Estimation of lung cancer deaths attributable to indoor radon exposure in upper northern Thailand

The correlation between indoor and soil gas radon concentrations in Kiraz district, İzmir

All humans are exposed to radon, the primary source of natural radiation, which can harm people due to natural processes rather than human activity. Thus, it is of significant importance to determine the levels of radon in indoor, soil gas, water, and outdoors. Radon concentration (CRn) was measured in Kiraz district, İzmir, and the correlation between the indoor and soil gas CRn values was investigated. The indoor CRn values measured in 40 randomly selected dwellings in Kiraz exhibited a wide range from 19.50 ± 2.50 to 204.70 ± 8.00 Bq m-3 with an average value of 61.11 ± 4.23 Bq m-3. The measured indoor CRn values were compared to the reference levels in the world to help control radon in the dwellings. Indoor CRn values were lower than the ICRP reference level of 300 Bq m-3 in all of the dwellings studied. Furthermore, in 34 dwellings (representing 85% of the total number of dwellings studied), indoor CRn values were lower than the WHO reference level of 100 Bq m-3. Health hazard indices, namely annual effective dose (AED) and excess lifetime cancer risk (ELCR), were also calculated for each dwelling and compared with internationally acceptable levels to estimate the risk to human health. The AED values varied from 0.49 ± 0.06 to 5.16 ± 0.20 mSv y-1 with an average value of 1.54 ± 0.11 mSv y-1, which exceeds the world average of 1.15 mSv y-1 as reported by UNSCEAR. The ELCR values ranged from 2.05 ± 0.26 × 10-3 to 21.55 ± 0.84 × 10-3 with an average value of 6.43 ± 0.44 × 10-3, exceeding the world average of 0.29 × 10-3 as reported by UNSCEAR. The soil gas CRn values measured exhibited a wide variation ranging from 129.25 ± 6.38 Bq m-3 to 6172.64 ± 44.06 Bq m-3 with an average value of 1291.79 ± 18.70 Bq m-3. The soil gas CRn values were less than 10,000 Bq m-3; hence, the research area is categorized as "low radon risk areas" according to Sweden Criteria, and so no special constructions are required in the studied area. When soil gas CRn values were compared to indoor CRn values, no linear relationship was found between the CRn values. However, a strong positive linear correlation was found between indoor and soil gas CRn values less than 200 Bq m-3 and 2500 Bq m-3, respectively.

Exploring the Disparity in Indoor/Outdoor Time and Radon Exposure as Possible Factors Contributing to the Unexpected Increase in Lung Cancer Risk among Non-Smoking Women

According to a NIH study, Lung cancer among individuals who have never smoked is more prevalent in women and occurs at an earlier age than in smokers. The rise in lung cancer rates among female non-smokers might be linked to radon inhalation and should be further investigated. Our theory is based on the differences in radon exposure between males and females, which can be attributed to the variations in time spent indoors versus outdoors. Over the past few years, the smoking rates have shown a steady decline in the United States and other developed countries. This decrease in smoking prevalence has led to a new shift in the primary risk factors associated with lung cancer. Although tobacco smoke historically served as the primary cause of lung cancer, the reduction in smoking rates has allowed other risk factors, such as radon exposure, to come to the forefront. Given that women in certain countries, on average, might spend more time indoors compared to men, they are potentially exposed to higher levels of radon. This increased exposure could explain the rising rates of lung cancer among female non-smokers. The theory is still in its nascent stages and requires further research and validation. However, if proven correct, it could significantly alter our understanding of lung cancer risk factors and lead to new prevention. It is therefore crucial to expedite the review and publication of this theory, given its potential implications for public health.

Radon and lung cancer: Current status and future prospects

Beyond tobacco smoking, radon takes its place as the second most significant contributor to lung cancer, excluding hereditary and other biologically related factors. Radon and its byproducts play a pivotal role in exposing humans to elevated levels of natural radiation. Approximately 10-20 % of lung cancer cases worldwide can be attributed to radon exposure, leading to between 3 % and 20 % of all lung cancer-related deaths. Nevertheless, a knowledge gap persists regarding the association between radon and lung cancer, impeding radon risk reduction initiatives globally. This review presents a comprehensive overview of the current state of research in epidemiology, cell biology, dosimetry, and risk modeling concerning radon exposure and its relevance to lung cancer. It also delves into methods for measuring radon concentrations, monitoring radon risk zones, and identifying priorities for future research.

Health Risk Assessment of Heavy Metals in Indoor Household Dust in Urban and Rural Areas of Chiang Mai and Lamphun Provinces, Thailand

Indoor exposure to heavy metals poses human health risks worldwide, but study reports from Thailand are still limited, particularly in rural and urban areas. We measured the heavy metals in a hundred indoor household dust samples collected from urban and rural areas in Chiang Mai and Lamphun provinces and found a significantly higher concentration of As in rural areas and Cd in urban areas with industrial activities. The source identification of the heavy metals showed significant enrichment from traffic emissions, paint, smoking, and mixed sources with natural soil. From health risk assessment models, children were more vulnerable to noncarcinogenic risks (HI = 1.45), primarily via ingestion (HQ = 1.39). Lifetime cancer risks (LCRs) due to heavy metal exposure were found in adults (LCR = 5.31 × 10-4) and children (LCR = 9.05 × 10-4). The cancer risks from As were higher in rural areas via ingestion, while Cr and Ni were higher in urban areas via inhalation and ingestion, respectively. This study estimated that approximately 5 out of 10,000 adults and 9 out of 10,000 children among the population may develop cancer in their lifetime from exposure to indoor heavy metals in this region.

