International Residential Radon Project Radiation and Environmental Health Programme Department of...

International Residential Radon ProjectInternational Residential Radon Project

Radiation and Environmental Health ProgrammeRadiation and Environmental Health Programme

Department of Protection of the Human EnvironmentDepartment of Protection of the Human Environment

World Health Organization HQ - Geneva, SwitzerlandWorld Health Organization HQ - Geneva, Switzerland

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 inCrises(HAC)

General Management(GM)

Director General Office (DGO)

WHO HQWHO HQStructureStructure

Radiation & Environmental Health Program in WHORadiation & Environmental Health Program in WHO


Develop and promote evidence-based policy for Member States Develop and promote evidence-based policy for Member States that reduce risks and protect health from exposure to radiationthat reduce risks and protect health from exposure to radiation

Provide medical support and public health advice in case of Provide medical support and public health advice in case of major radiation accidents or terrorist eventsmajor radiation accidents or terrorist events

Build capacity and provide information to support national Build capacity and provide information to support national programsprograms

RAD MandateRAD Mandate


Ionizing Radiation Risk Factors by OriginIonizing Radiation Risk Factors by Origin

Natural background radiationNatural 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 applicationsMedical applications• Diagnostic X-raysDiagnostic X-rays

Radioactive pollutionRadioactive pollution• Chernobyl and other accidentsChernobyl and other accidents• Nuclear fallout and waste disposalNuclear fallout and waste disposal• Depleted uraniumDepleted uranium

Occupational exposureOccupational exposure• Nuclear workersNuclear workers• Cosmic radiation (Air crews)Cosmic radiation (Air crews)


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 RadiationEnvironmental Radiation• Radon in homes Radon 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 EvaluationOccupational Radiation Health Evaluation • Nuclear workersNuclear workers• Cosmic Radiation Cosmic 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 ProjectsWHO/RAD: Ionizing Radiation Projects


Scientific literature is now suggesting that 10% of lungScientific literature is now suggesting that 10% of lung

cancers are due to exposure to indoor radon.cancers are due to exposure to indoor radon.

People and politicians are not taking enough notice of People and politicians are not taking enough notice of this problem.this problem.

Mitigation is easilyMitigation is easily

There is a need for an international focus to raise There is a need for an international focus to raise awarenessawareness

RadonRadon


Scope:Scope: Establish a global project (3-year), with all key international and Establish a global project (3-year), with all key international and national partners participating, to identify and promote programs that national partners participating, to identify and promote programs that reduce the health impact of exposure to residential radonreduce the health impact of exposure to residential radon

Objectives:Objectives: Estimate the global health impact of exposure to residential radonEstimate the global health impact of exposure to residential radon Create a global database of residential radon exposureCreate a global database of residential radon exposure Identify effective measures to reduce radon's health impactIdentify effective measures to reduce radon's health impact Promote sound policy options and mitigation programs to Member StatesPromote sound policy options and mitigation programs to Member States Raise public and political awareness about the consequences of exposure to Raise public and political awareness about the consequences of exposure to

radonradon Monitor and periodically review mitigation measures to ensure effectivenessMonitor and periodically review mitigation measures to ensure effectiveness Provide annual reportsProvide annual reports

International Radon ProjectInternational Radon Project First Meeting of the Expert Group First Meeting of the Expert Group

Geneva, Switzerland - January 17-18, 2005Geneva, Switzerland - January 17-18, 2005


GBD is the GBD is the quantificationquantification of health impacts of health impacts (mortality and morbidity) caused by risk (mortality and morbidity) caused by risk factors at factors at population levelpopulation level, using a comparable , using a comparable and internally consistent framework, and internally consistent framework, definitions and outcome measures.definitions and outcome measures. A national burden of disease for radon has A national burden of disease for radon has already been completed in Canada: protocol already been completed in Canada: protocol could used for a full GBDcould used for a full GBD

Global Burden of DiseaseGlobal Burden of Disease


Why Assess GBD?Why Assess GBD?

