950R91032
United States Air and Energy Environmental
Environmental Protection Research Laboratory April 1991
Agency Research Triangle Park NC 27711
Research and Development
&EPA The 1991 International
Symposium on Radon
and Radon Reduction
Technology:
Volume 1. Preprints
Session I: Government
Programs and Policies
Relating to Radon
Session II: Radon-Related
Health Studies
April 2-5,1991
Adam's Mark Hotel
Philadelphia, Pennsylvania
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The 1991 International
Symposium on Radon and
Radon Reduction Technology
"A New Decade of Progress"
April 2-5,1991
Adam's Mark Hotel
Philadelphia, Pennsylvania
Sponsored by:
U.S. Environmental Protection Agency
Air and Energy Engineering Research Laboratory
and
U. S. Environmental Protection Agency
Office of Radiation Programs
and
Conference of Radiation Control Program Directors, Inc.
(CRCPD)
Printed on Recycled Paper
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The 1991 International Symposium on Radon
and Radon Reduction Technology
Opening Session
Opening Remarks Symposium Co-Chairpersons
Introduction Charles M. Hardin, CRCPD, Inc.
Welcome Edwin B. Erickson,
EPA Region III Administrator
An Overview of the NAS Report on Radon Dosimetry Jonathan Samet
New Mexico Tumor Registry
iii
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The 1991 International Symposium on Radon
and Radon Reduction Technology
Table of Contents
Session I: Government Programs and Policies Relating to Radon
The Need for Coordinated International Assessment of the
Radon Problem - the IAEA Approach
Friedrich Steinhausler, International Atomic Energy Agency, Austria 1-1
The European Research Program and the Commission of
European Communities
Jaak Sinnaeve, Belgium I-2
United Kingdom Programs
Michael O'Riordan, National Radiological Protection Board, UK I-3
The U.S. DOE Radon Research Program: A Different Viewpoint
Susan L. Rose, Office of Energy Research, U. S. DOE I-4
U.S. EPA Future Directions
Margo Oge, U.S. EPA, Office of Radiation Programs I-5
Session I Posters
The State Indoor Radon Grants Program: Analysis of Results
After the First Year of Funding
Sharon Saile, U.S. EPA, Office of Radiation Programs IP-1
EPA Radon Policy and Its Effects on the Private Sector
David Saum and Marc Messing, INFILTEC IP-2
Evaluation of EPA's National Radon Contractor Proficiency Program
and Network of Regional Radon Training Centers
G. Lee Salmon, U.S. EPA, Office of Radiation Programs IP-3
State Certification Guidance
John Hoornbeek, U.S. EPA, Office of Radiation Programs IP-4
The U.S. EPA Radon Measurement Proficiency (RMP) Program
Jed Harrison, U.S. EPA, Office of Radiation Programs IP-5
iv
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Session II: Radon-Related Health Studies
Residential Radon Exposure and Lung Cancer in Women
Goran Pershagen, Karolinska Institute, Sweden 11-1
An Evaluation of Ecologic Studies of Indoor Radon and Lung Cancer
Christine Stidley, University of New Mexico II-2
Comparison of Radon Risk Estimates
Richard Hornung, NIOSH II-3
Lung Cancer in Rats Exposed to Radon/Radon Progeny
F. T. Cross and G. E. Dagle, Pacific Northwest Laboratory II-4
Startling Radon Risk Comparisons
JoAnne D. Martin, DMA-RADTECH, Inc 11-5
Estimated Levels of Radon from Absorbed Polonium-210 in Glass
Hans Vanmarcke, Belgium II-6
Expanded and Upgraded Tests of the Linear-No Threshold Theory
for Radon-Induced Lung Cancer
Bernard L. Cohen, University of Pittsburgh II-7
Session II Panel: Risk Communication
Apathy vs. Hysteria, Science vs. Drama: What Works in Radon
Risk Communication
Peter Sandman, Rutgers University II-8
American Lung Association's Radon Public Information Program
Leyla Erk McCurdy, American Lung Association II-9
Ad Council Radon Campaign Evaluation
Mark Dickson and Dennis Wagner, U.S. EPA, Office of
Radiation Programs 11-10
Developing a Community Radon Outreach Program: A Model for
Statewide Implementation
M. Jeana Phelps, Kentucky Cabinet for Human Resources 11-11
v
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Session II Posters
Occupational Safety During Radon Mitigation: Field Experience and
Survey Monitoring Results
Jean-Claude F. Dehmel, S. Cohen & Associates; Peter Nowlan,
R. F. Simon Company; Eugene Fisher, U.S. EPA,
Office of Radiation Programs IIP-1
Consumer Cost/Benefit Analysis of Radon Reductions in 146 Homes
Kenneth D. Wiggers, American Radon Services, Ltd IIP-2
The Effect of Passive Cigarette Smoke on Working Level
Exposures in Homes
Raymond H. Johnson, Jr. and Randolph S. Kline, Key Technology, Inc.;
Eric Geiger and Augustine Rosario, Jr., Radon QC IIP-3
Session III: Measurement Methods
Quality Assurance of Radon and Radon Decay Product Measurements
During Controlled Exposures
Douglas J. Van Cleef, U.S. EPA, Office of Radiation Programs 111-1
Current Status of Glass as a Retrospective Radon Monitor
Richard Lively, MN Geological Survey, and Daniel Steck,
St. John's University HI-2
Soil Gas Measurement Technologies
Harry E. Rector, GEOMET Technologies, Inc III-3
Results From a Pilot Study to Compare Residential Radon Concentrations
with Occupant Exposures Using Personal Monitoring
B. R. Litt, New Jersey Department of Environmental Protection,
J. M. Waldman, UMDNJ, and N. H. Hariey and P. Chittaporn,
New York University Medical Center III-4
Rapid Determination of the Radon Profile in a Structure by
Measuring Ions in the Ambient Atmosphere
W. G. Buckman and H. B. Steen III, Western Kentucky University III-5
Intercomparison of Activity Size Distribution Measurements with
Manual and Automated Diffusion Batteries - Field Test
P. K. Hopke and P. Wasiolek, Clarkson University; E. O. Knutson,
K. W. Tu, and C. Gogolak, U. S. DOE; A. Cavallo and K. Gadsby,
Princeton University; D. Van Cleef, NAREL III-6
vi
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Influence of Radon Concentrations on the Relationship Among Radon
Measurements Within Dwellings
Judith B. Klotz, NJ State Department of Health 111-7
The Use of Indoor Radon Measurements and Geological Data in Assessing
the Radon Risk of Soil and Rock in Construction Sites in Tampere
Anne Voutilainen and llona Makelainen, Finnish Centre for
Radiation and Nuclear Safety 111-8
Session III Panel: Detection of Radon Measurement Tampering
Policy and Technical Considerations for the Development of EPA
Guidance on Radon and Real Estate
Lawrence Pratt, U. S. EPA, Office of Radiation Programs 111-9
State Property Transfer Laws Now Include Radon Gas Disclosure
Michael A. Nardi, The Nardi Group 111-10
Update of AARST Real Estate Testing Guidelines
William P. Brodhead, WPB Enterprises 111-11
Real Estate Transaction Radon Testing Interference
Dean Ritter, ABE Testing 111-12
How to Determine if Radon Measurement Firms are Providing
Accurate Readings
Herbert C. Roy and Mohammed Rahman, New Jersey Department
of Environmental Protection 111-13
Grab Sampling as a Method of Discovering Test Interference
Marvin Goldstein, Building Inspection Service, Inc 111-14
Exploring Software Device Management Routines that Ensure the Overall
Quality of Continuous Working Level and Continuous Radon Monitor
