Radiation literature survey

Article review data

August 2024

Article publication date

June 2024

ARPANSA summary

This cohort study, conducted in the USA, examined the impact of ambient ultraviolet radiation (UVR)  on the incidence of ocular melanoma. The study included 18,089 cases of ocular melanoma collected from 21 of the Surveillance, Epidemiology, and End Results (SEER) population-based cancer registries from 2000-2019. Cases were stratified by county of residence, sex, age at diagnosis and year of diagnosis (2000–2003, 2004–2007, 2008–2011, 2012–2015, 2016–2019). The UVR exposure used in the study was based on cloud adjusted UVR measurements from 2000 different locations that are meant to represent high population areas.

The authors reported no association for the highest quartile of UVR exposure and total ocular melanoma (UVR Q4 versus Q1 incidence rate ratio (IRR) = 0.98; 95% confidence interval (CI):0.94-1.03). However, there was an association for the highest quartile of UVR exposure and ocular melanoma in ciliary body/iris cases specifically (IRR = 1.63; 95%CI:1.43-1.87). The authors concluded there was association between solar UVR and ocular melanoma in the ciliary body/iris, but not for all anatomical sites when using the highest exposed category of solar UVR. 

Link to study

Ambient ultraviolet radiation and ocular melanoma incidence in the United States, 2000−2019

Published in

Eye

ARPANSA commentary

This study indicated an association between high solar UVR exposure and ocular melanoma in the ciliary body/iris. For the highest exposed category there was no association for total ocular melanoma cases. The observed lack of an association is contrary to the well-established link between UVR and skin melanoma (Olsen et al 2015). The lack of an association in total ocular melanoma could be due to a number of confounders relating to the lack of individualised exposure assessment in this study.  The actual ocular UVR a person is exposed to could deviate significantly from the UVR depending on how much time they spend outside each day, usage of eye protection (sunglasses) and their occupation. None of these factors were considered by the authors. This could result in misclassification bias where the people in the low exposure group could have high exposure and those in the high exposure group could have low exposure. While the study does provide interesting results for how solar UVR might impact ocular melanoma no firm conclusions can be drawn from their findings. An Australian study that looked at ocular  melanoma reported a higher age-standardized incidence rate in people 55 and older between 2008-2013 (ASR) in Queensland (ASR 3.9, 95% CI 3.3–4.5) that has a higher average UV index compared to Victoria (ASR 2.8, 95% CI 2.4–3.1) (Chalada et al 2021). However, this study also suffers from misclassification bias as it also does not present individual exposure data or account for sun protective behaviours.

Review date

July 2024

Article publication date

June 2024

Summary

This systematic review and meta-analysis evaluated the current evidence on the association between radiofrequency electromagnetic field (RF-EMF) exposure and female pregnancy outcomes in human epidemiological studies. A total of 18 studies (eight on general public exposure and 10 on occupational exposure) were identified for this evaluation. The studies had RF-EMF exposure measures in terms of self-reported mobile phone use, measured distance to mobile base station (for general public exposures); and measurements and/or expert assessment or exposure modelled based on job-exposure matrices (for occupational exposures). The pregnancy outcomes considered included pre-term birth, small for gestational age (SGA), miscarriage, stillbirth. The associations between RF-EMF exposure and the outcomes were examined in terms of pooled relative risk (RR) or odds ratio (OR) with 95% confidence interval (CI). The synthesis of evidence was conducted according to the OHAT guidelines. For general public studies, maternal mobile phone exposure was not associated with pre-term birth risk (RR 1.14, 95 % CI: 0.97–1.34), or low birth weight (RR 1.14, 95 % CI 0.96–1.36), there was an association with SGA (RR 1.13, 95 % CI 1.02–1.24). For occupational studies, no association between maternal RF-EMF exposure and miscarriage (RR 1.06, 95 % CI 0.96–1.18), congenital anomalies (OR 1.06, 95 % CI 0.85–2.32), pre-term birth (RR 1.19, 95 % CI 0.32–4.37) or low birth weight (RR 2.90, 95 % CI 0.69–12.23) were found. Both the general public and occupational findings were low to very low certainty evidence. Overall evidence from review and meta-analysis indicates no or little association between maternal RF-EMF exposure and pregnancy outcomes in general public and occupational populations. 

