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Radon exposures in a Jerusalem public school.

In December 1995, ambient radon levels exceeding 10,000 Bq/m3 were measured in a basement shelter workroom of a multilevel East Talpiot, Jerusalem, public elementary school (six grades, 600 students). The measurements were taken after cancers (breast and multiple myeloma) were diagnosed in two workers who spent their workdays in basement rooms. The school was located on a hill that geologic maps show to be rich in phosphate deposits, which are a recognized source for radon gas and its daughter products. Levels exceeding 1000,000 Bq/m3 were measured at the mouth of a pipe in the basement shelter workroom, the major point of radon entry. The school was closed and charcoal and electret ion chamber detectors were used to carry out repeated 5-day measurements in all rooms in the multilevel building over a period of several months. Radon concentrations were generally higher in rooms in the four levels of the building that were below ground level. There were some ground-level rooms in the building in which levels reached up to 1300 Bq/m3. In rooms above ground level, however, peak levels did not exceed 300 Bq/m3. Exposure control based on sealing and positive pressure ventilation was inadequate. These findings suggested that radon diffused from highly contaminated basement and ground-floor rooms to other areas of the building and that sealing off the source may have led to reaccumulation of radon beneath the building. Later, subslab venting of below-ground radon pockets to the outside air was followed by more sustained reductions in indoor radon levels to levels below 75 Bq/m3. Even so, radon accumulated in certain rooms when the building was closed. This sentinel episode called attention to the need for a national radon policy requiring threshold exposure levels for response and control. A uniform nationwide standard for school buildings below 75 Bq/m3 level was suggested after considering prudent avoidance, the controversies over risk assessment of prolonged low-level exposures in children, and the fact that exposures in most locations in the Talpiot school could be reduced below this level. Proposal of this stringent standard stimulated the search for a strategy of risk control and management based on control at the source. This strategy was more effective and probably more cost effective than one based on suppression of exposure based on sealing and ventilation. Because many Israeli areas and much of the West Bank area of the Palestinian National Authority sit on the same phosphate deposits, regional joint projects for surveillance and control may be indicated.

Air Pollutants, Radioactive↗

[Radon and domestic exposure].

Radon is a noble gas derived from the decay of radium, which itself is a decay product of uranium. The decay products of radon can collect electrostatically on dust particles in the air and, if these particles are inhaled and attach to bronchial epithelium, produce a high local radiation dose. Alpha particles can induce DNA double-strand breaks and the development of cancer. A causal relation between lung cancer and radon exposure and its progeny has been demonstrated in epidemiological studies of miners. Radon exposure became a public health issue almost 15 years ago. Most radon exposure occurs indoors, predominantly in the home. There is however, a wide range of radon concentration values in different countries. The highest level occurs in areas with granite and permeable soils. The risk for smoking, the leading cause of lung cancer, is far greater than for radon, the second leading cause. The estimates obtained from case-control studies of indoor radon are very contradictory. Scientific knowledge of effects of low levels of exposure to radon and the role of cigarette smoking, as a combined factor, must be studied. Smoking and radon probably interact in a multiplicative fashion.

Air Movements↗

[Importance of studying exposure of the population to radon and its daughters].

INTRODUCTION: Radon and thoron are naturally-occurring radioactive gases, which are products of uranium and thorium decay series, respectively. Uranium and thorium occur widely in the environment, in rocks, soil, air, water, building materials, humans, etc. Radon daughters in the air are predominantly attached to aerosols. A minor part, normally less than 10%, occurs as unattached atoms or ions. The relative distribution of attached daughters in indoor air and equilibrium factor depend on many variables, such as the decay constant, the concentration and size distribution of aerosols and ventilation rates. Increased ventilation decreases the concentration of radon and daughters in the air. OCCURRENCE: Concentration of radon, thoron and their decay products in the air indoors, in mines or houses, is higher than outdoors. In houses, the level of radon daughters may be enhanced by radon from radium rich building materials, landfill, soil and bedrock under the house, radon rich water and by poor ventilation. CONCLUSION: In recent years, several evaluations of human health risks and estimations have been made in regard to the dose-response relationship and lung cancer risk attributable to inhaled radon daughters. Inhalation of radon and thoron daughters leads to deposition in the human respiratory tract and consequent irradiation. Deposition depends on various factors, such as the size distribution of aerosols to which the daughter products of radon are attached, and fraction of unattached daughters. On average, the dose to the basal cell layer in the lung is about 5 to 8 times higher than the dose in the pulmonary region.

