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Background: The objective of this review was to assess the quality and strength of the evidence provided by human observational studies for a causal association between exposure to radiofrequency electromagnetic fields (RF-EMF) and risk of the most investigated neoplastic diseases. Methods: Eligibility criteria: We included cohort and case-control studies of 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 hand-held transceivers or RF-emitting equipment in the workplace (SR-C). While no restrictions on tumour type were applied, in the current paper we focus on incidence-based studies of selected “critical” 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). We focussed on investigations of specific neoplasms in relation to specific exposure sources (i.e. E-O pairs), noting that a single article may address multiple E-O pairs.Information sources: Eligible studies were identified by literature searches through Medline, Embase, and EMF-Portal.Risk-of-bias (RoB) assessment: We used a tailored version of the Office of Health Assessment and Translation (OHAT) RoB tool to evaluate each study’s internal validity. At the summary RoB step, studies were classified into three tiers according to their overall potential for bias (low, moderate and high).Data synthesis: We synthesized the study results using random effects restricted maximum likelihood (REML) models (overall and subgroup meta-analyses of dichotomous and categorical exposure variables), and weighted mixed effects models (dose–response meta-analyses of lifetime exposure intensity).Evidence assessment: Confidence in evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results: We included 63 aetiological articles, published between 1994 and 2022, with participants from 22 countries, reporting on 119 different E-O pairs. RF-EMF exposure from mobile phones (ever or regular use vs no or non-regular use) was not associated with an increased risk of glioma [meta-estimate of the relative risk (mRR) = 1.01, 95 % CI = 0.89–1.13), meningioma (mRR = 0.92, 95 % CI = 0.82–1.02), acoustic neuroma (mRR = 1.03, 95 % CI = 0.85–1.24), pituitary tumours (mRR = 0.81, 95 % CI = 0.61–1.06), salivary gland tumours (mRR = 0.91, 95 % CI = 0.78–1.06), or paediatric (children, adolescents and young adults) brain tumours (mRR = 1.06, 95 % CI = 0.74–1.51), with variable degree of across-study heterogeneity (I2 = 0 %-62 %). There was no observable increase in mRRs for the most investigated neoplasms (glioma, meningioma, and acoustic neuroma) with increasing time since start (TSS) use of mobile phones, cumulative call time (CCT), or cumulative number of calls (CNC). Cordless phone use was not significantly associated with risks of glioma [mRR = 1.04, 95 % CI = 0.74–1.46; I2 = 74 %) meningioma, (mRR = 0.91, 95 % CI = 0.70–1.18; I2 = 59 %), or acoustic neuroma (mRR = 1.16; 95 % CI = 0.83–1.61; I2 = 63 %). Exposure from fixed-site transmitters (broadcasting antennas or base stations) was not associated with childhood leukaemia or paediatric brain tumour risks, independently of the level of the modelled RF exposure. Glioma risk was not significantly increased following occupational RF exposure (ever vs never), and no differences were detected between increasing categories of modelled cumulative exposure levels. Discussion: In the sensitivity analyses of glioma, meningioma, and acoustic neuroma risks in relation to mobile phone use (ever use, TSS, CCT, and CNC) the presented results were robust and not affected by changes in study aggregation.In a leave-one-out meta-analyses of glioma risk in relation to mobile phone use we identified one influential study. In subsequent meta-analyses performed after excluding this study, we observed a substantial reduction in the mRR and the heterogeneity between studies, for both the contrast Ever vs Never (regular) use (mRR = 0.96, 95 % CI = 0.87–1.07, I2 = 47 %), and in the analysis by increasing categories of TSS (“ 1.5 with a 10+ years induction period were definitely implausible, and could be used to set a “credibility benchmark”. In the sensitivity meta-analyses of glioma risk in the upper category of TSS excluding five studies reporting implausible effect sizes, we observed strong reductions in both the mRR [mRR of 0.95 (95 % CI = 0.86–1.05)], and the degree of heterogeneity across studies (I2 = 3.6 %). Conclusions: Consistently with the published protocol, our final conclusions were formulated separately for each exposure-outcome combination, and primarily based on the line of evidence with the highest confidence, taking into account the ranking of RF sources by exposure level as inferred from dosimetric studies, and the external coherence with findings from time-trend simulation studies (limited to glioma in relation to mobile phone use).For near field RF-EMF exposure to the head from mobile phone use, there was moderate certainty evidence that it likely does not increase the risk of glioma, meningioma, acoustic neuroma, pituitary tumours, and salivary gland tumours in adults, or of paediatric brain tumours.For near field RF-EMF exposure to the head from cordless phone use, there was low certainty evidence that it may not increase the risk of glioma, meningioma or acoustic neuroma.For whole-body far-field RF-EMF exposure from fixed-site transmitters (broadcasting antennas or base stations), there was moderate certainty evidence that it likely does not increase childhood leukaemia risk and low certainty evidence that it may not increase the risk of paediatric brain tumours. There were no studies eligible for inclusion investigating RF-EMF exposure from fixed-site transmitters and critical tumours in adults.For occupational RF-EMF exposure, there was low certainty evidence that it may not increase the risk of brain cancer/glioma, but there were no included studies of leukemias (the second critical outcome in SR-C).The evidence rating regarding paediatric brain tumours in relation to environmental RF exposure from fixed-site transmitters should be interpreted with caution, due to the small number of studies. Similar interpretative cautions apply to the evidence rating of the relation between glioma/brain cancer and occupational RF exposure, due to differences in exposure sources and metrics across the few included studies. Other: This project was commissioned and partially funded by the World Health Organization (WHO). 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; and ARPANSA as a WHO Collaborating Centre for Radiation Protection. Registration: PROSPERO CRD42021236798. Published protocol: [(Lagorio et al., 2021) DOI https://doi.org/10.1016/j.envint.2021.106828].

