A Novel Strategy for the Assessment of Radon Risk Based on Indicators.

Among the physical pollutants affecting indoor air, the radioactive gas radon may turn out to be the most hazardous. Health effects related to radon exposure have been investigated for several decades, providing major scientific evidence to conclude that chronic exposures can cause lung cancer. Additionally, an association with other diseases, such as leukemia and cancers of the extra-thoracic airways, has been advanced. The implementation of a strategy to reduce the exposure of the population and minimize the health risk, according to the European Directive 59/2013/Euratom on ionizing radiations, is a new challenge in public health management. Starting from an understanding of the general state-of-the-art, a critical analysis of existing approaches has been conducted, identifying strengths and weaknesses. Then, a strategy for assessing the radon exposure of the general population, in a new comprehensive way, is proposed. It identifies three main areas of intervention and provides a list of hazard indicators and operative solutions to control human exposure. The strategy has been conceived to provide a supporting tool to authorities in the introduction of effective measures to assess population health risks due to radon exposure.

DOSIMETRIC AND EPIDEMIOLOGICAL APPROACHES TO RADON LUNG CANCER RISK ASSESSMENT.

The two principal approaches used to assess the risk of lung cancer due to radon exposure are those based on dosimetric modelling and on epidemiology. Outline accounts are given of the main features of dosimetric models that have evolved over past decades. The main results of some occupational and residential epidemiological studies are also discussed. The doubling of the ICRP radon dose conversion factors estimated using the epidemiological based dose conversion convention in the period 1993-2010 are discussed. Also discussed is the more recent ICRP approach in which it is recommended that in future the doses should be estimated on the basis of dosimetric and biokinetic models thereby treating radon and its progeny as other radionuclides within its system of protection.

RISK ASSESSMENT FOR RADON EXPOSURE IN VARIOUS INDOOR ENVIRONMENTS.

Using data from a number of radon surveys, it was assessed that on average, radon progeny concentrations in Canadian homes are about three times higher than in school buildings, 4.7 times higher than in public buildings and indoor workplaces, and 12 times higher than in outdoor air. Canadian statistics show that most Canadians spend ~70% of their time indoors at home, 20% indoors away from home and 10% in outdoors. Due to relatively higher radon concentration in residential homes and longer time spent indoors at home, the exposure at home contributes to 90% of the radon-induced lung-cancer risk.

ASSESSMENT OF INDOOR GAMMA RADIATION AND DETERMINATION OF EXCESS LIFETIME CANCER RISK IN TEHRAN IN WINTER AND SPRING 2017.

Natural radiation is a feature of the environment in which we live. One of the contributions of human exposure to ionizing radiation due to natural sources arises from gamma radiation. Therefore, present study was aimed to evaluate and map indoor gamma dose rate in Tehran. The corresponding annual effective dose (AED) and excess lifetime cancer risk (ELCR) were also calculated. All measurements were performed by a Geiger Muller detector in 43 dwellings in Tehran. The average indoor gamma dose rate in Tehran was appointed as 343.2 nGy/h. AED and ELCR were calculated as 2.4 mSv and 10.3 × 10-3, respectively. The evaluated indoor gamma dose rate and calculated AEDs and lifetime cancer risk were found higher than the world average value.

Radiation Dose and Hazard Assessment of Potential Contamination Events During Use of 223Ra Dichloride in Radionuclide Therapy.

