Exposures to radio-frequency electromagnetic fields and their impacts on children's health – What the science knows?

Abstract

Exposures to radio-frequency electromagnetic fields and their impacts on children's health – What the science knows? Lim H, Choi J, Joo H, Ha M. Exposures to radio-frequency electromagnetic fields and their impacts on children's health – What the science knows? Current Opinion in Environmental Science & Health. Volume 32, 2023, 100456. doi: 10.1016/j.coesh.2023.100456. Highlights • We mainly reviewed epidemiological studies of the health effects of radiofrequency electromagnetic radiation on children. • We could not find a consistent health effect of children in association with the exposure. • The qualities of the epidemiological studies are mostly low to moderate levels in the risk-of-bias assessment. • The current studies do not provide sufficient evidence to determine the adverse effects. • Improved exposure assessment, causal study design and analytical models are needed for high- quality scientific evidence. Abstract The possible health effects of radiofrequency electromagnetic radiation on children have become a public concern due to biological vulnerability of developing children. To evaluate the evidence for possible adverse health effects on children, we systematically reviewed epidemiological studies, and briefly reviewed the experimental animal or mechanistic studies. Using a search strategy and risk-of-bias assessment, we summarized the existing data on cancer, birth outcome, neurocognitive development, and behavioral problems. There was no sufficient evidence to determine the adverse effects. Recent large-scale animal studies have shown carcinogenic findings, but the biological mechanism has not yet been elucidated. A well-designed future study is needed to produce high-quality scientific evidence of the possible harmful effects of radiofrequency electromagnetic radiation exposure in children. Excerpts We systematically reviewed 49 epidemiological studies and briefly reviewed an additional 5 epidemiological and 15 animal and mechanistic studies. There was less evidence for the prenatal exposure effects on neurocognitive development while more evidence was reported on behavioral problems. Postnatal exposure than prenatal showed more evidence for effects both on neurocognition or behavior. Fetal exposure did not show a definite effect on birth outcomes. Far- or near-field exposure to RF showed no evidence for carcinogenic effect on children. However, the effect of postnatal exposure on the neurocognition and behavior of children should be cautiously interpreted due to the possibility of reverse causality. Behavioral characteristics may associate with the usage of mobile phones or any other IT devices. Furthermore, sleep deprivation and depressive moods by mobile phone usage in children may be another pathway to resulting behavioral problems. Of several birth outcomes, shortened pregnancy duration was significantly associated with increased maternal mobile phone use. However, this finding should be interpreted with caution owing to the difficulties in disentangling the effects of RF-EMF exposure and maternal physical activity/behavioral factors, such as child- raising characteristics, caused by mobile phone usage. The same caution also should be applied to the results indicating an effect of prenatal exposure on the neurocognitive development and behavior of children. We did not find clear evidence to determine whether RF-EMF exposure affects children’s health outcomes. The quality of the epidemiological studies is mostly low to moderate, and the direction and size of effect estimates are inconsistent. We found that few studies have been assessed as high quality (low RoB) (Table 1). This is mostly due to the exposure assessment (Table S4). RF-EMF exposure has been assessed using proxy exposure variables for the use of electronic devices, mainly mobile phone use, or distance from mobile communication base stations. This type of exposure assessment may cause a nondifferential misclassification which leads the association toward the null. Despite the remaining ambiguity of the biological mechanism, recent animal studies showing consistent carcinogenic findings have driven more epidemiological studies, repetition of animal studies, and mechanistic studies, with higher levels of quality.... Conclusions The current studies examining the possible association between RF-EMF exposure and children’s health do not provide conclusive evidence. The results should be interpreted with caution due to the possibility of reverse causality, confounding or mediation of behavioral/environmental factors, and exposure misclassification. Above all, in the epidemiological research, the accuracy of personal RF-EMF exposure assessment needs to be improved. A recent systematic review on the health effects of RF-EMFexposure in children and adolescents also recommended high-quality research [76]. Furthermore, advanced study design or analysis method that mimic a counter-factual model or randomization and strengthen causal inference, such as instrumental variable analysis, difference-in-differences analysis, and causal mediation analysis, are warranted. Moreover, we suggest designing a census-based cohort that incorporates data from telecommunication operators. This would be relatively free from the recall and measurement biases of exposure, and exposure history can be profiled in detail. A sufficient statistical power with a large sample size would reveal the relatively small effect of RF-EMF from other competing risk factors, and be effective in the modeling to control confounding or modifying factors, such as restriction or stratified analysis. With the ongoing development of next-generation mobile communication, RF-EMF exposure is expected to increase in the general population. A well-designed future study is needed to produce high-quality scientific evidence of the possible harmful effects of RF-EMF exposure in children. sciencedirect.com

