Environmental Medicine Integrating a Missing Element into Medical Education (1995) / Chapter Skim
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Case Study 38: Radon Toxicity
Case Study 38: Radon Toxicity
Pages 674-694
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From page 674... ...
The combination of smoking and radon exposure results in an especially serious health risk. The risk of lung cancer due to indoor radon exposure can be decreased with current technology.
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From page 675... ...
There is no cyanosis or clubbing of the extremities, and there are no palpable lymph nodes. Blood tests, including a complete blood count and chemistry panel, are normal, with the exception of a total Venom calcium level of 12.7 mg/dL (normal range: 9 2 to 1 1 .0 rng/dL)
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Normally, construction materials do not contribute significantly to indoor radon levels. In rare cases, however, building materials themselves have been the main source of radioactive gas.
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Groundwaterthat comes from deep subterranean sources and passes over rock rich in radium, such as that found in northern New England, may dissolve some of the radon gas produced from radium decay. As the water splashes during showering, toilet flushing, dishwashing, and laundering, radon is released into the air and may result in inhalation exposure.
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Hazarc/ Assessment O Radon can be detected only by testing. O EPA recommends remediation for homes with radon levels at or above 4 pCi/L.
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In colder climates, radon levels are often higher in the winter and lower in the summer. O For a lifetime exposure at EPA's recommended guideline of 4 pCI/L, EPA estimates that the risk of developing lung cancer is 1% to 5%, depending on whether a person is a smoker, former smoker, or nonsmoker.
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From page 680... ...
8 pCilL About 57 people could Fix your home get lung cancer 4 pCilL About 29 people could - 100 times the risk of dying Fix your home get lung cancer in an airplane crash Consider fixing 2 pCilL About 15 people could ~ 2 times the risk of dying between 2 and 4 pCilL get lung cancer in a car crash 1.3 pCilL About 9 people could (Average indoor radon level) (Reducing get lung cancer radon levels below 0.4 pCilL About 3 people could (Average outdoor radon level)
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It has become standard practice in some states to measure radon levels in homes at the time of real estate transactions. The amount of radon emanating from the earth and concentrating inside homes varies considerably by region and locality.
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Due to the many determinants of indoor radon levels, local geology alone is an inadequate predictor of risk. Currently, the only way to determine indoor radon concentration is by testing.
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Physiologic Effects Radon exposure causes no acute or subacute health effects, no irritating effects, and has no warning signs at levels normally encountered in the environment. The only established human health effect currently associated with residential radon exposure is lung cancer.
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When these emissions occur within the lungs, the genetic material of cells lining the airways can be damaged, resulting in lung cancer. The risk of lung cancer due to radon exposure is thought to be second only to that of smoking.
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The most effective methods of prevention are reduction of radon exposure and modification of other simultaneous risk factors for lung cancer, such as smoking. Smoking cessation coupled with detection and mitigation of high radon levels is currently the only long-term solution for reducing the risk of lung cancer.
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From page 686... ...
The Swedish government plansto spend approximately $1000 per home reducing high radon levels, resulting in about $10,000 of cost per life spared. EPA estimates that the cost of remediation in most homes is less than $1500.
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Using vapor barriers around the foundation, sealing cracks and holes with epoxies and caulks, and sealing the crawl space from the rest of the house are all methods with some application. Subslabdepressurization can reduce radon levels by es much as 99%.
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From page 688... ...
About 0.4 pCI/L of radon is normally found in outside air. Currently, no regulations mandate specific radon levels for indoor residential and school environments.
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From page 689... ...
Kerr RA. Indoor radon: the deadliest pollutant.
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Health hazards associated with elevated levels of indoor radon—Pennsylvania. Atlanta: US Department of Health and Human Services, MMWR 1985; 34: 657-8.
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639-6204. State Radon Contacts Congress has mandated that each state set up an office to deal with requests for assistance.
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for evaluation before treatment. Depending on histologic type, local extension into adjacent anatomical structures, presence of metastases, and the general health of the patient, treatment options would include surgical excision, radiation, chemotherapy, and possibly immunotherapy.
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From page 693... ...
Even if the neighbors were exposed to the same radon levels, they would not be at equal risk of health effects. The risk of lung cancer to each occupant does not depend only on the radon level, but also on the occupants themselves and their lifestyles.
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From page 694... ...
EP^ Commends man i1 1he radon ieveUndoors ~ above 4 pCi/L: 1he n~lonai goal ~ ~ reduce indoor radon Ives 10 outdoor ieve~, a~u10.4 pCkL. CieaMy the schoors dassmoms exceed these levee.
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