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Radon and Healthy Housing: What’s
Happening Now, What’s in Store for the Future
Bill LongUS EPA
Acknowledgements
• Antonio Neri MD, MPH• Medical Epidemiologist• CDC Comprehensive Cancer Control Branch
• R. William Field, PhD, MS• Professor, Department of Occupational and
Environmental Health• Department of Epidemiology, College of Public Health,
University of Iowa
• Phil Jalbert• US EPA radon program
Radon Decay
Products
Lead-210Lead-210
Polonium-214Polonium-214
Bismuth-214Bismuth-214
Lead-214Lead-214
Polonium-218Polonium-218
Radon-222Radon-222
Lead-206Lead-206
Polonium-210Polonium-210
Bismuth-210Bismuth-210
22 yrs22 yrs
4 day
3 min
27 min
20 min
0.2 ms
5 day
138 day
Stable
Po-218 and Po-214deliver the majority of radiation dose to
the lung.
Ionizing radiation can directly and indirectly damage DNA
Alpha Alpha ParticleParticle
Defects in tumor suppressor genes – p53
At risk individuals–GSTM1
(glutathione S-transferase M1)
Dou
ble
–stra
nd
Dou
ble
–stra
nd
DN
A br
eaks
DN
A br
eaks
Free
radi
cal
Free
radi
cal
form
atio
n
form
atio
n
Reading Reading ProngProng
From NCRP Report No. 160, “Ionizing Radiation Exposure of the Population of the
United States” (2009)
U.S. Radon PotentialU.S. Radon Potential
Based on geology and Based on geology and
surveyssurveys
Expected closed Expected closed
building radon (pCi/L):building radon (pCi/L):
Zone 1: 4.0 and aboveZone 1: 4.0 and above
Zone 2: between 2.0 & Zone 2: between 2.0 &
4.0 4.0
Zone 3: 2.0 and lowerZone 3: 2.0 and lowerEPA Radon Action Level 4 pCi/L
National Academy of SciencesNational Academy of SciencesBEIR VI 1999BEIR VI 1999
• Risk estimates based primarily on radon-exposed miners
• Estimated 18,600 lung cancer deaths each year in the U.S. from residential radon exposure
BEIR VI Conclusions Serious public health problem
Second-leading cause of lung cancer
No evidence of a threshold
Effects of Radon & Smoking more powerful in combination
Radon contributed to 15K or 21K US lung cancer deaths in 1995 [2,100 or 2,900 in never smokers].
Reduction of residential radon levels above 4 pCi/L could prevent approx. 1/3 of the annual deaths
Residential Radon Case-Control Residential Radon Case-Control Around the World Around the World
European StudiesEuropean Studies
13 Studies from 9 Countries• Austria• Czech Republic• Finland [nationwide]• Finland [south]• France• Germany [eastern]• Germany [western]• Italy• Spain• Sweden [nationwide]• Sweden [never smokers]• Sweden [Stockholm]• United Kingdom
• Total 7,148 cases and 14,208 controls
North American StudiesNorth American Studies
• 7 Studies from 2 countries:• New Jersey• Winnipeg• Missouri I [non-smoking
women]• Missouri II [women]• IowaIowa• Connecticut• Utah-South Idaho
• Total 3,622 cases and 4,966 controls
In 2003, the EPA updated the BEIR VI risk
estimates to 21,000 radon-related lung
cancer deaths each year in the United States.
http://www.epa.gov/radon/risk_assessment.html
EPA Radon Assessment Results
Modified & extended the NAS BEIR VI report [consultation with SAB and NAS panel members]
Best estimate of US population risk in homes is about 21,000 lung cancer deaths per year. [At US average indoor radon conc.]
Current Risks at Action Level Smokers 6/100 Never Smokers 7/1000
Cancer Statistics 2014CA: A Cancer Journal for CliniciansVolume 64, Issue 1, pages 9-29, 7 JAN 2014 DOI: 10.3322/caac.21208http://onlinelibrary.wiley.com/doi/10.3322/caac.21208/full#caac21208-fig-0001
CANCER MORTALITY – 2014
CANCER TYPE ESTIMATED U.S. DEATHS in 2014
1. Lung and Bronchus 159,260
2. Colon and Rectum 50,310
3. Breast Cancer 40,430
4. Pancreas 39,590
5. Prostate 29,480
6. Leukemia 24,090
7. Liver and Bile Duct 23,0008. Lymphoma 20,1709. Urinary Bladder 15,580
10. Esophagus 15,450
11. Ovary 14,270
12. Kidney and Renal Pelvis 13,860
13. Myeloma 11,090
14. Stomach 10,990
15. Melanoma - skin 9,710
CANCER MORTALITY – 2014
CANCER TYPE ESTIMATED U.S. DEATHS in 2014
1. Lung and Bronchus 159,2602. Colon and Rectum 50,3103. Breast Cancer 40,4304. Pancreas 39,5905. Prostate 29,4806. Leukemia 24,0907. Liver and Bile Duct 23,000 Radon- Induced Lung Cancer 21,0008. Lymphoma 20,1709. Urinary Bladder 15,58010. Esophagus 15,45011. Ovary 14,27012. Kidney and Renal Pelvis 13,86013. Myeloma 11,09014. Stomach 10,99015. Melanoma - skin 9,710
Toxic Substances Control Act (TSCA)Title III (1988)
Indoor Radon Abatement Act (IRAA)
• Section 306. Grant Assistance to States for Radon Programs• Governor Designates the Recipient• Recipient can be a Department, Agency or State Institution,
e.g., University• EPA Responsibilities Delegated to Regional
Administrators & Assistant Administrator for OAR
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21,000 Radon-related U.S. Lung Cancer Deaths Annually21,000 Radon-related U.S. Lung Cancer Deaths AnnuallyLeading Environmental Cause of Cancer MortalityLeading Environmental Cause of Cancer Mortality