Air Pollutants, Radioactive↗

Radon-induced lung cancer in smokers and non-smokers: risk implications using a two-mutation carcinogenesis model.

Three sets of data (population statistics in non-smokers, data from an investigation of the smoking habits of British doctors and a study of Colorado uranium miners) were used to analyse lung cancer in humans as a function of exposure to radon and smoking. One of the aims was to derive implications for radon risk estimates. The data were analysed using a two-mutation radiation carcinogenesis model and a stepwise determination of the model parameters. The basic model parameters for lung cancer were derived from the age dependence fit of the spontaneous lung cancer incidence in non-smokers. The effect of smoking was described by two additional parameters and, subsequently, the effect of radon by three other parameters; these five parameters define the dependence of the two mutation steps on smoking and exposure to radon. Using this approach, a consistent fit and comprehensive description of the three sets of data have been achieved, and the parameters could, at least partly, be related to cellular radiobiological data. The model results explain the different effect of radon on non-smokers and smokers as seen in epidemiological data. Although the analysis was only applied to a limited number of populations, lung cancer incidence as a result of radon exposure is estimated to be about ten times higher for people exposed at the age of about 15 than at about 50, although this effect is masked (especially for smokers) by the high lung cancer incidence from smoking. Using the model to calculate the lung cancer risks from lifetime exposure to radon, as is the case for indoor radon, higher risks were estimated than previously derived from epidemiological studies of the miners' data. The excess absolute risk per unit exposure of radon is about 1.7 times higher for smokers of 30 cigarettes per day than for non-smokers, even though, as a result of the low spontaneous tumour incidence in the non-smokers, the excess relative risk per unit exposure for the smokers is about 20 times lower than for the non-smokers. This prediction could have serious consequences for the transfer of risk estimates between populations. Although the solution of the model presented here is not unique but dependent on the model assumptions, the predictions and risk implications are sufficiently supported to justify a thorough investigation of the applicability of the model to other radon data sets.

Adolescent↗

An ecological study of cancer incidence and radon levels in South West England.

To investigate the relationship of domestic radon levels and cancer, the incidence of 14 major cancers in Devon and Cornwall were examined in relation to the local radon levels. Cancer registrations for 1989-1992 were provided by the South-Western Regional Cancer Registry. The average radon levels for postcode sectors were sorted into ten categories from low (< 40 Bq/m3) to extremely high (> or = 230 Bq/m3) and age-standardised incidence rates were calculated for each radon category. The incidence rates for lung cancer, where radon has been claimed to be a risk factor, were very similar across all domestic radon categories. Only non-melanoma skin cancers, showed a significant increase in incidence in the high-radon postcode sectors (> or = 100 Bq/m3) compared with the low-radon sectors (< 60 Bq/m3) and this effect was observed for both sexes. The remaining 12 cancer sites showed no significant trend in incidence rates with increasing radon concentration. There was no significant difference in corrected survival rates for any cancer site between the low- and high-radon areas. The possible contribution of confounding factors to the results of this study is discussed.

England↗

A prediction method for radon in groundwater using GIS and multivariate statistics.

Radon (222Rn) in groundwater constitutes a source of natural radioactivity to indoor air. It is difficult to make predictions of radon levels in groundwater due to the heterogeneous distribution of uranium and radium, flow patterns and varying geochemical conditions. High radon concentrations in groundwater are not always associated with high uranium content in the bedrock, since groundwater with a high radon content has been found in regions with low to moderate uranium concentrations in the bedrock. This paper describes a methodology for predicting areas with high concentrations of 222Rn in groundwater on a general scale, within an area of approximately 185x145km2. The methodology is based on multivariate statistical analyses, including principal component analysis and regression analysis, and investigates the factors of geology, land use, topography and uranium (U) content in the bedrock. A statistical variable based method (the RV method) was used to estimate risk values related to different radon concentrations. The method was calibrated and tested on more than 4400 drilled wells in Stockholm County. The results showed that radon concentration was clearly correlated to bedrock type, well altitude and distance from fracture zones. The weighted index (risk value) estimated by the RV method provided a fair prediction of radon potential in groundwater on a general scale. Risk values obtained using the RV method were compared to radon measurements in 12 test areas (on a local scale, each of area 25x25km2) in Stockholm County and a high correlation (r=-0.87) was observed. The study showed that the occurrence and spread of radon in groundwater are guided by multiple factors, which can be used in a radon prediction method on a general scale. However, it does not provide any direct information on the geochemical and flow processes involved.

