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Liu Y, Xu Y, Xu W, He Z, Fu C, Du F. Radon and lung cancer: Current status and future prospects. Crit Rev Oncol Hematol 2024; 198:104363. [PMID: 38657702 DOI: 10.1016/j.critrevonc.2024.104363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/24/2024] [Accepted: 04/13/2024] [Indexed: 04/26/2024] Open
Abstract
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.
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Affiliation(s)
- Yan Liu
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei 430079, China
| | - Yanqing Xu
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei 430079, China.
| | - Wei Xu
- Health Management Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Zhengzhong He
- School of Nuclear Science and Technology, University of South China, Hengyang, Hunan 421001, China
| | - Cong Fu
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei 430079, China
| | - Fen Du
- Department of Biochemistry and Molecular Biology, Wuhan University TaiKang Medical School (School of Basic Medical Sciences), Wuhan, Hubei 430071, China
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Zhang Y, Yan Q, Angley M, Lu L, Miller EC, Judd S, Field RW, Kahe K. Smoking Modifies the Association Between Radon Exposure and Incident Ischemic Stroke: The REGARDS Study. Stroke 2023; 54:2737-2744. [PMID: 37846562 PMCID: PMC10615728 DOI: 10.1161/strokeaha.123.043648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/23/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Exposure to radon has been linked to lung cancer and other lung diseases. Although biologically plausible, research of residential radon exposure in relation to stroke risk is scarce. METHODS Study participants were from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) cohort (n=30 239), which consisted of male and female non-Hispanic Black and White adults aged 45 and older. After excluding participants with baseline stroke and transient ischemic attack, and missing information on exposure and outcome of interest, the final sample size was 26 950. The primary outcome was time to the first ischemic stroke through September 30, 2020. County-level radon measures from Lawrence Berkeley National Laboratory were linked to each participant based on their geocoded residential history. We used Cox proportional hazards regression models with a time-dependent exposure to estimate hazard ratios and 95% CIs for the association. RESULTS After controlling for potential confounding factors including demographic, lifestyle, clinical variables, and PM2.5, radon exposure was significantly associated with incident ischemic stroke among never-smokers (hazard ratio, 1.39 [95% CI, 1.01-1.90]) but not ever-smokers. The results were generally consistent in the sensitivity analysis when using radon measures from state/Environmental Protection Agency residential radon survey. CONCLUSIONS Findings from this study suggest that the association between residential radon exposure and incidence of ischemic stroke varies by smoking status and may be prominent in never-smokers. Further studies incorporating indoor-radon measures are needed to confirm these findings.
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Affiliation(s)
- Yijia Zhang
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Qi Yan
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, NY
| | - Meghan Angley
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Liping Lu
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Eliza C Miller
- Department of Neurology, Division of Stroke and Cerebrovascular Disease, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York
| | - Suzanne Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL
| | - R. William Field
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, NY
- Department of Occupational and Environmental Health and Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Ka Kahe
- Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
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Yarsky E, Banzon TM, Phipatanakul W. Effects of Allergen Exposure and Environmental Risk Factors in Schools on Childhood Asthma. Curr Allergy Asthma Rep 2023; 23:613-620. [PMID: 37651001 PMCID: PMC11262705 DOI: 10.1007/s11882-023-01108-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE OF REVIEW This review aims to assess the prevalence of common allergen exposures and environmental risk factors for asthma in schools, examine the underlying mechanisms of these environmental risk factors, and explore possible prevention strategies. RECENT FINDINGS Cockroach, mouse, dust mites, fungi, viral infections, ozone pollution, and cleaning products are common allergen exposures and environmental risk factors in schools which may affect asthma morbidity. Novel modifiable environmental risk factors in schools are also being investigated to identify potential associations with increased asthma morbidity. While several studies have investigated the benefit of environmental remediation strategies in schools and their impact on asthma morbidity, future studies are warranted to further define the effects of modifiable risk factors in schools and determine whether school mitigation strategies may help improve asthma symptoms in students with asthma.
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Affiliation(s)
- Eva Yarsky
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Tina M Banzon
- Division of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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Martinelli S, Medeiros AN, de Souza RF, Marconi AM, Navoni JA. Analysis of the cancer occurrence related to natural radioactivity in the Rio Grande do Norte State, Brazil. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:89140-89152. [PMID: 37442937 DOI: 10.1007/s11356-023-28708-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023]
Abstract
The state of Rio Grande do Norte, located in the Northeast region of Brazil, has areas of granites and pegmatites with minerals that have varying concentrations of uranium. Consequently, high concentrations of radon gas, a carcinogenic substance for humans, can occur. The present study aimed to assess the occurrence of cancer and its association with exposure to sources of natural radioactivity using geological and geophysical information in the aforementioned state. The spatial dependence of pulmonary, breast, stomach, leukemia, and skin cancer cases with the location of radioisotope sources were analyzed using geoprocessing tools. The geoprocessing analysis showed a differential pattern of uranium emission throughout the state, with the highest emission from areas with pegmatites outcrops. A spatial dependency of cancer cases was shown (Moran index: 0.43; p < 0.01). Moreover, a higher rate of natural radioactivity-cancer cases was associated with the high-intensity natural radioactivity areas: odds ratio:1.21 (95% CI 1.20; 1.23), following the same pattern when separately compared the different related types of cancer. These results highlight the importance of natural radioactivity as a public health problem in the Brazilian environmental scenario, confirming the need for further studies as the first toward understanding and implementing health management strategies mitigating the exposures, especially in areas of environmental risk.
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Affiliation(s)
- Simone Martinelli
- Development and Environment, Biosciences Center, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
| | - Amanda Nogueira Medeiros
- Development and Environment, Biosciences Center, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
| | - Raquel Franco de Souza
- Development and Environment, Biosciences Center, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
- Center for Exact and Earth Sciences - Department of Geology, Laboratory of Geochemistry, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
| | | | - Julio Alejandro Navoni
- Development and Environment, Biosciences Center, Federal University of Rio Grande Do Norte, Avenida Sen. Salgado Filho, No. 3000, Lagoa Nova, Natal, RN, 59078-970, Brazil.
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Banzon TM, Greco KF, Li L, Mukharesh L, Vieira CLZ, Steiner MK, Hauptman M, Ratchataswan T, Koutrakis P, Phipatanakul W, Gaffin JM. Effect of radon exposure on asthma morbidity in the School Inner-City Asthma study. Pediatr Pulmonol 2023; 58:2042-2049. [PMID: 37083192 PMCID: PMC10330665 DOI: 10.1002/ppul.26429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/06/2023] [Accepted: 03/31/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Radon may have a role in obstructive lung disease outside its known carcinogenicity. Little is known about radon's effects on asthma morbidity. OBJECTIVE To determine the effect of radon on fractional exhaled nitric oxide (FE NO), asthma symptom-days, and lung function in inner-city asthmatic school children. METHODS Two hundred ninety-nine school-aged asthmatic children enrolled in the School Inner-City Asthma Study (SICAS-1) were followed. One and two-month averaged radon was assessed using a spatiotemporal model predicting zip code-specific monthly exposures. FE NO and spirometry were measured twice during the academic year. Asthma symptoms were assessed four times during the academic year. The interaction between indoor radon exposure (Bq/m3 ) and seasonality predicting log-transformed FE NO, forced expiratory volume in 1 s (FEV1 ) % predicted, forced vital capacity (FVC) % predicted, FEV1 /FVC, and asthma symptom-days was evaluated. RESULTS Participants with high radon exposure had greater change in FE NO from warm to cold periods compared to low radon exposure (interaction p = 0.0013). Participants with >50th percentile radon exposure experience significant FE NO increase from warm to cold weather (β $\beta $ = 0.29 [95% confidence interval [CI]: 0.04-0.54], p = 0.0240). We report a positive association between radon 1-month moving average (incidence rate ratio [IRR] = 1.01, p = 0.0273) and 2-month moving average (IRR = 1.01, p = 0.0286) with maximum asthma symptom-days (n = 299, obs = 1167). CONCLUSIONS In asthmatic children, radon may be associated with increased asthma morbidity, suggesting radon may be a modifiable environmental risk factor for airway inflammation.
