Risk of lung cancer associated with residential radon exposure in south-west England: a case-control study

Is thoron a problem in radon measurements with NRPB/SSI passive radon detectors-experimental study

The UKHSA radon detectors with polyallyldiglycol carbonate sensing material produced from 2010 onward were used to confirm that they are purely radon detectors only with negligible interference from thoron presence. The statistical analysis of results, after following standard detector processing procedures, showed that such devices can only detect 2.4% ± 0.3% of the total thoron activity concentration compared to the calibrated reference device. It was also demonstrated that thoron, unlike radon, can only travel a very short distance from the source to be effectively measured. Based on the above, it has been concluded that interference of thoron in radon measurement is negligible (within the statistical measurement error), and hence can be ignored in standard indoor and outdoor measurements.

Characteristics of radon transport and optimization of ventilation parameters in large-scale underground cavern

Radon penetrates into the underground caverns through the pores/fissures of the surrounding rock, resulting in high radon concentration area and endangering the health of construction personnel. The on-site monitoring of radon concentration in the underground powerhouse of Tuoba Hydropower Station is conducted in order to study the radon concentration level. The radon transport during the construction period of underground powerhouse under forced ventilation is established by Computational Fluid Dynamics (CFD) numerical simulation method. Furthermore, the distribution characteristics and long-term evolution law of radon concentration in underground powerhouse are revealed, and reasonable ventilation optimization measures are put forward and the results show that: (1) Blasting promotes the increase of radon concentration, while forced ventilation accelerates radon transport. (2) The airflow field along the axis is divided into a vortex distribution zone, a vortex influence zone and stable regions. (3) The radon transport includes both migration and diffusion processes based on forced ventilation. (4) The radon concentration decreases with the increase of height, while exhibits low concentration in the middle and high concentration on both sides at the same height. (5) Compared with forced ventilation, the combined ventilation can improve the ventilation efficiency and shorten the radon transport time. The research results can provide a scientific basis for the safety analysis and evaluation of deep engineering environment.

Indoor radon exposure: A systematic review of radon-induced health risks and evidence quality using GRADE approach

Background

Radon (Rn) is a radioactive gas with well-established carcinogenic properties. It is a significant contributor to natural background ionizing radiation exposure, accounting for over 50 % of human exposure. Prolonged exposure to radon gas has been conclusively linked to various health issues such as lung cancer, leukemia, and Chronic Obstructive Pulmonary Diseases (COPD). Despite this, there is a scarcity of comprehensive studies examining the quality of evidence establishing an association between indoor radon exposure and these health problems.

Objective

We performed a systematic review of peer-reviewed research articles to explore the current evidence on the potential association between residential radon exposure and human health, specifically focusing on lung cancer, COPD, and leukemia.

Methods

A comprehensive search was conducted on PubMed and Google Scholar using MeSH terms and keywords (residential radon, radon AND lung cancer, radon AND COPD, radon AND leukemia). The inclusion criteria focused on studies that analyzed the link between residential radon exposure and lung cancer, leukemia and COPD. We searched for peer-reviewed studies published from 2010 to 2024. Studies carried out in occupational settings were not considered. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to select relevant studies. Reviewers independently collected data, resolving disagreements through discussion. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate evidence quality, and the study was registered with PROSPERO, CRD42024550735.

Results

The evidence indicating an associative or causal link between indoor radon and lung cancer was found to be of high quality or conclusive, particularly with stronger support from case-control studies. The findings for COPD and leukemia were inconclusive, indicating that additional research is necessary to establish a definitive link between residential radon exposure and these health outcomes. These associations was deemed moderate or inconclusive primarily due to methodological shortcomings, conflicting findings and the prevalence of weak study designs and poor exposure data. The existing evidence on the potential connection between residential radon exposure and the risk of COPD and leukemia is currently limited. In order to definitively confirm or disprove this association, more studies are needed. Further research is crucial to elucidate these relationships and to guide the development of effective public health interventions.

Conclusion

The review found that the association between radon exposure and lung cancer was consistent with existing scientific knowledge. However, the evidence for association between indoor radon exposure and COPD was inconclusive. Additionally, evidence linking indoor radon exposure to leukemia was uncertain. Future research should use more robust study designs (cohort and case control studies) and directly measure long-term radon levels to investigate the potential association between residential radon exposure and COPD and leukemia.

Overview of radon gas in groundwater around the world: Health effects and treatment technologies

The natural radioactive decay of uranium in rocks and soils gives rise to the presence of radon in groundwater. The existence of radon in groundwater at activity levels way higher than the reference limits set by US-EPA and WHO was widely covered in literature. The exposure to elevated levels of radon in ground and drinking water have been reported in literature to cause adverse health impacts. The aim of the present paper is to give an overview of radon gas in groundwater followed by the safe limits suggested by international organizations and agencies such as US-EPA and WHO. The paper also discusses the health effects associated with the exposure to radon levels and the estimation of the annual effective dose through ingestion and inhalation. This is followed by the radon levels around the world as well as the corresponding annual effective doses reported in literature. The determination techniques of radon levels in water covered in literature such as liquid scintillation counting, gamma-ray spectrometry and emanometry were also discussed and reviewed in the present work. Next, the paper sheds light on the most frequently used treatment techniques such as aeration, adsorption, filtration as well as biological techniques and evaluates their efficiency in mitigating radon levels in water. The paper also highlights the main precautions and future mitigation plans for radon in groundwater as well as delved onto future research perspectives of radon. It was found out that the type of rock played a key role in determining the radon levels. For instance, granitic rock types were reported to contribute to the elevation in the groundwater radon levels due to their characteristic permeability as a result of the formed fractures as well as their natural incorporation of high levels of uranium. Some of the reported radon levels in groundwater in literature were way higher than the guidelines set by the World Health Organization (WHO) for drinking water and US-EPA alternative higher maximum contaminant level. This review paper could be of importance to researchers working on the evaluation as well as the treatment of radon gas in water as it will provide a critical and state of the art review on radon gas in groundwater.

Dosimetry in the lungs of α-particles (210Po) and β-particles (210Pb) present in the tobacco smoke of conventional cigarettes and heated tobacco products

Tobacco products contain radioactive ²¹⁰Pb and ²¹⁰Po which can be transferred from the filler to the mainstream smoke. When inhaled, they can contribute to the radioactive dose to the lungs and are suspected to significantly contribute to lung cancer from smoking. Currently, no data are available on the radioactive risk of the heated tobacco products (HTP). However, due to the relatively high heat involved in some of these devices, there are concerns about the volatility of polonium particles. Here we used data on the ²¹⁰Po and ²¹⁰Pb content in tobacco smoke along with biokinetic and dosimetric models to compute the effective dose induced by conventional smoking and by using an HTP device (PMI IQOS system). Results show that conventional smoking of one pack per day induces a dose to the lung of about 0.3 mSv/year. This dose decreases by a factor of ten (0.03 mSv/year) for the IQOS system. However, this dose reduction is not obtained by specific countermeasures but by the fact that the IQOS system heats only 15% of the tobacco filler to the target temperature of 330 °C. When heated homogeneously to 300 °C, both conventional and Heets (IQOS) cigarettes release about 80% of the ²¹⁰Po from the tobacco, leading to similar doses to lungs.

