Dose to red bone marrow from natural radon and thoron exposure

Residential radon exposure and leukemia: A meta-analysis and dose-response meta-analyses for ecological, case-control, and cohort studies

INTRODUCTION

In this study, the authors conducted a comprehensive systematic review and meta-analysis (including a dose-response meta-analysis) for a possible causal association between residential radon exposure and leukemia. All 3 types of study design, including ecological, case-control, and cohort studies, were included in this study. In particular, different measurement units of radon exposure among studies were dealt with and analyzed thoroughly.

METHODS

A medical librarian searched MEDLINE (PubMed), EMBASE, and the Cochrane Library (from January 01, 1970 to November 05, 2020). For ecological studies, a conventional meta-analysis and subgroup analyses with meta-ANOVA analyses were conducted. For case-control and cohort studies, a two-stage dose-response meta-analysis was conducted.

RESULTS

A total of 8 ecological, 9 case-control, and 15 ecological-cohort studies were analyzed. For ecological studies, the pooled correlation coefficient was 0.48 (95% CI 0.41-0.54). In the meta-analysis of variance (ANOVA) analyses, the age group (childhood vs. adult) showed a statistically significant result (Q = 7.93 and p = 0.019) with the pooled correlation coefficient for childhood, adult, and all age group of 0.67 (95% CI 0.53-0.77), 0.46 (95% CI 0.05-0.74), and 0.44 (95% CI 0.36-0.51), respectively. For case-control studies, the dose-response meta-analysis showed the pooled OR increase of 1.0308 (95% CI 1.0050-1.0573) for each 100 Bq/m³ increase of radon dose. The pooled OR increase was 1.0361 (95% CI 1.0014-1.0720) for each 100 Bq/m³ increase of radon dose for lymphoid leukemia subgroup and 1.0309 (95% CI 1.0050-1.0575) for each 100 Bq/m³ increase of radon dose for childhood leukemia subgroup. Because of the inclusion of ecological studies with larger exposure assessment units, the pooled RR from ecological-cohort studies should be interpreted conservatively (a tendency towards a higher risk estimate). The overall pooled RR increase for each 100 Bq/m³ increase of radon dose was 1.1221 (95% CI 1.0184-1.2363). The pooled RR increase was 1.2257 (95% CI 1.0034-1.4972) for each 100 Bq/m³ increase of radon dose for the myeloid leukemia subgroup and 1.2503 (95% CI 1.0233-1.5276) for each 100 Bq/m³ increase of radon dose for adult leukemia subgroup.

DISCUSSION

A number of epidemiologic concepts, including the issue of sample size justification, the possibility of differential participation selection bias for case-control studies, the possibility of random and systematic errors in radon measurement, ecological fallacy for ecological studies, were discussed. The effect of age group, socioeconomic status, and gamma radiation exposure was also discussed. Future more accurate and conclusive large-scale case-control and cohort studies are needed.

SURVEY OF INDOOR RADON LEVELS IN SOME UNIVERSITIES IN SOUTH WESTERN NIGERIA

Indoor radon investigation was carried out in offices of three university campuses located in South-Western part of Nigeria; Federal University of Technology Akure (FUTA), Ekiti State University (EKSU) and Federal University Oye-Ekiti (FUOYE) using CR39 detectors. The mean activity concentration of indoor radon for the investigated offices of all three university campuses was estimated to be 222 ± 44 Bq m-3, which was below the reference level of 300 Bq m-3 recommended by the International Commission on Radiological Protection (ICRP 115). For the three institutions, the probability of lung cancer induction at age 70 years with respect to age of exposure (40, 50, and 60 years) ranged between 1.06 × 10-7 and 6.24 × 10-5. The expected mortality rate due to exposure to a radon activity concentration ranging from 7 to 1358 Bq m-3 was estimated to range from 0 to 44 deaths among a population of 10,000 persons.

RADON IN GROUNDWATER OF MAGADI TALUK, RAMANAGARA DISTRICT IN KARNATAKA

Radon is a water-soluble radioactive noble gas produced from the alpha decay of 226Ra in uranium series. Its presence in drinking water and open air increases the risk of lung and intestinal cancers in human beings. In view of this, radon concentration in groundwater and its dose due to inhalation and ingestion to the population of Magadi taluk of Ramanagara district in Karnataka state, India was studied. The groundwater samples were analyzed for radon concentration using emanometry technique. The study showed that the radon concentration in this area varied from 27.4 ± 1.0 to 167.5 ± 3.9 Bq/L and the effective dose ranged from 104.2 ± 2.7 to 636.2 ± 11.0 μSv/a. The study also revealed that 95% of the 37 samples studied showed higher radon concentration compared to the UNSCEAR recommendation (40 Bq/L) and all the samples showed higher than the USEPA recommendation (11.1 Bq/L). Ten samples have concentration above the maximum permissible level prescribed by WHO (100 Bq/L). The groundwater samples are found to be slightly alkaline within the permissible limit of Indian Standards.

Assessing cancer risk factors faced by an Ancestral Puebloan population in the North American Southwest

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.

Cancer incidence and mortality from exposure to radon progeny among Ontario uranium miners

OBJECTIVES

The study objectives were to extend the follow-up of the Ontario uranium miners cohort, one of the largest cohorts of uranium miners with low cumulative exposures, to examine the relationship between radon exposure and lung cancer mortality and, for the first time incidence, and address gaps in the literature, including dose-response relationship between radon exposure and other cancer sites, and non-cancer mortality.

METHODS

The cohort of mine and mill workers was created using data from Canada's National Dose Registry and the Ontario Mining Master File. The follow-up for the cohort was recently extended for mortality (1954-2007) and for the first time includes cancer incidence (1969-2005). The Poisson regression was used to estimate relative risks (RR) and excess relative risks (ERR) and their 95% CIs with levels of cumulative radon exposure.

RESULTS

The cohort consisted of 28 546 male miners with a mean cumulative radon exposure of 21.0 working level months (WLM). An increased risk of lung cancer and a dose-response relationship was observed with cumulative radon exposure. Miners exposed to >100 WLM demonstrated a twofold increase in the risk of lung cancer incidence (RR=1.89, CI 1.43 to 2.50) compared with the non-exposed group, and a linear ERR of 0.64/100 WLM (CI 0.43 to 0.85), with similar results observed for mortality. No association was observed for other cancer sites (stomach, leukaemia, kidney and extrathoracic airways) or non-cancer sites (cardiovascular diseases) with increasing cumulative exposure to radon.