Environmental Monitoring↗

Push-pull partitioning tracer tests using radon-222 to quantify non-aqueous phase liquid contamination.

Naturally occurring radon in groundwater can be used as an in situ partitioning tracer for locating and quantifying non-aqueous phase liquid (NAPL) contamination in the subsurface. When combined with the single-well, push-pull test, this methodology has the potential to provide a low-cost alternative to inter-well partitioning tracer tests. During a push-pull test, a known volume of test solution (radon-free water containing a conservative tracer) is first injected ("pushed") into a well; flow is then reversed and the test solution/groundwater mixture is extracted ("pulled") from the same well. In the presence of NAPL radon transport is retarded relative to the conservative tracer. Assuming linear equilibrium partitioning, retardation factors for radon can be used to estimate NAPL saturations. The utility of this methodology was evaluated in laboratory and field settings. Laboratory push-pull tests were conducted in both non-contaminated and trichloroethene NAPL (TCE)-contaminated sediment. The methodology was then applied in wells located in non-contaminated and light non-aqueous phase liquid (LNAPL)-contaminated portions of an aquifer at a former petroleum refinery. The method of temporal moments and an approximate analytical solution to the governing transport equations were used to interpret breakthrough curves and estimate radon retardation factors; estimated retardation factors were then used to calculate TCE saturations. Numerical simulations were used to further investigate the behavior of the breakthrough curves. The laboratory and field push-pull tests demonstrated that radon retardation does occur in the presence of TCE and LNAPL and that radon retardation can be used to calculate TCE saturations. Laboratory injection-phase test results in TCE-contaminated sediment yielded radon retardation factors ranging from 1.1 to 1.5, resulting in calculated TCE saturations ranging from 0.2 to 0.9%. Laboratory extraction-phase test results in the same sediment yielded a radon retardation factor of 5.0, with a calculated TCE saturation of 6.5%. Numerical simulation breakthrough curves provided reasonably good matches to the approximate analytical solution breakthrough curves. However, non-equilibrium radon partitioning and heterogeneous TCE distributions may affect the retardation factors and TCE saturation estimates.

Environmental Monitoring↗

Estimation of radon concentrations in coal mines using a hybrid technique calibration curve.

The results of epidemiological studies in various countries show that radon and its progeny cause carcinogenic effects on mine workers. Therefore, it becomes of paramount importance to monitor radon concentrations and consequently determine the radon dose rates in coal mines for the protection of coal miners. A new calibration curve was obtained for radon concentration estimation using hybrid techniques. A calibration curve was generated using 226Ra activity concentration measured by a HPGe detector-based gamma-ray spectrometer versus alpha-track-density rate due to radon and its progeny on CR-39 track detector. Using the slope of the experimentally determined curve in the units of Becqueral per kilogram (Bq kg-1) per unit alpha-track-density per hour (cm-2 h-1), radon concentrations (Bq m-3) were estimated using coal samples from various coal mines in two provinces of Pakistan, Punjab and Balochistan. Consequently, radon dose rates were computed in the simulated environment of the coal mines. Results of these computations may be considered with a caveat that the method developed in this paper provides only a screening method to indicate the radon dose in coal mines. It has been shown that the actual measurements of radon concentrations in the coal mines are in agreement with the estimated radon concentrations using the hybrid-technique calibration curve.

Calibration↗

Time activity modelling of domestic exposures to radon.

Radon gas occurs naturally in the environment with a variable distribution. In some areas radon concentrates sufficiently within the built environment that it is considered as a public health risk. It is possible, successfully, to reduce radon levels in the built environment, and it has been shown that such remediation programmes can be justified in terms of the costs and benefits accruing. However, the estimated dose received by people in their homes depends on the time spent indoors. The research presented here uses data derived from time activity surveys in Northamptonshire, together with radon data from a representative home, to model potential exposures for different population sub-groups. Average home occupancy ranged from 14.8h (probable error 2.5h) for students to 17.7 (3.1) h for adults; schoolchildren spent an average of 14.9 (1.2) h at home. Over a quarter of adults, however, were in the home for 22 h on more. These differences in occupancy patterns lead to substantial differences in radon exposure. In a home with an average hourly ground floor radon concentration of 467 Bqm(-3), modelled hourly average exposures ranged from ca. 250 Bqm(-3) for students and school children, to over 340 Bqm(-3), for women based at home. Modelled exposures show a non-linear association with total time spent at home, suggesting that exposure estimates based on linear models may provide misleading estimates of health risks from radon and the potential benefits of radon remediation. Highest hourly exposures are likely to be experienced by people with highly occupancy, living in single-storey, ground floor accommodation (for example, the elderly the infirm and non-working young mothers). Since these may be least aware of radon risks, and least able to take up remediation measures, they should be specifically targeted for radon monitoring and for assistance in remediation schemes.