Link to

The effects of radiofrequency exposure on adverse female reproductive outcomes: A systematic review of human observational studies with dose–response meta-analysis

Published in

Environment International

Commentary by ARPANSA:

The review provides state-of-the art methods on investigating whether maternal RF-EMF exposure is related to adverse pregnancy outcomes in the general and working populations. The included studies in the review have numerous limitations, including use of exposure surrogates (e.g., self-reported time spent on mobile phones or mobile phone use). The analysis of evidence on the association resulted in low-or very low-certainty mainly due to risk of bias, inconsistencies, indirectness, and imprecisionin the included studies. This report indicates that there is no substantiated evidence that maternal RF-EMF exposure (below the public and occupational limits described in the ICNIRP guidelines) causes adverse reproductive outcomes in female populations. This is in line with the public health message of the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) on RF-EMF exposure and health. The RF-EMF exposures in Australia are generally far below the limits given in the Australian Safety Standard (e.g., RPS-S1) and the ICNIRP guidelines. The Australian Safety Standard, developed by ARPANSA, is consistent with the ICNIRP guidelines and is based on validated international scientific evidence. Further, the findings reinforce the assessment of ARPANSA that there is no substantiated evidence that RF-EMF exposures at levels below the limits set in the Australian standard cause any adverse health effects. The review forms a part of the World Health Organization’s ongoing project to assess potential health effects of RF-EMF in the general and working population and ARPANSA is supporting this process.  

Review date

July 2024

Article publication date

July 2024

Summary

This randomised controlled trial in the USA studied the effect of three digital intervention programs on skin cancer risk protection practices. The authors recruited 1369 participants aged 18-25 and provided them with information on skin cancer risk factors in the form of either a basic pamphlet, an interactive program from a previous study or a new, enhanced interactive program. The efficacy of the three programs was then assessed over a 52-week period by evaluating the self-reported sun protection and skin cancer awareness behaviours of the participants. 1144 people completed all 52 weeks of the sun protection program.

The results showed a statistically significant difference  between both interactive programs on sun protection and habitual skin protection behaviour compared to the basic pamphlet. Other behaviours like skin self-examinations, sunscreen use and indoor tanning were also examined and while some weeks showed a significant difference between the interactive programs and the basic pamphlet, there was no consistent difference. Overall, the authors concluded that while the interactive programs were more effective than the basic pamphlet, there was no difference in efficacy between their original interactive program and the newly enhanced program.

Link to

Digital Interventions to Modify Skin Cancer Risk Behaviors in a National Sample of Young Adults: Randomized Controlled Trial

Published in

Journal of Medical Internet Research

Commentary by ARPANSA

Despite the vast amount of conclusive scientific information available on the effects of sun exposure and ultraviolet radiation (UVR) on health, particularly on skin cancer and melanoma risk, it remains an ongoing challenge to translate this information into meaningful behavioural change. This is particularly important in Australia where, although the average UV-index is very high, the climate is moderate year-round and outdoor activities are a large part of the prevailing culture. Although recent studies (De Pinto et al., 2024) detail some positive trends for melanoma incidence in Australia, the incidence rates remain some of the highest in the world. As such, skin cancers, including melanoma, continue to constitute a large public health burden. Sun health promotion campaigns have been shown to have a beneficial impact on public awareness (Tabbakh et al., 2019) and are also cost-effective (Shih et al., 2009). This study, and others like it, help to develop methodologies for improving the prevalence of preventative behaviour, ultimately to reduce the incidence and mortality rates of skin cancers.

More information about the risks of sun exposure and methods of sun protection can be found from: The World Health Organization, The Cancer Council of Australia and SunSmart websites. ARPANSA recommends following the five sun protection principles when the UV-index is over three. ARPANSA administers and maintains UVR monitoring stations across Australia that can be used to see the UV-index in real time across Australia and make informed decisions about sun protection. 

