Neurotoxic effects of home radon exposure on oscillatory dynamics serving attentional orienting in children and adolescents.

Radon is a naturally occurring gas that contributes significantly to radiation in the environment and is the second leading cause of lung cancer globally. Previous studies have shown that other environmental toxins have deleterious effects on brain development, though radon has not been studied as thoroughly in this context. This study examined the impact of home radon exposure on the neural oscillatory activity serving attention reorientation in youths. Fifty-six participants (ages 6-14 years) completed a classic Posner cuing task during magnetoencephalography (MEG), and home radon levels were measured for each participant. Time-frequency spectrograms indicated stronger theta (3-7 Hz, 300-800 ms), alpha (9-13 Hz, 400-900 ms), and beta responses (14-24 Hz, 400-900 ms) during the task relative to baseline. Source reconstruction of each significant oscillatory response was performed, and validity maps were computed by subtracting the task conditions (invalidly cued - validly cued). These validity maps were examined for associations with radon exposure, age, and their interaction in a linear regression design. Children with greater radon exposure showed aberrant oscillatory activity across distributed regions critical for attentional processing and attention reorientation (e.g., dorsolateral prefrontal cortex, and anterior cingulate cortex). Generally, youths with greater radon exposure exhibited a reverse neural validity effect in almost all regions and showed greater overall power relative to peers with lesser radon exposure. We also detected an interactive effect between radon exposure and age where youths with greater radon exposure exhibited divergent developmental trajectories in neural substrates implicated in attentional processing (e.g., bilateral prefrontal cortices, superior temporal gyri, and inferior parietal lobules). These data suggest aberrant, but potentially compensatory neural processing as a function of increasing home radon exposure in areas critical for attention and higher order cognition.

Radioprotection issues in uraniferous minerals collections with reference to an actual case.

Our work investigated the radioprotection implications associated with the possession of a collection of uraniferous minerals. Considering different scenarios, we developed (and applied to an actual collection) specific formulas for radiation doses evaluation. We discussed the shielding necessary to reduce the gamma irradiation down to the required values. A mathematical model was developed to estimate the minimum air flow rate to reduce the radon air concentration below the reference values. The radiation risks associated to the handling of single specimens was also addressed, including hand skin irradiation and shielding capabilities of surgical lead gloves. Finally, we discussed the radiation risks associated to the exhibition of a single specimen. The results, compared to the safety standards of the EU Directive 13/59, show that the exhibition of uraniferous samples with activity of a few MBq do not need specific radioprotection requirements nor for the involved personnel nor for visitors.

Environmental radon, fracking wells, and lymphoma in dogs.

BACKGROUND: Multicentric lymphoma (ML) in dogs resembles non-Hodgkin lymphoma (NHL) in humans. Human NHL is associated with multiple environmental exposures, including to radon and volatile organic compounds (VOCs). HYPOTHESIS/OBJECTIVES: The objective of this study was to determine whether ML in dogs was associated with environmental radon or proximity to horizontal oil and drilling (fracking), a source of VOC pollution. METHODS: We identified dogs from the Golden Retriever Lifetime Study that developed ML (n = 52) along with matched controls (n = 104). Dog home addresses were categorized by Environmental Protection Agency radon zone and average residential radon by county, as well as by distance from fracking and associated wastewater wells. RESULTS: We found no significant differences in county level radon measurements. Individual household radon measurements were not available. There was no difference in residential proximity to active fracking wells between dogs with ML and unaffected dogs. While dogs with ML lived closer to wastewater wells (123 vs 206 km; P = .01), there was no difference in the percentage of cases vs controls that lived in close proximity (20 km) to a fracking well (11.5% for cases, 6.7% for controls; OR 1.81, 95% CI 0.55 to 5.22; P = .36), or a wastewater well (6.7% for cases, 4.4% for controls; P > .99). CONCLUSIONS AND CLINICAL IMPORTANCE: These data suggest that more proximate sources of chemical exposures need to be assessed in dogs with ML, including measurements of individual household radon and household VOC concentrations.

Radon exposure risks among residents proximal to gold mine tailings in Gauteng Province, South Africa: a cross-sectional preliminary study protocol.