Human Health Impacts of Residential Radon Exposure: Updated Systematic Review and Meta-Analysis of Case-Control Studies

This study investigated the impact of residential radon exposure on human cancers (i.e., lung cancer and childhood leukemia) through a systematic review and meta-analysis of case−control studies. A total of 9724 articles obtained from electronic databases were assessed; however, only 55 case−control studies were eligible after manually screening and eliminating unnecessary studies. The causal associations were addressed by determining the meta-analysis’s estimated size effects (i.e., ORs/RRs) of the meta-analysis. Residential radon was revealed to significantly increase the incidence of lung cancer and childhood leukemia with pooled ORs of 1.38 [1.19; 1.60] (I2 = 90%; p < 0.00001) and 1.43 [1.19; 1.72] (I2 = 0% and p = 0.51), respectively. In addition, subgroup analyses were performed to reduce the heterogeneity of the initial meta-analyses. The results provided strong evidence that inhaling radon in the indoor environments is closely associated with the development of lung cancer and childhood leukemia in patients living in Europe and areas with high radon levels (≥100 Bq/m3).

210Po and 210Pb content in the smoke of Heated Tobacco Products versus Conventional Cigarette smoking

210Po is a radioactive component of conventional cigarette tobacco smoke and is a recognized carcinogen. Despite the expanding market of heated tobacco products, no data are available on the activity of 210Po in the smoke of IQOS Heets cigarette. We determined the 210Po activity in the mainstream smoke of thirteen cigarette brands available on the Swiss market using a smoking machine and compared the results to the 210Po activity measured in the mainstream smoke of the IQOS system. In addition, we measured the 210Po and 210Pb loss on heating after uniform heating from 50 to 600 °C for several cigarette brands and the Heets cigarettes. 13.6 ± 4.1% of 210Po activity was found in the mainstream smoke in conventional cigarette smoking (7% for 210Pb). This dropped to 1.8 ± 0.3% in the mainstream smoke of IQOS Heets. Conversely, when the tobacco was heated uniformly at 330 °C, a loss of 210Po of more than 80% was observed for all type of cigarettes. Apparently, IQOS significantly reduced the 210Po and 210Pb activities in the mainstream smoke. However, our results show that only 15% of the Heets tobacco reaches 330 °C with IQOS. While IQOS reduces the 210Po and 210Pb activities in the mainstream smoke compared to conventional cigarettes, it only heats a marginal fraction of the tobacco present in the Heets cigarette. Because smoking is an addiction (mostly due to nicotine), IQOS could possibly deliver an unsatisfactory dose of nicotine to a Heets cigarette smoker, as most of the tobacco is left unaltered.

Epidemiological Study of Lung Cancer and Clinical Medication in England from 2001 to 2019

We aimed to explore the epidemiological characteristics and changes of lung cancer and the clinical medication in England from 2001 to 2019. We searched related research using search engine systems such as MEDLINE, PubMed, and PsychINFO. Lung cancer is a serious disease and the prognosis is usually very poor. The overall mortality rate of lung cancer decreased year by year in England from 2001 to 2019, but men, the elderly, and people exposed to polluted air are still more likely to be infected with lung cancer or die as a result, the prevalence and mortality rate of lung cancer in the north of England is significantly higher than that in the south, and the gap is increasing year by year. Lung cancer has changeable risk factors such as quitting smoking and improving air quality, which can effectively reduce the related risk. Paclitaxel, docetaxel, gemcitabine, and vinorelbine are the main drugs for the treatment of lung cancer in England and the treatment of these drugs is beneficial to the survival and quality of life of patients. Men and the elderly are at high risk of lung cancer, which means that lung cancer has obvious gender inequality and age inequality. At the same time, based on the statistical data of lung cancer risk in different regions, it can be concluded that lung cancer also has strong geographical and economic inequality. Changing risk factors and using drugs can effectively reduce the risk of lung cancer and provide effective treatment.

Indoor radon measurement in buildings of a university campus in central Iran and estimation of its effective dose and health risk assessment

Indoor radon is a serious health concern and contributes about 10% of deaths from lung cancer in the USA and Europe. In this study, radon and thoron levels of 20 multi-floor buildings on the campus of Isfahan University of Medical Sciences were measured in cold and hot seasons of a year. SARAD- RTM1688 radon and thoron monitor was used for measurement. The annual effective dose of radon exposure was also estimated for residences on the campus. The results showed that radon concentration was below the WHO guideline (100 Bq m- 3) in most of the buildings. The ranges of radon were from 3 ± 10% to 322 ± 15% Bq m- 3 in winter and from below the detectable level to 145 ± 8% Bq m- 3 in summer. Mostly, the radon concentration in the basement or ground floors was higher than upper floors, however, exceptions were observed in some locations. For thoron, no special trends were observed, and in the majority of buildings, its concentration was below the detectable level. However, in a few locations besides radon, thoron was also measured at a high level during both seasons. The average annual effective dose via radon exposure was estimated to be 0.261 ± 0.339 mSv y- 1. The mean excess lung cancer risk (ELCR) was estimated to be 0.10%. It was concluded that indoor air ventilation, buildings' flooring and construction materials, along with the geological structure of the ground could be the factors influencing the radon concentration inside the buildings. Thus, some applicable radon prevention and mitigation techniques were suggested.

Systematic review and meta-analysis of residential radon and lung cancer in never-smokers

Background

Globally, radon is the leading risk factor for lung cancer in never-smokers (LCINS). In this study, we systematically reviewed and meta-analysed the evidence of the risk of LCINS associated with residential radon exposure.

Methods

Medline and Embase databases were searched using predefined inclusion and exclusion criteria to identify relevant studies published from 1 January 1990 to 5 March 2020 focused on never-smokers. We identified four pooled collaborative studies (incorporating data from 24 case–control studies), one case–control study and one cohort study for systematic review. Meta-analysis was performed on the results of the four pooled studies due to different measures of effect and outcome reported in the cohort study and insufficient information reported for the case–control study. In a post hoc analysis, the corresponding risk for ever-smokers was also examined.

Results

Risk estimates of lung cancer from residential radon exposure were pooled in the meta-analysis for 2341 never-smoker cases, 8967 never-smoker controls, 9937 ever-smoker cases and 12 463 ever-smoker controls. Adjusted excess relative risks (aERRs) per 100 Bq·m⁻³ of radon level were 0.15 (95% CI 0.06–0.25) for never-smokers and 0.09 (95% CI 0.03–0.16) for ever-smokers, and the difference between them was statistically insignificant (p=0.32). The aERR per 100 Bq·m⁻³was higher for men (0.46; 95% CI 0.15–0.76) than for women (0.09; 95% CI −0.02–0.20) among never-smokers (p=0.027).

Conclusion

This study provided quantified risk estimates for lung cancer from residential radon exposure among both never-smokers and ever-smokers. Among never-smokers in radon-prone areas, men were at higher risk of lung cancer than women.