Provides a global picture of health impacts from Provides a global picture of health impacts from risks associated with radonrisks associated with radon

Identifies problem areas to focus resources more Identifies problem areas to focus resources more effectivelyeffectively

Provides tools for identifying intervention Provides tools for identifying intervention measures and monitoring progressmeasures and monitoring progress


Mitigation programsMitigation programs

Provide policy options for national authorities that Provide policy options for national authorities that lead to a reduction in exposure to radonlead to a reduction in exposure to radon

Draft international limits on radon concentrations Draft international limits on radon concentrations in collaboration with appropriate international in collaboration with appropriate international and national agenciesand national agencies

Provide elements of model legislationProvide elements of model legislation Others?Others?


Advocacy and Risk CommunicationAdvocacy and Risk Communication

Draft scientific reports, fact sheets, press releases Draft scientific reports, fact sheets, press releases and other documents to raise public and political and other documents to raise public and political awareness of health concerns about radon awareness of health concerns about radon exposureexposure

What more would you like WHO to do to assist What more would you like WHO to do to assist national programs?national programs?


International Radon Project:International Radon Project:Shaping the Project IShaping 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 If recommendations were developed to encourage more risk reduction from radon, what would they say?from radon, what would they say?

• What are some key opportunities for WHO and us to raise visibility for What are some key opportunities for WHO and us to raise visibility for such recommendations?such recommendations?

• How can we get started to develop and implement a step-by-step How can we get started to develop and implement a step-by-step process?process?


International Radon ProjectInternational Radon ProjectShaping the Project IIShaping the Project II

Communication issuesCommunication issues

Measurement issuesMeasurement issues

Modeling issuesModeling issues

Cost issuesCost issues


International Radon ProjectInternational Radon ProjectShaping the Project III: WorkplanShaping the Project III: Workplan

Program elementsProgram elements

WorkgroupsWorkgroups

TimelinesTimelines


International Radon ProjectInternational Radon ProjectShaping the Project IV: ConclusionShaping the Project IV: Conclusion

Consensus statementsConsensus statements

Next stepsNext steps


Q1. What are the benefits of an international action agenda on Q1. What are the benefits of an international action agenda on radon?radon?

Provide scientific consensus on radon health risksProvide scientific consensus on radon health risks Promote public awareness of health risks associated with residential radonPromote public awareness of health risks associated with residential radon Promote action at national levelPromote action at national level Increase homeowner compliance with voluntary/advisory radon guidelinesIncrease homeowner compliance with voluntary/advisory radon guidelines Set minimum criteria for radon risk management (but allow for country Set minimum criteria for radon risk management (but allow for country

specific needs)specific needs)


Q2. If recommendations were developed to encourage more Q2. If recommendations were developed to encourage more risk reduction from radon, what would they say?risk reduction from radon, what would they say?

Better to install mitigation devices at the time of construction, rather than Better to install mitigation devices at the time of construction, rather than retrofitretrofit

Building codes provide a natural point of intervention for control of Building codes provide a natural point of intervention for control of residential radon (radon levels have increased substantially in Norway residential radon (radon levels have increased substantially in Norway because of the use of aerated concrete in foundations; indoor radon levels because of the use of aerated concrete in foundations; indoor radon levels are also increasing in Finland)are also increasing in Finland)

Radon testing and mitigation might also be required when an existing Radon testing and mitigation might also be required when an existing home is soldhome is sold

Control measures should focus on medium exposure levels, which Control measures should focus on medium exposure levels, which contribute most to the overall radon lung cancer burdencontribute most to the overall radon lung cancer burden

Since the vast majority of radon related lung cancers occur in smokers, 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 consideration needs to be given to the role of tobacco smoking in radon risk reduction programsrisk reduction programs

Unburned brick and open floors in homes in developing countries can lead Unburned brick and open floors in homes in developing countries can lead to elevated thoron levels to elevated thoron levels

Since resources will be required to implement radon risk reduction Since resources will be required to implement radon risk reduction measures, it is important to demonstrate the cost-effectiveness of such measures, it is important to demonstrate the cost-effectiveness of such measures (cost-effectiveness will vary with radon levels)measures (cost-effectiveness will vary with radon levels)


Q2 (cont’d). If recommendations were developed to encourage more Q2 (cont’d). If recommendations were developed to encourage more risk reduction from radon, what would they say?risk reduction from radon, what would they say?