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Affiliation(s)
- Tina M. Banzon
- Division of Allergy and Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Kimberly F. Greco
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA, USA
| | - Longxiang Li
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Lana Mukharesh
- Division of Pulmonary Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | | | - M. Kathryn Steiner
- Department of Allergy and Immunology, Boston Children’s Hospital, Boston, MA, USA
| | - Marissa Hauptman
- Pediatric Environmental Health Center, Division of General Pediatrics, Boston Children’s Hospital
| | | | - Petros Koutrakis
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Jonathan M. Gaffin
- Division of Pulmonary Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
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Palmer JD, Prasad RN, Cioffi G, Kruchtko C, Zaorsky NG, Trifiletti DM, Gondi V, Brown PD, Perlow HK, Mishra MV, Chakravarti A, Barnholtz-Sloan JS, Ostrom QT. Exposure to radon and heavy particulate pollution and incidence of brain tumors. Neuro Oncol 2023; 25:407-417. [PMID: 35762336 PMCID: PMC9925706 DOI: 10.1093/neuonc/noac163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Global incidence for brain tumors varies substantially without explanation. Studies correlating radon exposure and incidence are inconclusive. Particulate pollution has been linked to increased tumor incidence. Particulates may disrupt the blood-brain barrier allowing intracranial exposure to oncogenic radon. We investigated the relationship between exposure to residential radon, particulate pollution, and brain tumor incidence in the United States (US). METHODS County-level median radon testing results and annual air quality index values were obtained and divided into tertiles. Counties without both values were excluded. Four groups of counties were generated: high particulate/high radon (high/high), high/low, low/high, and low/low. Using incidence data from the Central Brain Tumor Registry of the US (provided by CDC's National Program of Cancer Registries and NCI's SEER), annual age-adjusted incidence rates (AAAIRs) by group were generated by behavior. Incidence rate ratios were calculated to examine for significant differences (α = .05). Poisson regression accounting for possible confounders was conducted. RESULTS Counties with available data included 83% of the US population. High/high exposure was significantly associated with increased AAAIR of all non-malignant tumors (up to 26% higher, including most meningiomas) even after accounting for potential confounders. An increased AAAIR was noted for all malignant tumors (up to 10% higher), including glioblastoma, but was negated after accounting for demographic/socioeconomic differences. CONCLUSIONS We present the first report suggesting increased non-malignant brain tumor incidence in regions with high particulate and radon exposure. These findings provide insight into unexplained variation in tumor incidence. Future studies are needed to validate these findings in other populations.
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Affiliation(s)
- Joshua D Palmer
- Department of Radiation Oncology at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Rahul N Prasad
- Department of Radiation Oncology at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Gino Cioffi
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Carol Kruchtko
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Nicholas G Zaorsky
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Daniel M Trifiletti
- Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Vinai Gondi
- Brain and Spine Tumor Center, Northwestern Medicine Cancer Center and Proton Center, Warrensville, Illinois, USA
| | - Paul D Brown
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Haley K Perlow
- Department of Radiation Oncology at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Mark V Mishra
- Department of Radiation Oncology, University of Maryland, Baltimore, Maryland, USA
| | - Arnab Chakravarti
- Department of Radiation Oncology at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Jill S Barnholtz-Sloan
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.,Center for Biomedical Informatics and Information Technology (CBIIT), National Cancer Institute, Bethesda, Maryland, USA
| | - Quinn T Ostrom
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.,Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA.,The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, North Carolina, USA.,Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
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Ren J, Wang S, Bi K, Cheng M, Liu C, Zhou L, Xue X, Ji X. Machine Learning-Enabled Framework for High-Throughput Screening of MOFs: Application in Radon/Indoor Air Separation. ACS APPLIED MATERIALS & INTERFACES 2023; 15:1305-1316. [PMID: 36575576 DOI: 10.1021/acsami.2c19207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Radon and its progeny may cause severe health hazards, especially for people working in underground spaces. Therefore, in this study, a hybrid artificial intelligence machine learning-enabled framework is proposed for high-throughput screening of metal-organic frameworks (MOFs) as adsorbents for radon separation from indoor air. MOFs from a specific database were initially screened using a pore-limiting diameter filter. Subsequently, random forest classification and grand canonical Monte Carlo simulations were implemented to identify MOFs with a high adsorbent performance score (APS) and high regenerability (R %). Interpretability and trustworthiness were determined by variable importance analysis , and adsorption mechanisms were elucidated by calculating the adsorption sites using Materials Studio. Notably, two MOF candidates were discovered with higher APS values in both the radon/N2 and radon/O2 systems compared with that of ZrSQU which is the best-performing MOF thus far, with R % values exceeding 85%. Furthermore, the proposed framework can be flexibly applied to multiple data sets due to good performance in model transfer. Therefore, the proposed framework has the potential to provide guidelines for the strategic design of MOFs for radon separation.
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Affiliation(s)
- Junyu Ren
- School of Chemical Engineering, Sichuan University, Sichuan610065, China
| | - Shihui Wang
- School of Chemical Engineering, Sichuan University, Sichuan610065, China
| | - Kexin Bi
- School of Chemical Engineering, Sichuan University, Sichuan610065, China
- Department of Bioprocess Engineering, Institute of Biotechnology, Technische Universität Berlin, Berlin10623, Germany
| | - Min Cheng
- School of Chemical Engineering, Sichuan University, Sichuan610065, China
| | - Chong Liu
- School of Chemical Engineering, Sichuan University, Sichuan610065, China
| | - Li Zhou
- School of Chemical Engineering, Sichuan University, Sichuan610065, China
| | - Xiaoyu Xue
- School of Chemical Engineering, Sichuan University, Sichuan610065, China
| | - Xu Ji
- School of Chemical Engineering, Sichuan University, Sichuan610065, China
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Boz S, Berlin C, Kwiatkowski M, Bochud M, Bulliard JL, Zwahlen M, Röösli M, Vienneau D. A prospective cohort analysis of residential radon and UV exposures and malignant melanoma mortality in the Swiss population. ENVIRONMENT INTERNATIONAL 2022; 169:107437. [PMID: 36152363 DOI: 10.1016/j.envint.2022.107437] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/31/2022] [Accepted: 07/25/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Radon is a radioactive noble gas naturally found in the earth crust that can accumulate in buildings. In addition to lung cancer, alpha particles emitted by radon may contribute to the risk of skin cancer. We evaluated the association between residential radon exposure and skin cancer mortality, over a fifteen year period, taking residential ultra-violet (UV) exposure into account. METHODS We included 4.9 million adults from the Swiss National Cohort. Hazard ratios for melanoma mortality were estimated using Cox proportional hazard models (20+ years old; follow-up 2001-2015). Long-term modelled residential radon and ambient UV exposures were assigned at baseline, and included together in the Cox models. With age as a time scale, models were adjusted for calendar time, sex, marital status, education, mother tongue, socioeconomic position, and occupational environment with potential for UV exposure. Age specific hazard ratios were derived. Effect modification, sensitivity analyses and the shape of the exposure response, as well as secondary analysis using other outcome definitions, were investigated. RESULTS During follow-up (average of 13.6 years), 3,979 melanoma deaths were observed. Associations declined with age, with an adjusted hazard ratio per 100 Bq/m3 radon at age 60 of 1.10 (95% CI: 0.99, 1.23). The dose-response showed an approximate linear trend between the minimum and mean radon exposure of 75 Bq/m3. Having outdoor occupation significantly increased the risk of melanoma mortality associated with UV exposure compared to indoor jobs. Analysis restricted to the last five years of follow-up showed similar results compared to the main analysis. Similar associations were found for mortality from melanoma and non-melanoma skin cancer combined. CONCLUSION With double the follow-up time, this study confirmed the previously observed association between residential radon exposure and melanoma and non-melanoma skin cancer mortality in Switzerland. Accumulation of radon indoors is preventable and of public health importance.
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Affiliation(s)
- Seçkin Boz
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Claudia Berlin
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Marek Kwiatkowski
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Murielle Bochud
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
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Lu L, Zhang Y, Chen C, Field RW, Kahe K. Radon exposure and risk of cerebrovascular disease: a systematic review and meta-analysis in occupational and general population studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:45031-45043. [PMID: 35460001 PMCID: PMC9209369 DOI: 10.1007/s11356-022-20241-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
Although it is biologically plausible, findings relating radon exposure to the risk of cerebrovascular disease (CeVD) are inconsistent and inconclusive. To investigate whether radon exposure was associated with the risk of CeVD, we qualitatively and quantitatively summarized the literature on radon and CeVD in both occupational and general populations. A search of PubMed, Embase, Scopus, and Web of Science was performed for peer-reviewed articles published through March 2022. Studies were excluded if radon exposure was not assessed separately from other ionizing radiation. In the meta-analysis, excess relative risks (ERRs) were converted to relative risks (RRs), and the pooled RRs and 95% confidence intervals (CIs) were determined using the random-effects model (DerSimonian and Laird). In the systematic review, nine eligible studies were summarized. Six occupational studies indicated inconsistent associations between cumulative radon exposure and CeVD mortality among mine workers. With available data from four updated occupational studies (99,730 mine workers and 2745 deaths), the pooled RR of radon exposure with CeVD mortality showed a non-significant association (1.10, 95% CI 0.92, 1.31). Three studies (841,270 individuals and 24,288 events) conducted in general populations consistently demonstrated a significant inverse relationship between residential radon exposure and risk of CeVD. The existing literature suggested a potential link between radon exposure and CeVD risk in general population. The inconsistent association in occupationally exposed populations may be explained by different methods of radon assessment and other methodological issues. Since radon exposure is a common public health issue, more rigorously designed epidemiologic studies, especially in the general population are warranted.