Globally, radon is the leading cause of lung cancer in never-smokers. Yet its quantified link with lung cancer risk among never-smokers is not known. This study computes the risk estimate of lung cancer from residential radon exposure among never-smokers.https://bit.ly/32frCbq

A 10-year follow-up study of yearly indoor radon measurements in homes, review of other studies and implications on lung cancer risk estimates

Uncertainty on long-term average radon concentration has a large impact on lung cancer risk assessment in epidemiological studies. The uncertainty can be estimated by year-to-year radon concentration variability, however few data are available. In Italy a study has been planned and conducted to evaluate year-to-year radon variability over several years in normally inhabited dwellings, mainly located in Rome. This is the longest study of this kind in Europe; repeat radon measurements are carried out for 10 years using LR-115 radon detectors in the same home in consecutive years. The study includes 84 dwellings with long-term average radon concentration ranging from 28 to 636 Bq/m³. The result shows that year-to-year variability of repeated measurements made in the same home in different years is low, with an overall coefficient of variation of 17%. This is smaller than most of those observed in studies from other European countries and USA, ranging from 15% to 62%. Influencing factors that may explain the differences between this study and other studies have been discussed. Due to the low yearly variability estimated in the present 10-year study, a negligible impact on lung cancer risk estimate for the Italian epidemiological study is expected.

Study of baseline radon levels in the context of a shale gas development

This study reports the results from continuous measurement of indoor and outdoor radon concentrations in the area surrounding an unconventional shale gas exploration site in North Yorkshire, England, prior to the commencement of hydraulic fracturing. Public Health England has monitored the baseline radon levels in homes and in outdoor air in the Vale of Pickering since 2015. The statistical analysis presented here includes three full years (November 2015- -December 2018) of indoor and four and half years (October 2015 - April 2019) of outdoor radon measurements. Stratified sampling was used to select 171 dwellings in four areas, with two different radon potential. Statistical analysis confirms that homes in Kirby Misperton and Little Barugh and those in Yedingham are situated in areas with low radon potential, as was predicted by the UK radon potential map. On the other hand, both Pickering and Malton are confirmed as radon Affected Areas. Radon was measured continuously in the outdoor air using a newly developed outdoor kit containing passive radon detectors. The monitoring points were set up at 36 locations in the same local areas as those selected for the indoor monitoring. The results from statistical analysis show that outdoor radon had a different seasonality pattern to indoor radon. The monitoring of outdoor radon levels over the four and half years indicates a year-to-year variation in outdoor radon concentrations with levels fluctuating between 3 and 9 Bq m^-3. There was a very good agreement between long-term average radon concentrations measured using passive detectors and using an active AlphaGUARD monitor.

Indoor air pollution, physical and comfort parameters related to schoolchildren's health: Data from the European SINPHONIE study

Substantial knowledge is available on the association of the indoor school environment and its effect among schoolchildren. In the same context, the SINPHONIE (School indoor pollution and health: Observatory network in Europe) conducted a study to collect data and determine the distribution of several indoor air pollutants (IAPs), physical and thermal parameters and their association with eye, skin, upper-, lower respiratory and systemic disorder symptoms during the previous three months. Finally, data from 115 schools in 54 European cities from 23 countries were collected and included 5175 schoolchildren using a harmonized and standardized protocol. The association between exposures and the health outcomes were examined using logistic regression models on the environmental stressors assessed in classroom while adjusting for several confounding factors; a VOC (volatile organic compound) score defined as the sum of the number of pollutants to which the children were highly exposed (concentration > median of the distribution) in classroom was also introduced to evaluate the multiexposure - outcome association. Schoolchildren while adjusting for several confounding factors. Schoolchildren exposed to above or equal median concentration of PM_2.5, benzene, limonene_, ozone and radon were at significantly higher odds of suffering from upper, lower airways, eye and systemic disorders. Increased odds were also observed for any symptom (sick school syndrome) among schoolchildren exposed to concentrations of limonene and ozone above median values. Furthermore, the risks for upper and lower airways and systemic disorders significantly increased with the VOCs score. Results also showed that increased ventilation rate was significantly associated with decreased odds of suffering from eye and skin disorders whereas similar association was observed between temperature and upper airways symptoms. The present study provides evidence that exposure to IAPs in schools is associated with various health problems in children. Further investigations are needed to confirm our findings.

Residential Radon and Histological Types of Lung Cancer: A Meta-Analysis of Case‒Control Studies

Epidemiological studies on residential radon exposure and the risk of histological types of lung cancer have yielded inconsistent results. We conducted a meta-analysis on this topic and updated previous related meta-analyses. We searched the databases of Cochrane Library, Embase, PubMed, Web of Science and Chinese National Knowledge Infrastructure for papers published up to 13 November 2018. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using fixed and random effects models. Subgroup and dose‒response analyses were also conducted. This study was registered with PROSPERO (No. CRD42019127761). A total of 28 studies, which included 13,748 lung cancer cases and 23,112 controls, were used for this meta-analysis. The pooled OR indicated that the highest residential radon exposure was significantly associated with an increased risk of lung cancer (OR = 1.48, 95% CI = 1.26–1.73). All histological types of lung cancer were associated with residential radon. Strongest association with small-cell lung carcinoma (OR = 2.03, 95% CI = 1.52–2.71) was found, followed by adenocarcinoma (OR = 1.58, 95% CI = 1.31–1.91), other histological types (OR = 1.54, 95% CI = 1.11–2.15) and squamous cell carcinoma (OR = 1.43, 95% CI = 1.18–1.74). With increasing residential radon levels per 100 Bq/m³, the risk of lung cancer, small-cell lung carcinoma and adenocarcinoma increased by 11%, 19% and 13%, respectively. This meta-analysis provides new evidence for a potential relationship between residential radon and all histological types of lung cancer.

A cost effectiveness analysis of interventions to reduce residential radon exposure in Canada

The objective of this analysis is to estimate the incremental cost effectiveness ratios for the 2012 populations in Canada, each province/territory, and 17 census metropolitan areas, for practical radon mitigation scenarios to reduce residential radon exposures. Sixteen intervention scenarios compare radon mitigation implemented at differing rates in new and existing housing relative to preventive measures installed at construction, using three different radon mitigation thresholds. A period life-table analysis was conducted using data derived from two recent Canadian radon surveys, along with Canadian mortality and quality of life data. Analyses adopted a lifetime horizon and a discount rate of 1.5%. It is practical to reduce residential radon and associated lung cancer mortality in Canada, and the most cost effective scenario at each radon mitigation threshold is the combination of the activation of the preventive measures in new housing and mitigation of existing housing.

Health Effects of Radon Exposure

Radon is a naturally occurring radioactive material that is formed as the decay product of uranium and thorium, and is estimated to contribute to approximately half of the average annual natural background radiation. When inhaled, it damages the lungs during radioactive decay and affects the human body. Through many epidemiological studies regarding occupational exposure among miners and residential exposure among the general population, radon has been scientifically proven to cause lung cancer, and radon exposure is the second most common cause of lung cancer after cigarette smoking. However, it is unclear whether radon exposure causes diseases other than lung cancer. Media reports have often dealt with radon exposure in relation to health problems, although public attention has been limited to a one-off period. However, recently in Korea, social interest and concern about radon exposure and its health effects have increased greatly due to mass media reports of high concentrations of radon being released from various close-to-life products, such as mattresses and beauty masks. Accordingly, this review article is intended to provide comprehensive scientific information regarding the health effects of radon exposure.