An analysis is presented of the possible dosimetric consequences of various potential contamination events involving 223Ra dichloride (Xofigo), the FDA-approved therapeutic agent used in the treatment of bone metastases in patients with castration-resistant prostate cancer. Three exposure scenarios are considered: inhalation dose to an individual due to the hypothetical inhalation of 219Rn and its progeny assumed to be released into the air from a liquid spill on the floor, external dose from direct photon exposure of an individual assigned to clean up a spill, and skin dose to an individual should the liquid material come into contact with their skin. Doses from the first two scenarios were very small; 2.8 × 10(-3) mSv and 8.1 × 10(-4) mSv, respectively. Using extremely conservative assumptions, the skin dose was estimated to be 72 mSv; in a realistic scenario, this dose would likely be an order of magnitude or more lower. These doses are very small compared to regulatory limits, and good health physics practices likely to be employed in such incidents would lower them still further. The authors conclude that the medical use of Xofigo does not pose any significant radiation safety issue with respect to potential contamination events, even if multiple incidents might occur during the course of a year, since all worst-case potential contamination events considered in this study will not result in significant radiation exposures to workers.

Assessment of indoor absorbed gamma dose rate from natural radionuclides in concrete by the method of build-up factors.

The specific absorbed gamma dose rates, originating from natural radionuclides in concrete, were calculated at different positions of a detection point inside the standard room, as well as inside an example room. The specific absorbed dose rates corresponding to a wall with arbitrary dimensions and thickness were also evaluated, and appropriate fitting functions were developed, enabling dose rate calculation for most realistic rooms. In order to make calculation simpler, the expressions fitting the exposure build-up factors for whole (238)U and (232)Th radionuclide series and (40)K were derived in this work, as well as the specific absorbed dose rates from a point source in concrete. Calculated values of the specific absorbed dose rates at the centre point of the standard room for (238)U, (232)Th and (40)K are in the ranges of previously obtained data.

[The methods of assessment of health risk from exposure to radon and radon daughters].

The critical analysis of existing models of the relationship dose-effect (RDE) for radon exposure on human health has been performed. Conclusion about the necessity and possibility of improving these models has been made. A new improved version ofthe RDE has been developed. A technique for assessing the human health risk of exposure to radon, including the method for estimating of exposure doses of radon, an improved model of RDE, proper methodology risk assessment has been described. Methodology is proposed for the use in the territory of Russia.

[The radon exposure in mine: risk evaluation, risk assessment and health effects]. / L'esposizione a radon in miniera: valutazione del rischio, misure di prevenzione ed effetti sulla salute.

In mining sector, the natural presence of radon determines an exposition which deserves substantive consideration. The results of radon measure from '90 years in a talc mining show levels of radon below to the threshold limit of 400 Bq/m3, values influenced from air forced systems. The epidemiologic studies updated in a cohort of talc workers between 1946 and 1995 showed no excess for lung cancer mortality. No excess was found for lung cancer mortality in miners exposed to low dose of radon.

Absorption of plutonium compounds in the respiratory tract.

In order to optimise the monitoring of potentially exposed workers, it is desirable to determine specific values of absorption for the compounds handled. This study derives specific values of absorption rates for different chemical forms of plutonium from in vitro and animal (monkeys, dogs, mice, rats) experiments, and from human contamination cases. Different published experimental data have been reinterpreted here to derive values for the absorption parameters, f(r), s(r) and s(s), used in the human respiratory tract model currently adopted by the International Commission on Radiological Protection (ICRP). The consequences of the use of these values were investigated by calculating related committed effective doses per unit intake. Average and median estimates were calculated for f(r), s(r), and s(s) for each plutonium compound, that can be used as default values for specific chemical forms instead of the current reference types. Nevertheless, it was shown that the use of the current ICRP reference absorption types provides reasonable approximations. Moreover, this work provides estimates of the variability in pulmonary absorption and, therefore, facilitates analyses of the uncertainties associated with assessments, either from bioassay measurements or from prospective calculations, of intake and dose.

Room model based Monte Carlo simulation study of the relationship between the airborne dose rate and the surface-deposited radon progeny.

