño et al., 2012a). Here we review the current evidence regarding the effects of electromagnetic radiation and heat in male fertility.

https://www.sciencedirect.com/science/article/pii/B9780128012383645361

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Yahyazadeh A, Deniz OG, Kaplan AA, Altun G, Yurt KK, Davis D. The genomic effects of cell phone exposure on the reproductive system. Environ Res. 2018 Nov;167:684-693. doi: 10.1016/j.envres.2018.05.017.


Abstract

Humans are exposed to increasing levels of electromagnetic fields (EMF) at various frequencies as technology advances. In this context, improving understanding of the biological effects of EMF remains an important, high priority issue. Although a number of studies in this issue and elsewhere have focused on the mechanisms of the oxidative stress caused by EMF, the precise understanding of the processes involved remains to be elucidated. Due to unclear results among the studies, the issue of EMF exposure in the literature should be evaluated at the genomic level on the reproductive system. Based on this requirement, a detail review of recently published studies is necessary. The main objectives of this study are to show differences between negative and positive effect of EMF on the reproductive system of animal and human. Extensive review of literature has been made based on well known data bases like Web of Science, PubMed, MEDLINE, Google Scholar, Science Direct, Scopus. This paper reviews the current literature and is intended to contribute to a better understanding of the genotoxic effects of EMF emitted from mobile phones and wireless systems on the human reproductive system, especially on fertility. The current literature reveals that mobile phones can affect cellular functions via non-thermal effects. Although the cellular targets of global system for mobile communications (GSM)-modulated EMF are associated with the cell membrane, the subject is still controversial. Studies regarding the genotoxic effects of EMF have generally focused on DNA damage. Possible mechanisms are related to ROS formation due to oxidative stress. EMF increases ROS production by enhancing the activity of nicotinamide adenine dinucleotide (NADH) oxidase in the cell membrane. Further detailed studies are needed to elucidate DNA damage mechanisms and apoptotic pathways during oogenesis and spermatogenesis in germ cells exposed to EMF.

Conclusion

This paper reviews the current literature and is intended to contribute to a better understanding of the genotoxic effects of EMF emitted from mobile phones and wireless systems on the human reproductive system, especially on fertility. The current literature reveals that mobile phones can affect cellular functions via non-thermal effects (Diem et al., 2005; Hanci et al., 2013 ;  Odaci et al., 2016a). Although the cellular targets of GSM-modulated EMF are associated with the cell membrane, the subject is still controversial (Eberhardt et al., 2008). Studies regarding the genotoxic effects of EMF have generally focused on DNA damage (Mortelmans and Rupa, 2004; Young, 2002; Zeiger, 2004; Panagopoulos, 2012 ;  Turedi et al., 2016). Possible mechanisms are related to ROS formation due to oxidative stress (Moustafa et al., 2004; Hanukoglu et al., 2006). EMF increases ROS production by enhancing the activity of NADH oxidase in the cell membrane (Friedman et al., 2007b). In this context, EMF affected spermatozoa may have a high degree rate of infertilization. It seems that previous genomic studies do not show definitive evidence regarding EMF affected cells in the fertilization. Although we evaluated broadly the genomic effects of cell phone exposure on the reproductive system using both animal and human studies, one of the weaknesses of this work is insufficient review of human studies. This may come from limited number of EMF based human studies in the literature. Further detailed studies are needed to elucidate DNA damage mechanisms and apoptotic pathways during oogenesis and spermatogenesis in germ cells that are exposed to EMF.


https://www.ncbi.nlm.nih.gov/pubmed/29884549


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Altun G, Deniz OG, Yurt KK, Davis D, Kaplan S. Effects of mobile phone exposure on metabolomics in the male and female reproductive systems. Environ Res. 2018 Nov;167:700-707. doi: 10.1016/j.envres.2018.02.031. 

Highlights


• Long-term exposure to EMF decreases sperm motility and fertilization.
• Effects of EMF emitted from mobile phones are related to protein synthesis.
• Oxidative stress based EMF exposure modulates nitric oxide level in the germ cells.
• Oxidative stress based EMF exposure inhibits antioxidant mechanisms in the germ cells.


Abstract

With current advances in technology, a number of epidemiological and experimental studies have reported a broad range of adverse effects of electromagnetic fields (EMF) on human health. Multiple cellular mechanisms have been proposed as direct causes or contributors to these biological effects. EMF-induced alterations in cellular levels can activate voltage-gated calcium channels and lead to the formation of free radicals, protein misfolding and DNA damage. Because rapidly dividing germ cells go through meiosis and mitosis, they are more sensitive to EMF in contrast to other slower-growing cell types. In this review, possible mechanistic pathways of the effects of EMF exposure on fertilization, oogenesis and spermatogenesis are discussed. In addition, the present review also evaluates metabolomic effects of GSM-modulated EMFs on the male and female reproductive systems in recent human and animal studies. In this context, experimental and epidemiological studies which examine the impact of mobile phone radiation on the processes of oogenesis and spermatogenesis are examined in line with current approaches.

Conclusion

EMF emitted by mobile phones has a number of well-documented adverse metabolomic effects on the male and female reproductive systems and can lead to infertility by increasing ROS production and reducing GSH and other antioxidants. The primary target of the EMF emitted by mobile phones may be the cell membrane (Pall in press, this volume). This then results in accelerated activity of membrane NADH oxidase and, consequently, greater rates of ROS formation that cannot be easily conjugated or detoxified. Although many studies have reported morphological and functional deteriorations in testis and ovary following EMF exposures, as well both structural and functional deficits in reproductive health, the underlying mechanisms have not been fully elucidated. To assist in further clarification of these processes and mechanisms, Table 1 summarizes key studies on the metabolomic effects of EMF on reproductive systems. Future studies will benefit greatly from standardized exposure protocols and evaluations of key metabolomic indicators.


