RISK ASSESSMENT FOR RADON EXPOSURE IN VARIOUS INDOOR ENVIRONMENTS

Indoor radon exposure: A systematic review of radon-induced health risks and evidence quality using GRADE approach

Background

Radon (Rn) is a radioactive gas with well-established carcinogenic properties. It is a significant contributor to natural background ionizing radiation exposure, accounting for over 50 % of human exposure. Prolonged exposure to radon gas has been conclusively linked to various health issues such as lung cancer, leukemia, and Chronic Obstructive Pulmonary Diseases (COPD). Despite this, there is a scarcity of comprehensive studies examining the quality of evidence establishing an association between indoor radon exposure and these health problems.

Objective

We performed a systematic review of peer-reviewed research articles to explore the current evidence on the potential association between residential radon exposure and human health, specifically focusing on lung cancer, COPD, and leukemia.

Methods

A comprehensive search was conducted on PubMed and Google Scholar using MeSH terms and keywords (residential radon, radon AND lung cancer, radon AND COPD, radon AND leukemia). The inclusion criteria focused on studies that analyzed the link between residential radon exposure and lung cancer, leukemia and COPD. We searched for peer-reviewed studies published from 2010 to 2024. Studies carried out in occupational settings were not considered. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to select relevant studies. Reviewers independently collected data, resolving disagreements through discussion. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate evidence quality, and the study was registered with PROSPERO, CRD42024550735.

Results

The evidence indicating an associative or causal link between indoor radon and lung cancer was found to be of high quality or conclusive, particularly with stronger support from case-control studies. The findings for COPD and leukemia were inconclusive, indicating that additional research is necessary to establish a definitive link between residential radon exposure and these health outcomes. These associations was deemed moderate or inconclusive primarily due to methodological shortcomings, conflicting findings and the prevalence of weak study designs and poor exposure data. The existing evidence on the potential connection between residential radon exposure and the risk of COPD and leukemia is currently limited. In order to definitively confirm or disprove this association, more studies are needed. Further research is crucial to elucidate these relationships and to guide the development of effective public health interventions.

Conclusion

The review found that the association between radon exposure and lung cancer was consistent with existing scientific knowledge. However, the evidence for association between indoor radon exposure and COPD was inconclusive. Additionally, evidence linking indoor radon exposure to leukemia was uncertain. Future research should use more robust study designs (cohort and case control studies) and directly measure long-term radon levels to investigate the potential association between residential radon exposure and COPD and leukemia.

Radon exposure: a major cause of lung cancer in nonsmokers

Exposure to radon can impact human health. This is a nonsystematic review of articles written in English, Spanish, French, or Portuguese published in the last decade (2013-2023), using databases such as PubMed, Google Scholar, EMBASE, and SciELO. Search terms selected were radon, human health, respiratory diseases, children, and adults. After analyzing the titles and abstracts, the researchers initially identified 47 studies, which were subsequently reduced to 40 after excluding reviews, dissertations, theses, and case-control studies. The studies have shown that enclosed environments such as residences and workplaces have higher levels of radon than those outdoors. Moreover, radon is one of the leading causes of lung cancer, especially in nonsmokers. An association between exposure to radon and development of other lung diseases, such as asthma and COPD, was also observed. It is crucial to increase public awareness and implement governmental control measures to reduce radon exposure. It is essential to quantify radon levels in all types of buildings and train professionals to conduct such measurements according to proven efficacy standards. Health care professionals should also be informed about this threat and receive adequate training to deal with the effects of radon on human health.