The quantitative relationships between radon gas concentration, the surface-deposited activities of various radon progeny, the airborne radon progeny dose rate, and various residential environmental factors were investigated through a Monte Carlo simulation study based on the extended Jacobi room model. Airborne dose rates were calculated from the unattached and attached potential alpha-energy concentrations (PAECs) using two dosimetric models. Surface-deposited (218)Po and (214)Po were significantly correlated with radon concentration, PAECs, and airborne dose rate (p-values <0.0001) in both non-smoking and smoking environments. However, in non-smoking environments, the deposited radon progeny were not highly correlated to the attached PAEC. In multiple linear regression analysis, natural logarithm transformation was performed for airborne dose rate as a dependent variable, as well as for radon and deposited (218)Po and (214)Po as predictors. In non-smoking environments, after adjusting for the effect of radon, deposited (214)Po was a significant positive predictor for one dose model (RR 1.46, 95% CI 1.27-1.67), while deposited (218)Po was a negative predictor for the other dose model (RR 0.90, 95% CI 0.83-0.98). In smoking environments, after adjusting for radon and room size, deposited (218)Po was a significant positive predictor for one dose model (RR 1.10, 95% CI 1.02-1.19), while a significant negative predictor for the other model (RR 0.90, 95% CI 0.85-0.95). After adjusting for radon and deposited (218)Po, significant increases of 1.14 (95% CI 1.03-1.27) and 1.13 (95% CI 1.05-1.22) in the mean dose rates were found for large room sizes relative to small room sizes in the different dose models.

Waking a sleeping giant: the tobacco industry's response to the polonium-210 issue.

The major tobacco manufacturers discovered that polonium was part of tobacco and tobacco smoke more than 40 years ago and attempted, but failed, to remove this radioactive substance from their products. Internal tobacco industry documents reveal that the companies suppressed publication of their own internal research to avoid heightening the public's awareness of radioactivity in cigarettes. Tobacco companies continue to minimize their knowledge about polonium-210 in cigarettes in smoking and health litigation. Cigarette packs should carry a radiation-exposure warning label.

Assessment of lung cancer risk due to exposure to radon from coastal sediments.

We conducted a lung cancer risk assessment for internal exposure to naturally occurring 222Rn gas both indoor and outdoor. A series of equations were used to estimate Rn concentrations indoor and outdoor and the associated lung cancer risk in some coastal regions in Egypt. The mean 222Rn concentrations were 42.98 (SD 33.12) Bq/m3 and 8.63 (SD 6.16) Bq/m3 indoor and outdoor respectively. The mean risk of radon-induced cancer (deaths per million population) was 83.4 (SD 64.67) indoors and 25.1 (SD19.52) outdoors. Levels were higher for western regions of the country compared to eastern ones but the highest levels were in Rashid (Nile delta). Smoking was shown to increase the risk considerably.

Internal dose assessment of 210Po using biokinetic modeling and urinary excretion measurement.

The mysterious death of Mr. Alexander Litvinenko who was most possibly poisoned by Polonium-210 ((210)Po) in November 2006 in London attracted the attention of the public to the kinetics, dosimetry and the risk of this high radiotoxic isotope in the human body. In the present paper, the urinary excretion of seven persons who were possibly exposed to traces of (210)Po was monitored. The values measured in the GSF Radioanalytical Laboratory are in the range of natural background concentration. To assess the effective dose received by those persons, the time-dependence of the organ equivalent dose and the effective dose after acute ingestion and inhalation of (210)Po were calculated using the biokinetic model for polonium (Po) recommended by the International Commission on Radiological Protection (ICRP) and the one recently published by Leggett and Eckerman (L&E). The daily urinary excretion to effective dose conversion factors for ingestion and inhalation were evaluated based on the ICRP and L&E models for members of the public. The ingestion (inhalation) effective dose per unit intake integrated over one day is 1.7 x 10(-8) (1.4 x 10(-7)) Sv Bq(-1), 2.0 x 10(-7) (9.6 x 10(-7)) Sv Bq(-1) over 10 days, 5.2 x 10(-7) (2.0 x 10(-6)) Sv Bq(-1) over 30 days and 1.0 x 10(-6) (3.0 x 10(-6)) Sv Bq(-1) over 100 days. The daily urinary excretions after acute ingestion (inhalation) of 1 Bq of (210)Po are 1.1 x 10(-3) (1.0 x 10(-4)) on day 1, 2.0 x 10(-3) (1.9 x 10(-4)) on day 10, 1.3 x 10(-3) (1.7 x 10(-4)) on day 30 and 3.6 x 10(-4) (8.3 x 10(-5)) Bq d(-1) on day 100, respectively. The resulting committed effective doses range from 2.1 x 10(-3) to 1.7 x 10(-2) mSv by an assumption of ingestion and from 5.5 x 10(-2) to 4.5 x 10(-1) mSv by inhalation. For the case of Mr. Litvinenko, the mean organ absorbed dose as a function of time was calculated using both the above stated models. The red bone marrow, the kidneys and the liver were considered as the critical organs. Assuming a value of lethal absorbed dose of 5 Gy to the bone marrow, 6 Gy to the kidneys and 8 Gy to the liver, the amount of (210)Po which Mr. Litvinenko might have ingested is therefore estimated to range from 27 to 1,408 MBq, i.e 0.2-8.5 microg, depending on the modality of intake and on different assumptions about blood absorption.