Long-term Exposure to 1.25 pCi/LLong-term Exposure to 1.25 pCi/LAverage Indoor Radon Level in U.S. HomesAverage Indoor Radon Level in U.S. Homes
7,083,0007,083,000Homes ≥4pCi/L Homes ≥4pCi/L
2 ways to reduce risk: mitigate high homes; build homes 2 ways to reduce risk: mitigate high homes; build homes radon-resistantradon-resistant
EPA Radon ProgramEPA Radon Program
Radon
• Interventions• ≤ $20 / test, $300 – $2,000 remediate
• < $250 – $750 to build radon resistant homes
• EPA $8 million to state radon programs/yr• education, testing, remediation, policy-related radon activities
• Intervention = ↓ exposure• Vent air from under house
• Seal basement cracks
• Laws• 28 states + DC have laws specific to radon
• Req. testing, Req. Disclosure, Voluntary Testing
• Radon-Resistant New Construction o Int’l Building Code adoption
Website: http://sktelokkalong.co.cc/buy-radon-test-kit
States with Radon-specific Cancer Activities 2005 – 2011
Tribes and Territories with Radon-specific Cancer Plan Activities include: Alaska Native Tribal Healthcare Corporation, Fon du Lac Tribe,Northern Plains Native American Tribal CCC Program, Tohono O'odham Tribe, and Guam.
Note that Alaska, Hawaii, and DC do not have radon-specific cancer plan activities
States with Radon-specific Laws in 2014 *
* Washington, DC has one radon-specific law. The ELI database does not review or track radon laws for tribes
Annual Radon-related Lung Cancer Deaths
State16-20 Draft
Annual Radon-related Lung Cancer Deaths
State17-20 Draft
Progress on Risk Progress on Risk ReductionReduction
7.1M Homes ≥4pCi/L7.1M Homes ≥4pCi/LMitigate existing homes (2 – 4 pCi/L)
•1,244,000 mitigation systems installed since 1986•9,100 lives saved (lung cancer deaths avoided)•1,542 mitigated homes saves 1 life•Multi-pronged demand/supply strategy (partnerships [ELI, CRCPD, NCSL, NEHA, KSU], PSAs, real estate, home inspection, stakeholder trainings)
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State Indoor Radon Grant State Indoor Radon Grant (SIRG) Program(SIRG) Program
• 45 states participating
• 5 Not Participating (NH, MD, LA, AR, HI)
• Tribes: FY2013 10 Awards = Tribes: FY2013 10 Awards = $304,000$304,000
Philip Jalbert343.9431,
[email protected]://www.epa.gov/radon/
sirgprogram.html
Federal Radon Action Plan• Federal leadership required to accelerate action on
radon risk reduction – a key Healthy Homes concern
• An example of Inter-Agency Collaboration (USDA, DOD, DOE, EPA, GSA, HHS, HUD, DOI, VA)
• A special focus on families and low income communities
Framework for Federal Action: Our Areas of Focus
• Demonstrate Importance of radon risk reduction
• Provide Incentives to encourage testing and mitigation
• Build Demand for testing and mitigation
Key Milestones Tracking Our ProgressNov 2010: Held Federal Radon Summit where agencies agreed to develop the Federal Radon Action Plan
Jun 2011: Launched the Action Plan at the Healthy Homes Conference
Jan 2012: Released the Action Plan Scorecard
Aug 2012: Celebrated one-year anniversary at CDC’s National Cancer Conference in Washington DC
Feb 2013: Released the Accomplishments Report in conjunction with the unveiling of the Advancing Healthy Housing – A Strategy for Action.
Agency Green – Completed Yellow – On Track Red – No Progress
USDA 6
DoD 1 1 1
DOE 2 2
EPA 1 1
GSA 1 1
HHS 2 1
HUD 3 1
DOI 2 1
VA 1 1
Multi 1 3
TOTAL 19 12 2
33 Total CommitmentsTo access Scorecard visit www.epa.gov/radon/action_plan.html
Status of Commitments
www.epa.gov/radon
Build Demand for Testing & Mitigation
• The Department of Housing and Urban Development (HUD) wrote new radon testing and mitigation requirements for their multifamily housing mortgage insurance programs, estimated to reach 105,000 housing units in 2013.
• The Environmental Protection Agency (EPA) is investing in 4 new standards of practice. New provisional standard for radon mitigation in multifamily housing released this year.
Provide Incentives to Encourage Testing and Mitigation
• The Department of Agriculture (USDA) issued new secretary-level guidance to all of its field office housing, community, loan (~301K this year), and public information programs to promote radon mitigation and new construction.
Demonstrate the importance of radon testing & mitigation
•The Department of Health and Human Services reported that 27 CDC sponsored state five-year cancer plans now include radon, representing 41% of existing cancer plans.
– Of that total, two cancer programs have included radon activities for the first time and two have expanded radon activities within their plans.
Moving Forward: Leadership, Leverage and Visibility
Priorities for the Near-term Future
•Federal Radon Action Plan (FRAP)•Allied Leaders•Partnerships with NGOs•Standards of Practice•Code adoption•Labelling programs
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