CONCLUSIONS

These findings suggest no increased risk of cancer sites other than lung or non-cancer mortality from relatively low cumulative exposure to radon.

Childhood exposures to Rn-222 and background gamma radiation in the uranium provinces of south Kazakhstan and northern Kyrgyzstan

The project was undertaken in southern Kazakhstan and Kyrgyzstan. It was speculated that the radiation doses in these areas would be sufficiently high and dispersed to facilitate a case-control study where the radiation doses to leukaemia subjects/their siblings could be compared with those received by control children. As a precursor a pilot project was undertaken to confirm radiation exposures in the region. This was undertaken in association with regional childhood cancer treatment centres. Children from families affected by childhood leukaemia were monitored for 1 month for external γ-radiation dose and for exposure to radon gas. 28 children from families in Kazakhstan and from 31 families in Kyrgyzstan were monitored. The median measured radon in air concentration recorded in Kazakhstan was 123 Bq m(-3) and in Kyrgyzstan was 177 Bq m(-3). These represent 24-h average indoor/outdoor values. In the case of the γ-doses the mean annual dose was 1.2 mGy for Kazakhstan and 2.1 mGy for Kyrgyzstan. Overall, the results suggest that the populations studied receive similar annual radiation doses to those received by populations living in other areas with enhanced natural radioactivity and that further study of Kazakh and Kyrgyz populations would not facilitate a successful case-control study for childhood leukaemia.

The cellular and molecular carcinogenic effects of radon exposure: a review

Radon-222 is a naturally occurring radioactive gas that is responsible for approximately half of the human annual background radiation exposure globally. Chronic exposure to radon and its decay products is estimated to be the second leading cause of lung cancer behind smoking, and links to other forms of neoplasms have been postulated. Ionizing radiation emitted during the radioactive decay of radon and its progeny can induce a variety of cytogenetic effects that can be biologically damaging and result in an increased risk of carcinogenesis. Suggested effects produced as a result of alpha particle exposure from radon include mutations, chromosome aberrations, generation of reactive oxygen species, modification of the cell cycle, up or down regulation of cytokines and the increased production of proteins associated with cell-cycle regulation and carcinogenesis. A number of potential biomarkers of exposure, including translocations at codon 249 of TP53 in addition to HPRT mutations, have been suggested although, in conclusion, the evidence for such hotspots is insufficient. There is also substantial evidence of bystander effects, which may provide complications when calculating risk estimates as a result of exposure, particularly at low doses where cellular responses often appear to deviate from the linear, no-threshold hypothesis. At low doses, effects may also be dependent on cellular conditions as opposed to dose. The cellular and molecular carcinogenic effects of radon exposure have been observed to be both numerous and complex and the elevated chronic exposure of man may therefore pose a significant public health risk that may extend beyond the association with lung carcinogenesis.

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.

Occurrence of ²¹⁰Po and biological effects of low-level exposure: the need for research

BACKGROUND

Polonium-210 (²¹⁰Po) concentrations that exceed 1 Bq/L in drinking-water supplies have been reported from four widely separated U.S. states where exposure to it went unnoticed for decades. The radionuclide grandparents of ²¹⁰Po are common in sediments, and segments of the public may be chronically exposed to low levels of ²¹⁰Po in drinking water or in food products from animals raised in contaminated areas.

OBJECTIVES

We summarized information on the environmental behavior, biokinetics, and toxicology of ²¹⁰Po and identified the need for future research.

METHODS

Potential linkages between environmental exposure to ²¹⁰Po and human health effects were identified in a literature review.

DISCUSSION

²¹⁰Po accumulates in the ovaries where it kills primary oocytes at low doses. Because of its radiosensitivity and tendency to concentrate ²¹⁰Po, the ovary may be the critical organ in determining the lowest injurious dose for ²¹⁰Po. ²¹⁰Po also accumulates in the yolk sac of the embryo and in the fetal and placental tissues. Low-level exposure to ²¹⁰Po may have subtle, long-term biological effects because of its tropism towards reproductive and embryonic and fetal tissues where exposure to a single alpha particle may kill or damage critical cells. ²¹⁰Po is present in cigarettes and maternal smoking has several effects that appear consistent with the toxicology of ²¹⁰Po.

CONCLUSIONS

Much of the important biological and toxicological research on ²¹⁰Po is more than four decades old. New research is needed to evaluate environmental exposure to ²¹⁰Po and the biological effects of low-dose exposure to it so that public health officials can develop appropriate mitigation measures where necessary.

Environmental radon exposure and childhood leukemia

Despite the fact that animal and human epidemiological studies confirmed a link between radon exposure in homes and increased risk of lung cancer in general population, other types of cancers induced by radon, such as leukemia, have not been consistently demonstrated. The aim of this review was to summarize data published thus far from ecological and case-control studies in exposed populations, taking into account radon dose estimation and evidence of radon-induced genotoxicity, in an effort to clarify the correlation between home radon exposure and incidence of childhood leukemia. Among 12 ecological studies, 11 reported a positive association between radon levels and elevated frequency of childhood leukemia, with 8 being significant. In conjunction with ecological studies, several case-control studies on indoor radon exposure and childhood leukemia were examined, and most investigations indicated a weak association with only a few showing significance. A major source of uncertainty in radon risk assessment is radon dose estimate. Methods for radon exposure measurement in homes of children are one of the factors that affect the risk estimates in a case-control study. The effects of radon-induced genetic damage were studied both in vitro and in vivo using genetic endpoints including chromosomal aberration (CA), micronuclei (MN) formation, gene mutation, and deletions and insertions. By applying a meta-analysis, an increased risk of childhood leukemia induced by indoor radon exposure was noted for overall leukemia and for acute lymphoblastic leukemia (ALL). Data thus indicated an association between environmental radon exposure and elevated leukemia incidence, but more evidence is required in both human investigations and animal mechanistic research before this assumption may be confirmed with certainty.

