The effect of exposure to radiofrequency electromagnetic fields on cognitive performance in human experimental studies: Systematic review and meta-analyses

Background: The objective of this review is to evaluate the associations between short-term exposure to radio- frequency electromagnetic fields (RF-EMF) and cognitive performance in human experimental studies. Methods: Online databases (PubMed, Embase, Scopus, Web of Science and EMF-Portal) were searched for studies that evaluated effects of exposure to RF-EMF on seven domains of cognitive performance in human experimental studies. The assessment of study quality was based on the Risk of Bias (RoB) tool developed by the Office of Health Assessment and Translation (OHAT). Random effects meta-analyses of Hedges's g were conducted separately for accuracy- and speed-related performance measures of various cognitive domains, for which data from at least two studies were available. Finally, the certainty of evidence for each identified outcome was assessed according to Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: 57,543 records were identified and 76 studies (80 reports) met the inclusion criteria. The included 76 studies with 3846 participants, consisting of humans of different age, sex and health status from 19 countries, were conducted between 1989 and 2021. Quantitative data from 50 studies (52 reports) with 2433 participants were included into the meta-analyses. These studies were performed in 15 countries between 2001 and 2021. The majority of the included studies used head exposure with GSM 900 uplink. None of the meta-analyses observed a statistically significant effect of RF-EMF exposure compared to sham on cognitive performance as measured by the confidence interval surrounding the Hedges's g or the significance of the z-statistic. For the domain Orientation and Attention, , subclass Attention - Attentional Capacity RF-EMF exposure results in little to no difference in accuracy (Hedges's g 0.024, 95 % CI [-0.10; 0.15], I-2 = 28 %, 473 participants). For the domain Orientation and Attention, , subclass Attention - Concentration / Focused Attention RF-EMF exposure results in little to no difference in speed (Hedges's g 0.005, 95 % CI [-0.17; 0.18], I-2 = 7 %, 132 participants) and probably results in little to no difference in accuracy; it does not reduce accuracy (Hedges's g 0.097, 95 % CI [-0.05; 0.24], I-2 = 0 %, 217 participants). For the domain Orientation and Attention, , subclass Attention - Vigilance RF-EMF exposure probably results in little to no difference in speed and does not reduce speed (Hedges's g 0.118, 95 % CI [-0.04; 0.28], I-2 = 41 %, 247 participants) and results in little to no difference in accuracy (Hedges's g 0.042, 95% CI, [-0.09; 0.18], I-2 = 0%, 199 participants).