Performance in a Field Environment
Richard Tucker, Gemini Research, and Rick Holland,
Radonics, Inc 111-15
Use of Grab Samples as a Quality Assurance Tool to Enhance Overall
Radon Measurement Accuracy and Reproducibility
Brian Fimian, Radonics, Inc., and Richard Tucker, Gemini Research 111-16
vii
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Session II! Panel: Short-Term/Long-Term Measurement
Predicting Long-Term Indoor Radon Concentrations from Short-Term
Measurements: Evaluation of a Method Involving Temperature Correction
T. Agami Reddy, A. Cavallo, K. Gadsby, and R. Socolow,
Princeton University "1-17
Correlation Between Short-Term and Long-Term Indoor Radon
Concentrations in Florida Houses
Susan E. McDonough, Southern Research Institute 111-18
Relationship Between Two-day Screening Measurements of Radon-222
and Annual Living Area Averages in Basement and
Nonbasement Houses
S. B. White, N. F. Rodman, and B. V. Alexamder, Research Triangle
Institute; J. Phillips and F. Marcinowski, U. S. EPA, Office of
Radiation Programs 111-19
The Use of Multiple Short-Term Measurements to Predict Annual Average
Radon Concentrations
Frank Marcinowski, U. S. EPA, Office of Radiation Programs III-20
Session III Posters
Characterization of Structures Using Simultaneous Single Source
Continuous Working Level and Continuous Radon Gas Measurements
Brian Fimian and John E. McGreevy, Radonics, Inc IIIP-1
Pennsylvania Department of Environmental Resources Radon in Water
Measurement Intercomparison
Douglas Heim and Carl Granlund, Pennsylvania Department of
Environmental Resources IIIP-2
A Field Comparison of Several Types of Radon Measurement Devices
Elhannan L. Keller, Trenton State College IIIP-3
Radon and Water Vapor Co-Adsorption on Solid Adsorbents
Neguib M. Hassan, Tushar K. Ghosh, Sudarshan K. Loyalka,
and Anthony L. Hines, University of Missouri-Columbia, and
Davor Novosel, Gas Research Institute IIIP-4
Calibration of Modified Electret Ion Chamber for Passive Measurement
of Radon-222 (Thoron) in Air
P. Kotrappa and J. C. Dempsey, Rad Elec, Inc IIIP-5
viii
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Unii Ventilator Operation and Radon Concentrations in a
Pennsylvania School
William P. Brodhead, WPB Enterprises IIIP-6
Session IV: Radon Reduction Methods
Causes of Elevated Post-Mitigation Radon Concentrations in Basement
Houses Having Extremely High Pre-Mitigation Levels
D. Bruce Henschel, AEERL; Arthur G. Scott, AMERICAN
ATCON, Inc IV-1
A Measurement and Visual Inspection Critique to Evaluate the
Quality of Sub-Slab Ventilation Systems
Richard W. Tucker, Gemini Research, Inc.; Keith S. Fimian,
Radonics, Inc IV-2
Correlation of Diagnostic Data to Mitigation System Design and
Performance as Related to Soil Pressure Manipulation
Ronald F. Simon, R. F. Simon Company IV-3
Pressure Field Extension Using a Pressure Washer
William P. Brodhead, WPB Enterprises IV-4
A Variable and Discontinuous Subslab Ventilation System and Its
Impact on Radon Mitigation
Willy V. Abeele, New Mexico Environmental Improvement Division IV-5
Natural Basement Ventilation as a Radon Mitigation Technique
A. Cavallo, K. Gadsby, and T.A. Reddy, Princeton University IV-6
Attic Pressurization - A Radon Mitigation Technique for Residential Structures
Myron R. Edelkind, Southern Mechanical IV-7
Section IV Posters
Radon Mitigation Failure Modes
William M. Yeager, Research Triangle Institute; D. Bruce Harris, AEERL;
Terry Brennan and Mike Clarkin, Camroden Associates, Inc IVP-1
Mitigation by Sub-SlabDepressurization Under Structures Founded on
Relatively Impermeable Sand
Donald A. Crawshaw and Geoffrey K. Crawshaw, Pelican
Environmental Corporation IVP-2
ix
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A Laboratory Test of the Effects of Various Rain Caps on Sub-Slab
Depressurization Systems
Mike Clarkin, Camroden Associates, Inc IVP-3
Analysis of the Performance of a Radon Mitigation System Based on
Charcoal Beds
P. Wasiolek, N. Montassier, P. K. Hopke, Clarkson University;
R. Abrams, RAd Systems, Inc IVP-4
Control of Radon Releases in Indoor Commercial Water Treatment
D. Bruce Harris and A. B. Craig, AEERL IVP-5
Session V: Radon Entry Dynamics
A Modeling Examination of Parameters Affecting Radon and Soil Gas
Entry Into Florida-Style Slab-on-Grade Houses
G. G. Sextro, Lawrence Berkeley Laboratory V-1
Effect of Winds in Reducing Sub-Slab Radon Concentrations Under
Houses Laid Over Gravel Beds
P. C. Owczarski, D. J. Holford, K. W. Burk, H. D. Freeman, and
G. W. Gee, Pacific Northwest Laboratory V-2
Radon Entry Into Dwellings Through Concrete Floors
K. K. Nielson and V. C. Rogers, Rogers and Associates
Engineering Corporation V-3
Radon Dynamics in Swedish Dwellings: A Status Report
Lynn M. Hubbard, National Institute of Radiation Protection, Sweden V-4
Soil Gas and Radon Entry Potentials for Slab-on-Grade Houses
Bradley H. Turk, New Mexico; David Grumm, Yanxia Li, and Stephen
D. Schery, New Mexico Institute of Mining and Technology;
D. Bruce Henschel, AEERL V-5
Direct Measurement of the Dependence of Radon Flux Through
Structure Boundaries on Differential Pressure
D. T. Kendrick and G. Harold Langner, Jr., U.S. DOE/Chem-Nuclear
Geotech, Inc
Radon Resistance Under Pressure
William F. McKelvey, Versar, Inc.; Jay W. Davis, Versar A/E, Inc V-
Recommendations to Reduce Soil Gas Radon Entry Based on an
Evaluation of Air Permeability of Concrete Blocks and Coatings
J. S. Ruppersberger, U. S. EPA, Office of Research and Development V-8
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Session V Posters
A Simple Model for Describing Radon Migration and Entry Into Houses
Ronald B. Mosley, AEERL VP-1
Effect of Non-Darcy Flow on the Operation of Sub-Slab
Depressurization Systems
R. G. Sextro, Lawrence Berkeley Laboratory VP-2
Effects of Humidity and Rainfall on Radon Levels in a Residential Dwelling
Albert Montague and William E. Belanger, U. S. EPA;
Francis J. Haughey, Rutgers University VP-3
Session VI: Radon Surveys
Factors Associated with Home Radon Concentrations in Illinois
Thomas J. Bierma and Jennifer O'Neill, Illinois State University VI-1
Radon in Federal Buildings
Michael Boyd, U. S. EPA, Office of Radiation Programs VI-2
Radon in Switzerland
H. Surbeck and H. Volkle, University Perolles; W. Zeller, Federal
Office of Public Health VI-3
A Cross-Sectional Survey of Indoor Radon Concentrations in 966 Housing
Units at the Canadian Forces Base in Winnipeg, Manitoba
D. A. Figley and J. T. Makohon, Saskatchewan Research Council VI-4
Radon Studies in British Columbia, Canada
D. R. Morley and B. G. Phillips, Ministry of Health; M. M. Ghomshei,
Orchard Geothermal Inc.; C. Van Netten, The University of
British Columbia VI-5
The State of Maine Schools Radon Project: Results
L. Grodzins, NITON Corporation; T. Bradstreet, Division of Safety
and Environmental Services, Maine; E. Moreau, Department of
Human Services, Maine VI-6
Radon in Belgium: The Actual Situation and Plans for the Future
A. Poffijn, State University of Gent VI-7
A Radiological Study of the Greek Radon Spas
P. Kritidis, Institute of Nuclear Technology - Radiation Protection VI-8
