Radon awareness and mitigation in Vermont: a public health survey

Radon exposure is associated with an increased incidence of lung cancer, and elevated levels may be found in as many as 1 out of 15 homes. The U.S. EPA recommends testing homes for radon and mitigating over the advisory level of 4 picocuries per liter (4 pCi L(-1), or 148 Bq m(-3)). A sample population from a list of Vermont residents who had tested their residence for radon through the Vermont Department of Health and who had elevated levels were mailed a survey to assess demographic characteristics, knowledge about radon, mitigation rates, types of mitigation, as well as barriers to mitigation. The response rate was 63%. Forty-three percent of respondents mitigated. Roughly half were not completely knowledgeable of radon based upon the ability to associate radon exposure with lung cancer risk. Reasons not to mitigate radon levels in homes were cost and lack of concern over elevated levels. A multivariate logistic regression analysis revealed factors associated with mitigating: an education level of college or higher (p = 0.02), concern that a high radon level would affect real estate value (p = 0.04), and home age less than 10 y (p = 0.05). In summary, less than half of Vermonters with elevated radon levels participating in the Department of Health program mitigated. We identify factors associated with radon mitigation that may lead to improved radon education and mitigation practice.     

Radon awareness, testing, and remediation survey among New York State residents

Between November 1995 and January 1997, a radon awareness, testing, and remediation survey was conducted to measure general awareness and factual knowledge about radon and prevalence of radon testing and remediation among New York State residents. The survey found that 82% of 1,209 respondents had heard of radon, but only 21% were knowledgeably aware of radon. With regard to radon testing, only 15% of respondents who were aware of radon had their homes tested. The percentage of respondents who were aware or knowledgeably aware of radon increased with increasing education level. The findings from the study suggest that the New York State public awareness programs that targeted high radon areas did show some effect both by increasing public awareness and promoting residential testing. The relatively low percentage of respondents who were knowledgeably aware of radon and the low percentage who had tested their homes strongly suggest that renewed efforts by the public health community are needed to increase knowledge about radon and its health effects and to encourage radon testing and remediation.     

Validation of a geologically based radon risk map: are the indoor radon concentrations higher in high-risk areas?

Since geographically coded information is frequently used in studies of the relationships between environmental factors and illness at the population level and by authorities for promotion of mitigation, knowledge about the validity of proxy measures is essential. This study was an evaluation of a geologically based map describing the risk for high radon levels, which was used by the municipal authorities to determine the necessity of remedial actions. Annual mean radon gas concentrations for a random sample of one-family homes selected from high-risk areas (n = 252) were compared with those of a random sample of homes from normal and low-risk areas (n = 259). No difference in geometric mean radon concentration was found between the areas, 101 Bq m(-3) and 103 Bq m(-3), respectively. The proportion of homes in each area with radon gas concentrations above the current Swedish administrative limit value for mitigation (400 Bq m(-3)) was similar, approximately 10%. We conclude that the radon risk map was unsuitable for identifying areas of concern. The findings also indicate that geologically based and geographically coded information as a proxy for human exposures can be safely used for scientific and administrative purposes only following validation.     

Assessment of the multimedia mitigation of radon in New York

Although not yet implemented, the 1996 amendments to the Safe Drinking Water Act instructed the states (or local water suppliers) to address radon concentrations in community water systems (CWS). As an alternative to reducing waterborne radon concentrations in the CWS to the maximum contaminant level (MCL) of 11 Bq L(-1), states (or individual CWS) would be permitted to develop a multimedia mitigation (MMM) program, which allowed a greater concentration (148 Bq L(-1)) of waterborne radon in the CWS, if it could be shown that an equivalent health risk reduction could be achieved by reducing indoor radon concentrations. For a MMM program to be acceptable, the U.S. Environmental Protection Agency required the health-risk reduction attained through mitigations and radon-resistant new construction (RRNC) to offset the increased health risk due to radon in community water systems above the MCL of 11 Bq L(-1). A quantitative assessment indicates that the reduction in health risk currently achieved in New York State through radon mitigations and RRNC exceeded the increase in risk associated with an alternative MCL of 148 Bq L(-1). The implementation of a MMM program in New York would result in an overall reduction in the health risk associated with exposure to radon.     

Compliance with EPA guidelines for follow-up testing and mitigation after radon screening measurements.

A survey was taken of 314 individuals, 55 of whom had residences that exceeded the EPA action level of 148 Bq m-3 (4 pCi L-1) of radon as measured by a medical center radon testing service. The survey was designed to assess whether these individuals followed the 1986 EPA guidelines for follow-up testing and mitigation. The survey indicated 41% of respondents performed follow-up tests and 16% of the respondents performed some form of mitigation. Some respondents had performed mitigation after inadequate or no follow-up radon tests. There was a positive relationship between follow-up testing and mitigation and higher initial radon screening values.     