Review date

July 2024

Article publication date

June 2024

Summary

This systematic review and meta-analysis examined the effect of radiofrequency electromagnetic fields (RF-EMF) on male fertility as reported in human observational studies. The reviewers screened over twenty thousand articles that were identified in their literature search and ultimately included nine studies in the final review. Of the nine studies, seven related to mobile phone use and two studies related to occupational RF-EMF exposure (from radar or communications transmitters). The analysis of male fertility indicators for these two groups was performed separately. The fertility indicators that were considered were sperm concentration (amount), morphology (size, shape) and motility (movement) as well as total sperm count and time to pregnancy. Analysis on mobile phone use was further segmented by ‘duration of phone use’ and phone position (e.g., amount of time phone is kept in front pocket). The review also conducted certainty of evidence and risk of bias evaluations according to OHAT-GRADE.

Only four meta-analyses were possible on RF-EMF exposure from mobile phone use and each showed little to no effect on fertility outcomes. Each of these analyses were rated as very low certainty evidence. These ratings were mainly due to inconsistency and indirectness of the included studies resulting from poor exposure characterisation and outcome assessments. For outcomes where a meta-analysis was not possible, including those relating to the effect of phone position, all but one of the included studies reported no statistically significant effects. The study describing an effect presented a negative relation between mobile phone usage and sperm total motility. However, this result is weakened by very poorly classified exposure (measured by the total years participants had been using mobile phones and then grouped for comparison) and further weakened by probable selective reporting bias.

No meta-analysis was possible for occupational exposure due to large differences in the types of RF-EMF exposures between the two included studies. These studies reported a statistically significant difference in sperm concentration, motility and morphology for workers that were exposed compared to those who were not exposed. The authors cautioned against drawing overarching conclusions on occupational exposures from these findings due to the high risk of bias ratings for these studies and low amount of total data available on occupational exposures. 

Link to

The effects of radiofrequency exposure on male fertility: A systematic review of human observational studies with dose–response meta-analysis

Published in

Environment International

Commentary by ARPANSA

The review concluded that the currently available evidence on the effect of RF-EMF exposure on male fertility indicates little evidence of an association. However, the review also noted very low certainty of evidence and high risk of bias associated with the available evidence. Notably, the characterisation of exposure (e.g., phone call duration or self-reported usage) was highlighted as a major limitation of the currently available studies, introducing bias and uncertainty in the evidence. These crude surrogate exposure measures have also been highlighted as major limitations in other recent studies (Benke et al., 2024; Feychting et al., 2024; Röösli et al., 2024).

The International Commission on Non-Ionising Radiation Protection (ICNIRP) has also reviewed the effect of RF-EMF on fertility, concluding that there was no adverse effect of RF-EMF on human fertility, reproduction, or development. Overall, there remains no substantiated scientific evidence that exposure to RF-EMF below the limits set in ARPANSA safety standard  or the ICNIRP guidelines are a hazard to human fertility.

This review is part of the World Health Organization’s ongoing project assessing the health effects of RF-EMF (SR3 – Adverse reproductive outcomes (human observational studies)). ARPANSA is supporting this WHO review process. Another of these WHO reviews covered studies on male fertility in vitro and in non-human mammals which ARPANSA has reviewed in a previous literature survey. A systematic review of female fertility and reproductive outcomes has been published as a separate review by the same authors.

Review date

June 2024

Article publication date

June 2024

Summary 

This systematic review evaluated the evidence on exposure to radiofrequency electromagnetic energy (RF EME) and the long-term impacts on cognition in epidemiological studies. The review screened 3945 research papers and of these 5 prospective cohort studies were included in the final analysis. These studies were conducted between 2006 and 2017 and included 4639 participants consisting of 2808 adults and 1831 children across three countries (Australia, Singapore and Switzerland). The main source of RF EME was mobile phone use which was measured by the self-reported number of calls per week or minutes per day. Of the included studies only two, that investigated the effects of RF EME on cognition in children, were similar enough to be included in a meta-analysis (Bhatt et al. 2017 and Thomas et al. 2017). 