Gold mine tailings, a legacy of the mining industry, harbors significant amount of radon gas, a classified human carcinogen. Radon exposure, especially near tailings, is a significant public health threat, potentially leading to increased risk of lung cancer, leukemia, and chronic obstructive pulmonary disease (COPD). These health problems are often associated with lower survival rates and significant financial burdens. This ongoing research aim to evaluating the relationship between indoor radon exposure and lung cancer, leukemia, and COPD risks among residents proximal to gold mine tailings in Gauteng Province, South Africa. This cross-sectional preliminary study focus on two distinct groups: Riverlea (exposed group, <2 km to Gold mine tailings) and Orlando East (unexposed group, >2 km to Gold mine tailings). Indoor radon levels is measured using AlphaE monitors, while health risks (lung cancer, leukemia, and COPD) linked to exposure are evaluated through interview-administered questionnaire and secondary data from Gauteng Health Department. Of the 476 residents randomly selected for this study, 300 have already participated, with balanced representation from both the exposed and unexposed groups. The study will compare indoor radon levels and health outcomes between the two groups. This study's results could aid in creating targeted interventions and policies to mitigate indoor radon exposure risks and safeguard vulnerable communities from this significant public health hazard.

Use of air things radon detector in liquid samples (serum and urine).

This study involved the assessment of 222Rn concentrations in liquid samples (namely serum and urine) obtained from individuals who were smokers and non-smokers across five distinct age groups in the Najaf Governorate of Iraq. The measurements were conducted using a portable digital Air Things device commonly employed for detecting radon gas in residential environments. This device was placed in a container that is placed in liquid samples, which makes it work to capture the existing radon. The mean value of radon concentrations in serum and urine samples for smokers was 5.64 ± 2.80 Bq/m3 and 3.56 ± 2.31 Bq/m3, respectively. While, the mean value of radon concentrations in serum and urine samples for non-smokers was 2.32 ± 0.67 Bq/m3 and 1.61 ± 1.00 Bq/m3, respectively. By comparing the radon concentrations for serum and urine samples with age and smoking groups, the value of P-Value (p < 0.01) was increased significantly statistically. Also, it is found that a positive and good correlation for radon concentrations between serum and urine. Although the levels of radon were found to be under the globally accepted thresholds, the results of 222Rn in all samples of serum and urine in smokers were higher than in non-smokers. Thus, it may be concluded that cigarette smoking is used as a biomarker of the presence of radon gas.

The causes of the abrupt enhancement of the natural gamma radiation in the thunderous atmosphere on the mountain tops.

The study presented the relationship between sudden Natural Gamma Radiation (NGR) increases related to enhanced atmospheric electric fields. We pinpoint Thunderstorm Ground Enhancements (TGEs) as the primary source of abrupt and significant NGR spikes. These TGEs, which are transient, several-minute-long increases in elementary particle fluxes, originate from natural electron accelerators within thunderclouds. The more prolonged, yet less pronounced, increases in NGR, persisting for several hours, are attributed to the gamma radiation from radon progeny and enhanced positron fluxes. This radon, emanating from terrestrial materials, is carried aloft by the Near-Surface Electric Field (NSEF). To measure NGR at Aragats Mountain, we use an ORTEC detector and custom-built large NaI (Tl) spectrometers, employing lead filters to discriminate between cosmic ray fluxes and radon progeny radiation. Our analysis differentiates between radiation enhancements during positive and negative NSEF episodes. The resultant data provide a comprehensive measurement of the intensities of principal isotopes and positron flux during thunderstorms compared to fair weather conditions.

Geographical distribution of radon and associated health risks in drinking water samples collected from the Mulazai area of Peshawar, Pakistan.

