Predictors of Indoor Radon Concentrations in Pennsylvania, 1989–2013

Background

Radon is the second-leading cause of lung cancer worldwide. Most indoor exposure occurs by diffusion of soil gas. Radon is also found in well water, natural gas, and ambient air. Pennsylvania has high indoor radon concentrations; buildings are often tested during real estate transactions, with results reported to the Department of Environmental Protection (PADEP).

Objectives

We evaluated predictors of indoor radon concentrations.

Methods

Using first-floor and basement indoor radon results reported to the PADEP between 1987 and 2013, we evaluated associations of radon concentrations (natural log transformed) with geology, water source, building characteristics, season, weather, community socioeconomic status, community type, and unconventional natural gas development measures based on drilled and producing wells.

Results

Primary analysis included 866,735 first measurements by building, with the large majority from homes. The geologic rock layer on which the building sat was strongly associated with radon concentration (e.g., Axemann Formation, median = 365 Bq/m³, IQR = 167–679 vs. Stockton Formation, median = 93 Bq/m³, IQR = 52–178). In adjusted analysis, buildings using well water had 21% higher concentrations (β = 0.191, 95% CI: 0.184, 0.198). Buildings in cities (vs. townships) had lower concentrations (β = –0.323, 95% CI: –0.333, –0.314). When we included multiple tests per building, concentrations declined with repeated measurements over time. Between 2005 and 2013, 7,469 unconventional wells were drilled in Pennsylvania. Basement radon concentrations fluctuated between 1987 and 2003, but began an upward trend from 2004 to 2012 in all county categories (p < 0.001), with higher levels in counties having ≥ 100 drilled wells versus counties with none, and with highest levels in the Reading Prong.

Conclusions

Geologic unit, well water, community, weather, and unconventional natural gas development were associated with indoor radon concentrations. Future studies should include direct environmental measurement of radon, as well as building features unavailable for this analysis.

Citation

Casey JA, Ogburn EL, Rasmussen SG, Irving JK, Pollak J, Locke PA, Schwartz BS. 2015. Predictors of indoor radon concentrations in Pennsylvania, 1989–2013. Environ Health Perspect 123:1130–1137; http://dx.doi.org/10.1289/ehp.1409014     

太原市居民室内氡水平抽样调查与所致剂量估算

目的了解室内空气中氡的本底水平,找出氡的不同来源对室内的相对贡献。方法 REM-2型氡析出率仪对地面和墙壁表面进行氡析出的测量,利用FD-125氡钍分析仪对室内用水和煤气中氡的含量作了分析,探讨了太原市居室内空气中氡本底水平。结果室内氡主要是由土壤、建材中析出的,其次才是室外空气中氡的渗入,室内用水和煤气中氡贡献很小。结论根据调查结果,进行室内空气中氡对人体健康危害分析和剂量评价,建立了室内氡本底水平的数据库,为以后研究室内氡的防护措施提供了依据。     

室内氡的危害研究进展

阐述了人类赖以生存的环境中氡的来源、性质、进入人体的途径及致病机制和主要危害。同时介绍了世界各国在氡研究领域中的现状和最新进展情况。资料表明：随着经济的发展，住宅的条件逐步得到改善，特别是家庭空调的使用，以及不适当建筑材料或装饰材料的使用，已经使室内氡的问题成为人人都要面临的普遍性问题。介绍了过去10年各国对氡的研究情况，包括室内空气中氡的浓度，它给人们带来的内照射剂量，以及为减少氡所带来的危害要采取的补救措施和降低室内氡的主要技术方法。     

Radon concentration measurements and personnel exposure levels in Bavarian water supply facilities