The meta-analysis found little to no effect of RF EME on learning and memory, executive function and complex attention in children with low or very low certainty of evidence. The review also assessed the effects of RF EME in elderly people and also found no evidence of an effect in any of the examined cognitive domains with very low certainty of evidence. An exposure–response relationship was not identified for any of the cognitive outcomes. The authors concluded that further studies are needed to address all types of populations, exposures and cognitive outcomes. 

Link to

The effects of radiofrequency exposure on cognition: A systematic review and meta-analysis of human observational studies

Published in

Environment International

Commentary by ARPANSA

The review found no consistent evidence of an effect of RF EME on cognition. However, there were limitations in the available evidence. One issue with the available literature is that the majority of the previous studies are cross-sectional studies, and these were not included in the systematic review. This is because they are unable to assess the long-term impact of exposure as they assess exposure and effect simultaneously by design. While the number of included studies was reduced, inclusion of cross-sectional studies would not have increased the certainty of the evidence. Previous narrative reviews that included cross-sectional studies reported inconsistent associations, with some finding improved cognition (Ishihara et al, 2020; ARPANSA, 2014).

There were several other limitations in the evidence including the fact that the effects of RF EME on cognition could not be separated from the effects of mobile phone use on cognition. This includes the impact that behaviours such as texting, gaming and social media use have on cognition. Another limitation in the evidence is exposure assessment being based on self-reported mobile phone use which can result in recall bias. 

Another major issue is that all of the studies used different tests to examine cognition. One of the main recommendations of this systematic review is that in future studies a consistent set of cognitive function tests for evaluation of each cognitive domain should be used. 

Overall, while there is no consistent evidence of an effect of RF-EMF exposure on cognition more long-term observational studies are needed to address important knowledge gaps.

The effect of RF EME on cognition has been reviewed by the International Commission on Non-Ionising Radiation Protection (ICNIRP) in their 2020 guidelines and they concluded there is no substantiated experimental or epidemiological evidence that exposure to RF EME affects cognition.  Overall, there remains no consistent scientific evidence that exposure to RF EME below the limits set in ARPANSA safety standard which is aligned with the ICNIRP guidelines is a hazard to human cognition or any other health effects. 

This review is part of the World Health Organisation’s (WHO) ongoing project assessing the health effects of RF-EMF. ARPANSA is supporting this WHO review process. One of the ongoing WHO systematic reviews will be examining cognitive impairment in human experimental studies (Pophof et al, 2021). This review will include an examination of the acute effects that RF EME has on cognition. 

Review date

June 2024

Article publication date

June 2024

Summary

This review included experts from Africa, America, Asia, Australia, and Europe and aims to create comprehensive global advice on practical steps to be taken to reduce the toll of skin cancer. The review evaluated the information on when to avoid sun exposure, what types of materials are most effective at blocking sun exposure, and the dangers of using solariums. The human health impacts of absorbance of sunscreen into the body were also assessed in the review. It was reported that there is currently no evidence that long-term use (and absorbance) of sunscreen has an impact on human health. The authors recommend that people should use a combination of protective measures including seeking shade, physical protection (clothing, hat, sunglasses) and apply broad-spectrum SPF 30+ sunscreen to prevent skin cancer incidence. Further, it also recommends that these protective measures are more important for fair skinned people, especially children. 

Link to

2024:06 - Skin cancers are the most frequent cancers in fair-skinned populations, but we can prevent them

Published In

National Library of Medicine

ARPANSA commentary

The review made a number of recommendations on steps that individuals should take to protect themselves from sun exposure and that could be promoted by national organisations to help improve the health of their citizens. These recommendations are very similar to those promoted by  Australian Cancer Council and ARPANSA. The Australian messaging from these two organisations is that all Australians when spending time outdoors in the sun should slip on a hat, slop on sunscreen, slap on a hat, seek shade and slide on sunglasses (Slip, Slop, Slap, Seek and Slide). However, even when using these protective measures, sun exposure in the middle of the day when ultraviolet radiation (UVR) from the sun is at its peak should be avoided. 

