Friday, November 26, 2021

The "Havana syndrome": A special case of electrohypersensitivity?

Nov 9, 2021 (Updated Nov 26, 2021)

"Secretary of State Antony Blinken on Friday detailed new efforts to investigate "Havana syndrome," the mysterious health affliction affecting dozens of U.S. personnel first identified in Cuba and now including several countries."

"Symptoms include headaches, dizziness, cognitive difficulties, tinnitus, vertigo and trouble with seeing, hearing or balancing. Many officials have suffered symptoms years after reporting an incident, while some have been diagnosed with traumatic brain injuries."

"In an effort to learn more, Blinken confirmed Friday that the State Department has deployed new technology to U.S. missions around the world to help understand the cause.

'The details I can provide on this are limited as well, but I can say that new technology is helping us more quickly and thoroughly evaluate a variety of potential causes of these incidents, and we've distributed across posts so that we can respond rapidly to new reports,' he said."  

(Conor Finnegan and Matt Seyler, "Blinken details new efforts to investigate 'Havana syndrome," ABC News, Nov 5, 2021)

In my opinion, the "Havana syndrome" is likely caused by exposure to microwave or radio frequency radiation (RFR) resulting in the onset of electromagnetic hypersensitivity (EHS) in exposed individuals who have greater sensitivity to RFR. Moreover, as I explained to the Daily Mail in December 2017 the symptoms may be caused by exposure to low-moderate intensity microwave radiation used for surveillance:

"The finding that the attacks led to perceptible changes in their brains is also one of several factors fueling growing skepticism that some kind of sonic weapon was involved. 

'This makes me think the victims may have developed electromagnetic hypersensitivity (EHS) from exposure to electromagnetic fields in the embassy,' Joel Moskowitz, a community health professor at the University of California, Berkeley, told Daily Mail Online. 

'This happened during the Cold War to personnel stationed in the US embassy in Moscow when the Soviets were bombarding the embassy with microwaves to monitor oral communications in the ambassador's office.'"


If my hypothesis is correct that a surveillance device is the source of exposure for the "Havana syndrome" rather than a weapon, and if only a minority of exposed individuals are susceptible to developing serious symptoms associated with EHS, then the extent of surveillance could be widespread, placing our nation's secrets at risk.

William Broad of the New York Times interviewed me for a story on the "Havana syndrome" in September 2018. He dismissed my hypothesis that the effects observed in Havana were due to EHS and that the source of the exposure may have been microwave-based surveillance technology rather than weaponry.  In his article, he did not cite me or Dr. Beatrice Golomb, a colleague from UC San Diego whom he also interviewed who had published a paper on the Havana syndrome in which she hypothesized that it was caused by pulsed microwave radiation (see abstract below).

In October 2019, following up on a referral from Allan Frey (who pioneered the research on microwave hearing and blood-brain-barrier penetration), Dr. Thaddeus Thomas from the U.S. Army Research Laboratory (ARL) contacted me to learn about the science regarding health effects from RFR exposure. He informed me that the ARL was heading a joint military task force to determine whether an adversary had developed new weapon technology based on RFR. I shared with him the research on EHS. I cautioned him not to assume that the "attack" was a weapon as it could have been from microwave-based surveillance technology because health effects have been observed in many individuals who experienced relatively low levels of RFR exposure. Moreover, Russian surveillance was a prime explanation for similar incidents that occurred at the U.S. embassy in Moscow during the Cold War (aka "Moscow signal").

BTW, the smallest microwave weapon I am aware of, the Silent Guardian active denial system, requires a 10,000 pound containerized system to generate a 30-kilowatt beam. The primary symptom is a burning sensation in the skin, not strange sounds.

In October 2021, pursuing the military weapon angle, Dr. Thomas and his colleagues published the following paper in the AAAS journal Science Advances. This joint U.S. Army/Air Force study found pulsed microwaves compliant with current safety standards could potentially cause traumatic brain injury.