AI evidence extraction

Main findings

The authors systematically reviewed epidemiological studies on RF-EMF exposure and children’s health and report no consistent or conclusive evidence of adverse effects across outcomes. They note some reported associations for postnatal exposure with neurocognition/behavior and for maternal mobile phone use with shortened pregnancy duration, but emphasize cautious interpretation due to reverse causality, confounding/mediation, and exposure misclassification; far-/near-field RF exposure showed no evidence for carcinogenic effects in children.

Outcomes measured

• Cancer/carcinogenicity
• Birth outcomes (including pregnancy duration)
• Neurocognitive development
• Behavioral problems

Limitations

• Epidemiological study quality mostly low to moderate in risk-of-bias assessment
• Exposure assessment often based on proxy variables (e.g., device use, distance to base stations), risking nondifferential misclassification
• Possibility of reverse causality for behavioral/neurocognitive associations (behavior may influence device use)
• Potential confounding or mediation by behavioral/environmental factors (e.g., sleep deprivation, depressive mood, physical activity)
• Inconsistent direction and size of effect estimates across studies
• Biological mechanisms for animal carcinogenic findings not elucidated

Suggested hubs

• who-icnirp (0.35)
  Systematic review of RF-EMF health evidence relevant to guideline/policy discussions.

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    "study_type": "systematic_review",
    "exposure": {
        "band": "RF",
        "source": "mobile phone; mobile communication base stations; electronic/IT devices (proxy measures)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "Children (including prenatal/fetal and postnatal exposure contexts)",
    "sample_size": null,
    "outcomes": [
        "Cancer/carcinogenicity",
        "Birth outcomes (including pregnancy duration)",
        "Neurocognitive development",
        "Behavioral problems"
    ],
    "main_findings": "The authors systematically reviewed epidemiological studies on RF-EMF exposure and children’s health and report no consistent or conclusive evidence of adverse effects across outcomes. They note some reported associations for postnatal exposure with neurocognition/behavior and for maternal mobile phone use with shortened pregnancy duration, but emphasize cautious interpretation due to reverse causality, confounding/mediation, and exposure misclassification; far-/near-field RF exposure showed no evidence for carcinogenic effects in children.",
    "effect_direction": "unclear",
    "limitations": [
        "Epidemiological study quality mostly low to moderate in risk-of-bias assessment",
        "Exposure assessment often based on proxy variables (e.g., device use, distance to base stations), risking nondifferential misclassification",
        "Possibility of reverse causality for behavioral/neurocognitive associations (behavior may influence device use)",
        "Potential confounding or mediation by behavioral/environmental factors (e.g., sleep deprivation, depressive mood, physical activity)",
        "Inconsistent direction and size of effect estimates across studies",
        "Biological mechanisms for animal carcinogenic findings not elucidated"
    ],
    "evidence_strength": "insufficient",
    "confidence": 0.7800000000000000266453525910037569701671600341796875,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "radiofrequency electromagnetic fields",
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        "children",
        "prenatal exposure",
        "postnatal exposure",
        "mobile phone use",
        "base stations",
        "cancer",
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