View
217
Download
3
Category
Preview:
Citation preview
© UMn 2008 1
A Lung Cancer Victim SpeaksDennie Edwards, Elyria, OH, www.CanSAR.orgwww.CanSAR.org
““In 2004, I had a very bad cold, so my doctor performed a chest x-ray to check for pneumonia. I've never smoked, so you can imagine how shocked I was that he found a 4.5 centimeter mass in my left lung.“Even though I've been a real estate agent for 31 years, I had never bothered to test my house for radon. I always informed my clients that radon testing prior to purchase was an option (to protect my liability), but truthfully, I really didn't care if they tested or not. “Now I had to wonder whether my lung cancer had been caused by radon exposure. While the doctor scheduled my surgery, I scheduled a radon test. The result was 10 pCi/l, (2 ½ times the EPA's Action Level). I had lived in the home for 12 years. Needless to say, I called a contractor to have a mitigation system installed.“Two days later I had surgery. I thought I was surely going to die. When I woke up choking with tubes in my throat, panic set in. They had removed my entire left lung. I'm getting better. I can walk up to a mile. But, I can no longer dance, lift things, or exert myself.
““My clients now get a very personal testimonial My clients now get a very personal testimonial about the importance of testing for radonabout the importance of testing for radon."."
© UMn 2008 2
Introduction
Good AfternoonGood AfternoonWilliam J. AngellWilliam J. Angell
President, American Association of Radon Scientists and Technologists
• www.aarst.org or email director@aarst.org
Chair, Prevention and Mitigation Working GroupWorld Health Organization’s International Radon Project • www.who.int/ionizing_radiation/env/radon/en/
Professor, University of MinnesotaDirector, Midwest Universities Radon Consortium• U.S. EPA founded; serves 10 states• www.cce.umn.edu/radon
© UMn 2008 3
IntroductionPurposePurpose
To offer a basic perspective of:To offer a basic perspective of:Radon health effects and risksRadon health effects and risksHow radon enters homes and other buildingsHow radon enters homes and other buildingsHow we remediation existing homes and control radon in How we remediation existing homes and control radon in new homesnew homes
To offer an assessment of current radon policy and To offer an assessment of current radon policy and optionsoptions
To suggest sources for further informationTo suggest sources for further information•• Cancer Survivors Against Radon Cancer Survivors Against Radon www.CanSAR.orgwww.CanSAR.org•• Lead State Radon Contracts Lead State Radon Contracts www.epa.gov/iaq/whereyoulive.htmlwww.epa.gov/iaq/whereyoulive.html•• Radon Professionals Radon Professionals www.aarst.orgwww.aarst.org
© UMn 2008 4
1. Physics ... Introduction - Radon
Radon CharacteristicsRadioactive Gas1. Causes Lung Cancer2. Outdoors, Naturally Occurring, Naturally Occurring
But But indoors, human influenced~ The we design, build and use our buildings
– Primary exposure in the home2. No Static Electrical Charge 3. Noble Gas - Inert (does not chemically react)4. Colorless, Odorless, and Tasteless
Not Detected by Human Senses
New Ionizing RadiationWarning Symbol from theInternational Radiation Protection Association
© UMn 2008 5
1. Physics ... Introduction - Radioactive Decay and Radon Entry
Radon Entry
Radium
Radon
Uranium
100s - 100,000s pCi/L –
1.3 pCi/L* U.S. annual average indoors in homes (living areas)
0.4 pCi/L *U.S. annual average outdoors
pCi/L is a unit of radon radioactivity (or ‘activity’) concentration
1 PCi/L = 2.2 radioactive disintegrations per minute per liter
© UMn 2008 6
Health Effects of Radonand its Decay Products
Image from Switzerland’s Federal Office of Public Health
© UMn 2008 7
Health Effects
Cancer Deaths in the U.S.About 560,000 Americans died of cancer in 2007About 560,000 Americans died of cancer in 2007
Lung cancer is the leading cause of U.S. cancer deaths
About 213,400 lung cancer cases in 2007• 160,400 will die
Most important carcinogens• Tobacco smoke followed by
– Radon ~ 21,000 lung cancer deaths per year– Secondhand smoke ~ 3,000 lung cancer deaths
per year–– AsbestosAsbestos
The dominate forms of cancer deaths are:The dominate forms of cancer deaths are:For men: 1) lung, 2) prostate, 3) colon, and 4) rectum.For men: 1) lung, 2) prostate, 3) colon, and 4) rectum.For women: 1) lung, 2) breast, and 3) colon.For women: 1) lung, 2) breast, and 3) colon.