Quality control of mitigation methods for unusually high indoor radon concentrations

The present study's objective was to control the quality of different mitigation methods for unusually high indoor radon (222Rn) concentrations of up to 274,000 Bq m(-3) in a village (Umhausen, 2,600 inhabitants) in western Tyrol, Austria. Five years after mitigation, five different remedial actions were examined on their quality by means of measuring indoor radon concentrations with charcoal liquid scintillation radon detectors and with a continuously recording AlphaGuard detector. Mitigation method in house 1--a mechanical intake and outlet ventilation system with heat exchanger in the basement, combined with a soil depressurization system--was characterized by long-term stability. With most favorable air pressure (+100 Pa) in the basement, mean basement radon concentrations in the winter were reduced from 200,000 Bq m(-3) to 3,000 Bq m(-3) by this method 5 y after mitigation. Acting against experts' instructions, the inhabitants had switched off the ventilation system most of the time to minimize power consumption although it had been proven that ventilation reduced mean basement radon concentration by a factor of about 3 in the winter and about 15 in the summer. Mitigation method in house 2-soil depressurization with two fans and loops of drainage tubes to withdraw radon from the region below the floor and outside the basement walls, and from soil below that part of the house with no basement-had been the most successful remedial measure until the winter of 1999 (i.e., 6 y after mitigation), when micro-cracks opened and consequently mean basement radon concentration increased from 250 Bq m(-3) to 1,500 Bq m(-3). Measures to block these microcracks and to minimize soil drying are being developed. Five years after mitigation, the remedial method used in house 3--a multilayer floor construction, where a fan was used to suck radon from a layer between bottom slab and floor-reduced winter mean radon concentration from 25,000 Bq m(-3) to 1,200 Bq m(-3), with the ventilation on and the basement door open. Mitigation method in house 4--a basement sealing technique--was unsuccessful with almost identical radon concentrations during all the five years since mitigation had started. Mitigation method in house 5--a waterproof basement technique especially for future homes--reduced mean basement radon concentration below 300 Bq m(-3) and mean ground floor radon concentration below 200 Bq m(-3), which is the Austrian action level for newly constructed buildings. These findings indicate that even in areas with extremely high radon concentrations, effective mitigation of indoor radon can be achieved provided that house-specific long-term, stable mitigation techniques are applied.     

A survey of householders' mitigation strategy: Response to raised radon levels

Background: Many Irish homes have unacceptable levels of radon,but there is no information on mitigation actions. Methods:All householders in an urban area with levels above 200 Bq/m³were surveyed and a 10% sample was interviewed; 141 of 233 (61%)responded. Results: Only 43% accurately recalled their radonlevel. Seventy-four percent sought advice, 9% consulted a mitigationprofessional and 6% completed home modification. Disincentivesto action were indecision (41%) and expense (29%). Average knowledgeof health risk was 9.48 of 12 items. Interviewees were concernedabout impact on house value. Conclusions: Support is requiredfor households with high radon levels to effect mitigation.     

The effectiveness of mitigation for reducing radon risk in single-family Minnesota homes

ABSTRACT: Increased lung cancer incidence has been linked with long-term exposure to elevated residential radon. Experimental studies have shown that soil ventilation can be effective in reducing radon concentrations in single-family homes. Most radon mitigation systems in the U.S. are installed by private contractors. The long-term effectiveness of these systems is not well known, since few state radon programs regulate or independently confirm post-mitigation radon concentrations. The effectiveness of soil ventilation systems in Minnesota was measured for 140 randomly selected clients of six professional mitigators. Homeowners reported pre-mitigation radon screening concentrations that averaged 380 Bq m (10.3 pCi L). Long term post-mitigation radon measurements on the two lowest floors show that, even years after mitigation, 97% of these homes have concentrations below the 150 Bq m U.S. Environmental Protection Agency action level. The average post-mitigation radon in the houses was 30 Bq m, an average observed reduction of >90%. If that reduction was maintained over the lifetime of the 1.2 million Minnesotans who currently reside in single-family homes with living space radon above the EPA action level, approximately 50,000 lives could be extended for nearly two decades by preventing radon-related lung cancers.     