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Affiliation(s)
- Liping Lu
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, 10032, USA
| | - Yijia Zhang
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, 10032, USA
| | - Cheng Chen
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, 10032, USA
| | - Robert William Field
- Department of Occupational and Environmental Health and Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, 52242, USA
| | - Ka Kahe
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, 10032, USA.
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Twenty-seven years of primary salivary gland carcinoma in Wales: an analysis of histological subtype and associated risk factors. The Journal of Laryngology & Otology 2022; 136:167-172. [DOI: 10.1017/s002221512200007x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveRisk factors for salivary gland carcinoma are poorly understood. Although links between background radiation, smoking and obesity have been previously suggested, no studies have so far established any significant results. This study aimed to establish correlations between common environmental and lifestyle risk factors and different subtypes of salivary gland carcinoma.MethodA study of population data in Wales spanning 27 years was conducted; 2 national databases were used to identify 356 cases of primary salivary gland carcinoma over this period. Histological subtype of cancer and geographical location of each case was recorded. Public health data was used to establish radon levels, smoking, obesity and activity levels of populations in each geographical location. A population matched multivariate analysis of variance analysis was performed using histological subtype and risk factor data for each geographical location.ResultsA significantly higher incidence of mucoepidermoid cancer in populations with higher background radon levels (p = 0.006), epithelial-myoepithelial cancer in populations with higher smoking levels (p = 0.029) and adenoid cystic cancer in populations with higher obesity levels (p = 0.028) was found.ConclusionTo the authors’ knowledge, this is the first study to establish significant links between background radiation, smoking and obesity with different subtypes of salivary gland carcinoma.
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Mozzoni P, Pinelli S, Corradi M, Ranzieri S, Cavallo D, Poli D. Environmental/Occupational Exposure to Radon and Non-Pulmonary Neoplasm Risk: A Review of Epidemiologic Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10466. [PMID: 34639764 PMCID: PMC8508162 DOI: 10.3390/ijerph181910466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 12/01/2022]
Abstract
Although Radon (Rn) is a known agent for lung cancer, the link between Rn exposure and other non-pulmonary neoplasms remains unclear. The aim of this review is to investigate the role of Rn in the development of tumors other than lung cancer in both occupational and environmental exposure. Particularly, our attention has been focused on leukemia and tumors related to brain and central nervous system (CNS), skin, stomach, kidney, and breast. The epidemiologic literature has been systematically reviewed focusing on workers, general population, and pediatric population. A weak increase in leukemia risk due to Rn exposure was found, but bias and confounding factors cannot be ruled out. The results of studies conducted on stomach cancer are mixed, although with some prevalence for a positive association with Rn exposure. In the case of brain and CNS cancer and skin cancer, results are inconclusive, while no association was found for breast and kidney cancers. Overall, the available evidence does not support a conclusion that a causal association has been established between Rn exposure and the risk of other non-pulmonary neoplasms mainly due to the limited number and heterogeneity of existing studies. To confirm this result, a statistical analysis should be necessary, even if it is now not applicable for the few studies available.
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Affiliation(s)
- Paola Mozzoni
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
- Centre for Research in Toxicology (CERT), University of Parma, Via A. Gramsci 14, 43126 Parma, Italy
| | - Silvana Pinelli
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
| | - Massimo Corradi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
- Centre for Research in Toxicology (CERT), University of Parma, Via A. Gramsci 14, 43126 Parma, Italy
| | - Silvia Ranzieri
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (P.M.); (S.P.); (M.C.); (S.R.)
| | - Delia Cavallo
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy;
| | - Diana Poli
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy;
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Li L, Blomberg AJ, Stern RA, Kang CM, Papatheodorou S, Wei Y, Liu M, Peralta AA, Vieira CLZ, Koutrakis P. Predicting Monthly Community-Level Domestic Radon Concentrations in the Greater Boston Area with an Ensemble Learning Model. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:7157-7166. [PMID: 33939421 DOI: 10.1021/acs.est.0c08792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Inhaling radon and its progeny is associated with adverse health outcomes. However, previous studies of the health effects of residential exposure to radon in the United States were commonly based on a county-level temporally invariant radon model that was developed using measurements collected in the mid- to late 1980s. We developed a machine learning model to predict monthly radon concentrations for each ZIP Code Tabulation Area (ZCTA) in the Greater Boston area based on 363,783 short-term measurements by Spruce Environmental Technologies, Inc., during the period 2005-2018. A two-stage ensemble-based model was developed to predict radon concentrations for all ZCTAs and months. Stage one included 12 base statistical models that independently predicted ZCTA-level radon concentrations based on geological, architectural, socioeconomic, and meteorological factors for each ZCTA. Stage two aggregated the predictions of these 12 base models using an ensemble learning method. The results of a 10-fold cross-validation showed that the stage-two model has a good prediction accuracy with a weighted R2 of 0.63 and root mean square error of 22.6 Bq/m3. The community-level time-varying predictions from our model have good predictive precision and accuracy and can be used in future prospective epidemiological studies in the Greater Boston area.
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Affiliation(s)
- Longxiang Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, Massachusetts 02114, United States
| | - Annelise J Blomberg
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, Massachusetts 02114, United States
| | - Rebecca A Stern
- Harvard John A. Paulson School of Engineering and Applied Sciences, 29 Oxford St., Cambridge, Massachusetts 02138, United States
| | - Choong-Min Kang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, Massachusetts 02114, United States
| | - Stefania Papatheodorou
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, Massachusetts 02115, United States
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, Massachusetts 02114, United States
| | - Man Liu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, Massachusetts 02114, United States
| | - Adjani A Peralta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, Massachusetts 02114, United States
| | - Carolina L Z Vieira
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, Massachusetts 02114, United States
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, Massachusetts 02114, United States
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Vienneau D, Boz S, Forlin L, Flückiger B, de Hoogh K, Berlin C, Bochud M, Bulliard JL, Zwahlen M, Röösli M. Residential radon - Comparative analysis of exposure models in Switzerland. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 271:116356. [PMID: 33387778 DOI: 10.1016/j.envpol.2020.116356] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
Residential radon exposure is a major public health issue in Switzerland due to the known association between inhaled radon progeny and lung cancer. To confirm recent findings of an association with skin cancer mortality, an updated national radon model is needed. The aim of this study was to derive the best possible residential radon prediction model for subsequent epidemiological analyses. Two different radon prediction models were developed (linear regression model vs. random forest) using ca. 80,000 measurements in the Swiss Radon Database (1994-2017). A range of geographic predictors and building specific predictors were considered in the 3-D models (x,y, floor of dwelling). A five-fold modelling strategy was used to evaluate the robustness of each approach, with models developed (80% measurement locations) and validated (20%) using standard diagnostics. Random forest consistently outperformed the linear regression model, with higher Spearman's rank correlation (51% vs. 36%), validation coefficient of determination (R2 31% vs. 15%), lower root mean square error (RMSE) and lower fractional bias. Applied to the population of 5.4 million adults in 2000, the random forest resulted in an arithmetic mean (standard deviation) of 75.5 (31.7) Bq/m3, and indicated a respective 16.1% and 0.1% adults with predicted radon concentrations exceeding the World Health Organization (100 Bq/m3) and Swiss (300 Bq/m3) reference values.
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Affiliation(s)
- Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Switzerland.
| | - Seçkin Boz
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Switzerland
| | - Lukas Forlin
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Switzerland
| | - Benjamin Flückiger
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Switzerland
| | - Claudia Berlin
- Institute of Social and Preventive Medicine, Bern, Switzerland
| | - Murielle Bochud
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, Bern, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Switzerland
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Giraldo-Osorio A, Ruano-Ravina A, Pérez-Ríos M, Varela-Lema L, Barros-Dios JM, Arias-Ortiz NE. Residential Radon in Manizales, Colombia: Results of a Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031228. [PMID: 33573028 PMCID: PMC7908556 DOI: 10.3390/ijerph18031228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/20/2021] [Accepted: 01/23/2021] [Indexed: 11/16/2022]
Abstract
Radon is a colorless, odorless, and tasteless noble gas, causally related with the onset of lung cancer. We aimed to describe the distribution of radon exposure in the municipality of Manizales, Colombia, in order to estimate the population's exposure and establish the percentage of dwellings that surpass reference levels. A cross-sectional study representing all geographical areas was carried out by measuring indoor radon concentrations. Participants answered a short questionnaire. Alpha-track type radon detectors were installed in all residences for six months. The detectors were subsequently processed at the Galician Radon Laboratory, an accredited laboratory at the University of Santiago de Compostela. A total of 202 homes were measured. Seventy-seven percent of the sampled houses were three stories high, their median age was 30 years, and half were inhabited by three people or fewer. For most dwellings, the building materials of walls and flooring were brick and covered cement, respectively. Results showed a geometric mean of radon concentration of 8.5 Bq/m3 and a maximum value of 50 Bq/m3. No statistically significant differences were found either between the geometric mean of the dwelling's site, the height at which detectors were placed inside the home, or the wall and flooring materials, or between mean 222Rn concentrations in rural and urban areas. No dwelling surpassed the 222Rn reference level established by the WHO. This study shows that residential radon levels in Manizales, Colombia, seem to be low, though a more in-depth approach should be carried out. Despite these results, it is essential to create a national radon program and establish a radon concentration reference level for Colombia in line with international recommendations.
