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Monalisha Sahu, M.D., Shyambhavee Behera, M.D., Biswadip Chattopadhyay, M.D.
Senior Resident, Department of Community Medicine, University College of Medical Sciences, Delhi-110095, India.
The Inuence of Electromagnetic Field Pollution on
Human Health: A Systematic Review
ABSTRACT
Objective: Recent technological advances have exponentially expanded globally; harbouring upon Electromagnetic
elds (EMF). e utilization of Electromagnetic eld has become universal from everyday usage of electronic
appliances such as micro wave ovens, tablets and portable computers to telecommunication systems mobile phone
towers, radio- television broadcast systems and electronic power transmission systems resulting in electromagnetic
eld and associated radiations. EMF can have biological eects on cell at microlevel and have the potential ability
to cause cell dysfunction manifesting in various biological eects. is review tried to gather evidence from the
existing literature about the biological eects of EMF on human health.
Materials and Methods: We did extensive literature search using PubMed and Cochrane database using key words,
“electromagnetic elds”, “Extremely low frequency electromagnetic elds (ELF-EMFs)”, “biological eects”, “health
eects”, “public health”. We included 20 studies conducted from Dec 2009 to Dec 2019 in our systematic review.
Data from each study was extracted by two independent researchers and discrepancies were resolved by consensus.
Results: Signicant biological eects of EMF exposure were reported on human health ranging from anxiety,
depression, sleep disturbance, increased risk of Alzheimer’s disease and ALS (Amyotrophic Lateral Sclerosis),
hypersensitivity to infertility and increased risk of multiple carcinomas.
Conclusion: Application of preventive measures in order to minimize the exposure becomes the need of the hour
especially so in occupational settings.
Keywords: Electromagnetic elds; health eects; biological eects; carcinogen (Siriraj Med J 2021; 73: 485-492)
Corresponding author: Shyambhavee Behera
E-mail: shyambhavee@gmail.com
Received 24 January 2021 Revised 29 June 2021 Accepted 30 June 2021
ORCID ID: https://orcid.org/0000-0003-1789-8104
http://dx.doi.org/10.33192/Smj.2021.63
INTRODUCTION
Since the arrival of 20
th
century everyone is exposed
to a complex mix of weak electric and magnetic elds,
at home as well as at work places, from the generation
and transmission of electricity, domestic appliances
and industrial equipment, to telecommunications and
broadcasting resulting in electromagnetic field and
associated radiations. With ubiquitous expansion of
current technology system globally in the last few decades,
EMF has crept up as a new type of pollution in the
physical environment due to resulting electromagnetic
radiations. is anthropogenic pollution is much stronger
than the known natural sources of electromagnetic elds
or radiation. One of the rst reports of their potentially
harmful eects on living organisms was an epidemiological
research report published in 1979 by Wertheimer and
Leeper.
1
ey studied the health status of children from
Denver (Colorado, USA), who lived in homes exposed
to magnetic elds of high intensities and concluded that
the children exposed to higher intensity magnetic elds
had slightly higher risks of developing leukaemia.
1
Anthropogenic electromagnetic elds can be classied
by their physical parameters such as frequency, and intensity.
ey can range from extremely low frequency (associated
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with electricity supplies and electrical appliances) to low,
medium, high, and extremely high frequency (mostly
associated with wireless communication). Electronic
devices such as smartphones, tablets, microwave ovens,
radio, and television sets emit low intensity electromagnetic
radiation at frequencies from 300 MHz to 300 GHz
that can be associated with microwaves. On the other
hand, power transmission lines and electric devices are
strong sources of electromagnetic elds and radiation
of much lower frequencies but much higher intensities.
Electromagnetic elds and/or electromagnetic radiation,
as electromagnetic pollution, aect various elements of
the environment and living organism. EMF pollution
in public health literature refers to the hazard bestowed
by non-ionising radiations with a frequency towards
the lower half of the electromagnetic spectrum. Tiny
electrical circuits exist in the human body that occur as
part of the normal bodily functions like transmission of
electric impulses for brain activities, heart beating and
even due to chemical reactions for digestion of food.
