French population exposure to radon, terrestrial gamma and cosmic rays

Analysis of indoor radon concentration levels and trends in China

A systematic review of publicly available papers on indoor radon data from 1980 to 2023 was conducted to provide a preliminary understanding of indoor radon concentration levels and trends in China. Keywords were used to collect literature on indoor radon surveys in China during the periods of before 2000, 2000-2010 and after 2010 in the CNKI, WANFANG, VIP and PubMed databases. This paper also collected indoor radon concentration data from WHO, UNSCEAR publications and PubMed databases for other countries. A total of 37,886 indoor radon concentration data points were collected in China, covering 31 provinces. The results showed that the weighted and arithmetic mean radon concentrations in China were 29.4 Bq/m3 and 33.2 Bq/m3 (n = 17,940) before 2000, 44.7 Bq/m3 and 43.3 Bq/m3 (n = 10,692) in 2000-2010, 57.6 Bq/m3 and 60.8 Bq/m3(n = 9,254) after 2010, respectively. It indicated an increasing trend in indoor radon concentrations in China. The differences in mean indoor radon concentrations across time periods were significant (p < 0.001). In the regional analysis, the differences in indoor radon concentrations between different administrative geographic regions for each time period were significant (p < 0.05). Furthermore, the differences in indoor radon concentrations among climatic areas were significant for the periods 2000-2010 and after 2010 (p < 0.05). Additionally, this paper collected indoor radon data from 63 countries worldwide. The mean radon concentrations across the three periods-before 2000, 2000-2010 and after 2010-were 56.5 Bq/m3, 67.9 Bq/m3 and 81 Bq/m3, respectively. Meanwhile, a comparison of indoor radon concentration was made before and after 2000 among 26 countries, of which 16 countries showed an increasing trend. So, it can be seen the increase in indoor radon concentration in China is not an isolated phenomenon, and the issue of indoor radon pollution still requires further attention.

Countrywide monitoring of absorbed dose rate in air due to outdoor natural gamma radiation in India

The Indian Environmental Radiation Monitoring Network continuously monitors, throughout India, the absorbed dose rate in air due to outdoor natural gamma radiation, by using Geiger-Mueller detector-based standalone environmental radiation monitors. The network consists of 546 monitors spread across 91 monitoring locations distributed all over the country. In this paper, the countrywide long-term monitoring results are summarised. The measured mean dose rate of the monitoring locations followed a log-normal distribution and ranged from 50 to 535 nGy.h-1 with a median value of 91 nGy.h-1. Due to outdoor natural gamma radiation, the average annual effective dose was estimated to be 0.11 mSv.y-1.

Impact of Environmental Radiation on the Incidence of Cancer and Birth Defects in Regions with High Natural Radioactivity

Four regions of high natural radioactivity were selected to assess radionuclide levels in rocks and soils, ambient radiation doses, radon exhalation from the ground, and radon concentrations in the air. The regions have different geochemical characteristics and radioactivity levels, which modulate the radiation exposure of local populations. Combining radiometric data with data from regional health statistics on non-infectious diseases, a statistically significant positive correlation was found between radiation exposure and the incidence of cancer and birth defects. Although this is a preliminary and prospective study, the empirical evidence gathered in this paper indicated increased the incidence of some diseases in relationship with the natural radiation background. It is suggested that further research, including epidemiological studies and direct determination of radiation exposures in regions with a high natural radiation background, is needed and justified.

Residential exposure to natural background radiation at birth and risk of childhood acute leukemia in France, 1990-2009

BACKGROUND

The role of natural background radiation (NBR) in childhood acute leukemia (AL) remains unclear. Several large record based studies have recently reported heterogeneous results. Differences in exposure assessment timing may explain this heterogeneity.

OBJECTIVES

In a previous ecological study we did not observe any association between childhood AL incidence in France and NBR exposure at the time of diagnosis. With the same methodology, the present study focused on NBR exposure at the time of birth. Based on data from the French national registry of childhood cancer, we analyzed all AL together, and lymphoblastic and myeloid AL, separately.