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Affiliation(s)
- Alexandra Giraldo-Osorio
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.G.-O.); (M.P.-R.); (L.V.-L.); (J.M.B.-D.)
- Grupo de Investigación Promoción de la Salud y Prevención de la Enfermedad (GIPSPE), Departamento de Salud Pública, Universidad de Caldas, Manizales 170002, Colombia;
- Scholarship Holder of Fundación Carolina (C.2020), 28071 Madrid, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.G.-O.); (M.P.-R.); (L.V.-L.); (J.M.B.-D.)
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública/CIBERESP), 15782 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela—IDIS), 15706 Santiago de Compostela, Spain
- Correspondence:
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.G.-O.); (M.P.-R.); (L.V.-L.); (J.M.B.-D.)
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública/CIBERESP), 15782 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela—IDIS), 15706 Santiago de Compostela, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.G.-O.); (M.P.-R.); (L.V.-L.); (J.M.B.-D.)
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.G.-O.); (M.P.-R.); (L.V.-L.); (J.M.B.-D.)
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública/CIBERESP), 15782 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela—IDIS), 15706 Santiago de Compostela, Spain
| | - Nelson Enrique Arias-Ortiz
- Grupo de Investigación Promoción de la Salud y Prevención de la Enfermedad (GIPSPE), Departamento de Salud Pública, Universidad de Caldas, Manizales 170002, Colombia;
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Ou JY, Hanson HA, Ramsay JM, Kaddas HK, Pope CA, Leiser CL, VanDerslice J, Kirchhoff AC. Fine Particulate Matter Air Pollution and Mortality among Pediatric, Adolescent, and Young Adult Cancer Patients. Cancer Epidemiol Biomarkers Prev 2020; 29:1929-1939. [PMID: 32404444 DOI: 10.1158/1055-9965.epi-19-1363] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/28/2020] [Accepted: 03/03/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Air pollution is a carcinogen and causes pulmonary and cardiac complications. We examined the association of fine particulate matter pollution (PM2.5) and mortality from cancer and all causes among pediatric, adolescent, and young adult (AYA) patients with cancer in Utah, a state with considerable variation in PM2.5. METHODS We followed 2,444 pediatric (diagnosed ages 0-14) and 13,459 AYA (diagnosed ages 15-39) patients diagnosed in 1986-2015 from diagnosis to 5 and 10 years postdiagnosis, death, or emigration. We measured average monthly PM2.5 by ZIP code during follow-up. Separate pediatric and AYA multivariable Cox models estimated the association of PM2.5 and mortality. Among AYAs, we examined effect modification of PM2.5 and mortality by stage while controlling for cancer type. RESULTS Increases in PM2.5 per 5 μg/m3 were associated with cancer mortality in pediatric lymphomas and central nervous system (CNS) tumors at both time points, and all cause mortality in lymphoid leukemias [HR5-year = 1.32 (1.02-1.71)]. Among AYAs, PM2.5 per 5 μg/m3 was associated with cancer mortality in CNS tumors and carcinomas at both time points, and all cause mortality for all AYA cancer types [HR5-year = 1.06 (1.01-1.13)]. PM2.5 ≥12 μg/m3 was associated with cancer mortality among breast [HR5-year = 1.50 (1.29-1.74); HR10-year = 1.30 (1.13-1.50)] and colorectal cancers [HR5-year = 1.74 (1.29-2.35); HR10-year = 1.67 (1.20-2.31)] at both time points. Effect modification by stage was significant, with local tumors at highest risk. CONCLUSIONS PM2.5 was associated with mortality in pediatric and AYA patients with specific cancers. IMPACT Limiting PM2.5 exposure may be important for young cancer patients with certain cancers.See all articles in this CEBP Focus section, "Environmental Carcinogenesis: Pathways to Prevention."
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Affiliation(s)
- Judy Y Ou
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah.
| | - Heidi A Hanson
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Joemy M Ramsay
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
| | - Heydon K Kaddas
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
| | | | - Claire L Leiser
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah
| | - James VanDerslice
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
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Monastero RN, Meliker JR. Incidence of brain and spinal cord cancer and county-level radon levels in New Jersey, Wisconsin, Minnesota, Pennsylvania, and Iowa, USA. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2020; 42:389-395. [PMID: 31309376 DOI: 10.1007/s10653-019-00368-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 07/03/2019] [Indexed: 06/10/2023]
Abstract
Ionizing radiation at diagnostic and therapeutic doses is a known contributor to the development of brain and spinal cord (CNS) cancer. However, little is known about risk from exposure to radon, a natural radiation source which the general population is exposed to residentially and environmentally. This study investigated correlations between mean county radon levels and CNS cancer incidence in five highly populated and radon-enriched US states (Minnesota, mean radon level 4.6 pCi/L; Wisconsin, 5.7 pCi/L; Pennsylvania, 8.6 pCi/L; Iowa, 6.1 pCi/L; and New Jersey, 4.4 pCi/L). Mean radon levels per county were accessed through AirChek, which provides publicly available radon data measured in residences and workplaces. CNS cancer incidence data were accessed through the states' health department websites and span differing amounts of time due to the publicly accessible nature of the data, though all time spans were over 10 years. Negative binomial regressions were run to assess correlations between mean radon and CNS cancer incidence per county. Quantile maps were constructed and Moran's I was calculated to assess spatial autocorrelation in residuals; no spatial autocorrelation was evident. Iowa was the only state with a significant positive association between radon and CNS incidence; no associations were detected in other states, and a negative association was observed in the 5 states combined. This study does not provide evidence that radon is a risk factor for CNS cancer; however, the possibility of an association cannot be ruled out due to limitations of the study, principally its ecologic nature and lack of individual-level exposure data.
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Affiliation(s)
- Rebecca N Monastero
- School of Medicine, Stony Brook University, HSC L3, Rm 071, Stony Brook, NY, 11794, USA.
| | - Jaymie R Meliker
- School of Medicine, Stony Brook University, HSC L3, Rm 071, Stony Brook, NY, 11794, USA
- Department of Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook University, HSC L3, Rm 071, Stony Brook, NY, 11794, USA
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Yitshak-Sade M, Blomberg AJ, Zanobetti A, Schwartz JD, Coull BA, Kloog I, Dominici F, Koutrakis P. County-level radon exposure and all-cause mortality risk among Medicare beneficiaries. ENVIRONMENT INTERNATIONAL 2019; 130:104865. [PMID: 31200153 PMCID: PMC6679989 DOI: 10.1016/j.envint.2019.05.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/29/2019] [Accepted: 05/23/2019] [Indexed: 05/12/2023]
Abstract
BACKGROUND Radon is an inert gas formed from the decay of naturally-occurring materials in the earth's crust. It infiltrates into homes from soil, water, and construction materials. Its decay products are radionuclides, which attach to ambient particles. Residential radon is one of the leading risk factors for lung cancer. The scarce evidence for associations with other mortality causes originates mostly from occupational studies. METHODS In a cohort study with 14 years of follow-up (2000-2013), we evaluated the association between chronic radon exposure and all-cause mortality, and explored whether there are subpopulations who are more vulnerable to radon effects. We included 87,296,195 person-years of follow-up from all Medicare beneficiaries in the Mid-Atlantic and Northeastern U.S. states. We examined the association between the logarithm of county-averaged radon (ln(Rn)) and mortality and assessed effect modification by chronic conditions. RESULTS An interquartile range increase in the ln(Rn) was associated with a 2·62% increase (95% CI 2·52%; 2·73%) in mortality, independent of PM2.5 exposure. Larger mortality risks were observed among individuals with respiratory, cardiovascular and metabolic diseases, with the highest associations observed among those with diabetes (4·98% increase), heart failure (4·58% increase), and chronic obstructive pulmonary disease (4·49% increase). CONCLUSION We found an increased risk for all-cause mortality associated with increased radon exposure. The risk was enhanced among susceptible individuals with chronic conditions. We believe this is the first cohort study to identify populations at higher risk for non-malignant health consequences of radon exposure. Due to the limitations in exposure assessment and availability of individual confounders, these findings should be interpreted with caution.