Geospatial methods, such as GIS and remote sensing, map radon levels, pinpoint high-risk areas and connect geological traits to radon presence. These findings direct health planning, focusing tests, mitigation, and policies where radon levels are high. Overall, geospatial analyses offer vital insights, shaping interventions and policies to reduce health risks from radon exposure. There is a formidable threat to human well-being posed by the naturally occurring carcinogenic radon (222Rn) gas due to high solubility in water. Under the current scenario, it is crucial to assess the extent of 222Rn pollution in our drinking water sources across various regions and thoroughly investigate the potential health hazards it poses. In this regard, the present study was conducted to investigate the concentration of 222Rn in groundwater samples collected from handpumps and wells and to estimate health risks associated with the consumption of 222Rn-contaminated water. For this purpose, groundwater samples (n = 30) were collected from handpumps, and wells located in the Mulazai area, District Peshawar. The RAD7 radon detector was used as per international standards to assess the concentration of 222Rn in the collected water samples. The results unveiled that the levels of 222Rn in the collected samples exceeded the acceptable thresholds set by the US Environmental Protection Agency (US-EPA) of 11.1 Bq L-1. Nevertheless, it was determined that the average annual dose was below the recommended limit of 0.1 mSv per year, as advised by both the European Union Council and the World Health Organization. In order to avoid the harmful effects of such excessive 222Rn concentrations on human health, proper ventilation and storage of water in storage reservoirs for a long time before use is recommended to lower the 222Rn concentration.

A Study on Geographic Correlation between Indoor Radon Exposure and Leukemia Incidence in Canada.

ABSTRACT: In Canada, leukemia is diagnosed at a rate of 15 cases per 100,000 persons and accounts for about 3% of all new primary cancers. In this study, geographical correlation between residential radon exposure and leukemia incidence was investigated at a provincial level with more accurate long-term radon measurement data in 21,330 homes and 10-y (2000-2009) age standardized incidence rates per 100,000 population for various subtypes of leukemia. The analyses showed that the incidence rate of non-Hodgkin lymphoma is statistically significantly correlated with average indoor radon (222Rn) concentration for Canadian females (p = 0.01210) but not for males. At a provincial level, the association between average indoor radon level and chronic lymphocytic leukemia incidence rate is statistically significant (p = 0.0167), and the correlation is somewhat stronger for females (p = 0.0043). No correlation was found between indoor radon exposure and any other subtypes of leukemia evaluated in this study.

Assessment of radiation dose to people and wildife inhabiting the Grote Nete catchment in Belgium.

We evaluate the impact of the radiological contamination of the Grote Nete catchment in Belgium to people and non-human biota. This region has received effluents from the phosphate and nuclear industries via tributaries of the Grote Nete river in past decades, resulting in the presence of radionuclides such as 241Am, 60Co, 137Cs, 40K, 210Pb, 238Pu, 239,240Pu, 226Ra, 228Ra, 228Th, 232Th, 234U, 235U and 238U. During the period 2016-2021, we measured these radionuclides in the water column, the bed sediment and riverbanks. Additionally, we carried out radon measurements on the riverbanks in 2022. Based on these measurements, the dose rates to people were calculated for different potential exposure scenarios, using the SCK CEN biosphere tool. We also performed an assessment of exposure of ionising radiation to non-human biota (including 222Rn and its daughters) using the ERICA Tool. We observed three types of areas at the Grote Nete riverbank: (a) a lower category exposure with 226Ra concentrations reflecting purely Belgian background values; (b) a middle category with enhanced 226Ra, mainly adsorbed on clay minerals and (c) an upper category extending to maximum values in the order of 103 Bq kg-1. The main component of the dose rate for terrestrial and aquatic organisms is 226Ra followed by 210Pb (terrestrial) or 228Ra, (aquatic). The anthropogenic vector of the contamination (40K, 60Co, 90Sr, 137Cs, 228Th, 232Th, 234,235,238U, 238,239Pu, 241Am) makes a negligible contribution to dose. Overall, the Grote Nete wildlife is not under significant risk from exposure to soil or water-borne radionuclides and radon emanating from the soil, even if the ERICA benchmark of 10 µGy h-1 is occasionally exceeded for 226Ra, 210Pb or 228Ra, because exposures are below the levels at which effects are known to occur. For people, radon inhalation is the main exposure pathway and exposures can reach 1 mSv y-1 for hypothetical residents living at the riverbanks and remaining most of their time in the area, but it can be expected that exposures are much lower at increasing distances from the river. It is concluded that neither people nor the environment are at any significant radiological risk from this situation.

Evaluating county-level lung cancer incidence from environmental radiation exposure, PM2.5, and other exposures with regression and machine learning models.