Activities of Daily Living↗

Effect of radon on the immune system: alterations in the cellularity and functions of T cells in lymphoid organs of mouse.

Exposure to radon and its progeny induces significant damage to the cells of the respiratory tract and causes lung cancer. Whether a similar exposure to radon would alter the functions of the immune system has not been previously investigated. In the current study, we investigated the effect of exposure of C57BL/6 mice to 1000 or 2500 working-level months (WLM) of radon and its progeny by inhalation, on the number and function of T lymphocytes in lymphoid organs. The control mice received uranium ore dust carrier aerosol by inhalation. Exposure to radon induced marked decrease in the total cellularity of most lymphoid organs such as thymus, peripheral lymph nodes (PLN), and lung-associated lymph nodes (LALN), when compared to the controls. The percentage of T cells increased, while that of non-T cells decreased, in all peripheral lymphoid organs at both the doses of radon. In the thymus, particularly at 2500 WLM of radon exposure, there was a marked decrease in CD4+CD8+ T cells and an increase in the immature CD4-CD8- T cells. Such alterations in both the numbers and percentages of lymphocytes and macrophages in radon-exposed mice may have resulted from the cell killing by the alpha particles as the immune cells were migrating through the lungs, or it may have been caused by altered migration of cells, inasmuch as expression of CD44, a molecule involved in migration and homing of immune cells, was significantly altered on cells found in different lymphoid organs. In the LALN, where one would predict the largest number of damaged cells to be present, there was a significant decrease in the T-cell responsiveness to mitogens while the B-cell response was not affected. Such alterations may have resulted from the direct effect of alpha-particle exposure on the migrating lymphocytes, altered percentage of lymphocytes as seen in secondary lymphoid organs, or altered expression of adhesion molecules involved in cell activation such as CD44 and CD3. Interestingly, radon exposure caused and increase in the T- and B-cell responsiveness to mitogens in the spleen and PLN. Since there is little evidence of direct radiation dose from radon in lymphoid organs, our studies demonstrating immunological alterations suggest an indirect effect of radon exposure that may have significant repercussions on the development of hypersensitivity and increased susceptibility to infections and cancer in the lung.

Administration, Inhalation↗

Current status of programmes to measure and reduce radon exposure in Irish workplaces.

National legislation, which implements European Council Directive 96/29/EURATOM in Ireland, sets a reference level of 400 Bq m(-3) averaged over any 3 month period for radon exposure in the workplace and also empowers the Radiological Protection Institute of Ireland to direct employers to have radon measurements carried out. This legislation came into effect in May 2000. Radon measurements have already been completed in show caves and other underground workplaces. Between 1998 and 2001, over 33 800 individual radon measurements were carried out in all ground floor offices and classrooms in 3444 schools nationwide as part of a programme undertaken jointly with the Department of Education and Science. Where the average indoor radon concentration in one or more rooms exceeded 200 Bq m(-3), remedial measures were implemented. For concentrations up to 400 Bq m(-3) this involved increased ventilation while for higher concentrations an active sump was normally installed. The results of the survey, as well as the effectiveness of the different remedial strategies, are discussed. In the case of other above ground workplaces, different approaches have been adopted. As a first step, workplaces in two known high radon areas were directed to have radon measurements carried out. This programme had limited success because of problems in obtaining accurate workplace databases and a general lack of awareness on the part of employers of the issues involved. From a sample of 2610 employers directed to measure radon, only 408 actually completed measurements and 37 workplaces were identified as having average 3 month average radon concentrations above 400 Bq m(-3). A total of 1356 employers ignored all correspondence, some of which was sent by registered post and signed for on receipt. Current initiatives are focused on the provision of information and include newspaper advertising as well as publications aimed specifically at both employer and employee representative groups. The ability to provide accurate information that encourages both measurement and remediation is seen as central to an effective radon workplace programme.