Consequences of changing Canadian activity patterns since the COVID-19 pandemic include increased residential radon gas exposure for younger people

The COVID-19 pandemic has produced widespread behaviour changes that shifted how people split their time between different environments, altering health risks. Here, we report an update of North American activity patterns before and after pandemic onset, and implications to radioactive radon gas exposure, a leading cause of lung cancer. We surveyed 4009 Canadian households home to people of varied age, gender, employment, community, and income. Whilst overall time spent indoors remained unchanged, time in primary residence increased from 66.4 to 77% of life (+ 1062 h/y) after pandemic onset, increasing annual radiation doses from residential radon by 19.2% (0.97 mSv/y). Disproportionately greater changes were experienced by younger people in newer urban or suburban properties with more occupants, and/or those employed in managerial, administrative, or professional roles excluding medicine. Microinfluencer-based public health messaging stimulated health-seeking behaviour amongst highly impacted, younger groups by > 50%. This work supports re-evaluating environmental health risks modified by still-changing activity patterns.

Indoor radon survey in Whitehorse, Canada, and dose assessment

Radon-222 (²²²Rn) and its decay products are the primary sources of a population's exposure to background ionizing radiation. Radon decay products are the leading cause of lung cancer for non-smokers and the second leading cause of lung cancer after smoking for smokers. A community-driven long-term radon survey was completed in 232 residential homes in different subdivisions of Whitehorse, the capital of the Yukon, during the heating season from November to April in 2016-2017 and in 2017-2018. Radon concentrations were measured in living rooms and bedrooms on ground floors. The arithmetic and geometric means of indoor radon activity concentrations in different subdivisions of Whitehorse ranged from 52 ± 0.6 Bq m^-3and 37 ± 2.3 Bq m^-3in the Downtown area of Whitehorse to 993.0 ± 55.0 Bq m^-3and 726.2 ± 2.4 Bq m^-3in Wolf Creek. Underlying geology and glacial surfaces may partly explain these variations of indoor radon concentrations in subdivisions of Whitehorse. A total of 78 homes (34.0%) had radon concentrations higher than 100 Bq m^-3, 47 homes (20.5%) had concentrations higher than 200 Bq m^-3and 33 homes (14.4%) had concentrations higher than 300 Bq m^-3. The indoor radon contribution to the annual effective inhalation dose to residents ranged from 3.0 mSv in the Downtown area to 51.0 mSv in Wolf Creek. The estimated annual average dose to adults in Whitehorse, Yukon, is higher than the world's average annual effective dose of 1.3 mSv due to the inhalation of indoor radon. The annual radon inhalation effective dose was assessed using radon measurements taken during winter; hence the assessed dose may be overestimated. Cost-efficient mitigation methods are available to reduce radon in existing buildings and to prevent radon entry into new buildings.

Indoor radon survey in Greenland and dose assessment

Indoor radon and its decay products are the primary sources of the population's exposure to background ionizing radiation. Radon decay products are one of the leading causes of lung cancer, with a higher lung cancer risk for smokers due to the synergistic effects of radon decay products and cigarette smoking. A total of 459 year-long radon measurements in 257 detached and semi-detached residential homes in southwest and south Greenland were carried out, and a dose assessment for adults was performed. The annual arithmetic and geometric means of indoor radon concentrations was 10.5 ± 0.2 Bq m^-3 and 8.0 ± 2.3 Bq m^-3 in Nuuk, 139.0 ± 1.0 Bq m^-3 and 97.3 ± 2.1 Bq m^-3 in Narsaq, and 42.1 ± 0.7 Bq m^-3 and 22.0 ± 3.1 Bq m^-3 in Qaqortoq. Arithmetic and geometric mean radon concentration of 79.0 Bq m^-3 and 50.3 Bq m^-3 were estimated for adult, person-weighted living in south Greenland. The total number of detached and semi-detached residential homes where indoor radon is exceeding 100 Bq m^-3, 200 Bq m^-3, and 300 Bq m^-3 is 37 homes (15.0%), 13 homes (5.2%), and 8 homes (3.2%), respectively. A positive correlation between indoor air radon concentrations and underlying geology was observed. The indoor radon contribution to the annual inhalation effective dose to an average adult was 0.5 mSv in Nuuk, 6.5 mSv in Narsaq, 2.0 mSv in Qaqortoq, and 4.0 mSv for south Greenland adult person weighted. The estimated annual average effective dose to adults in Narsaq is higher than the world's average annual effective dose of 1.3 mSv due to inhalation of indoor radon. Cost-efficient mitigation methods exist to reduce radon in existing buildings, and to prevent radon entry into new buildings.