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Sepehrimanesh, M. & Davis, D.L. Proteomic impacts of electromagnetic fields on the male reproductive system. Comp Clin Pathol. 26(2):309-313. 2017. doi:10.1007/s00580-016-2342-x. 

Abstract

The use of mobile phones and other wireless transmitting devices is increasing dramatically in developing and developed countries, as is the rate of infertility. A number of respected infertility clinics in Australia, India, USA, and Iran are reporting that those who regularly use mobile phones tend to have reduced sperm quantity and quality. Some experimental studies have found that human sperm exposed to electromagnetic fields (EMF), either simulated or from mobile phones, developed biomarkers of impaired structure and function, as well as reduced quantity. These encompass pathological, endocrine, and proteomic changes. Proteins perform a vast array of functions within living organisms, and the proteome is the entire array of proteins—the ultimate biomolecules in the pathways of DNA transcription to translation. Proteomics is the art and science of studying all proteins in cells, using different techniques. This paper reviews proteomic experimental and clinical evidence that EMF acts as a male-mediated teratogen and contributor to infertility.

Conclusions

As among the most rapidly proliferating human cells, spermatogenesis and associated activities offer an important endpoint for evaluation. More than 60 different compounds or industrial processes have been identified as increasing defects in human sperm or testicular tissue and possibly increasing the risk to offspring from male-mediated exposures. In this study, we reviewed structural and functional proteomic changes related to EMF exposure. Reported changes are categorized based on main affected tissue and also the most important adverse effects. Overall, these results demonstrate significant effects of radio frequency-modulated EMF exposure on the proteome, including both structural and functional impacts such as a decrease in the diameter and weight of the seminiferous tubules and the mean height of the germinal epithelium (Ozguner et al. 2005) and/or pathological and physiological changes in key biochemical components of the testicular tissues (Luo et al. 2013). These structural and functional changes may account for the pathological impact of EMF on the male reproductive system reported in the experimental work that we and others have conducted. While EMF is currently being used for a number of therapeutic applications (REF), the work we have reviewed here clearly indicates a range of harmful effects, especially on genital systems.

https://link.springer.com/article/10.1007/s00580-016-2342-x

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Houston B, Nixon B, King BV, De Iuliis G, Aitken RJ. The effects of radiofrequency electromagnetic radiation on sperm function. Reproduction. 2016 Dec;152(6):R263-R276. 

Abstract

Mobile phone usage has become an integral part of our lives. However, the effects of the radiofrequency electromagnetic radiation (RF-EMR) emitted by these devices on biological systems and specifically the reproductive systems are currently under active debate. A fundamental hindrance to the current debate is that there is no clear mechanism of how such non-ionising radiation influences biological systems. Therefore, we explored the documented impacts of RF-EMR on the male reproductive system and considered any common observations that could provide insights on a potential mechanism. 

Among a total of 27 studies investigating the effects of RF-EMR on the male reproductive system, negative consequences of exposure were reported in 21. Within these 21 studies, 11 of the 15 that investigated sperm motility reported significant declines, 7 of 7 that measured the production of reactive oxygen species documented elevated levels and 4 of 5 studies that probed for DNA damage highlighted increased damage, due to RF-EMR exposure. Associated with this, RF-EMR treatment reduced antioxidant levels in 6 of 6 studies that studied this phenomenon, while consequences of RF-EMR were successfully ameliorated with the supplementation of antioxidants in all 3 studies that carried out these experiments. 

In light of this, we envisage a two-step mechanism whereby RF-EMR is able to induce mitochondrial dysfunction leading to elevated ROS production. 

A continued focus on research which aims to shed light on the biological effects of RF-EMR will allow us to test and assess this proposed mechanism in a variety of cell types.

https://www.ncbi.nlm.nih.gov/pubmed/27601711

Conclusion

To date, contradictory studies surrounding the impacts of RF-EMR on biological systems maintain controversy over this subject. Nevertheless, research into the biological responses stimulated by RF-EMR is particularly important given our ever-increasing use of mobile phone technology. While clinical studies are identifying possible detrimental effects of RF-EMR, it is imperative that mechanistic studies are conducted that elucidate the manner in which RF-EMR perturbs biological function, thus supplying a rational cause. A focus on the male reproductive system may experience as consequences of the personal storage of mobile devices, the unique vulnerability of the highly specialised sperm cell, and the future health burden that may be created if conception proceeds with defective, DNA-damaged spermatozoa. While this subject remains a topic of active debate, this review has considered the growing body of evidence suggesting a possible role for RF-EMR induced damage of the male germ line. In a majority of studies, this damage has been characterized by loss of sperm motility and viability as well as the induction of ROS generation and DNA damage. We have therefore given consideration to the potential mechanisms through which RF-EMR may elicit these effects on spermatozoa, which we utilized as a sensitive model system. We propose a mechanistic model in which RF-EMR exposure leads to defective mitochondrial function associated with elevated levels of ROS production and culminates in a state of oxidative stress that would account the varying phenotypes observed in response to RF-EMR exposure. With further complementary data, this model will provide new impetus to the field and stimulate research that will allow us to confidently assess the reproductive hazards of mobile phone usage.

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Adams JA, Galloway TS, Mondal D, Esteves SC, Mathews F. Effect of mobile telephones on sperm quality: A systematic review and meta-analysis. Environ Int.  2014 Sep;70:106-12. doi: 10.1016/j.envint.2014.04.015.