METHODS

We included 6,059 childhood AL cases born and diagnosed in mainland France between 1990 and 2009. NBR levels in municipalities of residence at birth were estimated by cokriging models, using NBR measurements and precise geological data. The incidence rate ratio (IRR) per unit variation of exposure was estimated with Poisson regression models, with adjustment for socio-demographic indicators and ultraviolet radiation levels. NBR exposures were considered at the time of birth, and cumulatively from birth to diagnosis. We also estimated a total NBR dose to red-bone marrow (RBM).

RESULTS

There was no evidence for an association between NBR exposure at birth and childhood AL incidence, neither overall (gamma radiation: IRR = 0.99 (0.94,1.05) per 50 nSv/h; radon: IRR = 0.97 (0.91,1.03) per 100 Bq/m³) nor for the main AL types. The conclusions were similar with the cumulative exposures, and the total RBM dose.

CONCLUSIONS

The study was based on high quality incidence data, large numbers of AL cases, and validated models of NBR exposure assessment. In all, the results further support the hypothesis that NBR are not associated to childhood AL in France.

A discussion on the potential impact of residential radon exposure on the quality of exposure and risk assessment for former uranium miners

Epidemiological evidence of lung cancer risk from radon is based mainly on studies of underground miners where occupational exposures were, historically, relatively high in comparison to residential indoor exposure. However, radiation protection measures have caused radon levels in uranium mines to decrease significantly in more recent periods. Miners' occupational exposure is limited to their working years while they are exposed to environmental radon at home over their entire lifetime. Even during their limited working years, workers spend much more time at home than in workplaces. The biological effect of radon in mines cannot be distinguished from the biological effect of residential radon. Therefore, for an exposure-risk relationship study of former uranium miners, excess radon-induced lung cancer cases should be related to the combined radon exposure cumulated in workplaces and at homes in excess of the radon exposure of the reference population. This is especially important when residential radon levels differ or vary significantly between miners and the reference population over the course of extended follow-up years. This paper reviews some recent studies on former uranium miners, shares what seems controversial to the author and wonders whether lifetime exposure at home to widely varying radon concentrations can actually impact the quality of exposure assessment, and hence impact the results of the exposure-risk relationship.

COSMIC RADIATION EXPOSURE TO THE AUSTRALIAN PUBLIC

A component of natural background radiation is exposure to galactic cosmic radiation (GCR). Annual GCR doses to the Australian public at ground levels and at altitudes of commercial domestic and international flights were estimated using the cosmic radiation dose modelling tool CARI-6. The annual population weighted average dose to Australians from GCR was estimated to be 342 μSv, of which 14.7 μSv (5%) was from domestic travel, 30.7 μSv (10%) was from international travel and 297 μSv (85%) of the dose was received at ground level. This study showed that critical population groups that are frequent flyers may exceed reference levels where additional awareness or protection should be considered. The GCR dose portion is ~25% of the total annual background radiation dose received by the Australian public.

A review of studies of childhood cancer and natural background radiation

PURPOSE

The projected existence and magnitude of carcinogenic effects of ionizing radiation at low doses and low-dose rates is perhaps the most important issue in radiation protection today. Studies of childhood cancer and natural background radiation have the potential to throw direct light on this question, into a dose range below a few tens of mSv. This paper describes the studies that have been undertaken and their context, discusses some problems that arise and summarizes the present position.

CONCLUSIONS

Many such studies have been undertaken, but most were too small to have a realistic chance of detecting the small effects expected from such low doses, based on risk projections from higher exposures. Case-control or cohort studies are to be preferred methodologically to ecological studies but can be prone to problems of registration/participation bias. Interview-based studies of the requisite size would be prohibitively expensive and would undoubtedly also run into problems of participation bias. Register-based studies can be very large and are free of participation bias. However, they need to estimate the radiation exposure of study subjects using models rather than individual measurements in the homes of those concerned. At present, no firm conclusions can be drawn from the studies that have been published to date. Further data and perhaps pooled studies offer a way forward.