As part of a study covering the whole of Bavaria, the southern most of Germany's 16 states, water supply facilities were examined to determine the radon (222Rn) concentrations in ground water and indoor air and the radon exposure to the staff working in these buildings. Bavaria can be divided into ten geological regions of different geogenic radon potential. From each region, a number of water supply facilities proportional to the size of the region were selected for measurements. Over 500 of a total number of 2,600 water supply facilities were asked to take a 1-L groundwater sample and expose several track-etch detectors in order to obtain the mean room concentration of the main staff work places. In addition, for a period of 2 mo, the personnel had to wear a track-etch detector during the time they spent in the supply facilities. The resulting measurements were then used to estimate their individual effective dose of radon and its progenies. In the East Bavarian crystalline region, the region of the highest geogenic radon potential within Bavaria, indoor radon gas concentrations of up to 400 kBq m(-3) were observed. About 10% of the process controllers in this region are subjected to an annual effective dose of more than 20 mSv. In the other Bavarian regions, only 2% of staff exposure levels exceed this limit. The correlation between the radon concentration measurements of the indoor air, the ground water, and individual personnel exposure levels was determined. The average ratio of the radon indoor air to the processed groundwater concentration is 0.14. But due to the different types of ventilation in the various supply facilities, there can be great variations in this figure. Therefore, there is no clear relationship between the groundwater and the indoor air concentration of a supply facility. This study also reveals no clear relationship between radon indoor air concentrations and the personnel exposure levels of a supply facility.     

Models for retrospective quantification of indoor radon exposure in case-control studies

In epidemiologic studies on lung cancer risk due to indoor radon the quantification of individual radon exposure over a long time period is one of the main issues. Therefore, radon measurements in one or more dwellings, which in total have been inhabited by the participants for a sufficient time-period, are necessary as well as consideration of changes of building characteristics and ventilation habits, which influence radon concentration. Given data on 1-y alpha-track measurements and personal information from 6,000 participants of case-control studies in West and East Germany, an improved method is developed to assess individual radon exposure histories. Times spent in different rooms of the dwelling, which are known from a personal questionnaire, are taken into account. The time spent outside the house (average fraction 45%) varies substantially among the participants. Therefore, assuming a substantially lower radon exposure outside the dwelling, the residence time constitutes an important aspect of total radon exposure. By means of an analysis of variance, important determinants of indoor radon are identified, namely constant conditions such as type of house (one family house or multiple dwelling), type of construction (half-timbered, massive construction, lightweight construction), year of construction, floor and type of basement, and changeable conditions such as heating system, window insulation, and airing habits. A correction of measurements in former dwellings by factors derived from the analysis is applied if current living conditions differ from those of the participants at the time when they were living in the particular dwellings. In rare cases the adjustment for changes leads to a correction of the measurements with a factor of about 1.4, but a reduction of 5% on average only. Exposure assessment can be improved by considering time at home and changes of building and ventilation conditions that affect radon concentration. The major concern that changes in ventilation habits and building conditions lead to substantial errors in exposure (and therefore risk) assessment cannot be confirmed in the data analyzed.     

Indoor radon pollution in houses in the Apulian Region of Italy and evaluation of the probability of lung cancer in the population

BACKGROUND: Radon-222 is a gaseous radioactive chemical which can be transformed into other radioactive chemicals, defined as "products of decay" or "radon's daughter". The modality of radon penetration into the buildings depends on the convection motion created in the ground, which suck it back, so causing the penetration. The principal effect on human health is the increase risk of lung cancer, in proportion to the concentration and the time people spend indoors with exposure to radon. OBJECTIVES: The study proposed to estimate the expected cases of radon-induced lung cancer in the population of Apulia due to contamination by indoor radon. METHODS: The study used the data obtained in a national survey made by ANPA (National Environmental Protection Agency) and ISS (High Health Institute), with the collaboration of the Regional Reference Centres for the Control of Environmental Radioactivity (CRR). In the Apulia Region 310 families (5000 nationwide) were involved, which were selected so as to constitute a representative sample both of the region and the country. Appropriate instruments for the measurement of mean concentrations of indoor radon (passive nuclear trace monitors were installed in the homes of the sample families in two different periods of year). We evaluated the variations of indoor radon concentration in the houses during spring-summer and autumn-winter periods, observing a predictable increase in the latter period. We assessed concentrations in relation to: 1. architectural features and location, 2. construction year, 3. building material, 4. presence of windows. RESULTS: We found higher contamination in the oldest non-cement buildings and on the lower floors. In Lecce and Castrì di Lecce we found a mean radon concentration higher than the national and the regional mean, which is equivalent to annual exposure of 0.54 and 0.46 WLM respectively. For these levels we estimated that the expected cases of radon-induced lung cancer will be 1.5 in Lecce and 1.3 in Castrì per 10,000 inhabitants. CONCLUSION: The results of our investigations confirm that indoor radon pollution is a significant problem as it is one of the main causes of lung cancer. Hence, precautionary measures to reduce as much as possible exposure to indoor radon are highly recommended.     