Low-frequency electric elds inuence the human body
which is made up of charged particles, so inuence the
distribution of electric charges and causes small currents
inside. Similarly, Low-frequency magnetic elds may also
induce circulating currents within the body depending
on the intensity of the magnetic eld. Both electric and
magnetic elds induce voltages and currents in the body
that are usually very small. However, if suciently large,
these currents could cause stimulation of nerves and
muscles or aect other biological processes. Commonly,
the eects of EMF radiations can be broadly classied
as thermal and non-thermal eects. ough thermal
eects are well documented in public health literature
the non-thermal eect poses greater challenge for the
upcoming research as there are conicting results of
dierent epidemiological studies done on this matter.
We are currently living under this large gamut of EMF
with a limited knowledge of its biological impact. Although
in-vitro studies have proven negative impact of EMF at
cellular levels, lacunae exist in providing evidence towards
possible adverse outcomes in terms of health. Hence, it
becomes very important to appropriately determine the
nature and related side eects of electromagnetic pollution
and its impact on human health. e International Agency
of Research on Cancers (IARC) has declared EMF as
“Possibly carcinogenic to human health (category 2B)”.
2
e eect of these radiation on environment is of course
research-worthy yet practically dicult to conduct.
Objective: We conducted this systematic review with
the objective to identify and map the available evidences
regarding the possible biological eect of EMF pollution
on human health so that its public health eects could
be addressed.
MATERIALS AND METHODS
Literature search
We conducted a systematic search of Medline database
and the Cochrane Library in January 2020 to identify
all relevant peer-reviewed papers published using key
words, “electromagnetic elds”, “Extremely low frequency
electromagnetic elds (ELF-EMFs)”, “biological eects”,
“health eects”. e key words were arranged in dierent
Boolean combinations with dierent search phrases. e
search was further rened using lters/ mesh terms, “free
full text”, “10 years”, “English”, “MEDLINE”, “Humans”.
Inclusion and exclusion criteria: We included human
laboratory trials and epidemiological studies published
in English in last 10 years from Dec 2009 to Dec 2019.
e health eects due to EMF were then rearranged in
line with dierent human systems aected. However, we
excluded in-vitro studies, studies in animals and studies
discussing therapeutic eects of EMF.
Data extraction: e data from each study were
extracted independently by two researchers and recorded.
e form extracted information about study design
study sample, sampling procedure, exposure, results and
health eects. Dierences concerning data extraction
were resolved by consensus.
Selection of studies: In total, 2611 potentially relevant
abstracts were identied; from where 445 full text articles
were considered; based on our inclusion and exclusion
criteria 20 studies were nally included in the review
(Fig 1). Of the 20 articles included in the analyses, 8
were original studies and 12 were review articles.
RESULTS
Multiple adverse eects of EMF on dierent human
organ systems have been reported by dierent studies.
Dierent varieties of biological eects were observed in
presence of dierent type of electromagnetic radiations.
Findings from various epidemiological studies and their
major gaps have been listed in Table 1. We identied, seven
original studies out of the eight, included in the review,
suggested possible association of presence of various
physical symptoms and cell morphology alteration with
exposure to EMF.
3-8
One accepted mechanism of action
of EMF to exert their non thermal biological eect is via
breaking DNA strands in cell type dependent manner.
9
Ten out of 12 review studies included in the review
suggested possibility of linkage of EMF with cellular
pathways like apoptosis and other cellular regulatory
Sahu et al.
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Fig 1. Flowchart showing the identication and selection of studies on the health eects of exposure to electromagnetic elds (EMF)
mechanism which may lead to carcinogenesis.
10-19
One
study also reported increased reactive oxygen species on
exposure to EMF in human cell lines leading to cellular
damage.
11
However, two review articles reported unlikely
or inconsistent ndings of any eect of EMF exposure
on cognitive functions and brain tumours.
20,21
We identied multiple studies conducted at dierent
places and time that have provided evidence regarding
eects of EMF on multiple organ system. ough WHO
and its auxiliary organisations have repeatedly told that
the eect is not detrimental to health, but it didn’t satisfy
a large number of researchers who have explained that
only short-term eects had been taken into consideration
in the epidemiological studies, not the long term and
non-thermal eects, thus disapproving WHO’s stance
on the matter.
22
Based on the studies included in the
review we summarised the potential eects of EMF on
various organ systems. (Fig 2)
Eects on nervous system
Studies have also reported a positive correlation
between EMF exposure and neurodegenerative diseases
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TABLE 1. Summary of various epidemiological studies included in the systematic review.
