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. 2005 Jan 29;330(7485):223.
doi: 10.1136/bmj.38308.477650.63. Epub 2004 Dec 21.

Radon in homes and risk of lung cancer: collaborative analysis of individual data from 13 European case-control studies

S Darby  1 , D Hill, A Auvinen, J M Barros-Dios, H Baysson, F Bochicchio, H Deo, R Falk, F Forastiere, M Hakama, I Heid, L Kreienbrock, M Kreuzer, F Lagarde, I Mäkeläinen, C Muirhead, W Oberaigner, G Pershagen, A Ruano-Ravina, E Ruosteenoja, A Schaffrath Rosario, M Tirmarche, L Tomásek, E Whitley, H-E Wichmann, R Doll
Affiliations

Radon in homes and risk of lung cancer: collaborative analysis of individual data from 13 European case-control studies

S Darby et al. BMJ. .

Abstract

Objective: To determine the risk of lung cancer associated with exposure at home to the radioactive disintegration products of naturally occurring radon gas.

Design: Collaborative analysis of individual data from 13 case-control studies of residential radon and lung cancer.

Setting: Nine European countries.

Subjects: 7148 cases of lung cancer and 14,208 controls.

Main outcome measures: Relative risks of lung cancer and radon gas concentrations in homes inhabited during the previous 5-34 years measured in becquerels (radon disintegrations per second) per cubic metre (Bq/m3) of household air.

Results: The mean measured radon concentration in homes of people in the control group was 97 Bq/m3, with 11% measuring > 200 and 4% measuring > 400 Bq/m3. For cases of lung cancer the mean concentration was 104 Bq/m3. The risk of lung cancer increased by 8.4% (95% confidence interval 3.0% to 15.8%) per 100 Bq/m3 increase in measured radon (P = 0.0007). This corresponds to an increase of 16% (5% to 31%) per 100 Bq/m3 increase in usual radon--that is, after correction for the dilution caused by random uncertainties in measuring radon concentrations. The dose-response relation seemed to be linear with no threshold and remained significant (P = 0.04) in analyses limited to individuals from homes with measured radon < 200 Bq/m3. The proportionate excess risk did not differ significantly with study, age, sex, or smoking. In the absence of other causes of death, the absolute risks of lung cancer by age 75 years at usual radon concentrations of 0, 100, and 400 Bq/m3 would be about 0.4%, 0.5%, and 0.7%, respectively, for lifelong non-smokers, and about 25 times greater (10%, 12%, and 16%) for cigarette smokers.

Conclusions: Collectively, though not separately, these studies show appreciable hazards from residential radon, particularly for smokers and recent ex-smokers, and indicate that it is responsible for about 2% of all deaths from cancer in Europe.

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Figures

Fig 1
Fig 1
Relative risk of lung cancer according to measured residential radon concentration and usual residential radon concentration, with best fitting straight lines (risks are relative to that at 0 Bq/m3)
Fig 2
Fig 2
Percentage increase in risk of lung cancer per 100 Bq/m3 increase in measured radon concentration by study, age, sex, smoking, and histological type. Squares have areas inversely proportional to the square of the standard error of the percentage increase. For the Spanish study, the present non-significantly negative estimate differs from a previously published positive estimate based on quartiles of radon distribution. The negative estimate, based on individual radon concentrations, is dominated by three cases and 17 controls with measured radon ≥400 Bq/m3
Fig 3
Fig 3
Cumulative absolute risk of death from lung cancer by age 75 years versus usual radon concentration at home for cigarette smokers and lifelong non-smokers. Plotted values calculated using relative risks for smoking from men in all studies combined, and absolute risks in lifelong non-smokers from US data for men and women combined. Areas of circles proportional to numbers of controls with usual radon levels in ranges <200, 200-399, 400-599, and ≥600 Bq/m3
See this image and copyright information in PMC

Comment in

  • Radon blues.
    Watts G. Watts G. BMJ. 2005 Jan 29;330(7485):226-7. doi: 10.1136/bmj.38315.668009.63. Epub 2004 Dec 21. BMJ. 2005. PMID: 15613367 Free PMC article. No abstract available.
  • Attributable lung cancer risk from radon in homes may be low.
    Puskin JS, Pawel DJ. Puskin JS, et al. BMJ. 2005 May 14;330(7500):1151. doi: 10.1136/bmj.330.7500.1151-a. BMJ. 2005. PMID: 15891242 Free PMC article. No abstract available.

References

    1. United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and Effects of Ionizing Radiation. UNSCEAR 2000 Report to the General Assembly, with Scientific Annexes. Vol I: Sources. New York: United Nations, 2000.
    1. National Research Council. Committee on health risks of exposure to radon (BEIR VI). Health effects of exposure to radon. Washington, DC: National Academy Press, 1999. - PubMed
    1. International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans. Vol 78. Ionizing radiation. Part 2: Some internally deposited radionuclides. Lyons: IARC, 2001. - PMC - PubMed
    1. Puskin JS. Smoking as a confounder in ecologic correlations of cancer mortality rates with average county radon levels. Health Physics 2003;84: 526-32. - PubMed
    1. Heid IM, Schaffrath Rosario A, Kreienbrock L, Küchenhoff H, Wichmann HE. The impact of measurement error on studies on lung cancer and residential radon exposure in Germany. J Toxicol Environ Health (in press).

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