Indoor Radon Exposure and COPD, Synergic Association? A Multicentric, Hospital-Based Case–Control Study in a Radon-Prone Area / Exposición al radón en interiores y EPOC, ¿una asociación sinérgica? Un estudio de casos y controles multicéntrico hospitalario en un área propensa al radón

Background: COPD is a multifactorial disease which causes considerable mortality and morbidity worldwide. Previous studies assessing the possible relationship between indoor radon exposure and COPD have shown inconclusive results. Methods: A multicentric, hospital-based, case-control study was conducted in a Spanish radon-prone area. COPD cases were confirmed by spirometry and controls were selected due to trivial surgery or procedures not related to tobacco consumption. All participants had to have lived for at least 15 years in the same dwelling. Radon measurements were conducted individually in dwellings using alpha-track detectors. Results were obtained using multivariate logistic regression. Results: 189 cases and 747 controls took part. There was no significant association between residential radon concentrations and COPD onset with a OR of 1.12 (95%CI 0.41–3.06) for individuals exposed to more than 200Bq/m3 compared to those exposed to less than 50Bq/m3. Heavy smokers seem to increase their COPD risk if exposed to higher radon concentrations vs those exposed to lower concentrations. There was a statistically significant synergy index between radon exposure and tobacco consumption, S-index 11.60 (95%CI 3.71–36.26). Indoor radon concentration was higher in never/light smokers with COPD compared to controls. (AU)

Antecedentes: La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad multifactorial que causa una mortalidad y morbilidad considerables en todo el mundo. Los estudios previos que han evaluado la posible relación entre la exposición al radón en interiores y la EPOC no han mostrado resultados concluyentes. Métodos: Se realizó un estudio de casos y controles multicéntrico, hospitalario, en una zona española propensa al radón. Los casos de EPOC se confirmaron mediante espirometría y los controles se seleccionaron por cirugías triviales o procedimientos no relacionados con el consumo de tabaco. Todos los participantes debían haber vivido al menos 15 años en la misma vivienda. Las mediciones de radón se realizaron individualmente en las viviendas utilizando detectores de partículas alfa. Los resultados se obtuvieron mediante regresión logística multivariante. Resultados: Participaron 189 casos y 747 controles. No hubo una asociación significativa entre las concentraciones de radón en las residencias y la aparición de la EPOC con un OR de 1,12 (IC 95%: 0,41-3,06) para las personas expuestas a más de 200 Bq/m3 en comparación con las expuestas a menos de 50 Bq/m3. Los grandes fumadores parecen aumentar su riesgo de EPOC si se exponen a concentraciones de radón más altas en comparación con aquellos expuestos a concentraciones más bajas. Hubo un índice de sinergia estadísticamente significativo entre la exposición al radón y el consumo de tabaco: índice S=11,60 (IC 95%: 3,71 - 36,26). La concentración de radón en interiores fue mayor en los no fumadores y fumadores leves con EPOC en comparación con los controles. (AU)

Indoor Radon Exposure and COPD, Synergic Association? A Multicentric, Hospital-Based Case-Control Study in a Radon-Prone Area.

BACKGROUND: COPD is a multifactorial disease which causes considerable mortality and morbidity worldwide. Previous studies assessing the possible relationship between indoor radon exposure and COPD have shown inconclusive results. METHODS: A multicentric, hospital-based, case-control study was conducted in a Spanish radon-prone area. COPD cases were confirmed by spirometry and controls were selected due to trivial surgery or procedures not related to tobacco consumption. All participants had to have lived for at least 15 years in the same dwelling. Radon measurements were conducted individually in dwellings using alpha-track detectors. Results were obtained using multivariate logistic regression. RESULTS: 189 cases and 747 controls took part. There was no significant association between residential radon concentrations and COPD onset with a OR of 1.12 (95%CI 0.41-3.06) for individuals exposed to more than 200Bq/m3 compared to those exposed to less than 50Bq/m3. Heavy smokers seem to increase their COPD risk if exposed to higher radon concentrations vs those exposed to lower concentrations. There was a statistically significant synergy index between radon exposure and tobacco consumption, S-index 11.60 (95%CI 3.71-36.26). Indoor radon concentration was higher in never/light smokers with COPD compared to controls. CONCLUSIONS: No association between indoor radon and COPD has been observed. However, there might be some effect modification on the COPD risk in heavy smokers when high radon exposure is present. This is supported by the additive synergy observed. Also, a possible association between indoor radon and COPD onset in never and light smokers needs to be further studied.

Indoor Radon Exposure and COPD, Synergic Association? A Multicentric, Hospital-Based Case-Control Study in a Radon-Prone Area.

BACKGROUND: COPD is a multifactorial disease which causes considerable mortality and morbidity worldwide. Previous studies assessing the possible relationship between indoor radon exposure and COPD have shown inconclusive results. METHODS: A multicentric, hospital-based, case-control study was conducted in a Spanish radon-prone area. COPD cases were confirmed by spirometry and controls were selected due to trivial surgery or procedures not related to tobacco consumption. All participants had to have lived for at least 15 years in the same dwelling. Radon measurements were conducted individually in dwellings using alpha-track detectors. Results were obtained using multivariate logistic regression. RESULTS: 189 cases and 747 controls took part. There was no significant association between residential radon concentrations and COPD onset with a OR of 1.12 (95%CI 0.41-3.06) for individuals exposed to more than 200Bq/m3 compared to those exposed to less than 50Bq/m3. Heavy smokers seem to increase their COPD risk if exposed to higher radon concentrations vs those exposed to lower concentrations. There was a statistically significant synergy index between radon exposure and tobacco consumption, S-index 11.60 (95%CI 3.71-36.26). Indoor radon concentration was higher in never/light smokers with COPD compared to controls. CONCLUSIONS: No association between indoor radon and COPD has been observed. However, there might be some effect modification on the COPD risk in heavy smokers when high radon exposure is present. This is supported by the additive synergy observed. Also, a possible association between indoor radon and COPD onset in never and light smokers needs to be further studied.