Monash University, Melbourne, Australia.
Swinburne University, Melbourne, Australia.
Environ Int. 2022 Jan 15;159:106972. doi: 10.1016/j.envint.2021.106972. Epub 2021 Dec 23.
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.
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.
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.
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.
对于频率在 100 kHz 至 300 GHz 之间的射频（RF）电磁场（EMF）暴露对认知表现的长期影响，最好使用观察性研究进行评估。近年来，使用移动（蜂窝）电话已成为大脑接触 RF EMF 的主要来源，尽管其他接触源也可能很重要。认知功能包括各种心理和心理能力，可以在一系列领域进行测量，例如学习、记忆、推理、解决问题、决策和注意力。尽管在以后的生活中可能会发现对认知功能的影响，但在实验环境中，只能研究急性和即时的影响。在短期或长期暴露数月或数年后观察到影响时，需要进行观察性研究。最近还确定了接触对儿童的影响的重要性。
评估与无暴露或低水平暴露相比，RF EMF 局部和全身暴露对认知指标（包括复杂注意力、执行功能、学习和记忆、知觉运动能力和社会认知）的长期影响，但不包括由神经退行性疾病或神经发育障碍引起的认知影响，并评估是否存在剂量反应关系的证据。
我们将包括评估 RF 能量认知影响的观察性研究，包括具有不同暴露水平的对照组。研究必须报告至少一种经过验证的认知功能测量方法，包括全球或特定领域的测量方法，或认知障碍，随访时间至少为 6 个月。任何语言的同行评审文献中发表的队列或病例对照研究都符合条件。我们将排除横断面研究和仅报告脑结构或生物标志物的研究。
我们将对 PubMed、Embase、PsycINFO 和 EMF-Portal 进行检索。至少两名作者将独立筛选所有记录的标题/摘要，如果存在冲突，则由第三名评审员解决。两名作者也将独立对全文进行筛选，如果存在冲突，则通过共识解决。将从纳入的研究中提取数据，例如研究设计、暴露和对照组的标识符和特征、参与者、评估的结果和结果。将使用卫生评估和转化办公室 (OHAT) 工具评估偏倚风险。如果有两个或更多研究可用于特定的暴露-结果组合，则我们将使用 STATA 或类似软件对类似的研究进行汇总分析，采用随机效应模型。将使用 OHAT 为环境暴露审查改编的 GRADE 方法来判断证据的可信度。
