Radon and lung cancer: a cost-effectiveness analysis.
OBJECTIVES: This study examined the cost-effectiveness of general and targeted strategies for residential radon testing and mitigation in the United States. METHODS: A decision-tree model was used to perform a cost-effectiveness analysis of preventing radon-associated deaths from lung cancer. RESULTS: For a radon threshold of 4 pCi/L, the estimated costs to prevent 1 lung cancer death are about $3 million (154 lung cancer deaths prevented), or $480,000 per life-year saved, based on universal radon screening and mitigation, and about $2 million (104 lung cancer deaths prevented), or $330,000 per life-year saved, if testing and mitigation are confined to geographic areas at high risk for radon exposure. For mitigation undertaken after a single screening test and after a second confirmatory test, the estimated costs are about $920,000 and $520,000, respectively, to prevent a lung cancer death with universal screening and $130,000 and $80,000 per life-year for high risk screening. The numbers of preventable lung cancer deaths are 811 and 527 for universal and targeted approaches, respectively. CONCLUSIONS: These data suggest possible alternatives to current recommendations. (+info)
Residential radon exposure and risk of lung cancer in Missouri.
OBJECTIVES: This study investigated residential radon exposure and lung cancer risk, using both standard radon dosimetry and a new radon monitoring technology that, evidence suggests, is a better measure of cumulative radon exposure. METHODS: Missouri women (aged 30 to 84 years) newly diagnosed with primary lung cancer during the period January 1, 1993, to January 31, 1994, were invited to participate in this population-based case-control study. Both indoor air radon detectors and CR-39 alpha-particle detectors (surface monitors) were used. RESULTS: When surface monitors were used, a significant trend in lung cancer odds ratios was observed for 20-year time-weighted-average radon concentrations. CONCLUSIONS: When surface monitors were used, but not when standard radon dosimetry was used, a significant lung cancer risk was found for radon concentrations at and above the action level for mitigation of houses currently used in the United States (148 Bqm-3). The risk was below the action level used in Canada (750 Bqm-3) and many European countries (200-400 Bqm-3). (+info)
Chromosome breakage at sites of oncogenes in a population accidentally exposed to radioactive chemical pollution.
The purpose of the present study was to investigate the level of aberrations at fragile sites of chromosomes in peripheral blood lymphocytes of the population of an area polluted with radionuclides, following an accident at the Siberian Chemical Plant. We carried out the micronucleus test to screen people with radiation-related cytogenetic effects. Of the 1246 inhabitants of the settlement of Samus examined, 148 showed a significantly increased frequency of micronucleated erythrocytes and were selected for chromosome analysis as a radiation-exposed group. Additional analysis was carried out on 40 patients with gastric cancer and atrophic gastritis with stage II-III epithelial dysplasia. Eighty six individuals from a non-polluted area were used as a control group. Chromosomal breaks and exchanges occurred preferentially in chromosomes 3 and 6 among radiation-exposed persons and patients. The regions 3p14-25 and 6p23 were damaged most often. There was a tendency to preferential involvement of q21-25 of chromosome 6 in patients with gastric cancer and atrophic gastritis. Specific damage at certain chromosome sites was observed in the radiation-exposed population as well as in patients with gastric cancer. Most often this damage was located near oncogene loci, which could imply that chromosome damage induced by radiation is likely to be a predisposing factor to the expression of oncogenes and malignant transformation of cells in exposed individuals. (+info)
Radon testing in households with a residential smoker--United States, 1993-1994.
Epidemiologic investigations of underground miners and studies of alpha particle carcinogenesis among laboratory animals suggest that exposure to the radioactive decay products (progeny) of radon is an important risk factor for lung cancer. Persons who smoke cigarettes and are exposed to these radon progeny have a substantially greater risk for developing malignancy than nonsmokers. Residential radon concentrations above the U.S. Environmental Protection Agency's (EPA) action level of 4 pCi/L are the primary sources of exposure among the general population. EPA and the Public Health Service promote home testing for radon, especially in households with a person who smokes. However, it is unknown whether households that contain smokers are more likely than those without smokers to test for radon. To characterize radon testing practices of households that contain a person who smokes within the dwelling (i.e., residential smoker), CDC analyzed survey data from the National Health Interview Survey (NHIS). This report summarizes the results of this analysis, which indicates that households with a residential smoker are significantly less likely to test for radon than those without smokers. (+info)
Environmental radioactivity, population exposure and related health risks in the east Baltic region.