Meta-analysis of case-control studies on the relationship between lung cancer and indoor radon exposure

Indoor exposure to natural radon is a factor that influences lung cancer risk worldwide. The present study includes a meta-analysis of epidemiological data on the relationship between lung cancer and indoor radon. Altogether, 31 case-control studies with 20,703 cases, 34,518 controls and 140 individual odds ratio (OR) estimates are included in the meta-analysis. Weighted median OR was calculated for five radon intervals. The following parameters were used for the weighting: standard error of OR, duration of radon concentration measurement, and relative number of controls in reference intervals. The dependence of the weighted median OR on the radon concentration was estimated applying linear non-threshold and threshold models. The results obtained suggest a significant linear no-threshold exposure-effect relationship for radon concentrations above 100 Bq/m³, with a slope of 0.14 (95% confidence interval 0.08-0.21) per 100 Bq/m³.

Meta-analysis of thirty-two case-control and two ecological radon studies of lung cancer

A re-analysis has been carried out of thirty-two case-control and two ecological studies concerning the influence of radon, a radioactive gas, on the risk of lung cancer. Three mathematically simplest dose-response relationships (models) were tested: constant (zero health effect), linear, and parabolic (linear-quadratic). Health effect end-points reported in the analysed studies are odds ratios or relative risk ratios, related either to morbidity or mortality. In our preliminary analysis, we show that the results of dose-response fitting are qualitatively (within uncertainties, given as error bars) the same, whichever of these health effect end-points are applied. Therefore, we deemed it reasonable to aggregate all response data into the so-called Relative Health Factor and jointly analysed such mixed data, to obtain better statistical power. In the second part of our analysis, robust Bayesian and classical methods of analysis were applied to this combined dataset. In this part of our analysis, we selected different subranges of radon concentrations. In view of substantial differences between the methodology used by the authors of case-control and ecological studies, the mathematical relationships (models) were applied mainly to the thirty-two case-control studies. The degree to which the two ecological studies, analysed separately, affect the overall results when combined with the thirty-two case-control studies, has also been evaluated. In all, as a result of our meta-analysis of the combined cohort, we conclude that the analysed data concerning radon concentrations below ~1000 Bq/m3 (~20 mSv/year of effective dose to the whole body) do not support the thesis that radon may be a cause of any statistically significant increase in lung cancer incidence.

Indoor radon regulation using tabulated values of temporal radon variation

Mass measurements of indoor radon concentrations have been conducted for about 30 years. In most of the countries, a national reference/action/limit level is adopted, limiting the annual average indoor radon (AAIR) concentration. However, until now, there is no single and generally accepted international protocol for determining the AAIR with a known confidence interval, based on measurements of different durations. Obviously, as the duration of measurements increases, the uncertainty of the AAIR estimation decreases. The lack of the information about the confidence interval of the determined AAIR level does not allow correct comparison with the radon reference level. This greatly complicates development of an effective indoor radon measurement protocol and strategy. The paper proposes a general principle of indoor radon regulation, based on the simple criteria widely used in metrology, and introduces a new parameter - coefficient of temporal radon variation K_V(t) that depends on the measurement duration and determines the uncertainty of the AAIR. An algorithm for determining K_V(t) based on the results of annual continuous radon monitoring in experimental rooms is proposed. Included are indoor radon activity concentrations and equilibrium equivalent concentration (EEC) of radon progeny. The monitoring was conducted in 10 selected experimental rooms located in 7 buildings, mainly in the Moscow region (Russia), from 2006 to 2013. The experimental and tabulated values of K_V(t) and also the values of the coefficient of temporal EEC variation depending on the mode and duration of the measurements were obtained. The recommendations to improve the efficiency and reliability of indoor radon regulation are given. The importance of taking into account the geological factors is discussed. The representativity of the results of the study is estimated and the approach for their verification is proposed.

New Correction Factors Based on Seasonal Variability of Outdoor Temperature for Estimating Annual Radon Concentrations in UK

Indoor radon concentrations generally vary with season. Radon gas enters buildings from beneath due to a small air pressure difference between the inside of a house and outdoors. This underpressure which draws soil gas including radon into the house depends on the difference between the indoor and outdoor temperatures. The variation in a typical house in UK showed that the mean indoor radon concentration reaches a maximum in January and a minimum in July. Sine functions were used to model the indoor radon data and monthly average outdoor temperatures, covering the period between 2005 and 2014. The analysis showed a strong negative correlation between the modelled indoor radon data and outdoor temperature. This correlation was used to calculate new correction factors that could be used for estimation of annual radon concentration in UK homes. The comparison between the results obtained with the new correction factors and the previously published correction factors showed that the new correction factors perform consistently better on the selected data sets.

Radon Concentration in the Drinking Water of Aliabad Katoul, Iran

Background

According to the world health organization, radon is a leading cause of cancer in various internal organs and should be regarded with concern.

Objectives

The aim of this study is to evaluate the concentration of soluble radon in the drinking water of the city of Aliabad Katoul, Iran.

Materials and Methods

The radon concentration was measured by using a radon meter, SARAD^TM model RTM 1688-2, according to accepted standards of evaluation.

Results

The mean radon concentration in the drinking water of Aliabad Katoul is 2.90 ± 0.57 Bq/L.

Conclusions

The radon concentration in Aliabad Katoul is below the limit for hazardous levels, but some precautions will make conditions even safer for the local populace.

Residential mobility and associated factors in relation to the assessment of exposure to naturally occurring radiation in studies of childhood cancer

Migration, that is the study subjects moving from one residential address to another, is a complication for epidemiological studies where exposures to the agent of interest depend on place of residence [corrected]. In this paper we explore migration in cases from a large British case-control study of childhood cancer and natural background radiation. We find that 44% of cases had not moved house between birth and diagnosis, and about two-thirds were living within 2 km of their residence at birth. The estimated dose at the diagnosis address was strongly correlated with that at the birth address, suggesting that use of just the birth address in this case-control study does not lead to serious bias in risk estimates. We also review other individual-based studies of naturally occurring radiation, with particular emphasis on those from Great Britain. Interview-based case-control and cohort studies can potentially establish full residential histories for study subjects and make direct measurements of radiation levels in the dwellings in question. However, in practice, because of study size and difficulties in obtaining adequate response rates, interview-based studies generally do not use full residential histories, and a substantial proportion of dose estimates often derive from models rather than direct measurements. More seriously, problems of incomplete response may lead to bias, not just to loss of power. Record-based case-control studies, which do not require direct contact with study subjects, avoid such problems, but at the expense of having only model-based exposure estimates that use databases of measurements.

