Institute for Electromagnetic Sensing of the Environment (IREA), Italian National Research Council (CNR), 80124, Napoli, Italy.
Department of Oncology and Molecular Medicine, National Institute of Health, 00161 Roma, Italy.
Environ Int. 2024 Nov;193:109104. doi: 10.1016/j.envint.2024.109104. Epub 2024 Oct 26.
Over the last decades, great concern has been raised about possible adverse effects to human health due to exposures to radiofrequency electromagnetic fields (RF-EMF, 100 kHz - 300 GHz) emitted by wireless communication technologies. In 2011 the International Agency for Research on Cancer classified RF-EMF as possibly carcinogenic to humans, highlighting that the evidence was weak and far from conclusive. Updated systematic reviews of the scientific literature on this topic are lacking, especially for mechanistic studies.
To perform a systematic review of the scientific literature on genotoxic effects induced by RF-EMF in in vitro experimental models. The overall aim is to assess the confidence and level of evidence of the induced effects in mammalian cell cultures.
Full details regarding the eligibility criteria, information sources, and methods developed to assess risk of bias in the included study, are reported in our published protocol (Romeo et al. 2021). The databases NCBI PubMed, Web of Science, and EMF-Portal were used as information sources (last searched on 31st December 2022). In developing the systematic review, we followed the guidelines provided by the National Toxicology Program-Office of Health Assessment and Translation (NTP-OHAT), adapted to the evaluation of in vitro studies. A narrative synthesis of the body of evidence was performed by tabulating data classified according to meaningful groups (endpoints) and sub-groups (exposure parameters). This report, abstract included, conforms to the PRISMA 2020 (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines.
Out of 7750 unique records identified, 159 articles were eligible for inclusion. From the extracted data, we identified 1111 experiments (defined as independent specific combinations of diverse biological and electromagnetic parameters). The large majority (80%) of experiments reviewed did not show statistically significant genotoxic effects of RF-EMF exposures, and most "positive" studies were rated as of moderate to low quality, with negative ratings in the key bias domains. A qualitative evidence appraisal was conducted at the endpoint level, and then integrated across endpoints.
To the best of our knowledge, this is the first systematic review of the scientific literature on genotoxic effects in mammalian cell cultures in relation to RF-EMF exposure, which confirms and strengthens conclusions from previous syntheses of this specific topic thanks to the use of transparently reported methods, pre-defined inclusion criteria, and formal assessment of susceptibility to bias. Limitations of the evidence included the frequent reporting of findings in graphical display only, and the large heterogeneity of experimental data, which precluded a meta-analysis.
In the assessment restricted to studies reporting a significant effect of the exposure on the outcome, we reached an overall assessment of "low" confidence in the evidence that RF-EMF induce genotoxic effects in mammalian cells. However, 80% of experiments reviewed showed no effect of RF exposure on the large majority of endpoints, especially the irreversible ones, independently of the exposure features, level, and duration (moderate evidence of no effect). Therefore, we conclude that the analysis of the papers included in this review, although only qualitative, suggests that RF exposure does not increase the occurrence of genotoxic effects in vitro.
This systematic review addresses 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 electromagnetic fields".
在过去的几十年里，人们对无线通信技术产生的射频电磁场（RF-EMF，100 kHz-300 GHz）可能对人类健康造成的不良影响表示极大关注。2011 年，国际癌症研究机构将 RF-EMF 归类为可能对人类致癌物质，强调证据薄弱且远非定论。缺乏对这一主题科学文献的最新系统评价，特别是对机制研究。
对射频电磁场在体外实验模型中诱导遗传毒性效应的科学文献进行系统评价。总体目标是评估哺乳动物细胞培养中诱导效应的置信度和证据水平。
关于合格标准、信息来源和用于评估纳入研究偏倚风险的方法的详细信息在我们已发表的方案（Romeo 等人，2021 年）中报告。使用 NCBI PubMed、Web of Science 和 EMF-Portal 数据库作为信息来源（最后一次搜索于 2022 年 12 月 31 日）。在制定系统评价时，我们遵循了国家毒理学计划-健康评估和转化办公室（NTP-OHAT）提供的指南，并对其进行了调整，以评估体外研究。通过对按有意义的组别（终点）和子组（暴露参数）分类的数据进行制表，对证据进行叙述性综合。此报告，包括摘要，符合 PRISMA 2020（系统评价和荟萃分析的首选报告项目）指南。
在 7750 条独特记录中，有 159 篇文章符合纳入标准。从提取的数据中，我们确定了 1111 个实验（定义为不同生物学和电磁参数的独立特定组合）。审查的大多数实验（80%）未显示 RF-EMF 暴露的遗传毒性效应具有统计学意义，大多数“阳性”研究被评为中等至低质量，在关键偏差领域的评级为负面。在终点水平进行了定性证据评估，然后整合了各个终点。
据我们所知，这是首次对射频电磁场暴露与哺乳动物细胞培养中的遗传毒性效应相关的科学文献进行系统评价，由于使用了透明报告的方法、预定义的纳入标准以及对偏倚敏感性的正式评估，该评价证实并加强了之前对这一特定主题的综合结论。证据的局限性包括研究结果仅以图形显示的情况频繁发生，以及实验数据的高度异质性，这使得无法进行荟萃分析。
在对暴露对结果产生显著影响的研究进行评估时，我们对射频电磁场诱导哺乳动物细胞遗传毒性效应的证据得出了“低”置信度的总体评估。然而，审查的 80%的实验显示 RF 暴露对大多数终点没有影响，尤其是不可逆的终点，独立于暴露特征、水平和持续时间（无效应的中等证据）。因此，我们得出结论，尽管只是定性分析，但包括在本次综述中的论文分析表明，RF 暴露不会增加体外遗传毒性效应的发生。
本系统评价针对意大利几家公共研究机构的科学家进行的射频电磁场潜在致癌性科学文献更大系统评价中的一个证据流进行评估。该项目由意大利工人补偿局（INAIL）在意大利卫生研究院的“BRiC 2018/06-电磁场致癌性的科学证据”框架内支持。