© UMn 2008 8*Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.Source: American Cancer Society, 2007.
Men 667,860 Women 678,060
26%26% BreastBreast
15% Lung & bronchus11%11% Colon & rectumColon & rectum6%6%Uterine corpus Uterine corpus 4%4% NonNon--HodgkinHodgkin
lymphoma lymphoma 4%4%Melanoma of skinMelanoma of skin4% Thyroid4% Thyroid3%3% OvaryOvary3%3% KidneyKidney
3%3%LeukemiaLeukemia21%21% All Other SitesAll Other Sites
Prostate 29%
Lung & bronchus15%Colon & rectum 10%Urinary bladder 7%Non-Hodgkin 4% lymphomaMelanoma of skin 4%Kidney 4%Leukemia 3%Oral cavity 3%Pancreas 2%All Other Sites 19%
Health Effects
New U.S. Cancer Cases, 2007www.cancer.org/downloads/stt/CAFF06EsCsMcLd.pdf
© UMn 2008 9
Health Effects
U.S. Cancer Deaths, 2007 www.cancer.org/downloads/stt/CAFF06EsCsMcLd.pdf
ONS=Other nervous system. Source: American Cancer Society, 2007.
Men 289,550 Women 270,10026% Lung & bronchus15%15% BreastBreast10%10% Colon & rectumColon & rectum6%6% PancreasPancreas6%6% OvaryOvary4%4% LeukemiaLeukemia3%3% NonNon--HodgkinHodgkin
lymphomalymphoma3%3% Uterine corpusUterine corpus2%2% Brain/ONSBrain/ONS2%2% Liver & Liver & intrahepaticintrahepatic
bile ductbile duct23% All other sites23% All other sites
Lung & bronchus 31%Prostate 9%Colon & rectum 9%Pancreas 6%Leukemia 4%Liver & 4%
bile ductEsophagus 4%Urinary bladder 3% Non-Hodgkin 3%
lymphoma Kidney 3%All other sites 24%
© UMn 2008 10
Health Effects
Lung Cancer Incidence Rates High Among Female Never Smokers
Lung cancer incidence Lung cancer incidence rates per 100,000 personrates per 100,000 person--years among never years among never smokers aged 40 to 79 smokers aged 40 to 79 were:were:
14.4 to 20.8 for females
4.8 to 13.7 for males
Calculated from six large cohort Calculated from six large cohort populations populations
Several factors have been Several factors have been proposed for the development proposed for the development of LCINSof LCINS, including, including
secondhand smoke;occupational exposures such as asbestos, chromium, or arsenic;environmental exposures such asdomestic radon; indoor pollutants; previous lung disease; dietary factors; family history; and genetic factors
However, the relative significance of However, the relative significance of these individual factors among these individual factors among different ethnic populations in the different ethnic populations in the development of LCINS has not been development of LCINS has not been wellwell--characterized. characterized.
(Wakelee, H.A. et al. 2007 Lung Cancer in Never Smokers: A Review, Journal of Clinical Oncology, 25, 5 (February 10): 472-478
© UMn 2008 11
Health Effects
Summary of Lung Cancer Facts (Lung Cancer Alliance, www.lungcanceralliance.org/pdf_docs/lungcancer_factsheet.pdf)
Lung cancer is Lung cancer is the leading causethe leading cause of U.S. of U.S. cancer deathscancer deaths
Causes 1/3 of cancer deathsCauses 1/3 of cancer deathsKills more than breast, prostate, colon, liver, kidney, & Kills more than breast, prostate, colon, liver, kidney, & melanoma cancer melanoma cancer combined!combined!•• Kills 3 times as many men compared to prostate cancerKills 3 times as many men compared to prostate cancer•• Kills nearly twice as many women Kills nearly twice as many women compared tocompared to breast cancerbreast cancer
60% of those diagnosed are never or former 60% of those diagnosed are never or former smokerssmokers
Radon is the leading cause of lung cancer among never Radon is the leading cause of lung cancer among never smokers (U.S. EPA) smokers (U.S. EPA) Radon multiples the lung cancer risk for former and Radon multiples the lung cancer risk for former and current smokers (National Academy of Science, BEIR VI) current smokers (National Academy of Science, BEIR VI)
© UMn 2008 12
Health Effects: Opportunity for Exposure
Sources of Annual Radiation Exposure to the General U.S. Population
Assumes average Assumes average indoor living area indoor living area radon concentration of radon concentration of 1.3 pCi/L.1.3 pCi/L.Radon is by far the Radon is by far the greatest single source greatest single source of radiation to the of radiation to the general public.general public.
