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International Residential Radon Project Radiation and Environmental Health Programme Department of Protection of the Human Environment World Health Organization.

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Presentation on theme: "International Residential Radon Project Radiation and Environmental Health Programme Department of Protection of the Human Environment World Health Organization."— Presentation transcript:

1 International Residential Radon Project Radiation and Environmental Health Programme Department of Protection of the Human Environment World Health Organization HQ - Geneva, Switzerland

2 WHO Radiation and Environmental Health Programme RAD Unit Links to Regional and Country Offices (RO, CO) Communicable Diseases (CDS) Sustainable Development & Healthy Environments (SDE) Evidence and Information for Policy (EIP) Non-communicable Diseases & Mental Health (NMH) Family and Community Health (FCH) Health Technology & Pharmaceuticals (HTP) External Relations and Governing Bodies (EGB) HIV, Tuberculosis, Malaria (HTM) Health Action in Crises (HAC) General Management (GM) Director General Office (DGO) WHO HQ Structure Radiation & Environmental Health Program in WHO

3 WHO Radiation and Environmental Health Programme Develop and promote evidence-based policy for Member States that reduce risks and protect health from exposure to radiation Develop and promote evidence-based policy for Member States that reduce risks and protect health from exposure to radiation Provide medical support and public health advice in case of major radiation accidents or terrorist events Provide medical support and public health advice in case of major radiation accidents or terrorist events Build capacity and provide information to support national programs Build capacity and provide information to support national programs RAD Mandate

4 WHO Radiation and Environmental Health Programme Ionizing Radiation Risk Factors by Origin Natural background radiation Natural background radiation Radon in homesRadon in homes Elevated background radiation areas (e.g. India, Iran, Brazil, etc)Elevated background radiation areas (e.g. India, Iran, Brazil, etc) Medical applications Medical applications Diagnostic X-raysDiagnostic X-rays Radioactive pollution Radioactive pollution Chernobyl and other accidentsChernobyl and other accidents Nuclear fallout and waste disposalNuclear fallout and waste disposal Depleted uraniumDepleted uranium Occupational exposure Occupational exposure Nuclear workersNuclear workers Cosmic radiation (Air crews)Cosmic radiation (Air crews)

5 WHO Radiation and Environmental Health Programme Radiation Emergency Response (2 UN Conventions) Radiation Emergency Response (2 UN Conventions) REMPAN for emergency medical and public health responseREMPAN for emergency medical and public health response Education and TrainingEducation and Training TelemedicineTelemedicine Environmental Radiation Environmental Radiation Radon in homesRadon in homes Depleted UraniumDepleted Uranium High Natural Background Radiation Areas (Iran, India, Brazil, China)High Natural Background Radiation Areas (Iran, India, Brazil, China) Research agenda (With UNSCEAR, IAEA, etc) Research agenda (With UNSCEAR, IAEA, etc) Co-ordination of research on exposed populations (Chernobyl, Urals, Semipalatinsk)Co-ordination of research on exposed populations (Chernobyl, Urals, Semipalatinsk) International Research Reviews (Chernobyl….)International Research Reviews (Chernobyl….) Global Burden of Disease (GBD) assessmentGlobal Burden of Disease (GBD) assessment Occupational Radiation Health Evaluation Occupational Radiation Health Evaluation Nuclear workersNuclear workers Cosmic RadiationCosmic Radiation Health Aspects of Diagnostic Imaging (X-rays, CT, PET, MRI, Ultrasound) Health Aspects of Diagnostic Imaging (X-rays, CT, PET, MRI, Ultrasound) WHO/RAD: Ionizing Radiation Projects

6 WHO Radiation and Environmental Health Programme Scientific literature is now suggesting that 10% of lung cancers are due to exposure to indoor radon. People and politicians are not taking enough notice of this problem. Mitigation is easily There is a need for an international focus to raise awareness Radon