Characterizing the interplay between exposures shaping the human exposome is vital for uncovering the etiology of complex diseases. For example, cancer risk is modified by a range of multifactorial external environmental exposures. Environmental, socioeconomic, and lifestyle factors all shape lung cancer risk. However, epidemiological studies of radon aimed at identifying populations at high risk for lung cancer often fail to consider multiple exposures simultaneously. For example, moderating factors, such as PM2.5, may affect the transport of radon progeny to lung tissue. This ecological analysis leveraged a population-level dataset from the National Cancer Institute's Surveillance, Epidemiology, and End-Results data (2013-17) to simultaneously investigate the effect of multiple sources of low-dose radiation (gross [Formula: see text] activity and indoor radon) and PM2.5 on lung cancer incidence rates in the USA. County-level factors (environmental, sociodemographic, lifestyle) were controlled for, and Poisson regression and random forest models were used to assess the association between radon exposure and lung and bronchus cancer incidence rates. Tree-based machine learning (ML) method perform better than traditional regression: Poisson regression: 6.29/7.13 (mean absolute percentage error, MAPE), 12.70/12.77 (root mean square error, RMSE); Poisson random forest regression: 1.22/1.16 (MAPE), 8.01/8.15 (RMSE). The effect of PM2.5 increased with the concentration of environmental radon, thereby confirming findings from previous studies that investigated the possible synergistic effect of radon and PM2.5 on health outcomes. In summary, the results demonstrated (1) a need to consider multiple environmental exposures when assessing radon exposure's association with lung cancer risk, thereby highlighting (1) the importance of an exposomics framework and (2) that employing ML models may capture the complex interplay between environmental exposures and health, as in the case of indoor radon exposure and lung cancer incidence.

Radon indoors source potential from soil gas in a temperate climate: impact of infiltration rate and seismicity.

Indoor radon source potential from unground soil was monitored using prototype devices approaching a dwelling with a cellar basement at 1 depth from the soil-atmosphere interface. Therefore, the radon concentrations in soil gas were monitored at 1 m depth. Integrated radon measurements were performed, and the results correlated with meteorological parameters. The influence of the difference in outdoor and device-soil temperature was considered, and the infiltration rate was calculated. The effect of the soil temperature gradient on the soil radon entry rate was evaluated. The indoor radon entry rate due to the soil gas was 7.0 ± 2.7 Bq m-3 h-1. The radon entry rate was 5.0 ± 0.8 Bq m-3 h-1 due to diffusion. In contrast, the advection-drive flow of soil gas is ranged up to ± 4.0 Bq m-3 h-1. So, the infiltration rate of the model dwelling was 0.7 (± 0.5) × 10-1 h-1 if only the stack effect occurred. The radon levels in tap water were measured, and the radon entry rate was estimated at 1.3 ± 0.7 Bq m-3 h-1. If the ventilation rate is low or seismic faulting appears, the soil radon entry is increased by one order of magnitude. The soil radon appeared like the building materials, having 1/3 of the total indoor radon entry, while outdoor air was slightly lower (28%), with tap water at 5%. The resident's mortality risk occurred at < 2.5% for typical dwellings in temperate climate areas founded on sand-gravel underground. The risk rises to 34% with an extremely low ventilation rate between indoors and outdoors or high radon entry from the soil due to seismic faulting.

Rural communities experience higher radon exposure versus urban areas, potentially due to drilled groundwater well annuli acting as unintended radon gas migration conduits.

Repetitive, long-term inhalation of radioactive radon gas is one of the leading causes of lung cancer, with exposure differences being a function of geographic location, built environment, personal demographics, activity patterns, and decision-making. Here, we examine radon exposure disparities across the urban-to-rural landscape, based on 42,051 Canadian residential properties in 2034 distinct communities. People living in rural, lower population density communities experience as much as 31.2% greater average residential radon levels relative to urban equivalents, equating to an additional 26.7 Bq/m3 excess in geometric mean indoor air radon, and an additional 1 mSv/year in excess alpha radiation exposure dose rate to the lungs for occupants. Pairwise and multivariate analyses indicate that community-based radon exposure disparities are, in part, explained by increased prevalence of larger floorplan bungalows in rural areas, but that a majority of the effect is attributed to proximity to, but not water use from, drilled groundwater wells. We propose that unintended radon gas migration in the annulus of drilled groundwater wells provides radon migration pathways from the deeper subsurface into near-surface materials. Our findings highlight a previously under-appreciated determinant of radon-induced lung cancer risk, and support a need for targeted radon testing and reduction in rural communities.