Summary 

Mobile phones are owned by most of the adult population worldwide. Radio-frequency radiation (RFR) from these devices could affect sperm development and function. Around 14% of couples in high- and middle-income countries have difficulty conceiving. Male infertility is involved approximately 40% of the time. Several countries have reported unexplained declines in semen quality.
Animal research has found that RFR can affect the cell cycle of sperm, increase sperm cell death and produce histological changes in the testes. Research on humans has found that prolonged mobile phone use is associated with decreased motility, sperm concentration, morphology and viability suggesting a likely impact on fertility.

The authors of this peer-reviewed study conducted a systematic review of the research and a quantitative analysis to determine whether exposure to mobile phone radiation affects human sperm quality. Participants were from fertility clinics and research centers.

The study examined the sperm quality outcome measures most frequently used to assess fertility in clinical settings: motility (the ability to move properly through the female reproductive tract), viability (the ability to fertilize the egg), and concentration (the number of sperm in a milliliter of ejaculate).

Ten studies were examined including 1,492 human sperm samples. Exposure to mobile phones was found to be associated with a significant eight per cent average reduction in sperm motility and a significant nine per cent average reduction in sperm viability. The effects on sperm concentration were more equivocal. The results were consistent across experimental laboratory studies and correlational observational studies.

The authors concluded that the overall results suggest that mobile phone exposure negatively affects sperm quality in humans. The clinical importance of these effects  in this study may be limited to subfertile men and to men at the lower-end of the normal spectrum.
Open access paper: http://bit.ly/cellphonespermdamage.

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Liu K, Li Y, Zhang G, Liu J, Cao J, Ao L, Zhang S. 
Association between mobile phone use and semen quality: a systemic review and meta-analysis. Andrology. 2014 Jul;2(4):491-501.

Abstract

Possible hazardous health effects of radiofrequency electromagnetic radiations emitted from mobile phone on the reproductive system have raised public concern in recent years. This systemic review and meta-analysis was prepared following standard procedures of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and checklist. Relevant studies published up to May 2013 were identified from five major international and Chinese literature databases: Medline/PubMed, EMBASE, CNKI, the VIP database and the Cochrane Central Register of Controlled Trials in the Cochrane Library. Eighteen studies with 3947 men and 186 rats were included in the systemic review, of which 12 studies (four human studies, four in vitro studies and four animal studies) with 1533 men and 97 rats were used in the meta-analyses. Systemic review showed that results of most of the human studies and in vitro laboratory studies indicated mobile phone use or radiofrequency exposure had negative effects on the various semen parameters studied. However, meta-analysis indicated that mobile phone use had no adverse effects on semen parameters in human studies. In the in vitro studies, meta-analysis indicated that radiofrequency radiation had detrimental effect on sperm motility and viability in vitro [pooled mean difference (MDs) (95% CI): -4.11 (-8.08, -0.13), -3.82 (-7.00, -0.65) for sperm motility and viability respectively]. As for animal studies, radiofrequency exposure had harmful effects on sperm concentration and motility [pooled MDs (95% CI): -8.75 (-17.37, -0.12), -17.72 (-32.79, -2.65) for sperm concentration and motility respectively]. Evidence from current studies suggests potential harmful effects of mobile phone use on semen parameters. A further multicentred and standardized study is needed to assess the risk of mobile phone use on the reproductive system.






Recent Studies (Updated: 1/13/2022)

Abeer M. Hagras, Eman A. Toraih, Manal S. Fawzy. Mobile phones electromagnetic radiation and NAD+-dependent Isocitrate Dehydrogenase as a mitochondrial marker in Asthenozoospermia. Biochimie Open. Available online July 25, 2016. http://bit.ly/2b69gh9

Adams JA, Galloway TS, Mondal D, Esteves SC, Mathews F. Effect of mobile telephones on sperm quality: A systematic review and meta-analysis. Environment International70:106-112. September 2014. http://bit.ly/cellphonespermdamage

Agarwal A, Deepinder F, Sharma RK, Ranga G, Li J. Effect of cell phone usage on semen analysis in men attending infertility clinic: an observational study. Fertil Steril. 2008 Jan;89(1):124-8. http://www.ncbi.nlm.nih.gov/pubmed/17482179

Agarwal A, Desai NR, Makker K, Varghese A, Mouradi R, Sabanegh E, Sharma R. Effects of radiofrequency electromagnetic waves (RF-EMW) from cellular phones on human ejaculated semen: an in vitro pilot study. Fertil Steril. 2009;92(4):1318-25. http://www.ncbi.nlm.nih.gov/pubmed/18804757

Agarwal A, Singh A, Hamada A, Kesari K. Cell phones and male infertility: a review of recent innovations in technology and consequences.Int Braz J Urol. 2011; 37(4):432-54. http://www.ncbi.nlm.nih.gov/pubmed/21888695


Akbari HA, Gaeini AA. Moderate exercise training as an effective strategy to reduce the harmful effects of cell phone radiation on Wistar rat's semen quality. Int J Radiation Research. 19(2):317-323. 2021. doi: 10.18869/acadpub.ijrr.19.2.317. https://ijrr.com/article-1-3646-en.html

Akdag MZ, Dasdag S, Canturk F, Karabulut D, Caner Y, Adalier N. Does prolonged radiofrequency radiation emitted from Wi-Fi devices induce DNA damage in various tissues of rats? J Chem Neuroanat. 2016 Jan 8. http://1.usa.gov/1RjkMVb

Al-Bayyari N. Middle East Fertility Society Journal.  The effect of cell phone usage on semen quality and fertility among Jordanian males. Published online Apr 7, 2017. http://bit.ly/2pfcO6L

Al-Quzwini OF, Al-Taee, Al-Shaikh SF. Male fertility and its association with occupational and mobile phone towers hazards: An analytic study. Middle East Fertility Society Journal. 2016 Apr 8. http://bit.ly/1SRUWWs

