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

Garzillo, Carmine; Pugliese, M.; Loffredo, Filomena; Quarto, Maria

doi:10.21037/tcr.2017.05.42

Cited by 32 publications

(14 citation statements)

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“…Since 1990, numerous case-control studies have been conducted in both high-and low-radon areas in Europe, North America and China to assess the excess risks of lung cancer attributable to residential radon exposure . Due to the relatively small sample sizes of these case-control studies, large pooled collaborative studies [46][47][48][49][50][51][52] and several meta-analyses [53][54][55][56][57][58] were conducted, aiming to acquire similar statistical power as the epidemiologic studies of underground miners [59], as well as to provide a comparison of the pooled risk estimates with extrapolations from the miner-based risk models [49]. While the pooled collaborative studies have shown significant positive associations between residential radon exposure and lung cancer risk to varying degrees, all but one pooled study [52] assessed this association in populations of both ever-smokers and never-smokers.…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of residential radon and lung cancer in never-smokers

Cheng

Egger²,

Hughes

et al. 2021

Eur Respir Rev

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BackgroundGlobally, radon is the leading risk factor for lung cancer in never-smokers (LCINS). In this study, we systematically reviewed and meta-analysed the evidence of the risk of LCINS associated with residential radon exposure.MethodsMedline and Embase databases were searched using predefined inclusion and exclusion criteria to identify relevant studies published from 1 January 1990 to 5 March 2020 focused on never-smokers. We identified four pooled collaborative studies (incorporating data from 24 case–control studies), one case–control study and one cohort study for systematic review. Meta-analysis was performed on the results of the four pooled studies due to different measures of effect and outcome reported in the cohort study and insufficient information reported for the case–control study. In a post hoc analysis, the corresponding risk for ever-smokers was also examined.ResultsRisk estimates of lung cancer from residential radon exposure were pooled in the meta-analysis for 2341 never-smoker cases, 8967 never-smoker controls, 9937 ever-smoker cases and 12 463 ever-smoker controls. Adjusted excess relative risks (aERRs) per 100 Bq·m−3 of radon level were 0.15 (95% CI 0.06–0.25) for never-smokers and 0.09 (95% CI 0.03–0.16) for ever-smokers, and the difference between them was statistically insignificant (p=0.32). The aERR per 100 Bq·m−3was higher for men (0.46; 95% CI 0.15–0.76) than for women (0.09; 95% CI −0.02–0.20) among never-smokers (p=0.027).ConclusionThis study provided quantified risk estimates for lung cancer from residential radon exposure among both never-smokers and ever-smokers. Among never-smokers in radon-prone areas, men were at higher risk of lung cancer than women.

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Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of residential radon and lung cancer in never-smokers

Cheng

Egger²,

Hughes

et al. 2021

Eur Respir Rev

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“…After the residential exposure, the second important source of exposure to radon and its progenies, is the occupational exposure since people spend about 35% of their daytime in the workplace. Supported by the scientific evidence of epidemiological studies on residential exposure data [7][8][9][10][11][12] showing a statistically significant increase in the risk of lung cancer, due to the prolonged exposure to radon already at the level of 100 Bq/m 3 , the European Union has issued the Directive 59/2013 [13], which established a reference level for indoor radon concentrations in workplaces of 300 Bq/m 3 . Despite the European Union regulation, some authors [14][15][16] have questioned the correlation between the exposure to radon and the increased risk of lung cancer.…”

Section: Introductionmentioning

confidence: 99%

Indoor Radon Concentration and Risk Assessment in 27 Districts of a Public Healthcare Company in Naples, South Italy

Loffredo

Savino²,

Amato³

et al. 2021

Life

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Radon is a major source of ionizing radiation exposure for the general population. It is known that exposure to radon is a risk factor for the onset of lung cancer. In this study, the results of a radon survey conducted in all districts of a Public Healthcare in Italy, are reported. Measurements of indoor radon were performed using nuclear track detectors, CR-39. The entire survey was conducted according to a well-established quality assurance program. The annual effective dose and excess lifetime cancer risk were also calculated. Results show that the radon concentrations varied from 7 ± 1 Bq/m3 and 5148 ± 772 Bq/m3, with a geometric mean of 67 Bq/m3 and geometric standard deviation of 2.5. The annual effective dose to workers was found to be 1.6 mSv/y and comparable with the worldwide average. In Italy, following the transposition of the European Directive 59/2013, great attention was paid to the radon risk in workplaces. The interest of the workers of the monitored sites was very high and this, certainly contributed to the high return rate of the detectors after exposure and therefore, to the presence of few missing data. Although it was not possible to study the factors affecting radon concentrations, certainly the main advantage of this study is that it was the first in which an entire public health company was monitored in regards to all the premises on the underground and ground floor.

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“…The 222 Rn isotope and its decay products are the most abundant source of natural ionizing radiation, accounting for the vast majority of the effective dose to human life. Epidemiological studies have discovered a relationship between radon concentration exposure and the risk of lung cancer [5][6][7][8]. Dense radon concentration maps are required to execute successful locally based risk reduction efforts, with geostatistical interpolation approaches possibly inferring the expected concentration when fewer data are available.…”

Section: Introductionmentioning

confidence: 99%

Sorrentina Peninsula: Geographical Distribution of the Indoor Radon Concentrations in Dwellings—Gini Index Application

2021

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The radon isotope (222Rn, half-life 3.8 days) is a radioactive byproduct of the 238U decay chain. Because radon is the second biggest cause of lung cancer after smoking, dense maps of indoor radon concentration are required to implement effective locally based risk reduction strategies. In this regard, we present an innovative method for the construction of interpolated maps (kriging) based on the Gini index computation to characterize the distribution of Rn concentration. The Gini coefficient variogram has been shown to be an effective predictor of radon concentration inhomogeneity. It allows for a better constraint of the critical distance below which the radon geological source can be considered uniform, at least for the investigated length scales of variability; it also better distinguishes fluctuations due to environmental predisposing factors from those due to random spatially uncorrelated noise. This method has been shown to be effective in finding larger-scale geographical connections that can subsequently be connected to geological characteristics. It was tested using real dataset derived from indoor radon measurements conducted in the Sorrentina Peninsula in Campania, Italy. The measurement was carried out in different residences using passive detectors (CR-39) for two consecutive semesters, beginning in September–November 2019 and ending in September–November 2020, to estimate the yearly mean radon concentration. The measurements and analysis were conducted in accordance with the quality control plan. Radon concentrations ranged from 25 to 722 Bq/m3 before being normalized to ground level, and from 23 to 933 Bq/m3 after being normalized, with a geometric mean of 120 Bq/m3 and a geometric standard deviation of 1.35 before data normalization, and 139 Bq/m3 and a geometric standard deviation of 1.36 after data normalization. Approximately 13% of the tests conducted exceeded the 300 Bq/m3 reference level set by Italian Legislative Decree 101/2020. The data show that the municipalities under investigation had no influence on indoor radon levels. The geology of the monitored location is interesting, and because soil is the primary source of Rn, risk assessment and mitigation for radon exposure cannot be undertaken without first analyzing the local geology. This research examines the spatial link among radon readings using the mapping based on the Gini method (kriging).

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

Cited by 32 publications

References 0 publications

Systematic review and meta-analysis of residential radon and lung cancer in never-smokers

Systematic review and meta-analysis of residential radon and lung cancer in never-smokers

Indoor Radon Concentration and Risk Assessment in 27 Districts of a Public Healthcare Company in Naples, South Italy

Sorrentina Peninsula: Geographical Distribution of the Indoor Radon Concentrations in Dwellings—Gini Index Application

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