Background: We aimed to assess evidence of long-term effects of exposure to radiofrequency (RF) electromagnetic fields (EMF) on indicators of cognition, including domains of learning and memory, executive function, complex attention, language, perceptual motor ability and social cognition, and of an exposure–response relationship between RF-EMF and cognition. Methods: We searched PubMed, Embase, PsycInfo and the EMF-Portal on September 30, 2022 without limiting by date or language of publication. We included cohort or case-control studies that evaluated the effects of RF exposure on cognitive function in one or more of the cognitive domains. Studies were rated for risk of bias using the OHAT tool and synthesised using fixed effects meta-analysis. We assessed the certainty of the evidence using the GRADE approach and considered modification by OHAT for assessing evidence of exposures. Results: We included 5 studies that reported analyses of data from 4 cohorts with 4639 participants consisting of 2808 adults and 1831 children across three countries (Australia, Singapore and Switzerland) conducted between 2006 and 2017. The main source of RF-EMF exposure was mobile (cell) phone use measured as calls per week or minutes per day.For mobile phone use in children, two studies (615 participants) that compared an increase in mobile phone use to a decrease or no change were included in meta-analyses. Learning and memory. There was little effect on accuracy (mean difference, MD −0.03; 95% CI −0.07 to 0.02) or response time (MD −0.01; 95% CI −0.04 to 0.02) on the one-back memory task; and accuracy (MD −0.02; 95%CI −0.04 to 0.00) or response time (MD −0.01; 95%CI −0.04 to 0.03) on the one card learning task (low certainty evidence for all outcomes). Executive function. There was little to no effect on the Stroop test for the time ratio ((B-A)/A) response (MD 0.02; 95% CI −0.01 to 0.04, very low certainty) or the time ratio ((D-C)/C) response (MD 0.00; 95% CI −0.06 to 0.05, very low certainty), with both tests measuring susceptibility to interference effects. Complex attention. There was little to no effect on detection task accuracy (MD 0.02; 95% CI −0.04 to 0.08), or response time (MD 0.02;95% CI 0.01 to 0.03), and little to no effect on identification task accuracy (MD 0.00; 95% CI −0.04 to 0.05) or response time (MD 0.00;95% CI −0.01 to 0.02) (low certainty evidence for all outcomes). No other cognitive domains were investigated in children.A single study among elderly people provided very low certainty evidence that more frequent mobile phone use may have little to no effect on the odds of a decline in global cognitive function (odds ratio, OR 0.81; 95% CI 0.42 to 1.58, 649 participants) or a decline in executive function (OR 1.07; 95% CI 0.37 to 3.05, 146 participants), and may lead to a small, probably unimportant, reduction in the odds of a decline in complex attention (OR 0.67;95%CI 0.27 to 1.68, 159 participants) and a decline in learning and memory (OR 0.75; 95% CI 0.29 to 1.99, 159 participants). An exposure–response relationship was not identified for any of the cognitive outcomes. Discussion: This systematic review and meta-analysis found only a few studies that provided very low to low certainty evidence of little to no association between RF-EMF exposure and learning and memory, executive function and complex attention. None of the studies among children reported on global cognitive function or other domains of cognition. Only one study reported a lack of an effect for all domains in elderly persons but this was of very low certainty evidence. Further studies are needed to address all types of populations, exposures and cognitive outcomes, particularly studies investigating environmental and occupational exposure in adults. Future studies also need to address uncertainties in the assessment of exposure and standardise testing of specific domains of cognitive function to enable synthesis across studies and increase the certainty of the evidence. Other: This review was partially funded by the WHO radioprotection programme and prospectively registered on PROSPERO CRD42021257548.