Spatial distribution, risk assessment and influence factors of terrestrial gamma radiation dose in China

The current spatial distribution of the risk of terrestrial gamma radiation in China were investigated by using spatial interpolation. And the driving factors influence on the terrestrial gamma radiation dose (TGRD) distribution were identified using the geographic detector, a new statistical method based on the nonlinear hypothesis. The results showed that the values of TGRD were range from 60 to 195 nGy h^-1 with the average of 86.5 nGy h^-1, and the higher values were recorded in Qingahi-Tibet Plateau, which were all within the range of background value in China. In addition, the radiological indices, ELCR (Excess Lifetime Cancer Risk), TGRD and AEDE (Annual Effective Dose Equivalent) were also within the acceptable range of values by risk assessment. The results by use of the geographic detector showed that sunshine duration, atmosphere pressure, altitude, and rainfall condition have closely related to the TGRD distribution. In addition, these meteorological factors and altitude had more impact on TGRD than the air pollution-related factors. Our study can provide useful information on studying the influence mechanism of the TGRD distribution, the variability of the natural terrestrial gamma radiation in China, and exposure data for risk assessment from low dose chronic exposures.

Quantitative health impact of indoor radon in France

Radon is the second leading cause of lung cancer after smoking. Since the previous quantitative risk assessment of indoor radon conducted in France, input data have changed such as, estimates of indoor radon concentrations, lung cancer rates and the prevalence of tobacco consumption. The aim of this work was to update the risk assessment of lung cancer mortality attributable to indoor radon in France using recent risk models and data, improving the consideration of smoking, and providing results at a fine geographical scale. The data used were population data (2012), vital statistics on death from lung cancer (2008-2012), domestic radon exposure from a recent database that combines measurement results of indoor radon concentration and the geogenic radon potential map for France (2015), and smoking prevalence (2010). The risk model used was derived from a European epidemiological study, considering that lung cancer risk increased by 16% per 100 becquerels per cubic meter (Bq/m3) indoor radon concentration. The estimated number of lung cancer deaths attributable to indoor radon exposure is about 3000 (1000; 5000), which corresponds to about 10% of all lung cancer deaths each year in France. About 33% of lung cancer deaths attributable to radon are due to exposure levels above 100 Bq/m3. Considering the combined effect of tobacco and radon, the study shows that 75% of estimated radon-attributable lung cancer deaths occur among current smokers, 20% among ex-smokers and 5% among never-smokers. It is concluded that the results of this study, which are based on precise estimates of indoor radon concentrations at finest geographical scale, can serve as a basis for defining French policy against radon risk.

Quantitative Health Risk Assessment of Indoor Radon: A Systematic Review

Exposure to radon is a well-established cause of lung cancer in the general population. The aim of the present work is to identify and summarize the results of studies that have assessed the risk of lung cancer due to indoor radon, based on a systematic review of relevant published studies. Sixteen studies from 12 different countries met eligibility criteria. Large differences in radon concentrations were noted between and within individual countries, and variety of risk models used to estimate the attributable fraction. Calculating again the attributable fraction in each of these studies using the same model (coefficient of 16% per 100 becquerels per cubic meter (Bq/m3) derived from the European residential radon study), the new attributable fraction of these selected studies ranged from 3% to 17%. Radon remains a public health concern. Information about radon health risks is important and efforts are needed to decrease the associated health problems.

Estimation and mapping of uranium content of geological units in France

In France, natural radiation accounts for most of the population exposure to ionizing radiation. The Institute for Radiological Protection and Nuclear Safety (IRSN) carries out studies to evaluate the variability of natural radioactivity over the French territory. In this framework, the present study consisted in the evaluation of uranium concentrations in bedrocks. The objective was to provide estimate of uranium content of each geological unit defined in the geological map of France (1:1,000,000). The methodology was based on the interpretation of existing geochemical data (results of whole rock sample analysis) and the knowledge of petrology and lithology of the geological units, which allowed obtaining a first estimate of the uranium content of rocks. Then, this first estimate was improved thanks to some additional information. For example, some particular or regional sedimentary rocks which could present uranium contents higher than those generally observed for these lithologies, were identified. Moreover, databases on mining provided information on the location of uranium and coal/lignite mines and thus indicated the location of particular uranium-rich rocks. The geological units, defined from their boundaries extracted from the geological map of France (1:1,000,000), were finally classified into 5 categories based on their mean uranium content. The map obtained provided useful data for establishing the geogenic radon map of France, but also for mapping countrywide exposure to terrestrial radiation and for the evaluation of background levels of natural radioactivity used for impact assessment of anthropogenic activities.

