Frank John William
Usher Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
Front Public Health. 2025 May 27;13:1559868. doi: 10.3389/fpubh.2025.1559868. eCollection 2025.
This paper reviews the applicability of standard epidemiological criteria for causation, to the multidisciplinary studies of RF-EMF exposure and various adverse biological and health effects, with the aim of demonstrating that these criteria, although 60 years old, are still helpful in this context-albeit in some cases not entirely straightforward to apply.
This is a commentary, based on Bradford Hill's criteria for assessing evidence of causation, applied to recent primary studies and systematic reviews of the RF-EMF/health-effects literature. Every effort has been made to use non-epidemiological language to reach a wide readership of biologists, physicists, and engineers now active in this field.
A rapidly growing number of human observational epidemiological studies have assessed the association of diverse adverse health effects with RF-EMF exposures. However, existing systematic reviews and meta-analyses of these primary studies have substantially diverged in their conclusions. The application of Bradford Hill's epidemiological criteria for assessing evidence of causation, originally designed for use in occupational and environmental health, casts light on some of reasons for this divergence, mostly reflecting the key weaknesses in the primary literature, which are discussed in detail. As a result of these threats to their validity-particularly the facts that (1) exposure measurement is typically subject to substantial error, and (2) insufficient time has elapsed, since modern cell phone use began in earnest, to allow tumors of longer latency to develop-most primary studies to date, and therefore many published systematic reviews of them, probably underestimate the true potential for causation, if in fact this association is causal.
In view of these findings, international experts representing professional and scientific organizations in this field should convene an independent Guidelines development process to inform future epidemiological studies of associations between RF-EMF exposures and human health outcomes. Wide dissemination of such Guidelines could help researchers, journals and their reviewers in this field to execute, review and publish higher-quality studies to better inform evidence-based policy.
本文回顾了标准流行病学因果关系标准在射频电磁场暴露与各种不良生物和健康影响的多学科研究中的适用性，旨在表明这些标准虽然已有60年历史，但在这种情况下仍然有用，尽管在某些情况下应用起来并非完全直接明了。
这是一篇评论文章，基于布拉德福德·希尔评估因果关系证据的标准，应用于近期关于射频电磁场/健康影响文献的原始研究和系统评价。已尽一切努力使用非流行病学语言，以吸引目前活跃在该领域的生物学家、物理学家和工程师等广泛读者群体。
越来越多的人类观察性流行病学研究评估了各种不良健康影响与射频电磁场暴露之间的关联。然而，对这些原始研究的现有系统评价和荟萃分析在结论上存在很大分歧。最初设计用于职业和环境卫生的布拉德福德·希尔流行病学因果关系评估标准的应用，揭示了这种分歧的一些原因，主要反映了原始文献中的关键弱点，本文对此进行了详细讨论。由于这些对其有效性的威胁，特别是以下事实：（1）暴露测量通常存在大量误差；（2）自现代手机开始广泛使用以来，时间间隔不足，无法使潜伏期较长的肿瘤发展，因此迄今为止的大多数原始研究，以及许多已发表的对它们的系统评价，如果这种关联实际上是因果关系的话，可能低估了真正的因果潜力。
鉴于这些发现，代表该领域专业和科学组织的国际专家应召开一个独立的指南制定过程，为未来关于射频电磁场暴露与人类健康结果之间关联的流行病学研究提供信息。广泛传播此类指南可帮助该领域的研究人员、期刊及其审稿人开展、审查和发表更高质量的研究，以便为基于证据的政策提供更好的信息。