Prediction of residential radon exposure of the whole Swiss population: comparison of model-based predictions with measurement-based predictions

Radon plays an important role for human exposure to natural sources of ionizing radiation. The aim of this article is to compare two approaches to estimate mean radon exposure in the Swiss population: model-based predictions at individual level and measurement-based predictions based on measurements aggregated at municipality level. A nationwide model was used to predict radon levels in each household and for each individual based on the corresponding tectonic unit, building age, building type, soil texture, degree of urbanization, and floor. Measurement-based predictions were carried out within a health impact assessment on residential radon and lung cancer. Mean measured radon levels were corrected for the average floor distribution and weighted with population size of each municipality. Model-based predictions yielded a mean radon exposure of the Swiss population of 84.1 Bq/m(3) . Measurement-based predictions yielded an average exposure of 78 Bq/m(3) . This study demonstrates that the model- and the measurement-based predictions provided similar results. The advantage of the measurement-based approach is its simplicity, which is sufficient for assessing exposure distribution in a population. The model-based approach allows predicting radon levels at specific sites, which is needed in an epidemiological study, and the results do not depend on how the measurement sites have been selected.

Dose-response relationship of lung cancer to amount smoked, duration and age starting

AIM: To quantify smoking/lung cancer relationships accurately using parametric modelling.

METHODS: Using the International Epidemiological Studies on Smoking and Lung Cancer database of all epidemiological studies of 100+ lung cancer cases published before 2000, we analyzed 97 blocks of data for amount smoked, 35 for duration of smoking, and 27 for age started. Pseudo-numbers of cases and controls (or at risk) estimated from RRs by dose level formed the data modelled. We fitted various models relating log_e RR to dose (d), including βd, βd^Y and βlog_e (1 + Wd), and investigated goodness-of-fit and heterogeneity between studies.

RESULTS: The best-fitting models for log_e RR were 0.833 log_e [1 + (8.1c/10)] for cigarettes/d (c), 0.792 (y/10)^0.74 for years smoked (y) and 0.176 [(70 - a)/10]^1.44 for age of start (a). Each model fitted well overall, though some blocks misfitted. RRs rose from 3.86 to 22.31 between c = 10 and 50, from 2.21 to 13.54 between y = 10 and 50, and from 3.66 to 8.94 between a = 30 and 12.5. Heterogeneity (P < 0.001) existed by continent for amount, RRs for 50 cigarettes/d being 7.23 (Asia), 26.36 (North America) and 22.16 (Europe). Little heterogeneity was seen for duration of smoking or age started.

CONCLUSION: The models describe the dose-relationships well, though may be biased by factors including misclassification of smoking status and dose.

Residential radon and lung cancer risk: an updated meta- analysis of case-control studies

BACKGROUND

Numbers of epidemiological studies assessing residential radon exposure and risk of lung cancer have yielded inconsistent results.

METHODS

We therefore performed a meta-analysis of relevant published case- control studies searched in the PubMed database through July 2011 to examine the association. The combined odds ratio (OR) were calculated using fixed- or random-effects models. Subgroup and dose-response analyses were also performed.

RESULTS

We identified 22 case-control studies of residential radon and lung cancer risk involving 13,380 cases and 21,102 controls. The combined OR of lung cancer for the highest with the lowest exposure was 1.29 (95% CI 1.10-1.51). Dose-response analysis showed that every 100 Bq/m3 increment in residential radon exposure was associated with a significant 7% increase in lung cancer risk. Subgroup analysis displayed a more pronounced association in the studies conducted in Europe. Studies restricted to female or non-smokers demonstrated weakened associations between exposure and lung cancer.

CONCLUSIONS

This meta- analysis provides new evidence supporting the conclusion that residential exposure to radon can significantly increase the risk of lung cancer in a dose-response manner.

Residential radon and lung cancer incidence in a Danish cohort

High-level occupational radon exposure is an established risk factor for lung cancer. We assessed the long-term association between residential radon and lung cancer risk using a prospective Danish cohort using 57,053 persons recruited during 1993-1997. We followed each cohort member for cancer occurrence until 27 June 2006, identifying 589 lung cancer cases. We traced residential addresses from 1 January 1971 until 27 June 2006 and calculated radon at each of these addresses using information from central databases regarding geology and house construction. Cox proportional hazards models were used to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI) for lung cancer risk associated with residential radon exposure with and without adjustment for sex, smoking variables, education, socio-economic status, occupation, body mass index, air pollution and consumption of fruit and alcohol. Potential effect modification by sex, traffic-related air pollution and environmental tobacco smoke was assessed. Median estimated radon was 35.8 Bq/m(3). The adjusted IRR for lung cancer was 1.04 (95% CI: 0.69-1.56) in association with a 100 Bq/m(3) higher radon concentration and 1.67 (95% CI: 0.69-4.04) among non-smokers. We found no evidence of effect modification. We find a positive association between radon and lung cancer risk consistent with previous studies but the role of chance cannot be excluded as these associations were not statistically significant. Our results provide valuable information at the low-level radon dose range.

Systematic review with meta-analysis of the epidemiological evidence in the 1900s relating smoking to lung cancer

BACKGROUND

Smoking is a known lung cancer cause, but no detailed quantitative systematic review exists. We summarize evidence for various indices.

METHODS

Papers published before 2000 describing epidemiological studies involving 100+ lung cancer cases were obtained from Medline and other sources. Studies were classified as principal, or subsidiary where cases overlapped with principal studies. Data were extracted on design, exposures, histological types and confounder adjustment. RRs/ORs and 95% CIs were extracted for ever, current and ex smoking of cigarettes, pipes and cigars and indices of cigarette type and dose-response. Meta-analyses and meta-regressions investigated how relationships varied by study and RR characteristics, mainly for outcomes exactly or closely equivalent to all lung cancer, squamous cell carcinoma ("squamous") and adenocarcinoma ("adeno").

RESULTS

287 studies (20 subsidiary) were identified. Although RR estimates were markedly heterogeneous, the meta-analyses demonstrated a relationship of smoking with lung cancer risk, clearly seen for ever smoking (random-effects RR 5.50, CI 5.07-5.96) current smoking (8.43, 7.63-9.31), ex smoking (4.30, 3.93-4.71) and pipe/cigar only smoking (2.92, 2.38-3.57). It was stronger for squamous (current smoking RR 16.91, 13.14-21.76) than adeno (4.21, 3.32-5.34), and evident in both sexes (RRs somewhat higher in males), all continents (RRs highest for North America and lowest for Asia, particularly China), and both study types (RRs higher for prospective studies). Relationships were somewhat stronger in later starting and larger studies. RR estimates were similar in cigarette only and mixed smokers, and similar in smokers of pipes/cigars only, pipes only and cigars only. Exceptionally no increase in adeno risk was seen for pipe/cigar only smokers (0.93, 0.62-1.40). RRs were unrelated to mentholation, and higher for non-filter and handrolled cigarettes. RRs increased with amount smoked, duration, earlier starting age, tar level and fraction smoked and decreased with time quit. Relationships were strongest for small and squamous cell, intermediate for large cell and weakest for adenocarcinoma. Covariate-adjustment little affected RR estimates.

CONCLUSIONS

The association of lung cancer with smoking is strong, evident for all lung cancer types, dose-related and insensitive to covariate-adjustment. This emphasises the causal nature of the relationship. Our results quantify the relationships more precisely than previously.

