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Re: radon - documentation of exposure histories for Iowa study
Dear Don and Don, anf other rad fears,
I had the highest test scores in Epidemiology at UCB PH 40 years ago, but did not go into public health because political requirements dictated
selection. "Right" result or no more job. Familiar?
Please enlighten me:
1.Does location selection (Iowa) devalue conclusions for the rest of the USA? Iowa females are in a 1% outlier of the earlier USA study (Cohen's)!
2. Do small numbers (431 cases) inhibit proper matching of controls? Recommended procedure requires non-smoking cases and controls, or all smoking
cases and controls. "Adjustment" statistically has unproven assumptions, like LNT. Presumptious?
3. Do other studies support a 0.5 -1 rem/year supplement (4x background)? Consider, a, cancer rates (less where higher background radiation), b,
nuclear worker exposure (cancer resistance and longevitybetter where > 0.5 rem extra), c. Animal wound healing, coronary surgical stent restenosis
rate, bomb survivor data, etc, show benefit from low dose radiation.
Public health requires radiation source choice, with benefits like iodized salt choice. I am planning placebo control studies.
Howard Long
Rad health wrote:
> Dr. Long,
>
> I am not sure how much epidemiology you took in school, but it appears you
> never got past the chapter on double blind clinical trials. I have no idea
> what you are talking about.
>
> By the way, if you are such a critic of everyone else, what is keeping you
> from performing your own studies (double blind of course)?
>
> Truly,
> Don Nelson Epidemiologist
> Don Smith Epidemiologist
>
> >From: hflong@postoffice.pacbell.net
> >Reply-To: hflong@postoffice.pacbell.net
> >To: Rad health <healthrad@HOTMAIL.COM>
> >CC: radsafe@list.vanderbilt.edu
> >Subject: Re: radon - documentation of exposure histories for Iowa study
> >Date: Tue, 15 Jan 2002 16:19:04 -0800
> >
> > "Association". So 431 cases of lung cancer (86% smokers, therefore only
> >58 non-smokers) had more radon in their homes than "controls", (only 32% of
> >whom smoked). "Adjustment" statistically, is to replace data from truly
> >matched "controls"?! Why bother with double-blind placebo tests, with such
> >great effort to truly match controls?
> >
> >And that presumption was in the 1% exception in a nationwide study with
> >100,000 deaths from lung cancer not showing INVERSE association with home
> >radon. You infer to the total population of the USA from a selected, 1%
> >outlier (which could have had silo poisoning or other unknown
> >common to both smokers and radon level)?
> >
> > Why not properly control, with all smokers or all non-smokers, instead of
> >trusting in select statistical "adjustment"? "Difficult" - an admission of
> >numbers too small to properly match controls - as in the NSWS with >4,000
> >cancer deaths, that showed 25% better cancer resistance with >.5 rem than
> ><.1 rem (according to its TAC member, John Cameron).
> >
> >Howard Long
> >
> >Rad health wrote:
> >
> > > Jim Muckerheide,
> > >
> > > Ray Johnson may not be an epidemiologist, but the point was that Ray
> >knows a
> > > few things about radon exposure assessment. As far as Phillipe Dupont,
> >he
> > > is a frequent poster of emails on your Radiation and Science listserv
> >and an
> > > known anti LNT proponent.
> > >
> > > If the Iowa study did not find an association, then they may have said
> >the
> > > power was insufficient to detect an association as is likely the case in
> > > many studies with poor exposure ascertainment. But, the Iowa study did
> >find
> > > an association so therefore the sample size was of sufficient power to
> > > detect an association.
> > >
> > > I saw your "explanation" given to Les. It was nonsensical to me as it
> > > apparently was to Les. As far as your misrepresentations, I am not sure
> > > where to start. The latest item you have tried to mislead people with
> >is
> > > that the Iowa Study did not obtain individual exposure histories for
> >each
> > > subject. Your insistence is that because someone lives in Iowa, that
> >have to
> > > be exposed to high radon levels. As Les, pointed out. In the Iowa
> >study
> > > half, the people in the study were exposed to less than 4 pCi/L (average
> > > 15--year exposure). Their exposure data was log normally distributed
> >(that
> > > means they had a lot of data for lower exposed individuals).