Andrašková S, Holovská K, Ševčíková Z, Andrejčáková Z, Tóth Š, Martončíková M, Račeková E, Almášiová V. The potential adverse effect of 2.45 GHz microwave radiation on the testes of prenatally exposed peripubertal male rats. Histol Histopathol. 2021 Dec 2:18402. doi: 10.14670/HH-18-402. https://pubmed.ncbi.nlm.nih.gov/34854072/

Bin-Meferij MM, El-Kott AF. The radioprotective effects of Moringa oleifera against mobile phone electromagnetic radiation-induced infertility in rats.Int J Clin Exp Med. 2015 Aug 15;8(8):12487-97. http://1.usa.gov/1MURLR1

Boga A, Emre M, Sertdemir Y, Uncu İ, Binokay S, Demirhan O. Effects of GSM-like radiofrequency irradiation during the oogenesis and spermiogenesis of Xenopus laevis. Ecotoxicol Environ Saf. 2016 Mar 24;129:137-144. http://1.usa.gov/1VQh4pP

Çetkin M, Kızılkan N, Demirel C, Bozdağ Z, Erkılıç S, Erbağcı H. Quantitative changes in testicular structure and function in rat exposed to mobile phone radiation. Andrologia. 2017 Jan 26. http://bit.ly/2jIxlyh

Er H, Gamze Tas G, Soygur B, Ozen S, Sati L. Acute and Chronic Exposure to 900 MHz Radio Frequency Radiation Activates p38/JNK-mediated MAPK Pathway in Rat Testis. Reprod Sci. 2022 Jan 11. doi: 10.1007/s43032-022-00844-y. 

Fatehi D, Anjomshoa M, Mohammadi M, Seify M, Rostamzadeh A. Biological effects of cell-phone radiofrequency waves exposure on fertilization in mice; an in vivo and in vitro study. Middle East Fertility Society Journal. 23 October 2017. http://bit.ly/2iUT4Yd

Ford-Glanton BS, Melendez BA. Male Reproductive Toxicants: Electromagnetic Radiation and Heat. Reference Module in Biomedical Sciences. 2018. https://doi.org/10.1016/B978-0-12-801238-3.64536-1.

Gautam R, Singh KV, Nirala J, Murmu NN, Meena R, Rajamani P. Oxidative stress-mediated alterations on sperm parameters in male Wistar rats exposed to 3G mobile phone radiation. Andrologia. 2019 Apr 51(3):e13201. http://bit.ly/2PT5dwg

Gao XH, Hu HR, Ma X2, Chen J, Zhang GH. [Cellphone electromagnetic radiation damages the testicular ultrastructure of male rats]. [Article in Chinese].  Zhonghua Nan Ke Xue. 2016 Jun;22(6):491-495. http://bit.ly/2ywyJig

Gohari FA, Saranjam B, Asgari M, Omidi L, Ekrami H, Moussavi-Najarkola SA. An experimental study of the effects of combined exposure to microwave and heat on gene expression and sperm parameters in mice. J Hum Reprod Sci. 2017 Apr-Jun;10(2):128-134. http://bit.ly/2EpfWVM

Hancı H, Kerimoğlu G, Mercantepe T, Odacı E. Changes in testicular morphology and oxidative stress biomarkers in 60-day-old Sprague Dawley rats following exposure to continuous 900-MHz electromagnetic field for 1 h a day throughout adolescence. Reprod Toxicol. 2018 Oct;81:71-78. https://www.ncbi.nlm.nih.gov/pubmed/30009952

Hassanzadeh-Taheri M, Khalili MA, Mohebati AH, Zardast M, Hosseini M, Palmerini MG, Doostabadi MR. The detrimental effect of cell phone radiation on sperm biological characteristics in normozoospermic. Andrologia. 10 October 2021. doi: 10.1111/and.14257. https://pubmed.ncbi.nlm.nih.gov/34628682/

Hatch EE, Willis SK, Wesselink AK, Mikkelsen EM, Eisenberg ML, Sommer GJ, Sorensen HT, Rothman KJ, Wise LA. Male cellular telephone exposure, fecundability, and semen quality: results from two preconception cohort studies. Hum Reprod. 2021 Apr 20;36(5):1395-1404. doi: 10.1093/humrep/deab001. https://pubmed.ncbi.nlm.nih.gov/33564831/

Houston B, Nixon B, King BV, De Iuliis G, Aitken RJ. The effects of radiofrequency electromagnetic radiation on sperm function. Reproduction. 2016 Sep 6. pii: REP-16-0126. http://bit.ly/2cJJ2pE

Houston BJ, Nixon B, King BV, Aitken RJ, De Iuliis GN. Probing the origins of 1,800 MHz radio frequency electromagnetic radiation induced damage in mouse immortalized germ cells and spermatozoa in vitro. Front. Public Health. 2018 Sep 21. https://doi.org/10.3389/fpubh.2018.00270

Houston BJ, Nixon B, McEwan KE, Martin JH, King BV, Aitken RJ, De Iuliis GN. Whole-body exposures to radiofrequency-electromagnetic energy can cause DNA damage in mouse spermatozoa via an oxidative mechanism. Sci Rep. 2019 Nov 25;9(1):17478. 
https://www.nature.com/articles/s41598-019-53983-9

Kamali K, Atarod M, Sarhadi S, Nikbakht J, Emami M, Maghsoudi R, Salimi H, Fallahpour B, Kamali N, Momtazan A, Ameli M. Effects of electromagnetic waves emitted from 3G+wi-fi modems on human semen analysis. Urologia. 2017 Sep 14:0. 
https://www.ncbi.nlm.nih.gov/pubmed/28967061

Khoshbakht S, Motejaded F, Karimi S, Jalilvand N, Ebrahimzadeh-Bideskan A. Protective effects of selenium on electromagnetic field-induced apoptosis, aromatase P450 activity, and leptin receptor expression in rat testis. Iran J Basic Med Sci. 2021;24(3):322-330. doi: 10.22038/ijbms.2021.45358.10554. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087852/

Lewis RC, Mínguez-Alarcón L, Meeker JD, Williams PL, Mezei G, Ford JB, Hauser R; EARTH Study Team.Self-reported mobile phone use and semen parameters among men from a fertility clinic. Reprod Toxicol. 2016 Nov 9. pii: S0890-6238(16)30408-7. http://bit.ly/2fV0DuM 
(Note: Authors report conflict of interest and limited statistical power to detect effects.)