Consideration needs to be given to both guidelines (as is the case in homes 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 in Britain) and enforceable regulations (as is the case in the workplace in Britain)Britain)

Both voluntary and enforceable guidelines may be useful for residential Both voluntary and enforceable guidelines may be useful for residential exposure (as is the case in Switzerland, where homes exceeding 1,000 exposure (as is the case in Switzerland, where homes exceeding 1,000 Bq/mBq/m33 must be mitigated) 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 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 areas in which 1% of homes exceed the action level in Britain) might be selectively targeted for testingselectively targeted for testing

Government grants might be used to support radon mitigation actions in 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 cases of need (may require a means test to administer this type of public support for mitigation)support for mitigation)


Q2 (cont’d). If recommendations were developed to encourage more Q2 (cont’d). If recommendations were developed to encourage more risk reduction from radon, what would they say?risk reduction from radon, what would they say?

Should Should schoolsschools be identified as an environment that require special be identified as an environment that require special consideration with respect to radon mitigation?consideration with respect to radon mitigation?

Should Should workers workers be included within the scope of this project? be included within the scope of this project? Should Should thermal spasthermal spas with high radon content in the water be included? with high radon content in the water be included? Should new buildings have a more stringent radon reference level than Should new buildings have a more stringent radon reference level than

existing buildings? (some EU countries have two reference levels, with a existing buildings? (some EU countries have two reference levels, with a lower level for new buildings)lower level for new buildings)

All new homes constructed since 1998 are required to have a radon sump 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 in Ireland (nonetheless, 10% of new homes still have radon levels above the action level of 200 Bq/mthe action level of 200 Bq/m33))


Q3. What are some key opportunities for WHO and us to Q3. What are some key opportunities for WHO and us to raise visibility for such recommendations?raise visibility for such recommendations?

Information programs describing radon as a public health issueInformation programs describing radon as a public health issue Future (open) meetings to develop WHO International Residential Radon Future (open) meetings to develop WHO International Residential Radon

ProjectProject Education materials are available in a number of countries: these might be Education materials are available in a number of countries: these might be

used to develop an “international” radon information kitused to develop an “international” radon information kit


Q4. How can we get started to develop and implement a step-Q4. How can we get started to develop and implement a step-by-step process?by-step process?

Consensus report from the present meetingConsensus report from the present meeting Action plan for WHO residential radon projectAction plan for WHO residential radon project Obtain international residential (and outdoor?) radon levels from Obtain international residential (and outdoor?) radon levels from

UNSCEARUNSCEAR Reference levels for radon in 20 European countries have been tabulated as Reference levels for radon in 20 European countries have been tabulated as

part of ERRICA 2 (advisory levels are largely between 200 and 400 part of ERRICA 2 (advisory levels are largely between 200 and 400 Bq/m3)Bq/m3)


Communication IssuesCommunication Issues

Information needs to be made available to the public on how to determine 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 radon levels in their homes, and on ways in which radon in homes can be reducedreduced

Need to put residential radon lung cancer risk in perspective, perhaps by Need to put residential radon lung cancer risk in perspective, perhaps by comparison with other agents included in the WHO GBD programcomparison with other agents included in the WHO GBD program

Studies have indicated that people may not elect to take voluntary action to 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 reduce radon in their homes, although this depends on the level of knowledge that they have on radon health risksknowledge that they have on radon health risks

Radon is the largest source of environmental exposure to ionizing radiation Radon is the largest source of environmental exposure to ionizing radiation (approx 40% of total exposure in Switzerland)(approx 40% of total exposure in Switzerland)

Radon is the second leading contributor to the global lung cancer burden, Radon is the second leading contributor to the global lung cancer burden, after tobacco smokingafter tobacco smoking


