Genotoxicity of radiofrequency electromagnetic fields: Protocol for a systematic review of in vitro studies

Abstract

Genotoxicity of radiofrequency electromagnetic fields: Protocol for a systematic review of in vitro studies Stefania Romeo, Olga Zeni, Anna Sannino, Susanna Lagorio, Mauro Biffoni, Maria Rosaria Scarfì. Genotoxicity of radiofrequency electromagnetic fields: Protocol for a systematic review of in vitro studies. Environ Int. 2021 Jan 21;148:106386. doi: 10.1016/j.envint.2021.106386. Abstract Background: Exposure to radiofrequency electromagnetic fields (RF-EMF, 100 kHz - 300 GHz) emitted by wireless communication technologies is pervasive and ubiquitous. Concern has been raised about possible adverse effects to human health. In 2011 the International Agency for Research on Cancer has classified RF-EMF as possibly carcinogenic to humans, highlighting that the evidence is weak and far from conclusive. Updated systematic reviews of the scientific literature on this topic are lacking, especially for mechanistic studies. Objectives: To develop a protocol for a systematic review of experimental studies investigating genotoxic effects induced by RF-EMF in in vitro cellular models. Genotoxicity is one of the key-biological indicators of carcinogenicity, and the most common characteristics of established carcinogens. The predefined procedures for conducting the systematic review are outlined below. Methods: We will follow the guidelines developed by the National Toxicology Program-Office of Health Assessment and Translation (NTP-OHAT), adapted to the evaluation of in vitro studies. Eligibility criteria: We will include experimental in vitro studies addressing the relationship between controlled exposures to RF-EMF and genotoxicity in mammalian cells only. Eligibility for inclusion will be further restricted to peer reviewed articles reporting findings from primary studies. Information sources: We will search the scientific literature databases NCBI PubMed, Web of Science, and EMF- Portal. No filter on publication date will be applied. Only studies published in English will be considered. The reference lists of the included papers and available reviews will be screened for unidentified relevant papers. References will be managed through Endnote X9 software. Data extraction and synthesis of results: Data from included papers will be extracted according to predefined forms. Heterogeneity within the available evidence will determine the type of evidence synthesis that is appropriate. Findings will be summarized in tables, graphical displays and in a narrative synthesis of the available evidences. A meta-analysis will be carried out if subgroups of studies homogeneous in terms of exposure characteristics, endpoint, and cell types will be identified. Risk of bias: The internal validity of included studies will be assessed using the NTP-OHAT Risk of Bias Rating Tool for animal studies, adapted to in vitro studies. This stage of the process will be managed through the Health Assessment Workspace Collaborative (HAWC). Evidence appraisal: To rate confidence in the body of evidence, we will use the OHAT GRADE-based approach for animal studies. Framework and funding: This protocol concerns one of the evidence streams considered in a larger systematic review of the scientific literature on the potential carcinogenicity of RF-EMF, performed by scientists from several Italian public research agencies. The project is supported by the Italian Workers' Compensation Authority (INAIL) in the framework of the CRA with the Istituto Superiore di Sanità "BRiC 2018/06 - Scientific evidence on the carcinogenicity of radiofrequency electromagnetic fields". pubmed.ncbi.nlm.nih.gov

AI evidence extraction

Main findings

This paper describes a protocol to conduct a systematic review of peer-reviewed in vitro studies on whether controlled RF-EMF exposures induce genotoxic effects in mammalian cells. It outlines planned search strategies, eligibility criteria, risk-of-bias assessment, and evidence appraisal methods, and notes that a meta-analysis will be performed if sufficiently homogeneous subgroups are identified.

Outcomes measured

• Genotoxicity

Limitations

• Protocol paper; no results from included studies are reported.
• Restricted to in vitro mammalian cell studies and English-language publications.
• Inclusion limited to peer-reviewed primary studies, which may exclude relevant non-peer-reviewed evidence.