7 WHO Radiation and Environmental Health Programme Scope: Establish a global project (3-year), with all key international and national partners participating, to identify and promote programs that reduce the health impact of exposure to residential radon Objectives: Estimate the global health impact of exposure to residential radon Estimate the global health impact of exposure to residential radon Create a global database of residential radon exposure Create a global database of residential radon exposure Identify effective measures to reduce radon's health impact Identify effective measures to reduce radon's health impact Promote sound policy options and mitigation programs to Member States Promote sound policy options and mitigation programs to Member States Raise public and political awareness about the consequences of exposure to radon Raise public and political awareness about the consequences of exposure to radon Monitor and periodically review mitigation measures to ensure effectiveness Monitor and periodically review mitigation measures to ensure effectiveness Provide annual reports Provide annual reports International Radon Project First Meeting of the Expert Group Geneva, Switzerland - January 17-18, 2005

8 WHO Radiation and Environmental Health Programme GBD is the quantification of health impacts (mortality and morbidity) caused by risk factors at population level, using a comparable and internally consistent framework, definitions and outcome measures. GBD is the quantification of health impacts (mortality and morbidity) caused by risk factors at population level, using a comparable and internally consistent framework, definitions and outcome measures. A national burden of disease for radon has already been completed in Canada: protocol could used for a full GBD A national burden of disease for radon has already been completed in Canada: protocol could used for a full GBD Global Burden of Disease

9 WHO Radiation and Environmental Health Programme Why Assess GBD? Provides a global picture of health impacts from risks associated with radon Provides a global picture of health impacts from risks associated with radon Identifies problem areas to focus resources more effectively Identifies problem areas to focus resources more effectively Provides tools for identifying intervention measures and monitoring progress Provides tools for identifying intervention measures and monitoring progress

10 WHO Radiation and Environmental Health Programme Mitigation programs Provide policy options for national authorities that lead to a reduction in exposure to radon Provide policy options for national authorities that lead to a reduction in exposure to radon Draft international limits on radon concentrations in collaboration with appropriate international and national agencies Draft international limits on radon concentrations in collaboration with appropriate international and national agencies Provide elements of model legislation Provide elements of model legislation Others? Others?

11 WHO Radiation and Environmental Health Programme Advocacy and Risk Communication Draft scientific reports, fact sheets, press releases and other documents to raise public and political awareness of health concerns about radon exposure Draft scientific reports, fact sheets, press releases and other documents to raise public and political awareness of health concerns about radon exposure What more would you like WHO to do to assist national programs? What more would you like WHO to do to assist national programs?

12 WHO Radiation and Environmental Health Programme International Radon Project: Shaping the Project I Four questions (Barnes Johnson): Four questions (Barnes Johnson): What are the benefits of an international action agenda on radon?What are the benefits of an international action agenda on radon? If recommendations were developed to encourage more risk reduction from radon, what would they say?If recommendations were developed to encourage more risk reduction from radon, what would they say? What are some key opportunities for WHO and us to raise visibility for such recommendations?What are some key opportunities for WHO and us to raise visibility for such recommendations? How can we get started to develop and implement a step-by-step process?How can we get started to develop and implement a step-by-step process?

13 WHO Radiation and Environmental Health Programme International Radon Project Shaping the Project II Communication issues Communication issues Measurement issues Measurement issues Modeling issues Modeling issues Cost issues Cost issues

14 WHO Radiation and Environmental Health Programme International Radon Project Shaping the Project III: Workplan Program elements Program elements Workgroups Workgroups Timelines Timelines

15 WHO Radiation and Environmental Health Programme International Radon Project Shaping the Project IV: Conclusion Consensus statements Consensus statements Next steps Next steps

16 WHO Radiation and Environmental Health Programme Q1. What are the benefits of an international action agenda on radon? Provide scientific consensus on radon health risks Provide scientific consensus on radon health risks Promote public awareness of health risks associated with residential radon Promote public awareness of health risks associated with residential radon Promote action at national level Promote action at national level Increase homeowner compliance with voluntary/advisory radon guidelines Increase homeowner compliance with voluntary/advisory radon guidelines Set minimum criteria for radon risk management (but allow for country specific needs) Set minimum criteria for radon risk management (but allow for country specific needs)