CFD as a tool in risk assessment of inhaled radon progenies.

During the last decade, computational fluid dynamics techniques proved to be a powerful tool in the modelling of biological processes and the design of biomedical devices. In this work, a computational fluid dynamics method was applied to model the transport of inhaled air and radioactive particles within the human respiratory tract. A finite volume numerical approach was used to compute the flow field characteristics and particle trajectories in the lumen of the first five airway generations of the human tracheobronchial tree, leading to the right upper lobe. The computations were performed for breathing and exposure conditions characteristic of uranium mines and homes. Primary radon daughter deposition patterns and energy distributions were computed, exhibiting highly inhomogeneous particle and energy deposition patterns. The results of the present modelling effort can serve as input data in lung cancer risk analysis.

Rural parents' perceptions of risks associated with their children's exposure to radon.

OBJECTIVES: To examine the level of awareness of radon issues, correlates of elective testing behaviors, and the accuracy of risk perception for radon exposures among rural residents receiving public health services. DESIGN: A cross-sectional design was used in which questionnaire data and household analytic data for radon levels were collected from a nonprobabilistic sample of rural households. SAMPLE: Thirty-one rural households with 71 adults and 60 children participated in the study. Primary household respondents were female (100%), Caucasian (97%), and primarily (94%) between 21 and 40 years of age. MEASUREMENT: Questionnaire data consisted of knowledge and risk perception items about radon and all homes were tested for the presence of radon. RESULTS: The prevalence of high airborne radon (defined as> or=4 pCi/l) was 32%. More than a third of the sample underestimated the seriousness of health effects of radon exposure, 39% disagreed that being around less radon would improve the long-term health of their children, and 52% were unsure whether radon could cause health problems. After adjusting for chance, only 21% of the subjects correctly understood their risk status. CONCLUSIONS: This study provides preliminary evidence that low-income rural citizens do not understand their risk of radon exposure or the deleterious consequences of exposure.

Indoor radon and lung cancer risk in connecticut and utah.

Radon is a well-established cause of lung cancer in miners. Residents of homes with high levels of radon are potentially also at risk. Although most individual studies of indoor radon have failed to demonstrate significant risks, results have generally been consistent with estimates from studies of miners. We studied 1474 incident lung cancer cases aged 40-79 yr in Connecticut, Utah, and southern Idaho. Population controls (n = 1811) were identified by random telephone screening and from lists of Medicare recipients, and were selected to be similar to cases on age, gender, and smoking 10 yr before diagnosis/interview using randomized recruitment. Complete residential histories and information on known lung cancer risk factors were obtained by in-person and telephone interviews. Radon was measured on multiple levels of past and current homes using 12-mo alpha-track etch detectors. Missing data were imputed using mean radon concentrations for informative subgroups of controls. Average radon exposures were lower than anticipated, with median values of 23 Bq/m3 in Connecticut and 45 Bq/m3 in Utah/southern Idaho. Overall, there was little association between time-weighted average radon exposures 5 to 25 yr prior to diagnosis/interview and lung cancer risk. The excess relative risk (ERR) associated with a 100-Bq/m3 increase in radon level was 0.002 (95% CI -0.21, 0.21) in the overall population, 0.134 (95% CI -0.23, 0.50) in Connecticut, and -0.112 (95% CI -0.34, 0.11) in Utah/Idaho. ERRs were higher for some subgroups less prone to misclassification, but there was no group with a statistically significant linear increase in risk. While results were consistent with the estimates from studies of miners, this study provides no evidence of an increased risk for lung cancer at the exposure levels observed.