ResidentialRadon55%
Medical XMedical X--RaysRays11%11%
Other IndustrialOther IndustrialSources 1%Sources 1%
InternalInternal(potassium(potassium--40)40)
11%11%Nuclear MedicineNuclear Medicine
4%4%Consumer ProductsConsumer Products
3%3%TerrestrialTerrestrial
(earth’s crust)(earth’s crust)8%8%
CosmicCosmic8%8% Source: NCRP 93 (1987)
© UMn 2008 13
Health Effects: 2.A. Human Epidemiological Studies: Cohort - Miners
National Academy of Sciences Radon/Health Effects Findings
Committee on the Committee on the BBiological iological EEffects of ffects of IIonizing onizing RRadiation Report (adiation Report (BEIR VI)BEIR VI) “The Health Effects “The Health Effects of Exposure to Indoor Radon” (1999)of Exposure to Indoor Radon” (1999)
A definitive review of scientific dataA definitive review of scientific dataUsed updated data from 11 NCI miner studies Used updated data from 11 NCI miner studies since residential data was too sparse for valid since residential data was too sparse for valid risk estimaterisk estimate
•• Central estimate of radon attributed lung cancer Central estimate of radon attributed lung cancer in U.S. homes: up to 21,800in U.S. homes: up to 21,800
–– 18,900 ever18,900 ever--smokers 2,900 neversmokers 2,900 never--smokers smokers –– with an uncertain range of 3,000 to 33,000 with an uncertain range of 3,000 to 33,000
© UMn 2008 14
Health Effects: Risk Assessment
EPA Radon Risk Assessment (2004)
Lifetime risk in homes at 4 pCi/L Action Lifetime risk in homes at 4 pCi/L Action Level:Level:
7 of 1000 for Never7 of 1000 for Never--SmokersSmokersIncrease more than three times from 0.2% in 1992
62 of 1000 for Smokers (62 of 1000 for Smokers (7 X that of never7 X that of never--smokerssmokers))Increase more than double from 2.9% in 1992
Central risk estimate for all home radon Central risk estimate for all home radon concentrationsconcentrations
AboutAbout 21,000 lung cancer deaths/year21,000 lung cancer deaths/year•• Uncertainty range of Uncertainty range of 8,000 to 45,000 deaths/year8,000 to 45,000 deaths/year
© UMn 2008 15
Health Effects: Risk Assessment
North American Studies Combined Analysis (Krewski, D. et al. 2005 “Residential Radon and Risk of Lung Cancer: A Combined Analysis of 7 North American Case-Control Studies,” Epidemiology16(2):137-145, March)
3665 cases and 4966 controls from 7 studies of 3665 cases and 4966 controls from 7 studies of residential exposure using longresidential exposure using long--term detectorsterm detectors
Results: OR 1.11 for lung cancer at 2.7 pCi/LResults: OR 1.11 for lung cancer at 2.7 pCi/L over over 5 to 30 years 5 to 30 years
which are comparable to previous predications from which are comparable to previous predications from miner studies miner studies
Conclusion: results provide direct evidence of Conclusion: results provide direct evidence of association of residential radon and lung cancer association of residential radon and lung cancer riskrisk
© UMn 2008 16
Health Effects: Risk Assessment
European Radon Risk Assessment (Darby, S et al., 2004, Radon in homes and risk of lung cancer: Collaborative analysis of individual data from 13 European case-control studies, BMJ.com, doi: 10.1136/bmj.38308.477650.63)
This study found that This study found that the risk of lung cancer the risk of lung cancer increased 16% for each 2.7 pCi/L increaseincreased 16% for each 2.7 pCi/L increase
7,148 lung cancer cases, 14,208 controls in 9 European 7,148 lung cancer cases, 14,208 controls in 9 European countriescountriesMean concentration: 104 Bq/mMean concentration: 104 Bq/m33 (2.8 pC/l)(2.8 pC/l)
Conclusion: Conclusion: radon in homes is responsible for 15% radon in homes is responsible for 15% of all lung cancer deaths in Europe (similar to of all lung cancer deaths in Europe (similar to EPA’s 12% in U.S)EPA’s 12% in U.S)
However, Jerome Puskin of EPA’s Center for Risk However, Jerome Puskin of EPA’s Center for Risk Assessment notes that the European estimate may be biased Assessment notes that the European estimate may be biased low low (www.bmj.com/cgi/content/full/330/7500/1151(www.bmj.com/cgi/content/full/330/7500/1151--a)a)