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Computational modeling investigation of pulsed high peak power microwaves and the potential for traumatic brain injury

Amy M Dagro, Justin W Wilkerson, Thaddeus P Thomas, Benjamin T Kalinosky, Jason A Payne. Computational modeling investigation of pulsed high peak power microwaves and the potential for traumatic brain injury. Sci Adv. 2021 Oct 29;7(44):eabd8405. doi: 10.1126/sciadv.abd8405.

Amy Dagro and Thaddeus Thomas are with the U.S. Army Research Laboratory, Aberdeen Proving Ground, MD; Benjamin Kalinosky is with General Dynamics Information Technology, JBSA Fort Sam Houston, San Antonio, TX; and Jason Payne is with U.S, Air Force Research Laboratory, 711th Human Performance Wing, Airman Systems Directorate, Bioeffects Division, Radio Frequency Bioeffects Branch, JBSA Fort Sam Houston, San Antonio, TX; Justin Wilkerson is an Assistant Professor in the Department of Mechanical Engineering, Texas A&M University, College Station, TX.

Abstract

When considering safety standards for human exposure to radiofrequency (RF) and microwave energy, the dominant concerns pertain to a thermal effect. However, in the case of high-power pulsed RF/microwave energy, a rapid thermal expansion can lead to stress waves within the body. In this study, a computational model is used to estimate the temperature profile in the human brain resulting from exposure to various RF/microwave incident field parameters. The temperatures are subsequently used to simulate the resulting mechanical response of the brain. Our simulations show that, for certain extremely high-power microwave exposures (permissible by current safety standards), very high stresses may occur within the brain that may have implications for neuropathological effects. Although the required power densities are orders of magnitude larger than most real-world exposure conditions, they can be achieved with devices meant to emit high-power electromagnetic pulses in military and research applications.

Excerpts

"The bulk of scientific literature uses continuous waves and moderate field strengths (typical of real-life scenarios), with less emphasis on pulsed fields of very high peak strength that may occur with ultrawideband pulse generators or EM pulse simulators (4). It is worth investigating whether extremely high peak power sources applied with a slow repetition frequency, or low duty cycle, can induce injurious effects without thermal buildup greater than a few degrees Celsius."

"With the exception of low intracranial absorption at 1400 MHz, the highest ratio of peak average intracranial SAR* to peak average skin SAR* occurs between 1 to 1.8 GHz."

"The MAE, also referred to as “microwave hearing” or the “Frey effect” due to its discovery by Allan Frey in 1961 (7, 8), was initially observed when subjects standing up to hundreds of feet away from a radar transponder could hear an audible tonal noise (e.g., chirping, buzzing, or clicking). The scientific underpinnings of the MAE were controversial for the first several years (9–11). After more than a decade of investigations, it became generally accepted that the perceived sound is due to the cochlea detecting stress waves that result from a rapid temperature rise in tissues within the head due to pulsed RF/microwave exposure (11, 12)."

"Typically, relatively low-average powers and small temperature changes (10−6°C) are required to elicit the MAE (12). Although adverse health effects from the MAE have not been previously established, one study on rodents suggests that very high–peak power pulsed microwaves can result in cognitive deficits (13)."

"This study uses a two-simulation approach to investigate whether an HPM source could theoretically induce adverse mechanical responses within the brain."

"This study has shown that, by applying a small temperature increase (<0.0005°C) in a very short amount of time (less than several microseconds), potentially injurious stress waves are created."

"For frequencies between 400 MHz to 2 GHz, the IEEE C95.1 RF exposure guidelines limit the exposure reference limit (ERL) to fmhz/200 (W/m2) over an averaging time of 30 min. For 1-GHz exposures, the IEEE C95.1 ERL of 5 W/m2 over 30 min would equate to an average energy density of 9000 J/m2. Our computational model shows that, for sufficiently high incident power densities, a single pulse could potentially result in biologically meaningful pressures. For example, large pressures may occur following 1-GHz frequency, a pulse duration of 5 μs, and incident power densities of at least 1.5 × 107 W/m2. The energy density associated with such a pulse would be equal to PIN×τd or 75 J/m2 (significantly less than the ERL standard)."