In Australia  two-thirds of Australians receiving a skin cancer diagnosis of some type in their lifetime. For melanoma specifically, it is estimated that 1 in 21 Australian women and 1 in 14 Australian men will be diagnosed with melanoma by the time they reach the age of 85 (Australian Institute of Health and Welfare 2023).  

ARPANSA UVR monitors that provide real time data on UVR levels for cities across Australia. This forms the ARPANSA’s UV monitoring Network system, which provides  the daily UV index data (ARPANSA Ultraviolet Radiation Index webpage). This UV data are shared by news organisations and can be found on the Cancer Council website. The UV index helps Australians know when UV exposure is high, and they should avoid sun exposure or practice other sun protection measures. More information on UV protection can be found on the ARPANSA Sun Protection factsheet. 

Review date

June 2024

Article publication date

December 2023

Summary

This cohort study examined the association between residential radon exposure and risk of skin cancer (melanoma and squamous cell carcinoma) incidence. The study included 1.3 million adults (aged 20 years and more) from the Swiss National Cohort followed from the year 2000 to (up to) 2011. The data on individual exposures to residential radon (Bq/m³) were estimated by geographic location. Skin cancer incidence data during the same period were collected from regional cancer registries. The association between residential radon exposure and malignant melanoma or squamous cell carcinoma incidence was estimated in terms of the hazard ratio (HR) with 95% confidence interval (CI) per 100 Bq/m³, adjusting for solar ultraviolet (UV) radiation. A total of 4,937 incidences of melanoma were diagnosed during follow-up (average follow-up of nearly nine years). The mean radon exposure was 76.4 Bq/m³. No association was found for melanoma/squamous cell carcinoma incidence [HR (95% CI): 1.03 (0.94-1.13)] across all age groups. However, an association was reported for melanoma incidence [1.68 (1.29-2.19)] in the 20–29 years old age group. The results showed that residential radon exposure was largely not associated with the risk of developing skin cancers.

Link to

Volume 243, 15 February 2024, 117822, A cohort analysis of residential radon exposure and melanoma incidence in Switzerland

Published In

Environmental Research

ARPANSA commentary

The overall conclusion of the study is that there is little association between long-term exposure to residential radon and skin cancer incidence. This conclusion is inconsistent to the evidence from previous Swiss studies (Vienneau et al., 2017; Boz et al., 2022). The association between melanoma and radon exposure in young adults was based on only a small number (2.2%) of all melanoma cases. It is difficult to compare these findings in the Australian context due to a lack of similar evidence for Australia. In fact, according to the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) led nationwide survey of more than 3300 Australian homes, the average radon exposure level in Australian homes is ~ 10 Bq/m³, which is four times lower than the global average (40 Bq m⁻³) and 7.5 times lower than the mean radon level reported in this study. Consequently, residential radon exposure is not expected to be a significant contributor to skin cancer incidence in Australia. On the other hand, ambient UV levels in Australia are much higher compared to those reported in this study. 

A major strength of this study is that it used a robust study design, covering most Swiss regions with high geographic variability of radon levels. Contrarily, the relatively small number of melanoma cases is a key limitation, which limits the statistical power of the study. Other limitations include: radon exposure was not directly measured (but estimated); information on the amount of time spent indoors and ventilation practices at home was not available; exposure to ambient UV radiation, which was adjusted in the analysis, was obtained conservatively (i.e. a spatial resolution of 1 × 1 km across the geographic locations). All these contribute to exposure misclassification to some extent, however, this potential misclassification is unlikely to have altered the overall findings of the study. 

ARPANSA has a fact sheet on ionising radiation and health including dose levels from natural sources of ionising radiation, including radon. The International Commission on Radiological Protection has published guidance on radiological protection against radon exposure.