Characterizing occupational radon exposure greater than 100 Bq/m3 in a highly exposed country

Radon is an established lung carcinogen concentrating in indoor environments with importance for many workers worldwide. However, a systematic assessment of radon levels faced by all workers, not just those with direct uranium or radon exposure, has not previously been completed. The objective of this study was to estimate the prevalence of workers exposed to radon, and the level of exposure (> 100-200 Bq/m3, 200-400 Bq/m3, 400-800 Bq/m3, and > 800 Bq/m3) in a highly exposed country (Canada). Exposures among underground workers were assessed using the CAREX Canada approach. Radon concentrations in indoor workplaces, obtained from two Canadian surveys, were modelled using lognormal distributions. Distributions were then applied to the susceptible indoor worker population to yield the number of exposed workers, by occupation, industry, province, and sex. In total, an estimated 603,000 out of Canada's 18,268,120 workers are exposed to radon in Canada. An estimated52% of exposed workers are women, even though they comprise only 48% of the labour force. The majority (68%) are exposed at a level of > 100-200 Bq/m3. Workers are primarily exposed in educational services, professional, scientific and technical services, and health care and social assistance, but workers in mining, quarrying, and oil and gas extraction have the largest number of exposed workers at high levels (> 800 Bq/m3). Overall, a significant number of workers are exposed to radon, many of whom are not adequately protected by existing guidelines. Radon surveys across multiple industries and occupations are needed to better characterize occupational exposure. These results can be used to identify exposed workers, and to support lung cancer prevention programs within these groups.

Radiological risk estimation from indoor radon, thoron, and their progeny concentrations using nuclear track detectors

In this paper, we report the results of seasonal variations of indoor radon and thoron concentrations, equilibrium factors for gas progeny, and radiological risks to dwellers in the hilly area of Guwahati City, Assam, India. Twin-cup dosemeters with LR-115 (II) nuclear track detectors were used in this study. The findings show that values vary significantly, with winter having the highest values and summer having the lowest, with spring and autumn having moderate values. In winter, radon concentrations range from 61.6 ± 11.2 Bq m^-3 (Mud) to 115.3 ± 34.3 Bq m^-3 (AT), with geometric mean values of 69.2 ± 13.8 Bq m^-3 and 109.4 ± 27.9 Bq m^-3, and in summer, they range from 21.1 ± 5.9 Bq m^-3 (Mud) to 28.4 ± 8.3 Bq m^-3 (AT), with geometric mean values of 22.7 ± 6.3 Bq m^-3 and 26.1 ± 7.1 Bq m^-3, whereas thoron concentrations range from 13.1 ± 5.1 Bq m^-3 (Mud) to 58.8 ± 12.6 Bq m^-3 (AT), with geometric mean values of 27.6 ± 7.0 Bq m^-3 and 52.9 ± 10.1 Bq m^-3 in winter, respectively, and in summer, from 8.8 ± 2.3 Bq m^-3 (Mud) to 13.0 ± 5.5 Bq m^-3 (Mud), with a geometric mean value of 1.87 ± 1.29 Bq m^-3. Radon and thoron progeny levels are reported to vary from 4.1 ± 0.3 mWL (Mud) to 15.1 ± 4.3 mWL (AT) and 2.6 ± 0.9 mWL (Mud) to 14.3 ± 4.2 mWL (AT) in winter and from 1.5 ± 0.7 mWL (AT) to 3.0 ± 2.5 mWL (Mud) and 0.9 ± 0.3 mWL (AT) to 2.7 ± 0.5 mWL (Mud) in summer, respectively. The equilibrium factors for radon and its progeny have been reported to range from 0.23 ± 0.1 (Mud) to 0.51 ± 0.3 (AT) in winter, whereas from 0.23 ± 0.1 (AT) to 0.48 ± 0.4 (Mud) in summer, respectively. The equilibrium factors for thoron and its progeny have been estimated in the range of 0.02 ± 0.01 (Mud) to 0.09 ± 0.06 (AT) in winter, whereas 0.02 ± 0.02 (AT) to 0.07 ± 0.05 (Mud) in summer, respectively. The inhalation dose rates differed from house to house, having values in the range of 1.2 ± 0.2 mSv year^-1 (Mud) to 4.6 ± 1.3 mSv year^-1 (AT) in winter, whereas 0.5 ± 0.3 mSv year^-1 (AT) to 0.9 ± 0.5 mSv year^-1 (Mud) in summer, respectively. The effective doses (EDs) due to the exposure of radon and thoron in the study area have been found to range from 2.5 ± 0.3 mSv (Mud) to 9.1 ± 2.7 mSv (AT) in winter and 0.9 ± 0.4 mSv (AT) to 1.8 ± 1.3 mSv (Mud) in summer, respectively. The levels of radon and thoron in similar types of construction were found to be significantly different from one house to another. The estimated radon and thoron concentrations in the houses of that region during winter are found to be substantially higher than the global averages as reported by UNSCEAR.