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Affiliation(s)
- Maayan Yitshak-Sade
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Annelise J Blomberg
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonella Zanobetti
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel D Schwartz
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Brent A Coull
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Francesca Dominici
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Petros Koutrakis
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Ruano-Ravina A, Dacosta-Urbieta A, Barros-Dios JM, Kelsey KT. Radon exposure and tumors of the central nervous system. GACETA SANITARIA 2018; 32:567-575. [DOI: 10.1016/j.gaceta.2017.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/02/2017] [Accepted: 01/05/2017] [Indexed: 01/20/2023]
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Mortazavi SMJ. Exposure to indoor radon can be a concern in studies on the role of short-term exposure to air pollution and mortality. REVIEWS ON ENVIRONMENTAL HEALTH 2018; 33:315-317. [PMID: 29894303 DOI: 10.1515/reveh-2018-0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 05/18/2018] [Indexed: 06/08/2023]
Abstract
Abstract
Recent studies show that short-term exposure to ambient particulate matter is associated with more emergency department visits and hospitalizations for pneumonia as well as increased mortality and increased health care costs among older adults. Moreover, exposure to ambient particulate matter is shown to be connected with an increased rate of daily mortality and hospitalizations due to cardiovascular diseases (CVDs). The association between short-term exposures to particulate matter with a diameter less than 2.5 µm (PM2.5) and ozone [at levels below the current daily National Ambient Air Quality Standards (NAAQS)] and mortality in the continental United States has been recently addressed by some researchers. Although exposure to radon is usually known to cause late health effects such as lung cancer, some studies show a significant association between radon exposure and cerebrovascular disease (CeVD) mortality. In some residential areas with high levels of radon, it has been found that the incidences of respiratory, nervous system and cardiovascular system diseases exceed the average. Studies that calculated the radiation dose to blood and the walls of coronary arteries from radon and progeny also indicate that exposure to radon can increase the incidence of CVDs. Based on the evidence provided in this short communication, it can be concluded that ignoring the key role of radon in non-cancer mortality can easily affect the validity of the studies aimed at investigating the association between exposure to ambient fine particulate matter and mortality.
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Affiliation(s)
- S M J Mortazavi
- Professor of Medical Physics, Visiting Scientist, 1. Biophotonics Lab, Department of Electrical Engineering, University of Wisconsin Milwaukee, 3200 N Cramer St., Milwaukee, WI 53211, USA
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Özen SA, Celik N, Dursun E, Taskın H. Indoor and outdoor radon measurements at lung cancer patients' homes in the dwellings of Rize Province in Turkey. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2018; 40:1111-1125. [PMID: 28577063 DOI: 10.1007/s10653-017-9991-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 05/30/2017] [Indexed: 06/07/2023]
Abstract
In this study, indoor and outdoor radon (222Rn) surveys were carried out in the summer and winter seasons in homes of one hundred lung cancer patients in the year 2013-2014. The aim was to investigate the relationship between radon and cancer patients. Lung cancer patients completed a questionnaire concerning their living environment, various physical parameters and living habits. Pearson correlation and t tests revealed no meaningful results between radon concentrations, on one hand, and environmental and personal living habits, on the other hand. Consequently, the BEIR VI model was adapted and 222Rn exposure was estimated to be responsible for about 12% of the lung cancer incidences in the winter season and around 5% in the summer season in the Rize Province. However, due to the limited number of data and numerous parameters that could lead to lung cancer, the estimations done with the model should be taken very lightly. The annual effective doses due to inhalation of indoor and outdoor 222Rn were estimated to be, respectively, 1.43 and 0.94 mSv y-1. The indoor and outdoor annual effective doses were, respectively, close and below the world annual effective dose (1.3 mSv y-1). At the district level, the indoor annual effective dose equivalent in the İyidere district was 4.52 mSv y-1, which was 3.5 times greater than the world average. The number of patients in the majority of the houses in this district was more than one.
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Affiliation(s)
- Songül Akbulut Özen
- Department of Energy Systems Engineering, Bursa Technical University, 16310, Bursa, Turkey.
| | - Necati Celik
- Department of Physics Engineering, Gumushane University, Gumushane, Turkey
| | - Emrehan Dursun
- Department of Physics, Recep Tayyip Erdogan University, 53100, Rize, Turkey
| | - Halim Taskın
- Cekmece Nuclear Research and Training Center, Turkish Atomic Energy Authority (TAEK), 34303, Istanbul, Turkey
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Whitley CB, Boyer JL. Assessing cancer risk factors faced by an Ancestral Puebloan population in the North American Southwest. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 21:166-177. [PMID: 29778412 DOI: 10.1016/j.ijpp.2017.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 06/29/2017] [Accepted: 06/29/2017] [Indexed: 06/08/2023]
Abstract
Ancestral Puebloan people in the North American Southwest suffered high rates of disease, poor health, and early age-at-death. Four individuals with skeletal expressions of cancer were found in a pre-Columbian population in the Taos Valley - Reports of malignant neoplasms in the archaeological record are uncommon and their presence in four of 82 individuals is a high occurrence. This study continues Whitley and Boyer's (2012) research testing whether concentrations of ionizing radiation were sufficiently high to induce cancer and related health issues. Access to a preserved and partly reconstructed subterranean pit structure inhabited between AD 1120 and 1170, allows us to test radon concentrations in a residential dwelling. This study found radon occurring in high levels, 19.4-20.3 pCi/L (717.8-751.1 Bq/m3) within the structure. Epidemiological reports are inconsistent when linking specific cancers and radon exposure. However, this study can control for many of the confounding factors plaguing other studies, provide unique data that have the potential to initiate dialogue on the etiology of neoplastic disease in the American Southwest, and add new dimensions to the study of the living conditions and health of the Ancestral Puebloans and their descendants.
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Affiliation(s)
- Catrina Banks Whitley
- Principal Investigator, Bioarchaeology Support, Midlothian, TX, United States; Research Associate, Museum of New Mexico, Office of Archaeological Studies, Santa Fe, New Mexico, United States.
| | - Jeffrey L Boyer
- Research Associate, Museum of New Mexico, Office of Archaeological Studies, Santa Fe, New Mexico, United States.
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Vimercati L, Fucilli F, Cavone D, De Maria L, Birtolo F, Ferri GM, Soleo L, Lovreglio P. Radon Levels in Indoor Environments of the University Hospital in Bari-Apulia Region Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040694. [PMID: 29642436 PMCID: PMC5923736 DOI: 10.3390/ijerph15040694] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/03/2018] [Accepted: 04/03/2018] [Indexed: 11/30/2022]
Abstract
Since 1988, the International Agency for Research on Cancer (IARC) has classified radon among the compounds for which there is scientific evidence of carcinogenicity for humans (group 1). The World Health Organization (WHO) recommends a reference radon level between 100 and 300 Bq/m3 for homes. The objective of this study is to measure the radon concentrations in 401 workplaces, different from the patient rooms, in 28 different buildings of the university hospital in Bari (Apulia region, Southern Italy) to evaluate the exposure of health care workers. Radon environmental sampling is performed over two consecutive six-month periods via the use of passive dosimeters of the CR-39 type. We find an average annual radon concentration expressed as median value of 48.0 Bq/m3 (range 6.5–388.0 Bq/m3) with a significant difference between the two six-month periods (median value: February/July 41.0 Bq/m3 vs. August/January 55.0 Bq/m3). An average concentration of radon lower than the WHO reference level (100 Bq/m3) is detected in 76.1% of monitored environments, while higher than 300 Bq/m3 only in the 0.9%. Most workplaces report radon concentrations within the WHO reference level, therefore, the risk to workers’ health deriving from occupational exposure to radon can be considered to be low. Nevertheless, the goal is to achieve near-zero exposures to protect workers’ health.
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Affiliation(s)
- Luigi Vimercati
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro Medical School, 70124 Bari, Italy.
| | - Fulvio Fucilli
- Regional University Hospital Policlinico-Prevention and Protection Service/Health Physics-A.O.U. Consortium Policlinico di Bari, 7014 Bari, Italy.
| | - Domenica Cavone
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro Medical School, 70124 Bari, Italy.
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro Medical School, 70124 Bari, Italy.
| | - Francesco Birtolo
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro Medical School, 70124 Bari, Italy.
| | - Giovanni Maria Ferri
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro Medical School, 70124 Bari, Italy.
| | - Leonardo Soleo
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro Medical School, 70124 Bari, Italy.
| | - Piero Lovreglio
- Interdisciplinary Department of Medicine, Section of Occupational Medicine, University of Bari Aldo Moro Medical School, 70124 Bari, Italy.