Li R, Yang WQ, Chen HQ, Zhang YH. Morinda Officinalis How improves cellphone radiation-induced abnormality of LH and LHR in male rats. Article in Chinese.  2015 Sep;21(9):824-7. http://bit.ly/1Sn6Qsy

Lin YY, Wu T, Liu JY, Gao P, Li KC, Guo QY, Yuan M, Lang HY, Zeng LH, Guo GZ. 1950 MHz radio frequency electromagnetic radiation inhibits testosterone secretion of mouse Leydig cells. Int J Environ Res Public Health. 2017 Dec 23;15(1).  http://bit.ly/2CV3VKc

Liu Q, Si T, Xu X, Liang F, Wang L, Pan S. Electromagnetic radiation at 900 MHz induces sperm apoptosis through bcl-2, bax and caspase-3 signaling pathways in rats. Reprod Health. 2015; 12:65. http://bit.ly/2hhk9mF

Ma HR, Cao XH, Ma XL, Chen JJ, Chen JW, Yang H, Liu YX. [Protective effect of Liuweidihuang Pills against cellphone electromagnetic radiation-induced histomorphological abnormality, oxidative injury, and cell apoptosis in rat testes]. Zhonghua Nan Ke Xue. 2015 Aug;21(8):737-41. [Article in Chinese]. http://1.usa.gov/1MtbdCM 

Nakatani-Enomoto S, Okutsu M, Suzuki S et al. Effects of 1950 MHz W-CDMA-like signal on human spermatoza. Bioelectromagnetics. 11 Jun 2016. http://bit.ly/28L7nE5

Narayanan SN, Lukose ST, Arun G, Mohapatra N, Pamala J, Concessao PL, Jetti R, Kedage V, Nalini K, Bhat PG. Modulatory effect of 900 MHz radiation on biochemical and reproductive parameters in rats. Bratisl Lek Listy. 2018;119(9):581-587. http://bit.ly/2pxJx9B

Odaci E, Hanci H, Yuluğ E, Türedi S, Aliyazıcıoğlu Y, Kaya H, Çolakoğlu S.Effects of prenatal exposure to a 900 MHz electromagnetic field on 60-day-old rat testis and epididymal sperm quality. Biotech Histochem. 2015 Oct 15:1-11. http://1.usa.gov/1LB2jyE

Oh JJ, Byun SS, Lee SE, Choe G, Hong SK. Effect of Electromagnetic Waves from Mobile Phones on Spermatogenesis in the Era of 4G-LTE. Biomed Res Int. 2018 Jan 29;2018:1801798. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896334/

Oyewopo AO, Olaniyi SK, Oyewopo CI, Jimoh AT. Radiofrequency electromagnetic radiation from cell phone causes defective testicular function in male Wistar rats. Andrologia. 2017 Mar 6. http://bit.ly/2lZ1rP1

Pandey N, Giri S, Das S, Upadhaya P. Radiofrequency radiation (900 MHz)-induced DNA damage and cell cycle arrest in testicular germ cells in swiss albino mice. Toxicol Ind Health. 2016 Oct 13. http://bit.ly/2e1OscT
 

Parsanezhad M, Mortazavi SMJ, Doohandeh T, Namavar Jahromi B, Mozdarani , Zarei A, Davari M, Amjadi S, Soleimani A, Haghani M. Exposure to radiofrequency radiation emitted from mobile phone jammers adversely affects the quality of human sperm. International Journal of Radiation Research. 15(1). Jan 2017. http://bit.ly/2nyVhck

Radwan, M, Jurewicz, J, Merecz-Kot, D,  Sobala, W, Radwan, P, Bochenek, M, Hanke, W. Sperm DNA damage—the effect of stress and everyday life factors. International Journal of Impotence Research. 14 April 2016. http://bit.ly/1W0igXi

Saygin M, Asci H, Ozmen O, Cankara FN, Dincoglu D, Ilhan I. Impact of 2.45 GHz microwave radiation on the testicular inflammatory pathway biomarkers in young rats: The role of gallic acid. Environ Toxicol. 2015 Aug 13. doi: 10.1002/tox.22179. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/26268881?dopt=Abstract

Schauer I, Mohamad Al-Ali B. Combined effects of varicocele and cell phones on semen and hormonal parameters.  Wien Klin Wochenschr. 2017 Oct 13. doi: 10.1007/s00508-017-1277-9. https://www.ncbi.nlm.nih.gov/pubmed/29030685 

Sepehrimanesh, M. & Davis, D.L. Proteomic impacts of electromagnetic fields on the male reproductive system. Comp Clin Pathol (2016). doi:10.1007/s00580-016-2342-x. http://bit.ly/2dTj1oT

Sepehrimanesh M, Kazemipour N, Saeb M, Nazifi S, Davis DL.Proteomic analysis of continuous 900-MHz radiofrequency electromagnetic field exposure in testicular tissue: a rat model of human cell phone exposure. Environ Sci Pollut Res Int. 2017 Apr 10. doi: 10.1007/s11356-017-8882-z. https://www.ncbi.nlm.nih.gov/pubmed/28397118

Shokri M, Shamsaei ME, Malekshah AK, Amiri FT. The protective effect of melatonin on radiofrequency electromagnetic fields of mobile phone-induced testicular damage in an experimental mouse model. Andrologia. 2020 Oct 11;e13834. doi: 10.1111/and.13834. 