Social factors and behavioural reactions to radon test outcomes underlie differences in radiation exposure dose, independent of household radon level

Radioactive radon gas inhalation causes lung cancer, and public health strategies have responded by promoting testing and exposure reduction by individuals. However, a better understanding of how radon exposure disparities are driven by psychological and social variables is required. Here, we explored how behavioural factors modified residential radon-related radiation doses incurred by 2390 people who performed a radon test. The average time from first awareness to receiving a radon test outcome was 6.8–25.5 months, depending on behaviour and attitudes. 20.5% displayed radon test urgency that reduced irradiation between awareness and outcome to 1.8 mSv from a typical 3.5 mSv, while 14.8% (more likely to be men) displayed delaying behaviours that increased exposure to 8.0 mSv. Of those with low radon, 45.9% indicated no future testing intention, underscoring the importance of original tests to reliably establish risk. Among people finding high radon, 38% mitigated quickly, 29% reported economic impediments, and 33% displayed delaying behaviours. Economic barriers and delaying behaviours resulted in 8.4 mSv/year or 10.3 mSv/year long term excess exposure, respectively, increasing lifetime risk of lung cancer by ~ 30–40%. Excess radiation doses incurred from behaviour were independent of household radon level, highlighting the strong influence of psychological and socioeconomic factors on radon exposure and lung cancer risks.

Impacts of Indoor Radon on Health: A Comprehensive Review on Causes, Assessment and Remediation Strategies

Indoor radon exposure is raising concerns due to its impact on health, namely its known relationship with lung cancer. Consequently, there is an urgent need to understand the risk factors associated with radon exposure, and how this can be harmful to the health of exposed populations. This article presents a comprehensive review of studies indicating a correlation between indoor radon exposure and the higher probability of occurrence of health problems in exposed populations. The analyzed studies statistically justify this correlation between exposure to indoor radon and the incidence of lung diseases in regions where concentrations are particularly high. However, some studies also showed that even in situations where indoor radon concentrations are lower, can be found a tendency, albeit smaller, for the occurrence of negative impacts on lung cancer incidence. Lastly, regarding risk remediation, an analysis has been conducted and presented in two core perspectives: (i) focusing on the identification and application of corrective measures in pre-existing buildings, and (ii) focusing on the implementation of preventive measures during the project design and before construction, both focusing on mitigating negative impacts of indoor radon exposure on the health of populations.