Radon exposure: a major cause of lung cancer in nonsmokers

Exposure to radon can impact human health. This is a nonsystematic review of articles written in English, Spanish, French, or Portuguese published in the last decade (2013-2023), using databases such as PubMed, Google Scholar, EMBASE, and SciELO. Search terms selected were radon, human health, respiratory diseases, children, and adults. After analyzing the titles and abstracts, the researchers initially identified 47 studies, which were subsequently reduced to 40 after excluding reviews, dissertations, theses, and case-control studies. The studies have shown that enclosed environments such as residences and workplaces have higher levels of radon than those outdoors. Moreover, radon is one of the leading causes of lung cancer, especially in nonsmokers. An association between exposure to radon and development of other lung diseases, such as asthma and COPD, was also observed. It is crucial to increase public awareness and implement governmental control measures to reduce radon exposure. It is essential to quantify radon levels in all types of buildings and train professionals to conduct such measurements according to proven efficacy standards. Health care professionals should also be informed about this threat and receive adequate training to deal with the effects of radon on human health.

Small RNA Deep Sequencing of Circulating Small RNAs Discovers a Unique Panel of microRNAs as Feasible and Reliable Biomarkers of Non-Small Cell Lung Cancers in Northern Thailand

OBJECTIVE

This study aimed to assess the practicality and reliability of utilizing microRNAs (miRNAs) as a potential screening and diagnosing tool for non-small cell lung cancers (NSCLCs) in Northern Thailand.

METHODS

Small RNA sequencing and a literature review was performed to obtain a list of serum miRNA candidates. Serum levels of these selected miRNA candidates were measured in patients with NSCLC and healthy volunteers by real-time RT-PCR and receiver operating characteristic curve (ROC) were used to assess diagnostic performance.

RESULTS

Sequencing data revealed 148 known miRNAs and 230 novel putative miRNAs in serum samples; 19 serum miRNAs were significantly downregulated and 242 were upregulated. Seven miRNAs selected according to sequencing data and 11 miRNAs according to previous reports were evaluated in training cohort (45 lung cancer patients, 26 controls) and 6 miRNAs were found differentially expressed (p < 0.05, Mann Whitney U test) and associated (p < 0.05, Chi-square test) with NSCLC development. Further analysis and verification identified an optimal combination of 4 miRNAs composed of hsa-miR23a, hsa-miR26b, hsa-miR4488 and novel-130 to provide the optimal AUC of 0.901±0.034. Detection of serum miRNA by real-time RT-PCR showed good reproducibility with the coefficient of variation (CV) ≤ 4%. The optimal screening miRNAs panel was primarily identified through sequencing data of local patient population, thus indicating that the etiology of NSCLCs may differ from one population to other and thus require a unique panel of miRNAs for their identification.

CONCLUSION

Circulating miRNA is a feasible screening tool for NSCLCs. Nevertheless, populations with different lung cancer etiology may need to identify their own most suitable miRNA panel.

Evaluation of indoor 222Rn and 220Rn concentrations in Dakshina Kannada, Karnataka, India

Naturally occurring radioactive gases which tend to build up (radon and thoron) in indoor environs can cause deleterious health effects including the development of lung cancer. The present study aims to measure ²²²Rn and ²²⁰Rn levels in dwellings in different seasons in the environs of Dakshina Kannada region of India. The ²²²Rn and ²²⁰Rn concentrations were measured in the monsoon, autumn, winter, and summer seasons using Solid State Nuclear Track Detector (SSNTD, LR-115 type II) films fixed in single-entry pinhole cylindrical twin-cup dosimeters. The higher ²²²Rn levels in indoors were observed during winter with an average concentration of 38.8 Bq m^-3 and lower during summer with an average of 14.1 Bq m^-3. The average indoor thoron concentration was also highest in winter with an average value of 25.5 Bq m^-3 and lowest in summer with 8.8 Bq m^-3. The annual inhalation dose ranged from 0.44 to 1.06 mSv year^-1 with a mean value of 0.66 mSv year^-1. The annual effective dose varied from 1.03 to 2.57 mSv year^-1 with an average value of 1.59 mSv year^-1. The assessed values have been contrasted with the limit suggested by the UNSCEAR and the ICRP and were found to be within the permissible level. The normality of frequency distribution curves of ²²²Rn and ²²⁰Rn concentrations was assessed by the Kolmogorov-Smirnov test.

Health Effects of Natural Environmental Radiation during Burning Season in Chiang Mai, Thailand

This paper presents the first measurement of the investigation of the health impacts of indoor radon exposure and external dose from terrestrial radiation in Chiang Mai province during the dry season burning between 2018 and 2020. Indoor radon activity concentrations were carried out using a total of 220 RADUET detectors in 45 dwellings of Chiang Mai (7 districts) during burning and non-burning seasons. Results show that indoor radon activity concentration during the burning season (63 ± 33 Bq/m3) was significantly higher (p < 0.001) compared to the non-burning season (46 ± 19 Bq/m3), with an average annual value of 55 ± 28 Bq/m3. All values of indoor radon activity concentration were greater than the national (16 Bq/m3) and worldwide (39 Bq/m3) average values. In addition, the external dose from terrestrial radiation was measured using a car-borne survey during the burning season in 2018. The average absorbed rate in the air was 66 nGy/h, which is higher than the worldwide average value of 59 nGy/h. This might be due to the high activity concentrations of 238U and 323Th in the study area. With regards to the health risk assessment, the effective dose due to indoor radon exposure, external (outdoor) effective dose, and total annual effective dose were 1.6, 0.08, and 1.68 mSv/y, respectively. The total annual effective dose is higher than the worldwide average of 1.15 mSv/y. The excess lifetime cancer risk and radon-induced lung cancer risk during the burning season were 0.67% and 28.44 per million persons per year, respectively. Our results substantiate that indoor radon and natural radioactive elements in the air during the burning season are important contributors to the development of lung cancer.