苏州市室内氡浓度水平及其影响因素研究

目的：了解苏州市室内222Rn浓度及其影响因素.方法：使用固体径迹探测器,调查苏州市8个行政区域160户居民室内222Rn浓度,调查时间为1年,每3个月为一周期,即春、夏、秋、冬四季.探测器回收后,在6.25 mol/L的NaOH溶液中,恒温90℃蚀刻5 h,在显微镜下读数.结果：年平均222Rn浓度为29.9±21.0 Bq·m^-3;不同季节、不同通风时间、不同建筑结构及建筑年代的室内222Rn浓度存在显著差异（P〈0.05）;结论：苏州市居民室内年平均222Rn浓度低于国家标准〈电离辐射防护与辐射源安全基本标准（GB 18871-2002）〉;季节、通风时间、建筑材料是室内222Rn浓度的主要影响因素.     

Indoor radon exposure and lung cancer risk: a review of case-control studies

BACKGROUND: Radon is a radioactive gas that tends to accumulate in indoor environment. A causal relationship between lung cancer and radon exposure has been demonstrated in epidemiologic studies of miners. The objective of this paper is to present the results of case-control studies of lung cancer risk associated with indoor radon exposure. METHODS: Case-control studies published since 1990 are included in this review. This type of protocol is particularly well suited for studying the relationship between indoor radon exposure and lung cancer risk, taking into account possible confounding factors such as tobacco smoking. The characteristics and results of these studies are summarized. The limitations associated with each of these studies are also discussed. RESULTS: The results of available studies are relatively concordant and suggest a positive association between lung cancer risk and indoor radon exposure with an estimated excess relative risk of about 6 to 9% per 100Bq/m3 increase in the observed time-weighted average radon concentration. The order of magnitude of this estimation agrees with extrapolations from miners but some studies may suffer from inadequate statistical power. CONCLUSION: At present, efforts are underway to pool together the data from the existing studies of indoor radon. This pooling analysis with thousands of cases and controls will provide a more precise estimate of the lung cancer risk from indoor radon exposure and explore the effect of modifying factors, such as smoking.     

Survey of indoor radon concentrations in Fukuoka and Kagoshima prefectures

It is now well established that radon and its daughter products account for nearly half of the average population exposure to ionizing radiations and that radon is the greatest single source of natural radiation to the population. Radon and its daughters are alpha-emitters, which are more biologically damaging than beta- and gamma-radiations. A nationwide survey of radon concentration was conducted by the National Institute of Radiological Sciences in order to estimate the contribution of radon and its daughters to the population dose in Japan. Authors surveyed indoor radon concentrations in Fukuoka and Kagoshima prefectures as part of this project. A passive type radon dosimeter, in which a sheet of polycarbonate film as the alpha-ray detector was mounted, was used to measure indoor radon concentrations. The resulting distribution of the average annual indoor radon concentrations in both prefectures can be characterized by an arithmetic mean of 24.4 Bq/m3 and a standard deviation of 13.1 Bq/m3, by a geometric mean of 22.2 Bq/m3, and by a median of 20.7 Bq/m3. The geometric means of the distributions for Fukuoka and Kagoshima were 25.4, and 18.4 Bq/m3, respectively. Radon concentrations were also generally high in winter and low in summer. Regarding the analysis of correlations between the concentrations and construction materials, radon concentrations were generally high in Japanese houses with earthen walls and in concrete structures. These results showed that seasons, the type of building materials, and regional differences were significant factors in the variation of indoor radon concentration.     