ICRP Publication 115. Lung cancer risk from radon and progeny and statement on radon

Recent epidemiological studies of the association between lung cancer and exposure to radon and its decay products are reviewed. Particular emphasis is given to pooled case-control studies of residential exposures, and to cohorts of underground miners exposed to relatively low levels of radon. The residential and miner epidemiological studies provide consistent estimates of the risk of lung cancer, with significant associations observed at average annual concentrations of approximately 200 Bq/m³ and cumulative occupational levels of approximately 50 working level months (WLM), respectively. Based on recent results from combined analyses of epidemiological studies of miners, a lifetime excess absolute risk of 5 × 10⁻⁴ per WLM [14 × 10⁻⁵ per (mJh/m³)] should now be used as the nominal probability coefficient for radon- and radon-progeny-induced lung cancer, replacing the previous Publication 65 (ICRP, 1993) value of 2.8 × 10⁻⁴ per WLM [8 × 10⁻⁵ per (mJh/m³)]. Current knowledge of radon-associated risks for organs other than the lungs does not justify the selection of a detriment coefficient different from the fatality coefficient for radon-induced lung cancer. Publication 65 (ICRP, 2003) recommended that doses from radon and its progeny should be calculated using a dose conversion convention based on epidemiological data. It is now concluded that radon and its progeny should be treated in the same way as other radionuclides within the ICRP system of protection; that is, doses from radon and its progeny should be calculated using ICRP biokinetic and dosimetric models. ICRP will provide dose coefficients per unit exposure to radon and its progeny for different reference conditions of domestic and occupational exposure, with specified equilibrium factors and aerosol characteristics.

Radon measurements by nuclear track detectors in secondary schools in Oke-Ogun region, Nigeria

Radon measurements were performed in secondary schools in the Oke-Ogun area, South-west, Nigeria, by solid state nuclear track detectors (SSNTDs). About seventy CR-39 detectors were distributed in 35 high schools of the Oke-Ogun area. The CR-39 detectors were exposed in the schools for 3 months and then etched in NaOH 6 N solution at 90 °C for 3 h. The tracks were counted manually at the microscope and the radon concentration was determined at the Radioactivity Laboratory, Department of Physics, University of Trieste, Trieste, Italy. The overall average radon concentration in the surveyed area was 45 ± 27 Bq m(-3). The results indicate no radiological health hazard. The research also focused on parameters affecting radon concentrations such as the age of the building in relation to building materials and floor number of the classrooms. The results show that radon concentrations in ground floors are higher than in upper floors.

Awareness and perceptions of the risks of exposure to indoor radon: a population-based approach to evaluate a radon awareness and testing campaign in England and Wales

The current study aimed to evaluate the locally directed radon roll-out program that was conducted between 2001 and 2005 in England and Wales to increase radon awareness and testing rates. A representative sample of 1,578 residents aged 16 and older were interviewed who lived in radon-affected areas of 15 local authorities in England and Wales that were eligible for participation in the program. The study systematically sampled across participating and nonparticipating local authorities, "actionable" and "nonactionable" radon-affected areas, and geographic regions with different campaign histories (Wales, Southwest England, and the rest of England). As a multistage sampling strategy was used, the data were analyzed from a multilevel perspective. This study found that participants living in participating local authorities had higher levels of awareness and were more likely to have tested their home for radon than participants living in nonparticipating local authorities. Similar results were found for participants living in "actionable" areas as compared to those living in "nonactionable" radon-affected areas. The study further found that radon awareness and testing rates were the highest in Southwest England and the lowest in Wales. This study suggests that the radon roll-out program has been effective in raising awareness and testing rates, and that ongoing domestic radon campaigns in Southwest England may have raised radon awareness and testing in these areas, showing important reinforcement effects of multiple risk communication campaigns.

Pooled Bayesian analysis of twenty-eight studies on radon induced lung cancers

The influence of ionizing radiation of (222)Rn and its progeny on lung cancer risks that were published in 28 papers was re-analyzed using seven alternative dose-response models. The risks of incidence and mortality were studied in two ranges of low annual radiation dose: 0-70 mSv per year (391 Bq m(-3)) and 0-150 mSv per year (838 Bq m(-3)). Assumption-free Bayesian statistical methods were used. The analytical results demonstrate that the published incidence and mortality data do not show that radiation dose is associated with increased risk in this range of doses. This conclusion is based on the observation that the model assuming no dependence of the lung cancer induction on the radiation doses is at least ∼90 times more likely to be true than the other models tested, including the linear no-threshold (LNT) model.

Doses from beta radiation in sensitive layers of human lung and dose conversion factors due to 222Rn/220Rn progeny

Great deal of work has been devoted to determine doses from alpha particles emitted by (222)Rn and (220)Rn progeny. In contrast, contribution of beta particles to total dose has been neglected by most of the authors. The present work describes a study of the detriment of (222)Rn and (220)Rn progeny to the human lung due to beta particles. The dose conversion factor (DCF) was introduced to relate effective dose and exposure to radon progeny; it is defined as effective dose per unit exposure to inhaled radon or thoron progeny. Doses and DCFs were determined for beta radiation in sensitive layers of bronchi (BB) and bronchioles (bb), taking into account inhaled (222)Rn and (220)Rn progeny deposited in mucus and cilia layer. The nuclei columnar secretory and short basal cells were considered to be sensitive target layers. For dose calculation, electron-absorbed fractions (AFs) in the sensitive layers of the BB and bb regions were used. Activities in the fast and slow mucus of the BB and bb regions were obtained using the LUNGDOSE software developed earlier. Calculated DCFs due to beta radiation were 0.21 mSv/WLM for (222)Rn and 0.06 mSv/WLM for (220)Rn progeny. In addition, the influence of Jacobi room parameters on DCFs was investigated, and it was shown that DCFs vary with these parameters by up to 50%.

The cost effectiveness of radon mitigation in existing German dwellings--a decision theoretic analysis

Radon is a naturally occurring inert radioactive gas found in soils and rocks that can accumulate in dwellings, and is associated with an increased risk of lung cancer. This study aims to analyze the cost effectiveness of different intervention strategies to reduce radon concentrations in existing German dwellings. The cost effectiveness analysis (CEA) was conducted as a scenario analysis, where each scenario represents a specific regulatory regime. A decision theoretic model was developed, which reflects accepted recommendations for radon screening and mitigation and uses most up-to-date data on radon distribution and relative risks. The model was programmed to account for compliance with respect to the single steps of radon intervention, as well as data on the sensitivity/specificity of radon tests. A societal perspective was adopted to calculate costs and effects. All scenarios were calculated for different action levels. Cost effectiveness was measured in costs per averted case of lung cancer, costs per life year gained and costs per quality adjusted life year (QALY) gained. Univariate and multivariate deterministic and probabilistic sensitivity analyses (SA) were performed. Probabilistic sensitivity analyses were based on Monte Carlo simulations with 5000 model runs. The results show that legal regulations with mandatory screening and mitigation for indoor radon levels >100 Bq/m(3) are most cost effective. Incremental cost effectiveness compared to the no mitigation base case is 25,181 euro (95% CI: 7371 euro-90,593 euro) per QALY gained. Other intervention strategies focussing primarily on the personal responsibility for screening and/or mitigative actions show considerably worse cost effectiveness ratios. However, targeting radon intervention to radon-prone areas is significantly more cost effective. Most of the uncertainty that surrounds the results can be ascribed to the relative risk of radon exposure. It can be concluded that in the light of international experience a legal regulation requiring radon screening and, if necessary, mitigation is justifiable under the terms of CEA.