"Note that the proposed HPM power densities in this study are extremely large and several orders of magnitude larger than power densities typically experienced by the public. As an illustrative example, at around 200 feet from a cell phone base station, a person will be exposed to a power density of only 0.001 mW/cm2 or less (36). This study establishes a testable hypothesis between potential neurocognitive effects and the thermoelastic mechanism from HPM systems. To date, however, adverse effects from HPM systems have not been established in the scientific literature."


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New Report Assesses Illnesses Among U.S. Government Personnel and Their Families at Overseas Embassies

News Release, National Academy of Sciences, Engineering, and Medicine, December 5, 2020

WASHINGTON — Government personnel and their families at the U.S. embassy in Havana, Cuba, in late 2016, and later at the U.S. consulate in Guangzhou, China, began suffering from a range of unusual — and in some cases suddenly occurring — symptoms such as a perceived loud noise, ear pain, intense head pressure or vibration, dizziness, visual problems, and cognitive difficulties, and many still continue to experience these or other health problems.  As part of its effort to ascertain potential causes of the illnesses, inform government employees more effectively about health risks at posts abroad, and determine best medical practices for screening, prevention, and treatment for both short- and long-term health problems, the U.S. Department of State asked the National Academies of Sciences, Engineering, and Medicine to provide advice.  After undergoing a security review, the National Academies’ report is now available.

In examining plausible causes of these illnesses, the committee that conducted the study and wrote the report considered the possibilities of directed, pulsed radio frequency energy, chemical exposures, infectious diseases such as Zika, and psychological issues.  An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies says that among the mechanisms the committee considered, directed, pulsed radio frequency energy appears to be the most plausible mechanism in explaining these cases, especially in individuals with the distinct early symptoms.  Persistent postural-perceptual dizziness (PPPD) — a functional (not psychiatric) vestibular disorder that may be triggered by vestibular, neurologic, or other medical and psychological conditions — is a secondary reinforcing mechanism, as well as the possible additive effects of psychological conditions.

The committee could not rule out other possible mechanisms and found it is likely that a multiplicity of factors explains some cases and the differences between others.  In particular, it could not be certain that the individuals with only the chronic set of signs and symptoms suffered from the same causes and mechanisms as those who reported the initial, sudden onset set of signs and symptoms.  The committee noted that it faced several challenges in its assessment, related to the extreme variability in the clinical cases as well as lack of access to specific health or personal information on the affected individuals.

“The committee found these cases quite concerning, in part because of the plausible role of directed, pulsed radiofrequency energy as a mechanism, but also because of the significant suffering and debility that has occurred in some of these individuals,” said committee chair David Relman, Thomas C. and Joan M. Merigan Professor in Medicine, professor of microbiology and immunology, and senior fellow at the Center for International Security and Cooperation at Stanford University.  “We as a nation need to address these specific cases as well as the possibility of future cases with a concerted, coordinated, and comprehensive approach.”

The report includes a number of recommendations for rehabilitation and actions the State Department should take to enhance responses to future threats to the well-being of its personnel and their families.

The study — undertaken by the Standing Committee to Advise the U.S. Department of State on Unexplained Health Effects on U.S. Government Employees and Their Families at Overseas Embassies — was sponsored by the U.S. Department of State.  The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln.

Consensus Study Report: An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies


In late 2016, U.S. Embassy personnel in Havana, Cuba, began to report the development of an unusual set of symptoms and clinical signs. For some of these patients, their case began with the sudden onset of a loud noise, perceived to have directional features, and accompanied by pain in one or both ears or across a broad region of the head, and in some cases, a sensation of head pressure or vibration, dizziness, followed in some cases by tinnitus, visual problems, vertigo, and cognitive difficulties. Other personnel attached to the U.S. Consulate in Guangzhou, China, reported similar symptoms and signs to varying degrees, beginning in the following year. As of June 2020, many of these personnel continue to suffer from these and/or other health problems. Multiple hypotheses and mechanisms have been proposed to explain these clinical cases, but evidence has been lacking, no hypothesis has been proven, and the circumstances remain unclear.