Communication Issues (cont’d)Communication Issues (cont’d)

Consider tools developed by ERRICCA 2 Project (European Radon Consider tools developed by ERRICCA 2 Project (European Radon Research and Industry Collaboration Concerted Action): website, public Research and Industry Collaboration Concerted Action): website, public awareness, protection of new building, mitigation, mapping and awareness, protection of new building, mitigation, mapping and measurement)measurement)


1993 WHO Europe Communications Guidelines1993 WHO Europe Communications Guidelines Countries should collect baseline information on existing attitudes and Countries should collect baseline information on existing attitudes and

perceptions about radon before initiating a risk communication perceptions about radon before initiating a risk communication programme.programme.

The goal of the radon communications programme should be to provide The goal of the radon communications programme should be to provide accurate scientific information to reduce radon health risks.accurate scientific information to reduce radon health risks.

Continuous evaluation and improvement of the risk communication Continuous evaluation and improvement of the risk communication programmes should be undertaken in order to achieve the overall programmes should be undertaken in order to achieve the overall communications goals.communications goals.

For special target audiences, appropriate (and possibly different) radon risk For special target audiences, appropriate (and possibly different) radon risk communication messages should be prepared.communication messages should be prepared.

Radon risk communication efforts should be linked to key issues, such as Radon risk communication efforts should be linked to key issues, such as the availability of qualified radon contractors and testing services. the availability of qualified radon contractors and testing services.

Messages should be repeated and reinforced; a one-time message will not Messages should be repeated and reinforced; a one-time message will not result in behavioural change.result in behavioural change.

Countries should be encouraged to share information and discuss new Countries should be encouraged to share information and discuss new findings in the area of radon risk communication.findings in the area of radon risk communication.


Measurement IssuesMeasurement Issues

Although homeowners may want quick monitoring results based on short-Although homeowners may want quick monitoring results based on short-term measurements, it is difficult to determine long-term exposure levels term measurements, it is difficult to determine long-term exposure levels on the basis of short-term measurementson the basis of short-term measurements

Adjustment for residential radon exposure measurement error results in Adjustment for residential radon exposure measurement error results in increased estimates of the lifetime relative risk – what are the implications increased estimates of the lifetime relative risk – what are the implications of exposure measurement error for estimating the population attributable of exposure measurement error for estimating the population attributable risk?risk?

Spatial patterns in radon concentrations may be related to geographic Spatial patterns in radon concentrations may be related to geographic characteristics, which may help in identifying “radon affected areas”characteristics, which may help in identifying “radon affected areas”

Twenty EU countries have carried out radon mapping to some extent under Twenty EU countries have carried out radon mapping to some extent under the ERRICCA 2 Project (by measuring indoor radon gas concentrations, by the ERRICCA 2 Project (by measuring indoor radon gas concentrations, by soil gas measurements, by geological mapping, and by other radiological soil gas measurements, by geological mapping, and by other radiological techniques)techniques)

Maps can be used to plan radon campaigns, to distribute radon dosimeters, Maps can be used to plan radon campaigns, to distribute radon dosimeters, for radon prevention in new buildings, and to increase public awarenessfor radon prevention in new buildings, and to increase public awareness

Mapping studies have designated 1/3 of Ireland as “high radon areas” Mapping studies have designated 1/3 of Ireland as “high radon areas” (HRAs)(HRAs)


Measurement Issues (cont’d)Measurement Issues (cont’d)

Identification of high radon areas by direct measurement may take some Identification of high radon areas by direct measurement may take some time (10 years in Switzerland)time (10 years in Switzerland)

Can measurements of less than one year be used to reliably predict annual Can measurements of less than one year be used to reliably predict annual residential radon concentrations (possibly using seasonal adjustment residential radon concentrations (possibly using seasonal adjustment models developed by Pinel et al., 1995, and Krewski et al., 2004)?models developed by Pinel et al., 1995, and Krewski et al., 2004)?