Attributable risk of lung cancer deaths due to indoor radon exposure

Exposure to radon gas is the second most common cause of lung cancer after smoking. A large number of studies have reported that exposure to indoor radon, even at low concentrations, is associated with lung cancer in the general population. This paper reviewed studies from several countries to assess the attributable risk (AR) of lung cancer death due to indoor radon exposure and the effect of radon mitigation thereon. Worldwide, 3-20 % of all lung cancer deaths are likely caused by indoor radon exposure. These values tend to be higher in countries reporting high radon concentrations, which can depend on the estimation method. The estimated number of lung cancer deaths due to radon exposure in several countries varied from 150 to 40,477 annually. In general, the percent ARs were higher among never-smokers than among ever-smokers, whereas much more lung cancer deaths attributable to radon occurred among ever-smokers because of the higher rate of lung cancers among smokers. Regardless of smoking status, the proportion of lung cancer deaths induced by radon was slightly higher among females than males. However, after stratifying populations according to smoking status, the percent ARs were similar between genders. If all homes with radon above 100 Bq/m(3) were effectively remediated, studies in Germany and Canada found that 302 and 1704 lung cancer deaths could be prevented each year, respectively. These estimates, however, are subject to varying degrees of uncertainty related to the weakness of the models used and a number of factors influencing indoor radon concentrations.

Attributable risk of lung cancer deaths due to indoor radon exposure

Exposure to radon gas is the second most common cause of lung cancer after smoking. A large number of studies have reported that exposure to indoor radon, even at low concentrations, is associated with lung cancer in the general population. This paper reviewed studies from several countries to assess the attributable risk (AR) of lung cancer death due to indoor radon exposure and the effect of radon mitigation thereon. Worldwide, 3-20 % of all lung cancer deaths are likely caused by indoor radon exposure. These values tend to be higher in countries reporting high radon concentrations, which can depend on the estimation method. The estimated number of lung cancer deaths due to radon exposure in several countries varied from 150 to 40,477 annually. In general, the percent ARs were higher among never-smokers than among ever-smokers, whereas much more lung cancer deaths attributable to radon occurred among ever-smokers because of the higher rate of lung cancers among smokers. Regardless of smoking status, the proportion of lung cancer deaths induced by radon was slightly higher among females than males. However, after stratifying populations according to smoking status, the percent ARs were similar between genders. If all homes with radon above 100 Bq/m(3) were effectively remediated, studies in Germany and Canada found that 302 and 1704 lung cancer deaths could be prevented each year, respectively. These estimates, however, are subject to varying degrees of uncertainty related to the weakness of the models used and a number of factors influencing indoor radon concentrations.

Indoor terrestrial gamma dose rate mapping in France: a case study using two different geostatistical models