黄山市环境辐射水平及居民受照剂量调查分析

目的研究黄山市环境辐射水平及居民受照剂量,为辐射防护和经济建设提供背景资料。方法采用FD-71型闪烁辐射仪,测量室内外、道路γ辐射剂量率;采用低本底闪烁测氡仪,测量氡浓度;采用γ能谱分析方法,测量建材中放射性核素226Ra、232Th、40K的含量。结果室内、室外、道路γ辐射剂量率均值分别为12.2×10-8Gy.h-1、8.5×10-8Gy.h-1、8.6×10-8Gy.h-1。地球γ辐射水平室内比室外高,平均比值为1.44,道路与室外的γ辐射水平差异无统计学意义。室内和室外宇宙射线辐射剂量率分别为2.7×10-8Gy.h-1和3.0×10-8Gy.h-1。室内、室外氡浓度均值分别为27.3 Bq.m-3和13.2 Bq.m-3。建筑材料除碳化砖及个别类型中的样品外,其他建材内、外照射指数均低于国家标准。结论黄山市环境辐射外照射所致居民人均年有效剂量当量为0.92mSv,其辐射水平属正常本底水平;室内、外氡浓度致居民受到的人均年有效剂量当量为1.88 mSv。在世界值范围内,传统建材放射性核素含量与世界建材典型值比较接近,其他建材有部分则高于世界建材典型值,应引起相关部门的注意。     

Building-specific factors affecting indoor radon concentration variations in different regions in Bulgaria

The study was conducted to assess the spatiality of the building factors’ effect on air quality through evaluation of indoor radon concentration in areas with different geology and geographical position. For that matter, a survey of indoor radon concentration was carried out in 174 kindergartens of three Bulgarian cities. The time-integrated measurements were performed in 777 ground floor rooms using alpha tract detectors, exposed for 3 months in cold period of 2014. The results of indoor radon concentrations vary from 20 to 1117 Bq/m³. The differences in the mean radon concentrations measured in the different cities were related to geology. The effect of building-specific factors: elevator, basement, mechanical ventilation, type of windows, number of floors, building renovation, building materials, type of room, type of heating, construction period, and availability of foundation on radon concentration variations was examined applying univariate and multivariate analysis. Univariate analysis showed that the effects of building-specific factors on radon variation are different in different cities. The influence of building factors on radon concentration variations was more dominant in inland cities in comparison to the city situated on the sea coast. The multivariate analysis, which was applied to evaluate the impact of building factors simultaneously, confirmed this influence too.     

Exposure to atmospheric radon.

We measured radon (222Rn) concentrations in Iowa and Minnesota and found that unusually high annual average radon concentrations occur outdoors in portions of central North America. In some areas, outdoor concentrations exceed the national average indoor radon concentration. The general spatial patterns of outdoor radon and indoor radon are similar to the spatial distribution of radon progeny in the soil. Outdoor radon exposure in this region can be a substantial fraction of an individual's total radon exposure and is highly variable across the population. Estimated lifetime effective dose equivalents for the women participants in a radon-related lung cancer study varied by a factor of two at the median dose, 8 mSv, and ranged up to 60 mSv (6 rem). Failure to include these doses can reduce the statistical power of epidemiologic studies that examine the lung cancer risk associated with residential radon exposure.     

