County level incidence rates of chronic lymphocytic leukemia are associated with residential radon levels

Oancea, S. Cristina; Rundquist, Brad; Simon, Isaac J.; Swartz, Sami E.; Zheng, Yun; Zhou, Xinan; Sens, Mary Ann; Schwartz, Gary G.

doi:10.2217/fon-2017-0165

Cited by 11 publications

(9 citation statements)

References 47 publications

(45 reference statements)

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“…Residential radon levels are especially high in ND [13]. Our structural equation model confirmed that radon levels in homes were significantly associated with uranium measurements in soil.…”

Section: Discussionsupporting

confidence: 72%

“…These data were compiled from multiple sources, including government records for well permits, state agencies that regulate utility rates, and bills from wastewater treatment facilities and tax appraisers' offices [11]. Data on the uranium contest of soil was from the US Department of Energy [12] and data on indoor radon levels were from the ND State Radon Survey, as described previously [13].…”

Section: Data and Sourcesmentioning

confidence: 99%

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An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling

Schwartz

Klug

Rundquist

2019

Int J Colorectal Dis

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Purpose The state of North Dakota has one of the highest incidence rates for colorectal cancer in the USA. Its high incidence rate, coupled with a large variation in incidence rates among counties within the state, makes North Dakota a "natural laboratory" in which to investigate environmental clues to colorectal cancer. We conducted a hypothesis-generating study to explore potential determinants of colorectal cancer in North Dakota. Methods We obtained county-specific incidence rates for North Dakota's 53 counties from the statewide cancer registry and corresponding data on county demographic, agricultural, and geophysical features from population-based sources. Candidate demographic/agricultural variables included median household income, population density, colorectal cancer screening rates, average farm size (in acres), and the percent of county fertilized. Geophysical variables included the uranium content of soil, residential radon levels, and source of drinking water (municipal or well water). Statistical analyses were performed via multivariate regression and structural equation modeling.Results Colorectal cancer incidence rates across North Dakota counties varied 3-fold. The structural equation model identified a significant role for well water use (p < 0.05). This finding is consistent with studies that implicate well water in colorectal cancer. Conclusions Well water contains several agents, e.g., bacteria, disinfection by-products, and nitrates that are potent colorectal carcinogens. Studies of well water use and colorectal cancer risk at the individual level in North Dakota are warranted.

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Section: Discussionsupporting

confidence: 72%

Section: Data and Sourcesmentioning

confidence: 99%

An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling

Schwartz

Klug

Rundquist

2019

Int J Colorectal Dis

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“…Data on uranium levels in soil are from the U.S. Department of Energy [18]. Radon levels per county are from the state radon monitoring research program conducted in the 1980s, as described previously [19]. Data for I-131 levels for individuals in ND counties were obtained from the NCI website [20].…”

Section: Methodsmentioning

confidence: 99%

Thyroid Cancer Incidence Rates in North Dakota are Associated with Land and Water Use

Schwartz

Klug

2019

IJERPH

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Objective: The increasing rate of thyroid cancer diagnoses in the U.S. reflects the increasing use of ultrasonography and of specialist medical care. North Dakota is a rural state with limited access to specialist care, yet its incidence of thyroid cancer is significantly greater than that of the U.S. overall. We sought to identify factors responsible for the high incidence of thyroid cancer in North Dakota. Methods: We examined county-specific incidence rates for thyroid cancer in North Dakota in relation to demographic and geographic factors, including median household income, percent of land fertilized, cattle density per capita, and source of drinking water (city or well water), using structural equation modeling. We included county level data on residential radon levels and estimates of radioactive iodine in milk following nuclear weapons testing in the 1950s. Results: Thyroid cancer incidence rates were significantly associated with median income (p < 0.05); percent of land fertilized (p < 0.05); the use of city water (p < 0.01), and cattle density per capita (p < 0.001). Conclusions: The risk of thyroid cancer in North Dakota is positively associated with income and with factors related to land and water use. Our finding that thyroid cancer incidence rates are associated with the use of city water was unexpected and merits examination in other locations with a mix of city and well water use.

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“…The number of lung cancer deaths caused by radon far exceeds the number of deaths from more-publicized dangers, e.g., drunk driving (17,400) [2]. Indeed, the death toll from lung cancer likely underestimates radon's force of mortality as radon also causes potentially fatal non-malignant lung disease, e.g., interstitial lung fibrosis [3] and may contribute to death from other cancers, e.g., chronic lymphocytic leukemia [4,5] and malignant melanoma [6].…”

Section: Introductionmentioning

confidence: 99%

Communicating radon risk via a smartphone app: a pilot intervention study

2020

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Background: Residential radon is a major preventable cause of lung cancer. However, prevention requires radon testing and it has proven very challenging to motivate individuals to test their homes for hazards like radon that are invisible and whose health effects occur after a long latency following exposure. Novel approaches to radon communication are urgently needed. Methods: We created a novel radon-education app for smartphones and examined its effectiveness in increasing radon knowledge and radon testing. We studied radon knowledge and attitudes and behavior relevant to radon testing before and after app use. Results: Ninety-seven undergraduates installed the app on their smartphones and used it for a month. App use resulted in higher scores in the domains of radon knowledge (p < .001); self-efficacy (p < .001), and response efficacy (p < .001). Twenty-three participants (24%) used the app to obtain a free radon test kit. Self-efficacy (p < .05) and response efficacy (p < .01) were positive predictors of ordering a test kit. The test process completion rate (the fraction of participants who ordered test kits, used them to test their houses and sent the kits to the lab) was 9%. Conclusions: A smartphone app is a promising venue for communicating radon risk and for stimulating radon testing. Future interventions designed to increase actual test kit use are required to maximize the benefit of the app.

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County level incidence rates of chronic lymphocytic leukemia are associated with residential radon levels

Cited by 11 publications

References 47 publications

An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling

An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling

Thyroid Cancer Incidence Rates in North Dakota are Associated with Land and Water Use

Communicating radon risk via a smartphone app: a pilot intervention study

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