17 WHO Radiation and Environmental Health Programme Q2. If recommendations were developed to encourage more risk reduction from radon, what would they say? Better to install mitigation devices at the time of construction, rather than retrofit Better to install mitigation devices at the time of construction, rather than retrofit Building codes provide a natural point of intervention for control of residential radon (radon levels have increased substantially in Norway because of the use of aerated concrete in foundations; indoor radon levels are also increasing in Finland) Building codes provide a natural point of intervention for control of residential radon (radon levels have increased substantially in Norway because of the use of aerated concrete in foundations; indoor radon levels are also increasing in Finland) Radon testing and mitigation might also be required when an existing home is sold Radon testing and mitigation might also be required when an existing home is sold Control measures should focus on medium exposure levels, which contribute most to the overall radon lung cancer burden Control measures should focus on medium exposure levels, which contribute most to the overall radon lung cancer burden Since the vast majority of radon related lung cancers occur in smokers, consideration needs to be given to the role of tobacco smoking in radon risk reduction programs Since the vast majority of radon related lung cancers occur in smokers, consideration needs to be given to the role of tobacco smoking in radon risk reduction programs Unburned brick and open floors in homes in developing countries can lead to elevated thoron levels Unburned brick and open floors in homes in developing countries can lead to elevated thoron levels Since resources will be required to implement radon risk reduction measures, it is important to demonstrate the cost-effectiveness of such measures (cost-effectiveness will vary with radon levels) Since resources will be required to implement radon risk reduction measures, it is important to demonstrate the cost-effectiveness of such measures (cost-effectiveness will vary with radon levels)

18 WHO Radiation and Environmental Health Programme Q2 (contd). If recommendations were developed to encourage more risk reduction from radon, what would they say? Consideration needs to be given to both guidelines (as is the case in homes in Britain) and enforceable regulations (as is the case in the workplace in Britain) Consideration needs to be given to both guidelines (as is the case in homes in Britain) and enforceable regulations (as is the case in the workplace in Britain) Both voluntary and enforceable guidelines may be useful for residential exposure (as is the case in Switzerland, where homes exceeding 1,000 Bq/m 3 must be mitigated) Both voluntary and enforceable guidelines may be useful for residential exposure (as is the case in Switzerland, where homes exceeding 1,000 Bq/m 3 must be mitigated) Should mitigation focus on new homes only, or include existing homes? Should mitigation focus on new homes only, or include existing homes? Radon affected areas comprised of high radon levels (defined as those areas in which 1% of homes exceed the action level in Britain) might be selectively targeted for testing Radon affected areas comprised of high radon levels (defined as those areas in which 1% of homes exceed the action level in Britain) might be selectively targeted for testing Government grants might be used to support radon mitigation actions in cases of need (may require a means test to administer this type of public support for mitigation) Government grants might be used to support radon mitigation actions in cases of need (may require a means test to administer this type of public support for mitigation)

19 WHO Radiation and Environmental Health Programme Q2 (contd). If recommendations were developed to encourage more risk reduction from radon, what would they say? Should schools be identified as an environment that require special consideration with respect to radon mitigation? Should schools be identified as an environment that require special consideration with respect to radon mitigation? Should workers be included within the scope of this project? Should workers be included within the scope of this project? Should thermal spas with high radon content in the water be included? Should thermal spas with high radon content in the water be included? Should new buildings have a more stringent radon reference level than existing buildings? (some EU countries have two reference levels, with a lower level for new buildings) Should new buildings have a more stringent radon reference level than existing buildings? (some EU countries have two reference levels, with a lower level for new buildings) All new homes constructed since 1998 are required to have a radon sump in Ireland (nonetheless, 10% of new homes still have radon levels above the action level of 200 Bq/m 3 ) All new homes constructed since 1998 are required to have a radon sump in Ireland (nonetheless, 10% of new homes still have radon levels above the action level of 200 Bq/m 3 )

20 WHO Radiation and Environmental Health Programme Q3. What are some key opportunities for WHO and us to raise visibility for such recommendations? Information programs describing radon as a public health issue Information programs describing radon as a public health issue Future (open) meetings to develop WHO International Residential Radon Project Future (open) meetings to develop WHO International Residential Radon Project Education materials are available in a number of countries: these might be used to develop an international radon information kit Education materials are available in a number of countries: these might be used to develop an international radon information kit

21 WHO Radiation and Environmental Health Programme Q4. How can we get started to develop and implement a step- by-step process? Consensus report from the present meeting Consensus report from the present meeting Action plan for WHO residential radon project Action plan for WHO residential radon project Obtain international residential (and outdoor?) radon levels from UNSCEAR Obtain international residential (and outdoor?) radon levels from UNSCEAR Reference levels for radon in 20 European countries have been tabulated as part of ERRICA 2 (advisory levels are largely between 200 and 400 Bq/m3) Reference levels for radon in 20 European countries have been tabulated as part of ERRICA 2 (advisory levels are largely between 200 and 400 Bq/m3)

22 WHO Radiation and Environmental Health Programme Communication Issues Information needs to be made available to the public on how to determine radon levels in their homes, and on ways in which radon in homes can be reduced Information needs to be made available to the public on how to determine radon levels in their homes, and on ways in which radon in homes can be reduced Need to put residential radon lung cancer risk in perspective, perhaps by comparison with other agents included in the WHO GBD program Need to put residential radon lung cancer risk in perspective, perhaps by comparison with other agents included in the WHO GBD program Studies have indicated that people may not elect to take voluntary action to reduce radon in their homes, although this depends on the level of knowledge that they have on radon health risks Studies have indicated that people may not elect to take voluntary action to reduce radon in their homes, although this depends on the level of knowledge that they have on radon health risks Radon is the largest source of environmental exposure to ionizing radiation (approx 40% of total exposure in Switzerland) Radon is the largest source of environmental exposure to ionizing radiation (approx 40% of total exposure in Switzerland) Radon is the second leading contributor to the global lung cancer burden, after tobacco smoking Radon is the second leading contributor to the global lung cancer burden, after tobacco smoking

23 WHO Radiation and Environmental Health Programme Communication Issues (contd) Consider tools developed by ERRICCA 2 Project (European Radon Research and Industry Collaboration Concerted Action): website, public awareness, protection of new building, mitigation, mapping and measurement) Consider tools developed by ERRICCA 2 Project (European Radon Research and Industry Collaboration Concerted Action): website, public awareness, protection of new building, mitigation, mapping and measurement)

24 WHO Radiation and Environmental Health Programme 1993 WHO Europe Communications Guidelines Countries should collect baseline information on existing attitudes and perceptions about radon before initiating a risk communication programme. Countries should collect baseline information on existing attitudes and perceptions about radon before initiating a risk communication programme. The goal of the radon communications programme should be to provide accurate scientific information to reduce radon health risks. The goal of the radon communications programme should be to provide accurate scientific information to reduce radon health risks. Continuous evaluation and improvement of the risk communication programmes should be undertaken in order to achieve the overall communications goals. Continuous evaluation and improvement of the risk communication programmes should be undertaken in order to achieve the overall communications goals. For special target audiences, appropriate (and possibly different) radon risk communication messages should be prepared. For special target audiences, appropriate (and possibly different) radon risk communication messages should be prepared. Radon risk communication efforts should be linked to key issues, such as the availability of qualified radon contractors and testing services. Radon risk communication efforts should be linked to key issues, such as the availability of qualified radon contractors and testing services. Messages should be repeated and reinforced; a one-time message will not result in behavioural change. Messages should be repeated and reinforced; a one-time message will not result in behavioural change. Countries should be encouraged to share information and discuss new findings in the area of radon risk communication. Countries should be encouraged to share information and discuss new findings in the area of radon risk communication.

25 WHO Radiation and Environmental Health Programme Measurement Issues Although homeowners may want quick monitoring results based on short- term measurements, it is difficult to determine long-term exposure levels on the basis of short-term measurements Although homeowners may want quick monitoring results based on short- term measurements, it is difficult to determine long-term exposure levels on the basis of short-term measurements Adjustment for residential radon exposure measurement error results in increased estimates of the lifetime relative risk – what are the implications of exposure measurement error for estimating the population attributable risk? Adjustment for residential radon exposure measurement error results in increased estimates of the lifetime relative risk – what are the implications of exposure measurement error for estimating the population attributable risk? Spatial patterns in radon concentrations may be related to geographic characteristics, which may help in identifying radon affected areas Spatial patterns in radon concentrations may be related to geographic characteristics, which may help in identifying radon affected areas Twenty EU countries have carried out radon mapping to some extent under the ERRICCA 2 Project (by measuring indoor radon gas concentrations, by soil gas measurements, by geological mapping, and by other radiological techniques) Twenty EU countries have carried out radon mapping to some extent under the ERRICCA 2 Project (by measuring indoor radon gas concentrations, by soil gas measurements, by geological mapping, and by other radiological techniques) Maps can be used to plan radon campaigns, to distribute radon dosimeters, for radon prevention in new buildings, and to increase public awareness Maps can be used to plan radon campaigns, to distribute radon dosimeters, for radon prevention in new buildings, and to increase public awareness Mapping studies have designated 1/3 of Ireland as high radon areas (HRAs) Mapping studies have designated 1/3 of Ireland as high radon areas (HRAs)

26 WHO Radiation and Environmental Health Programme Measurement Issues (contd) Identification of high radon areas by direct measurement may take some time (10 years in Switzerland) Identification of high radon areas by direct measurement may take some time (10 years in Switzerland) Can measurements of less than one year be used to reliably predict annual residential radon concentrations (possibly using seasonal adjustment models developed by Pinel et al., 1995, and Krewski et al., 2004)? Can measurements of less than one year be used to reliably predict annual residential radon concentrations (possibly using seasonal adjustment models developed by Pinel et al., 1995, and Krewski et al., 2004)?

27 WHO Radiation and Environmental Health Programme Modeling Issues Develop updated radon risk projection models based on BEIR VI (considering recent modifications by US EPA) Develop updated radon risk projection models based on BEIR VI (considering recent modifications by US EPA) Develop updated risk projection models based on combined analysis of residential studies, including the ongoing combining of European and North American studies Develop updated risk projection models based on combined analysis of residential studies, including the ongoing combining of European and North American studies Consider the use of simple approximations to these models, which provide insight into different indices of risk are inter- related, and on how to extrapolate results among different conditions Consider the use of simple approximations to these models, which provide insight into different indices of risk are inter- related, and on how to extrapolate results among different conditions Characterize sources of uncertainty in radon risk projections Characterize sources of uncertainty in radon risk projections

28 WHO Radiation and Environmental Health Programme Main Program Elements I: Science Risk models – develop WHO model for projecting radon lung cancer risk (build on BEIR VI and European and North American combined analyses, including joint effects of tobacco smoking) Risk models – develop WHO model for projecting radon lung cancer risk (build on BEIR VI and European and North American combined analyses, including joint effects of tobacco smoking) Radon database – develop global database on indoor (and outdoor?) radon levels; describe spatial variation in radon levels using mapping techniques Radon database – develop global database on indoor (and outdoor?) radon levels; describe spatial variation in radon levels using mapping techniques Population health impact – estimate global burden of disease for radon Population health impact – estimate global burden of disease for radon

29 WHO Radiation and Environmental Health Programme Main Program Elements II: Policy Exposure guidelines – develop WHO guidelines for residential radon exposure levels Exposure guidelines – develop WHO guidelines for residential radon exposure levels Cost effectiveness – conduct economic analyses of alternative mitigation strategies Cost effectiveness – conduct economic analyses of alternative mitigation strategies

30 WHO Radiation and Environmental Health Programme Main Program Elements III: Measurement and Mitigation Measuring residential radon – recommend measurement methods for indoor radon Measuring residential radon – recommend measurement methods for indoor radon Radon reduction – recommend technologies for reducing indoor radon levels Radon reduction – recommend technologies for reducing indoor radon levels

31 WHO Radiation and Environmental Health Programme Main Program Elements IV: Communication Communications – develop communications materials to promote program to the public and to national public health agencies Communications – develop communications materials to promote program to the public and to national public health agencies

32 WHO Radiation and Environmental Health Programme Main Program Elements V: Program Evaluation Effectiveness monitoring – track reductions in indoor radon concentrations related to radon mitigation Effectiveness monitoring – track reductions in indoor radon concentrations related to radon mitigation Reporting – annual project reports Reporting – annual project reports

33 WHO Radiation and Environmental Health Programme Work Groups 1. Risk assessment (risk modeling, GBD, and global radon database) 2. WHO exposure guidelines 3. Cost effectiveness (framework + analyses) 4. Measurement and mitigation 5. Risk communication (including education and training) 6. Program coordination and evaluation [All groups should identify research and information needs as part of their work]

34 WHO Radiation and Environmental Health Programme Timelines: Year 1 Develop WHO residential radon risk projection model Develop WHO residential radon risk projection model Preliminary GBD estimates (based on approximate methods: need average radon concentration, lifetime risk of dying of lung cancer, prevalence of ever-smokers, life- expectancy, geometric standard deviation of indoor radon levels also useful) Preliminary GBD estimates (based on approximate methods: need average radon concentration, lifetime risk of dying of lung cancer, prevalence of ever-smokers, life- expectancy, geometric standard deviation of indoor radon levels also useful) Establish global radon database Establish global radon database Review current residential radon exposure guidelines, and recommend radon WHO radon guidelines Review current residential radon exposure guidelines, and recommend radon WHO radon guidelines Review current radon measurement methods Review current radon measurement methods Review current methods of radon reduction Review current methods of radon reduction Outline main elements of communications strategy Outline main elements of communications strategy Develop framework for cost-effectiveness analysis Develop framework for cost-effectiveness analysis Consolidate findings into first annual report Consolidate findings into first annual report

35 WHO Radiation and Environmental Health Programme Timelines: Year 2 Conduct GBD analysis for radon Conduct GBD analysis for radon Map global residential radon levels Map global residential radon levels Conduct cost-effectiveness analysis of alternative radon mitigation strategies Conduct cost-effectiveness analysis of alternative radon mitigation strategies Complete communications strategy and develop communications materials, including radon fact sheets Complete communications strategy and develop communications materials, including radon fact sheets Second annual report Second annual report

36 WHO Radiation and Environmental Health Programme Timelines: Year 3 WHO Radon Handbook describing radon as a global population health issue (with input from all workgroups) WHO Radon Handbook describing radon as a global population health issue (with input from all workgroups) International symposium on WHO Radon Mitigation Program (showcasing WHO Handbook) International symposium on WHO Radon Mitigation Program (showcasing WHO Handbook) Program evaluation (impact on national public health agencies, changes in building codes, reduction in exposure, other impacts) Program evaluation (impact on national public health agencies, changes in building codes, reduction in exposure, other impacts) Third annual report Third annual report

37 WHO Radiation and Environmental Health Programme Workgroup 1: Risk Assessment J. Zielinski J. Zielinski S. Darby S. Darby M. Tirmarche M. Tirmarche H. Paretzke H. Paretzke D. Chambers D. Chambers M. Kreuzer M. Kreuzer L. Kreienbrock L. Kreienbrock K. Brand K. Brand D. Krewski D. Krewski M. Zhukovsky M. Zhukovsky B. Shang B. Shang L. Veiga L. Veiga D. Hill D. Hill M. Pavia M. Pavia E. Wichmann E. Wichmann J. Puskin J. Puskin S. Akiba S. Akiba B. Field B. Field

38 WHO Radiation and Environmental Health Programme Workgroup 2: Exposure Guidelines J. McLaughlin J. McLaughlin E. Ettenhuber E. Ettenhuber G. Kendall G. Kendall D. Fenton (to be confirmed) D. Fenton (to be confirmed) A-L Soderman A-L Soderman T. Strand T. Strand B. Johnson B. Johnson H. Yonehara H. Yonehara

39 WHO Radiation and Environmental Health Programme Workgroup 3: Cost-effectiveness A. Gray A. Gray K. Brand K. Brand T. Strand T. Strand B. Johnson B. Johnson Q. Sun Q. Sun I. Makelainen I. Makelainen D. Krewski D. Krewski

40 WHO Radiation and Environmental Health Programme Workgroup 4: Measurement and Mitigation B. Field (measurement M1) B. Field (measurement M1) C. Scivyer (mitigation M2) (to be confirmed) C. Scivyer (mitigation M2) (to be confirmed) Y. Yamada (M1) Y. Yamada (M1) G. Kendall (M1) G. Kendall (M1) T. Strand (M1, M2) T. Strand (M1, M2) E. Ettenhuber (M1) E. Ettenhuber (M1) G. Piller (M1, M2) G. Piller (M1, M2) D. Steck (M1) D. Steck (M1) G. Fisher (M1, M2) G. Fisher (M1, M2) J. Jankowski (M1, M2) J. Jankowski (M1, M2) L. Quindos (M1, M2) L. Quindos (M1, M2) A-L. Soderman (M1, M2) A-L. Soderman (M1, M2) J. Tschiersch (M1) J. Tschiersch (M1) H. Arvela (M2, M1) (mitigation) (to be confirmed) H. Arvela (M2, M1) (mitigation) (to be confirmed) Q. Guo (M1) Q. Guo (M1) W. Zhuo (M1, M2) W. Zhuo (M1, M2) B. Shang (M1, M2) B. Shang (M1, M2) M. Zhukovsky (M1) M. Zhukovsky (M1)

41 WHO Radiation and Environmental Health Programme Workgroup 5: Risk Communication V. Koukouliou V. Koukouliou A-L. Soderman A-L. Soderman J. McLaughlin J. McLaughlin G. Piller G. Piller H.H. Landfermann H.H. Landfermann L. Quindos L. Quindos Q. Sun Q. Sun T. Strand T. Strand B. Johnson B. Johnson H. Walker H. Walker D. Fenton D. Fenton

42 WHO Radiation and Environmental Health Programme Workgroup 6: Program Monitoring and Evaluation Z. Carr Z. Carr B. Johnson B. Johnson H. Walker H. Walker A. Gray A. Gray A. Auvinen A. Auvinen V. Koukouliou V. Koukouliou

43 WHO Radiation and Environmental Health Programme Consensus Statements For many people, radon represents the largest source of exposure to ionizing radiation in humans. For many people, radon represents the largest source of exposure to ionizing radiation in humans. Radon is a known cause of lung cancer in humans. Radon is a known cause of lung cancer in humans. Radon is an important contributor to the human lung cancer burden, after tobacco smoking. Radon is an important contributor to the human lung cancer burden, after tobacco smoking. Radon is considered to be responsible for some 10% of the human lung cancer burden in developed countries/worldwide (will differ between developed and undeveloped countries) Radon is considered to be responsible for some 10% of the human lung cancer burden in developed countries/worldwide (will differ between developed and undeveloped countries) The BEIR VI Report estimated that there are approximately 22,000 deaths annually from radon in the United States alone. (Add European results here) The BEIR VI Report estimated that there are approximately 22,000 deaths annually from radon in the United States alone. (Add European results here) Radon related lung cancer risk is affected by tobacco smoking, with most radon related lung cancers occur in smokers; however, radon is one of the leading causes of lung cancer in nonsmokers. Radon related lung cancer risk is affected by tobacco smoking, with most radon related lung cancers occur in smokers; however, radon is one of the leading causes of lung cancer in nonsmokers.

44 WHO Radiation and Environmental Health Programme Consensus Statements (contd) Radon should be a priority public health issue for national environmental and radiation safety programs Radon should be a priority public health issue for national environmental and radiation safety programs There is a need to carefully evaluate the costs and benefits of national and international radon mitigation programs. There is a need to carefully evaluate the costs and benefits of national and international radon mitigation programs. Based on existing knowledge of geological conditions and building types, and consideration of the total lung cancer burden, countries should consider developing cost-effective national or regional policies on testing and mitigation Based on existing knowledge of geological conditions and building types, and consideration of the total lung cancer burden, countries should consider developing cost-effective national or regional policies on testing and mitigation Where appropriate, countries should build capacity within the public and/or private sectors to provide testing, mitigation, and radon-resistant new construction Where appropriate, countries should build capacity within the public and/or private sectors to provide testing, mitigation, and radon-resistant new construction Where appropriate, countries should issue and widely disseminate statements which address the importance of radon risk reduction and the steps that can be taken to reduce such risks Where appropriate, countries should issue and widely disseminate statements which address the importance of radon risk reduction and the steps that can be taken to reduce such risks

45 WHO Radiation and Environmental Health Programme Consensus Statements (contd) Countries should explore ways to address radon health risks in a cost-effective manner, considering both the installation of preventive measures in new buildings and remediation of existing buildings. Countries should explore ways to address radon health risks in a cost-effective manner, considering both the installation of preventive measures in new buildings and remediation of existing buildings. National governments should team with other stakeholders to ensure radon risk communication messages are delivered from multiple sources National governments should team with other stakeholders to ensure radon risk communication messages are delivered from multiple sources Governments should strive to include radon health messages and action steps with other national efforts on green buildings, housing policy, and the built environment. Governments should strive to include radon health messages and action steps with other national efforts on green buildings, housing policy, and the built environment.

46 WHO Radiation and Environmental Health Programme Towards the WHO Radon Guideline Immediate remedial action at levels exceeding 1000 Bq/m 3 Immediate remedial action at levels exceeding 1000 Bq/m 3 Guideline of maximum of 400 Bq/m 3 for existing homes Guideline of maximum of 400 Bq/m 3 for existing homes Guideline of 200 Bq/m 3 for new homes Guideline of 200 Bq/m 3 for new homes Efforts should be made to reduce radon to even lower levels, where possible, since there is still some risk of lung cancer below the above guidelines Efforts should be made to reduce radon to even lower levels, where possible, since there is still some risk of lung cancer below the above guidelines Group recommended giving risk at different proposed guideline levels, for smokers and nonsmokers. Group recommended giving risk at different proposed guideline levels, for smokers and nonsmokers. Explain role of smoking in relation to radon risk? Explain role of smoking in relation to radon risk?

47 WHO Radiation and Environmental Health Programme Next Steps & Related Activities Next annual meeting: January 23-26, 2006 in Geneva) [WHO Geneva] Next annual meeting: January 23-26, 2006 in Geneva) [WHO Geneva] Four page fact sheet on radon (what radon is, characterizes health effects, testing and mitigation techniques known and easily implemented, cost effectiveness of exposure reduction, raise awareness, what WHO will do) (May 30, 2005) [WHO Geneva] Four page fact sheet on radon (what radon is, characterizes health effects, testing and mitigation techniques known and easily implemented, cost effectiveness of exposure reduction, raise awareness, what WHO will do) (May 30, 2005) [WHO Geneva] Press conference to launch WHO project (June, 2005) [WHO Geneva] Press conference to launch WHO project (June, 2005) [WHO Geneva]

48 WHO Radiation and Environmental Health Programme


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