> > >
> > > The Iowa study did an incredible job documenting individual exposure
> > > including many supporting papers as Les has pointed out to me. On one
> >hand
> > > we have your misrepresentation and on the other hand we have these
> >detailed
> > > papers below laying out how they accounted for radon exposure.
> > >
> > > ------------------------------------------
> > > Citation: Field RW, Smith BJ, Brus CP, Lynch CF, Neuberger JS, Steck DJ,
> > > Retrospective temporal and spatial mobility of adult Iowa women., Risk
> >Anal
> > > 18: 5, 575-84, Oct, 1998.
> > >
> > > Abstract
> > > Human exposure assessments require a linkage between toxicant
> >concentrations
> > > in occupied spaces and the receptor's mobility pattern. Databases
> >reporting
> > > distinct populations' mobility in various parts of the home, time
> >outside
> > > the home, and time in another building are scarce. Temporal longitudinal
> > > trends in these mobility patterns for specific age and gender groups are
> > > nonexistent. This paper describes subgroup trends in the spatial and
> > > temporal mobility patterns within the home, outside the home, and in
> >another
> > > building for 619 Iowa females that occupied the same home for at least
> >20
> > > years. The study found that the mean time spent at home for the
> >participants
> > > ranged from a low of 69.4% for the 50-59 year age group to a high of
> >81.6%
> > > for the over 80-year-old age group. Participants who lived in either
> >one- or
> > > two- story homes with basements spent the majority of their residential
> > > occupancy on the first story. Trends across age varied for other
> >subgroups
> > > by number of children, education, and urban/rural status. Since all of
> >these
> > > trends were nonlinear, they indicate that error exists when assuming a
> > > constant, such as a 75% home occupancy factor, which has been advocated
> >by
> > > some researchers and agencies. In addition, while aggregate data, such
> >as
> > > presented in this report, are more helpful in deriving risk estimates
> >for
> > > population subgroups, they cannot supplant good individual-level data
> >for
> > > determining risks.
> > >
> > > ------------------------------------------------------------
> > >
> > > Medline ID: 21270976
> > >
> > > Citation: Field RW, Steck DJ, Smith BJ, Brus CP, Fisher EF, Neuberger
> >JS,
> > > Lynch CF, The Iowa radon lung cancer study--phase I: Residential radon
> >gas
> > > exposure and lung cancer., Sci Total Environ 272: 1-3, 67-72, May14,
> >2001.
> > >
> > > Abstract
> > > Exposure to high concentrations of radon (222Rn) progeny produces lung
> > > cancer in both underground miners and experimentally-exposed laboratory
> > > animals. The goal of the study was to determine whether or not
> >residential
> > > radon exposure exhibits a statistically significant association with
> >lung
> > > cancer in a state with high residential radon concentrations. A
> > > population-based, case-control epidemiologic study was conducted
> >examining
> > > the relationship between residential radon gas exposure and lung cancer
> >in
> > > Iowa females who occupied their current home for at least 20 years. The
> > > study included 413 incident lung cancer cases and 614
> >age-frequency-matched
> > > controls. Participant information was obtained by a mailed-out
> >questionnaire
> > > with face-to-face follow-up. Radon dosimetry assessment consisted of
> >five
> > > components: (1) on-site residential assessment survey; (2) on-site radon
> > > measurements; (3) regional outdoor radon measurements; (4) assessment of
> > > subjects' exposure when in another building; and (5) linkage of historic
> > > subject mobility with residential, outdoor, and other building radon
> > > concentrations. Histologic review was performed for 96% of the cases.
> > > Approximately 60% of the basement radon concentrations and 30% of the
> >first
> > > floor radon concentrations of study participants' homes exceeded the US
> > > Environmental Protection Agency action level of 150 Bq m(-3) (4 pCi
> >l(-1)).