Sokolovic D, Djordjevic B, Kocic G, Stoimenov TJ, Stanojkovic Z, Sokolovic DM, et al. The Effects of Melatonin on Oxidative Stress Parameters and DNA Fragmentation in Testicular Tissue of Rats Exposed to Microwave Radiation. Adv Clin Exp Med. 2015 May-Jun;24(3):429-36. doi: 10.17219/acem/43888. http://1.usa.gov/1hJdzAz

Solek P, Majchrowicz L, Bloniarz D, Krotoszynska E, Koziorowski M. Pulsed or continuous electromagnetic field induce p53/p21-mediated apoptotic signaling pathway in mouse spermatogenic cells in vitro and thus may affect male fertility. Toxicology. 2017 Mar 16. pii: S0300-483X(17)30092-6. http://bit.ly/2ntlHvN


Wang D, Li B, Liu Y, Ma YF, Chen SQ, Sun HJ, Dong J, Ma XH, Zhou J, Wang XH. [Impact of mobile phone radiation on the quality and DNA methylation of human sperm in vitro]. [Article in Chinese]. Zhonghua Nan Ke Xue. 2015 Jun;21(6):515-520. http://1.usa.gov/1OTD4tG

Wessapan T, Rattanadecho P. Temperature induced in the testicular and related tissues due to electromagnetic fields exposure at 900 MHz and 1800 MHz. International Journal of Heat and Mass Transfer, 102:1130-1140. 2016. http://bit.ly/2bh0xtd

Yahyazadeh A, Altunkaynak BZ, Kaplan S. Biochemical, immunohistochemical and morphometrical investigation of the effect of thymoquinone on the rat testis following exposure to a 900-MHz electromagnetic field. Acta Histochem. 2019 Nov 26:151467. 

Yildirim et al. What is harmful for male fertility, cell phone or the wireless internet? Kaohsiung Journal of Medical Sciences. Published online Jul 26, 2015. Abstract and summary: http://www.saferemr.com/2013/03/opposition-to-los-angeles-public.html.

Yu G, Tang Z, Chen H, et al.  Long-term exposure to 4G smartphone radiofrequency electromagnetic radiation diminished male reproductive potential by directly disrupting Spock3-MMP2-BTB axis in the testes of adult rats. Sci Total Environ. 2019 Aug 31;698:133860. https://www.ncbi.nlm.nih.gov/pubmed/31514029

Zang Z, Ji S, Huang S, Jiang M, Fang Y. (2016) Impact of Cellphone Radiation on Sexual Behavior and Serum Concentration of Testosterone and LH in Male Mice. Occupational Diseases and Environmental Medicine, 4(3):56-62. http://bit.ly/2bgF6Y4

Zhang G, Yan H, Chen Q, Liu K, Ling X, Sun L, Zhou N, Wang Z, Zou P, Wang X, Tan L, Cui Z, Zhou Z, Liu J, Ao L, Cao J. Effects of cell phone use on semen parameters: Results from the MARHCS cohort study in Chongqing, China. Environ Int. 2016 Mar 4;91:116-121. http://1.usa.gov/1pvU2YV

Zilberlicht et al. Habits of cell phone usage and sperm quality – does it warrant attention? Reproductive BioMedicine Online. 31(3):421-426. Sep2015. https://www.ncbi.nlm.nih.gov/pubmed/26206279

Friday, January 21, 2022

Why did JAMA Oncology publish a paper written by a Telecom industry spokesperson?

 JAMA Oncology published a paper on radiofrequency radiation written by a Telecom industry spokesperson.

January 18, 2022 (Updated Jan 21, 2022)

JAMA Oncology recently published a paper, "Radiofrequency Radiation and Cancer: A Review,” that provides a biased, highly selective review of the scientific literature written by David Grimes, a pro-industry science writer and physicist.

Several experts who have worked in this field for decades and two former U.S. government health officials wrote to me expressing their concerns about this paper:

  • "The mentioned paper contains hardly one page of actual review. It is trying to fixate the old paradigm of not enough energy to cause harm. What a poor and pathetic attempt by the industry proponents."
  • "I could go on at length about the flaws in his arguments ... I hope someone with oncological/epidemiological clout in the community takes this crank to task and highlights the enormous holes and one-sided nature of his argument."
  • "Confidentially, this is garbage. Grimes gets this published because he is a naysayer. He claims to discuss mechanisms, but only discusses his own irrelevant hobby horse.”
  • "Grimes is going to get a bit of scrutiny over this piece. It is really bad."
  • "I think this needs to be retracted."

On December 20, 2021, I sent the journal’s editor-in-chief, Mary “Nora” Disis, MD, my comments along with a recommendation that the journal retract the paper. Her response:


The JAMA Network journals reserve retractions for articles that have been fabricated, falsified, or plagiarized. There does not appear to be evidence of such misconduct in this article.”

She suggested I submit a (400-word) letter to the editor so the paper’s author could respond to my comments (with a 500-word letter). In my professional opinion, letters to the editor would not suffice to undo the potential damage caused by publication of this industry propaganda piece in a journal sponsored by the American Medical Association.