Assessment and management of residential radon health risks: a report from the health Canada radon workshop.

Epidemiologic studies of uranium miners and other underground miners have consistently shown miners exposed to high levels of radon to be at increased risk of lung cancer. More recently, concern has arisen about lung cancer risks among people exposed to lower levels of radon in homes. The current Canadian guideline for residential radon exposure was set in 1988 at 800 Bq/m(3). Because of the accumulation of a considerable body of new scientific evidence on radon lung cancer risks since that time, Health Canada sponsored a workshop to review the current state-of-the-science on radon health risks. The specific objectives of the workshop were (1) to collect and assess scientific information relevant to setting national radon policy in Canada, and (2) to gather information on social, political, and operational considerations in setting national policy. The workshop, held on 3-4 March 2004, was attended by 38 invited scientists, regulators, and other stakeholders from Canada and the United States. The presentations on the first day dealt primarily with scientific issues. The combined analysis of North American residential radon and lung cancer studies was reviewed. The analysis confirmed a small but detectable increase in lung cancer risk at residential exposure levels. Current estimates suggest that radon in homes is responsible for approximately 10% of all lung cancer deaths in Canada, making radon the second leading cause of lung cancer after tobacco smoking. This was followed by a perspective from an UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation) working group on radon. There were two presentations on occupational exposures to radon and two presentations considered the possibility of radon as a causative factor for cardiovascular disease and for cancer in other organs besides the lung. The possible contribution of environmental tobacco smoke to lung cancers in nonsmokers was also considered. Areas for future research were identified. The second day was devoted to policy and operational issues. The presentations began with a perspective from the U.S. Environmental Protection Agency, followed by a history of radon policy development in Canada. Subsequent presentations dealt with the cost-effectiveness of radon mitigation, Canadian building codes and radon, and a summary of radon standards from around the world. Provincial representatives and a private consultant were given opportunities to present their viewpoints. A number of strategies for reducing residential radon exposure in Canada were recognized, including testing and mitigation of existing homes (on either a widespread or targeted basis) and changing the building code to require that radon mitigation devices be installed at the time a new home is constructed. The various elements of a comprehensive national radon policy were set forth.

Cost assessment of ventilation and averted dose due to radon in dwellings.

The inhalation dose due to radon and its progenies could be averted by ventilation in dwellings; however, on the other hand the increased ventilation augments the heating cost. Therefore a cost-benefit analysis could contribute to optimise the ventilation rate. In our current work we applied our former defined parameters of the optimising procedure to assess the optimised ventilation and radon concentration in dwellings with average parameters. To assess the inhalation dose rates the time-dependent concentrations of all the progenies were calculated in case of periodic and continuous ventilation as well, at three different radon entry rates (5, 10, 20kBqh(-1)). The optimal ventilation rates in case of continuous ventilation are 0.22, 0.40 and 0.66h(-1), respectively. By these conditions the optimal radon concentration takes 160-210Bqm(-3). According to the more detailed analysis the periodic ventilation gives, in general, a better solution than the continuous one. The Monte Carlo simulations provided a large uncertainty; therefore, before the practical application of the results the uncertainty should be decreased taken into account the local conditions.