> > > Large areas of western Iowa had outdoor radon concentrations comparable
> >to
> > > the national average indoor value of 55 Bq m(-3) (1.5 pCi l(-1)). Excess
> > > odds of 0.24 (95% CI = -0.05-0.92) and 0.49 (95% CI = 0.03-1.84) per 11
> > > WLM(5-19) were calculated using the continuous radon exposure estimates
> >for
> > > all cases and live cases, respectively. Slightly higher excess odds of
> >0.50
> > > (95% CI = 0.004-1.80) and 0.83 (CI = 0.11-3.34) per 11 WLM(5-19) were
> >noted
> > > for the categorical radon exposure estimates for all cases and the live
> > > cases. A positive association between cumulative radon gas exposure and
> >lung
> > > cancer was demonstrated using both categorical and continuous analyses.
> >The
> > > risk estimates obtained in this study indicate that cumulative radon
> > > exposure presents an important environmental health hazard.
> > >
> > > ----------------------------------------------------------------
> > > Environmental Health Perspectives Volume 107, Number 11, November 1999
> > >
> > > Intercomparison of Retrospective Radon Detectors
> > > R. William Field,1 Daniel J. Steck,2 Mary Ann Parkhurst,3 Judy A.
> >Mahaffey,3
> > > and Michael C.R. Alavanja4
> > >
> > > 1Department of Epidemiology, College of Public Health, University of
> >Iowa,
> > > Iowa City, Iowa, USA
> > > 2Physics Department, St. John's University, Collegeville, Minnesota, USA
> > > 3Pacific Northwest National Laboratory, Richland, Washington, USA
> > > 4National Cancer Institute, Bethesda, Maryland, USA
> > >
> > > Abstract
> > > We performed both a laboratory and a field intercomparison of two novel
> > > glass-based retrospective radon detectors previously used in major radon
> > > case-control studies performed in Missouri and Iowa. The new detectors
> > > estimate retrospective residential radon exposure from the accumulation
> >of a
> > > long-lived radon decay product, 210Pb, in glass. The detectors use track
> > > registration material in direct contact with glass surfaces to measure
> >the
> > > -emission of a 210Pb-decay product, 210Po. The detector's track density
> > > generation rate (tracks per square centimeter per hour) is proportional
> >to
> > > the surface -activity. In the absence of other strong sources of
> >-emission
> > > in the glass, the implanted surface -activity should be proportional to
> >the
> > > accumulated 210Po, and hence to the cumulative radon gas exposure. The
> >goals
> > > of the intercomparison were to a) perform collocated measurements using
> >two
> > > different glass-based retrospective radon detectors in a controlled
> > > laboratory environment to compare their relative response to implanted
> > > polonium in the absence of environmental variation, b) perform
> >collocated
> > > measurements using two different retrospective radon progeny detectors
> >in a
> > > variety of residential settings to compare their detection of
> > > glass-implanted polonium activities, and c) examine the correlation
> >between
> > > track density rates and contemporary radon gas concentrations. The
> > > laboratory results suggested that the materials and methods used by the
> > > studies produced similar track densities in detectors exposed to the
> >same
> > > implanted 210Po activity. The field phase of the intercomparison found
> > > excellent agreement between the track density rates for the two types of
> > > retrospective detectors. The correlation between the track density rates
> >and
> > > direct contemporary radon concentration measurements was relatively
> >high,
> > > considering that no adjustments were performed to account for either the
> > > residential depositional environment or glass surface type. Preliminary
> > > comparisons of the models used to translate track rate densities to
> >average
> > > long-term radon concentrations differ between the two studies. Further
> > > calibration of the retrospective detectors' models for interpretation of
> > > track rate density may allow the pooling of studies that use glass-based
> > > retrospective radon detectors to determine historic residential radon
> > > exposures. Key words: case-control studies, dose-response relationship
> > > (radiation), epidemiologic methods, epidemiologic studies, lung
> >neoplasms,
> > > radon, radon progeny, smoking. Environ Health Perspect 107:905-910
> >(1999).
> > > [Online 15 October 1999]
> > > http://ehpnet1.niehs.nih.gov/docs/1999/107p905-910field/abstract.html
> > > Address correspondence to R.W. Field, College of Public Health,
> >Department
> > > of Epidemiology, N222 Oakdale Hall, University of Iowa, Iowa City, IA
> >52242
> > > USA. Telephone: (319) 335-4413. Fax: (319) 335-4747. E-mail:
> > > bill-field@uiowa.edu
> > > We thank J. Huber, C. Greaves, G. Buckner, J. Jesse, and E. Berger for
> >their
> > > assistance with data collection. We also thank C. Lynch and J. Lubin for
> > > their reviews of previous versions of this manuscript.