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López-Abente G, Núñez O, Fernández-Navarro P, Barros-Dios JM, Martín-Méndez I, Bel-Lan A, Locutura J, Quindós L, Sainz C, Ruano-Ravina A. Residential radon and cancer mortality in Galicia, Spain. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 610-611:1125-1132. [PMID: 28847132 DOI: 10.1016/j.scitotenv.2017.08.144] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/14/2017] [Accepted: 08/14/2017] [Indexed: 06/07/2023]
Abstract
Residential radon exposure is a serious public health concern, and as such appears in the recommendations of European Code Against Cancer. The objective of this study was to assess the association between residential radon levels and mortality due to different types of cancer, using misaligned data analysis techniques. Mortality data (observed cases) for each of the 313 Galician municipalities were drawn from the records of the National Statistics Institute for the study period (1999-2008). Expected cases were computed using Galician mortality rates for 14 types of malignant tumors as reference, with a total of 56,385 deaths due to the tumors analyzed. The effect estimates of indoor radon (3371 sampling points) were adjusted for sociodemographic variables, altitude, and arsenic topsoil levels (1069 sampling points), using spatial/geostatistical models fitted with stochastic partial differential equations and integrated nested Laplace approximations. These models are capable of processing misaligned data. The results showed a statistical association between indoor radon and lung, stomach and brain cancer in women in Galicia. Apart from lung cancer (relative risk (RR)=1.09), in which a twofold increase in radon exposure led to a 9% rise in mortality, the association was particularly relevant in stomach (RR=1.17) and brain cancer (RR=1.28). Further analytical epidemiologic studies are needed to confirm these results, and an assessment should be made of the advisability of implementing interventions targeting such exposure in higher-risk areas.
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Affiliation(s)
- Gonzalo López-Abente
- Cancer and Environmental Epidemiology Unit, National Epidemiology Center, Carlos III, Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Olivier Núñez
- Cancer and Environmental Epidemiology Unit, National Epidemiology Center, Carlos III, Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Pablo Fernández-Navarro
- Cancer and Environmental Epidemiology Unit, National Epidemiology Center, Carlos III, Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Juan M Barros-Dios
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, School of Medicine, San Francisco Street, 15782 Santiago de Compostela, Galicia, Spain; Preventive Medicine Unit, Santiago de Compostela Clinic University Hospital, Santiago de Compostela, Galicia, Spain
| | - Iván Martín-Méndez
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003 Madrid, Spain
| | - Alejandro Bel-Lan
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003 Madrid, Spain
| | - Juan Locutura
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003 Madrid, Spain
| | - Luis Quindós
- RADON Group, Faculty of Medicine, University of Cantabria, c/Cardenal Herrera Oria s/n, 39011 Santander, Cantabria, Spain
| | - Carlos Sainz
- RADON Group, Faculty of Medicine, University of Cantabria, c/Cardenal Herrera Oria s/n, 39011 Santander, Cantabria, Spain
| | - Alberto Ruano-Ravina
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, School of Medicine, San Francisco Street, 15782 Santiago de Compostela, Galicia, Spain; Preventive Medicine Unit, Santiago de Compostela Clinic University Hospital, Santiago de Compostela, Galicia, Spain
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VoPham T, DuPré N, Tamimi RM, James P, Bertrand KA, Vieira V, Laden F, Hart JE. Environmental radon exposure and breast cancer risk in the Nurses' Health Study II. Environ Health 2017; 16:97. [PMID: 28882148 PMCID: PMC5590193 DOI: 10.1186/s12940-017-0305-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 09/03/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Radon and its decay products, a source of ionizing radiation, are primarily inhaled and can deliver a radiation dose to breast tissue, where they may continue to decay and emit DNA damage-inducing particles. Few studies have examined the relationship between radon and breast cancer. METHODS The Nurses' Health Study II (NHSII) includes U.S. female registered nurses who completed biennial questionnaires since 1989. Self-reported breast cancer was confirmed from medical records. County-level radon exposures were linked with geocoded residential addresses updated throughout follow-up. Time-varying Cox regression models adjusted for established breast cancer risk factors were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS From 1989 to 2013, 3966 invasive breast cancer cases occurred among 112,639 participants. Increasing radon exposure was not associated with breast cancer risk overall (adjusted HR comparing highest to lowest quintile = 1.06, 95% CI: 0.94, 1.21, p for trend = 0.30). However, women in the highest quintile of exposure (≥74.9 Bq/m3) had a suggested elevated risk of ER-/PR- breast cancer compared to women in the lowest quintile (<27.0 Bq/m3) (adjusted HR = 1.38, 95% CI: 0.97, 1.96, p for trend = 0.05). No association was observed for ER+/PR+ breast cancer. CONCLUSIONS Although we did not find an association between radon exposure and risk of overall or ER+/PR+ breast cancer, we observed a suggestive association with risk of ER-/PR- breast cancer.
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Affiliation(s)
- Trang VoPham
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Landmark Center 3rd Floor West (HSPH/BWH), 401 Park Drive, Boston, MA 02215 USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | - Natalie DuPré
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Landmark Center 3rd Floor West (HSPH/BWH), 401 Park Drive, Boston, MA 02215 USA
| | - Rulla M. Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Landmark Center 3rd Floor West (HSPH/BWH), 401 Park Drive, Boston, MA 02215 USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | - Peter James
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Landmark Center 3rd Floor West (HSPH/BWH), 401 Park Drive, Boston, MA 02215 USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | | | - Veronica Vieira
- Program in Public Health, University of California, Irvine, CA USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Landmark Center 3rd Floor West (HSPH/BWH), 401 Park Drive, Boston, MA 02215 USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
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25
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Oancea SC, Rundquist BC, Simon I, Swartz S, Zheng Y, Zhou X, Sens MA, Schwartz GG. County level incidence rates of chronic lymphocytic leukemia are associated with residential radon levels. Future Oncol 2017; 13:1873-1881. [PMID: 28835109 PMCID: PMC5618932 DOI: 10.2217/fon-2017-0165] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: We previously reported that incidence rates for chronic lymphocytic leukemia (CLL) among US states are significantly correlated with levels of residential radon (RR). Because these correlations could be influenced by confounding and/or misclassification among large geographic units, we reinvestigated them using smaller geographic units that better reflect exposure and disease at the individual level. Methods: We examined the relationships between CLL and RR per county in 478 counties with publicly-available data. Results: After adjustment for ultraviolet radiation, a possible risk factor for CLL, county rates for CLL and RR were significantly correlated among males and females both together and separately (p < 0.0001). Conclusion: CLL is significantly associated with RR at the county level.
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Affiliation(s)
- S Cristina Oancea
- Department of Population Health, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND 58202, USA
| | - Bradley C Rundquist
- Department of Geography & Geographic Information Science, University of North Dakota, College of Arts & Sciences, Grand Forks, ND 58202, USA
| | - Isaac Simon
- Department of Earth System Science & Policy, University of North Dakota, John D. Odegard School of Aerospace Sciences, Grand Forks, ND, 58202, USA
| | - Sami Swartz
- Department of Geography & Geographic Information Science, University of North Dakota, College of Arts & Sciences, Grand Forks, ND 58202, USA
| | - Yun Zheng
- Department of Pathology, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, ND 58202, USA
| | - Xudong Zhou
- Department of Pathology, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, ND 58202, USA
| | - Mary Ann Sens
- Department of Pathology, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, ND 58202, USA
| | - Gary G Schwartz
- Department of Population Health, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND 58202, USA
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Vienneau D, de Hoogh K, Hauri D, Vicedo-Cabrera AM, Schindler C, Huss A, Röösli M. Effects of Radon and UV Exposure on Skin Cancer Mortality in Switzerland. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:067009. [PMID: 28686556 PMCID: PMC5744747 DOI: 10.1289/ehp825] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/28/2016] [Accepted: 11/15/2016] [Indexed: 05/17/2023]
Abstract
BACKGROUND Skin cancer incidence in Switzerland is among the highest in the world. In addition to exposure to ultraviolet (UV) radiation, radon alpha particles attached to aerosols can adhere to the skin and potentially cause carcinogenic effects. OBJECTIVES We investigated the effects of radon and UV exposure on skin cancer mortality. METHODS Cox proportional hazard regression was used to study the association between exposures and skin cancer mortality in adults from the Swiss National Cohort. Modeled radon exposure and erythemal-weighted UV dose were assigned to addresses at baseline. Effect estimates were adjusted for sex, civil status, mother tongue, education, job position, neighborhood socioeconomic position, and UV exposure from outdoor occupation. RESULTS The study included 5.2 million adults (mean age 48 y) and 2,989 skin cancer deaths, with 1,900 indicating malignant melanoma (MM) as the primary cause of death. Adjusted hazard ratios (HR) for MM at age 60 were 1.16 (95% CI: 1.04, 1.29) per 100 Bq/m3 radon and 1.11 (1.01, 1.23) per W/m2 in UV dose. Radon effects decreased with age. Risk of MM death associated with residential UV exposure was higher for individuals engaged in outdoor work with UV exposure (HR 1.94 [1.17, 3.23]), though not statistically significantly different compared to not working outdoors (HR 1.09 [0.99, 1.21], p=0.09). CONCLUSIONS There is considerable variation in radon and UV exposure across Switzerland. Our study suggests both are relevant risk factors for skin cancer mortality. A better understanding of the role of the UV radiation and radon exposure is of high public health relevance. https://doi.org/10.1289/EHP825.