Status of radon exposure in Bangladeshi locations and dwellings

Potentially higher cancer risk due to exposure from natural background radiation was indicated for the Bangladeshi population by estimations based on the countrywide study. Several regions with elevated natural background exhibited higher soil radium and thorium contents than the world average. Being the decay products of these radioactive elements, natural radon isotopes could constitute environmental risk factors for internal radiation exposure to the lungs of people living in these areas. Although lung cancer is one of the most prevalent types of cancer in Bangladesh, its status and features are still unclear. To clarify the present status of one of the potential risk factors for lung cancer in the country, this review intends to ascertain the countrywide radon exposure, and its pathways by types of local dwelling and by regions, which would provide an indication of the internal exposures in areas of elevated natural background radiation and radionuclides of soil as well as an understanding of the preliminary contribution of environmental radon on the country's lung cancer prevalence. In this review, countrywide monitored air radon exposures for Bangladeshi dwellings and workplaces are organized from peer-reviewed published papers. Radon has been identified as one of influential sources of radiation dose in Bangladesh with its higher radon exhalation and emanation rate from soil. A novel nationwide depiction of the overall assessed indoor and soil radon levels for Bangladesh has been made through radiation maps. This would be helpful for designing future systematic radon/radiological monitoring and research on the country's lung cancer prevalence.

Rising Canadian and falling Swedish radon gas exposure as a consequence of 20th to 21st century residential build practices

Radioactive radon gas inhalation is a major cause of lung cancer worldwide and is a consequence of the built environment. The average radon level of properties built in a given period (their 'innate radon risk') varies over time and by region, although the underlying reasons for these differences are unclear. To investigate this, we analyzed long term radon tests and buildings from 25,489 Canadian to 38,596 Swedish residential properties constructed after 1945. While Canadian and Swedish properties built from 1970 to 1980s are comparable (96-103 Bq/m3), innate radon risks subsequently diverge, rising in Canada and falling in Sweden such that Canadian houses built in the 2010-2020s have 467% greater radon (131 Bq/m3) versus Swedish equivalents (28 Bq/m3). These trends are consistent across distinct building types, and regional subdivisions. The introduction of energy efficiency measures (such as heat recovery ventilation) within each nation's build codes are independent of radon fluctuations over time. Deep learning-based models forecast that (without intervention) the average Canadian residential radon level will increase to 176 Bq/m3 by 2050. Provisions in the 2010 Canada Build Code have not significantly reduced innate radon risks, highlighting the urgency of novel code interventions to achieve systemic radon reduction and cancer prevention in Canada.

Designing an Indoor Radon Risk Exposure Indicator (IRREI): An Evaluation Tool for Risk Management and Communication in the IoT Age

The explosive data growth in the current information age requires consistent new methodologies harmonized with the new IoT era for data analysis in a space-time context. Moreover, intuitive data visualization is a central feature in exploring, interpreting, and extracting specific insights for subsequent numerical data representation. This integrated process is normally based on the definition of relevant metrics and specific performance indicators, both computed upon continuous real-time data, considering the specificities of a particular application case for data validation. This article presents an IoT-oriented evaluation tool for Radon Risk Management (RRM), based on the design of a simple and intuitive Indoor Radon Risk Exposure Indicator (IRREI), specifically tailored to be used as a decision-making aid tool for building owners, building designers, and buildings managers, or simply as an alert flag for the problem awareness of ordinary citizens. The proposed methodology was designed for graphic representation aligned with the requirements of the current IoT age, i.e., the methodology is robust enough for continuous data collection with specific Spatio-temporal attributes and, therefore, a set of adequate Radon risk-related metrics can be extracted and proposed. Metrics are summarized considering the application case, taken as a case study for data validation, by including relevant variables to frame the study, such as the regulatory International Commission on Radiological Protection (ICRP) dosimetric limits, building occupancy (spatial dimension), and occupants' exposure periods (temporal dimension). This work has the following main contributions: (1) providing a historical perspective regarding RRM indicator evolution along time; (2) outlining both the formulation and the validation of the proposed IRREI indicator; (3) implementing an IoT-oriented methodology for an RRM indicator; and (4) a discussion on Radon risk public perception, undertaken based on the results obtained after assessment of the IRREI indicator by applying a screening questionnaire with a total of 873 valid answers.