xi
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Session VI Posters
A Cumulative Examination of the State/EPA Radon Survey
Jeffrey Phillips, U. S. EPA, Office of Radiation Programs VIP-1
Seasonal Variation in Two-Day Screening Measurements of Radon-222
Nat F. Rodman, Barbara V. Alexander, and S. B. White, Research
Triangle Institute; Jeffrey Phillips and Frank Marcinowski,
U. S. EPA, Office of Radiations Programs VIP-2
The State of Maine School Radon Project: Protocols and Procedures of
the Testing Program
Lee Grodzins and Ethel G. Romm, NITON Corporation,
Henry E. Warren, Bureau of Public Improvement, Maine VIP-3
Results of the Nationwide Screening for Radon in DOE Buildings
Mark D. Pearson, D. T. Kendrick, and G. H. Langner, Jr., U. S. DOE/
Chem-Nuclear Geotech, Inc VIP-4
Session VII: State Programs and Policies Relating to Radon
Washington State's Innovative Grant: Community Support Radon Action
Team for Schools
Patricia A. McLachlan, Department of Health, Washington VII-1
Kentucky Innovative Grant: Radon in Schools Telecommunication Project
M. Jeana Phelps, Kentucky Cabinet for Human Resources;
Carolyn Rude-Parkins, University of Louisville VII-2
Regulation of Radon Professionals by States: the Connecticut Experience
and Policy Issues
Alan J. Siniscalchi, Zygmunt F. Dembek, Nicholas Maceiletti, Laurie
Gokey, and Paul Schur, Connecticut Department of Health Services;
Susan Nichols, Connecticut Department of Consumer Protection;
Jessie Stratton, State Representative, Connecticut
General Assembly v"'3
New Jersey's Program - A Three-tiered Approach to Radon
Jill A. Lapoti, New Jersey Department of Environmental Protection VII-4
Session VII Posters
Quality Assurance - The Key to Successful Radon Programs in the 1990s
Raymond H. Johnson, Jr., Key Technology, Inc VIIP-1
xii
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Radon in Illinois: A Status Report
Richard Allen and Melanie Hamel-Caspary, Illinois Department
of Nuclear Safety VIIP-2
Session VIII: Radon Prevention in New Construction
Long-Term Monitoring of the Effect of Soil and Construction Type on
Radon Mitigation Systems in New Houses
D. B. Harris, U. S. EPA, Office of Research and Development Vlll-1
A Comparison of Indoor Radon Concentrations Between Preconstruction
and Post-Construction Mitigated Single Family Dwellings
James F. Burkhart, University of Colorado at Colorado Springs;
Douglas L. Kladder, Residential Service Network, Inc VIII-2
Radon Reduction in New Construction: Double-Barrier Approach
C. Kunz, New York State Department of Health VIII-3
Radon Control - Towards a Systems Approach
R. M. Nuess and R. J. Prill, Washington State Energy Office VIII -4
Mini Fan for SSD Radon Mitigation
David Saum, INFILTEC VIII-5
Building Radon Mitigation into Inaccessible Crawlspace New
Residential Construction
D. Bruce Harris and A. B. Craig, AEERL; Jerry Haynes, Hunt
Building Corporation VIII-6
The Effect of Subslab Aggregate Size on Pressure Field Extension
K. J. Gadsby, T. Agami Reddy, D. F. Anderson, and R. Gafgen,
Princeton University; A. B. Craig, AEERL VIII-7
Session VIII Posters
Radon Prevention in Residential New Construction: Passive Designs
That Work
C. Martin Grisham, National Radon Consulting Group VIIIP-1
Preliminary Results of HVAC System Modifications to Control Indoor
Radon Concentrations
Terry Brennan and Michael Clarkin, Camroden Associates;
Timothy M. Dyess, AEERL; William Brodhead, Buffalo Homes VIIIP-2
xiii
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Correlation of Soil Radon Availability Number with Indoor Radon and
Geology in Virginia and Maryland
Stephen T. Hall, Radon Control Professionals, Inc Vlllp-3
Session IX: Radon Occurrence In the Natural Environment
Combining Mitigation and Geology: Indoor Radon Reduction by
Accessing the Source
Stephen T. Hall, Radon Control Professionals, Inc IX-1
A Comparison of Radon Results to Geologic Formations for the
State of Kentucky
David McFarland, Merit Environmental Services IX-2
Geologic Radon Potential of the United States
Linda Gunderson, U. S. Geological Survey IX-3
Technological Enhancement of Radon Daughter Exposures Due to
Non-nuclear Energy Activities
Jadranka Kovac, University of Zagreb, Yugoslavia IX-4
A Site Study of Soil Characteristics and Soil Gas Radon
Richard Lively, Minnesota Geological Survey; Daniel Steck,
St. John's University IX-5
Geological Parameters in Radon Risk Assessment - A Case History
of Deliberate Exploration
Donald Carlisle and Haydar Azzouz, University of California
at Los Angeles IX-6
Session IX Posters
Geologic Evaluation of Radon Availability in New Mexico: A Progress Report
Virginia T. McLemore and John W. Hawley, New Mexico Bureau of Mines
and Mineral Resources; Ralph A. Manchego, New Mexico
Environmental Improvement Division IXP-1
Paleozoic Granites in the Southeastern United States as Sources
of Indoor Radon
Stephen T. Hall, Radon Control Professionals, Inc IXP-2
Comparison of Long-Term Radon Detectors and Their Correlations with
Bedrock Sources and Fracturing
Darioush T. Gharemani, Radon Survey Systems, Inc IXP-3
xiv
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Geologic Assessment of Radon-222 in McLennan County, Texas
Mary L. Podsednik, Law Engineering, Inc IXP-4
Radon Emanation from Fractal Surfaces
Thomas M. Semkow, Pravin P. Parekh, and Charles O. Kunz, New York
State Department of Health and State University of New York
at Albany; Charles D. Schwenker, New York State Department
of Health IXP-5
National Ambient Radon Study
Richard Hopper, U. S. EPA, Office of Radiation Programs IXP-6
Session X: Radon in Schools and Large Buildings
The Results of EPA's School Protocol Development Study
Anita L. Schmidt, U. S. EPA, Office of Radiation Programs X-1
Diagnostic Evaluations of Twenty-six U. S. School - EPA's School
Evaluation Program
Gene Fisher, U. S. EPA, Office of Radiation Programs X-2
Extended Heating, Ventilating and Air Conditioning Diagnostics in
Schools in Maine
Terry Brennan, Camroden Associates X-3
Mitigation Diagnostics: The Need for Understanding Both HVAC and
Geologic Effects in Schools
Stephen T. Hall, Radon Control Professionals, Inc X-4
A Comparison of Radon Mitigation Options for Crawl Space School Buildings
Bobby E. Pyle, Southern Research Institute; Kelly W. Leovic, AEERL X-5
HVAC System Complications and Controls for Radon Reduction in
School Buildings
Kelly W. Leovic, D. Bruce Harris, and Timothy M. Dyess, AEERL;
Bobby E. Pyle, Sourthe Research Institute; Tom Borak, Western
Radon Regional Training Center; David W. Saum, INFILTEC X-6
Radon Diagnosis and Mitigation of a Large Commercial Office Building
David Saum, INFILTEC X-7
New School Radon Abatement Systems
Ronald F. Simon, R. F. Simon Company X-8
Design of Radon-Resistant and Easy-to-Mitigate New School Buildings
Alfred B. Craig, Kelly W. Leovic, and D. Bruce Harris, AEERL X-9
xv
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Session X Posters
Design and Application of Active Soil Depressurization (ASD) Systems
in School Buildings
Kelly W. Leovic, A. B. Craig, and D. Bruce Harris, AEERL; Bobby E.