Environmental Exposure↗

Effect of soil parameters on radon entry into a building by means of the transrad numerical model.

High indoor radon concentration means an increased risk of developing lung cancer. When high radon levels are present in a dwelling, the major source is normally the soil. Therefore, it is useful to know the radon concentration field in the soil underneath a building. A steady-state two-dimensional radon transport model has been used to calculate the effect of a reference building on the soil radon concentration, and the influence of soil parameters on radon entry through a single crack in the basement. Both advective and diffusive flows are considered. Away from the building, the well-known undisturbed soil radon concentration profile has been obtained, while under the house the radon level is increased. A variability analysis around the reference site has shown that the most relevant soil parameters on the radon flux at the top of the crack are, in this case, effective diffusion coefficient, soil gas-permeability and deep soil radon concentration.

Air Pollutants, Radioactive↗

Indoor radon concentration measurement in the dwellings of Al-Jauf region of Saudi Arabia.

Indoor radon concentration measurement in the dwellings of Al-Jauf region of Saudi Arabia was carried out using passive radon dosemeters. The objective of this radon survey was to obtain representative indoor radon data of Al-Jauf region. The study is a continuation of radon survey in main cities of Saudi Arabia which constitutes a baseline for Saudi Arabia in the Radon World Atlas. A total of 318 passive radon dosemeters were distributed randomly in the region and placed for a period of 1 y starting from April 2004 to April 2005. The results of indoor radon concentration measurement in 136 dwellings distributed in Al-Jauf region are presented. The remaining dosemeters were lost in the dwellings or mishandled. The results showed that the average, minimum, maximum radon concentrations and standard deviation were 35, 7, 168 and 30 Bq m(-3), respectively. Geometric mean and geometric standard deviation of the radon distribution were found to be 28 and 1.83, respectively.

Air Pollutants, Radioactive↗

Electret method for continuous measurement of the concentration of radon in water.

A passive system using an electret ion chamber to measure dissolved radon in a water sample has been recently described. In the current work, an electret ion chamber has been used to measure time-averaged concentration of dissolved radon in water. A steady concentration of radon in water is generated by bubbling radon gas into water in a 20-L jar and maintaining constant rates of feed and bleed of the water. To perform the measurement, the outgoing water flows into a 4-L cylindrical chamber. Air is bubbled at 1 L min-1 through a 10 cm long sintered stainless steel tube immersed in this water releasing the radon from water into the chamber volume. A 1-L electret ion chamber ("H" chamber) loaded with an electret is hung in the 4-L chamber. Radon diffuses into the "H" chamber through its tyvek (carbon-coated) covered openings. The radon concentration in air is measured from the change in electret voltage. The concentration of radon in water is then obtained from the concentration of radon in air and the air and water flow rates. For comparison, the radon concentration in water was measured using a standard liquid scintillation counting method. For the concentration range covered (4.7 to 72 Bq L-1), there was a good agreement between the two methods.

Radon↗

On the discrepancy between epidemiologic studies in individuals of lung cancer and residential radon and Cohen's ecologic regression.

There is still substantial confusion in the radiation effects community about the inherent limitations of ecologic analysis. As a result, inordinate attention has been given to the discrepant results of Cohen, in which a negative estimate is observed for the regression of county mortality rates for lung cancer on estimated county radon levels. This paper demonstrates that Cohen's ecologic analysis cannot produce valid inference on the exposure-response relationship for individuals unless lung cancer risk factors (smoking, age, occupation, etc.) for individuals are statistically uncorrelated with indoor radon level within counties or unless risk effects for radon and other factors are additive. Both of these assumptions are contradicted in the literature. Thus, contrary to common assumption, when a linear no-threshold model is the true model for radon risk for individuals, higher average radon concentration for a county does not necessarily imply a higher lung cancer rate for the county. In addition, valid inference from county-level ecologic analysis and the elimination of the ecologic bias cannot be achieved with the addition of county-wide summary variables (including "stratification" variables) to the regression equation. Using hypothetical data for smoking and radon and assuming a true positive association for radon and lung cancer for individuals, the analysis demonstrates that a negative county-level ecologic regression can be induced when correlation coefficients for smoking and radon within county are in the range -0.05 to 0.05. Since adverse effects for radon at low exposures are supported by analysis of miner data (all data and data restricted only to low cumulative exposures), a meta-analysis of indoor radon studies, and molecular and cellular studies, and since ecologic regressions are burdened by severe limitations, the negative results from Cohen's analysis are most likely due to bias and should be rejected.