Stem cell niches and other factors that influence the sensitivity of bone marrow to radiation-induced bone cancer and leukaemia in children and adults

PURPOSE

This paper reviews and reassesses the internationally accepted niches or 'targets' in bone marrow that are sensitive to the induction of leukaemia and primary bone cancer by radiation.

CONCLUSIONS

The hypoxic conditions of the 10 μm thick endosteal/osteoblastic niche where preleukemic stem cells and hematopoietic stem cells (HSC) reside provides a radioprotective microenvironment that is 2- to 3-fold less radiosensitive than vascular niches. This supports partitioning the whole marrow target between the low haematological cancer risk of irradiating HSC in the endosteum and the vascular niches within central marrow. There is a greater risk of induced bone cancer when irradiating a 50 μm thick peripheral marrow adjacent to the remodelling/reforming portion of the trabecular bone surface, rather than marrow next to the quiescent bone surface. This choice of partitioned bone cancer target is substantiated by the greater radiosensitivity of: (i) Bone with high remodelling rates, (ii) the young, (iii) individuals with hypermetabolic benign diseases of bone, and (iv) the epidemiology of alpha-emitting exposures. Evidence is given to show that the absence of excess bone-cancer in atomic-bomb survivors may be partially related to the extremely low prevalence among Japanese of Paget's disease of bone. Radiation-induced fibrosis and the wound healing response may be implicated in not only radiogenic bone cancers but also leukaemia. A novel biological mechanism for adaptive response, and possibility of dynamic targets, is advocated whereby stem cells migrate from vascular niches to stress-mitigated, hypoxic niches.

A physiological skeletal model for radionuclide and stable element biokinetics in children and adults

A physiological skeletal model (PSM) is described that represents the skeletal uptake, retention, and clearance of both bone-surface-seeking and bone-volume-seeking radionuclides and stable elements. A key objective of the PSM is to model the higher skeletal growth and bone turnover in infants and children (compared to adults) in order to account for their greater uptake and cancer risk from bone-seeking contaminants such as lead and plutonium. The PSM is a compartmental model that allows for the incorporation of organic and inorganic material in the bone volume via quiescent bone surfaces, forming bone surfaces and the lacuno-canaliculi system. The model uniquely incorporates a tertiary phase of mineralization via bone fluids. The PSM's structural concepts and biokinetic parameters--such as realistic mass transfers, organ and tissue masses, and bone remodeling half-times--are selected mainly on the basis of physiological and anatomical criteria. For brevity, model parameter values are evaluated for adults only. The PSM is an improvement on existing skeletal models that are based more on compartment structures and pathways that rendered good fits to biokinetic data rather than on being anatomically and physiologically accurate.

Updated estimates of the proportion of childhood leukaemia incidence in Great Britain that may be caused by natural background ionising radiation

The aetiology of childhood leukaemia remains generally unknown, although exposure to moderate and high levels of ionising radiation, such as was experienced during the atomic bombings of Japan or from radiotherapy, is an established cause. Risk models based primarily upon studies of the Japanese A-bomb survivors imply that low-level exposure to ionising radiation, including to ubiquitous natural background radiation, also raises the risk of childhood leukaemia. In a recent paper (Wakeford et al 2009 Leukaemia 23 770-6) we estimated the proportion of childhood leukaemia incidence in Great Britain attributable to natural background radiation to be about 20%. In this paper we employ the two sets of published leukaemia risk models used previously, but use recently published revised estimates of natural background radiation doses received by the red bone marrow of British children to update the previous results. Using the newer dosimetry we calculate that the best estimate of the proportion of cases of childhood leukaemia in Great Britain predicted to be attributable to this source of exposure is 15-20%, although the uncertainty associated with certain stages in the calculation (e.g. the nature of the transfer of risk between populations and the pertinent dose received from naturally occurring alpha-particle-emitting radionuclides) is significant. The slightly lower attributable proportions compared with those previously derived by Wakeford et al (Leukaemia 2009 23 770-6) are largely due to the lower doses (and in particular lower high LET doses) for the first year of life.

Radon and leukemia in the Danish study: another source of dose

An epidemiologic study of childhood leukemia in Denmark (2,400 cases; 6,697 controls) from 1968 to 1994 suggested a weak, but statistically significant, association of residential radon exposure and acute childhood lymphoblastic leukemia (ALL). The Danish study estimated a relative risk (RR) = 1.56 (95% CI, 1.05-2.30) for a cumulative exposure of 1,000 Bq m-3 y. For an exposure duration of 10 y their RR corresponds to a radon concentration of 100 Bq m-3. There are two dose pathways of interest where alpha particles could damage potential stem cells for ALL. One is the alpha dose to bone marrow, and two is the dose to bronchial mucosa where an abundance of circulating lymphocytes is found. Compared with an exposure of about 1 mSv y-1 from natural external background, radon and decay products contribute an additional 10 to 60% to the bone marrow equivalent dose. The other pathway for exposure of T (or B) lymphocytes is within the tracheobronchial epithelium (BE). Inhaled radon decay products deposit on the relatively small area of airway surfaces and deliver a significant dose to the nearby basal or mucous cells implicated in human lung cancer. Lymphocytes are co-located with basal cells and are half as abundant. Using a 10-y exposure to 100 Bq m-3, our dose estimates suggest that the equivalent dose to these lymphocytes could approach 1 Sv. The relatively high dose estimate to lymphocytes circulating through the BE, potential precursor cells for ALL, provides a dose pathway for an association.

Long‐term accumulation and microdistribution of uranium in the bone and marrow of beagle dog

The accumulation and microdistribution of uranium in the bone and marrow of Beagle dogs were determined by both neutron activation and neutron-fission analysis. The experiment started immediately after the weaning period, lasting till maturity. Two animal groups were fed daily with uranyl nitrate at concentrations of 20 and 100 microg g(-1) food. Of the two measuring techniques, uranium accumulated along the marrow as much as in the bone, contrary to the results obtained with single, acute doses. The role played by this finding for the evaluation of radiobiological long-term risks is discussed. It was demonstrated, by means of a biokinetical approach, that the long-term accumulation of uranium in bone and marrow could be described by a piling up of single dose daily incorporation.

