Lung Cancer Risk from Occupational and Environmental Radon and Role of Smoking in Two Czech Nested Case-Control Studies

Abstract

The aim of the present study was to evaluate the risk of lung cancer from combined exposure to radon and smoking. Methodologically, it is based on case-control studies nested within two Czech cohort studies of nearly 11,000 miners followed-up for mortality in 1952–2010 and nearly 12,000 inhabitants exposed to high levels of radon in homes, with mortality follow-up in 1960–2010. In addition to recorded radon exposure, these studies use information on smoking collected from the subjects or their relatives. A total of 1,029 and 370 cases with smoking information have been observed in the occupational and environmental (residential) studies, respectively. Three or four control subjects have been individually matched to cases according to sex, year of birth, and age. The combined effect from radon and smoking is analyzed in terms of geometric mixture models of which the additive and multiplicative models are special cases. The resulting models are relatively close to the additive interaction (mixing parameter 0.2 and 0.3 in the occupational and residential studies, respectively). The impact of the resulting model in the residential radon study is illustrated by estimates of lifetime risk in hypothetical populations of smokers and non-smokers. In comparison to the multiplicative risk model, the lifetime risk from the best geometric mixture model is considerably higher, particularly in the non-smoking population.

What are the health costs of uranium mining? A case study of miners in Grants, New Mexico

“…The relationship between smoking, radon, and lung cancer is nuanced, with extant literature finding additive and sub-multiplicative interactions, particularly among uranium miners. 13,58,59 However, miner smoking histories were unknown and not included in this analysis. Potential impacts of this on overall cost results are inconclusive from the literature, but likely insignificant.…”

Combined effect of alpha particles and cigarette smoke on human lung epithelial cells in vitro

“…Figure 4 presents the numbers of gamma-H2AX foci per cell observed (black rectangles) in BEAS-2B, Nuli-1, and SVEC4-10EHR1 cells after alpha particle exposure in CSE-treated culture media. Each experimental data point is compared with the values calculated by combining two separate data obtained from alpha particle exposure (Figure 3(a)) and CSE treatment (Figure 3(b)) in an additive (blue triangles) or multiplicative (red circles) mode (Piao and Hei 1993;Kreisheimer et al 2003;Tomasek 2013). The calculations in additive and multiplicative modes were made by the following equations on the basis of previous studies (Furukawa et al 2010;Egawa et al 2012), with the number of gamma-H2AX foci at no treatment (0 Gy in CSE-free culture medium) normalized to 1: In all three cell lines, the numbers of gamma-H2AX foci per cell from the combined treatment were closer to the additive data.…”

“…Harmful factors that coexist in the body may affect an individual in a completely independent way or in a certain combination. Previous studies described the following three possible ways of interaction between radiation exposure (alpha particles in epidemiological studies) and cigarette smoking: additive (Narayanan and Rao 1988;Piao and Hei 1993;Zhou et al 1999;Pierce et al 2003;Tomasek 2013), multiplicative (Pershagen et al 1994;Kreisheimer et al 2003;Jacob et al 2005;Hunter et al 2015;Kreuzer et al 2018), and supra-additive (or sub-multiplicative) (Moolgavkar et al 1993;Zhang et al 2006;Mauderly et al 2010;Leuraud et al 2011;Tomasek 2011;Meenakshi and Mohankumar 2013;Gilbert et al 2013;Hunter et al 2015;Kreuzer et al 2018). In recent years, the possibility of a supramultiplicative model has been further claimed (Kreuzer et al 2018).…”

Nonlinear dose–response relationship between radon exposure and the risk of lung cancer

“…Meanwhile, the correlation between radon and the risk of LC has been confirmed by extensive cohort and case-control studies. Evidence of the link between radon and LC in miners, especially uranium miners (Tirmarche et al, 2012;Tomasek, 2013), has also raised concern that indoor radon might be causing LC in the general population, although the radon levels in homes are much lower than those found in mines.…”