The Department of State asked the National Academies to review the cases, their clinical features and management, epidemiologic investigations, and scientific evidence in support of possible causes, and advise on approaches for the investigation of potential future cases. In An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies, the committee identifies distinctive clinical features, considers possible causes, evaluates plausible mechanisms and rehabilitation efforts, and offers recommendations for future planning and responses.


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Diplomats' Mystery Illness and Pulsed Radiofrequency/ Microwave Radiation

Beatrice Alexandra Golomb. Diplomats' Mystery Illness and Pulsed Radiofrequency/ Microwave Radiation. Neural Computation. November 2018. 30(11):2882-2985. doi: 10.1162/neco_a_01133.

UC San Diego School of Medicine, La Jolla, CA.

Abstract

Importance: 

A mystery illness striking U.S. and Canadian diplomats to Cuba (and now China) “has confounded the FBI, the State Department and US intelligence agencies” (Lederman, Weissenstein, & Lee, 2017). Sonic explanations for the so-called health attacks have long dominated media reports, propelled by peculiar sounds heard and auditory symptoms experienced. Sonic mediation was justly rejected by experts. We assessed whether pulsed radiofrequency/microwave radiation (RF/MW) exposure can accommodate reported facts in diplomats, including unusual ones.

Observations: 

(1) Noises: Many diplomats heard chirping, ringing or grinding noises at night during episodes reportedly triggering health problems. Some reported that noises were localized with laser-like precision or said the sounds seemed to follow them (within the territory in which they were perceived). Pulsed RF/MW engenders just these apparent “sounds” via the Frey effect. Perceived “sounds” differ by head dimensions and pulse characteristics and can be perceived as located behind in or above the head. Ability to hear the “sounds” depends on high-frequency hearing and low ambient noise. 

(2) Signs/symptoms: Hearing loss and tinnitus are prominent in affected diplomats and in RF/MW-affected individuals. Each of the protean symptoms that diplomats report also affect persons reporting symptoms from RF/MW: sleep problems, headaches, and cognitive problems dominate in both groups. Sensations of pressure or vibration figure in each. Both encompass vision, balance, and speech problems and nosebleeds. Brain injury and brain swelling are reported in both. 

(3) Mechanisms: Oxidative stress provides a documented mechanism of RF/MW injury compatible with reported signs and symptoms; sequelae of endothelial dysfunction (yielding blood flow compromise), membrane damage, blood-brain barrier disruption, mitochondrial injury, apoptosis, and autoimmune triggering afford downstream mechanisms, of varying persistence, that merit investigation. 

(4) Of note, microwaving of the U.S. embassy in Moscow is historically documented.

Conclusions and relevance:  

Reported facts appear consistent with pulsed RF/MW as the source of injury in affected diplomats. Nondiplomats citing symptoms from RF/MW, often with an inciting pulsed-RF/MW exposure, report compatible health conditions. Under the RF/MW hypothesis, lessons learned for diplomats and for RF/MW-affected civilians may each aid the other.


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The "Moscow signal" epidemiological study, 40 years on

Martínez JA. The "Moscow signal" epidemiological study, 40 years on. Rev Environ Health. 2019 Mar 26;34(1):13-24. doi: 10.1515/reveh-2018-0061.