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Affiliation(s)
- Danielle Vienneau
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute , Basel, Switzerland ; University of Basel , Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute , Basel, Switzerland ; University of Basel , Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Dimitri Hauri
- Federal Statistical Office, Neuchâtel, Switzerland
- ImmoCompass AG, Zurich, Switzerland
| | - Ana M Vicedo-Cabrera
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute , Basel, Switzerland ; University of Basel , Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Christian Schindler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute , Basel, Switzerland ; University of Basel , Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Anke Huss
- Institute for Risk Assessment Sciences, University Utrecht, Utrecht, the Netherlands
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute , Basel, Switzerland ; University of Basel , Basel, Switzerland
- University of Basel, Basel, Switzerland
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27
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Ruano-Ravina A, Aragonés N, Kelsey KT, Pérez-Ríos M, Piñeiro-Lamas M, López-Abente G, Barros-Dios JM. Residential radon exposure and brain cancer: an ecological study in a radon prone area (Galicia, Spain). Sci Rep 2017; 7:3595. [PMID: 28620182 PMCID: PMC5472649 DOI: 10.1038/s41598-017-03938-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 05/05/2017] [Indexed: 12/15/2022] Open
Abstract
We aimed to know if radon concentration is associated with municipal mortality due to brain cancer in Galicia, Spain. We designed an ecological study taking as study unit Galician municipalities. To be included, municipalities had to have at least three radon measurements. We correlated radon concentrations with municipal mortality due to these malignant tumors during the period 1999-2008. We calculated the relative risk of dying of brain cancers for each municipality and correlated this value with municipal radon concentration using Spearman's Rho. 251 municipalities were included, with close to 3,500 radon measurements and an average of 14 radon measurements at each municipality. We observed a significant correlation between residential radon with brain cancer mortality for males and females and the intensity of the correlation was higher for females. These results were reinforced when the analysis was restricted to municipalities with more than 5 radon measurements: Spearman's Rho 0.286 (p-value < 0.001) and Spearman's Rho 0.509 (p-value < 0.001) for males and females, respectively. These results suggest an association between residential radon and brain cancer mortality. More research using more robust epidemiological designs is needed to confirm these findings.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago, Spain.
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago, Spain.
- Department of Epidemiology, Brown School of Public Health, Providence, Rhode, Island, USA.
| | - Nuria Aragonés
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago, Spain
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Public Health, Madrid, Spain
| | - Karl T Kelsey
- Department of Epidemiology, Brown School of Public Health, Providence, Rhode, Island, USA
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago, Spain
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago, Spain
| | | | - Gonzalo López-Abente
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago, Spain
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Public Health, Madrid, Spain
| | - Juan M Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago, Spain
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago, Spain
- Preventive Medicine Unit, Santiago de Compostela Clinic University Hospital, Santiago, Spain
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28
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Jian Y, Messer LC, Jagai JS, Rappazzo KM, Gray CL, Grabich SC, Lobdell DT. Associations between Environmental Quality and Mortality in the Contiguous United States, 2000-2005. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:355-362. [PMID: 27713110 PMCID: PMC5332172 DOI: 10.1289/ehp119] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/28/2016] [Accepted: 08/23/2016] [Indexed: 05/08/2023]
Abstract
BACKGROUND Assessing cumulative effects of the multiple environmental factors influencing mortality remains a challenging task. OBJECTIVES This study aimed to examine the associations between cumulative environmental quality and all-cause and leading cause-specific (heart disease, cancer, and stroke) mortality rates. METHODS We used the overall Environmental Quality Index (EQI) and its five domain indices (air, water, land, built, and sociodemographic) to represent environmental exposure. Associations between the EQI and mortality rates (CDC WONDER) for counties in the contiguous United States (n = 3,109) were investigated using multiple linear regression models and random intercept and random slope hierarchical models. Urbanicity, climate, and a combination of the two were used to explore the spatial patterns in the associations. RESULTS We found 1 standard deviation increase in the overall EQI (worse environment) was associated with a mean 3.22% (95% CI: 2.80%, 3.64%) increase in all-cause mortality, a 0.54% (95% CI: -0.17%, 1.25%) increase in heart disease mortality, a 2.71% (95% CI: 2.21%, 3.22%) increase in cancer mortality, and a 2.25% (95% CI: 1.11%, 3.39%) increase in stroke mortality. Among the environmental domains, the associations ranged from -1.27% (95% CI: -1.70%, -0.84%) to 3.37% (95% CI: 2.90%, 3.84%) for all-cause mortality, -2.62% (95% CI: -3.52%, -1.73%) to 4.50% (95% CI: 3.73%, 5.27%) for heart disease mortality, -0.88% (95% CI: -2.12%, 0.36%) to 3.72% (95% CI: 2.38%, 5.06%) for stroke mortality, and -0.68% (95% CI: -1.19%, -0.18%) to 3.01% (95% CI: 2.46%, 3.56%) for cancer mortality. Air had the largest associations with all-cause, heart disease, and cancer mortality, whereas the sociodemographic index had the largest association with stroke mortality. Across the urbanicity gradient, no consistent trend was found. Across climate regions, the associations ranged from 2.29% (95% CI: 1.87%, 2.72%) to 5.30% (95% CI: 4.30%, 6.30%) for overall EQI, and larger associations were generally found in dry areas for both overall EQI and domain indices. CONCLUSIONS These results suggest that poor environmental quality, particularly poor air quality, was associated with increased mortality and that associations vary by urbanicity and climate region. Citation: Jian Y, Messer LC, Jagai JS, Rappazzo KM, Gray CL, Grabich SC, Lobdell DT. 2017. Associations between environmental quality and mortality in the contiguous United States, 2000-2005. Environ Health Perspect 125:355-362; http://dx.doi.org/10.1289/EHP119.
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Affiliation(s)
- Yun Jian
- Oak Ridge Institute for Science and Education, National Health and Environmental Effects Research Laboratory (NHEERL), U.S. Environmental Protection Agency (EPA), Chapel Hill, North Carolina, USA
| | - Lynne C. Messer
- School of Community Health, College of Urban and Public Affairs, Portland State University, Portland, Oregon, USA
| | - Jyotsna S. Jagai
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, Chicago, Illinois, USA
| | | | - Christine L. Gray
- Oak Ridge Institute for Science and Education, National Health and Environmental Effects Research Laboratory (NHEERL), U.S. Environmental Protection Agency (EPA), Chapel Hill, North Carolina, USA
- UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | | | - Danelle T. Lobdell
- NHEERL, U.S. EPA, Chapel Hill, North Carolina, USA
- Address correspondence to D.T. Lobdell, U.S. Environmental Protection Agency, National Health and Environmental Effects Research Laboratory, MD 58A, Research Triangle Park, NC 27711 USA. Telephone: (919) 843-4434. E-mail:
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29
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Teras LR, Diver WR, Turner MC, Krewski D, Sahar L, Ward E, Gapstur SM. Residential radon exposure and risk of incident hematologic malignancies in the Cancer Prevention Study-II Nutrition Cohort. ENVIRONMENTAL RESEARCH 2016; 148:46-54. [PMID: 27015563 DOI: 10.1016/j.envres.2016.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/29/2016] [Accepted: 03/01/2016] [Indexed: 06/05/2023]
Abstract
Dosimetric models show that radon, an established cause of lung cancer, delivers a non-negligible dose of alpha radiation to the bone marrow, as well as to lymphocytes in the tracheobronchial epithelium, and therefore could be related to risk of hematologic cancers. Studies of radon and hematologic cancer risk, however, have produced inconsistent results. To date there is no published prospective, population-based study of residential radon exposure and hematologic malignancy incidence. We used data from the American Cancer Society Cancer Prevention Study-II Nutrition Cohort established in 1992, to examine the association between county-level residential radon exposure and risk of hematologic cancer. The analytic cohort included 140,652 participants (66,572 men, 74,080 women) among which 3019 incident hematologic cancer cases (1711 men, 1308 women) were identified during 19 years of follow-up. Cox proportional hazard regression was used to calculate multivariable-adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for radon exposure and hematologic cancer risk. Women living in counties with the highest mean radon concentrations (>148Bq/m(3)) had a statistically significant higher risk of hematologic cancer compared to those living in counties with the lowest (<74Bq/m(3)) radon levels (HR=1.63, 95% CI:1.23-2.18), and there was evidence of a dose-response relationship (HRcontinuous=1.38, 95% CI:1.15-1.65 per 100Bq/m(3); p-trend=0.001). There was no association between county-level radon and hematologic cancer risk among men. The findings of this large, prospective study suggest residential radon may be a risk factor for lymphoid malignancies among women. Further study is needed to confirm these findings.