© UMn 2008 17
Health Effects: Cumulative Exposure
Lifetime Lung Cancer Death Risk Per Person (out of 1,000; 2004 Updated)
202010108842 2 1.31.3
36 36 1818151574422
2602601501501201206232322020
Never Smokers
CurrentSmokers
GeneralPopulation
1101105656454523121277
pCi/LpCi/L
‘Remember, each of these numbers represent a real person with a loving family,’ Bill Field, UIa
© UMn 2008 18
Health Effects: Risks
Radon Compared to Other Risks (A Citizen’s Guide to Radon, 2003, EPA; Health Risk, 2007, EPA and National Electronic Injury Surveillance System Consumer Product Safety Commission, 2003)
Health Effects: Risks
Radon Compared to Other Risks (A Citizen’s Guide to Radon, 2003, EPA; Health Risk, 2007, EPA and National Electronic Injury Surveillance System Consumer Product Safety Commission, 2003)
0
5000
10000
15000
20000
25000 Radon in HomesDrunk DrivingFalls in HomesDrowningsETS Lung CancerHome FiresCO in Homes
Perspective: ten years ago, radon ~14,000; drunk driving ~22,000
© UMn 2008 19
Health Effects: Risks
How Do Radon and Mold Compare?
© UMn 2008 20
Factors Affecting Radon Entry and Concentrations
Note: Image from Switzerland’s Federal Office of Public Health
© UMn 2008 21
Indoor Radon Concentrations: Introduction
Radon Entry Dynamics OverviewCan be influenced by the complex interaction of:Can be influenced by the complex interaction of:
Building characteristics Building characteristics Heating system (e.g., type, use)Heating system (e.g., type, use)Pressure differences
House ~ soilIntraIntra--zonal zonal
Dynamic ventilation rateDynamic ventilation rateWater source (e.g., radon Water source (e.g., radon concentration in well water)concentration in well water)Building materials (emanation)Building materials (emanation)
DiffusionDiffusionOccupant activitiesOccupant activities
Window opening (e.g., location)Window opening (e.g., location)Fireplace and wood stove useFireplace and wood stove useExhaust fan useExhaust fan use
Local geologyLocal geology (including karst)(including karst)Soil
Radium contentMoisture contentMoisture contentTemperature differencesTemperature differencesPermeability Permeability Water table (e.g., fluctuation) Water table (e.g., fluctuation)
Metrological factorsMetrological factorsBarometric pressure changes Barometric pressure changes Wind speed and directionWind speed and directionPrecipitation (e.g., rate, amount)Precipitation (e.g., rate, amount)Season (e.g., indoor Season (e.g., indoor –– outdoor outdoor temperature difference ~ stack temperature difference ~ stack effect)effect)Temperature inversionsTemperature inversionsSnow cover or soil saturationSnow cover or soil saturation
© UMn 2008 22
Indoor Radon Concentrations: Introduction - Mapping
U.S. Radon Zone MapMap based on Map based on
Geologic factorsGeologic factorsAerial surveys Aerial surveys Results of home surveysResults of home surveys
Primarily shortPrimarily short--term term tests in lowest lived tests in lowest lived in level in level
Home foundation typeHome foundation typeSoil surveys Soil surveys
Expected average short term Radon (pCi/L):
Red = Zone 1 > 4.0High probability
Orange = Zone 2 > 2 < 4Yellow = Zone 3 < 2
Low probabilityShould use map with EPA manual explaining methodology. High and low radon may be found in any zone.
© UMn 2008 23
Indoor Radon Concentrations: Introduction Indoor Radon Concentrations: Introduction Rock, Soil, IndoorsRock, Soil, Indoors
Indoor Radon in a Community Indoor Radon in a Community --FYIFYI
Source: Mike Mudrey, 2005, UW-
Test Results< 4 pCi/L
4 - 1010 - 1212 - 1616 – 2020 – 30>30
© UMn 2008 24
2. Transport, B. Driving Forces, 1) Air Pressure Differences
The Predominant Driving Force is Building Induced Soil Suction
Buildings create Buildings create vacuums that vacuums that draw in soil gas.draw in soil gas.These vacuums These vacuums may be very small may be very small and are referred to and are referred to as air pressure as air pressure differentials.differentials.