Abstract

Between 1953 and 1979, the USSR irradiated the United States embassy in Moscow with microwaves. This episode, a classic Cold War affair, has acquired enormous importance in the discussions on the effect of non-ionizing radiation on people's health. In 2011, the International Agency for Research on Cancer (IARC) classified radiofrequency electromagnetic fields as being a possible human carcinogen (Group 2B), but the results of recent laboratory and epidemiological studies have led some researchers to conclude that radiofrequency electromagnetic fields should be reclassified as a human carcinogen instead of merely a possible human carcinogen. In 1978, the "Moscow signal" case was officially closed after the publication of the epidemiological study of (Lilienfeld AM, Tonascia J, Tonascia S, Libauer CA, Cauthen GM. Foreign Service health status study. Evaluation of health status of foreign service and other employees from selected Eastern European posts. Report on Foreign Service Health Status Study, U.S. Department of State 6025-619073, 1978.), showing no apparent evidence of increased mortality rates and limited evidence regarding general health status. However, several loose ends still remain with respect to this epidemiological study, as well as the affair as a whole. In this paper, we summarize the available evidence concerning this case, paying special attention to the epidemiological study of Lilienfeld et al. After reviewing the available literature (including declassified documents), and after some additional statistical analyses, we provide new insights which do not complete the puzzle, but which may help to better understand it.


Excerpts

The Soviet objective

To activate listening devices on the walls? This may well have been, as we have just indicated, one of the explanations given by the Americans, but serious doubts had, by this time, been cast on American institutional credibility. After all, the State Department had, for more than 15 years, hidden from its own employees the fact that that they were being irradiated, had lied to them about the purpose of the blood tests, and had categorically denied that some of the results were of concern to their health. For example, the State Department had reported that Ambassador Walter Stoessel was in good health and that blood tests showing high levels of white blood cells were unrelated to leukemia (13). Nevertheless, Stoessel died of leukemia on December 9, 1986, aged 66 (27).

The mind control hypothesis was also considered by the American government (28). The Americans themselves had been experimenting on mind control as part of the MK ULTRA project, and suspected that the Soviets might be doing the same.

The former CIA agent Victor Marchetti claimed that the microwave bombardment had nothing to do with a threat to health, but with a strategy of confusion in order to waste the time of the American government while it studied and analyzed what it believed might be taking place (13). Whether this is true or not, the reality is that the American government had indeed devoted huge resources and efforts to analyzing what had happened, especially with the epidemiological study of Lilienfeld et al. (1).

The Soviets, on the other hand, finally admitted at the beginning of 1976 to the use of microwaves, after denying it for 15 years. The official version until then had been that the radiation detected by the Americans at the embassy was caused by the industrial activity of a large city such as Moscow. When they finally came clean, they indicated that the purpose of the bombardment had not been to damage the health of the American personnel, but to interfere in the communications of the embassy (11).

In the end, both official versions concurred, which, given the history of lies and deceit by the two sides involved, may be equally suspect....


Four decades on, the “Moscow signal” case has transmuted into “the Thing” or “the Havana syndrome” (45). From December, 2016, to August, 2017, some State Department personnel and other CIA employees began to suffer a series of neurological symptoms, including headaches, dizziness and sleep abnormalities, while working at the Cuban embassy, or staying at other places in Havana, such as the Capri and Nacional hotels.

Because of the political nature of this affair, many details remain undisclosed, such as the names of the CIA employees affected, who exactly was responsible for the attack (the Cuban government continues to deny all knowledge), or the specific “weapon” employed (some scientists suspect a microwave attack). However, the preliminary results of the study of Swanson et al. (7) on 21 individuals identified by the US Department of State as having possibly been exposed, showed persistent cognitive, vestibular, and oculomotor dysfunction, as well as sleep impairment and headaches, along with reports of directional audible and/or sensory phenomena of unclear origin. As Swanson et al. (7) concluded, these individuals appeared to have sustained injury to widespread brain networks without an associated history of head trauma.

Therefore, there exist clear similitudes with the Moscow embassy case; a (hypothesized) directional weapon that produces several identifiable neurocognitive symptoms and that leaves no detectable traces, contextualized in a framework of secrecy and political tension. The main difference is that, in the Cuban case, there is still no confirmation of the use of microwaves....