Modeling IssuesModeling Issues

Develop updated radon risk projection models based on BEIR Develop updated radon risk projection models based on BEIR VI (considering recent modifications by US EPA)VI (considering recent modifications by US EPA)

Develop updated risk projection models based on combined Develop updated risk projection models based on combined analysis of residential studies, including the ongoing analysis of residential studies, including the ongoing combining of European and North American studiescombining of European and North American studies

Consider the use of simple approximations to these models, Consider the use of simple approximations to these models, which provide insight into different indices of risk are inter-which provide insight into different indices of risk are inter-related, and on how to extrapolate results among different related, and on how to extrapolate results among different conditionsconditions

Characterize sources of uncertainty in radon risk projectionsCharacterize sources of uncertainty in radon risk projections


Main Program Elements I: Main Program Elements I: ScienceScience

Risk models – develop “WHO” model for Risk models – develop “WHO” model for projecting radon lung cancer risk (build on BEIR projecting radon lung cancer risk (build on BEIR VI and European and North American combined VI and European and North American combined analyses, including joint effects of tobacco analyses, including joint effects of tobacco smoking)smoking)

Radon database – develop global database on Radon database – develop global database on indoor (and outdoor?) radon levels; describe indoor (and outdoor?) radon levels; describe spatial variation in radon levels using mapping spatial variation in radon levels using mapping techniquestechniques

Population health impact – estimate global burden Population health impact – estimate global burden of disease for radonof disease for radon


Main Program Elements II:Main Program Elements II: Policy Policy

Exposure guidelines – develop WHO guidelines Exposure guidelines – develop WHO guidelines for residential radon exposure levelsfor residential radon exposure levels

Cost effectiveness – conduct economic analyses of Cost effectiveness – conduct economic analyses of alternative mitigation strategiesalternative mitigation strategies


Main Program Elements III: Main Program Elements III: Measurement and MitigationMeasurement and Mitigation

Measuring residential radon – recommend Measuring residential radon – recommend measurement methods for indoor radon measurement methods for indoor radon

Radon reduction – recommend technologies for Radon reduction – recommend technologies for reducing indoor radon levelsreducing indoor radon levels


Main Program Elements IV:Main Program Elements IV:CommunicationCommunication

Communications – develop communications Communications – develop communications materials to promote program to the public and to materials to promote program to the public and to national public health agenciesnational public health agencies


Main Program Elements V:Main Program Elements V:Program EvaluationProgram Evaluation

Effectiveness monitoring – track reductions in Effectiveness monitoring – track reductions in indoor radon concentrations related to radon indoor radon concentrations related to radon mitigationmitigation

Reporting – annual project reportsReporting – annual project reports


Work GroupsWork Groups

1.1. Risk assessment (risk modeling , GBD, and Risk assessment (risk modeling , GBD, and global radon database)global radon database)

2.2. WHO exposure guidelinesWHO exposure guidelines

3.3. Cost effectiveness (framework + analyses)Cost effectiveness (framework + analyses)

4.4. Measurement and mitigationMeasurement and mitigation

5.5. Risk communication (including education and Risk communication (including education and training)training)

6.6. Program coordination and evaluationProgram coordination and evaluation

[All groups should identify research and [All groups should identify research and information needs as part of their work]information needs as part of their work]


Timelines: Year 1Timelines: Year 1

Develop WHO residential radon risk projection modelDevelop WHO residential radon risk projection model Preliminary GBD estimates (based on approximate Preliminary GBD estimates (based on approximate

methods: need average radon concentration, lifetime risk methods: need average radon concentration, lifetime risk of dying of lung cancer, prevalence of ever-smokers, life-of dying of lung cancer, prevalence of ever-smokers, life-expectancy, geometric standard deviation of indoor radon expectancy, geometric standard deviation of indoor radon levels also useful)levels also useful)

