Health Effects of Radon Exposure

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Abstract

Radon is a naturally occurring radioactive material that is formed as the decay product of uranium and thorium, and is estimated to contribute to approximately half of the average annual natural background radiation. When inhaled, it damages the lungs during radioactive decay and affects the human body. Through many epidemiological studies regarding occupational exposure among miners and residential exposure among the general population, radon has been scientifically proven to cause lung cancer, and radon exposure is the second most common cause of lung cancer after cigarette smoking. However, it is unclear whether radon exposure causes diseases other than lung cancer. Media reports have often dealt with radon exposure in relation to health problems, although public attention has been limited to a one-off period. However, recently in Korea, social interest and concern about radon exposure and its health effects have increased greatly due to mass media reports of high concentrations of radon being released from various close-to-life products, such as mattresses and beauty masks. Accordingly, this review article is intended to provide comprehensive scientific information regarding the health effects of radon exposure.

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

Dale Sandler, M. Zielinski, J Stolwijk … (2005)

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. 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. 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. 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.

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Lung cancer risk from residential radon: meta-analysis of eight epidemiologic studies.

J Lubin, J A Boice (1997)

Studies of underground miners exposed to radioactive radon and its decay products have found that exposure increases risk of lung cancer. Consequently, when radon was found to accumulate in houses, there was concern about the public health impact from exposure to a known carcinogen. Estimates on the basis of studies of underground miners suggest that indoor radon may account for 6000-36,000 lung cancer deaths each year in the United States. Because of differences between working in underground mines and living in houses, estimates are subject to major uncertainties. Numerous case-control studies were launched to assess directly the lung cancer risk from indoor radon. Some studies report positive or weakly positive findings, while others report no increased risk. Thus, the potential hazard from indoor radon remains answered only indirectly through miner studies, experimental animal studies, and cellular studies. To provide more information on the risk of lung cancer from indoor radon, we conducted a meta-analysis of all case-control studies that included at least 200 case subjects each and that used long-term indoor radon measurements. Eight studies were available and included a total of 4263 lung cancer case subjects and 6612 control subjects. From the published results of each study, confounder-adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for categories of radon concentration were obtained, and weighted linear regression analyses were performed. The combined trend in the RR was significantly different from zero (two-sided P = .03), and an estimated RR of 1.14 (95% CI = 1.0-1.3) at 150 Bq/m3 was found. An influence analysis indicated that no single study dominated the combined results. The exposure-response trend was similar to model-based extrapolations from miners and to RRs computed directly from miners with low cumulative exposures. However, there were significant differences in the study-specific estimates of the exposure response (two-sided P < .001), which were not explained by study differences in percent of the defined exposure interval covered by radon measurements, mean number of residences per subject, and other factors. Meta-analyses are valuable for identifying differences among studies and for summarizing results, but they should be interpreted cautiously when expected RRs are low as with indoor radon exposure, when there is study heterogeneity and where there is the potential for confounding and exposure misclassification. Nonetheless, the results of this meta-analysis suggest that the risk from indoor radon is not likely to be markedly greater than that predicted from miners and indicate that the negative exposure response reported in some ecologic studies is likely due to model misspecification or uncontrolled confounding and can be rejected. Until ongoing case-control studies of indoor radon are completed and the data are pooled and analyzed, the studies of underground miners remain the best source of data to use to assess risk from indoor radon. This meta-analysis provides support for their general validity.

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Doses to organs and tissues from radon and its decay products.

Peter J S Smith, G Kendall (2002)

This paper discusses the doses from radon and from its short-lived decay products to a number of organs and tissues and to the foetus. The aim is to put all these doses into context rather than concentrating only on the largest contributions. There is also a brief discussion of the evidence from epidemiology on the risks of exposure to radon and its decay products. As is well known, under normal circumstances the greatest hazard is to the respiratory tract from inhalation of radon decay products. Radon decay products may also give substantial doses to skin. Under some circumstances it seems likely that ingested radon could give significant doses to the stomach. Other risks appear to be smaller; the results given here allow them to be compared.

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Author and article information

Journal

Journal ID (nlm-ta): Yonsei Med J

Journal ID (iso-abbrev): Yonsei Med. J

Journal ID (publisher-id): YMJ

Title: Yonsei Medical Journal

Publisher: Yonsei University College of Medicine

ISSN (Print): 0513-5796

ISSN (Electronic): 1976-2437

Publication date (Print): 01 July 2019

Publication date (Electronic): 24 June 2019

Volume: 60

Issue: 7

Pages: 597-603

Affiliations

[1 ]Dongnam Radiation Emergency Medical Center, Busan, Korea.

[2 ]Department of Radiation Oncology, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea.

[3 ]National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.

Author notes

Corresponding author: Young Woo Jin, MD, PhD, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul 01812, Korea. Tel: 82-2-3399-5800, Fax: 82-2-3399-5870, ywjin@ 123456kirams.re.kr

Author information

Jin-Kyu Kang https://orcid.org/0000-0003-4398-1788

Songwon Seo https://orcid.org/0000-0001-6200-5120

Young Woo Jin https://orcid.org/0000-0002-0029-9028

Article

DOI: 10.3349/ymj.2019.60.7.597

PMC ID: 6597470

PubMed ID: 31250572

SO-VID: 05fc1592-cab3-483b-8316-73380b362459

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 08 May 2019

Date revision received : 03 June 2019

Date accepted : 06 June 2019

Funding

Funded by: Nuclear Safety and Security Commission, CrossRef https://doi.org/10.13039/501100003630;

Health Effects of Radon Exposure

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Most cited references 53

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

Lung cancer risk from residential radon: meta-analysis of eight epidemiologic studies.

Doses to organs and tissues from radon and its decay products.

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