Pyle, Southern Research Institute; Kenneth Webb, Bowling Green
(KY) Public Schools XP-1
Radon in Large Buildings: Pre-Construction Soil Radon Surveys
Ralph A. Llewellyn, University of Central Florida XP-2
Radon Measurements in North Dakota Schools
Thomas H. Morth, Arlen L. Jacobson, James E. Killingbeck,
Terry D. Lindsey, and Allen L. Johnson, North Dakota State
Department of Health and Consolidated Laboratories XP-3
Major Renovation of Public Schools that Includes Radon Prevention:
A case Study of Approach, System Design and Installation, and
Problems Encountered
Thomas Meehan XP-4
The State of Maine School Radon Project: The Design Study
Henry E. Warren, Maine Bureau of Public Improvement;
Ethel G. Romm, NITON Corporation XP-5
Design for the National Schools Survey
Lisa Ratcliff, U. S. EPA, Office of Radiation Programs XP-6
xvi
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Session I:
Government Programs and Policies Relating to Radon
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1-1
TITLE: The Need for Coordinated International Assessment of the Radon Problem
- The IAEA Approach
AUTHOR: Friedrich Steinhausler, International Atomic Energy Agency, Austria
This paper was not received in time to be included in the
preprints and the abstract was not available. Please check your
registration packet for a complete copy of the paper.
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1-2
TITLE: jhe European Research Program and the Commission of European Communities
AUTHOR: jaak Sinnaeve, Belgium
This paper was not received in time to be included in the
preprints and the abstract was not available. Please check your
registration packet for a complete copy of the paper.
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1-3
TITLE: UK Programs
AUTHOR: Michael O'Riordan, National Radiologcial Protection Board, United Kingdom
This paper was not received in tine to be included in the
preprints and the abstract was not available. Please check your
registration packet for a complete copy of the paper.
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1-4
THE US DOE RADON RESEARCH PROGRAM:
A DIFFERENT VIEWPOINT
Dr. Susan L. Rose
Office of Energy Research
US DOE
Washington, D.C. 20585
ABSTRACT
The United States Department of Energy, Office of Health and Environmental
Research (DOE/OHER) is the principal federal agency conducting basic research
related to indoor radon. The OHER has supported research on the biological
effects of ionizing radiation for many decades and is responsible for the
scientific knowledge upon which occupational exposure standards are based.
Legislative mandates, including the Atomic Energy Acts of 1946 and 1954, The
Energy Reorganization Act of 1974, and The Federal Nonnuclear Energy Research
and Development Act of 1974, provide the broad authority under which the radon
research program is funded.
In 1987, the OHER targeted several million dollars of support for basic
research targeted toward evaluating the health risk of environmental levels of
radon. In 1989, this program expanded again to an annual level of approximately
$11-13 million. The scientific information being sought in this program
encompasses research designed to determine radon availability and transport
outdoors, modeling transport into and within building, physics and chemistry of
radon and radon progeny, dose response relationships, lung cancer risk, and
mechanisms of radon carcinogenesis. The main goal of the DOE/OHER Radon Research
Program is to develop information to enable an improved health risk estimate for
radon exposure and thereby facilitate sound public policy decisions.
Introduction
The Department of Energy (and its predecessor agencies) is an historic
participant in radiation issues currently facing the U.S. government and U.S.
population, as both a generator of radioactive materials and as the leading
radiation research organization. Indeed much of the basic knowledge of radiation
effects which underlie occupational radiation standards comes from DOE research
efforts. This paper is directed toward a discussion of the radon research
program, the major radiation research program currently supported by the Office
of Health and Environmental Research.
This program, basic in nature and mandate, has not been able to keep
abreast of the radon policies rapidly being developed by the US EPA, nor
adequately provide for the immediate scientific needs of a burgeoning radon
industry that is often driven by economic factors. Scientific uncertainty on
radon risk, the key factor driving the DOE radon research program, often differs
in perspective from radon action and risk communication interests. The inherent
"give and take" between science and action contribute to more balanced and
reasonable policy choices.
1
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THE DOE RADON PROGRAM: UNCERTAINTY REDUCTION (Figure 1)
Addressing areas of uncertainty is the focus of the DOE Radon
Prooram Six specific areas of research have been developed to describe the
areas in which Sat ion is needed. These six areas are discussed below.
In most cases, radon found in homes originates from the soil around and
u 4-u h«„co H^uiov/or fhp exact relationship between the occurrence of
beneath the house. amount of radon available for transport into the home
radon in the soil and * Questions regarding the levels of radon progeny
remains unknown. To address questions »0HER has established the
likely to be found in homes and other ^ ^ of Ra(Jon _n ^ anrf
following two program areas: ,
Transport of RaHnn into and withijl_Bui
r nMnB„u and thus radiation received is dependent on a
The dose of ra?°n ^ t0 tj,e overall level of radon in the building,
number of variables in ad ... radon progeny attached to particles
These variables include_ thei Darticles, among others. To investigate how
and the size ^istributio radiation received by an individual, OHER
these parameters affect nrnaram a*,oas: Phvsical/Chemical Interactions of
5tLf^!,if;1nthA%f0arES&l-e"
A1 though underg^uncexposed U elevated^oncentrations of radon
have been shown to c this effect causes lung cancer remain unknown. Two
on the lungs and the i8 m are directed at examining the types of damage
areaS/tft roils bv radiation from alpha progeny and how this damage ultimately
caused to cells by racii Dron^am areas are the followina: Mechanisms
SMlSgilM Of Ca^er fro. Radon Exposure,
MANAGEMENT OF THE RADON RFSFABr.H PROGRAM I Figure 2)
The DOE technical staff developed the original research program goals and
continue to guide the program tasks in support of the attainment of these qoals
and the reduction of critical uncertainties. These tasks include the evaluation
and selection of research projects relevant to the reduction of uncertainties-
the continual coordination, maintenance, and review of the projects; and the
promotion of exchange of research findings among members within the national and
international radon research communities. In these tasks, management is assisted
by a panel of principal scientists selected from among the researchers
participating in the program. These scientists, chosen to represent different
disciplines, work together to ensure that levels of technical quality and
relevance of program activities meet high standards.
2
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Development of Relevant and Coordinated Program Goals
The Radon Research Program coordinates research goals and share information
with other national and international programs. While OHER has for some time
coordinated its efforts with other DOE offices, such as the Office of
Conservation and Renewable Energy, the Office of Nuclear Energy, the Office of
Environment, Safety and Health, and the Bonneville Power Administration, recent
efforts have broadened the scope of the coordination to include other agencies,
both Federal and International.
DOE signed a Memorandum of Understanding to coordinate its research efforts
with those of the Environmental Protection Agency (EPA). As a result, DOE has
taken responsibility for conducting basic research related to radon, particularly
as it relates to public health. EPA has taken responsibility for conducting
applied research, public outreach, and operational programs involving the states
and the private sector.
The DOE Radon Research Program, now over four years old, is mature enough
for a reevaluation of the research vs. uncertainties and risk. An effort to
identify contributions to risk assessment approaches with this newly available
data will commence in 1991 with an initial planning meeting of key scientists.
DOE also signed a Memorandum of Understanding with the Commission of
European Communities (CEC) and meets annually with the managers of the CEC Radon
Program to coordinate activities. The program managers have agreed to hold
annual meetings, review each other's programs, and cooperate in the funding of
international workshops on radon research findings. Emphasis is being placed
on conducting complementary research programs across national boundaries.
A major scientific accomplishment occurred in July 1989, when over 50
participants representing many different countries attended an International
Workshop on Residential Radon Epidemiology sponsored by DOE and CEC. Discussions
focused on assessment of lifetime radon exposure, design considerations for
residential radon epidemiological studies, and statistical power and data
analysis. Participants concluded that pooling data from different studies was
essential to obtain quantitatively useful information. Participants also
emphasized the relationship (or lack of) between the needs of policy makers and
the capacity of epidemiological investigations to satisfy these needs. Plans
now call for a repeat workshop of the epidemiology investigators in the summer
of 1991 to plan a meta-analysis of their combined data when it is available.