Air Pollutants, Radioactive↗

The residential radon-lung cancer association in U.S. counties: a commentary.

There is little doubt that underground miners exposed to radon and its progeny have increased rates of lung cancer. Residential radon exposures should carry a possibly smaller risk of increased cancer. When it became possible to collect radon data in a large number of U.S. homes and the data were aggregated by counties, the apparent association with lung cancer was a negative one, even when many other variables were taken into account. Residential radon levels are higher in suburban residences leading to a negative association with population density. Population density is strongly positively associated with lung cancer. It follows that aggregate residential radon and lung cancer rates should be negatively associated for reasons having nothing to do with the possibility of radon being carcinogenic to the lung. A second problem presented by the data is the one of sampling bias since the county lung cancer data are from the whole county population, but only a few residences are tested. Examples of other inherent associations in environmental epidemiology are cited. One strategy is to study areas of the same population density but with radon exposure gradients. This is approximated by choice of rural high radon states. Counties in such states have weak and inconsistent associations between radon and lung cancer, some of which are positive. I conclude that counties are generally inappropriate units for study of radon and lung cancer associations.

Air Pollutants, Radioactive↗

Should radon be reduced in homes? A cost-effect analysis.

BACKGROUND: Radon is a radioactive gas that may leak into buildings from the ground. Radon exposure is a risk factor for lung cancer. An intervention against radon exposure in homes may consist of locating homes with high radon exposure (above 200 Bq m(-3)) and improving these, and protecting future houses. The purpose of this paper is to calculate the costs and the effects of this intervention. METHODS: We performed a cost-effect analysis from the perspective of the society, followed by an uncertainty and sensitivity analysis. The distribution of radon levels in Norwegian homes is lognormal with mean = 74.5 Bq m(-3), and 7.6% above 200 Bq m(-3). RESULTS: The preventable attributable fraction of radon on lung cancer was 3.8% (95% uncertainty interval: 0.6%, 8.3%). In cumulative present values the intervention would cost $238 (145, 310) million and save 892 (133, 1981) lives; each life saved costs $0.27 (0.09, 0.9) million. The cost-effect ratio was sensitive to the radon risk, the radon exposure distribution, and the latency period of lung cancer. Together these three parameters explained 90% of the variation in the cost-effect ratio. CONCLUSIONS: The uncertainty in the estimated cost per life is large, mainly due to uncertainty in the risk of lung cancer from radon. Based on estimates from road construction, the Norwegian society has been willing to pay $1 million to save a life. This is above the upper uncertainty limit of the cost per life. The intervention against radon in homes, therefore, seems justifiable.

Air Pollution, Indoor↗

Residential radon and risk of lung cancer: a combined analysis of 7 North American case-control studies.

BACKGROUND: Underground miners exposed to high levels of radon have an excess risk of lung cancer. Residential exposure to radon is at much lower levels, and the risk of lung cancer with residential exposure is less clear. We conducted a systematic analysis of pooled data from all North American residential radon studies. METHODS: The pooling project included original data from 7 North American case-control studies, all of which used long-term alpha-track detectors to assess residential radon concentrations. A total of 3662 cases and 4966 controls were retained for the analysis. We used conditional likelihood regression to estimate the excess risk of lung cancer. RESULTS: Odds ratios (ORs) for lung cancer increased with residential radon concentration. The estimated OR after exposure to radon at a concentration of 100 Bq/m3 in the exposure time window 5 to 30 years before the index date was 1.11 (95% confidence interval = 1.00-1.28). This estimate is compatible with the estimate of 1.12 (1.02-1.25) predicted by downward extrapolation of the miner data. There was no evidence of heterogeneity of radon effects across studies. There was no apparent heterogeneity in the association by sex, educational level, type of respondent (proxy or self), or cigarette smoking, although there was some evidence of a decreasing radon-associated lung cancer risk with age. Analyses restricted to subsets of the data with presumed more accurate radon dosimetry resulted in increased estimates of risk. CONCLUSIONS: These results provide direct evidence of an association between residential radon and lung cancer risk, a finding predicted using miner data and consistent with results from animal and in vitro studies.

Adult↗