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Re: Radon and Never Smokers
Indeed an interesting study. Thanks Jim for bringing it to our attention.
Some comments:
1) The relative risks presented in Table 5 adjusted with missing data
imputed. They state the relative risk as 1.55 for radon concentrations
greater than 140 Bq/m^3. From Table 4, concentrations greater than 200
Bq/m^3 (with imputed data) give a RR of 1.067 [Cases: 13/258; Controls:
23/487]. Big difference. New math?
2) Looking over Table 4, there really isn't a discernible difference
between the cases and controls. Any differences in percentages can easily
be swayed by one or two cases (or controls) improperly grouped.
3) It doesn't look like Sweden has a genuine radon problem. The control
distribution of radon concentration should represent the country at large.
In such case, less than 5% of the population is exposed to radon
concentration more than 200 Bq/m^3 (the European action level for new
construction) and 0.6% of the population is exposed to radon concentrations
more than 400 Bq/m^3 ( the action level for existing structures).
4) I would have liked to see the authors include higher categories of radon
concentrations, such as 800 and 1200 Bq/m^3, since these levels do exist
and are biologically more important. Using administrative values as data
cutoff point is OK as long as higher cutoff values are presented for
comparison (i.e., 400 Bq/m^3 to infinity represents an enormous spectrum of
concentrations).
Tom
Jim Nelson wrote:
>
> Interesting article recently published.
> http://www.epidem.com/article.asp?ISSN=1044-3983&VOL=12&ISS=4&PAGE=396
>
> Residential Radon and Lung Cancer among Never-Smokers in Sweden
>
> Frédéric Lagarde1; Gösta Axelsson2; Lena Damber3; Hans Mellander4; Fredrik
> Nyberg1; Göran Pershagen1,5
>
> >From the 1Institute of Environmental Medicine, Karolinska Institutet,
> Stockholm;
> 2Department of Environmental Medicine, Göteborg University, Gothenburg;
> 3Department of Oncology, University Hospital, Ume;
> 4Swedish Radiation Protection Institute, Stockholm; and
> 5Department of Environmental Health, Stockholm County Council, Stockholm,
> Sweden.
>
> EPIDEMIOLOGY 2001;12:396-404
>
> --------------------------------------------------------------------------------
>
> In this study, we attempted to reduce existing uncertainty about the
> relative risk of lung cancer from residential radon exposure among
> never-smokers. Comprehensive measurements of domestic radon were performed
> for 258 never-smoking lung cancer cases and 487 never-smoking controls from
> five Swedish case-control studies. With additional never-smokers from a
> previous case-control study of lung cancer and residential radon exposure in
> Sweden, a total of 436 never-smoking lung cancer cases diagnosed in Sweden
> between 1980 and 1995 and 1,649 never-smoking controls were included. The
> relative risks (with 95% confidence intervals in parentheses) of lung cancer
> in relation to categories of time-weighted average domestic radon
> concentration during three decades, delimited by cutpoints at 50, 80, and
> 140 Bq m–3, were 1.08 (0.8–1.5), 1.18 (0.9–1.6), and 1.44 (1.0–2.1),
> respectively, with average radon concentrations below 50 Bq m–3 used as
> reference category and with adjustment for other risk factors. The data
> suggested that among never-smokers residential radon exposure may be more
> harmful for those exposed to environmental tobacco smoke. Overall, an excess
> relative risk of 10% per 100 Bq m–3 average radon concentration was
> estimated, which is similar to the summary effect estimate for all subjects
> in the main residential radon studies to date.
>
> Keywords: case-control study; lung neoplasms; risk assessment; radon;
> never-smokers; cocarcinogenesis; tobacco smoke pollution; environmental
> exposures
>
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--
Thomas Mohaupt, M.S., CHP
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