210Po implanted in glass surfaces by long term exposure to indoor radon

Recent epidemiologic investigations of the relationship between residential radon gas exposure and lung cancer relied on contemporary radon gas measurements to estimate past radon gas exposures. Significant uncertainties in these exposure estimates can arise from year-to-year variation of indoor radon concentrations and subject mobility. Surface implanted 210Po has shown potential for improving retrospective radon gas exposure estimates. However, in previous studies, the ability of implanted 210Po activity to reconstruct cumulative radon gas exposure was not tested because glass was not available from homes with known radon-gas concentration histories. In this study, we tested the validity of the retrospective radon gas reconstruction using implanted 210Po surface activity by measuring glass surfaces from homes whose annual-average radon gas concentrations had been measured almost every year during two decades. Regression analysis showed a higher correlation between measured surface activity and cumulative radon gas exposure in these homes (R2>0.8) than was observed in homes where only contemporary radon gas measurements were available. The regression slope (0.57 ky m(-1)) was consistent with our earlier retrospective results. Surface activity measurements were as reliable for retrospective radon gas exposure reconstruction as yearlong gas measurements. Both methods produced estimates that were within 25% of the long-term average radon gas concentrations in a home. Surface measurements can be used for home screening tests because they can provide rapid, reliable estimates of past radon gas concentrations. Implanted 210Po measurements are also useful in retrospective epidemiologic studies that include participants who may have been exposed to highly variable radon concentrations in previously occupied or structurally modified homes.     

Radon 222Rn in residential buildings of Swieradów Zdrój and Czerniawa Zdrój

Swieradrów Zdrój and Czerniawa Zdrój are located in Region Izera Block. A total of 789 radon passive dosimeters were distributed in 183 dwellings in these town Swieradów Zdrój and Czerniawa Zdrój to measure the indoor radon concentration in 1999. Three-five measurements were performed in each dwelling, one in the basement, and the others in the main bedroom, in the kitchen, in the bathroom, since these rooms are the most frequently occupied. In addition, the occupants of each dwelling were requested to answer a questionnaire in which a number of questions about the building, ventilation habits and other related aspects were formulated. A charcoal detectors (Pico-Rad system) were used in experiment. It is a passive short-term screening method of radon gas concentration measurements. The indoor radon level was found to range from 14.8 Bq/m3 to 5,723.9 Bq/m3. The arithmetic mean overall indoor concentration was 420.4 Bq/m3 and the geometric mean was 159.7 Bq/m3. The average concentration of indoor radon, which reflects the real risk for inhabitants, is 193.5 Bq/m3. The results hand a log-normal distribution. In Poland, an action level of 400 Bq/m3 was recommended for existing buildings and 200 Bq/m3 for newly built (after 1.01.1998) buildings. In about 23% rooms the level of Rn-222 were above the top limit of 400 Bq/m3. The highest average concentrations were present in a basement (mean 919.9 Bq/m3). A decrease of average activity were observed at the upper levels: at the ground floor (225.2 Bq/m3), at the first floor and at the higher floors (137.6 Bq/m3). The above results indicate that radon emission from the ground provides the main contribution to the radon concentration measured in dwellings indoors in Swieradów Zdrój and Czerniawa Zdrój. The effective dose to the population of the Swieradów Zdrój and Czerniawa Zdrój from indoor radon and its progeny can be derived from this data if we use an equilibrium factor of 0.4 between radon and its progeny and assuming an indoor occupation index of 0.8. Taking into account that a conversion coefficient of 1.1 mSv per mJ h m-3 is recommended in ICRP 65 for members of public, the measured average annual dose is then about 3.3 mSv per year.     

Prevention measures against radiation exposure to radon in well waters: analysis of the present situation in Finland

Naturally occurring radioactive elements are found in all groundwaters, especially in bedrock waters. Exposure to these radioactive elements increases the risk of cancer. The most significant of these elements is radon which, as a gas, is mobile and dissolves in groundwater. In Finland, water supply plants are obliged to carry out statutory monitoring of the water quality, including radon. Monitoring of private wells, however, is often neglected. In this paper, we outline the problem by reviewing the outcomes of the studies conducted in Finland since the 1960s. We also summarise the development of legislation, regulations and political decisions made so far that have affected the amount of public exposure to radon in drinking water. A review of the studies on radon removal techniques is provided, together with newly obtained results. New data on the transfer of radon from water into indoor air are presented. The new assessments also take into account the expanding use of domestic radionuclide removal units by Finnish households.     