COHERE - strengthening cooperation within the Canadian government on radiation research

PURPOSE

Canadian Organization on Health Effects from Radiation Exposure (COHERE) is a government initiative to better understand biological and human health risks from ionizing radiation exposures relevant to occupational and environmental settings (<100 mGy, <6 mGy/h). It is currently a partnership between two federal agencies, Health Canada (HC) and the Canadian Nuclear Safety Commission (CNSC). COHERE's vision is to contribute knowledge to reduce scientific uncertainties from low dose and dose-rate exposures. COHERE will advance our understanding by bridging the knowledge gap between human health risks and linkages to molecular- and cellular-level responses to radiation. Research focuses on identifying sensitive, early, and key molecular events of relevance to risk assessment.

CONCLUSIONS

The initiative will address questions of relevance to better apprize Canadians, including radiation workers and members of the public and Indigenous peoples, on health risks from low dose radiation exposure and inform radiation protection frameworks at a national and international level. Furthermore, it will support global efforts to conduct collaborative undertakings and better coordinate research. Here, we describe a historical overview of the research conducted, the strategic research agenda that outlines the scientific framework, stakeholders, opportunities to harmonize internationally, and how research outcomes will better inform communication of risk to Canadians.

Radon Survey in Bank Buildings of Campania Region According to the Italian Transposition of Euratom 59/2013

222Rn gas represents the major contributor to human health risk from environmental radiological exposure. In confined spaces radon can accumulate to relatively high levels so that mitigation actions are necessary. The Italian legislation on radiation protection has set a reference value for the activity concentration of radon at 300 Bq/m3. In this study, measurements of the annual radon concentration of 62 bank buildings spread throughout the Campania region (Southern Italy) were carried out. Using devices based on CR-39 solid-state nuclear track detectors, the 222Rn level was assessed in 136 confined spaces (127 at underground floors and 9 at ground floors) frequented by workers and/or the public. The survey parameters considered in the analysis of the results were: floor types, wall cladding materials, number of openings, door/window opening duration for air exchange. Radon levels were found to be between 17 and 680 Bq/m3, with an average value of 130 Bq/m3 and a standard deviation of 120 Bq/m3. About 7% of the results gave a radon activity concentration above 300 Bq/m3. The analysis showed that the floor level and air exchange have the most significant influence. This study highlighted the importance of the assessment of indoor radon levels for work environments in particular, to protect the workers and public from radon-induced health effects.

Determination of optimal ventilation rates in educational environment in terms of radon dosimetry

INTRODUCTION

New and renovated energy efficient buildings with minimised ventilation rates together with increased building airtightness are often associated with higher indoor radon concentrations compared to the concentrations in existing buildings. The purpose of our study is to analyse the problem associated with the increased radon concentration and ventilation requirements and recommendations in schools. The radon concentration was critically assessed by varying the design ventilation rates (DVRs) within fifteen cases according to legislative requirements and recommendations. The case study is a branch primary school in western part of Slovenia situated in a radon prone area.

METHODS

Radon (²²²Rn) concentrations were simulated in the classroom, using CONTAM 3.2.

PROGRAM

For validation, measurements were performed on 8 measuring days in September and 6 measuring days in March. The simulated and measured ²²²Rn concentrations are well correlated for all measurement days, with the simulated/measured ratio of 0.85-1.39. In order to define optimal DVRs in terms of dosimetry, the effective dose and its ratio to the worldwide average effective dose at workplace, received by radon progeny in 950 h (expected effective dose, 0.13 mSv/y), were calculated for each case.