Evaluation and equity audit of the domestic radon programme in England

The U.K. has a radon programme to limit the radon risk to health. This involves advice on protective measures in new buildings, technical guidance on their installation, encouragement of radon measurements and remediation in existing dwellings in high radon areas. We have audited the radon programme at the level of individual homes to identify factors that influence the likelihood of remediation. 49% of the householders responded to our survey and 30% of the respondents stated that they had done some remediation to reduce the indoor radon levels. We found that householders with higher incomes and higher socio-economic status are more likely than others to remediate. Householders are less likely to remediate if they have one of the following: living in a property with a high radon concentration, current smokers in the dwelling, being unemployed or an unskilled worker, long length of time living in that property or elderly (65+ years) living by themselves. Householders appeared to be more likely to remediate if they considered the information on radon and its risk to be very clear and useful. This emphasises the importance of communication with householders.

Indoor radon survey in a university campus of Nigeria

CR-39 tracketch detectors were used for the measurement of (222)Rn concentration in 24 offices in Nigeria's oldest university campus in order to estimate the effective dose to the occupants from (222)Rn and its progeny. The dosimetric measurements were made over a period of 3 months. Questionnaires were distributed and analyzed. The radon concentration ranged from 157 to 495 Bq/m(3), with an arithmetic mean and standard deviation of 293.3 and 79.6 Bq/ m(3), respectively. The effective dose to the workers was estimated and this varied from 0.99 to 3.12 mSv/ y, with a mean of 1.85 mSv/y. The radon concentrations were found to be within the reference levels of ICRP.

Thoron: its metrology, health effects and implications for radon epidemiology: a summary of roundtable discussions

A roundtable discussion was made at the end of the workshop. All the presentations were summarised in this discussion. It involved measurement techniques, quality assurance and dose assessment and health effects of thoron and its progeny. In particular, major epidemiological studies may be affected by thoron interference in radon measurements. Since their data are not sufficient when compared with that of radon, further efforts in thoron studies will be needed.

Soil quality assessment under emerging regulatory requirements

New and emerging policies that aim to set standards for protection and sustainable use of soil are likely to require identification of geographical risk/priority areas. Soil degradation can be seen as the change or disturbance in soil quality and it is therefore crucial that soil and soil quality are well understood to protect soils and to meet legislative requirements. To increase this understanding a review of the soil quality definition evaluated its development, with a formal scientific approach to assessment beginning in the 1970s, followed by a period of discussion and refinement. A number of reservations about soil quality assessment expressed in the literature are summarised. Taking concerns into account, a definition of soil quality incorporating soil's ability to meet multifunctional requirements, to provide ecosystem services, and the potential for soils to affect other environmental media is described. Assessment using this definition requires a large number of soil function dependent indicators that can be expensive, laborious, prone to error, and problematic in comparison. Findings demonstrate the need for a method that is not function dependent, but uses a number of cross-functional indicators instead. This method to systematically prioritise areas where detailed investigation is required, using a ranking based against a desired level of action, could be relatively quick, easy and cost effective. As such this has potential to fill in gaps and compliment existing monitoring programs and assist in development and implementation of current and future soil protection legislation.

The impact of dosimetry uncertainties on dose-response analyses

Radiation dose estimates used in epidemiological studies are subject to many sources of uncertainty, and the error structure may be a complicated mixture of different types of error. Increasingly, efforts are being made to evaluate dosimetry uncertainties and to take account of them in statistical analyses. The impact of these uncertainties on dose-response analyses depends on the magnitude and type of error. Errors that are independent from subject to subject (random errors) reduce statistical power for detecting a dose-response relationship, increase uncertainties in estimated risk coefficients, and may lead to underestimation of risk coefficients. The specific effects of random errors depend on whether the errors are "classical" or "Berkson." Classical error can be thought of as error that arises from an imprecise measuring device, whereas Berkson error occurs when a single dose is used to represent a group of subjects (with varying true doses). Uncertainties in quantities that are common to some or all subjects are "shared" uncertainties. Such uncertainties increase the possibility of bias, and accounting for this possibility increases the length of confidence intervals. In studies that provide a direct evaluation of risk at low doses and dose rates, dosimetry errors are more likely to mask a true effect than to create a spurious one. In addition, classical errors and shared dosimetry uncertainties increase the potential for bias in estimated risks coefficients, but this potential may already be large due to the extreme vulnerability to confounding in studies involving very small relative risk.

A simulation study of radon and thoron discrimination problem in case-control studies

In most countries, radon is the dominant contributor among natural radiation sources to the radiation exposure dose of the general population. Numerous case-control studies of residential radon and lung cancer have been conducted using passive radon (Rn-222) detectors. These studies showed that radon may increase lung cancer risk, but most of them did not show a significant risk. Recently it was shown that the readings of passive radon detectors that do not employ thoron (Rn-220) discrimination techniques are affected by thoron. Therefore, we conducted a simulation study to evaluate the possible effect of thoron interference on the estimation of radon-related lung cancer risk. Various assumptions were made based on the number of cases, matching ratio, baseline risk, true radon-related risk, distribution of radon and thoron concentrations, correlation between radon and thoron, and radon detectors. The results suggested that in certain circumstances thoron interference in radon measurements resulted in an approximately 90% downward bias. In addition, the magnitude of the bias increased as the geometric mean and geometric standard error of radon concentration decreased and those of thoron increased. In order to resolve this problem, it is necessary to use passive radon detectors with thoron discrimination techniques in epidemiological studies.

Radon control systems in existing and new construction: a review

In support of the implementation of the new Canadian radon guideline, a comprehensive review of radon mitigation techniques used in countries around the world was undertaken, with particular emphasis on North America and Europe that have climates and construction techniques similar to Canada. The results of this review are presented here as an aid to administrators of radon control programmes, companies offering radon testing and mitigation services and other concerned parties, both in Canada and elsewhere, who are facing issues of implementing a radon control strategy. A wide variety of radon mitigation strategies have been employed worldwide and all have achieved some success in reducing radon concentrations. Generally, active mitigation techniques involving physical alterations to a house (e.g. sub-slab depressurisation) are more effective in achieving a sustained and substantial radon reduction than passive techniques (e.g. improved ventilation or sealing of cracks). To a large extent, the choice of an optimal mitigation strategy will depend on the building type, soil conditions and climate. Radon levels should be measured at periodic intervals after remediation, perhaps once every 5 y, to ensure that concentrations continue to remain at acceptable levels.

Health effects of radon: a review of the literature

PURPOSE

Radon is natural radioactive noble gas that can be found in soil, water, outdoor and indoor air. Exposure to radon accounts for more that 50% of the annual effective dose of natural radioactivity. The purpose of the current review is to summarize recent literature and evaluate the weight of evidence on the adverse health effects of radon.