Factors that elevate the internal radionuclide and chemical retention, dose and health risks to infants and children in a radiological-nuclear emergency

The factors that influence the dose and risk to vulnerable population groups from exposure and internal uptake of chemicals are examined and, in particular, the radionuclides released in chemical, biological, radiological, nuclear and explosive events. The paper seeks to identify the areas that would benefit from further research. The intake and body burdens of carbon and calcium were assessed as surrogates for contaminants that either act like or bind to hydrocarbons (e.g. tritium and (14)C) or bone-seeking radionuclides (e.g. (90)Sr and (239)Pu). The shortest turnover times for such materials in the whole body were evaluated for the newborn: 11 d and 0.5 y for carbon and calcium, respectively. However, their biokinetic behaviour is complicated by a particularly high percentage of the gut-absorbed dietary intake of carbon (approximately 16%) and calcium (approximately 100%) that is incorporated into the soft tissue and skeleton of the growing neonate. The International Commission on Radiological Protection dose coefficients (Sv Bq(-1)) were examined for 14 radionuclides, including 9 of concern because of their potential use in radiological dispersal devices. The dose coefficients for a 3-month-old are greater than those for adults (2-56 times more for ingestion and 2-12 times for inhalation). The age-dependent dose and exposure assessment of contaminant intakes would improve by accounting for gender and growth where it is currently neglected. Health risk is evaluated as the product of the exposure and hazard factors, the latter being about 10-fold greater in infants than in adults. The exposure factor is also approximately 10-fold higher for ingestion by infants than by adults, and unity for inhalation varying with the contaminant. Qualitative and quantitative physiological and epidemiological evidence supports infants being more vulnerable to cancer and neurological deficit than older children.

Health effects of radon: a review of the literature

PURPOSE

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

CONCLUSIONS

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

Age-dependent changes in oxygen tension, radiation dose and sensitivity within normal and diseased coronary arteries-Part A: dose from radon and thoron

PURPOSE

There is mounting evidence that a significant fraction of radiation-induced mortality and years-life lost are non-cancerous in nature. This study quantifies the radon dose to the coronary artery walls, especially the intimal layer, vulnerable to the development of atherosclerosis, and associated cardiovascular disease (CVD). Two accompanying papers determine the oxygen levels (Part B) in coronary arteries and the oxygen effect for radon and other exposures (Part C).

MATERIALS AND METHODS

The alpha-radiation dose to coronary artery walls was calculated from the proportion of inhaled radon ((222)Rn), thoron ((220)Rn) and their short-lived progeny, which was not deposited in the lung and passed into blood. Age- and gender-dependent morphology and composition for the wall layers of coronary arteries were developed from published data for a normal population and also for individuals with cardiovascular disease. The alpha particle dose to the coronary artery walls was evaluated taking account the diffusion of radon from blood and the solubility of radon-gas in tissues.

RESULTS

Diseased arteries exhibited a moderate increase in the solubility of lipophylic radon (190%) in arteries with 88% luminal narrowing, as the high Rn solubility in fat was partially offset by the lower solubility in calcium deposits. The average worldwide dose rate to the diseased intimal layer from (222)Rn and its short-lived progeny was estimated to be as high as 68 muSv y(-1) per 40 Bq m(-3) in air, whereas the corresponding dose rate from (220)Rn per 0.3 Bq m(-3) in air was <or=0.1% in comparison. Gender had little influence on the dose.

CONCLUSION

The Rn dose to the coronary arteries is significant, but has a large uncertainty due to poor knowledge of Rn and its progeny concentrations in the body.

Age-dependent changes in oxygen tension, radiation dose and sensitivity within normal and diseased coronary arteries-Part B: modeling oxygen diffusion into vessel walls

PURPOSE

The aim is to assess the change with age and disease of the oxygen concentration within the coronary artery walls.

MATERIALS AND METHODS

In an accompanying paper, Part A, the age-dependent morphology and composition for the wall layers of normal and diseased coronary arteries were developed from published data. In this paper, Part B, the oxygen concentration in the coronary artery walls was evaluated taking account the diffusion of oxygen from blood and the solubility of oxygen in tissues. Part C evaluates the oxygen effect and its biological implications for different radiations.

RESULTS

Diseased arteries exhibited a relatively moderate increase in the solubility of oxygen (<or=59%) in arteries with 88% luminal narrowing, as the high solubility in fat was partially offset by the lower solubility in calcium deposits. The oxygen partial pressure across the arterial wall was modeled and the avascular regions of arteries with >or=38% stenosis had anoxic areas.

CONCLUSION

Based on simulation results from the one-dimensional diffusion model, extensive hypoxic areas were determined for atherosclerotic arteries in this analysis of oxygen levels in coronary arteries modelling for the first time the effects of age and disease and associated changes in oxygen solubility due to the presence of lipids and calcium.

Age-dependent changes in oxygen tension, radiation dose and sensitivity within normal and diseased coronary arteries-Part C: oxygen effect and its implications on high- and low-LET dose

PURPOSE

The aim is to study the implications of the decrease in oxygen concentration in the coronary artery walls with age and atherosclerosis, particularly with regard to an associated reduction in the radiosensitivity to high-and low-linear-energy-transfer (LET) irradiation.

MATERIALS AND METHODS

In accompanying papers, the age-dependent morphology and composition for the wall layers of normal and diseased coronary arteries were developed in Part A from published data. In Part B, the oxygen concentration in the coronary artery walls was evaluated taking account the diffusion of oxygen from blood and the solubility of oxygen in tissues. In this part the oxygen effect was evaluated using published experimental data.

RESULTS

Based on simulation results from the one-dimensional diffusion model, the oxygen enhancement ratio (OER) is lower in the hypoxic vessel walls of aged and atherosclerotic arteries. Consequently the high-LET radiation damage arising from both the radon ((222)Rn) and thoron ((220)Rn) decay chains to the intimal layer of highly diseased arteries was estimated to be reduced by approximately 37% due to hypoxia. A greater reduction in radiosensitivity (51%) due to hypoxia was determined for low-LET irradiation.

CONCLUSION

These results imply that the oxygen effect, and other radiation biological factors, have a significant influence on radiation biological effects and risk of cardiovascular disease (CVD) to Japanese atomic bomb (A-bomb) survivors and patients receiving radiotherapy of the mediastinum.