Since the journal refused to retract the paper despite what I suspect was a flawed peer-review process, the journal should change the paper’s title to accurately reflect its contents (e.g., “Radiofrequency radiation and cancer: Telecom industry talking points”). Moreover, the journal should publish a companion piece written by experts independent of the industry so the journal’s readers are not misled by an article replete with industry sound bites.

My critique of the Grimes paper appears below. 

Also see the following links to articles and letters critiquing Grimes' paper:

Environmental Health Trust. Wireless Industry Spokesperson Pens Article on Wireless Health Effects for Top Academic Journal. January 18, 2022.

Environmental Health Trust. Documentation of inaccuracies, mischaracterizations and critical omissions in David Grimes’ JAMA Oncology review of RFR and Cancer. January 18, 2022. 

Microwave News. Four Reasons Why David Grimes’s RF-Cancer Review Must Be Retracted: Open Letter to Editor-in-Chief, AMA Journals. January 18, 2022
Microwave News. David Robert Grimes Is Not Affiliated with University of Oxford. January 19, 2022 
Paul D. Thacker. Experts Blast David Robert Grimes for His Failure to Understand Science and Love of Self-Citation. Journal of Scientific Practice and Integrity. January 18, 2022

Environmental Health Trust. Call for Retraction JAMA Skewed "Review" on Cell Phone Radio-Frequency Radiation. January 16, 2022. Open letter signed by Devra Davis, PhD, MPH; Linda S. Birnbaum, PhD [former director, National Institute for Environmental Health Sciences]; Ron Melnick, PhD [retired toxicologist, National Toxicology Program]; Dr. Anthony Miller [Professor Emeritus, University of Toronto], and Theodora Scarato.

Kent Chamberlin. Letter to Dr. Mary Disis, JAMA Oncology Editor. January 5, 2022
 
Paul D. Thacker. Physicist David Robert Grimes Finds Conspiracies Everywhere. The Disinformation Chronicle. December 7, 2021

 --

 A Critique of “Radiofrequency Radiation and Cancer: A Review”

Joel M. Moskowitz, Ph.D.
School of Public Health
University of California, Berkeley

January 3, 2022

Grimes DR. Radiofrequency Radiation and Cancer: A Review. JAMA Oncol. Published online December 09, 2021. doi:10.1001/jamaoncol.2021.5964. https://jamanetwork.com/journals/jamaoncology/article-abstract/2786776

The title of this paper, "Radiofrequency Radiation and Cancer: A Review," is misleading because this is not a literature review. Rather, this is an opinion piece written by David Grimes, a science writer and physicist who has served as a paid spokesperson for the telecommunications industry.

Following is a link to an “informational video” he recorded for Vodafone UK: 


Vodafone UK News Centre. “5G and health: Everything you need to know.” Video (2:23). April 24, 2020. https://newscentre.vodafone.co.uk/5g/5g-and-health-everything-you-need-to-know/

The Grimes paper rehashes arguments I have heard for more than a decade. It reflects the perspective of some physical scientists and engineers since the 1980’s that only ionizing radiation is harmful due to photon energy. Their position is that radiofrequency radiation (RFR), or non-ionizing radiation, is harmless unless its intensity exceeds a certain heating threshold, and the only plausible mechanism for harm from RFR is acute heating. These scientists employ a common industry strategy to manufacture doubt about the science by dismissing thousands of peer-reviewed RFR studies published since the 1980's with the claim that these studies are not methodologically sound or have not been replicated.

Grimes implies that anyone concerned about health effects from 5G or RFR is a conspiracy theorist. 

It is indeed unfortunate that many people distrust science and believe in conspiracy theories. However, distrust in government and the proliferation of conspiracy theories may be attributable to a history of governmental failure to regulate environmental toxins and protect public and environmental health instead of industry profits.

Grimes' paper devotes five paragraphs to the discussion of the “biophysical overview” -- how ionizing radiation can harm living organisms through direct action caused by the energy in photons. 


This overview is a "straw man" argument used for decades to dismiss the peer-reviewed research that found adverse biologic and health effects from exposure to non-ionizing electromagnetic fields including radiofrequency radiation (RFR).  Although Grimes acknowledges that much of the damage caused by ionizing radiation is through indirect action which requires much less energy than direct action, he ignores the substantial body of peer-reviewed research that has found non-ionizing radiation including low-intensity RFR can also cause biologic harm and adverse health effects through indirect actions.

Numerous peer-reviewed papers have been published that discuss biophysical mechanisms for adverse RFR effects. Even though the mechanisms are not fully understood, substantial empirical evidence exists that low-intensity RFR can induce oxidative stress, reactive oxygen species (or free radicals), and stress proteins via indirect action.


In contrast to the paper’s claim, 65% (n=78) of 125 published studies of RFR found significant evidence of DNA damage using the comet assay test.


The paper failed to mention that the Interphone study found significantly increased risk of glioma, a malignant brain tumor, for those who used cellphones 1640 or more hours in their lifetime. This effect held up in sensitivity analyses presented in two appendices to the Interphone study paper. Moreover, Appendix 2 of that paper found a dose-response relationship between number of years of cellphone use and incidence of glioma. Subsequent papers published using Interphone study data provided additional support for increased risk of glioma for heavy cellphone users, especially in proximity to the cellphone’s antenna and on the side of the head where the cellphone was held.

Besides the Interphone study, several case-control studies in Sweden and a French study also found heavy cellphone use associated with increased glioma risk. In addition to the Interphone study, several other case-control studies found that heavy cellphone use increased the risk of acoustic neuroma, a nonmalignant tumor on the nerve from the ear to the brain, on the side of the head where the cellphone was held.


