Esther YoonMPH500

Concordia University – Nebraska

June 24, 2013

The Health Effects of Radon on Lung Cancer From Radon

in the Home

A naturally occurring clear, odorless, and tasteless gas

Has been found to be the 2nd leading cause of lung cancer after smoking(U.S. Department, 2010)Exposure correlates with the chance of lung cancer

Kidney and cardiovascular cancer has also been linked to radon exposure (National Cancer)

U.S. Congress has mandated each state to have an office in charge ofradon assistance (U.S. Department,2010)

What is Radon?

Figure 1. Radon. Periodic Table

Radon in HomesSo small it easily

enters homes through cracks in floors, construction joints, and gas appliances (U.S. Department, 2010)

6 million U.S. homes have radonlevels above the EPA recommended 4.0 pCi/L (U.S. Department, 2010)

The only way to measure levels is to test with a short or long-term test kit

Figure 2. Radon Test Kit. (Radon.com)

Discovered in 1900 by German physicist Friedrich Ernst Dorn (U.S. Department, 2010)

Dangerous isotope: radon-220 (thoron) and radon-222 (Yamada, 2003)

Its stable half-life = 3.8 days (Yamada, 2003)Very small (50 to 300 nm) so can get into most

places (Yamada, 2003)Risk of lung cancer linearly proportional to

exposure (Yamada, 2003)Link between radon and lung cancer made when

miners had spike (U.S. Department, 2010)

Biomedical Basis

Alpha-particles

enter the body

and get stuck to

a thin layer of

the epidermis of

the lung. Decay

products are

deposited in the

respiratory tract

and directly

deliver alpha-

energy.

The Issue

Figure 3. Radon and its transformation. (Radon Detection)

EpidemiologyNo discrimination, every is

exposed to some radonMore mountainous areas

have higher levels (EPA)Children have a higher risk due to lung shape, size differences, and more rapid breathing (U.S. Department, 2010)

Rural, low-income families also are at-risk because they more more likely to not know of the risks (Larsson, 2009)

Figure 3. EPA Radon Zones. (EPA).

Figure 4. Montana Radon Zones. (Larsson).

Environmental FactorsAmericans spend 90% of their time inside so

poor ventilation has dangerous effects (Larsson, 2009)

Good air ventilation drastically decreases the dangers of radon (National Cancer Institute)

Radon cannot be removed from our environment, so we must change our actions to adjust and create a healthier environment

Population-based case-control study of Iowa women

About 4 radon detectors were placed in each home (majority of basements’ levels were over EPA’s recommended)

No correlation between radon exposure and active smokingRadon exposure has significant risk for lung

cancer in womenRisk estimates were in agreement with

National Research Council’s predicted cancer risk from radon exposure

Biostatistics – Iowa Radon Lung Cancer Study (Field et al., 2000)

Examined awareness, behaviors, and accuracy of parent’s risk perceptions of their children

Used National Health Interview SurveyRural residents had basic knowledge of radon,

most disagreed about health effects being seriousOver half of sample didn’t know how to measure

level in their home or how to reduce levelsTesting increased from 9.7% to 15.5% in 4 years

(Larsson, 2009)This intervention suggested to nurses how to be

successful at presenting to at-risk populations

Biostatistics – Children’s Exposure to Radon (Hill, Butterfield, & Larsson, 2006)

Social and Behavioral FactorsTo change the behavior

of the public, the key has been raising awareness (EPA, 2009)

EPA created National Radon Action Month in January

Event Planning Kit made by EPA for any groups or communities to use as a tool to advertise the dangers of radon (EPA, 2009)

Some states have free radon test kits available (Kafer, 2013)

Montana State University is using digital signage technology in WIC clinics to advertise (Reuters, 2011)

Federal Radon Action Plan led by EPA works to increase public understanding (EPA: Protecting people, 2011) January 2011 – January

2015

Successful Intervention through the Ecological Model of Health

Present to public so they become personally knowledgeable

The educated will go and tell their friends and family of the dangers

Local groups build it up through the community and educate

Government and society fully accepts the dangers and acts

Figure 5. The Ecological Model with explanation. (CDC)

Government PoliciesIt is not required

that all homes on the market be tested for radon, but EPA and Surgeon General highly recommend it (EPA, 2009)

High radon concentrations can be in new and old homes (EPA, 2009) Figure 6. How radon enters a home. (

Kearney Home Inspection)

