Lesson 2

Why is radon a health problem?

Radon and lung cancer

• Radon is largest source of radiation exposure to general public • Radon is leading cause of lung cancer among nonsmokers – Only cigarette smoking causes more deaths from lung cancer – Radon causes more deaths than secondhand smoke • Reducing radon in homes could reduce radon-related lung cancers by about 1/3 – Home inspectors can help when they measure radon levels accurately Slide 2-1

What do you hear people say about radon?

Radon can’t really hurt you. The only problem is those government alarmists, who are always trying to scare us about some environmental hazard. There’s really nothing to worry about.

Have you heard statements like this?

Do you agree with this statement?

Slide 2-2

The facts about radon

• All radon studies confirm the connection between radon exposure and lung cancer • Respected national and international organizations agree that radon causes lung cancer • American Lung Association • American Medical Association • American Public Health Association • National Academy of Sciences • U.S. Centers for Disease Control and Prevention • U.S. Environmental Protection Agency • World Health Organization Slide 2-3

Can you fill in the numbers?

• Annual deaths (1995) from lung cancer:

???

• Total radon-related deaths per year:

???

• Average years of life lost for radon-related lung cancer:

???

Slide 2-4

Radon and lung cancer

• Annual deaths (1995) from lung cancer: 146,400 • Total radon-related deaths per year: 21,000 (14%) • Average years of life lost for radon-related lung cancer: 17 Slide 2-5

How radon harms the lungs

• Radon gas is inhaled • Radon decay products become trapped in the lungs • As products decay, some release alpha radiation • Radiation damages lung tissue • Even very small exposures to radon can cause lung cancer – No known safe level of radon • Radon causes no immediate symptoms – Lung cancer usually occurs 5 to 25 years after exposure • Cancer cells spread to other parts of the body

Lung cancer is deadly

• The leading cause of cancer death for men and women – Kills more people than colon, breast, and prostate cancers combined • 60% of people with lung cancer die within 1 year of diagnosis • 70-80% die within 2 years of diagnosis Slide 2-7

Radon and other health concerns

• No evidence that radon causes other respiratory diseases, such as asthma Slide 2-8

Cancer deaths from radon in tap water

Total 168 cancer deaths per year related to radon in water Lung cancer from breathing radon released by water—as in showering or washing dishes— accounts for 89% of those deaths

Lung cancer 89% Stomach cancer 11%

Stomach cancer from swallowing water that contains radon accounts for 11% of those deaths Slide 2-9

Match cause with estimated deaths per year

25,000 20,000 15,000 10,000 5,000 0

21,000

Radon

17,400 8,000 3,900 2,800

Drunk driving Falls in the home Drownings Home fires Cause

Drownings Drunk driving Falls in the home Home fires Radon Slide 2-10

Relative risk: estimated deaths per year

25,000 20,000 15,000 10,000 5,000 0

21,000

Radon

17,400 8,000 3,900 2,800

Drunk driving Falls in the home Drownings Home fires

Slide 2-11

Risk factors

• Duration of exposure Longer exposure time = greater risk • Levels of radon Higher levels = greater risk • Smoking In combination with radon exposure = greater risk DANGER Lungs at work Slide 2-12

Radon concentrations in the air

Average outdoor Average indoor Consider fixing the home Action level: fix the home Picocuries/liter (pCi/L) 0.4

1.3

2-under 4 4 or above Action level is based on level that can be achieved technically. It is not based on health standards. No known level of radon is safe.

Slide 2-13

How common are high radon levels?

EPA estimates that

1 in 15 U.S. homes

has a radon concentration at or above the action level of 4 pCi/L Recall: EPA also estimates that reducing radon in homes could reduce radon related lung cancers by about one-third Slide 2-14

Radon risk for people who never smoked

Radon level (pCi/L) 20 10 8 4 2 If 1,000 nonsmokers were exposed to this radon level, the number who could get lung cancer after lifetime exposure* 36 Lung cancer risk equal to** 35 times the risk of dying by drowning 18 15 20 times the risk of dying in a home fire 4 times the risk of dying in a fall 7 4 The risk of dying in a car crash The risk of dying from poison

Slide 2-15

Radon level (pCi/L) 20 10 8 4 2

Radon risk for smokers

If 1,000 smokers were exposed to this level, the number who could get lung cancer after lifetime exposure* 260 150 120 62 32 Lung cancer risk equal to** 250 times the risk of dying by drowning 200 times the risk of dying in a home fire 30 times the risk of dying in a fall 5 times the risk of dying in a car crash 6 times the risk of dying from poison

Radon risk comparison

Estimated number of people who could get lung cancer per 1,000 people exposed over a lifetime Radon level (pCi/L) 20 10 8 4 2 1.3

0.4

People who never smoked 36 18 15 7 4 2 People who smoke 260 150 120 62 32 20 3

Slide 2-17 See handout 2-1

National Health Advisory 2005

Richard Carmona U.S. Surgeon General “Indoor radon is the second leading cause of lung cancer in the United States … Breathing it over prolonged periods can present a significant health risk to families all over the country. It’s important to know that this threat is completely preventable. Radon can be detected with a simple test and fixed through well-established venting techniques.” Slide 2-18

Role play activity

• Two characters – Home inspector – Client • Action – Home inspector is trying to persuade a client to have a home tested – Client is reluctant – Home inspector emphasizes health issues Slide 2-19

After the activity

• Inspector – What arguments did you use to convince the client to have home tested?

– Could you have been more persuasive?

• If so, how?

• Client – Did the inspector convince you?

• Why or why not?

– Could the inspector have been more persuasive? • If so, how?

Slide 2-20

Summary

Radon is known to cause lung cancer Estimated radon-related deaths each year: 21,000 Reducing radon in homes could reduce radon-related lung cancers by about 1/3 EPA action level: 4 pCi/L When people breathe in radon and its decay products, radioactive particles get trapped in the lungs – As particles decay, they damage lung tissue – With long-term exposure, damage increases risk of lung cancer Slide 2-21

Summary

Chances of developing lung cancer depend on • Duration of exposure • Level of radon in the home • Smoking – Greatly increases the risk of developing lung cancer Slide 2-22

Questions?

• About why radon is a health problem Slide 2-23

Check your understanding

• See handout 2-2 Slide 2-24