Review date

4 June 2024

Article publication date

6 May 2024

Summary

This study conducted  computer simulations comparing the specific absorption rate (SAR) of radiofrequency electromagnetic energy (RF-EME) at the male reproductive system from different mobile telecommunication frequencies. The study explored frequencies between 0.69 GHz and 4.9 GHz. The primary benefit of computing SAR instead of  considering incident power density (S_inc) is that it allows for more accurate comparison between exposures from electromagnetic fields of different frequencies. The study also performed calculations for exposure scenarios in three postures (standing, sitting and sleeping).

While maintaining an equal level of exposure across frequencies, the calculations showed that a higher frequency resulted in lower SAR at the reproductive system. Both a sitting and sleeping posture resulted in less exposure than a standing posture. When calculations were repeated for incident power densities at the exposure limits prescribed in the Institute of Electrical and Electronics Engineers (IEEE) guidelines the corresponding SAR values for each frequency band were highest at 2.2 GHz and decreased at higher or lower frequency bands. The same relationship between dose and posture was observed for exposures at the limit.

Link to

Absorption of 5G sub-6 GHz electromagnetic radiation from base station to male reproduction system

Published in

International Journal of Radiation Biology

ARPANSA commentary

There is a growing volume of longitudinal studies (e.g. Ramirez-Vazquez et al., 2023; Markussen et al., 2022; Iakovidis et al., 2022), including those published by ARPANSA (Bhatt et al., 2024),  showing that public exposures to RF-EME have remained largely the same throughout the introduction of new communication technologies despite an overwhelming increase in the total usage of wireless telecommunication infrastructure by the public. The conclusions of this study provide similar reassurance by indicating that exposures to higher frequency RF-EME, like those used in newer communication technologies, contribute less SAR than an equivalent exposure from a lower frequency band. 

The calculations at exposure limits in this study were performed according to exposure limit guidance prepared by the IEEE. These guidelines, while similar to those in the Australian standard RPS-S1, are slightly less restrictive. The Australian standard is based on guidelines by the International Commission on Non-Ionizing Radiation Protection (ICNIRP), which are considered international best practice. More information on these differences can be found in a previous radiation literature survey. Notably, the study demonstrated the suitability of using power density limits (termed reference levels) which are easier to quantify for complying with SAR limits (termed basic restrictions) which are more difficult to quantify.

Review date

May 2024

Article publication date

March 2024

Summary

This review report published on behalf of the Swedish Radiation Safety Authority (SSM) aims to inform health risk assessment of exposure to electromagnetic fields (EMF). It included different study types (in vitro, animal, human and epidemiological) published in the year 2021 related to several EMF exposure types (static, low frequency or extremely low frequency, intermediate and radio frequency fields). A variety of outcomes (DNA damage, oxidate stress, animal behaviour, animal physiology, human cancer, reproduction, etc.) associated with EMF exposure were assessed. This report did not identify any new established causal relationships between EMF exposure and health risk. For example, epidemiological studies on static EMFs (e.g., from MRI) are limited and hence underlying mechanisms for rarely observed associations due to effect of static fields are unclear. The recent studies on extremely low frequency (ELF) magnetic field exposure do not provide any evidence whether the consistently observed association between ELF and childhood leukaemia is causal or not. Similarly, no definite conclusions can be drawn from a recent study on intermediate EMF exposure and human health effects. Several new studies on brain tumours and mobile phone use largely continue to provide no indication of health risk.

Link to

2024: 05 Recent Research on EMF and Health Risk, Seventeenth report from SSM’s Scientific Council on Electromagnetic Fields, 2022

Published In

Swedish Radiation Safety Authority

ARPANSA commentary

The overall conclusion of the report is similar to the conclusions provided in the previous years’ reports from the SSM. The strength of this report is that it was reviewed by a multidisciplinary team of experts evaluating a range of EMF exposure types and health-related endpoints, reviewing various types of evidence. Therefore, it consolidates all emerging evidence generated in the year 2021 while presenting its review findings. 

The findings of the report are consistent with the health risk advice from the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA), and other national and international organisations. For example, the health advice of ARPANSA on ELF-MF and radiofrequency field exposure, and the health risk assessment of radiofrequency fields by the US Food and Drug Administration on RF-EMF and Cancer, are in line with the findings from the report. The World Health Organization is currently assessing available evidence on potential human health effects of radiofrequency field exposure, including that associated with mobile phone use. ARPANSA is supporting this process to inform evidence-based health risk assessment of EMF exposures.