Abstract Background Exposure to radiofrequency (RF) electromagnetic fields (EMF), particularly from telecommunications sources, is one of the most common and fastest growing anthropogenic factors on the environment. In many countries, humans are protected from harmful RF EMF exposure by safety standards that are based on guidelines by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). The ICNIRP guidelines are based on knowledge of how RF EMF affects the human body, however, there are currently no recognised international guidelines to specifically protect animals and plants. Whether the ICNIRP guidelines for humans are adequate to provide protection to the environment is a subject of active debate. There is some public concern that new telecommunications technologies, like the 5G mobile phone network may affect the natural environment. This systematic map presents a searchable database of all the available evidence on whether anthropogenic RF EMF has an effect on plants and animals in the environment. The map also identifies gaps in knowledge, recommends future research and informs environmental and radiation protection authorities. Methods The method used was published in an a priori protocol. Searches included peer-reviewed and grey literature published in English with no time and geographic restrictions. The EMF-Portal, PubMed and Web of Science databases were searched, and the resulting articles were screened in three stages: title, abstract and full text. Studies were included with a subject population of all animals and plants, with exposures to anthropogenic RF EMF (frequency range 100 kHz–300 GHz) compared to no or lower-level exposure, and for any outcomes related to the studied populations. For each included study, metadata were extracted on key variables of interest that were used to represent the distribution of available evidence. Review findings The initial search, search update and supplementary searches produced 24,432 articles and of those 334 articles (237 on fauna and 97 on flora) that were relevant were included in the systematic map. The vast majority of studies were experiments conducted in a laboratory rather than observational studies of animals and plants in the natural environment. The majority of the studies investigated exposures with frequencies between 300 and 3000 MHz, and although the exposure level varied, it was mainly low and below the ICNIRP limits. Most of the animal studies investigated insects and birds, whereas grains and legumes were the most investigated plants. Reproduction, development and behaviour were the most investigated effects for animals, and germination and growth for plants. The vast majority of the studies employed poor quality methods. Conclusion There are distinct evidence clusters: for fauna, on insect and bird reproduction, development and behaviour; and for flora, grain and legume germination and growth that would benefit from specific systematic reviews. The systematic map also highlights the clear need for investigating the effects of RF EMF on more species and more types of effects, and for an improvement in the quality of all studies.

Objective: Due to the negative connotations around radiation, there is a great deal of angst in the community regarding radiation exposure and health; especially electromagnetic radiation (EMR) sources such as powerlines, mobile phone towers and the rollout of the 5G network. As such, it is important for health authorities to provide the public with information and assurances regarding radiation safety. The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) set up community engagement programs to address community concerns. Type of program or service: From 2003 until April 2022, ARPANSA operated a Health Complaints Register, which collected reports of health complaints from members of the public related to possible EMR exposures. Methods: Collected data was used to produce annual statistical summaries on the nature and level of complaints received. Since 2016, ARPANSA has also run the Talk to a Scientist program, which allows the public to communicate directly with scientists on issues about radiation exposure, health and protection in Australia. Data is collected on the type of radiation and radiation source. Results: There was a low level of interest in the Register, with only 180 reports received over the duration of its operation. Smart meters were the most common source of EMR exposure reported to be responsible for adverse health effects. The most common adverse health effect reported was headaches. The Register was closed in April 2022 due to a lack of interest. In contrast, the Talk to a Scientist program has responded to 6546 enquiries since 2016, most of which have been on EMR sources and the success of the Talk to a Scientist program, which rendered the Register obsolete. Lessons learnt: The EMR Health Complaints Register never received much interest from the public, potentially due to a perceived lack of engagement with authorities. The Talk to a Scientist program, which facilitated direct interaction with subject matter experts, has been much more successful in engaging with the public and addressing community concerns on radiation safety

As the fifth-generation (5G) network is introduced in the millimetre-wave (mmWave) spectrum, and the widespread deployment of 5G standalone (SA) is approaching, it becomes essential to establish scientifically grounded exposure limits in the mmWave frequency band. To achieve this, conducting experiments at specific frequencies is crucial for obtaining reliable evidence of potential biological impacts. However, there is a literature gap where experimental research either does not utilise the mmWave high band (e.g., the 26 Gigahertz (GHz) band) or most studies mainly rely on computational approaches. Moreover, some experimental studies do not establish reproducible test environment and exposure systems. Addressing these gaps is vital for a comprehensive exploration of the biological implications associated with mmWave exposure. This study was designed to develop and implement a mmWave exposure system operating at 26 GHz. The step-by-step design and development of the system are explained. This specialised system was designed and implemented within an anechoic chamber to minimise external electromagnetic (EM) interference, creating a controlled and reproducible environment for experiments involving high-frequency EM fields. The exposure system features a 1 cm radiation spot size, enabling highly localised exposure for various biological studies. This configuration facilitates numerous dosimetry studies related to mmWave frequencies.