Effective and organ doses from thoron decay products at different ages

The dosimetry of radon-220, often known as thoron, and its decay products has received less attention than has that of radon-222. Dose coefficients used by international bodies such as UNSCEAR and ICRP and by the UK's former National Radiological Protection Board are based on calculations from the 1980s. We present calculations for thoron decay products using the most recent ICRP models. These indicate that the effective dose is dominated by the doses to lung and that, under the present models, these doses are somewhat higher than under the previous consensus. Conversely, the present models give doses to organs outside the respiratory tract that are somewhat lower than those previously calculated. Dose coefficients for children are somewhat higher than those for adults. However, breathing rates for children are lower than those for adults and there are no great differences in annual doses.

Effect of linear energy transfer (LET) on the complexity of alpha-particle-induced chromosome aberrations in human CD34+ cells

The aim of this study was to assess the relative influence of the linear energy transfer (LET) of alpha particles on the complexity of chromosome aberrations in the absence of significant other differences in track structure. To do this, we irradiated human hemopoietic stem cells (CD34+) with alpha particles of various incident LETs (110-152 keV/microm, with mean LETs through the cell of 119-182 keV/microm) at an equi-fluence of approximately one particle/cell and assayed for chromosome aberrations by mFISH. Based on a single harvest time to collect early-division mitotic cells, complex aberrations were observed at comparable frequencies irrespective of incident LET; however, when expressed as a proportion of the total exchanges detected, their occurrence was seen to increase with increasing LET. Cycle analysis to predict theoretical DNA double-strand break rejoining cycles was also carried out on all complex chromosome aberrations detected. By doing this we found that the majority of complex aberrations are formed in single non-reducible cycles that involve just two or three different chromosomes and three or four different breaks. Each non-reducible cycle is suggested to represent "an area" of finite size within the nucleus where double-strand break repair occurs. We suggest that the local density of damage induced and the proximity of independent repair areas within the interphase nucleus determine the complexity of aberrations resolved in metaphase. Overall, the most likely outcome of a single nuclear traversal of a single alpha particle in CD34+ cells is a single chromosome aberration per damaged cell. As the incident LET of the alpha particle increases, the likelihood of this aberration being classed as complex is greater.

Screening of differential expression genes in bone marrow cells of radon-exposed mice

This study was designed to screen for differential expression genes in bone marrow cells of mice exposed to radon inhalation. Based upon established pathological findings in mouse, differential screening of gene expressions was conducted by using the SSH method. Among 285 cDNA clones selected from both forward- and reverse subtracted libraries, 45 were chosen for their differential expressions based on reverse Northern blot and quantitative real-time PCR analysis. Of these, up-regulation of the mRNA levels of E-cadherin and down-regulation of the replication protein A1 (RPA1) and casein kinase 1 delta (CKI delta) were also verified by a quantitative real-time PCR. Biological roles of these obtained cDNAs are described and the results of the screening may provide important clues for further investigations of the adverse molecular events induced by radon exposure.

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.

Incidence of leukemia, lymphoma, and multiple myeloma in Czech uranium miners: a case-cohort study

OBJECTIVE

Uranium miners are chronically exposed to low levels of radon and its progeny. We investigated whether radon exposure is associated with increased incidence of leukemia, lymphoma, or multiple myeloma in this population.

DESIGN

We conducted a retrospective case-cohort study in 23,043 uranium miners and identified a total of 177 incident cases of leukemia, lymphoma, and myeloma. Detailed information on occupational radon exposure was obtained for the cases and a randomly selected subcohort of 2,393 subjects. We used the proportional hazards model with power relative risk (RR) function to estimate and test the effects of cumulative radon exposures on incidence rates.

RESULTS

Incidence of all leukemia combined and chronic lymphocytic leukemia (CLL) alone was positively associated with cumulative radon exposure. The RR comparing high radon exposure [110 working level months (WLM) ; 80th percentile] to low radon exposure (3 WLM ; 20th percentile) was 1.75 [95% confidence interval (CI) , 1.10-2.78 ; p = 0.014] for all leukemia combined and 1.98 (95% CI, 1.10-3.59 ; p = 0.016) for CLL. Myeloid leukemia and Hodgkin lymphoma were also associated with radon, but RRs were not statistically significant. There was no apparent association of radon with either non-Hodgkin lymphoma or multiple myeloma. Exposure to radon and its progeny was associated with an increased risk of developing leukemia in underground uranium miners. CLL, not previously believed to be radiogenic, was linked to radon exposure.

Assessment and management of residential radon health risks: a report from the health Canada radon workshop

Epidemiologic studies of uranium miners and other underground miners have consistently shown miners exposed to high levels of radon to be at increased risk of lung cancer. More recently, concern has arisen about lung cancer risks among people exposed to lower levels of radon in homes. The current Canadian guideline for residential radon exposure was set in 1988 at 800 Bq/m(3). Because of the accumulation of a considerable body of new scientific evidence on radon lung cancer risks since that time, Health Canada sponsored a workshop to review the current state-of-the-science on radon health risks. The specific objectives of the workshop were (1) to collect and assess scientific information relevant to setting national radon policy in Canada, and (2) to gather information on social, political, and operational considerations in setting national policy. The workshop, held on 3-4 March 2004, was attended by 38 invited scientists, regulators, and other stakeholders from Canada and the United States. The presentations on the first day dealt primarily with scientific issues. The combined analysis of North American residential radon and lung cancer studies was reviewed. The analysis confirmed a small but detectable increase in lung cancer risk at residential exposure levels. Current estimates suggest that radon in homes is responsible for approximately 10% of all lung cancer deaths in Canada, making radon the second leading cause of lung cancer after tobacco smoking. This was followed by a perspective from an UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation) working group on radon. There were two presentations on occupational exposures to radon and two presentations considered the possibility of radon as a causative factor for cardiovascular disease and for cancer in other organs besides the lung. The possible contribution of environmental tobacco smoke to lung cancers in nonsmokers was also considered. Areas for future research were identified. The second day was devoted to policy and operational issues. The presentations began with a perspective from the U.S. Environmental Protection Agency, followed by a history of radon policy development in Canada. Subsequent presentations dealt with the cost-effectiveness of radon mitigation, Canadian building codes and radon, and a summary of radon standards from around the world. Provincial representatives and a private consultant were given opportunities to present their viewpoints. A number of strategies for reducing residential radon exposure in Canada were recognized, including testing and mitigation of existing homes (on either a widespread or targeted basis) and changing the building code to require that radon mitigation devices be installed at the time a new home is constructed. The various elements of a comprehensive national radon policy were set forth.