Establish global radon databaseEstablish global radon database Review current residential radon exposure guidelines, and Review current residential radon exposure guidelines, and

recommend radon WHO radon guidelinesrecommend radon WHO radon guidelines Review current radon measurement methodsReview current radon measurement methods Review current methods of radon reductionReview current methods of radon reduction Outline main elements of communications strategyOutline main elements of communications strategy Develop framework for cost-effectiveness analysisDevelop framework for cost-effectiveness analysis Consolidate findings into first annual reportConsolidate findings into first annual report



Conduct GBD analysis for radonConduct GBD analysis for radon Map global residential radon levelsMap global residential radon levels Conduct cost-effectiveness analysis of alternative Conduct cost-effectiveness analysis of alternative

radon mitigation strategiesradon mitigation strategies Complete communications strategy and develop Complete communications strategy and develop

communications materials, including radon fact communications materials, including radon fact sheetssheets

Second annual reportSecond annual report



WHO Radon “Handbook” describing radon as a WHO Radon “Handbook” describing radon as a global population health issue (with input from all global population health issue (with input from all workgroups)workgroups)

International symposium on WHO Radon International symposium on WHO Radon Mitigation Program (showcasing WHO Mitigation Program (showcasing WHO Handbook)Handbook)

Program evaluation (impact on national public Program evaluation (impact on national public health agencies, changes in building codes, health agencies, changes in building codes, reduction in exposure, other impacts)reduction in exposure, other impacts)

Third annual reportThird annual report


Workgroup 1: Risk AssessmentWorkgroup 1: Risk Assessment J. ZielinskiJ. Zielinski S. DarbyS. Darby M. TirmarcheM. Tirmarche H. ParetzkeH. Paretzke D. ChambersD. Chambers M. KreuzerM. Kreuzer L. KreienbrockL. Kreienbrock K. BrandK. Brand D. KrewskiD. Krewski M. ZhukovskyM. Zhukovsky B. ShangB. Shang L. VeigaL. Veiga D. HillD. Hill M. PaviaM. Pavia E. WichmannE. Wichmann J. PuskinJ. Puskin S. AkibaS. Akiba B. FieldB. Field


Workgroup 2: Exposure GuidelinesWorkgroup 2: Exposure Guidelines

J. McLaughlinJ. McLaughlin E. EttenhuberE. Ettenhuber G. KendallG. Kendall D. Fenton (to be confirmed)D. Fenton (to be confirmed) A-L SodermanA-L Soderman T. StrandT. Strand B. Johnson B. Johnson H. YoneharaH. Yonehara


Workgroup 3: Cost-effectivenessWorkgroup 3: Cost-effectiveness

A. GrayA. Gray K. BrandK. Brand T. StrandT. Strand B. JohnsonB. Johnson Q. SunQ. Sun I. MakelainenI. Makelainen D. KrewskiD. Krewski


Workgroup 4: Measurement and MitigationWorkgroup 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)


Workgroup 5: Risk CommunicationWorkgroup 5: Risk Communication V. KoukouliouV. Koukouliou A-L. SodermanA-L. Soderman J. McLaughlinJ. McLaughlin G. PillerG. Piller H.H. LandfermannH.H. Landfermann L. QuindosL. Quindos Q. SunQ. Sun T. Strand T. Strand B. JohnsonB. Johnson H. WalkerH. Walker D. FentonD. Fenton


Workgroup 6: Program Monitoring and Workgroup 6: Program Monitoring and EvaluationEvaluation

Z. CarrZ. Carr B. JohnsonB. Johnson H. WalkerH. Walker A. GrayA. Gray A. AuvinenA. Auvinen V. KoukouliouV. Koukouliou


Consensus StatementsConsensus Statements For many people, radon represents the largest source of exposure to ionizing For many people, radon represents the largest source of exposure to ionizing

radiation in humans. 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 Radon is an important contributor to the human lung cancer burden, after tobacco smoking.smoking.