Comparison of natural background dose rates for residents of the Amargosa Valley, NV, to those in Leadville, CO, and the states of Colorado and Nevada

In the latter half of 2005, the U.S. Environmental Protection Agency (U.S. EPA) published a Proposed Rule (40 CFR Part 197) for establishing a dose rate standard for limiting radionuclide releases from the proposed Yucca Mountain high-level radioactive waste repository during the time period from 10 to 10 years after closure. The proposed standard was based on the difference in the estimated dose rate from natural background in the Amargosa Valley and the "average annual background radiation" for the State of Colorado. As defined by the U.S. EPA, "natural background radiation consists of external exposures from cosmic and terrestrial sources, and internal exposures from indoor exposures to naturally-occurring radon." On the basis of its assessments, the U.S. EPA estimated that the difference in the dose rate in the two identified areas was 3.5 mSv y. The purpose of this paper is to provide an independent evaluation and review of this estimate. One of the first observations was that, because site-specific dose rate measurements for the Amargosa Valley "were not available," the dose rates for various sources of natural background in that area, used by the U.S. EPA in its assessment, were based on modifications of the average values for the State of Nevada. A second observation was that the conversion coefficient applied in estimating the dose rates due to exposures to indoor radon and its decay products was a factor of >2 higher than the currently internationally accepted value. Further review revealed that site-specific data for many natural background sources in the Amargosa Valley were available. One particularly important observation was that about 91% of the residents of that area live in mobile homes which, due to their construction and design, have indoor radon concentrations comparable to, or less than, those outdoors. For that reason, alone, the U.S. EPA estimate of the average dose rate for residents of the Amargosa Valley, due to exposures to indoor radon, was not valid. For purposes of the comparisons in this paper, site-specific dose rates were estimated for all major natural background sources of exposure to residents of the Amargosa Valley, and those in Leadville, CO. The latter community was selected for comparison because of its altitude (3,200 m) and accompanying relatively high cosmic radiation dose rate, and the fact the size of its population is comparable to that of the Amargosa Valley. Another reason for this selection was that a comparison of the average natural background dose rate in the Amargosa Valley to that for the State of Colorado is not suitable because it fails to consider those locations within the State that have dose rates that are higher than the average. Nonetheless, for completeness, and to provide a number that could be compared to the U.S. EPA estimated difference, similar comparisons of the estimated dose rate in the Amargosa Valley to those for average residents of the States of Colorado and Nevada were included in the assessments that follow. The outcome showed that the estimated dose rates in Leadville, the State of Colorado, and the State of Nevada, were higher than those in the Amargosa Valley by 3.94 +/- 1.09, 2.54 +/- 2.18, and 0.95 +/- 0.82 mSv y, respectively. Associated uncertainties were highest for the estimated dose rates due to exposures to radon and its decay products. Had the systematic errors in the radon dose conversion coefficient and the random distribution in radon concentrations been included, the overall uncertainty in the total dose rate estimates could have been as high as 150%.     