The DOE Radon Research Program manager co-chairs with EPA, the Federal
Interagency Committee on Indoor Air Quality (CIAQ) Radon Work Group. This work
group coordinates activities among all Federal agencies involved in radon
research. Members meet regularly to exchange information and review and comment
on technical documents. In addition, special activities, such as the development
of a Federal Radon Activities Inventory, have been undertaken.
DOE is also a participant of the Committee on Interagency Radiation
Research and Policy Coordination (CIRPPC). This committee is comprised of
3
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members of all the Federal agencies conducting radiation research.
Funding of Selected Pro.iects
Radon Research Program management supports the attainment of the research
goals by selecting and funding projects likely to produce information needed for
reducing uncertainties. The Radon Research Program management sets priorities
for research activities through an evaluation and ranking of proposals. In FY
1987, OHER solicited applications for funding and received 128 research
proposals. The proposals were reviewed and projects were selected to receive
funding based on scientific merit and relevance to program initiatives.
Funded projects are reviewed continually on an informal basis. A formal
scientific peer review process was undertaken in FY 1990 and evaluated the entire
radon program. A significant number of projects were terminated and
recommendations were made for program redirection, adding risk assessment and
modelling components. Management staff will use significant research
developments revealed in the formal review process to target the next three-year
phase of the program, incorporating the change in emphasis in their selection
of the next round of projects for funding.
Information Flow
DOE hastens the progress toward program goals by facilitating the flow of
information among research laboratories, other agencies, national and
international committees. The ready exchange of information serves to maximize
technical input on research projects and helps to prevent duplication of
activities.
The panel of seven principal scientists from various research disciplines
serves to facilitate communications between the managers and radon scientists.
The group meets to evaluate the status of the program with regard to the quality,
relevance, and cohesiveness of the research being conducted and to exchange
information.
Meetings
The Radon Research Program conducts an annual contractor meeting of all
OHER radon researchers, radon technical staff, and guests from other Federal
programs. The scientists highlight accomplishments, resolve problems, share
collaborative results, and address changes in program emphasis.
OHER also plans small workshops for the various research areas. Specific
goals for each meeting ar® Identified, and other scientists are invited as the
needs for specific expertise are identified.
Pnhlicat ions
Each year, the Radon Research Program publishes a research program update
with project summaries aJ™ accomplishments. In 1990 it began the publication
of a newsletter which M9"'19hts radon research activities in DOE and elsewhere.
This can be obtained at no cost by writing Gloria Caton, Oak Ridge National
4
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Laboratory, Oak Ridge, Tennessee 37831.
A series of technical radon documents continues each year as topics are
identified and manuscripts are completed. Several documents on epidemiology
and animal studies have been completed in the last several years.
The Radon Research Program oversees and funds the research activities of
a national network of over 60 projects in university, private, national, and
contractor-operated laboratories. In addition, the program manages various
activities which promote the exchanges of information among all radon research
programs, both nationally and internationally, in order to promote the reduction
of uncertainties surrounding human exposure to radon.
UNCERTAINTIES; AN OVERVIEW fFIGURE 31
Reducing radon uncertainties is the goal of the DOE Scientific Research
Program. This program has evaluated these uncertainties, determined those which
are amenable to scientific methods, and is attempting to address many of the
most outstanding questions. The major uncertainties in Radon Risk are listed
here as a broad overview of the research issues.
Miners vs. Public
Using observations in underground miners as a basis for estimating the
risks of radon to public health yields a risk estimate containing major
uncertainties. Some of the uncertainties exist within the miner data and make
the risk estimate calculated for miners uncertain. Other uncertainties are
added when the miner estimate is used as a basis for predicting health risks to
the public because of differences that exist between mining and residential
exposures and between miners and other members of the population. An EPA
sponsored National Academy of Science Panel on dosimetry has explored this issue
and will be publishing its findings this year. Although there is general
scientific agreement that exposure to radon progeny is associated with an
increased occurrence of lung cancer in miners, there remains some uncertainty
as to the relationship between the extent of exposure and risk, even in miners.
Potential Errors in Measurement
A major source of uncertainty in most scientific radon studies is the
validity and accuracy of the radon measurements used to determine exposure.
Using currently available techniques, radon measurements may vary from some
"actual" or calibrated level by more than twenty-five percent. Also, differences
in readings may arise as a result of variations in monitoring, calibration, and
quality control procedures. This issue is further complicated in radon studies
because technical limitations discourage the direct measurement of radon progeny,
the factor causing the lung cancer.
5
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Potential Errors in Exposure
Radon levels fluctuate throughout the work day and from place to place
within a* mine. Consequently, the exposure level for a given individual may
differ from the level at the time and place the measurement was taken. In fact,
in many miner studies, the levels were not measured during the period of exposure
but were estimated based on measurements acquired more recently or "guestimated"
from other sources.
Potential Errors in Diagnosis
In addition to errors in the exposure estimates, there may be errors In
the number and kind of lung cancer cases diagnosed for the members of the
studies.
Potential Errors i" MnHel Selection
Selecting an appropriate model for relating the history of exposure for
the study subjects to the observed lung cancer rate is a complicated task. For
example, how do you quantitate the exposure of an individual who spent five years
in a mine over twenty years ago? How does this compare with a person exposed
for five years just five years ago? In the case of radon, model selection is
particularly difficult because two of the variables, radon and cigarette smoke,
are believed to interact.
ENVIRONMENTAL CONDITIONS
Another category of uncertainty is a result of the inadequate understanding
of how the environmental conditions that predominate in a mine contribute to the
health effects seen in miners, and how these environmental conditions compare
to those found in a home.
Factors such as the distance to the source of the radon and the amount
of ventilation, influence the concentration of radon progeny present in the air.
If everything else is equal, the higher the concentration, the more radiation
that may be available to be inhaled. But generally everything else is not equal,
and the relationship between exposure level and dose is not straightforward.
At least two other environmental parameters affect the dose-the number and size
of particles in the air.
Differences in Environmental Sources
Environmental conditions and radon sources within mines are relatively
constant compared to conditions and inputs to homes. Radon levels within homes
can vary more than an order of magnitude, depending on environmental factors such
as climate season wind speeds, pressure differences, humidity, and radon
emanation potentials from heterogeneous soils and rocks.
6
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Differences in Levels of Radon Progeny in Mines and in Homes
Although some homes have been found with extremely high levels of radon,
the majority of homes have levels much lower than those generally found in
underground mines. Currently there is very limited information about the health
effects associated with radon at the levels commonly encountered by the public.
As a result, some of the uncertainty in the risk estimates stems from having to
extrapolate risks that are likely to occur at the low concentrations of radon
commonly found in homes from data about the higher concentrations found in mines.
Differences in Particle Sizes and the Unattached Fraction
Investigators of homes in New York and New Jersey and mines in Colorado
and Canada have shown the sizes of particles differ in the two environments.
Poor ventilation in mines and the preponderance of dust-generating activities
keeps the concentration of airborne dust high and perhaps the fraction of
unattached particles low. Although recent improvements in ventilation in mines
have reduced the concentrations of dust, this has been counteracted by an
increased use of diesel driven equipment. Unattached fractions in mines have
been found to range from less than 1% to as high as 16%.
Various activities within the home such as cooking and smoking contribute
to the prevalence of particulate matter in indoor air and affect the fraction
of attached progeny found in homes. However, many of the aerosol creating
activities are reduced at night when residential exposures predominate and
consequently the particulate concentration is also reduced. Unattached fractions
in homes have been measured to range from below 5% in the presence of specific
aerosol sources to between 6% and 15% in the absence of the sources. This value
indicates that the unattached fraction in homes may be twice as high as that
found in mines although more adequate information is needed for mines.
Other Toxicants
Toxic air pollutants, such as those found in diesel exhaust, can accumulate
in the air of mines due to confined conditions and inadequate ventilation. The
contributions of these pollutants to the effects observed in miners is unknown.