Doses from radon and its decay products to children

This paper considers doses from radon and decay products when inhaled or ingested by one year old infants and by ten year old children. Doses from decay products deposited on skin are also discussed. For inhalation and ingestion, the general pattern of doses to organs is broadly similar to that in adults. Much the largest doses are received by the organ of intake (respiratory tract and stomach respectively). Otherwise, tissues with higher fat content tend to receive somewhat higher doses from radon gas than other tissues. Dose coefficients (dose per unit intake factors) for children are generally larger than those for adults. However, total annual doses are more similar across the age groups because of smaller intakes of air and water by children. Radon decay products deposited on skin may be able to induce skin cancer. However, the location of the sensitive cells is not known with certainty and they may lie too deep to receive significant dose. If they are irradiated, it is likely that doses to children would be larger than for adults. The radiological significance of doses to children is discussed.

Deaths from Neoplasms and Detection of Radionuclides in Excised Human Lungs in the Eordea Basin, Greece

Lignite contains various trace-metal natural radioactive contaminants. In the Eordea Basin, the most important lignite field in Greece, the authors conducted a proportional mortality ratio (PMR) study that compared the mortality rates of individuals who lived in the basin vs. a control group who resided in the city of Kilkis, over a 30-yr period. The following information was used in the study: (a) municipal registrations of deaths from neoplasms during the period from 1971 to 2000, and (b) detection of radioactive substances in samples obtained from excised lungs of individuals living in Eordea Basin who suffered from neoplasm. The corresponding registrations of deaths from neoplasm of the inhabitants of Kilkis, a city located outside the Eordea Basin, formed the control group. A diachronic increase of the PMR was detected as a result of neoplasms and, particularly, as a result of lung cancer in Eordea Basin. However, the above ratio did not exceed the corresponding PMR recorded in Kilkis. In 20 lung samples obtained from patients who had lived in Eordea Basin, and in 19 lung samples from patients in Kilkis, the activity of the radionuclides of uranium and thorium radioactive decay series, potassium-40, and cesium-137 was not higher than expected. No statistically significant difference was found between the inhabitants of the 2 regions, thus it was concluded that the increase in respiratory-system neoplasms was likely associated with the high prevalence of smoking among the regions' inhabitants. In future studies, a longer observation period and examination of more cases will be necessary to further investigate a possible association between radionuclides and lung neoplasms in the Eordea Basin.

Transmissible and nontransmissible complex chromosome aberrations characterized by three-color and mFISH define a biomarker of exposure to high-LET alpha particles

Insertions have been proposed as potential stable biomarkers of chronic high-LET radiation exposure. To examine this in vitro, we irradiated human peripheral blood lymphocytes in G(0) with either 50 cGy (238)Pu alpha particles (LET 121.4 keV/microm) or 3 Gy 250 kV X rays and stimulated their long-term culture up to approximately 22 population doublings postirradiation. Mitotic cells were harvested at regular intervals throughout this culture period and were assayed for chromosome aberrations using the techniques of three-color and 24-color mFISH. We observed the stable persistence of transmissible-type complex rearrangements, all involving at least one insertion. This supports the hypothesis that insertions are relevant indicators of exposure to high-LET radiation. However, one practical caveat of insertions being effective biomarkers is that their frequency is low due to the complexity and cell lethality of the majority of alpha-particle-induced complexes. Therefore, we propose a "profile of damage" that relies on the presence of insertions, a low frequency of stable simple reciprocal translocations (2B), and, significantly, the complexity of the damage initially induced. We suggest that the complexity of first- and second-division alpha-particle-induced nontransmissible complex aberrations reflects the structure of the alpha-particle track and as a consequence adds radiation-quality specificity to the biomarker, increasing the signal:noise ratio of the characteristic 2B:insertion ratio.

The United Kingdom Childhood Cancer Study of exposure to domestic sources of ionising radiation: 1: radon gas

This paper reports the results of the United Kingdom Childhood Cancer Study relating to risks associated with radon concentrations in participants homes at the time of diagnosis of cancer and for at least 6 months before. Results are given for 2226 case and 3773 control homes. No evidence to support an association between higher radon concentrations and risk of any of the childhood cancers was found. Indeed, evidence of decreasing cancer risks with increasing radon concentrations was observed. Adjustment for deprivation score for area of residence made little difference to this trend and similar patterns were evident in all regions and in all diagnostic groups. The study suggests that control houses had more features, such as double glazing and central heating, leading to higher radon levels than case houses. Further, case houses have features more likely to lead to lower radon levels, e.g. living-rooms above ground level. Consequently the case-control differences could have arisen because of differences between houses associated with deprivation that are not adequately allowed for by the deprivation score.

Radon exposure and the risk of leukemia: a review of epidemiological studies

Since the 1990's, several authors estimated that radon inhalation may deliver a small amount of irradiation to the red bone marrow, and consequently may increase the risk of leukemia in humans. The objective of this review is to conduct a critical analysis of epidemiologic results currently available concerning the relationship between radon exposure and the risk of leukemia. Nineteen ecological studies, six miner cohort studies, and eight case-control studies published between 1987 and 2000 are included in this review. The limitations associated with each of these studies are discussed. The results of the ecological studies are relatively concordant and suggest an association between radon concentrations and the risk of leukemia at a geographic level. But these ecological studies present important limitations, and some are only crude analyses. Moreover, the results of the cohort and case-control studies, based on individual data, do not show any significant association between radon exposure and leukemia risk. Our conclusion is that the overall epidemiologic results currently available do not provide evidence for an association between radon exposure and leukemia.