Authors Findings Challenges in understanding the
Article Types biological effects of EMF radiations
Publication Year
Bogers RP et al.
6
(Original Article), 2018
Lasalvia M et al.
5
(Original Article), 2018
Jazi SD et al.
27
(Original Article), 2017
Kapri-Pardes E et al.
7
(Original Article), 2017
Fang Q et al.
3
(Original Article), 2016
Luo Q et al.
2
(Original Article), 2013
Balamuralikrishnan B et al.
4
(Original Article), 2012
Augner C Et al.
8
(Original Article), 2010
Naarala J, et al.
10
(Review Article), 2019
Singh R et al.
14
(Review Article), 2018
• PossibleassociationofNonspecic
Physical symptoms (Positive or negative)
with EMF exposure
• Possible alterations of morphology of
lympho-monocytes of exposure to
microwave radiation.
• No effect of EMF on physiological
tremor and EEG
• Evidence of potential of ELF-EMF
towards cellular proliferation and
oncogenic transformation.
• Change in RR interval on short term
exposure to EMF.
No change in rest of the ECG intervals
on EMF exposure.
• EMF exposure adversely affects
placental functions and foetal
development among pregnant mothers.
• Genotoxic potential of ELF-EMF in
peripheral lymphocytes among workers
exposed to prolonged low level non
ionizing radiation
• Higher incident of psychological
strain and anxiety among people living
100 meters or less, from the
tele-communication base stations.
• Linkage of Radiofrequency MF with
pathways like apoptosis, cellular
regulation and cytoskeleton
maintenance.
• Effects of EMF on circadian rhythm and
sleep cycle.
• Possible mechanism of action of non-
thermal effects can be production of
reactive oxygen species.
• Effect of EMF on reproductive system
by causing decreased sperm motility,
viability as well as altered sperm
morphology.
• Small sample size (n=7) due complex
study design including use of
explosimeters to assess the exposure.
• Larger samples required to assess the
biologicalconsequencesofndings.
• Generalizationofthestudyndingswas
limited to small sample size () and nature
of the study
• NosufcientriseinERK1/1
phosphorylation on EMF exposure
sufcienttojustifyoncogenicpotential.
• In view of overlapping ECG frequency
and ELF-EMF operating frequency, it is
difculttoconcludedenitiveeffectof
EMF on ECG.
• Altered protein expression on foetus
cannotbeverieddueinethical
concerns.
• It was a case control study, however only
20 controls for 50 exposed were taken.
Control group could have been
increased.
• Thendingsweregeneratedwiththe
helpofparticipant'ssubjectiveoutlook
regarding the EMF exposure.
• Lack of consistency regarding effects of
EMF exposure by different studies.
• Inhomogeneous study designs.
• Different exposure parameters, variations
in body structures and environment.
Sahu et al.
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TABLE 1. Summary of various epidemiological studies included in the systematic review. (Continue)
Authors Findings Challenges in understanding the
Article Types biological effects of EMF radiations
Publication Year
Santini SJ et al.
18
(Review Article), 2018
Kesari KK et al.
13
(Review Article), 2018
Wang H et al.
11
(Review Article), 2017
Carlberg M et al.
19
(Review Article), 2017
Medeiros LN et al.
12
(Review Article), 2015
Teepen JC, et al.
16
(Review Article), 2012
Pall ML et al.
15
(Review Article), 2015
Vijaylaxmietal.
17
(Review Article), 2014
Swerdlow AJ et al.
21
(Commentary), 2011
Regel SJ et al.
20
(Review Article), 2011
• Cellular effects like altered molecular
pathways, apoptosis and dysregulated
cell cycle.
• Raised reactive oxygen species.
Possible role of EMF as co-carcinogen.
• Increased risk of neurodegenerative
diseases, autism.
• Possible effect of both male and female
reproductive systems.
• Detrimental effect of EMF on quality of
sperms including count, morphology
and motility.
• Increased levels of reactive oxygen
speciesonexposuretoEMFinmajority
of the reviewed research.
• Potential association of gliomas and
EMF exposure in the basis of nine
Bradford Hill viewpoints.
• Association between EMF exposure
and tinnitus, especially in persons with
electromagnetic hypersensitivity.