Review date

April 2024

Article publication date

March 2024

Summary

This systematic review and meta-analysis examined the results of 41 human experimental studies on self-reported symptoms associated with  radiofrequency electromagnetic field (RF-EMF) exposure in the general population and people who self-identify as having idiopathic environmental intolerance attributed to EMF (IEI-EMF), commonly referred to as electromagnetic hypersensitivity. The symptoms were grouped into headache, sleep disturbances and composite symptoms, and then further divided by exposure type (localised head or whole body) as well as by participant group, general population or IEI-EMF individuals. Results were reported as the standardised mean difference (SMD) with a 95% confidence interval (CI). Evidence of a dose-response relationship and  data relating to RF-EMF exposure perception were also assessed.

For each of the health outcomes investigated, the SMD was very small, and the 95% confidence interval encompassed zero, indicating that there is no effect. For example: Headache for the general population was reported as SMD 0.08 (95% CI -0.07 to 0.22) from head exposure and SMD 0.09 (95% CI -0.35 to 0.54) from whole body exposure. For IEI-EMF individuals, headache was reported as SMD 0.16 (95% CI -0.38 to 0.06) for head exposure and SMD 0.11 (95% CI -0.29 to 0.52) for whole body exposure. The report did not find evidence of any dose-response relationship. Certainty of evidence assessments for each outcome were rated high to moderate except for sleeping disturbance from whole body exposure which was rated as low and composite symptoms from head exposure for both IEI-EMF individuals and the general population which was rated as very low. The main contributor to alterations in the certainty of evidence assessments were the risk of bias (ROB) classifications. The ROB assessments were performed according to OHAT guidelines and the most common sources of bias identified were from a lack of exposure randomisation and how the outcomes were assessed. Inconsistency and indirectness were secondary contributors to downgrades in the certainty of evidence.

The review further analysed data relating to EMF perception. The available evidence showed that study participants were not able to perceive RF-EMF exposure beyond what is expected by pure chance and that there was no difference in RF-EMF perception between IEI-EMF individuals and the general population. Interestingly, the authors noted that in open provocation studies, where the subjects are informed of their exposure, more symptoms are reported indicating that symptoms are associated with the perception of exposure and not the physiological reality. The authors further suggested that these results indicate that acute affects attributed to everyday RF-EMF are more likely to be a result of the nocebo effect.

Link to

The effects of radiofrequency electromagnetic fields exposure on human self-reported symptoms: A systematic review of human experimental studies

Published In

Environmental International 

ARPANSA commentary

This review provides high quality evidence on the acute effects of RF-EMF exposure on self-reported symptoms. The overall conclusion of the review showed that RF-EMF exposure to the head or whole body does not cause headache, sleep disturbances or composite symptoms. A WHO review assessing similar symptoms in human observational studies (Röösli, et al., 2024) that ARPANSA has previously summarised also showed similar results. The lack of any significant difference between results from the general population and IEI-EMF persons aligns with the assertion of ARPANSA and the World Health Organization (WHO) that exposure to the low levels of electromagnetic radiation experienced by the public is not the cause of symptoms experienced by IEI-EMF individuals. A limitation of the study is that it only examined acute effects from RF-EMF exposure, due to the nature of the human experimental studies. However, findings from human observational studies indicate similar results.

It should be noted that the RF-EMF exposure levels in the included studies are below the exposure limits for the general public given in the ARPANSA safety standard and the International Commission on Non-Ionizing Radiation Protection (ICNIRP) guidelines. The conclusions of this review therefore further reiterate the assessment of ARPANSA that exposure to RF-EMF fields at levels below those prescribed in the standard does not cause adverse health effects. This review is part of the World Health Organisation’s ongoing project assessing the health effects of RF-EMF (SR8 – Symptoms (human experimental studies)). ARPANSA is supporting this WHO review process.