SEER cancer registries (Luo & Hendryx, 2011)Registry that adjusts age of lung cancer mortalities to

make population proportionalToxics Release Inventory (Luo & Hendryx, 2011)

Assesses mortality ratesProvides conclusions on lung cancer by toxins

WHO’s Ionizing Radiation Programme (WHO, 2013)Through Sustainable Development and Healthy

Environments ClusterEvaluates health risks and public health issues

because of radon exposureMakes recommendations to public health response

groups

Awareness & Prevention Movements

Public health has raised awareness of the dangers of radon in the past years Dr. Oz has a piece in February 2011 on residential radon

(Morley, 2011) Many county health departments have free test kits

available, local hardware stores have them for ~$20 If levels are high after testing, there are solutions for any

budget (EPA, 2009) Full mitigation to just changing a filter The recommended radon level in the home is below 4.0 pCi/L

Lung cancer is the leading killer cancer in the US (Chan, 2010) Smoking is the major cause of lung cancer but there are those

who never have smoked also have lung cancerReaching out to the public is important because lung cancer

due to radon exposure is completely preventable

Conclusion

Chan, A. (2010, September 10). The top 10 deadliest cancers-and why there’s no cure. NBCNews. Retrieved from http://www.nbcnews.com.

Environmental Protection Agency: Radon (Rn). (2009, January). Home Buyer’s and Seller’s Guide to Radon. Retrieved from http://www.epa.gov/radon/pdfs/hmbuygud.pdf

Hill, W.G., Butterfield, P., & Larsson, L.S. (2006). Rural parents’ perceptions of risks associated with their children’s exposure to radon. Public Health Nursing, 23 (5), 392-399, doi: 10.1111/j.1525-1446.2006.00578.x

Kafer, T. (2013, May 16). Health officials encourage radon testing. Isanti-Chisago County Star. Retrieved from http://www.presspubs.com/isanti/news/article_1d82001e-be3b-11e2-946b-001a4bcf887a.html

Larsson, L.S., Hill, W.G., Odom-Maryon, T., & Yu, P. (2009). Householder status and residence type as correlates of radon awareness and testing behaviors. Public Health Nursing, 26 (5), 387-395. doi: 10.1111/j.1525-1446.2009.00796.x

Luo, J., & Hendryx, M. (2011). Environmental Carcinogen Releases and Lung Cancer Mortality in Rural-Urban Areas of the United States. The Journal of Rural Health, 27, 342 – 349, doi: 10.1111/j.1748-0361.2010.00357.x.

Morley, R. (2011, February 9). Radon: A danger in your home. The Dr. Oz Show. Retrieved from http://www.doctoroz.com/videos/radon-danger-your-home

National Cancer Institute at the National Institute of Health, National Cancer Institute Fact Sheet. (2011, December 6). Radon and Cancer. Retrieved from http://www.cancer.gov/cancer topics/factsheet/Risk/radon.

Reuters. (2011, November 15). Montana state university educates about harmful radon gas with Vericom’s ChannelCare Digital Signage. [Press release]. Retrieved from http://www.reuters.com/article/2011/11/15/idUS212839+15-Nov-2011+GNW20111115

U.S. Department of Health and Human Services, National Institute of Health, Agency for Toxic Substances and Disease Registry. (2010). Radon Toxicity: Case studies in environmental medicine. Retrieved from http://www.atsdr.cdc.gov/csem/csem.asp?csem=8&po=0.

World Health Organization, Programmes and Projects. (2013). Ionizing Radiation. Retrieved from http://www.who.int/ionizing_radiation/about/en/

Yamada, Y. (2003). Radon exposure and its health effects. Journal of Health Sciences, 49(6), 417-422).

References

Centers for Disease Control and Prevention [Electronic Image], Retrieved from http://www.cdc.gov/violenceprevention/overview/social-ecologicalmodel.html

EPA Map of Radon Zones [Electronic Image], Retrieved from www.epa.gov/radon/zonemap.html

Kearney Home Inspector: Integrity Home Inspection and Testing [Electronic Image], Retrieved from http://www.kearneyhomeinspections.com/index.php?page_id=xi6f55er&description=Radon_FAQs

Larsson, L. (2010) [Electronic Image], Montana Radon ProjectRadon [Electronic Image], Retrieved from

http://periodictable.com/Elements/086/index.htmlRadon Test Kit [Electronic Image], Retrieved from

www.radon.com/radon/radon_airchek.html

Image References