• Increased potential risk of Childhood
Leukaemia for EMF exposure although
its causal association cannot be
conrmed.
• Non thermal biological effects of EMF
need to be emphasized, esp. the
genotoxic potential in presence of vast
arrayofliteraturewithconictingresults.
• Eveninpresenceofcontrastingndings
from different group of experts about the
biological effects of EMF, a preventive
approach towards the same remains
the key.
• Unlikely evidence of increased brain
tumours among adults.
• Inconsistentndingsofanyeffectof
EMF exposure and cognitive functions.
• Different biological models used in
different settings, diverse exposure.
• Controversialndingsamongvarious
studies.
• Eveninpresenceofsignicantevidence,
the true mechanism behind effect of EMF
on reproductive system inaccessible.
• Disparities among various studies which
couldbeduetomagneticeldtype/
intensity/frequency.
• Findings are based on Hills viewpoint of
causality and analyses secondary data
• Prospective cohort studies are further
requiredforprovidingdenitiveevidence
ofthendings.
• Limited epidemiological studies on impact
of EMF with inbuilt biases in the present
studies.
• Emphasis of selection of only consistent
studies while addressing the research
question with preformed
• It was compilation of the various
guidelines and conclusions of studies on
the biological effects of RF exposures,
from various national and international
expert groups.
• Presenceofrecallmisclassicationinthe
case control studies, limited time duration.
• Reason behind the inconsistent
ndingscouldbelackofvalidatedtools,
study designs and different sample sizes.
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Fig 2. Figure showing possible adverse eects of EMF on dierent organ system.
and autism.
18,23
Gunnarsson LG et al in their study on
occupational exposure of EMF reported 10% increase
in the risk of ALS (Amyotrophic Lateral Sclerosis) and
Alzheimer’s disease due to exposure.
24
In an Indian
study amongst school going students, “Ringxiety” or
phantom ringing is seen in the students frequently using
mobile phones in classroom and library.
25
Augner C et
al, also reported higher psychological stress and anxiety
among those living near base stations.
8
Medeiros LN et.al,
in a review, reported association of long-term mobile
phone use and tinnitus and other hearing disorders.
12
A study by Reale et.al, also provide data on potential
eect of ELF- EMF on neurodegenerative processes
which further needs to be established with the help of
experimental models.
20
EMFs have also been reported to
alter pineal melatonin concentration, aect sleep cycle,
lower mood, reduced concentration, and depression;
decrease in release of melatonin hampers maintaining
the molecular structure of DNA strands, entitling EMFs
as teratogenic and mutagenic.
26
A study by Jazi AD et al.,
however reported no eect of EL-EMF on physiological
tremors and EEG.
27
Eects on reproductive system
Kesari et al. have reported negative eect of EMF on
male fertility due to adverse eect on quality of spermatozoa.
13
A decrease in the normal sperm morphology, motility
and count on exposure to EMF including mobile phones
has also been reported in literature.
14,18
Another case
control study done in Iran reported 4 times higher risk of
infertility among women living within 500 mts proximity
of high voltage power lines in comparison to women living
at more than 1,000 mts distance.
28
Clinical studies on
pregnant women exposed to ELF RF like Video display
terminal (VDT) have indicated a signicant increase
in spontaneous abortions.
29
Exposure of EMF in early
embryo stage may also have an adverse eect on nervous
system development and cellular proliferation.
30
Eect of cardiovascular and circulatory system
Fang et al in their study reported a significant
change in RR interval on ECG on short term exposure
to ELF-EMF, with no significant change on other
intervals. However, physiological implication to the
above ndings requires further research.
3
Evidence also
supports genotoxic potential of ELF-EMF in peripheral
lymphocytes among workers exposed to prolonged low
level non-ionizing radiation.
4
Possible eect of EMF
exposure on the lymphomonocyte morphology was also
reported but was limited to further research in terms of
EMF type/ intensity/ frequency, etc.
5
Electromagnetic Hypersensitivity Syndromes (EHS)
Some individuals reported dermatological symptoms
like redness, itching relating to exposure to EMFs termed
as Electromagnetic Hypersensitivity syndromes (EHS). It
was sometimes associated with or without vegetative or
neurasthenic symptoms like nausea, general weakness,
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dizziness, nystagmus, sometimes even haemoptysis
and paralysis.
