Abstract
Background: The objective of this investigation was to determine the effectiveness of Canada’s residential radon exposure guideline in influencing individuals’ health protection decisions.
Method: Homeowners with known exposure levels in a high residential radon area (Winnipeg, Manitoba) were surveyed to document what they had done and spent to reduce their exposure to radon. The 507 respondents were then re-surveyed to elucidate their response to hypothetical scenarios. Logistic regression was used to model risk reduction decisions as a function of exposure and other explanatory variables.
Results: Homeowners were only likely to have taken action to reduce exposure at levels exceeding 1,100 Bq/m3, well above Canada’s guideline of 800 Bq/m3. However, when informed of the guideline, respondents indicated they would act at exposures of 702 Bq/m3.
Interpretation: The Canadian residential radon exposure guideline, as it has been implemented, has not effectively prompted homeowner actions to reduce exposures to radon.
Résumé
Contexte: Cette enquête avait pour but de déterminer l’efficacité des directives d’exposition concernant le radon dans l’air intérieur des maisons au Canada dans les décisions individuelles en matière de protection de la santé.
Méthode: Les propriétaires de maisons situées dans une région à haute teneur de radon dans l’air des résidences (Winnipeg, au Manitoba) ont fait l’objet d’un sondage au sujet des mesures qu’ils ont prises pour réduire les niveaux d’exposition au radon et des montants dépensés à cet effet. Les 507 répondants ont été interrogés une deuxième fois pour expliquer leurs réponses à des scénarios hypothétiques. La régression logistique a été utilisée pour modéliser les décisions liées à la réduction du risque en fonction de l’exposition et d’autres variables explicatives.
Résultats: Les propriétaires de maisons les plus susceptibles d’avoir agi étaient ceux dont les teneurs en radon étaient supérieures à 1 100 Bq/m3, soit bien au delà de la directive canadienne de 800 Bq/m3. Cependant, après s’être familiarizés avec cette dernière, les répondants ont indiqué qu’ils agiraient désormais lorsque les teneurs atteindraient 700 Bq/m3.
Interprétation: Nos résultats laissent entendre que les directives d’exposition concernant le radon dans l’air intérieur des maisons au Canada, dans leur application actuelle, ne semblent pas inciter les propriétaires de maisons à réduire les teneurs en radon.
References
- 1.National Research Council. Health Effects of Exposure to Radon: BEIR VI. Washington, DC: National Academy Press; 1999. [PubMed] [Google Scholar]
- 2.Lubin JH, Boice J Jr. Lung cancer risk from residential radon: Meta-analysis of eight epidemi-ologic studies. J Natl Cancer Inst. 1997;89:49–57. doi: 10.1093/jnci/89.1.49. [DOI] [PubMed] [Google Scholar]
- 3.Lubin JH, Boice JD, Jr, Edling C, et al. Lung cancer in radon-exposed miners and estimation of risk from indoor exposure. J Natl Cancer Inst. 1995;87:817–27. doi: 10.1093/jnci/87.11.817. [DOI] [PubMed] [Google Scholar]
- 4.IARC. Man-Made Fibres and Radon. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Lyon: International Agency for Research on Cancer; 1988. [PMC free article] [PubMed] [Google Scholar]
- 5.Krewski D, Rai SN, Zielinski JM, et al. Characterization of uncertainty and variability in residential radon cancer risks. Ann NY Academ Sci. 1999;895:245–72. doi: 10.1111/j.1749-6632.1999.tb08090.x. [DOI] [PubMed] [Google Scholar]
- 6.Canada MortgageHousing Corporation CMHC. Radon — A Guide for Canadian Homeowners. Ottawa: CMHC and Health Canada Report C97-090282-2; 1997. [Google Scholar]
- 7.Spiegel JM. A Comparison of Economic Valuation Methods for Environmental Health Risk Reduction: Assessing Residential Radon Mitigation in Manitoba [dissertation] Winnipeg, MB: University of Manitoba; 2000. [Google Scholar]
- 8.Letourneau EG, et al. A Radon Standard for Canada. In: Walkinshaw DS, et al., editors. Transactions of Indoor Air Quality in Cold Climates: Hazards and Abatement Measures. 1985. [Google Scholar]