Lifetime excess absolute risk for lung cancer due to exposure to radon: results of the pooled uranium miners cohort study PUMA.

The Pooled Uranium Miners Analysis (PUMA) study is the largest uranium miners cohort with 119,709 miners, 4.3 million person-years at risk and 7754 lung cancer deaths. Excess relative rate (ERR) estimates for lung cancer mortality per unit of cumulative exposure to radon progeny in working level months (WLM) based on the PUMA study have been reported. The ERR/WLM was modified by attained age, time since exposure or age at exposure, and exposure rate. This pattern was found for the full PUMA cohort and the 1960 + sub-cohort, i.e., miners hired in 1960 or later with chronic low radon exposures and exposure rates. The aim of the present paper is to calculate the lifetime excess absolute risk (LEAR) of lung cancer mortality per WLM using the PUMA risk models, as well as risk models derived in previously published smaller uranium miner studies, some of which are included in PUMA. The same methods were applied for all risk models, i.e., relative risk projection up to <95 years of age, an exposure scenario of 2 WLM per year from age 18-64 years, and baseline mortality rates representing a mixed Euro-American-Asian population. Depending upon the choice of model, the estimated LEAR per WLM are 5.38 × 10-4 or 5.57 × 10-4 in the full PUMA cohort and 7.50 × 10-4 or 7.66 × 10-4 in the PUMA 1960 + sub-cohort, respectively. The LEAR per WLM estimates derived from risk models reported for previously published uranium miners studies range from 2.5 × 10-4 to 9.2 × 10-4. PUMA strengthens knowledge on the radon-related lung cancer LEAR, a useful way to translate models for policy purposes.

Radon Exposure, Clonal Hematopoiesis, and Stroke Susceptibility in the Women's Health Initiative.

BACKGROUND AND OBJECTIVES: Studies suggest that clonal hematopoiesis of indeterminate potential (CHIP) may increase risk of hematologic malignancy and cardiovascular disease, including stroke. However, few studies have investigated plausible environmental risk factors for CHIP such as radon, despite the climate-related increases in and documented infrequency of testing for this common indoor air pollutant.The purpose of this study was to estimate the risk of CHIP related to radon, an established environmental mutagen. METHODS: We linked geocoded addresses of 10,799 Women's Health Initiative Trans-Omics for Precision Medicine (WHI TOPMed) participants to US Environmental Protection Agency-predicted, county-level, indoor average screening radon concentrations, categorized as follows: Zone 1 (>4 pCi/L), Zone 2 (2-4 pCi/L), and Zone 3 (<2 pCi/L). We defined CHIP as the presence of one or more leukemogenic driver mutations with variant allele frequency >0.02. We identified prevalent and incident ischemic and hemorrhagic strokes; subtyped ischemic stroke using Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria; and then estimated radon-related risk of CHIP as an odds ratio (OR) and 95% CI using multivariable-adjusted, design-weighted logistic regression stratified by age, race/ethnicity, smoking status, and stroke type/subtype. RESULTS: The percentages of participants with CHIP in Zones 1, 2, and 3 were 9.0%, 8.4%, and 7.7%, respectively (ptrend = 0.06). Among participants with ischemic stroke, Zones 2 and 1 were associated with higher estimated risks of CHIP relative to Zone 3: 1.39 (1.15-1.68) and 1.46 (1.15-1.87), but not among participants with hemorrhagic stroke: 0.98 (0.68-1.40) and 1.03 (0.70-1.52), or without stroke: 1.04 (0.74-1.46) and 0.95 (0.63-1.42), respectively (pinteraction = 0.03). Corresponding estimates were particularly high among TOAST-subtyped cardioembolism: 1.78 (1.30-2.47) and 1.88 (1.31-2.72), or other ischemic etiologies: 1.37 (1.06-1.78) and 1.50 (1.11-2.04), but not small vessel occlusion: 1.05 (0.74-1.49) and 1.00 (0.68-1.47), respectively (pinteraction = 0.10). Observed patterns of association among strata were insensitive to attrition weighting, ancestry adjustment, prevalent stroke exclusion, separate analysis of DNMT3A driver mutations, and substitution with 3 alternative estimates of radon exposure. DISCUSSION: The robust elevation of radon-related risk of CHIP among postmenopausal women who develop incident cardioembolic stroke is consistent with a potential role of somatic genomic mutation in this societally burdensome form of cerebrovascular disease, although the mechanism has yet to be confirmed.