2
Bogers et.al, also reported association
of non-specic physical symptoms (including, headache,
fatigue and dizziness that cannot be explained by other
medical condition), with radio frequency electromagnetic
elds.
6
However, aer conducting several double-blinded
cohort studies, the causal association of EHS with EMF
could not be established. EHS was then regarded as the
consequence of predicament of assuming harmfulness
of EMF rather than EMF itself by many leading health
professional and scientic bodies.
31
EMF and cancers
A study by Kapri-Pardes et al., yielded some evidence
of potential of ELF-EMF towards cellular proliferation
and oncogenic transformation.
7
Teepen JC, et al, also
provided epidemiological evidence of higher population
attributable risk of Childhood Leukaemia among children
exposed to ELF-EMF levels above 0.3 µT.
16
e Interphone
study published in 2010, reported more than double
the risk of brain Glioma in the people using mobile
phones for more than 10 years.
32
A meta-analysis done
by Bortkiewicz A, et al, also provided evidence increased
risk of increased risk of intracranial tumours with long
term use of mobile phones.
33
However, many other
studies proved inconclusive evidences of mobile phone
usage and cancers.
15,21,34
A study relating occurrence
of cancers (Glioma, Acoustic Neuroma and Parotid
gland cancers) with respect to the residential distance
from GSM or UMTS found no relationship between the
occurrence of cancer and various distances..
35
Carlberg
M et al., using Bradford Hill viewpoints also concluded
a positive association of gliomas and EMF exposure.
19
DISCUSSION
As, there are multiple sources of EMF in any particular
residence or workplace, proper epidemiological evaluation
of this matter is quite ambiguous. As the time of use of
electronic appliances and telecommunication tools like
mobile phones and other EMF devices will increase in
coming years, we are exposed to EMF radiation from
multiple sources simultaneously every day at work and
home. So accurate data regarding EMF pollution from
any epidemiological studies could not possibly made in
real human population. Experimental studies indicate
that short-term exposure at the levels present in the
environment or in the home do not cause any apparent
detrimental eects. us, till the time a denitive health
eect has been proven, considering a high index of
suspicion, a need arise for proper legislative measure
that should be taken to reduce usage of materials that
contributes to electromagnetic eld pollution. Such as,
limitation of numbers of radio stations in crowded area
or base station in public place. Electric lines and wiring
should be done as such that EMF emission should be
least. IEC activities should be undertaken targeting young
population to decrease mobile phone time in their daily
life, which is increasing day-by-day. Awareness of young
population regarding the EMF emission from video
displaying units would markedly reduce screen time,
thus, electromagnetic eld pollution.
WHO established the International EMF Project in
the year 1996 to provide an international platform for
coordinated response towards EMF issues. However,
International Commission on Non-Ionizing Radiation
Protection (ICNIRP) aided by Institute of Electrical
and Electronics Engineer (IEEE) puts up the guidelines
regarding the exposure limits of EMF in residential and
occupational elds. ey do the research regarding the
EMF and its importance in environment and present their
analysed information to WHO for making guidelines
and decisions regarding EMF. ough WHO and its
auxiliary organisations have repeatedly told that the
eect is not detrimental to health, but it didn’t satisfy a
large number of researchers, who have argued that only
short term eects had been taken into consideration in
the epidemiological studies and not the long term and
non-thermal eects. WHO also issued a risk-assessment
monograph EHC (Environmental Health Criteria) for EMF
but a group of researchers from Karolinska University
reported that the committee presiding over the EHC
risk-assessment study mostly comprised of people who
are from ICNIRP and IEEE itself and so can be biased.
22
CONCLUSION
There is no denying that the existing research
works are pointing towards greater risk of adverse health
eects ranging from irritability and sleep disturbance to
paralysis and cancers. erefore. the need of the hour
is undertaking various preventive measures in order to
minimize the exposure in the occupational as well as non-
occupational settings. ere should be Mass media eort
to generate awareness about the possible health impacts
of EMF, particularly focusing on young population and
proper legislative measures should be taken to minimize
EMF exposure at occupational settings. In long run for
overall benet and sustainable development we should
start searching option to substitute the contemporary
technologies with ones having favourable benet-risk
ratio.
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