> > >
> > > NCI contract 263-MQ-820009 and NIEHS grant P30 ESO5605 supported this
> > > research. This report is solely the responsibility of the authors and
> >does
> > > not necessarily reflect the official views of the NCI, NIEHS, or NIH.
> > >
> > > ----------------------------------------------------------------
> > > Medline ID: 99122934
> > >
> > > Citation: Steck DJ, Field RW, Lynch CF, Exposure to atmospheric radon.,
> > > Environ Health Perspect 107: 2, 123-7, Feb, 1999.
> > > Address: Department of Physics
> > >
> > > Abstract
> > > We measured radon (222Rn) concentrations in Iowa and Minnesota and found
> > > that unusually high annual average radon concentrations occur outdoors
> >in
> > > portions of central North America. In some areas, outdoor concentrations
> > > exceed the national average indoor radon concentration. The general
> >spatial
> > > patterns of outdoor radon and indoor radon are similar to the spatial
> > > distribution of radon progeny in the soil. Outdoor radon exposure in
> >this
> > > region can be a substantial fraction of an individual's total radon
> >exposure
> > > and is highly variable across the population. Estimated lifetime
> >effective
> > > dose equivalents for the women participants in a radon-related lung
> >cancer
> > > study varied by a factor of two at the median dose, 8 mSv, and ranged up
> >to
> > > 60 mSv (6 rem). Failure to include these doses can reduce the
> >statistical
> > > power of epidemiologic studies that examine the lung cancer risk
> >associated
> > > with residential radon exposure.
> > > -----------------------------------
> > >
> > > Medline ID: 99005221
> > > Citation: Fisher EL, Field RW, Smith BJ, Lynch CF, Steck DJ, Neuberger
> >JS,
> > > Spatial variation of residential radon concentrations: the Iowa Radon
> >Lung
> > > Cancer Study., Health Phys 75: 5, 506-13, Nov, 1998.
> > >
> > > Abstract
> > > Homeowners and researchers frequently estimate the radon concentrations
> >in
> > > various areas of the home from a single radon measurement often
> >performed in
> > > the home's basement. This study describes the spatial variation of radon
> > > concentrations both between floors and between rooms on the same floor.
> >The
> > > geometric mean basement and first floor radon concentrations for
> >one-story
> > > homes were 13.8% and 9.0% higher, respectively, as compared to their
> > > counterparts in two-story homes. The median first floor/basement ratio
> >of
> > > radon concentrations for one-story homes was 0.60. The median ratios
> >between
> > > first floor/basement and second floor/basement for two-story homes were
> >0.51
> > > and 0.62, respectively. The mean coefficient of variation for detectors
> > > placed on the same floor was 9.5%, which was only 2.6% higher than the
> >mean
> > > coefficient of variation found for collocated (duplicate) quality
> >control
> > > detectors. The wide individual variations noted in radon concentrations
> > > serve as a reminder of the importance of performing multiple radon
> > > measurements in various parts of the home when estimating home radon
> > > concentrations.
> > >
> > > -------------------------------------------------------
> > > Field, R.W., Lynch, C.F., Steck, D.J. and Fisher, E.F.. Dosimetry
> >Quality
> > > assurance: the Iowa residential radon lung cancer study. Radiation
> > > Protection Dosimetry. 78(4): 295-303, 1998
> > >
> > > -----------------------------------------------
> > > Medline ID: 96384408
> > > Citation: Field RW, Steck DJ, Lynch CF, Brus CP, Neuberger JS, Kross BC,
> > > Residential radon-222 exposure and lung cancer: exposure assessment
> > > methodology., J Expo Anal Environ Epidemiol 6: 2, 181-95, Apr-Jun, 1996.