Additionally, most of the miners that have been studied were cigarette-
smokers. Not only does cigarette smoking itself lead to lung cancer, the
presence of naturally occurring radionuclides in tobacco contributes to the
overall radiation exposure. It 1s believed that the combined effect of radon
progeny exposure and cigarette smoking is multiplicative. As a substantial
portion of the general population is nonsmoking, the extrapolation of effects
from a predominantly smoking miner population to other members of the public may
result in an overestimated risk.
7
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UNCERTAINTIES IN CHARACTERISTICS OF THE EXPOSED POPULATION
A final category of uncertainty results from a poor understanding of the
actual differences in the physical characteristics of miners and members of the
general public and how these factors affect risk. Even if the same environmental
conditions prevailed in mines and in homes, uncertainties would remain because
differences in sex, age, smoking status, and activity level affect an
individual's response to radon exposure.
Amount of Air Inhaled per Unit Time
During the period of exposure, miners are expected to be participating in
relatively strenuous activities. As a result they are likely to be breathing
deeply and frequently. In contrast, residential exposures generally take place
when individuals are involved in light activity or are sleeping. Under these
conditions, breathing is likely to be shallow and slow.
The increased volume of air brought into the lungs brings in a greater
amount of radon progeny; however, the increased frequency of breathing decreases
the mean residence time of aerosols in the lung and consequently, reduces the
time available for diffusion to deposit particles on the bronchial airways.
Oral vs. Nasal Breathing
The dose of radon progeny delivered to the lungs can be influenced by the
proportion of oral and nasal breathing because larger portions of some sizes of
particles are deposited in the nose during nasal breathing than in the mouth
during oral breathing, though the significance of this difference is not known.
Differences in the Luna Characteristics
The dose of radon progeny is dependent on the amount of material deposited
in the lungs which in turn is dependent not only on the factors mentioned above,
but also on the sizes and branching patterns of the airways. Size and branching
factors can vary with the sex and age of the exposed individual. The geometry
of the female airway is similar enough to that of the male that the use of
scaling factors can probably account for differences. The same is not true for
children, however. The extent to which the adult miner data need to be adjusted
to account for different lung characteristics is uncertain, particularly for
children. This is further complicated by reports of a National Cancer Institute
epidemiological study of miners exposed as children to radon while working in
tin mines in China in which it was reported that there was no evidence of an
increased incidence of lung cancer from these early exposures.
The dose is also dependent on the rate at which deposited materials are
cleared from the lungs. Clearance rates are affected by smoking status and age,
and it is important to consider differences in these parameters when comparing
miners and the general public. There are no data on clearance rates for
children.
8
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UNCERTAINTIES IN EXTENT AND DURATION OF EXPOSURE
In addition to differences in environmental and physical factors,
significant differences in the timing of exposure exist between miners and the
general population. For the general population, exposure may begin at birth
and continue throughout the lifetime or until the radon is detected and remedial
action is taken. The effects of the differences in the timing of exposure
between miners and the general population are difficult to judge and add
uncertainty when miner risk estimates are used to predict risks to the public.
9
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OTHER
AGENCIES
NATIONAL/
INTERNATIONAL
OHER
RESEARCH AREAS
PRINCIPAL
SCIENTISTS
FUNDAMENTAL
MECHANISMS
LUNG CANCER
INDUCTION
LUNG
CANCER
RISKS
PHYSICAL AND
CHEMICAL
INTERACTIONS
INDOORS
Rn AVAIL-
ABILITY
AND
TRANSPORT
DOSE-
RESPONSE
RELATIONSHIPS
MODELING INTO
AND WITHIN
BUILDINGS
CIRRPC
CIAQ
CEC
SCIENTIFIC REVIEW
OFFICE OF ENERGY RES.
Flpn I, Principal Elements of the DOE/OHER Radon Research Program.
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CEC
CIRRPC
CIAQ
DOE
EPA
COORDINATION
MANAGEMENT
OHER
UNIVERSITIES
DEDICATED LABORATORIES
PRIVATE INSTITUTIONS
NATIONAL LABORATORIES
ENVIRONMENTAL MEASUREMENTS LABORATORY
RADON SCIENTISTS
Figure 2. Mechanisms for Radon Program Coordination. Abbreviations used are: CIAQ « Committee
on Indoor Air Quality, CIRRPC - Committee on Interagency Radiation Research and Policy
Coordination, and CEC - Commission of the European Community.
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Exposure
• Find geologic hotspots
• Improve measurement technologies
• Understand Radon variability/house
Interaction#
• Explore Radon entry mechanism*
• Behavior and fate of Radon/Radon progeny
and aerosol indoors i
Response
• Studies in nonminers
• Residential epidemiology
e Dose/effect
e Genetic Susceptibility
e Animal/cellular/molecular studies
e Dosimetry
e Effect of copollutants, cooking, smoking
HEATING^
VENTILATION and
AIR CONDITIONING
jjOtE
S
SMOKING . ^
IN-HOUSE
MASONRY FOUNDATION
Radium in *oil " ("•"•RnlsaaJ)
Radon dillun* through toll into hout*
¦GENDER AND AGE
UOVfLACt
JZSD
Sketch Illustrating Some of the Uncertainties in Estimating Lung Cancer Risk from Indoor
Radon Progeny.
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TITLE: u.S. EPA Future Directions
author: Margo Oge, EPA - Office of Radiation Programs
This paper was not received in time to be included in the
preprints and the abstract was not available. Please check your
registration packet for a complete copy of the paper.
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Session I:
Government Programs and Policies Relating
to Radon - POSTERS
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TITLE: State Indoor Radon Grant Program: Analysis of Results After First
Year of Funding
AUTHOR: Sharon Saile, EPA - Office of Radiation Programs
This paper was not received in time to be included in the
preprints so only the abstract has been included. Please check
your registration packet for a complete copy of the paper.
The State Indoor Radon Grant (SIRG) program was authorized by the Indoor
Radon Abatement Act (IRAA) of 1988 in order to provide seed money to assist States
in developing and implementing State radon programs. The first SIRG grants were
awarded in 1990 to 48 States, the District of Columbia, and Guam, with an average
grant award of $150.000 in Federal funding per State. EPA established the following
four goals for the SIRG program:
¦ To achieve widespread participation in the program
¦ To establish basic, core capabilities in States for radon response, and to
stimulate innovation and expansion in State radon programs
¦ To foster radon program development that appropriately reflects the
differences in the scope and severity of radon problems
¦ To help States develop programs that will continue to reduce radon risk
beyond the life of the SIRG Program.
This paper will examine the State's progress toward fulfilling these goals, based on the
completion of their first year of activities under the SIRG program. In addition, this
paper will present a preliminary analysis of the success of this type of "seed money"
program for State capability development.
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IP - 2
TITLE: epa Radon Policy and its Effects on the Private Sector
AUTHOR: David Saum and Marc Messing - KJFILTEC
This paper was not received in time to be included in the
preprints so only the abstract has been included. Please check
your registration packet for a complete copy of the paper.
Although the EPA has always publically stated a goal of solving the indoor radon
problem through private sector testing and mitigation, EPA programs may be impeding the
development of a viable private radon industry. Several possibilities for modification of the EPA
programs are discussed: 1) "sunset" provisions for EPA programs that would schedule their
termination so that the private sector could plan for privatization, 2) increased utilization of
voluntary consensus standards organizations such as ASTM and ASHRAE to replace EPA
protocols and guidelines, 3) cost/benefit analyses of impact of past and future EPA programs on
the radon industry, 4) an EPA ombudsman to serve as a contact point for radon industry
comments to the EPA, 5) increased radon industry participation in future EPA programs and
guidelines to prevent surprises and allow for longer term planning, 6) a revision of the EPA
authority to issuing guidelines, protocols, examinations, etc. so that this de facto rulemaking
would be subject to the same review as formal EPA rule making.