Simultaneous measurements of radon, thoron and thoron progeny and induced cancer risk assessment in Djeno, Pointe-Noire, Republic of Congo.

In this study, the activity concentrations of radon (222Rn), thoron (220Rn) and thoron progeny were measured simultaneously in Djeno (Pointe-Noire, Republic of Congo) using RADUET detectors to evaluate the air quality and the radiological risks due to the inhalation of these radionuclides. Activity concentrations of radon progeny were calculated from those of radon. Indoor radon, thoron and progenies followed a lognormal distribution ranging between 20 and 40, 6 and 62, 8 and 17.6 and 0.4 and 19.6 Bq m-3 for radon, thoron, radon progeny and thoron progeny, respectively. Mean values for radon were lower than the worldwide values estimated by the United Nation Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), which are 40 Bq m-3 (arithmetic mean) and 45 Bq m-3 (geometric mean). Radon concentrations in the dwellings under study were below the World Health Organization and the International Commission on Radiological Protection recommended reference levels, which are, respectively, 100 and 300 Bq m-3. The mean concentration of thoron was twice the world average value of 10 Bq m-3 estimated by UNSCEAR. Thoron progeny mean concentration was sharply greater than the typical value (0.3 Bq m-3) for indoor atmosphere provided by UNSCEAR. Annual effective dose ranges were 0.40-0.87 mSv (arithmetic mean, 0.57 ± 0.11 mSv) for radon and 0.10-4.14 mSv (arithmetic mean, 0.55 ± 0.77 mSv) for thoron. The mean value for radon was lower than the value (1.15 mSv) estimated by UNSCEAR, while the mean value for thoron was five times higher than the UNSCEAR value (0.10 mSv). The study showed that the use of the typical equilibrium factor value given by UNSCEAR to compute effective dose led to an error above 80%. Finally, the results of this study showed that the excess relative risk of radon-induced cancer was low, below 2% for the population under 55 y. The results presented in the present study prove that the population of Djeno is exposed to a relatively low potential risk of radon- and thoron-induced cancer.

Assessment of internal radiation exposure caused by radon in commercially bottled spring waters consumed in Turkey.

The variation of dissolved radon levels in water supplies remains of interest since radon ingested through drinking water can give considerable radiation to the lining of the stomach. This study aims to determine the radon concentration levels in bottled spring drinking water (BSW) brands commercially sold in Turkey using a radon gas monitor and to assess the internal radiation exposure caused by the ingestion and inhalation of radon. The activity concentrations of radon analyzed in 77 BSW brands varied from 7.1±0.8 to 28.7±2.7 mBq/L with an average of 15.7±5.1 mBq/L. The total annual effective dose was estimated to assess the radiological risk for three age groups in four different scenarios based on annual drinking water intake. All estimated dose values are well below the recommended reference dose of 100 µSv for drinking water. Therefore, radon gas in the investigated BSW samples poses no significant radiological risk to the public.

Epidemiological trend of lung cancer burden caused by residential radon exposure in China from 1990 to 2019.

OBJECTIVE: This study employed time series data to assess long-term changes in the burden of lung cancer (LC) caused by residential radon exposure, an important environmental risk factor, so as to develop evidence-based strategies for future public health management. METHODS: Based on the open data from the Global Burden of Disease (GBD 2019) database, we conducted an analysis of the residential radon exposure-caused LC mortality, disability-adjusted life years (DALYs), and corresponding crude rates and age-standardized rates (ASRs) for various age groups. We employed the employed age-period-cohort (APC) model to investigate the age, period, and cohort effects of the data, allowing us to discern the trends in LC disease burden attributable to radon exposure in residential settings over time. RESULTS: From 1990 to 2019, age-standardized mortality rates (ASMR) and age-standardized DALYs rates of LC caused by residential radon exposure in China demonstrated an overall increasing trend, with males higher than females. The CMR and crude DALYs rate for males were higher than those for females across all age groups. The APC analysis revealed that the local drift of LC death and DALYs rates in males and females showed a decreasing trend before 60 and an increasing trend after 60. CONCLUSION: The persistent presence of residential radon exposure as a crucial risk factor for LC underscores the need for public health authorities and policymakers to take more proactive measures to reduce radon exposure. Particularly, attention should be paid on the elderly population and male patients.