Terrestrial gamma dose rates show important spatial variations in France. Previous studies resulted in maps of arithmetic means of indoor terrestrial gamma dose rates by "departement" (French district). However, numerous areas could not be characterized due to the lack of data. The aim of our work was to obtain more precise estimates of the spatial variability of indoor terrestrial gamma dose rates in France by using a more recent and complete data base and geostatistics. The study was based on the exploitation of 97,595 measurements results distributed in 17,404 locations covering all of France. Measurements were done by the Institute for Radioprotection and Nuclear Safety (IRSN) using RPL (Radio Photo Luminescent) dosimeters, exposed during several months between years 2011 and 2012 in French dentist surgeries and veterinary clinics. The data used came from dosimeters which were not exposed to anthropic sources. After removing the cosmic rays contribution in order to study only the telluric gamma radiation, it was decided to work with the arithmetic means of the time-series measurements, weighted by the time-exposure of the dosimeters, for each location. The values varied between 13 and 349 nSv/h, with an arithmetic mean of 76 nSv/h. The observed statistical distribution of the gamma dose rates was skewed to the right. Firstly, ordinary kriging was performed in order to predict the gamma dose rate on cells of 1*1 km(2), all over the domain. The second step of the study was to use an auxiliary variable in estimates. The IRSN achieved in 2010 a classification of the French geological formations, characterizing their uranium potential on the bases of geology and local measurement results of rocks uranium content. This information is georeferenced in a map at the scale 1:1,000,000. The geological uranium potential (GUP) was classified in 5 qualitative categories. As telluric gamma rays mostly come from the progenies of the (238)Uranium series present in rocks, this information, which is exhaustive throughout France, could help in estimating the telluric gamma dose rates. Such an approach is possible using multivariate geostatistics and cokriging. Multi-collocated cokriging has been performed on 1*1 km(2) cells over the domain. This model used gamma dose rate measurement results and GUP classes. Our results provide useful information on the variability of the natural terrestrial gamma radiation in France ('natural background') and exposure data for epidemiological studies and risk assessment from low dose chronic exposures.

A statistical evaluation of the influence of housing characteristics and geogenic radon potential on indoor radon concentrations in France

Radon-222 is a radioactive natural gas produced by the decay of radium-226, known to be the main contributor to natural background radiation exposure. Effective risk management needs to determine the areas in which the density of buildings with high radon levels is likely to be highest. Predicting radon exposure from the location and characteristics of a dwelling could also contribute to epidemiological studies. Beginning in the nineteen-eighties, a national radon survey consisting in more than 10,000 measurements of indoor radon concentrations was conducted in French dwellings by the Institute for Radiological Protection and Nuclear Safety (IRSN). Housing characteristics, which may influence radon accumulation in dwellings, were also collected. More recently, the IRSN generated a French geogenic radon potential map based on the interpretation of geological features. The present study analyzed the two datasets to investigate the factors influencing indoor radon concentrations using statistical modeling and to determine the optimum use of the information on geogenic radon potential that showed the best statistical association with indoor radon concentration. The results showed that the variables associated with indoor radon concentrations were geogenic radon potential, building material, year of construction, foundation type, building type and floor level. The model, which included the surrounding geogenic radon potential (i.e. the average geogenic radon potential within a disc of radius 20 km centered on the indoor radon measurement point) and variables describing house-specific factors and lifestyle explained about 20% of the overall variability of the logarithm of radon concentration. The surrounding geogenic radon potential was fairly closely associated with the local average indoor radon concentration. The prevalence of exposure to radon above specific thresholds and the average exposures to radon clearly increased with increasing classes of geogenic radon potential. Combining the two datasets enabled improved assessment of radon exposure in a given area in France.

[Knowledge about radon and its associated risk perception in France]

PURPOSE

Radon exposure is a major environmental risk in health. It remains badly known by the general population. It is the second cause of lung cancer, after tobacco smoking. The aim of this cross-sectional general population survey was to describe radon exposure risk knowledge and the socioeconomic factors related to this knowledge.

MATERIALS AND METHODS

The Cancer Barometer survey 2010 questioned the French population about its knowledge of radon as such and as health risk factor. This survey was a two-stage random sampling with computer-assisted telephone interview that was performed from April 3, 2010 to August 7, 2010 on a sample of 3,359 people aged 15 to 75 years old.

RESULTS

Among people aged 15 to 75 years old, only one in five knows that radon is a natural gas coming from the ground. This knowledge is more frequent among people living in an area that is directly concerned by radon, among men and increases with age, with the level of education and the level of income. Radon risk remains still widely underestimated by the general public, including in areas concerned by this risk. When people were confronted with radon exposure, few intended to remedy by improving their home.

CONCLUSION

The success of prevention initiatives implies the support and the collaboration of various national and local actors. To improve their impact for the prevention of lung cancers, it could be more effective to couple these actions with prevention messages on tobacco.