Power densities measured at the Moscow embassy were higher than the average levels typically found nowadays in homes, schools and urban areas, and were of the same order of magnitude as the more extreme case of living just a few meters from a base station (see (19)) This means that exposure at the embassy could have been high in terms of today’s typical levels of exposure. Nevertheless, the exposure was several orders of magnitude lower than those suggested by the ICNRIP guidelines, adopted by many countries as legal limits. As Hardell et al. (19) indicated, the BioInitiative Report (49) with updated references defined the scientific benchmark for possible health risks as 0.000003–0.000006 mW/cm2. Consequently, the exposure at the Moscow embassy was from 3 to 4 orders of magnitude higher than this safety benchmark, but 3 orders of magnitude lower than the legal limits of many countries.


WHO Radiofrequency EMF Health Risk Assessment Monograph (EHC series)

Sep 1, 2021 (Updated Nov 26, 2021)

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 #197).

According to Microwave News, WHO originally began work on this monograph in 2012 and released 11 chapters of a draft report in 2014 for public comment. Comments on the draft report from other scientists were highly critical. "After that the process stalled, and the RF EHC was stuck in limbo." In October 2019, WHO issued a call for ten systematic reviews of the RF effects research (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 WHO refused to state publicly whom they selected to conduct these reviews, some of their identities became known when papers describing research protocols for seven (SR1, 3, 4, 6, 7, 8, 9) of the forthcoming ten reviews were recently published. See abstracts below.

All of the research protocols will be published online for 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.

We should not forget there has never been a perfect study--every study has either limited internal or construct validity and/or limited generalizability (external validity).

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." (4)

(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) 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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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. Environment International. 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).

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.


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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: https://www.sciencedirect.com/science/article/pii/S0160412021004086?via%3Dihub

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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. Environment International, 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. Environment International. 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. Environment International. 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. Environment International. Volume 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.


Wednesday, November 3, 2021

Health Effects of Cellphone & Cell Tower Radiation: Implications for 5G Webinar


Speaker: Joel M. Moskowitz, PhD
University of California, Berkeley

November 3, 2021

The Center for Occupational and Environmental Health (COEH) is one of 18 regional Education and Research Centers (ERC), funded by the National Institute for Occupational Safety and Health (NIOSH). The ERC supports traineeships at three University of California campuses: UC Berkeley, UC Davis and UCSF.

This presentation summarized the research on biologic and health effects from exposure to radio frequency radiation emitted by cell phones and cell towers along with the implications of this research for 5G, the fifth generation of cellular technology. The inadequacy of current national and international radio frequency exposure limits to protect environmental and public health was also discussed.

Indicative of the widespread interest in this public health issue, the webinar was attended by 660 people from 40 states and 30 countries. About 20% of attendees were from California and 19% from foreign countries. More than 100 people submitted questions; however, there was only enough time to answer a handful.

Webinar video: https://bit.ly/cellphonewebinar2021 (1 hour 22 minutes; starts 5 minutes in)

Slides: https://bit.ly/COEHcellphonewebinar

Speaker: Joel M. Moskowitz, PhD

Joel M. Moskowitz, PhD, has directed the Center for Family and Community Health in the School of Public Health at the University of California, Berkeley since 1993. Dr. Moskowitz has published research on disease prevention for 40 years. In 2009 he served as the senior author on a hallmark paper reviewing research on mobile phone use and tumor risk published in the Journal of Clinical Oncology. Last year he updated this meta-analysis in a paper published in the International Journal of Environmental Research and Public Health. This year he co-authored a paper on electrohypersensitivity published in the International Journal of Molecular Sciences.

Since 2013 he has translated and disseminated research on the biologic and health effects of wireless radiation through his website (https://saferemr.com). In 2017, with legal representation from the UC Berkeley Environmental Law Clinic, he won a lawsuit against the California Department of Public Health for suppressing its own scientists' cell phone safety guidance for eight years. This resulted in the Department finally publishing cell phone health warnings. He serves as an advisor to Physicians for Safe Technology and to the International EMF Scientist Appeal which was signed by over 240 scientists who published more than 2,000 papers and letters in professional journals on electromagnetic fields and biology or health.

Webinar video: https://bit.ly/cellphonewebinar2021 (1 hour 22 minutes; starts 5 minutes in)

Slides: https://bit.ly/COEHcellphonewebinar