CONCLUSIONS

Radon is an established human lung carcinogen based on human epidemiological data supported by experimental evidence of mutagenesis studies in cell culture and laboratory animals. Extrapolation from cohort studies on miners suggested that radon is the second leading cause of lung cancer death after tobacco smoke. The majority of studies on the relationship between radon and other types of cancers showed weak or no association. Low levels of radon can be found in drinking water; however, radon released during water usage adds small quantities to indoor radon concentration. Studies showed that the risk of stomach cancer and other gastrointestinal malignancies from radon in drinking water is small. Studies of the genetic and cytogenetic effects of indoor radon yielded equivocal results; while radon exposure in miners induces gene mutations and chromosomal aberrations. Numerous in vitro cytogenetic studies demonstrated that radon induces different types of genetic and cytogenetic damage that is likely to play a role in radon lung carcinogenesis.

Measurement error in the explanatory variable of a binary regression: regression calibration and integrated conditional likelihood in studies of residential radon and lung cancer

In epidemiology, one approach to investigating the dependence of disease risk on an explanatory variable in the presence of several confounding variables is by fitting a binary regression using a conditional likelihood, thus eliminating the nuisance parameters. When the explanatory variable is measured with error, the estimated regression coefficient is biased usually towards zero. Motivated by the need to correct for this bias in analyses that combine data from a number of case-control studies of lung cancer risk associated with exposure to residential radon, two approaches are investigated. Both employ the conditional distribution of the true explanatory variable given the measured one. The method of regression calibration uses the expected value of the true given measured variable as the covariate. The second approach integrates the conditional likelihood numerically by sampling from the distribution of the true given measured explanatory variable. The two approaches give very similar point estimates and confidence intervals not only for the motivating example but also for an artificial data set with known properties. These results and some further simulations that demonstrate correct coverage for the confidence intervals suggest that for studies of residential radon and lung cancer the regression calibration approach will perform very well, so that nothing more sophisticated is needed to correct for measurement error.

Environmental inequity in England: small area associations between socio-economic status and environmental pollution

Recent studies have suggested that more deprived people tend to live in areas characterised by higher levels of environmental pollution. If generally true, these environmental inequities may combine to cause adverse effects on health and also exacerbate problems of confounding in epidemiological studies. Previous studies of environmental inequity have nevertheless indicated considerable complexity in the associations involved, which merit further investigation using more detailed data and more advanced analytical methods. This study investigates the ways in which environmental inequity in England varies in relation to: (a) different environmental pollutants (measured in different ways); (b) different aspects of socio-economic status; and (c) different geographical scales and contexts (urban vs. rural). Associations were analysed between the Index of Multiple Deprivation (IMD2004) and its domains and five sets of environmental pollutants (relating to road traffic, industry, electro-magnetic frequency radiation, disinfection by-products in drinking water and radon), measured in terms of proximity, emission intensity and environmental concentration. Associations were assessed using bivariate and multivariate correlation, and by comparing the highest and lowest quintiles of deprivation using Student's t-test and Hotelling's T2. Associations are generally weak (R(2) < 0.10), and vary depending on the specific measures used. Strongest associations occur with what can be regarded as contingent components of deprivation (e.g. crime, living environment, health) rather than causative factors such as income, employment or education. Associations also become stronger with increasing level of spatial aggregation. Overall, the results suggest that any triple jeopardy for health, and problems of confounding, associated with environmental inequities are likely to be limited.

A detailed evaluation of the individual health benefits arising in a domestic property following radon remediation--a case-study in Northamptonshire, U.K

Radon gas occurs naturally in the environment with variable distribution, concentrating sufficiently in the built environment in some areas to pose a public health risk. Radon levels can be successfully reduced in affected buildings, and large-scale remediation programmes have been justified in terms of accrued costs and benefits. We present results from a house where radon levels in the main living-room and master bedroom were monitored on an hourly basis over extended periods before and after radon remediation by sub-slab depressurisation. These results were combined with results from a recent occupancy survey to estimate the health impact on occupants spending varying times in the home. Prior to remediation, mean hourly radon exposure is moderately linearly correlated (R(2)=0.66-0.78) with time spent in the house. Following remediation, correlation is significantly enhanced (R(2)=0.91-0.95), but the exposure reduction of an occupant following remediation is less than that predicted using the NRPB protocol.

Lowering the UK domestic radon Action Level to prevent more lung cancers--is it cost-effective?

Case studies have shown that radon gas can accumulate within domestic properties at sufficiently high levels that it can cause lung cancer, and recent studies have suggested that this risk remains significant below the UK domestic Action Level of 200 Bq m(-3). Raised radon levels can be reduced by engineering measures, and it has been shown that domestic radon remediation programmes in UK Affected Areas can result in reduced risks to the population and can be cost-effective. We consider here the benefits and costs of the domestic radon remediation programme in Northamptonshire, UK, and consider the implications for that programme of reducing the UK Action Level below its present value. A radon remediation programme based on an Action Level above 200 Bq m(-3) will cost less and will target those most at risk, but will be less cost-effective and will lead to higher residual dose and greater risk of cancer in the remaining population. Reducing the Action Level below 200 Bq m(-3) will prevent more cancers, but at significantly higher cost. It will also be less cost-effective, because remediation of a significant number of houses with moderate radon levels will provide only a modest health benefit to occupants. Overall, a completed radon remediation programme of the type implemented in Northamptonshire is most cost-effective for an Action Level between 200 and 300 Bq m(-3). The implications for future health policy are discussed.

Absorbed fractions for electrons and beta particles in sensitive regions of human respiratory tract

The absorbed fractions (AF) of electrons in sensitive layers of human respiratory tract were calculated in this paper. For that purpose the source code for simulation package PENELOPE, based on Monte Carlo method, was developed. The human respiratory tract was modeled according to ICRP66 publication, where AF of electrons was calculated using EGS4 simulation software. Some approximations used in ICRP66 were corrected in this work, and new values of AF for radon progeny are given. Minimal energy (EABS) that electron can have during transport through material is 1 keV in ICRP66, while it is set as low as 100 eV in the presented work. Lowering value of EABS gives more accurate results for AF when initial energy of electrons is below 50 keV. To represent tissue, water is used in ICRP66, while in this work epithelia tissue is used.

The perceived health risks of indoor radon gas and overhead powerlines: a comparative multilevel approach

Radon and overhead powerlines are two radiation risk cases that have raised varying levels of concern among the general public and experts. Despite both involving radiation-a typically feared and unseen health hazard-individuals' perceptions of the two risk cases may invoke rather different factors. We examined individual and geographic-contextual factors influencing public perceptions of the health risks of indoor radon gas and overhead powerlines in a comparative research design, utilizing a postal questionnaire with 1,528 members of the general public (response rate 28%) and multilevel modeling techniques. This study found that beliefs about the two risk cases mainly differed according to the level of "exposure"-defined here in terms of spatial proximity. We argue that there are two alternative explanations for this pattern of findings: that risk perception itself varies directly with proximity, or that risk is more salient to concerned people in the exposed areas. We also found that while people living in high radon areas are more concerned about the risks of indoor radon gas, they find these risks more acceptable and have more trust in authorities. These results might reflect the positive effects of successive radon campaigns in high radon areas, which may have raised awareness and concern, and at the same time may have helped to increase trust by showing that the government takes the health risks of indoor radon gas seriously, suggesting that genuine risk communication initiatives may have positive impacts on trust in risk management institutions.