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IP-3
TITLE: Evaluation of EPA's National Radon Contractor Proficiency Program
and Network of Regional Radon Training Centers
AUTHOR: G. Lee Salmon, EPA - Office of Radiation Programs
This paper was not received in time to be included in the
preprints so only the abstract has been included. Please check
your registration packet for a complete copy of the paper.
This paper presents an evaluation of two EPA programs
mandated by Congress in the indoor Radon Abatement Act of 1988.
It discusses the impact of ths Radon Contractor Proficiency (Rep)
Program which evaluates the proficiency of radon reduction
contractors nationwide. An outline of major accomplishments
since its inception in October 1989 and planned future directions
are discussed. The paper also evaluates radon training offered
through EPA's national training network of four centers and
describes future training activities.
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IP-4
TITLE: State Certification Guidance
AUTHOR: John Hoornbeek, EPA - Office of Radiation Programs
This paper was not received in time to be included in the
preprints so only the abstract has been included. Please check
your registration packet for a complete copy of the paper.
The Environmental Protection Agency issued specific guidance
on state certification programs for radon measurement and
mitigation in FY 1991. The purpose of the guidance is to assist
States in developing radon certification programs which
complement EPA's voluntary radon measurement and mitigation
proficiency programs. The guidance also provides a framework for
encouraging reciprocity among State Radon Certification Programs.
This paper reviews the contents and rationale of this State
certification guidance and provides an overview of measures EPA
is taking in order to encourage adoption of State radon
certification programs.
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IP-5
TITLE: The U.S. EPA Radon Measurement Proficiency (RMP) Program
AUTHOR: Jed Harrison, EPA - Office of Radiation Programs
This paper was not received in time to be included in the
preprints so only the abstract has been included. Please check
your registration packet for a complete copy of the paper.
The U S EPA developed the voluntary **don Metturement Proficiency Program in 19M m response 10 « Federal and State
nct-J for meAHircmcnt service* firm* id demonstrate (heir proficiency. Since that time, the projmtn has *e( batic standard* for the radon
measurement industry, The program hat grown dramatically »mce iu inception. In 1986, fewer than 50 companies participated m the
program. Dy 1%9, more than 5 .000 compamea were participating Participant* repiwent firm* with an analytical capability » well at firm*
thai rely upon another nriD for analysi* tcrvice. Since the beginning of 1990, the Agency hai been carefully evaluating the RMP Program
and implementing appropriate prograffl improvements.
This paper overview the RMP Program, review* recent program change* and experiences, pnd de*erib« anticipated directions
Tor future program improvements. Recent program change* include Ihc move to cominuoui operation,»twaed performance mt criteria
more explicit quality awursnce requirement*, and increased emphaai* on Wind tatting. Anticipated future improvement! include
implementation of a measurement operator examination and further urnlance in radon measurement device calibration
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Session II:
Radon-Related Health Studies
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II-l
TITLE: Res idential Radon Exposure and Lung Cancer in Women
AUTHOR: Goran Pershagen, Karolinska Institute, Sweden
This paper was not received in time to be included in the
preprints and the abstract was not available. Please check your
registration packet for a complete copy of the paper.
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II—2
TITLES
AUTHOR:
An Evaluation of Ecologic Studies of Indoor Radon and Lung Cancer
Christine Stidley, University of New Mexico
This paper was not received in time to be included in the
preprints and the abstract was not available. Please check your
registration packet for a complete copy of the paper.
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TITLE: Comparison of Radon Risk Estimates
AUTHOR: Richard Hornung, NIOSH
This paper was not received in time to be included in
preprints and the abstract was not available. Please check
registration packet for a complete copy of the paper.
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II—4
LUNG CANCER IN RATS EXPOSED TO RADON/RADON PROGENY
F. T. Cross and G. E. Dagle
Pacific Northwest Laboratory, P. 0. Box 999, Richland, WA 99352
The lifespan effects of inhaled radon/radon progeny were studied in male
Wfstar rats. Lung tumors were the principal biological effects observed,
consisting primarily of pulmonary adenomas, bronchioloalveolar carcinomas,
papillary adenocarcinomas, epidermoid carcinomas, and adenosquamous
carcinomas. Four variables appeared to Influence the tumorigenic potential of
radon progeny in the experiments: 1) radon-progeny cumulative exposure; 2)
radon-progeny exposure rate; 3) radon-progeny unattached fraction; and, 4)
radon-progeny disequilibrium. Tumorigenic potential increased with:
1)increase in WLM-exposure until llfespan-shortening reversed the trend; 2)
decrease in radon-progeny exposure rate; and 3) Increase in radon-progeny
unattached fraction and disequilibrium. The experimentally derived lung cancer
risk of 300/10" animals/WLM was similar to the BEIR IV estimate of 350/10"
humans/WLM. The similarities in the human and animal data presently outweigh
the differences between them, and suggests the animal model may be useful for
studying pulmonary carcinogenic risk in humans.
Planned presentation at The 1991 International Symposium on Radon and Radon
Reduction Technology, U. S. Environmental Protection Agency, Philadelphia, PA,
April 2-5, 1991.
Work supported by U. S. Department of Energy under DE-AC0-76RL0 1830
Further information regarding this topic may be found in:
Cross, F.T. Evidence of Lung Cancer Risk from Animal Studies. In:
Proceedings of the Twenty-fourth Annual Meeting of the National Council
on Radiation Protection and Measurement. March 30-31, 1988. pp. 129-140.
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II-5
STARTLING RADON RISK COMPARISONS
by: JoAnne D. Martin
DMA-RADTECH, INC.
1011 Brookside Road, Suite 155
P.O. Box 3026
Allentown, PA 18106
ABSTRACT
It has long been known that radon causes lung cancer in
humans. Radon, in fact, has been called the greatest environmental
health threat facing the nation. Despite the fact that people in
the United States generally have a great fear of radiation, their
attitude toward radon risk has been one of apathy. Traditional
radon risk comparison data have, to say the least, been uninspired
as well as unmotivating to the public. This study, using publicly-
available data, compares radon risk to other pollutants, diseases
and health issues that do concern and motivate the public. These
health data have been assembled together in a dramatic tabulation
making the radon risk clearly evident and tangible. Results of a'
nationwide risk opinion survey will also be discussed.
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INTRODUCTION
Radiation from nuclear power is perceived by many in the U.S.
to be the greatest health risk we face.* Billions of dollars are
spent every year on sunscreens to protect us from natural solar
radiation. The EPA, the U.S. Surgeon General, NIOSH, The American
Lung Association, The American Cancer Society, The World Health
Organization, Consumers Union, The National Research Council's
Committee On The Biological Effects Of Ionizing Radiation, and The
American Medical Association concur that radon in homes and work
places is dangerous.
Why, then, is the public so apathetic toward the risk from
radon exposure? Public perceptions range from "We don't have radon
around here," to "If radon were a significant health threat,...it
would be in the news a lot more than it is." Health Physics Society
policy-makers have said that radon is not a serious health risk
(but neglect to add, "compared to smoking").
Traditional presentations of radon risk data have not
motivated the public. Scientific professionals have difficultly
communicating technical concepts to the public simply because their
style of providing information (logic-based, thinking) is different
from how most people gather information and make decisions
(emotion-based, feeling). It has been demonstrated that an
audience will believe a charismatic, entertaining presentation,
whether the information is correct or not (1).
Since the public is not motivated simply by being presented
with radon risk information, as has been proven by EPA
experience (2), another communication approach is needed. The
problem lies not with the quantity of radon risk information
presented to the public, but with the quality or relevance of the
information.
This study compares the health risks of radon exposure, not to
smoking (which provides a perceived beneficial feeling to the
smoker), and not to lung x-rays (which people cannot relate to
personal risk of death), but to health risks that the public does
care about.