Population attributable fraction for lung cancer due to residential radon in Switzerland and Germany

Studies on miners as well as epidemiological studies in the general population show an increased lung cancer risk after exposure to radon and its progeny. The European pooled analysis of indoor radon studies estimates an excess relative risk of 8% (16% after correction for measurement uncertainties) per 100 Bq m(-3) indoor radon concentration. Here, we determine the population attributable fraction (PAF) for lung cancer due to residential radon based on this risk estimate for Switzerland and Germany. Based on regionally stratified radon data, the PAF was calculated following the World Health Organization concept of global burden of disease, compared to a realistic baseline radon concentration equal to the outdoor concentration. Lifetable approaches were used taking smoking and sex into account. Measurement error corrections were applied to both risk estimates and the radon distribution. In Switzerland, the average indoor radon concentration is 78 Bq m(-3), resulting in a PAF of 8.3%. Therefore, 169 male lung cancer deaths and 62 deaths in women can be attributed to residential radon per year. For Germany, the average indoor radon concentration is 49 Bq m(-3), corresponding to a PAF of 5.0% (1,422 male and 474 female deaths annually). In both countries, a large regional variation in the PAF was observed due to regional differences in radon concentrations and population structure. Both calculations show a strong dependency on the risk model used. Risk models based on miner studies result in higher PAF estimates than risk models based on indoor radon studies due to different assumptions regarding exposures received more than 35 years ago. The use of a non-zero baseline radon concentration also contributes to the lower PAF estimates reported here. Although the estimates of the population attributable fraction of residential radon presented here are lower than previously reported estimates, the risk is still one of the most widespread environmental hazards. Radon monitoring and radon reduction programs are therefore important issues for environmental public health management.     

An improved model for the reconstruction of past radon exposure

If the behavior of long-lived radon progeny was well understood, measurements of these could be used in epidemiological studies to estimate past radon exposure. Field measurements were done in a radon-prone area in the Ardennes (Belgium). The surface activity of several glass sheets was measured using detectors that were fixed on indoor glass surfaces. Simultaneously the indoor radon concentration was measured using diffusion chambers. By using Monte Carlo techniques, it could be proven that there is a discrepancy between this data set and the room model calculations, which are normally used to correlate surface activity and past radon exposure. To solve this, a modification of the model is proposed.     

A case-referent study of lung cancer and incense smoke, smoking, and residential radon in Chinese men

Background: Burning incense generates large amounts of air pollutants, many of which are confirmed or suspected human lung carcinogens.Objectives: We conducted a population-based case-referent study to examine the effect of incense smoke exposure on lung cancer risk among Chinese males and explored the joint effect of cigarette smoking and exposure to residential radon.Methods: We recruited 1,208 male lung cancer incident cases and 1,069 community referents from 2004 to 2006 and estimated their lifetime exposures to incense smoke and other residential indoor air pollutants based on self-reported information collected during interviews. We performed unconditional multivariable logistic regression analysis to estimate the odds ratio (OR) for lung cancer associated with exposure to incense smoke after adjusting for possible confounders. We conducted stratified analyses by smoking status and exposures to incense burning and residential radon and explored the potential additive-scale interactions.Results: We observed an association between incense exposure and lung cancer that was limited primarily to smokers. Cigarette smoking and high cumulative incense exposure at home appeared to have a synergistic effect on lung cancer (compared with never-smokers who never used incense, the OR for lung cancer for smokers who used incense ≥ 60 day-years = 5.00; 95% confidence interval: 3.34, 7.51). Power was limited, but we also found preliminary evidence suggesting that radon exposure may increase risk among smokers using incense.Conclusion: Our study suggests that exposure to incense smoke in the home may increase the risk of lung cancer among smokers and that exposure to radon may further increase risk.     

Theoretical study of the relation between radon and its long-lived progeny in a room

We present a theoretical study of the complex relation between radon and its long-lived progeny implanted in glass surfaces. The well known (extended) Jacobi room model, which is normally used to describe radon and its progeny in a room, was transformed into a two-parameter model revealing a linear correlation between long term radon exposure and surface activity due to implanted radon decay products. Furthermore, this new approach made integration into a Monte Carlo simulation possible so that the large variation of different room model parameters could be taken into account. This allowed the calculation of a probability distribution for radon exposure from the measurement of the implanted 210Po activity. The availability of a 95% confidence interval for the radon exposure is valuable in the application of retrospective radon assessment in epidemiological studies.