- 9.Yuill GK. A Survey of Radon Concentrations in Manitoba Outside Winnipeg. 1992. [Google Scholar]
- 10.Health Canada Medical Services Branch. Radon Study of Manitoba Reserves. 1992. [Google Scholar]
- 11.Letourneau EG, Krewski D, Choi NW, et al. Case-control study of residential radon and lung cancer in Winnipeg, Manitoba, Canada. Am J Epidemiol. 1994;140:310–22. doi: 10.1093/oxfordjournals.aje.a117253. [DOI] [PubMed] [Google Scholar]
- 12.MTS Advanced Inc. Who Called Me? Directory. 1998. [Google Scholar]
- 13.Mitchell RC, Carson RT. Using Surveys to Value Public Goods: An Assessment of the Contingent Valuation Method. Washington, DC: Resources for the Future; 1989. [Google Scholar]
- 14.Tolley G, Fabian R. Future directions for health value research. In: Tolley G, Kenkel D, Fabian R, editors. Valuing Health for Policy. Chicago: University of Chicago Press; 1988. pp. 300–18. [Google Scholar]
- 15.Hannemann M, Loomis J, Kanninen B. Statistical efficiency of double-bounded dichoto-mous choice contingent valuation. Am J Agr Econ. 1991;73:1255–63. doi: 10.2307/1242453. [DOI] [Google Scholar]
- 16.Bennett P, Calman C, editors. Risk Communication and Public Health. Oxford: Oxford University Press; 1999. [Google Scholar]
- 17.Menard S. Applied Logistic Regression Analysis. London: Sage Publications; 1995. [Google Scholar]
- 18.Weinstein ND, Rothman AJ, Sutton SR. Stages theories of health behaviour: Conceptual and methodological issues. Health Psychology. 1998;17(3):290–99. doi: 10.1037/0278-6133.17.3.290. [DOI] [PubMed] [Google Scholar]
- 19.Weinstein ND, Sandman PM. Experimental evidence for stages of health behaviour change: The precaution adoption process model applied to home radon testing. Health Psychology. 1998;17(5):445–53. doi: 10.1037/0278-6133.17.5.445. [DOI] [PubMed] [Google Scholar]
- 20.Burton P, Gurrin L, Sly P. Extending the simple linear regression model to account for correlated responses: An introduction to generalized estimating equations and multi-level mixed modeling. Statistics in Medicine. 1998;17:351–63. doi: 10.1002/(SICI)1097-0258(19980615)17:11<1261::AID-SIM846>3.0.CO;2-Z. [DOI] [PubMed] [Google Scholar]
- 21.Williamson DS, Bangdiwala SI, Marshall SW, et al. Repeated measures analysis of binary outcomes: Applications to injury research. Accid Anal and Prev. 1996;28(5):571–79. doi: 10.1016/0001-4575(96)00023-1. [DOI] [PubMed] [Google Scholar]
- 22.Krewski D, Oxman D, Torrance GW. A decision-oriented framework for evaluating environmental risk management strategies: A case study of lead in gasoline. In: Paustenbach DJ, editor. The Risk Assessment of Human Health Hazards: A Textbook of Case Studies. New York: John Wiley and Sons; 1986. [Google Scholar]
- 23.Adler RS, Pittle RD. Cajolery or command: Are education campaigns an adequate substitute for regulation? Yale J Regulation. 1984;1:159–93. [Google Scholar]
- 24.Johnson FR. Risk communication and regulatory culture clash. In: Garrick BJ, Gekler WC, editors. The Analysis, Communication and Perception of Risk. New York: Plenum Press; 1991. pp. 441–50. [Google Scholar]
- 25.Stieb DM, Paola J, Neuman K. Do smog advisories work? Results of an evaluation of the Canadian Smog Advisory Program. Can J Public Health. 1996;87(3):166–69. [PubMed] [Google Scholar]
- 26.Akerman J, Johnson FR, Bergman L. Paying for safety: Voluntary reduction of residential radon risks. Land Economics. 1991;67(4):435–46. doi: 10.2307/3146550. [DOI] [Google Scholar]
- 27.Tengs TO, Adams ME, Pliskin JS, et al. Five hundred life-saving interventions and their cost-effectiveness. Risk Analysis. 1995;15:369–90. doi: 10.1111/j.1539-6924.1995.tb00330.x. [DOI] [PubMed] [Google Scholar]
- 28.Letourneau EG, Krewski D, Zielinski JM, McGregor RG. Cost-effectiveness of radon mitigation in Canada. Radiation Protection Dosimetry. 1992;45:593–98. doi: 10.1093/rpd/45.1-4.593. [DOI] [Google Scholar]
- 29.Ford ES, Kelly AE, Teutsch SM, et al. Radon and lung cancer: A cost-effectiveness analysis. Am J Public Health. 1999;89(3):351–57. doi: 10.2105/AJPH.89.3.351. [DOI] [PMC free article] [PubMed] [Google Scholar]