Radon is considered to be responsible for some 10% of the human lung cancer Radon is considered to be responsible for some 10% of the human lung cancer burden in developed countries/worldwide (will differ between developed and burden in developed countries/worldwide (will differ between developed and undeveloped countries)undeveloped countries)

The BEIR VI Report estimated that there are approximately 22,000 deaths The BEIR VI Report estimated that there are approximately 22,000 deaths annually from radon in the United States alone. (annually from radon in the United States alone. (Add European results here)Add European results here)

Radon related lung cancer risk is affected by tobacco smoking, with most radon 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 related lung cancers occur in smokers; however, radon is one of the leading causes of lung cancer in nonsmokers.of lung cancer in nonsmokers.


Consensus Statements (cont’d)Consensus Statements (cont’d) Radon should be a priority public health issue for national environmental and Radon should be a priority public health issue for national environmental and

radiation safety programsradiation safety programs

There is a need to carefully evaluate the costs and benefits of national and There is a need to carefully evaluate the costs and benefits of national and international radon mitigation programs. international radon mitigation programs.

Based on existing knowledge of geological conditions and building types, Based on existing knowledge of geological conditions and building types, and consideration of the total lung cancer burden, countries should consider and consideration of the total lung cancer burden, countries should consider developing cost-effective national or regional policies on testing and developing cost-effective national or regional policies on testing and mitigationmitigation

Where appropriate, countries should build capacity within the public and/or Where appropriate, countries should build capacity within the public and/or private sectors to provide testing, mitigation, and radon-resistant new private sectors to provide testing, mitigation, and radon-resistant new constructionconstruction

Where appropriate, countries should issue and widely disseminate statements Where appropriate, countries should issue and widely disseminate statements which address the importance of radon risk reduction and the steps that can which address the importance of radon risk reduction and the steps that can be taken to reduce such risksbe taken to reduce such risks


Consensus Statements (cont’d)Consensus Statements (cont’d)

Countries should explore ways to address radon health risks in a cost-effective Countries should explore ways to address radon health risks in a cost-effective manner, considering both the installation of preventive measures in new manner, considering both the installation of preventive measures in new buildings and remediation of existing buildings. buildings and remediation of existing buildings.

National governments should team with other stakeholders to ensure radon risk National governments should team with other stakeholders to ensure radon risk communication messages are delivered from multiple sourcescommunication messages are delivered from multiple sources

Governments should strive to include radon health messages and action steps Governments should strive to include radon health messages and action steps with other national efforts on green buildings, housing policy, and the built with other national efforts on green buildings, housing policy, and the built environment.environment.


Towards the WHO Radon GuidelineTowards the WHO Radon Guideline

Immediate remedial action at levels exceeding 1000 Bq/mImmediate remedial action at levels exceeding 1000 Bq/m33

Guideline of maximum of 400 Bq/mGuideline of maximum of 400 Bq/m3 3 for existing homes for existing homes

Guideline of 200 Bq/mGuideline of 200 Bq/m3 3 for new homes for new homes

Efforts should be made to reduce radon to even lower levels, where 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 possible, since there is still some risk of lung cancer below the above guidelines guidelines

Group recommended giving risk at different proposed guideline levels, Group recommended giving risk at different proposed guideline levels, for smokers and nonsmokers.for smokers and nonsmokers.

Explain role of smoking in relation to radon risk?Explain role of smoking in relation to radon risk?


Next Steps & Related ActivitiesNext Steps & Related Activities

Next annual meeting: January 23-26, 2006 in Geneva) [Next annual meeting: January 23-26, 2006 in Geneva) [WHO GenevaWHO Geneva]] Four page fact sheet on radon (what radon is, characterizes health effects, testing Four page fact sheet on radon (what radon is, characterizes health effects, testing

and mitigation techniques known and easily implemented, cost effectiveness of and mitigation techniques known and easily implemented, cost effectiveness of exposure reduction, raise awareness, what WHO will do) (May 30, 2005) [exposure reduction, raise awareness, what WHO will do) (May 30, 2005) [WHO WHO GenevaGeneva]]

Press conference to launch WHO project (June, 2005) [Press conference to launch WHO project (June, 2005) [WHO GenevaWHO Geneva]]


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International Residential Radon Project Radiation and Environmental Health Programme Department of...

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