Factors underlying residential radon concentration: results from Galicia, Spain

Radon causes lung cancer when inhaled for prolonged periods of time. A range of factors influence residential radon concentration and this study therefore sought to ascertain which dwelling-related factors exert an influence on radon levels. A cross-sectional study was conducted from 2001 to 2003 which analyzed 983 homes of as many subjects randomly selected from the 1991 census. Sampling was carried out by district and stratified by population density to ensure that more detectors were placed in the most heavily populated areas. Radon concentration and different dwelling characteristics were measured in each of the homes selected. Bivariate and multivariate analyses were performed to ascertain which factors influenced radon concentration. The geometric mean of radon concentration was 69.5 Bq/m3, and 21.3% of homes had concentrations above 148 Bq/m3. Factors shown to influence radon concentration in the bivariate analysis were: age of dwelling; interior building material; exterior building material; and storey on which the detector was placed. Explanatory variables in the multivariate analysis were: age of dwelling; number of storeys; distance off floor; and interior building material. The model was significant, but the variability explained was around 10%. These results highlight the fact that the study area is an area of high radon emission and that factors other than those directly related with the characteristics of the dwelling also influence radon concentration.     

High radon concentrations in a house near Castleisland, County Kerry (Ireland)--identification, remediation and post-remediation.

In July 2003, a passive radon measurement carried out over a 3-month period in a house near Castleisland in County Kerry (South-West of Ireland) identified a seasonally adjusted annual average concentration of approximately 49 000 Bq m(-3). This is the highest radon concentration ever recorded in a house in Ireland. It is almost 250 times higher than the national reference level of 200 Bq m(-3) for homes and it gives rise to an estimated annual radiation dose of approximately 1.2 Sv to the occupants. This paper describes the identification of the 'Castleisland house' and gives information on the local geology, the levels of natural background radiation in the area and the follow-up actions taken to remediate the house as well as the efforts made to heighten awareness in the locality of the hazards from radon.     

Using willingness to pay to evaluate the implementation of Canada's residential radon exposure guideline

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.     

An assessment of radon in groundwater in new york state

ABSTRACT: A set of 317 samples collected from wells throughout New York State (excluding Long Island) from 2003 through 2008 was used to assess the distribution of radon gas in drinking water. Previous studies have documented high concentrations of radon in groundwater from granitic and metamorphic bedrock, but there have been only limited characterizations of radon in water from sedimentary rock and unconsolidated sand-and-gravel deposits in New York. Approximately 8% of the samples from bedrock wells exceed 89 Bq L (eight times the proposed regulatory limit), but only 2% of samples from sand-and-gravel wells exceed 44 Bq L. Specific metamorphic and sedimentary rock formations in New York are associated with the high radon concentrations, indicating that specific areas of New York could be targeted with efforts to reduce the risk of exposure to radon in groundwater. Additionally, radon in groundwater from the sand-and-gravel aquifers was found to be directly correlated to radon in indoor air when assessed by county.     

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.     

Should radon be reduced in homes? A cost-effect analysis

BACKGROUND: Radon is a radioactive gas that may leak into buildings from the ground. Radon exposure is a risk factor for lung cancer. An intervention against radon exposure in homes may consist of locating homes with high radon exposure (above 200 Bq m(-3)) and improving these, and protecting future houses. The purpose of this paper is to calculate the costs and the effects of this intervention. METHODS: We performed a cost-effect analysis from the perspective of the society, followed by an uncertainty and sensitivity analysis. The distribution of radon levels in Norwegian homes is lognormal with mean = 74.5 Bq m(-3), and 7.6% above 200 Bq m(-3). RESULTS: The preventable attributable fraction of radon on lung cancer was 3.8% (95% uncertainty interval: 0.6%, 8.3%). In cumulative present values the intervention would cost $238 (145, 310) million and save 892 (133, 1981) lives; each life saved costs $0.27 (0.09, 0.9) million. The cost-effect ratio was sensitive to the radon risk, the radon exposure distribution, and the latency period of lung cancer. Together these three parameters explained 90% of the variation in the cost-effect ratio. CONCLUSIONS: The uncertainty in the estimated cost per life is large, mainly due to uncertainty in the risk of lung cancer from radon. Based on estimates from road construction, the Norwegian society has been willing to pay $1 million to save a life. This is above the upper uncertainty limit of the cost per life. The intervention against radon in homes, therefore, seems justifiable.     

Residential randon exposure and lung cancer risk in Misasa, Japan: a case-control study

In order to investigate an association between residential radon exposure and risk of lung cancer, a case-control study was conducted in Misasa Town, Tottori Prefecture, Japan. The case series consisted of 28 people who had died of lung cancer in the years 1976-96 and 36 controls chosen randomly from the residents in 1976, matched by sex and year of birth. Individual residential radon concentrations were measured for 1 year with alpha track detectors. The average radon concentration was 46 Bq/m3 for cases and 51 Bq/m3 for controls. Compared to the level of 24 or less Bq/m3, the adjusted odds ratios of lung cancer associated with radon levels of 25-49, 50-99 and 100 or more Bq/m3, were 1.13 (95% confidence interval; 0.29-4.40), 1.23 (0.16-9.39) and 0.25 (0.03-2.33), respectively. None of the estimates showed statistical significance, due to small sample size. When the subjects were limited to only include residents of more than 30 years, the estimates did not change substantially. This study did not find that the risk pattern of lung cancer, possibly associated with residential radon exposure, in Misasa Town differed from patterns observed in other countries.     