One would not expect a “direct link” or a proportional increase in rates of common brain tumors relative to adoption of cellphones because the latency between exposure to a carcinogen and diagnosis of a solid tumor is often several decades. In the U.S., there have been increases in specific brain tumors in some anatomic locations since cellphones have become popular. Data from the National Cancer Institute’s SEER cancer registry indicates that the incidence of glioblastoma, the most common and serious malignant brain tumor, has increased in recent years while glioma incidence has declined. This suggests that heavy long-term cellphone use promotes tumor growth. A study in the UK obtained similar results.

With the advent of the smartphone about a decade ago, the transmitting antennas in many phones are now located in the bottom, instead of the top, of the phone. Hence, the primary tumor site for those who hold their phones to their ear may now be the thyroid gland instead of the brain. Two Yale University studies found increased thyroid tumor risk with heavy cellphone use. Moreover, the incidence of thyroid cancer has increased substantially in the U.S. and many other countries. Smartphone use may have contributed to this increase.

The Danish cohort cellphone study has been widely discredited (see responses to this study). The WHO International Agency for Research on Cancer dismissed this study in its comprehensive report about RFR cancer risk due to the study’s misclassification of many cellphone users as non-users and its lack of individual exposure data.The UK cohort study also suffered from misclassification because exposure data were only collected at baseline and cellphone use likely changed during the course of the study. Thus, neither of these cohort studies provides a reliable assessment of brain tumor risk among cellphone users.


In Sweden brain tumor incidence increased from 1998–2015. The incidence of glioblastoma increased in Finland from 1990 to 2016 as well as in England from 1995 to 2014.

In 2015 I interviewed the "most knowledgeable person" at the U.S. FDA regarding cell phone radiation risks, the head of the FDA Center for Devices and Radiological Health who served as the agency’s representative to the now-defunct federal Radiofrequency Interagency Working Group. He informed me that every cellphone study that found evidence of harm had at least one methodological problem; hence, the FDA dismissed all of these studies. Apparently, little has changed in the ensuing years at the FDA.

As a researcher for more than 30 years in the School of Public Health at the University of California, Berkeley, I have never read a study without “inherent limitations.” That no study is perfect is not a valid reason to exclude many hundreds of peer-reviewed studies which found significant evidence of harm from RFR or cellphone radiation.

The FDA review paper was not subjected to an independent, external peer review process, unlike the NTP cellphone radiation study discussed next.


Research conducted by the National Toxicology Program (NTP) of the U.S. National Institute of Environmental Health Sciences is considered the “gold standard” by most toxicologists. The $30 million NTP cellphone study was one of the largest animal studies ever conducted by the NTP so to criticize it for ”low-power” is ludicrous. Prior to publication of the NTP reports, the study was subjected to extensive peer review and addressed the concerns of the reviewers. The study’s methodology has also been defended in a peer-reviewed paper.

The NTP study found "clear evidence" of increased tumor incidence from long-term exposure to cellphone radiation in male rats and DNA damage from shorter exposures to male and female rats and mice. Two other major randomized, controlled animal studies, the Ramazzini Institute study and a U.S. Air Force study, support the NTP’s finding that long-term exposure to low-intensity (i.e. non-thermal levels of) RFR can cause cancer.


The NTP study has been attacked by pro-industry scientists because it demonstrates the inadequacy of the RF exposure guidelines promoted by the ICNIRP, the IEEE, and the FCC. The ICNIRP is a self-selected group of scientists who believe that non-thermal exposure to non-ionizing radiation including RFR is harmless. Moreover, these pro-industry scientists have co-opted the WHO EMF Project and biased many national health agency reviews of cellphone radiation health risks according to multiple news stories published by Investigate Europe, a multinational group of investigative journalists.

The IEEE or Institute of Electrical and Electronics Engineers is a professional association for engineers. Their committees that established RFR exposure limits were dominated by engineers and physical scientists with little input from biologists or health scientists.

The FCC, the agency in the U.S. that regulates RFR exposure, has no health expertise and relies on the FDA for advice; however, the FDA does no research on RFR health effects. For more than two decades, the FCC has been “captured” by the telecommunications industry according to a Harvard study. Most FCC commissioners have worked for this industry before and after their appointments to the Commission.

The Grimes paper is a prime example of a common industry tactic when a product or technology is harmful to humans or the environment -- manufacture doubt about the state of the science:

Despite Grimes’ claim, Michael Carlberg and Lennart Hardell applied the Bradford Hill criteria to the peer-reviewed data and concluded that long-term exposure to cell phone radiation is a causal factor for tumor risk. Hardell and his colleagues in Sweden were not the only researchers to conduct case-control studies which found increased brain tumor risk with heavy cellphone use. See also the 13-nation Interphone study and a French study. 

Our 2020 review and meta-analysis of the case-control tumor risk studies (Choi, Moskowitz et al., 2020) went through extensive peer review prior to publication. Moreover, post-publication we defended the paper against every criticism raised in two letters to the editor submitted by ICNIRP scientists and their associates. Our quantitative review of 46 case-control studies “found significant evidence linking cellular phone use to increased tumor risk, especially among cell phone users with cumulative cell phone use of 1000 or more hours in their lifetime (which corresponds to about 17 min per day over 10 years), and especially among studies that employed high quality methods.”


Although more is to be learned regarding mechanisms, there are plausible biophysical mechanisms for carcinogenesis due to RFR exposure. In contrast to the Grimes’ paper, for an evidence-based perspective on the state of the science see a paper published in 2018 in the journal Environmental Pollution by Dominique Belpomme and colleagues, “Thermal and non-thermal health effects of low intensity non-ionizing radiation: An international perspective.”

More than 240 EMF scientists, all of whom have published peer-reviewed papers on electromagnetic fields (EMF) and biology or health totaling more than 2,000 papers and letters in professional journals have endorsed the International EMF Scientist Appeal: