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The Wyoming Department of Health 6101 Yellowstone Cheyenne, WY 307-777-6015 Radon-Induced Lung Cancer… An Environmental Hazard and A Community Health Concern.

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Presentation on theme: "The Wyoming Department of Health 6101 Yellowstone Cheyenne, WY 307-777-6015 Radon-Induced Lung Cancer… An Environmental Hazard and A Community Health Concern."— Presentation transcript:

1 The Wyoming Department of Health 6101 Yellowstone Cheyenne, WY 307-777-6015 Radon-Induced Lung Cancer… An Environmental Hazard and A Community Health Concern

2 OBJECTIVES 1. Increase Physician and allied healthcare provider knowledge on Radon and the related health effects. 2. Enlist the assistance of the Wyoming physicians in promoting Home Radon Testing to their patients. 3. Supply the physicians with Radon Test Kit Coupons and all necessary material in support of Home Radon testing to their patients.

3 Radon is part of the Earth’s crust and radiates on a continual basis

4 Rn 86 222 Periodic Table of the Elements Rn 86 222 Radon behaves like an inert gas – Does not combine chemically with other atoms to form molecules. – Allows it to move freely through soil Its nuclear configuration is unstable – Will easily lose two protons, causing it to change its characteristics to that of another element (polonium)

5 Pico Curie pCi/L Pico = Trillionth Curie = Radium Measurement 1 Curie = 1 Gram of Radium Per Liter of Air “L” Number of Liters of Air per Room

6 U.S. Radon Potential Many parts of the country have elevated radon concentrations Map developed as basis for radon control techniques in new construction.

7 Why Is Radon A Concern? Radon decays into radioactive particles known as radon decay products. These particles are easily inhaled and deposited in the lungs where they can damage sensitive lung tissue. Radon Decay Products Radon Radon

8 Because…. Radon Causes Lung Cancer & LUNG CANCER KILLS! Why is Radon a Concern? Statistically Speaking, ONLY 21,000 + People Die Each Year Because of Radon That’s not TOO Many… Unless you happen to be One of those 21,000!

9 Radon Radium Uranium Radon is a gas. It is naturally occurring. It cannot be seen or smelled. It enters buildings from the soil beneath them

10 What Happens When Radon- 222 Enters a House? Radon enters home. Radon radioactively decays into RDPs in the air. Some RDPs remain in the air. Some RDPs plate out on surfaces. Radon RDPs RDPs

11 Radon Progeny 218 Po and 214 Po deliver the radiologically significant dose to the respiratory epithelium. Lead-210 Polonium-214 Bismuth-214 Lead-214 Polonium-218 Radon-222      Lead-206 Polonium-210 Bismuth-210    22 yrs 4 day 3 min 27 min 20 min 0.2 ms 5 day 138 day Stable

12 How Radon Gas / RDP Cause Lung Cancer Inhalation of Radon Decay Products AlphaParticles Irradiate Lungs Radiation Damage to DNA / P53 Gene > Lung Cancer

13 Ionizing radiation can directly and indirectly damage DNA Alpha Particle Defects in tumor suppressor genes – p53 At risk individuals–GSTM 1 (glutathione S-transferase M1) Double –strand DNA breaks Free radical formation

14 What Happens When Radon Decay Products Are Inhaled? n Highly radioactive particles adhere to lung tissue, where they can irradiate sensitive cells. n Radiation can alter the cells, increasing the potential for cancer. Double Strand Breaks

15 Alpha  Decay 4 He Nucleus Ejected from 222 Rn Nucleus +2 He + Po 4 He + 218 Po + + + + + + + + + Radon - 222

16 Alpha Particles Are Strong Enough To Pit Plastic Plastic chip from passive radon test (alpha track) Magnified only 100 times 3 months at EPA Action Level of 4 pCi/L

17 Scientific Basis For Radon Risk Estimates Studies on miners –Uranium miners in U.S. and other countries Studies on residential occupants –On-going and as a group confirm application of miner data to residential exposures Studies on laboratory animals

18 National Research Council BEIR VI: February 19, 1998 Lung cancer due to radon exposure –Higher risk among smokers –High non-smoker risk “Radon is one of the most extensively investigated human carcinogens.” Radon is a “...public-health problem and makes indoor radon the second leading cause of lung cancer after cigarette smoking.”

19 International Pooling of Residential Radon Case-Control Studies New Jersey, Missouri I, Canada, Iowa, Missouri II, a combined study from Connecticut, Utah and S. Idaho Shenyang, China, Stockholm, Sweden, Swedish nationwide, Winnipeg, Canada, S. Finland, Finnish nationwide, SW England, W. Germany, Sweden, Czech Republic, Italy- Trento, Spain, Austria, France, China - Gansu Province, E. Germany

20 Medical Radon Studies Study Location Publication Date CasesControls Shenyang, China1990308356 Stockholm, Sweden1992201378 Swedish nationwide19941,2812,576 Winnipeg, Canada1994738514 S. Finland1996164331 Finnish nationwide1996517 SW England19989823,185 W. Germany19981,4492,297 Sweden2001258487 Czech Republic200121011,794 Italy-Trento2001138210 Spain2002163241 Austria2002194198 France2002486984 China –Gansu Province20027681,659 E. Germany20031,0531,667

21 Residential Radon Epidemiology Bill Field, MS, Ph.D 319-335-4413 Iowa Radon Lung Cancer Study National Institutes of Health Radon Professionals Listserv College of Public Health Department of Occupational and Environmental Health Department of Epidemiology University of Iowa

22 IRLCS sites

23 Histopathologic Review Blinded review by two surgical pathologists Consensus diagnosis based on World Health Organization 1981 (WHO) histologic type 72% agreement between Iowa Cancer Registry and consensus histologic type The relative odds of misclassification for samples collected using cytology and biopsy as compared to resection was 2.4 (CI; 1.1- 5.2) and 2.2 (CI; 1.1 - 4.2), respectively. JNCI 2004, in press

24 STUDY DEMOGRAPHICS Cases Controls Total413 614 Age in yrs. (median) 68 67 Residency in yrs. (median) 33 31 Alive at interview 69% 100% Ever-smokers86% 33% Previous lung disease 44% 27% At least H.S. Education 90% 92%

25 Morphologic Distribution of 413 Lung Cancers Morphology Number % Adenocarcinoma 17542.4 Squamous Cell 8219.9 Small Cell 7417.9 Large Cell 32 7.7 Carcinoma, NOS 5012.1

26 OVERVIEW. Lung Cancer Trends Iowa Radon Lung Cancer Study Residential Radon Studies Have Residential Radon Studies Underestimated Risk? Glass-Based Retrospective Radon Measurements Future Directions

27 SUMMARY The Iowa Radon Lung Cancer Study found a statistically significant association between residential Radon exposure and lung cancer. The findings suggest that prolonged exposure to Radon, even at 4 pCi/L, increases lung cancer risk. These findings suggest that Radon is a major environmental carcinogen.

28 “Radon Is A Serious National Health Problem” American Lung Association American Medical Association Environmental Protection Agency National Academy of Sciences National Council on Radiation Protection and Measurement U.S. Surgeon General World Health Organization

29 EPA & Surgeon General Recommend That People Not Have Exposures Above 4 pCi/L On A Long-Term Basis n One is advised to take action if a home is at or above 4.0 pCi/L n Average indoor: 1.3 pCi/L n Average outdoor: 0.4 pCi/L n Recommendations

30 How Does Radon Rank As A Cancer Causing Agent? Radon is ranked as a Group A carcinogen –Highest ranking for cancer potential –Known to cause cancer in humans –Tobacco smoke and tobacco products in same category Provides basis for regulatory and liability concerns!

31 It is the 2 nd Leading Cause of Lung Cancer Only 21,000+ Die / Year


33 Wyoming Cancer Deaths 2004


35 Incidence By Age

36 Is Wyoming The Only State Where Radon Concerns Exist? Radon is a National and World-Wide problem NO!

37 Radon Potential By County In Wyoming n Based on geology and surveys n Expected closed building radon (pCi/L): Zone 1: 4.0 and above Zone 1: 4.0 and above Zone 2: between 2.0 & 4.0 Zone 2: between 2.0 & 4.0 Zone 3: 2.0 and lower Zone 3: 2.0 and lower

38 Distribution Of Radon In Housing Units In Wyoming Counties* * Source:Homeowner test devices obtained through Wyoming Radon Project

39 Indoor Radon Average, National and Wyoming 1/3rd @ or above 4.0 pCi/L / 2/3rds @ or below 4.0 pCi/l Estimated Radon-Induced Lung Cancer Deaths (National and Wyoming) 1/3 rd of Cases @ or above 4.0 pCi/L 2/3rds @ or below 4.0 pCi/l

40 U.S. Annual Radon Source Death Rates Comparison Comprehensive multi-media health risk reduction program includes radon reduction from both soil and water 18,20072018149.6

41 Outdoor 222 Rn Concentrations

42 How Is Radon Drawn Into A Building? Vacuum –Exhaust systems –Thermal stack effects 0 20 40 60 80 1234 Days Radon pCi/L Vacuum (pa.)

43 How Radon Gets into a Home:

44 Radon Distribution Radon enters from beneath foundation and travels upward. –Diluted with outdoor air infiltrating building If radon is less than 4 pCi/L in lower level, one can say with reasonable confidence that upper floors are also less than 4 pCi/L. 10 1 4-5

45 45 Average Contributions From Radon Sources In U.S. Homes n The movement of soil gas into a home is the predominant entry route. n These are averages - a particular home can be different! Water < 1% Soil Gas 85 - 90% Diffusion 1 - 4% Emanation 2 - 5% Radium Containing Soil

46 Some Radon Can Also Enter Building From Water Supply Radon enters water in ground and outgasses in building. Concern primarily isolated to private wells. Typically adds minor amount to air compared to that from soil gas.

47 Various Perceptions of Radon AlphaParticle? Radiation Damage to DNA? Lung Cancer? ? Radon ? Lung Cancer ? Myth !

48 Why is the Evidence Ignored or Not Accepted ?  Naturally occurring (no villains)  Invisible, odorless, colorless  No sensory reminders to repetitively stimulate us to think about it  Lack of press – no sensational story  Long latency period  Cancers occur one at a time  Lung cancer does not occur in children  Can not directly link deaths to radon exposure  Voluntary risk  Not a “Dread Hazard”

49 Environmental Risk Comparison 0 5,000 10,000 15,000 20,000 Estimated Annual Cancer Deaths Pesticide Applications Hazardous Waste Sites Toxic Outdoor Air Pollutants Pesticide Residue on Food RADON

50 Ranking of Environmental Hazards Public Ranking Scientific Ranking 1.Active Hazardous Waste Sites 1. Radon 2.Abandoned HZ Waste Sites 2. Worker Exposure to Chemicals 3.Ozone Layer 3. Pesticides on Food 4.Accidental oil spills 4. Consumer exposure to chemicals 5.Water Pollution (Industry) 7. Indoor Air pollutants 6.Worker Chemical Exposure 8. Ozone depletion 7.(18) Pesticides on Food 13. Abandoned HZ Waste Sites 8.(26) Indoor Air Pollution 23. Point source discharge to water 9.(29) Radon 26. Accidental oil spills

51 Radon Mines

52 How can Physicians help, regarding Radon- induced lung cancer, given that the risk pales in comparison to the risk posed by smoking? ? Dr.’s Cory and Renee Stirling of Casper Patients Trust, Respect and Look To You For Guidance Regarding Their Health Talk to them about testing their homes for Radon

53 Easy Accurate Inexpensive Testing is:

54 Testing is the only way to know if you and your family are at risk Residential Construction Team

55 Radon Test Kits

56 Short-Term Testing Determines Radon Exposure POTENTIAL Long-Term Testing Determines Radon Exposure ACTUALITY Both Help Determine the Need for Radon Mitigation






62 New Homes Can Be Built With Radon Control Systems RADON VENT RADON VENT


64 Typical Cost of Radon Mitigation Retro-Fitting an Existing Home –Lowest Cost = $500.00 –Highest Cost = $3,000.00 + –Average Cost = $1,700.00 New Construction –Approximately $500 - $1,000 (Method Dependant)

65 Advantages of Radon Mitigation Systems Reduces Radon in the Home Reduces Excess Moisture in the Soil Helps to Control Mold Helps to Control Mildew Helps to Control Indoor Air Pollutants Helps to Control Asthma Triggers Increases Property Value of your Home Adds a Value-Added Feature to your Home

66 WDH maintains a listing of Radon Professionals 777-6015 Average Cost of a Radon Mitigation System is:$1,700.00 Cost Range = $500 to $2,500

67 Cost of Radon-Induced Lung Cancer Doctor’s Office Visits: $100.00’s +/ - Tests/CT Scans: $5,000.00 + / - Chemotherapy: $25,000.00 + / - Radiation Therapy: $25,000.00 + / - Follow-up Exams / Tests: $10,000.00 + / - Quality of Life Deterioration / Death?

68 National Environmental Health Association's National Radon Proficiency Program Measurement and mitigation contractors trained and certified by NEHA carry ID cards. Lists of certified individuals, labs and other helpful informationcan be found at: Lists of certified individuals, labs and other helpful information can be found at:

69 Testing is the only way to know if you and your family are at risk RADON TEST KIT COUPON Name ____________________________________________________________ Address __________________________________________________________ City, State, Zip _____________________________________________________ Phone ___________________________________________________________ Mail Coupon, & Make Check Payable to: Please Indicate Type of Kit & Amount *Wyoming Radon Program □ Short-Term Kit $5.00 *6101 Yellowstone Road □ Long-Term Kit $15.00 *Qwest Building; Room # 510 □ Water Test Kit $20.00 *Cheyenne, WY 82002

70 Radon Does NOT Have To Be A Problem ….. UNLESS….. You IGNORE It. For More Information Contact: Wyoming Department Of Health (307) 777-6015

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