RESULTS

Simulations showed that the highest radon concentrations were observed in case 1 with a DVR of 79.6 m³/h (621 Bq/m³) and case 4 with a DVR of 69.4 m³/h (711 Bq/m³), both defined by national regulations. The calculated values in both cases exceeded the national reference value for radon (300 Bq/m³) by 2.1 times and 2.4 times, and the WHO guideline value (100 Bq/m³) by 6.2 times and 7.1 times, respectively. The simulations are in line with the results of radon dosimetry. Both DVRs correspond to the highest effective doses, 1.88 mSv/y (about 14-fold higher than expected effective dose) for case 1 and 2.15 mSv/y (about 17-fold higher than expected effective dose) for case 4. Case 11_Cat I with a DVR of 1999.7 m³/h defined by EN 15251: 2007 resulted in minimal Rn concentration (35 Bq/m³) and corresponds to the lowest effective dose 0.11 mSv/y and its ratio to the expected effective dose 0.8.

CONCLUSIONS

Ventilation is an immediate measure to reduce radon concentration in a classroom and it must be performed in line with other holistic measures to prevent and control radon as a health risk factor.

Radon-222: environmental behavior and impact to (human and non-human) biota

As an inert radioactive gas, ²²²Rn could be easily transported to the atmosphere via emanation, migration, or exhalation. Research measurements pointed out that ²²²Rn activity concentration changes during the winter and summer months, as well as during wet and dry season periods. Changes in radon concentration can affect the atmospheric electric field. At the boundary layer near the ground, short-lived daughters of ²²²Rn can be used as natural tracers in the atmosphere. In this work, factors controlling ²²²Rn pathways in the environment and its levels in soil gas and outdoor air are summarized. ²²²Rn has a short half-life of 3.82 days, but the dose rate due to radon and its radioactive progeny could be significant to the living beings. Epidemiological studies on humans pointed out that up to 14% of lung cancers are induced by exposure to low and moderate concentrations of radon. Animals that breed in ground holes have been exposed to the higher doses due to radiation present in soil air. During the years, different dose-effect models are developed for risk assessment on human and non-human biota. In this work are reviewed research results of ²²²Rn exposure of human and non-human biota.

Indoor radon exposure and excess of lung cancer mortality: the case of Mexico-an ecological study

Radon is a radioactive gas that can migrate from soils and rocks and accumulate in indoor areas such as dwellings and buildings. Many studies have shown a strong association between the exposure to radon, and its decay products, and lung cancer (LC), particularly in miners. In Mexico, according to published surveys, there is evidence of radon exposure in large groups of the population, nevertheless, only few attention has been paid to its association as a risk factor for LC. The aim of this ecological study is to evaluate the excess risk of lung cancer mortality in Mexico due to indoor radon exposure. Mean radon levels per state of the Country were obtained from different publications and lung cancer mortality was obtained from the National Institute of Statistics, Geography and Informatics for the period 2001-2013. A model proposed by the International Commission on Radiological Protection to estimate the annual excess risk of LC mortality (per 10⁵ inhabitants) per dose unit of radon was used. The average indoor radon concentrations found rank from 51 to 1863 Bq m^-3, the higher average dose exposure found was 3.13 mSv year^-1 in the north of the country (Chihuahua) and the mortality excess of LC cases found in the country was 10 ± 1.5 (range 1-235 deaths) per 10⁵ inhabitants. The highest values were found mainly in the Northern part of the country, where numerous uranium deposits are found, followed by Mexico City, the most crowded and most air polluted area in the country. A positive correlation (r = 0.98 p < 0.0001) was found between the excess of LC cases and the dose of radon exposure. Although the excess risk of LC mortality associated with indoor radon found in this study was relatively low, further studies are needed in order to accurately establish its magnitude in the country.