> > >
> > > Abstract
> > > Although occupational epidemiological studies and animal experimentation
> > > provide strong evidence that radon-222 (222Rn) progeny exposure causes
> >lung
> > > cancer, residential epidemiological studies have not confirmed this
> > > association. Past residential epidemiological studies have yielded
> > > contradictory findings. Exposure misclassification has seriously
> >compromised
> > > the ability of these studies to detect whether an association exists
> >between
> > > 222Rn exposure and lung cancer. Misclassification of 222Rn exposure has
> > > arisen primarily from: 1) detector measurement error; 2) failure to
> >consider
> > > temporal and spatial 222Rn variations within a home; 3) missing data
> >from
> > > previously occupied homes that currently are inaccessible; 4) failure to
> > > link 222Rn concentrations with subject mobility; and 5) measuring 222Rn
> >gas
> > > concentration as a surrogate for 222Rn progeny exposure. This paper
> >examines
> > > these methodological dosimetry problems and addresses how we are
> >accounting
> > > for them in an ongoing, population-based, case-control study of 222Rn
> >and
> > > lung cancer in Iowa.
> > >
> > > --------------------------------------------
> > >
> > > Medline ID: 20329535
> > > Citation: Field RW, Steck DJ, Smith BJ, Brus CP, Fisher EL, Neuberger
> >JS,
> > > Platz CE, Robinson RA, Woolson RF, Lynch CF, Residential radon gas
> >exposure
> > > and lung cancer: the Iowa Radon Lung Cancer Study., Am J Epidemiol 151:
> >11,
> > > 1091-102, Jun1, 2000.
> > >
> > > Abstract
> > > Exposure to high concentrations of radon progeny (radon) produces lung
> > > cancer in both underground miners and experimentally exposed laboratory
> > > animals. To determine the risk posed by residential radon exposure, the
> > > authors performed a population-based, case-control epidemiologic study
> >in
> > > Iowa from 1993 to 1997. Subjects were female Iowa residents who had
> >occupied
> > > their current home for at least 20 years. A total of 413 lung cancer
> >cases
> > > and 614 age-frequency-matched controls were included in the final
> >analysis.
> > > Excess odds were calculated per 11 working-level months for exposures
> >that
> > > occurred 5-19 years (WLM(5-19)) prior to diagnosis for cases or prior to
> > > time of interview for controls. Eleven WLM(5-19) is approximately equal
> >to
> > > an average residential radon exposure of 4 pCl/liter (148 Bq/m3) during
> >this
> > > period. After adjustment for age, smoking, and education, the authors
> >found
> > > excess odds of 0.50 (95% confidence interval: 0.004, 1.81) and 0.83 (95%
> > > percent confidence interval: 0.11, 3.34) using categorical radon
> >exposure
> > > estimates for all cases and for live cases, respectively. Slightly lower
> > > excess odds of 0.24 (95 percent confidence interval: -0.05, 0.92) and
> >0.49
> > > (95 percent confidence interval: 0.03, 1.84) per 11 WLM(5-19) were noted
> >for
> > > continuous radon exposure estimates for all subjects and live subjects
> >only.
> > > The observed risk estimates suggest that cumulative ambient radon
> >exposure
> > > presents an important environmental health hazard.
> > >
> > > Don Smith
> > >
> > > ----------------------------------------------
> > > >From: "Jim Muckerheide" <jmuckerheide@cnts.wpi.edu>
> > > >To: "Rad health" <healthrad@hotmail.com>, <lescrable@hotmail.com>,
> > > ><jkotton@usgs.gov>
> > > >CC: <radsafe@list.vanderbilt.edu>
> > > >Subject: RE: radon - and tackling the issues
> > > >Date: Tue, 15 Jan 2002 04:11:47 -0500
> > > >
> > > You haven't read, or perhaps understood, the problem. See the
> > > explanation provided to Les. If you think something is "misleading," let
> >me
> > > know. It's just my take on the failure of radon case-control studies.
> > >
> > > And why Iowa is the worst place, despite Field's efforts to relate a
> > > lifetime of radon exposure to house measurements. It just can't work,
> > > and the study is too small to produce a credible, replicable result.
> > >
> > > Ray's a great guy, but his forte is HP training, and communication. If
> > > you want an expert on radon health effects try Philippe Duport at U
> > > Ottawa, with 40 years originally focused on the French miners and the
> > > industry, then to Canada, as a regulator, and nor at the university. No
> > > adverse radon effects at low-dose, low dose-rate, at much higher than
> > >
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