Potential impacts of radon, terrestrial gamma and cosmic rays on childhood leukemia in France: a quantitative risk assessment

Previous epidemiological studies and quantitative risk assessments (QRA) have suggested that natural background radiation may be a cause of childhood leukemia. The present work uses a QRA approach to predict the excess risk of childhood leukemia in France related to three components of natural radiation: radon, cosmic rays and terrestrial gamma rays, using excess relative and absolute risk models proposed by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Both models were developed from the Life Span Study (LSS) of Japanese A-bomb survivors. Previous risk assessments were extended by considering uncertainties in radiation-related leukemia risk model parameters as part of this process, within a Bayesian framework. Estimated red bone marrow doses cumulated during childhood by the average French child due to radon, terrestrial gamma and cosmic rays are 4.4, 7.5 and 4.3 mSv, respectively. The excess fractions of cases (expressed as percentages) associated with these sources of natural radiation are 20 % [95 % credible interval (CI) 0-68 %] and 4 % (95 % CI 0-11 %) under the excess relative and excess absolute risk models, respectively. The large CIs, as well as the different point estimates obtained under these two models, highlight the uncertainties in predictions of radiation-related childhood leukemia risks. These results are only valid provided that models developed from the LSS can be transferred to the population of French children and to chronic natural radiation exposures, and must be considered in view of the currently limited knowledge concerning other potential risk factors for childhood leukemia. Last, they emphasize the need for further epidemiological investigations of the effects of natural radiation on childhood leukemia to reduce uncertainties and help refine radiation protection standards.

Radiation exposure from CT in early childhood: a French large-scale multicentre study

OBJECTIVES

The increasing use of CT scans in the paediatric population raises the question of a possible health impact of ionising radiation exposure associated with CT scans. The aim of this study was to describe the pattern of CT use in early childhood.

METHODS

In 14 major French paediatric radiology departments, children undergoing at least 1 CT scan before age 5, between 2000 and 2006, were included. For each examination, absorbed organ doses were calculated.

RESULTS

43% of the 27 362 children in the cohort were aged less than 1 year during their first exposure, with 9% being aged less than 1 month. The mean number of examinations per child was 1.6 (range 1-43). The examinations included: head in 63% of the cases, chest in 21%, abdomen and pelvis in 8% and others in 8%. Brain and eye lenses received the highest cumulative doses from head examinations, with mean organ dose values of 22 mGy (maximum 1107 mGy) and 26 mGy (maximum 1392 mGy), respectively. The mean cumulative effective dose was 3.2 mSv (range 0.1-189 mSv).

CONCLUSION

CT scan exposure in childhood is responsible for relatively high doses to radiosensitive organs. The rather large dose range according to the protocols used requires their optimisation. The cohort follow-up will study the risk of long-term radiation-induced cancer.

Cancer and non-cancer mortality among Inhabitants in the high background radiation area of Yangjiang, China (1979-1998)

The present study aimed to evaluate the effects of high background radiation (HBR) on mortality. A cohort of 31,604 men and women aged 30-74 y living in the study area in Guangdong Province, China, was followed during the period 1979-1998. The information on deaths and migrations of cohort members was collected by visiting study areas every 3-4 y. Cumulative external radiation dose, lagged by 2 y for leukemia and 10 y for cancer excluding leukemia, was estimated for each individual based on hamlet-specific indoor and outdoor doses, and gender- and age-specific house occupancy factors. The follow-up study accumulated 736,942 person-years at risk and ascertained 6,005 deaths, including 956 cancer deaths and 4,525 non-cancer disease deaths. Mean cumulative radiation doses from natural radiation in the HBR and control area residents were 84.8 mGy and 21.6 mGy, respectively. Mortality due to leukemia (15 deaths) or cancer excluding leukemia (941 deaths) was not related to cumulative radiation dose. The excess relative risk (ERR) Gy of cancer excluding leukemia was estimated to be -1.01 (95% CI: -2.53, 0.95). In site-specific analysis, liver-cancer mortality was inversely related to the cumulative dose (p=0.002). Note, however, that liver cancer is well known for its difficulty in accurate diagnosis. The ERR Gy of cancer excluding leukemia and liver cancer was 0.19 (95% CI: -1.87, 3.04). Non-cancer disease mortality was not related to cumulative radiation dose either. The cumulative HBR dose was not related to the mortality due to cancer or all non-cancer diseases among residents in Yangjiang HBR areas.

