Systematic review of the physiological and health-related effects of radiofrequency electromagnetic field exposure from wireless communication devices on children and adolescents in experimental and epidemiological human studies

Abstract

Background: For more than 20 years, the potential health risks of radiofrequency electromagnetic field (RF EMF) exposure from mobile communication devices on children and adolescents have been examined because they are considered sensitive population groups; however, it remains unclear whether such exposure poses any particular risk to them.

Objectives: The aim of this review was to systematically analyze and evaluate the physiological and health-related effects of RF EMF exposures from wireless communication devices (mobile phones, cordless phones, Bluetooth, etc.) on children and adolescents.

Methods: This review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological limitations in individual studies were assessed using the Office of Health Assessment and Translation (OHAT) Risk-of-Bias Rating Tool for Human and Animal Studies.

Results: A total of 42 epidemiological and 11 experimental studies were eligible for this review. Most of the studies displayed several methodological weaknesses that limited the internal validity of the results. Due to a lack of consistency regarding the outcomes as well as the lack of scientific rigor in most reviewed studies, the body of evidence for the effects of RF EMF of mobile communication devices on subjective symptoms, cognition, and behavior in children and adolescents was low to inadequate. Evidence from the studies investigating early childhood development, brain activity, cancer, and physiological parameters was considered inadequate for drawing conclusions about possible effects.

Discussion: Overall, the body of evidence allows no final conclusion on the question whether exposure to RF EMF from mobile communication devices poses a particular risk to children and adolescents. There has been rapid development in technologies generating RF EMF, which are extensively used by children and adolescents. Therefore, we strongly recommend high-quality systematic research on children and adolescents, since they are generally considered as sensitive age groups.

Fig 1. Flow diagram of literature search, eligibility and inclusion process according to PRISMA statement.

Fig 2. Risk-of-bias ratings for epidemiological studies (n = 42).

Criteria ratings served as the basis for the assignment of individual studies to one out of 3 study quality categories (1^st tier, 2^nd tier, 3^rd tier; see S1 Fig). Black frames indicate key risk-of-bias criteria.

Fig 3. Risk-of-bias ratings for experimental studies (n = 11).

Criteria ratings served as the basis for the assignment of individual studies to one out of 3 study quality categories (1^st tier, 2^nd tier, 3^rd tier; see S1 Fig). Black frames indicate key risk-of-bias criteria.

Fig 4. Overview of study quality and effects/associations found in the included studies.

Each study is represented by a numbered and colored point, indicating the study quality assessed with the risk-of-bias tool recommended by OHAT [37, 39] (1/green = 1^st tier, 2/yellow = 2^nd tier, 3/red = 3^rd tier). Each study is allocated to an effect category (columns) according to the conclusive result stated by the authors (cf. S4–S10 Tables). Please note that Roser et al. (2016) [45] investigated both cognitive functions and behavior and was therefore considered in both lines separately.