{
    "publication_year": 2021,
    "study_type": "systematic_review",
    "exposure": {
        "band": "RF",
        "source": "wireless communication technologies",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "In vitro mammalian cell models",
    "sample_size": null,
    "outcomes": [
        "Genotoxicity"
    ],
    "main_findings": "This paper describes a protocol to conduct a systematic review of peer-reviewed in vitro studies on whether controlled RF-EMF exposures induce genotoxic effects in mammalian cells. It outlines planned search strategies, eligibility criteria, risk-of-bias assessment, and evidence appraisal methods, and notes that a meta-analysis will be performed if sufficiently homogeneous subgroups are identified.",
    "effect_direction": "unclear",
    "limitations": [
        "Protocol paper; no results from included studies are reported.",
        "Restricted to in vitro mammalian cell studies and English-language publications.",
        "Inclusion limited to peer-reviewed primary studies, which may exclude relevant non-peer-reviewed evidence."
    ],
    "evidence_strength": "high",
    "confidence": 0.7800000000000000266453525910037569701671600341796875,
    "peer_reviewed_likely": "yes",
    "stance": "neutral",
    "stance_confidence": 0.61999999999999999555910790149937383830547332763671875,
    "summary": "This article presents a protocol for a systematic review of experimental in vitro studies assessing whether radiofrequency electromagnetic fields (100 kHz\u001500 GHz) cause genotoxic effects in mammalian cells. The protocol specifies database searches (PubMed, Web of Science, EMF-Portal), inclusion criteria, and planned approaches for evidence synthesis, risk-of-bias assessment (NTP-OHAT adapted tools), and confidence rating (OHAT GRADE-based approach). No findings on genotoxicity are reported because this is a methods/protocol publication.",
    "key_points": [
        "The paper is a protocol for a systematic review focused on RF-EMF-induced genotoxicity in in vitro mammalian cell models.",
        "RF-EMF exposure is defined broadly (100 kHz\u001500 GHz) and linked to wireless communication technologies.",
        "Only peer-reviewed primary in vitro studies in English are planned for inclusion.",
        "Searches are planned in PubMed, Web of Science, and EMF-Portal without publication-date limits.",
        "Evidence synthesis will depend on heterogeneity, with meta-analysis planned only for sufficiently homogeneous subgroups.",
        "Risk of bias will be assessed using an NTP-OHAT tool adapted for in vitro studies and managed in HAWC.",
        "Confidence in the body of evidence will be rated using an OHAT GRADE-based approach."
    ],
    "categories": [
        "Systematic Reviews & Protocols",
        "Mechanisms (Genotoxicity)"
    ],
    "tags": [
        "Systematic Review Protocol",
        "In Vitro Studies",
        "Mammalian Cells",
        "Radiofrequency EMF",
        "Wireless Technologies",
        "Genotoxicity",
        "Carcinogenicity",
        "Risk Of Bias",
        "OHAT",
        "GRADE"
    ],
    "keywords": [
        "RF-EMF",
        "radiofrequency electromagnetic fields",
        "genotoxicity",
        "in vitro",
        "systematic review",
        "protocol",
        "NTP-OHAT",
        "HAWC",
        "GRADE",
        "mammalian cells"
    ],
    "suggested_hubs": [],
    "social": {
        "tweet": "New protocol outlines a systematic review of peer-reviewed in vitro studies on whether RF-EMF (100 kHz\u001500 GHz) induces genotoxic effects in mammalian cells, including planned search strategy, risk-of-bias assessment (NTP-OHAT), and evidence grading (OHAT/GRADE).",
        "facebook": "This paper presents a protocol for a systematic review of experimental in vitro studies examining whether radiofrequency electromagnetic fields (RF-EMF) can cause genotoxic effects in mammalian cells. It details planned database searches, inclusion criteria, risk-of-bias assessment methods, and how the overall evidence will be graded; it does not report results.",
        "linkedin": "Protocol publication: a planned systematic review of peer-reviewed in vitro mammalian cell studies assessing RF-EMF exposure and genotoxicity. The authors describe search methods (PubMed, Web of Science, EMF-Portal), risk-of-bias assessment using adapted NTP-OHAT tools, and evidence appraisal using an OHAT GRADE-based approach."
    }
}

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