Eye lens radiation exposure and repeated head CT scans: A problem to keep in mind

OBJECTIVES

The deterministic character of radiation-induced cataract is being called into question, raising the possibility of a risk in patients, especially children, exposed to ionizing radiation in case of repeated head CT-scans. This study aims to estimate the eye lens doses of a pediatric population exposed to repeated head CTs and to assess the feasibility of an epidemiological study.

METHODS

Children treated for a cholesteatoma, who had had at least one CT-scan of the middle ear before their tenth birthday, were included. Radiation exposure has been assessed from medical records and telephone interviews.

RESULTS

Out of the 39 subjects contacted, 32 accepted to participate. A total of 76 CT-scans were retrieved from medical records. At the time of the interview (mean age: 16 years), the mean number of CT per child was 3. Cumulative mean effective and eye lens doses were 1.7mSv and 168mGy, respectively.

CONCLUSION

A relatively high lens radiation dose was observed in children exposed to repeated CT-scans. Due to that exposure and despite the difficulties met when trying to reach patients' families, a large scale epidemiological study should be performed in order to assess the risk of radiation-induced cataracts associated with repeated head CT.

Background radiation and cancer incidence in Kerala, India-Karanagappally cohort study

The coastal belt of Karunagappally, Kerala, India, is known for high background radiation (HBR) from thorium-containing monazite sand. In coastal panchayats, median outdoor radiation levels are more than 4 mGy y-1 and, in certain locations on the coast, it is as high as 70 mGy y-1. Although HBR has been repeatedly shown to increase the frequency of chromosome aberrations in the circulating lymphocytes of exposed persons, its carcinogenic effect is still unproven. A cohort of all 385,103 residents in Karunagappally was established in the 1990's to evaluate health effects of HBR. Based on radiation level measurements, a radiation subcohort consisting of 173,067 residents was chosen. Cancer incidence in this subcohort aged 30-84 y (N = 69,958) was analyzed. Cumulative radiation dose for each individual was estimated based on outdoor and indoor dosimetry of each household, taking into account sex- and age-specific house occupancy factors. Following 69,958 residents for 10.5 years on average, 736,586 person-years of observation were accumulated and 1,379 cancer cases including 30 cases of leukemia were identified by the end of 2005. Poisson regression analysis of cohort data, stratified by sex, attained age, follow-up interval, socio-demographic factors and bidi smoking, showed no excess cancer risk from exposure to terrestrial gamma radiation. The excess relative risk of cancer excluding leukemia was estimated to be -0.13 Gy-1 (95% CI: -0.58, 0.46). In site-specific analysis, no cancer site was significantly related to cumulative radiation dose. Leukemia was not significantly related to HBR, either. Although the statistical power of the study might not be adequate due to the low dose, our cancer incidence study, together with previously reported cancer mortality studies in the HBR area of Yangjiang, China, suggests it is unlikely that estimates of risk at low doses are substantially greater than currently believed.

Gamma radiation doses to people living in Western Sweden

Indoor environments contribute to gamma radiation in the general population. The aims of the present study were to investigate average gamma radiation doses in a rural and an urban area of Sweden, compare indoor dose rates with personal exposure, and study the effects of building characteristics on radiation levels. Radiation was measured with thermoluminescence dosimeters (TLDs). Repeated measurements were performed with TLDs worn by participants (n=46) and placed in their dwellings. Personal dose rates were 0.092microSv/h (rural) and 0.096microSv/h (urban). The mean effective gamma dose rates in dwellings were 0.091microSv/h (rural) and 0.11microSv/h (urban), which are higher than the world average. Dose rates in apartments were higher than in detached houses and higher for concrete than wooden dwellings. Personal dose rates were strongly associated with dwelling dose rates (r(p)=0.68, p<0.01) and could be modelled. Within-participant variability was low.