Exposure of red bone marrow to ionising radiation from natural and medical sources in France

This paper presents a review of available data on the average level of equivalent dose to the red bone marrow in France, due to natural and some medical exposures. The sources of exposure to ionising radiation which were studied are medical examinations involving x-rays (diagnostic radiology), inhalation of radon and thoron, cosmic irradiation, terrestrial irradiation and intakes of natural radionuclides. This review is based, where possible, on specific data for France. The influence of age on exposure levels is studied when data are available. The total equivalent dose to the red bone marrow is estimated at 2.4 mSv year(-1), 2.7 mSv year(-1) and 5.4 mSv year(-1) respectively for adults (> or =18 years old), children (3-17 years old) and infants (0-1 year old). The high level of exposure for infants is explained by the important contribution of 210Po. The average equivalent dose to the red bone marrow for adults is also compared with the average committed effective dose due to the same exposure sources. The importance of medical exposure and natural exposure due to intake of natural radionuclides emphasises the importance of obtaining more information about these sources of exposure.

A study to verify a reported excess of chromosomal aberrations in blood lymphocytes of Namibian uranium miners

This report describes a study to verify an earlier report of excess chromosomal damage in the blood lymphocytes of uranium miners. Coded blood samples from 10 miners and 10 controls were analyzed conventionally for unstable aberrations and by FISH for translocations. Conventional analysis, scoring 1000 metaphases per subject, showed no significant difference between miners and controls in the frequencies of chromosome- and chromatid-type aberrations. Investigators at two laboratories undertook FISH analyses, each scoring 4000 metaphases per subject. When the data from each laboratory were examined separately, one found slightly more translocations in the miners while the other found fewer. In neither case was the difference significant at the 95% level of confidence. Combining the data likewise showed no significant excess of damage in the miners. This applied to simple one- and two-way translocations and to cells with complex exchanges. There was no correlation between levels of translocations and total lifetime doses from occupational and/or background irradiation. A borderline significant excess of rogue cells was found in the miners. This may be a chance observation, as these rare, highly abnormal cells are considered to be unrelated to radiation exposure and are probably due to a virus. The overall conclusion is that the frequency of chromosomal damage in the miners did not exceed that in the controls. Therefore, the result of the earlier study was not confirmed.

hprt mutant frequencies, nonpulmonary malignancies, and domestic radon exposure: "postmortem" analysis of an interesting hypothesis

The hypothesis that exposure to domestic radon raises the risk for leukemia and other nonpulmonary cancers has been proposed and tested in a number of epidemiologic studies over the past decade. During this period, interest in this hypothesis was heightened by evidence of increased frequencies of mutations at the hypoxanthine guanine phosphoribosyl transferase (hprt) gene in persons exposed to domestic radon (Bridges BA et al. [1991]: Lancet 337:1187-1189). An extension of this study (Cole J et al. [lsqb[1996]: Radiat Res 145:61-69) and two independent studies (Albering HJ et al. [1992[: Lancet 340:739; Albering HJ et al. [1994[: Lancet 344:750-751) found that hprt mutant frequency was not correlated with domestic radon exposure, and two well-designed epidemiologic studies showed no evidence of a relation between radon exposure and leukemia in children or adults. In this report, we present additional data from a study of Colorado high school students showing no correlation between domestic radon exposure and hprt mutant frequency. We use reanalyses of previous studies of radon and hprt mutant frequency to identify problems with this assay as a biomarker for domestic radon exposure and to illustrate difficulties in interpreting the statistical data. We also show with analyses of combined data sets that there is no support for the hypothesis that domestic radon exposure elevates hprt mutant frequency. Taken together, the scientific evidence provides a useful example of the problems associated with analyzing and interpreting data that link environmental exposures, biomarkers, and diseases in epidemiologic studies.

Inducible genomic instability: new insights into the biological effects of ionizing radiation

The biological consequences of exposure to ionizing radiation include gene mutation, chromosome aberrations, malignant transformation and cell death. These effects are attributed to the production of irreversible damage at the time of the irradiation. However, there is now considerable evidence that cells that have survived irradiation may produce descendants in which a high frequency of de novo chromosome aberrations and gene mutations arise or in which there is an enhanced death rate. These delayed effects are manifestations of an induced genomic instability. All the various delayed effects are induced at very high frequency and are unlikely to be due to conventional mutational changes. At present little is understood of the processes involved in the initiation of inducible instabilities and in the maintenance and transmission of the phenotype over many generations of cell replication. However, it is becoming evident that the expression of inducible instability has a strong dependence on the type of radiation exposure, the cell type irradiated and the 'genetic predisposition' of the irradiated cell. Radiation-induced genomic instability presents a major challenge to conventional radiobiology concepts and has important implications for mechanistic studies of radiation action particularly in the context of radiogenic malignancy.

Indoor residential radon exposure and risk of childhood acute myeloid leukaemia

Exposure to radon has been identified as a risk factor for lung cancer in uranium miners, but evidence of adverse health effects due to indoor radon exposure is inconsistent. Ecological studies have suggested a correlation between indoor radon levels and leukaemia incidence. We evaluated the risk associated with indoor residential radon exposure within a larger interview-based case-control study of risk factors for childhood acute myeloid leukaemia (AML). A total of 173 cases and 254 controls met the eligibility criteria, and information was collected through telephone interviews with parents and analysis of alpha-track radon detectors placed in the home for a period of 1 year. No association was observed between radon exposure and risk of AML, with adjusted odds ratios of 1.2 (95% confidence interval (CI) 0.7-1.8) for 37-100 Bq m(-3) and 1.1 (95% CI 0.6-2.0) for > 100 Bq m(-3) compared with < 37 Bq m(-3). Although there was an inverse association between radon level and AML risk among children < 2 years at diagnosis, among children > or = 2 years, AML risk was increased among those with higher radon exposure. The observed association after age 2 is most likely due to chance. Overall, there was no association between residential radon and risk of childhood AML.

Possible mechanisms by which electric fields from power lines might affect airborne particles harmful to health

Power lines produce alternating electric fields and modify static electric fields in their vicinity. These electric fields, if large enough, can alter the concentration or transport of airborne particles (including particles harmful to health), for example by causing deposition of charged particles, polarisation of neutral particles, or by production of ions. It has been suggested that this could lead to adverse health effects being associated with power lines. Theoretical considerations and experimental evidence relevant to eight separate postulated mechanisms involving power lines and airborne particles are examined. On theoretical grounds, none should lead to any adverse health effect, primarily because the effects produced are very small and are swamped by air currents or by gravity, and because people spend limited time in the relevant conditions. The experimental evidence also weighs against any adverse health effects. Further, even if significant health effects were produced, they would be different from those suggested by existing epidemiology concerning power lines.