Optimistic biases in public perceptions of the risk from radon.

Survey data were obtained from a random sample of 657 homeowners in New Jersey and also from 141 homeowners who had already monitored their homes for radon. People who had not tested tended to believe that they were less at risk than their neighbors, and they interpreted ambiguous predictors of home radon levels in ways that supported their beliefs of below-average risk. Residents who had already tested their homes were relatively accurate about the probability of health effects. In both groups less than half of those who knew that radon can cause lung cancer were willing to admit that it would be serious if they suffered health effects from this source. The optimistic biases of the public may hamper attempts to encourage home radon monitoring and to promote appropriate mitigation measures in homes with elevated radon concentrations.     

A cost-effectiveness analysis of lowering residential radon levels in Sweden—Results from a modelling study

PurposeResidential exposure to radon is considered as the second leading cause of lung cancer after smoking. The purpose of this study was to conduct a cost-effectiveness analysis of reducing the indoor radon levels in Sweden from the current reference level of 200 Bq/m³ to the WHO suggested reference level of maximum 100 Bq/m³.MethodsWe constructed a decision-analytic cost-effectiveness model using input data from published literature and administrative records. The model compared the increase in economic costs to the health benefits of lower indoor radon-levels in a Swedish policy context. We estimated the cost per life-year and quality adjusted life year (QALY) gained and assessed the robustness of the results using both deterministic and probabilistic sensitivity analysis.ResultsIncluding (excluding) costs of added life years the cost per QALY for existing homes was €130,000 (€99,000). For new homes the cost per QALY including (excluding) costs of added life years was €39,000 (€25,000).ConclusionsThe results indicate that it is not cost-effective to reduce indoor radon levels from 200 Bq/m³ to a maximum of 100 Bq/m³ in existing homes, whereas it is cost-effective for new homes.     

Indoor air pollutants: limited-resource households and child care facilities

This paper reports on a study of indoor air quality in homes and child care facilities in non-metropolitan counties of New York State. Specific pollutants examined were lead, radon, carbon monoxide, asbestos, and mold. Some homes had high levels of pollutants, and certain pollutants were significantly and negatively correlated with household income. High levels of pollutants also were observed in many child care facilities, which raises questions about constant exposure of children to pollutants. Recommendations are made for lowering pollutant levels in low-income households and child care facilities.     

Nationwide survey of radon levels in Korea

A nationwide radon survey was conducted to provide data on the annual average indoor radon concentration in Korean homes. This survey also provided data on the variation of radon concentration with season, house type, and building age. The arithmetic mean (AM) of annual radon concentration in Korean homes was 53.4 +/- 57.5 Bq m(-3). The indoor radon concentration showed a lognormal distribution with a geometric mean (GM) and its standard deviation (GSD) of 43.3 +/- 1.8 Bq m(-3). The radon concentrations in the traditional Korean-style houses were about two times higher than those in apartments and row houses. The average annual outdoor radon concentration was 23.3 Bq m(-3). The average annual effective dose to the general public from radon was 1.63 mSv y(-1).     

Estimating Rn-induced lung cancer in the United States

The proportion of lung cancer deaths attributable to Rn among residents of single-family homes in the U.S. (approximately 70% of the housing stock) is estimated using the log-normal distribution of Rn concentrations proposed by Nero et al. (1986) and the risk model developed by the National Academy of Sciences' BEIR IV Committee. The risk model, together with the exposure distribution, predicts that approximately 14% of lung cancer deaths among such residents (about 13,300 deaths per year, or 10% of all U.S. lung cancer deaths) may be due to indoor Rn exposure. The 95% confidence interval is 7%-25%, or approximately 6600 to 24,000 lung cancer deaths. These estimated attributable risks due to Rn are similar for males and females and for smokers and nonsmokers, but higher baseline risks of lung cancer result in much larger absolute numbers of Rn-attributable cancers among males (approximately 9000) and among smokers (approximately 11,000). Because of the apparent skewness of the exposure distribution, most of the contribution to the attributable risks arises from exposure rates below 148 Bq m-3 (4 pCi L-1), i.e., below the EPA "action level." As a result, if all exposure rates that exceed 148 Bq m-3 (approximately 8% of homes) were eliminated, the models predict that the total annual lung cancer burden in the U.S. would drop by 4-5%, or by about 3800 lung cancer deaths, in contrast to a maximum reduction of 14% if all indoor Rn exposure above the 1st percentile were eliminated.