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Affiliation(s)
- Lauren R Teras
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA.
| | - W Ryan Diver
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Michelle C Turner
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada; School of Epidemiology, Public Health and Disease Prevention, University of Ottawa, Ottawa, Ontario, Canada
| | - Liora Sahar
- Statistics and Evaluation Center, American Cancer Society, Atlanta, GA, USA
| | - Elizabeth Ward
- Intramural Research, American Cancer Society, Atlanta, GA, USA
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
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Barbosa-Lorenzo R, Barros-Dios JM, Raíces Aldrey M, Cerdeira Caramés S, Ruano-Ravina A. Residential radon and cancers other than lung cancer: a cohort study in Galicia, a Spanish radon-prone area. Eur J Epidemiol 2016; 31:437-41. [DOI: 10.1007/s10654-016-0134-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/27/2016] [Indexed: 01/19/2023]
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31
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Radon exposure and oropharyngeal cancer risk. Cancer Lett 2015; 369:45-9. [DOI: 10.1016/j.canlet.2015.08.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/18/2015] [Accepted: 08/19/2015] [Indexed: 11/21/2022]
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32
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Lee HA, Lee WK, Lim D, Park SH, Baik SJ, Kong KA, Jung-Choi K, Park H. Risks of Lung Cancer due to Radon Exposure among the Regions of Korea. J Korean Med Sci 2015; 30:542-8. [PMID: 25931783 PMCID: PMC4414636 DOI: 10.3346/jkms.2015.30.5.542] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 01/15/2015] [Indexed: 12/18/2022] Open
Abstract
Radon is likely the second most common cause of lung cancer after smoking. We estimated the lung cancer risk due to radon using common risk models. Based on national radon survey data, we estimated the population-attributable fraction (PAF) and the number of lung cancer deaths attributable to radon. The exposure-age duration (EAD) and exposure-age concentration (EAC) models were used. The regional average indoor radon concentration was 37.5 95 Bq/m(3). The PAF for lung cancer was 8.3% (European Pooling Study model), 13.5% in males and 20.4% in females by EAD model, and 19.5% in males and 28.2% in females by EAC model. Due to differences in smoking by gender, the PAF of radon-induced lung cancer deaths was higher in females. In the Republic of Korea, the risk of radon is not widely recognized. Thus, information about radon health risks is important and efforts are needed to decrease the associated health problems.
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Affiliation(s)
- Hye Ah Lee
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Won Kyung Lee
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Dohee Lim
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Su Hyun Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Sun Jung Baik
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Kyoung Ae Kong
- Ewha Clinical Trial Center, Ewha Womans University Medical Center, Seoul, Korea
| | - Kyunghee Jung-Choi
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
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33
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Kreuzer M, Dufey F, Marsh JW, Nowak D, Schnelzer M, Walsh L. Mortality from cancers of the extra-thoracic airways in relation to radon progeny in the Wismut cohort, 1946–2008. Int J Radiat Biol 2014; 90:1030-5. [DOI: 10.3109/09553002.2014.909074] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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34
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Lung cancer mortality and radon concentration in a chronically exposed neighborhood in Chihuahua, Mexico: a geospatial analysis. ScientificWorldJournal 2014; 2014:935380. [PMID: 25165752 PMCID: PMC4138886 DOI: 10.1155/2014/935380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 05/24/2014] [Accepted: 06/09/2014] [Indexed: 11/25/2022] Open
Abstract
This study correlated lung cancer (LC) mortality with statistical data obtained from government public databases. In order to asses a relationship between LC deaths and radon accumulation in dwellings, indoor radon concentrations were measured with passive detectors randomly distributed in Chihuahua City. Kriging (K) and Inverse-Distance Weighting (IDW) spatial interpolations were carried out. Deaths were georeferenced and Moran's I correlation coefficients were calculated. The mean values (over n = 171) of the interpolation of radon concentrations of deceased's dwellings were 247.8 and 217.1 Bq/m3, for K and IDW, respectively. Through the Moran's I values obtained, correspondingly equal to 0.56 and 0.61, it was evident that LC mortality was directly associated with locations with high levels of radon, considering a stable population for more than 25 years, suggesting spatial clustering of LC deaths due to indoor radon concentrations.
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35
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Zaatari M, Nirlo E, Jareemit D, Crain N, Srebric J, Siegel J. Ventilation and indoor air quality in retail stores: A critical review (RP-1596). ACTA ACUST UNITED AC 2014. [DOI: 10.1080/10789669.2013.869126] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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36
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Kreuzer M, Sogl M, Brüske I, Möhner M, Nowak D, Schnelzer M, Walsh L. Silica dust, radon and death from non-malignant respiratory diseases in German uranium miners. Occup Environ Med 2013; 70:869-75. [PMID: 24142976 DOI: 10.1136/oemed-2013-101582] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To quantify the relationship between death from non-malignant respiratory diseases (NMRD) and exposure to silica dust or radon in a cohort of 58,690 former German uranium miners. METHODS In the follow-up period from 1946 to 2008, a total of 2336 underlying deaths from NMRDs occurred, including 715 deaths from chronic obstructive pulmonary diseases (COPD) and 975 deaths from silicosis or other pneumoconiosis. Exposure to respirable crystalline silica and radon was individually assessed by means of a comprehensive job-exposure matrix. Risk analyses were based on a linear Poisson regression model with the baseline stratified by age, calendar year and duration of employment. RESULTS There was no increase in risk of death from COPDs or any other NMRDs in relation to cumulative exposure to silica (mean=5.9, max=56 mg/m(3)-years), except in the group of deaths from silicosis or other pneumoconiosis. Here, a strong non-linear increase in risk was observed. Cumulative radon exposure (mean=280; max=3224 Working Level Months) was not related to death from COPDs or any other NMRDs. CONCLUSIONS The present findings do not indicate a relationship between mortality from COPD with silica dust or radon. However, validity of cause of death and lack of control for smoking remain potential sources of bias.
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Affiliation(s)
- M Kreuzer
- Department of Radiation Protection and Health, Federal Office for Radiation Protection, Neuherberg, Germany
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37
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Hauri D, Spycher B, Huss A, Zimmermann F, Grotzer M, von der Weid N, Weber D, Spoerri A, Kuehni CE, Röösli M. Domestic radon exposure and risk of childhood cancer: a prospective census-based cohort study. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:1239-1244. [PMID: 23942326 PMCID: PMC3801468 DOI: 10.1289/ehp.1306500] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 08/09/2013] [Indexed: 05/30/2023]
Abstract
BACKGROUND In contrast with established evidence linking high doses of ionizing radiation with childhood cancer, research on low-dose ionizing radiation and childhood cancer has produced inconsistent results. OBJECTIVE We investigated the association between domestic radon exposure and childhood cancers, particularly leukemia and central nervous system (CNS) tumors. METHODS We conducted a nationwide census-based cohort study including all children < 16 years of age living in Switzerland on 5 December 2000, the date of the 2000 census. Follow-up lasted until the date of diagnosis, death, emigration, a child's 16th birthday, or 31 December 2008. Domestic radon levels were estimated for each individual home address using a model developed and validated based on approximately 45,000 measurements taken throughout Switzerland. Data were analyzed with Cox proportional hazard models adjusted for child age, child sex, birth order, parents' socioeconomic status, environmental gamma radiation, and period effects. RESULTS In total, 997 childhood cancer cases were included in the study. Compared with children exposed to a radon concentration below the median (< 77.7 Bq/m3), adjusted hazard ratios for children with exposure ≥ the 90th percentile (≥ 139.9 Bq/m3) were 0.93 (95% CI: 0.74, 1.16) for all cancers, 0.95 (95% CI: 0.63, 1.43) for all leukemias, 0.90 (95% CI: 0.56, 1.43) for acute lymphoblastic leukemia, and 1.05 (95% CI: 0.68, 1.61) for CNS tumors. CONCLUSIONS We did not find evidence that domestic radon exposure is associated with childhood cancer, despite relatively high radon levels in Switzerland.
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Affiliation(s)
- Dimitri Hauri
- Swiss Tropical and Public Health Institute, Basel, Switzerland
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