Chromosomal instability in the descendants of unirradiated surviving cells after alpha-particle irradiation

We have demonstrated chromosomal instability in the clonal descendants of hemopoietic stem cells after irradiating murine bone marrow with alpha-particles. However, because cells that are irradiated by alpha-particles are defined by a Poisson distribution of individual particle traversals, there is an inevitable proportion of unirradiated cells in the surviving population. The calculated expected proportions of irradiated and nonirradiated cells indicate that the number of clonogenic cells transmitting chromosomal instability is greater than the number expected to be hit and survive. To investigate further this discrepancy, we studied the effects of interposing a grid between the cells and the alpha-particle source so that the surviving population consists predominantly of untraversed stem cells. Comparison with the same irradiation conditions without the grid reveals that the same level of instability is induced. The data confirm that alpha-particles induce chromosomal instability but instability is demonstrated in the progeny of nonirradiated stem cells and must be due to unexpected interactions between irradiated and nonirradiated cells. This untargeted effect has important implications for mechanistic studies of radiation action and for assessment of radiation risk.

Case-control study of childhood acute lymphoblastic leukemia and residential radon exposure

BACKGROUND

Several ecologic analyses have shown significant positive associations between mean indoor radon concentrations and risk of leukemia at all ages (acute myeloid leukemia and chronic lymphocytic leukemia) and for children (all leukemia, acute myeloid leukemia, and acute lymphoblastic leukemia [ALL]). As part of an age-matched, case-control study of childhood ALL in the United States, we investigated the association between the incidence of ALL in children under age 15 years and indoor radon exposure.

METHODS

Radon detectors were placed in current and previous homes of subjects where they resided for 6 months or longer. Children were included in analyses if radon measurements covered 70% or more of the 5-year period prior to diagnosis for case subjects (or from birth for case subjects under age 5 years) and the corresponding reference dates for control subjects. Radon levels could be estimated for 97% of the exposure period for the eligible 505 case subjects and 443 control subjects.

RESULTS

Mean radon concentration was lower for case subjects (65.4 becquerels per cubic meter [Bqm(-3)]) than for control subjects (79.1 Bqm(-3)). For categories less than 37, 37-73, 74-147, and 148 or more Bqm(-3) of radon exposure, relative risks based on matched case-control pairs were 1.00, 1.22, 0.82, and 1.02, respectively, and were similar to results from an unmatched analysis. There was no association between ALL and radon exposure within subgroups defined by categories of age, income, birth order, birth weight, sex, type of residence, magnetic field exposure, parental age at the subject's birth, parental occupation, or parental smoking habits.

CONCLUSIONS

In contrast to prior ecologic studies, the results from this analytic study provide no evidence for an association between indoor radon exposure and childhood ALL.

Adult myeloid leukaemia, geology, and domestic exposure to radon and gamma radiation: a case control study in central Italy

OBJECTIVES

To investigate whether indoor randon or gamma radiation might play a part in myeloid leukaemia as suggested by studies based on crude geographical or geological data for exposure assessment.

METHODS

For six months randon and gamma radiation was measured with solid state nuclear track detectors and thermoluminescent dosimeters in dwellings of 44 adult male cases of acute myeloid leukaemia and 211 controls (all subjects deceased). Conditional logistic regression ORs (ORs) and 95% confidence intervals (95% CIs) were estimated for quartiles of radon and gamma radiation and for municipality and dwelling characteristics.

RESULTS

The risk of leukaemia was associated with an increasing urbanisation index (p value for trend = 0.008). An increased OR was found among those living in more modern houses (OR 3.0, 95% CI 1.4 to 6.6). Confirming the findings of a previous study in the same area, geological features bore a positive association with myeloid leukemia, even by adjusting for level of urbanisation. Contrary to expectations from the previous study, however, no association appeared between myeloid leukaemia and radon and gamma radiation; for the highest quartiles of exposure, ORs were 0.56 (95% CI 0.2 to 1.4) and 0.52 (95% CI 0.2 to 1.4), respectively. Considering only subjects who had lived > or = 20 years in the monitored home and adjusting for urbanisation, there was still no effect of exposure to radiation.

CONCLUSIONS

In view of the limited numbers, the results do not in general refute a possible risk of myeloid leukaemia from exposure to indoor radon or gamma radiation, but decrease the credibility of such a relation in the area studied and also of other studies suggesting an effect without monitoring indoor radiation. Some other fairly strong determinants have appeared--that is, level of urbanisation and living in modern houses--that might need further consideration.

Genetic factors influencing alpha-particle-induced chromosomal instability

Alpha-particle-induced chromosomal instability in haemopoietic cells obtained from the CBA/H, DBA/2 and C57BL/6 inbred strains of mouse has been demonstrated at frequencies dependent on genotype. The CBA/H and DBA/2 strains may be regarded as 'sensitive' and the C57BL/6 strain as 'resistant'; resistance was dominant in cells from F1 hybrids. Previously, in cultures where we demonstrated radiation-induced chromosomal instability we also demonstrated an enhanced and persisting oxyradical activity. Quantitative differences in superoxide generation have now been correlated with genetically determined differences in the expression of chromosomal instability. Our findings demonstrate an important influence of genetic factors in alpha-particle-induced chromosomal instability.

Quantification of FISH-painted chromosome aberrations after domestic radon exposure

Chromosome painting (target chromosomes 1, 4, 12) was performed in peripheral lymphocytes from 25 occupants of nine houses with indoor radon concentrations of 210-3000 Bqm-3. Compared to a control group, the mean frequency of symmetrical translocations of the radon group was slightly but not significantly (p < 0.10) increased. A similar tendency became apparent for a comparison of two groups of subjects with cumulative radon exposures above and below 2800 Bqm-3 y. It is concluded that FISH-based measurements of stable symmetrical translocations should reflect the cumulative radon exposure to haematopoietic compartments such as the red bone marrow rather than to mature blood lymphocytes. Since, however, radon-derived bone marrow doses are low and control frequencies of translocations are very high (about 10-fold higher than the value for conventionally scored dicentrics), the observed relative increase (1.5-fold) of the translocation frequency in blood lymphocytes is too small to discriminate chronic radon exposure from background.