Lung cancer attributable to indoor radon exposure in france: impact of the risk models and uncertainty analysis

OBJECTIVE

The inhalation of radon, a well-established human carcinogen, is the principal-and omnipresent-source of radioactivity exposure for the general population of most countries. Scientists have thus sought to assess the lung cancer risk associated with indoor radon. Our aim here is to assess this risk in France, using all available epidemiologic results and performing an uncertainty analysis.

METHODS

We examined the exposure-response relations derived from cohorts of miners and from joint analyses of residential case-control studies and considered the interaction between radon and tobacco. The exposure data come from measurement campaigns conducted since the beginning of the 1980s by the Institute for Radiation Protection and Nuclear Safety and the Directorate-General of Health in France. We quantified the uncertainties associated with risk coefficients and exposures and calculated their impact on risk estimates.

RESULTS

The estimated number of lung cancer deaths attributable to indoor radon exposure ranges from 543 [90% uncertainty interval (UI) , 75-1,097] to 3,108 (90% UI, 2,996-3,221) , depending on the model considered. This calculation suggests that from 2.2% (90% UI, 0.3-4.4) to 12.4% (90% UI, 11.9-12.8) of these deaths in France may be attributable to indoor radon.

DISCUSSION

In this original work we used different exposure-response relations from several epidemiologic studies and found that regardless of the relation chosen, the number of lung cancer deaths attributable to indoor radon appears relatively stable. Smokers can reduce their risk not only by reducing their indoor radon concentration but also by giving up smoking.

Childhood leukaemia incidence around French nuclear installations using geographic zoning based on gaseous discharge dose estimates

The present study investigated for the first time the incidence of childhood leukaemia (1990–2001) around French nuclear installations using a geographic zoning based on estimated doses to the red bone marrow due to gaseous radioactive discharges. The observed number of cases of acute leukaemia (O=750) in 40 km² centred on 23 French nuclear installations between 1990 and 2001 was lower than expected (E=795.01), although not significantly so (standardised incidence ratio SIR=0.94, 95% confidence interval=(0.88–1.01)). In none of the five zones defined on the basis of the estimated doses was the SIR significantly >1. There was no evidence of a trend in SIR with the estimated doses for all the children or for any of the three age groups studied. This study confirmed that there was no evidence of an increased incidence of childhood leukaemia around the 23 French nuclear sites.

Childhood leukemia incidence and exposure to indoor radon, terrestrial and cosmic gamma radiation

This study was undertaken to evaluate the ecological association between terrestrial and cosmic gamma radiation, indoor radon, and acute leukemia incidence among children under 15 y of age. From 1990 to 2001, 5,330 cases of acute leukemia were registered by the French National Registry of Childhood Leukemia and Lymphoma. Exposure to terrestrial gamma radiation was based on measurements, using thermoluminescent dosimeters, at about 1,000 sites covering all the "Départements." In addition, 8,737 indoor terrestrial gamma dose rate measurements covering 62% of the "Départements" and 13,240 indoor radon concentration measurements covering all the "Départements" were made during a national campaign. Cosmic ray doses were estimated in each of the 36,363 "Communes" of France. There was no evidence of an ecological association between terrestrial gamma dose (range: 0.22-0.90 mSv y) or total gamma dose (range: 0.49-1.28 mSv y) and childhood acute leukemia incidence, for acute myeloid leukemia (AML) or for acute lymphoblastic leukemia (ALL), in univariate or multivariate regression analyses including indoor radon. A significant positive association between indoor radon (range: 22-262 Bq m) and AML incidence among children was observed and remained significant in multivariate regression analyses including either terrestrial gamma dose [SIR per 100 Bq m = 1.29 (1.09-1.53)] or total gamma dose [SIR per 100 Bq m = 1.29 (1.09-1.53)]. The study showed no ecological association between terrestrial gamma radiation and childhood leukemia for the range of variation in gamma dose rates observed in France. The moderate ecological association between childhood AML incidence and indoor radon does not appear to be confounded by terrestrial gamma dose.