© UMn 2008 25
Radon Mitigationand Prevention Strategies
© UMn 2008 26
Mitigation of Existing Dwellings
Remediation in Existing Homes: Active Soil Depressurization
Mitigation of Existing Dwellings
Remediation in Existing Homes: Active Soil Depressurization
Active Active = FanFanReverses air Reverses air pressure pressure difference difference between indoors between indoors and soiland soilReduces radon Reduces radon concentrations in concentrations in soil adjacent to soil adjacent to the foundationthe foundation
© UMn 2008 27
Radon Control Options in New Homes
Radon Control in New HomesPassive or Active Soil Depressurization
Minimum 3” passive stack routed Minimum 3” passive stack routed through conditioned space through conditioned space
Connects to subslab tee, interior Connects to subslab tee, interior drain tile or sumpdrain tile or sumpInsulate outside conditioned spaceInsulate outside conditioned spaceMinimize horizontal pipeMinimize horizontal pipePitch to drain condensation Pitch to drain condensation
Electrical roughElectrical rough--in provided in in provided in accessibleaccessible attic near vent stack attic near vent stack
Sealing and caulking of possible Sealing and caulking of possible radon entry pointsradon entry points
Gas permeable material beneath Gas permeable material beneath slabslab
Minimize building depressurizationMinimize building depressurizationLabel system Label system
Avoid unsealed ducts and air Avoid unsealed ducts and air handlers outside conditioned spacehandlers outside conditioned space
Stack terminates 12” above roofStack terminates 12” above roof
© UMn 2008 28
State Radon Policy Considerations
© UMn 2008 29
Policy Considerations
Radon Policy in Other Countries
Norway has required test of all new homesNorway has required test of all new homesMust be less that reference levelMust be less that reference level
Goal for all new homes ¼ of reference levelGoal for all new homes ¼ of reference levelSweden is most advancedSweden is most advanced
Local health authorities have the power to orderLocal health authorities have the power to orderRadon testingRadon testing•• Used for rental housingUsed for rental housing
Radon mitigationRadon mitigation•• 50% grant up to 1500 Euros for owner50% grant up to 1500 Euros for owner--occupiedoccupied
–– Switzerland offers a tax creditSwitzerland offers a tax credit
Switzerland has established goals, e.g.,Switzerland has established goals, e.g.,All elevated homes and schools must be mitigated by 2014 All elevated homes and schools must be mitigated by 2014
© UMn 2008 30
Policy Considerations
Status of U.S. Radon Policy
Today in the U.S. and probably every state, we have more homes that need to be mitigated than anytime in our history
The reason for this situation is that we have built The reason for this situation is that we have built more new homes with elevated radon than we have more new homes with elevated radon than we have mitigationmitigation
EPA has recognized this problem and initiated a EPA has recognized this problem and initiated a major emphasis on radon control systems in new major emphasis on radon control systems in new homeshomesSeveral State Legislature have passed a bills that Several State Legislature have passed a bills that call for building code adoption of radon control call for building code adoption of radon control requirements requirements
© UMn 2008 31
Policy Considerations
Radon Policy Options
1. For all ground contact units:A. Statewide building code requirements
1) Low-rise residential buildings2) Schools and child care facilities
B. Mandatory radon testing prior to: 1) Leasing an apartment or other dwelling unit
• Especially important ~ environmental justice2) Home sale
2. Radon testing of all:A. State owned or leased buildings B. Schools and child care facilities every 5 years
3. Certification or licensing of radon professionals
© UMn 2008 32
Radon Policy Considerations
Countries with Radon Control Building Code Requirements
Czech RepublicCzech RepublicDenmarkDenmarkFinlandFinlandIrelandIrelandLatviaLatviaNorwayNorwaySlovak RepublicSlovak RepublicSwedenSwedenUnited KingdomUnited Kingdom
© UMn 2008 33
Summary
Indoor radon is a very serious environmental health Indoor radon is a very serious environmental health riskriskIt is easy and inexpensive to It is easy and inexpensive to
Test for indoor radonTest for indoor radonRemediation high concentrations in existing buildingsRemediation high concentrations in existing buildingsPrevention in new constructionPrevention in new construction
Public policy is needed ~Public policy is needed ~Building codesBuilding codesTestingTesting
Rental housingRental housingHomes for saleHomes for salePublic buildings including schools and day care facilitiesPublic buildings including schools and day care facilities
Strong certification or licensing programs Strong certification or licensing programs
Recommended