The role of sex and gender in the diagnosis and treatment of lung cancer: the 6th ICAPEM Annual Symposium.

The incidence and mortality of lung cancer in women are rising, with both increasing by 124% between 2003 and 2019. The main risk factor for lung cancer is tobacco use, but indoor radon gas exposure is one of the leading causes in nonsmokers. The most recent evidence demonstrates that multiple factors can make women more susceptible to harm from these risk factors or carcinogens. For this consensus statement, the Association for Lung Cancer Research in Women (ICAPEM) invited a group of lung cancer experts to perform a detailed gender-based analysis of lung cancer. Clinically, female patients have different lung cancer profiles, and most actionable driver alterations are more prevalent in women, particularly in never-smokers. Additionally, the impact of certain therapies seems to be different. In the future, it will be necessary to carry out specific studies to improve the understanding of the role of certain biomarkers and gender in the prognosis and evolution of lung cancer.

Third mortality follow-up of the Mallinckrodt uranium processing workers, 1942-2019.

INTRODUCTION: Mallinckrodt Chemical Works was a uranium processing facility during the Manhattan Project from 1942 to 1966. Thousands of workers were exposed to low-dose-rates of ionizing radiation from external and internal sources. This third follow-up of 2514 White male employees updates cancer and noncancer mortality potentially associated with radiation and silica dust. MATERIALS AND METHODS: Individual, annualized organ doses were estimated from film badge records (n monitored = 2514), occupational chest x-rays (n = 2514), uranium urinalysis (n = 1868), radium intake through radon breath measurements (n = 487), and radon ambient measurements (n = 1356). Silica dust exposure from pitchblende processing was estimated (n = 1317). Vital status and cause of death determination through 2019 relied upon the National Death Index and Social Security Administration Epidemiological Vital Status Service. The analysis included standardized mortality ratios (SMRs), Cox proportional hazards, and Poisson regression models. RESULTS: Vital status was confirmed for 99.4% of workers (84.0% deceased). For a dose weighting factor of 1 for intakes of uranium, radium, and radon decay products, the mean and median lung doses were 65.6 and 29.9 mGy, respectively. SMRs indicated a difference in health outcomes between salaried and hourly workers, and more brain cancer deaths than expected [SMR: 1.79; 95% confidence interval (CI): 1.14, 2.70]. No association was seen between radiation and lung cancer [hazard ratio (HR) at 100 mGy: 0.93; 95%CI: 0.78, 1.11]. The relationship between radiation and kidney cancer observed in the previous follow-up was maintained (HR at 100 mGy: 2.07; 95%CI: 1.12, 3.79). Cardiovascular disease (CVD) also increased significantly with heart dose (HR at 100 mGy: 1.11; 95%CI: 1.02, 1.21). Exposures to dust ≥23.6 mg/m3-year were associated with nonmalignant kidney disease (NMKD) (HR: 3.02; 95%CI: 1.12, 8.16) and kidney cancer combined with NMKD (HR: 2.46; 95%CI: 1.04, 5.81), though without evidence of a dose-response per 100 mg/m3-year. CONCLUSIONS: This third follow-up of Mallinckrodt uranium processors reinforced the results of the previous studies. There was an excess of brain cancers compared with the US population, although no radiation dose-response was detected. The association between radiation and kidney cancer remained, though potentially due to few cases at higher doses. The association between levels of silica dust ≥23.6 mg/m3-year and NMKD also remained. No association was observed between radiation and lung cancer. A positive dose-response was observed between radiation and CVD; however, this association may be confounded by smoking, which was unmeasured. Future work will pool these data with other uranium processing worker cohorts within the Million Person Study.