Abstract
Studies of underground miners occupationally exposed to radon have consistently demonstrated an increased risk of lung cancer in both smokers and non-smokers. Radon exposure also occurs elsewhere, especially in houses, and estimates based on the findings for miners suggest that residential radon is responsible for about one in 20 lung cancers in the UK, most being caused in combination with smoking. These calculations depend, however, on several assumptions and more direct evidence on the magnitude of the risk is needed. To obtain such evidence, a case-control study was carried out in south-west England in which 982 subjects with lung cancer and 3185 control subjects were interviewed. In addition, radon concentrations were measured at the addresses at which subjects had lived during the 30-year period ending 5 years before the interview. Lung cancer risk was examined in relation to residential radon concentration after taking into account the length of time that subjects had lived at each address and adjusting for age, sex, smoking status, county of residence and social class. The relative risk of lung cancer increased by 0.08 (95% CI -0.03, 0.20) per 100 Bq m(-3) increase in the observed time-weighted residential radon concentration. When the analysis was restricted to the 484 subjects with lung cancer and the 1637 control subjects with radon measurements available for the entire 30-year period of interest, the corresponding increase was somewhat higher at 0.14 per 100 Bq m(-3) (95% CI 0.01, 0.29), although the difference between this group and the remaining subjects was not statistically significant. When the analysis was repeated taking into account uncertainties in the assessment of radon exposure, the estimated increases in relative risk per 100 Bq m(-3) were larger, at 0.12 (95% CI -0.05, 0.33) when all subjects were included and 0.24 (95% CI -0.01, 0.56) when limited to subjects with radon measurements available for all 30 years. These results are consistent with those from studies of residential radon carried out in other countries in which data on individual subjects have been collected. The combined evidence suggests that the risk of lung cancer associated with residential radon exposure is about the size that has been postulated on the basis of the studies of miners exposed to radon.
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- Alavanja M. C., Brownson R. C., Lubin J. H., Berger E., Chang J., Boice J. D., Jr Residential radon exposure and lung cancer among nonsmoking women. J Natl Cancer Inst. 1994 Dec 21;86(24):1829–1837. doi: 10.1093/jnci/86.24.1829. [DOI] [PubMed] [Google Scholar]
- Auvinen A., Mäkeläinen I., Hakama M., Castrén O., Pukkala E., Reisbacka H., Rytömaa T. Indoor radon exposure and risk of lung cancer: a nested case-control study in Finland. J Natl Cancer Inst. 1996 Jul 17;88(14):966–972. doi: 10.1093/jnci/88.14.966. [DOI] [PubMed] [Google Scholar]
- Blot W. J., Xu Z. Y., Boice J. D., Jr, Zhao D. Z., Stone B. J., Sun J., Jing L. B., Fraumeni J. F., Jr Indoor radon and lung cancer in China. J Natl Cancer Inst. 1990 Jun 20;82(12):1025–1030. doi: 10.1093/jnci/82.12.1025. [DOI] [PubMed] [Google Scholar]
- Clarke R. H., Southwood T. R. Risks from ionizing radiation. Nature. 1989 Mar 16;338(6212):197–198. doi: 10.1038/338197a0. [DOI] [PubMed] [Google Scholar]
- Cohen B. L. Test of the linear-no threshold theory of radiation carcinogenesis for inhaled radon decay products. Health Phys. 1995 Feb;68(2):157–174. doi: 10.1097/00004032-199502000-00002. [DOI] [PubMed] [Google Scholar]
- Doll R., Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. doi: 10.1136/bmj.2.6051.1525. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gunby J. A., Darby S. C., Miles J. C., Green B. M., Cox D. R. Factors affecting indoor radon concentrations in the United Kingdom. Health Phys. 1993 Jan;64(1):2–12. doi: 10.1097/00004032-199301000-00001. [DOI] [PubMed] [Google Scholar]
