The effects of radiofrequency electromagnetic fields exposure on tinnitus, migraine and non-specific

Abstract

The effects of radiofrequency electromagnetic fields exposure on tinnitus, migraine and non-specific symptoms in the general and working population: A systematic review and meta-analysis on human observational studies My note: Numerous problems have been identified with this paper and other systematic reviews commissioned by the WHO for an upcoming monograph on radio frequency effects. Röösli M, Dongus S, Jalilian H, Eyers J, Esu E, Oringanje CM, Meremikwu M, Bosch-Capblanch X. The effects of radiofrequency electromagnetic fields exposure on tinnitus, migraine and non-specific symptoms in the general and working population: A systematic review and meta-analysis on human observational studies. Environ Int. 2024 Jan;183:108338. doi: 10.1016/j.envint.2023.108338. 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). Objectives: The objective is to systematically review the effects of longer-term or repeated local and whole human body radiofrequency electromagnetic field (RF-EMF) exposure on the occurrence of symptoms. Primary hypotheses were tinnitus, migraine and headaches in relation to RF-EMF exposure of the brain, sleep disturbances and composite symptom scores in relation to whole-body RF-EMF exposure. Methods: Eligibility criteria: We included case-control and prospective cohort studies in the general population or workers estimating local or whole-body RF-EMF exposure for at least one week. Information sources: We conducted a systematic literature search in various databases including Web of Science and Medline. Risk of bias: We used the Risk of Bias (RoB) tool developed by OHAT adapted to the topic of this review. Synthesis of results: We synthesized studies using random effects meta-analysis. Results: Included studies: We included 13 papers from eight distinct cohort and one case-control studies with a total of 486,558 participants conducted exclusively in Europe. Tinnitus is addressed in three papers, migraine in one, headaches in six, sleep disturbances in five, and composite symptom scores in five papers. Only one study addressed occupational exposure. Synthesis of results: For all five priority hypotheses, available research suggests that RF-EMF exposure below guideline values does not cause symptoms, but the evidence is very uncertain. The very low certainty evidence is due the low number of studies, possible risk of bias in some studies, inconsistencies, indirectness, and imprecision. In terms of non-priority hypotheses numerous exposure- outcome combinations were addressed in the 13 eligible papers without indication for an association related to a specific symptom or exposure source. Discussion: Limitations of evidence: This review topic includes various challenges related to confounding control and exposure assessment. Many of these aspects are inherently present and not easy to be solved in future research. Since near-field exposure from wireless communication devices is related to lifestyle, a particular challenge is to differentiate between potential biophysical effects and other potential effects from extensive use of wireless communication devices that may compete with healthy behaviour such as sleeping or physical activity. Future research needs novel and innovative methods to differentiate between these two hypothetical mechanisms. Interpretation: This is currently the best available evidence to underpin safety of RF-EMF. There is no indication that RF-EMF below guideline values causes symptoms. However, inherent limitations of the research results in substantial uncertainty. Other: Funding: This review was partially funded by the WHO radioprotection programme. Registration: The protocol for this review has been registered in Prospero (reg no CRD42021239432) and published in Environment International (Röösli et al., 2021). 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. Martin Röösli’s research is entirely funded by public or not-for-profit foundations. He has served as advisor to a number of national and international public advisory and research steering groups concerning the potential health effects of exposure to nonionizing radiation, including the World Health Organization, the International Agency for Research on Cancer, the International Commission on Non- Ionizing Radiation Protection, the Swiss Government (member of the working group "mobile phone and radiation" and chair of the expert group BERENIS), the German Radiation Protection Commission (member of the committee Non-ionizing Radiation (A6) and member of the working group 5G (A630)) and the Independent Expert Group of the Swedish Radiation Safety Authority. sciencedirect.com

AI evidence extraction

Main findings

Across 13 papers from eight cohort studies and one case-control study (486,558 participants), the review reports no indication that RF-EMF exposure below guideline values causes tinnitus, migraine/headache, sleep disturbances, or composite symptom scores, but states the evidence is very uncertain. The authors attribute very low certainty to few studies and concerns including possible risk of bias, inconsistencies, indirectness, and imprecision.

Outcomes measured

• tinnitus
• migraine
• headaches
• sleep disturbances
• composite symptom scores
• non-specific symptoms

Limitations

• Very low certainty evidence due to low number of studies
• Possible risk of bias in some included studies
• Inconsistencies across studies
• Indirectness and imprecision
• Challenges in confounding control and exposure assessment
• Difficulty separating potential biophysical effects from lifestyle-related factors linked to device use
• Only one study addressed occupational exposure
• Evidence base limited to studies conducted in Europe

Suggested hubs

• who-icnirp (0.74)
  The review was partially funded by the WHO radioprotection programme and discusses guideline values and advisory roles involving WHO/ICNIRP.
• occupational-exposure (0.35)
  The eligibility criteria included workers and one included study addressed occupational exposure.

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    "study_type": "meta_analysis",
    "exposure": {
        "band": "RF",
        "source": "mobile phone, medical diathermy, industrial RF heaters (general RF-EMF applications)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": "at least one week (longer-term or repeated exposure)"
    },
    "population": "General population and workers (human observational studies; studies conducted exclusively in Europe)",
    "sample_size": 486558,
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    "effect_direction": "no_effect",
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    "stance": "reassurance",
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    "summary": "This systematic review and random-effects meta-analysis evaluated longer-term or repeated local and whole-body RF-EMF exposure (≥1 week) and symptoms in the general and working population. It included 13 papers from eight cohort studies and one case-control study (486,558 participants), all conducted in Europe. For tinnitus, migraine/headache, sleep disturbances, and composite symptom scores, the review reports no indication of effects from RF-EMF exposure below guideline values, while emphasizing that the certainty of evidence is very low and substantially uncertain.",
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        "Thirteen papers from eight cohort studies and one case-control study were included, totaling 486,558 participants.",
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        "Only one included study addressed occupational RF-EMF exposure.",
        "For all five priority hypotheses, the review reports no indication that RF-EMF below guideline values causes symptoms, but the evidence is described as very uncertain.",
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    "social": {
        "tweet": "Systematic review/meta-analysis (13 papers; 486,558 participants, Europe) reports no indication that RF-EMF exposure below guideline values causes tinnitus, migraine/headache, sleep disturbances, or composite symptom scores—while emphasizing very low certainty and substantial uncertainty due to limited and imperfect evidence.",
        "facebook": "A new systematic review and meta-analysis of human observational studies (13 papers; 486,558 participants, all in Europe) found no indication that RF-EMF exposure below guideline values causes tinnitus, migraine/headache, sleep disturbances, or composite symptom scores. The authors stress that the certainty of evidence is very low, citing few studies and challenges such as confounding and exposure assessment.",
        "linkedin": "Systematic review and random-effects meta-analysis of human observational studies (13 papers; 486,558 participants, Europe) reports no indication that RF-EMF exposure below guideline values causes tinnitus, migraine/headache, sleep disturbances, or composite symptom scores. The review highlights very low certainty evidence and methodological challenges including confounding control and exposure assessment."
    }
}

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