The paper considers radioactive contamination of the east Baltic region, population exposures, and the risk of damage to human health. Principal sources include global fallout, the Chernobyl accident, and marine transport of radionuclides. A mean annual exposure of 2-3 mSv comes from environmental radioactivity. Main contributors are primarily radon and its decay products. The Chernobyl accident brought an additional dose of about 0.5 mSv in southern Finland and 1.4 mSv in the most contaminated districts of the Leningrad region, Russia. Both external and internal exposure via contaminated food contributed. Currently, significant long-term radiological consequences of the Chernobyl accident include persistent radioactive contamination of natural terrestrial (forest) and freshwater (oligotrophic lakes) ecosystems and food products. Radiation health risks are lung cancer among the general population from indoor exposure to radon, acute radiation syndrome from occupational exposure, thyroid cancer among children in heavily contaminated non-Baltic areas, and mutations among offspring of exposed parents. (+info)
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. (+info)
Evaluation of the impact of Chernobyl on the prevalence of congenital anomalies in 16 regions of Europe. EUROCAT Working Group.
BACKGROUND: Surveillance data from population-based congenital anomaly registers in 16 regions of Europe (mainly Western Europe) were analysed to assess the impact of the Chernobyl accident on the prevalence of selected congenital anomalies. METHODS: Three cohorts of pregnancies were defined: those exposed during the first month following Chernobyl (External Exposure Cohort), the first year (Total Exposure Cohort) and the two subsequent years (Control Cohort). Expected numbers of congenital anomalies in these cohorts were calculated from 1980-1985 baseline rates. Registries were grouped into three exposure categories according to first-year exposure estimates. RESULTS: There was no overall or dose-related increase in prevalence in the two exposed cohorts for Down's Syndrome, neural tube defects, other central nervous system defects or eye defects. There was a statistically significant overall 22% (95% CI: 13-31%) excess of Down's Syndrome in the Control Cohort, with no dose-response relationship. CONCLUSIONS: Chernobyl had no detectable impact on the prevalence of congenital anomalies in Western Europe, suggesting that in retrospect the widespread fear in the population about the possible effects of exposure on the unborn fetus was not justified. An increasing prevalence of Down's Syndrome in the 1980s, probably unrelated to Chernobyl, merits further investigation. (+info)
Residential radon gas exposure and lung cancer: the Iowa Radon Lung Cancer Study.
Exposure to high concentrations of radon progeny (radon) produces lung cancer in both underground miners and experimentally exposed laboratory animals. To determine the risk posed by residential radon exposure, the authors performed a population-based, case-control epidemiologic study in Iowa from 1993 to 1997. Subjects were female Iowa residents who had occupied their current home for at least 20 years. A total of 413 lung cancer cases and 614 age-frequency-matched controls were included in the final analysis. Excess odds were calculated per 11 working-level months for exposures that occurred 5-19 years (WLM(5-19)) prior to diagnosis for cases or prior to time of interview for controls. Eleven WLM(5-19) is approximately equal to an average residential radon exposure of 4 pCl/liter (148 Bq/m3) during this period. After adjustment for age, smoking, and education, the authors found excess odds of 0.50 (95% confidence interval: 0.004, 1.81) and 0.83 (95% percent confidence interval: 0.11, 3.34) using categorical radon exposure estimates for all cases and for live cases, respectively. Slightly lower excess odds of 0.24 (95 percent confidence interval: -0.05, 0.92) and 0.49 (95 percent confidence interval: 0.03, 1.84) per 11 WLM(5-19) were noted for continuous radon exposure estimates for all subjects and live subjects only. The observed risk estimates suggest that cumulative ambient radon exposure presents an important environmental health hazard. (+info)