- Harries P. G. Asbestos hazards in naval dockyards. Ann Occup Hyg. 1968 Apr;11(2):135–145. doi: 10.1093/annhyg/11.2.135. [DOI] [PubMed] [Google Scholar]
- Hodgson J. T., Jones R. D. Mortality of a cohort of tin miners 1941-86. Br J Ind Med. 1990 Oct;47(10):665–676. doi: 10.1136/oem.47.10.665. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lagarde F., Pershagen G., Akerblom G., Axelson O., Bäverstam U., Damber L., Enflo A., Svartengren M., Swedjemark G. A. Residential radon and lung cancer in Sweden: risk analysis accounting for random error in the exposure assessment. Health Phys. 1997 Feb;72(2):269–276. doi: 10.1097/00004032-199702000-00010. [DOI] [PubMed] [Google Scholar]
- Lubin J. H., Boice J. D., Jr, Edling C., Hornung R. W., Howe G. R., Kunz E., Kusiak R. A., Morrison H. I., Radford E. P., Samet J. M. Lung cancer in radon-exposed miners and estimation of risk from indoor exposure. J Natl Cancer Inst. 1995 Jun 7;87(11):817–827. doi: 10.1093/jnci/87.11.817. [DOI] [PubMed] [Google Scholar]
- Lubin J. H., Boice J. D., Jr, Edling C., Hornung R. W., Howe G., Kunz E., Kusiak R. A., Morrison H. I., Radford E. P., Samet J. M. Radon-exposed underground miners and inverse dose-rate (protraction enhancement) effects. Health Phys. 1995 Oct;69(4):494–500. doi: 10.1097/00004032-199510000-00007. [DOI] [PubMed] [Google Scholar]
- Lubin J. H., Boice J. D., Jr Lung cancer risk from residential radon: meta-analysis of eight epidemiologic studies. J Natl Cancer Inst. 1997 Jan 1;89(1):49–57. doi: 10.1093/jnci/89.1.49. [DOI] [PubMed] [Google Scholar]
- Lubin J. H., Tomásek L., Edling C., Hornung R. W., Howe G., Kunz E., Kusiak R. A., Morrison H. I., Radford E. P., Samet J. M. Estimating lung cancer mortality from residential radon using data for low exposures of miners. Radiat Res. 1997 Feb;147(2):126–134. [PubMed] [Google Scholar]
- Létourneau E. G., Krewski D., Choi N. W., Goddard M. J., McGregor R. G., Zielinski J. M., Du J. Case-control study of residential radon and lung cancer in Winnipeg, Manitoba, Canada. Am J Epidemiol. 1994 Aug 15;140(4):310–322. doi: 10.1093/oxfordjournals.aje.a117253. [DOI] [PubMed] [Google Scholar]
- Pershagen G., Akerblom G., Axelson O., Clavensjö B., Damber L., Desai G., Enflo A., Lagarde F., Mellander H., Svartengren M. Residential radon exposure and lung cancer in Sweden. N Engl J Med. 1994 Jan 20;330(3):159–164. doi: 10.1056/NEJM199401203300302. [DOI] [PubMed] [Google Scholar]
- Pershagen G., Liang Z. H., Hrubec Z., Svensson C., Boice J. D., Jr Residential radon exposure and lung cancer in Swedish women. Health Phys. 1992 Aug;63(2):179–186. doi: 10.1097/00004032-199208000-00004. [DOI] [PubMed] [Google Scholar]
- Piantadosi S., Byar D. P., Green S. B. The ecological fallacy. Am J Epidemiol. 1988 May;127(5):893–904. doi: 10.1093/oxfordjournals.aje.a114892. [DOI] [PubMed] [Google Scholar]
- Ruosteenoja E., Mäkeläinen I., Rytömaa T., Hakulinen T., Hakama M. Radon and lung cancer in Finland. Health Phys. 1996 Aug;71(2):185–189. doi: 10.1097/00004032-199608000-00009. [DOI] [PubMed] [Google Scholar]
- Stidley C. A., Samet J. M. A review of ecologic studies of lung cancer and indoor radon. Health Phys. 1993 Sep;65(3):234–251. doi: 10.1097/00004032-199309000-00001. [DOI] [PubMed] [Google Scholar]
- Tomásek L., Darby S. C., Fearn T., Swerdlow A. J., Placek V., Kunz E. Patterns of lung cancer mortality among uranium miners in West Bohemia with varying rates of exposure to radon and its progeny. Radiat Res. 1994 Feb;137(2):251–261. [PubMed] [Google Scholar]
- Weinberg C. R., Moledor E. S., Umbach D. M., Sandler D. P. Imputation for exposure histories with gaps, under an excess relative risk model. Epidemiology. 1996 Sep;7(5):490–497. [PubMed] [Google Scholar]