Abstract Background Exposure to radiofrequency (RF) electromagnetic fields (EMF), particularly from telecommunications sources, is one of the most common and fastest growing anthropogenic factors on the environment. In many countries, humans are protected from excessive RF EMF exposure by safety standards that are based on guidelines by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). The ICNIRP guidelines are based on knowledge of how RF EMF affects the human body, however, there are currently no recognised international guidelines to specifically protect animals and plants. Whether the ICNIRP guidelines for humans is adequate to provide protection to the environment is a subject of active debate. This systematic map will collate all the available evidence on whether anthropogenic RF EMF has a negative effect on plants and animals in the environment. The map will also identify gaps in knowledge, recommend future research and inform environmental and radiation protection authorities. Methods The proposed systematic map will include peer-reviewed and grey literature published in English. The EMF—Portal, PubMed and Web of Science databases will be searched using a search string prepared by the review team and tested for comprehensiveness against a list of known relevant reviews. Once duplicates are removed, retrieved articles will be screened in three stages: title, abstract, and full text. Studies will be selected with a subject population of all plants and animals, with exposures to anthropogenic RF EMF (frequency range 100 kHz–300 GHz) compared to no or lower-level exposure, and for all outcomes related to the studied populations. Kappa statistic tests will be conducted at each stage to ensure consistency of decision-making regarding the predefined inclusion/exclusion criteria. Eligible studies will then proceed to the data extraction phase, which will extract meta-data such as bibliographic information, taxonomic information, RF EMF exposure data, outcome(s), sample size, etc. The extracted data will then be organised into a systematic map and the findings summarised by cross-tabulating key meta-data variables in heat maps, charts or other data visualization methods. The systematic map will identify gaps in knowledge, priorities for future research and potential subtopics for further analysis and/or systematic review.

Background: The long term effects of exposure to radiofrequency (RF) electromagnetic fields (EMF) for frequencies from 100 kHz to 300 GHz on cognitive performance are best assessed using observational studies. In recent years, the use of mobile (cell) phones has been the main source of RF EMF exposure to the brain, although other sources of exposure may be significant. Cognitive function includes various mental and psychological abilities, which can be measured in a range of domains, such as learning, memory, reasoning, problem solving, decision making and attention. Although effects on cognitive function may be most evident later in life, in the experimental setting acute and immediate effects can only be studied. Observational studies are needed when effects are observed after months or years following short or long-term exposure. The importance of the effects of exposure on children has also been recently identified. Objectives: To assess the long-term effects of RF EMF local and whole-body exposure compared to no or a lower level of exposure on indicators of cognition, including complex attention, executive function, learning and memory, perceptual motor ability and social cognition, but excluding cognitive effects caused by neurodegenerative diseases or neurodevelopmental disorders, and to assess if there is evidence of a dose response relationship. Study eligibility and criteria: We will include observational studies that have evaluated cognitive effects of RF energy including a comparator group with a different level of exposure. Studies must report at least one validated measure of cognitive function, including global or domain specific measures, or cognitive impairment, with a minimum follow-up of 6 months. Cohort or case-control studies published in the peer review literature in any language are eligible. We will exclude cross-sectional studies and any that only report brain structure or biomarkers. Study appraisal and synthesis method: We will conduct searches of PubMed, Embase, PsycINFO and the EMF-Portal. At least two authors will independently screen the titles/abstracts of all records, with any conflicts resolved by a third reviewer. Full-text screening will also be conducted independently by two authors with conflicts resolved by consensus. Data will be extracted from the studies included, such as identifiers and characteristics of the study design, exposure and comparator groups, participants, outcomes assessed and results. Risk of bias will be assessed with the Office of Health Assessment and Translation (OHAT) tool. We will conduct a meta-analysis of similar studies with a random effects model in STATA or similar software, if two or more studies are available for a given exposure-outcome combination. Confidence in the body evidence will be judged using GRADE methods as adapted by OHAT for reviews of environmental exposures.

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.