Several preliminary statements regarding this study's data
must be made:
1. The risk data cited are from publicly-available documents
and information services. These data, however, have now
~Risk table courtesy Porter Consultants, Inc., Ardmore, PA.
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been arranged into a format that the public understands.
2. It is assumed that the BEIR IV/ICRP/EPA radon risk data
are correct. Leading scientists have developed these risk
estimates based on a linear no-threshold dose/response
relationship, which is admittedly conservative. I must
and do, believe that these scientists know what they are
doing.
3. I have not generated any raw risk data or conducted any
epidemiological studies. I have only interpreted the
already available information.
4. The radon risk estimates assume that lung cancer is the
only cause of death. No other potential/possible organ
cancers are considered.
HEALTH EFFECTS
RADON KILLS 21,000 AMERICANS (MAYBE AS MANY AS 40,000) EVERY
YEAR (3). RADON KILLS 50-100 PEOPLE EVERY DAY, WHICH IS ABOUT 1
PERSON EVERY 20 MINUTES.
This figure is based upon EPA averaging of the BEIR IV and
ICRP 50 models, the average residential radon exposure,
and a 240 million U.S. population. It also includes a risk of
360 deaths per one million person-WLM, which represents an
age-averaged rate for the general population using lifetable
and U.S. vital statistics information. It is assumed that
the person spends 75% of the day in the radon environment.
World-wide risk figures are, of course, much higher.
RADON IN WATER KILLS AT LEAST FOUR AMERICANS EVERY DAY. WATERBORNE
RADON MAY CAUSE MORE CANCER DEATHS THAN ALL OTHER DRINKING WATER
CONTAMINANTS COMBINED (4,5).
EPA estimates that between 1000 and 1800 people in the U.S.
die of lung cancer each year as the result of radon
contamination of well water. EPA also estimates that at least
eight million people may have undesirably high radon levels in
their water supply.
RADON KILLS MORE AMERICANS EACH YEAR THAN THE AIDS VIRUS
(i.e., 19,161 DEATHS)(6). UNLIKE AIDS, WHICH CAN ONLY BE
TRANSMITTED BY BODILY FLUIDS,** RADON CAN KILL ANYBODY.
AIDS is a disease that has this country panicked. Most areas
have state and Federally-funded AIDS task forces, and Congress
recently appropriated a three-billion dollar research and
treatment package. Because of grass-roots activism,
AIDS has gone from being unknown and controversial to a
~~Telephone conversation, AIDS Hotline, 1989 data.
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household word, yet AIDS doesn't kill as many people annually
as does radon.
HUNDREDS OF THOUSANDS OF AMERICANS LIVING IN HOUSES THAT HAVE HIGH
RADON LEVELS RECEIVE AS LARGE AN EXPOSURE OF RADIATION YEARLY AS
THOSE PEOPLE LIVING IN THE VICINITY OF THE CHERNOBYL NUCLEAR POWER
PLANT DID IN 1986, THE YEAR OF THE DISASTER (7).
COMMERCIAL NUCLEAR POWER HAS NEVER KILLED ONE MEMBER OF THE U.S.
PUBLIC, YET MILLIONS OF DOLLARS ARE SPENT EVERY YEAR TO PROTECT THE
PUBLIC "JUST IN CASE".
Despite widespread fear of nuclear power and radiation, few
have discussed the fact that radon exposures produce higher
doses than all nuclear plants, and in fact, produce higher
doses than dreaded nuclear accidents. Clearly, there is a
cost-effectiveness problem here. In fact, if the strict
regulations covering nuclear power plants were applied to the
famous Watras house, the spending of up to 9.8 million dollars
would have been justified by law to eliminate the risk in that
one home (7).
THE EPA CONSIDERS INDOOR RADON TO BE ONE OF THE MOST SERIOUS
ENVIRONMENTAL CARCINOGENS TO WHICH THE PUBLIC IS EXPOSED (3).
RADON KILLS THOUSANDS MORE AMERICANS EVERY YEAR THAN LEAD, PCB'S,
DIOXINS, AND ASBESTOS COMBINED (ASBESTOS, 189 DEATHS; LEAD PAINT, 7
DEATHS; PCB'S AND DIOXINS, NO HUMAN DEATHS EVER CONFIRMED)
(3,8). ***
USING ORANGE DYE NUMBER 19 IN LIPSTICK IS BANNED BECAUSE IT HAS A
ONE IN 19 BILLION CHANCE OF CAUSING CANCER, BUT THREE OF EVERY 100
PEOPLE EXPOSED TO RADON AT EPA'S ACTION LEVEL WILL DIE OF LUNG
CANCER (7).
Radon is a Group A carcinogen, which means that there are
human data proving it causes lung cancer in people. Only a
few other carcinogens such as asbestos, benzene, and vinyl
chloride are proven to kill humans. Group B carcinogens have
produced cancer in laboratory animals, and include dioxins,
PCB's and chlordane. Group C carcinogens have limited animal
data. Only Group A carcinogens have been shown to cause
cancer in humans.
Congress has, in the past, directed EPA to regulate toxic and
cancer-causing substances (e.g., The Toxic Substances Control
Act), and has given EPA authority to set maximum permissible
concentrations; thus, there is a precedent for EPA to
establish maximum contaminant levels.
~~~Telephone conversation, National Center for Health Statistics,
1987 data.
-------
Even the lowest estimates of tfte risk maKe radon's
radioactivity the biggest killer among environmental hazards
The lifetime risk of dying of radon-related lung cancer dwarfs
the lethal risks of typical exposures to asbestos, pesticides
like ethylene dibromide, and air pollutants like benzene (7).
IT IS ESTIMATED THAT ALMOST AS MANY AMERICANS DIE FROM RADON EACH
YEAR AS FROM DRUG-OVERDOSE INCIDENTS (i.e., 24,000), (9,
extrapolated to entire population) YET THE PRESIDENT HAS DECLARED A
"WAR ON DRUGS", AND THE ADMINISTRATION IS SPENDING BILLIONS OF
DOLLARS ON THE "TERRIBLE DRUG PROBLEM".
There is no doubt that drugs are a severe problem, leading to
robbery, murder, and other crimes. Drug abuse directly or
indirectly affects a large number of people, it must be kept
in mind, however, that only one billion of those "drug war
dollars" would go a long way toward abating the entire
population's radon risk.
RADON KILLS ABOUT AS MANY AMERICANS EVERY YEAR AS DRUNK DRIVING
(i.e., 25,000 DEATHS), YET DRUNK DRIVING IS A CRIMINAL OFFENSE. #
RADON KILLS MORE AMERICANS EVERY YEAR THAN HANDGUNS
(i.e., 17,000 DEATHS, INCLUDING ACCIDENTS AND CRIMES). ##
Drunk driving and firearm accidents are considered especially
heinous by activists because they are preventable. MADD and
other organizations mount huge campaigns to prevent these
deaths, yet little public or private funding is available to
help prevent radon-related deaths, which are also preventable
Parents and schools are aloowed to subject children to this
cancer-causing substance daily without penalty.
COSTS
A LUNG CANCER PATIENT COSTS AMERICAN SOCIETY THREE THOUSAND DOLLARS
A DAY (MINIMUM) IN MEDICAL EXPENSES ALONE, FOR A TOTAL OF 50 TO
60 THOUSAND DOLLARS UNTIL HE/SHE DIES. ADDED TO THIS IS THE COST
TO SOCIETY OF REDUCED OUTPUT, SICK LEAVE, ETC. OF ALMOST 100,000
DOLLARS PER CASE. THIS AMOUNTS TO AROUND 2.6 BILLION DOLLARS SPENT
EVERY YEAR ON THE RADON VICTIMS WHO DIE (10). ###
ON THE OTHER HAND, THE COSTS TO AMERICAN SOCIETY TO REDUCE RADON TO
ACCEPTABLE LEVELS IN ALL EXISTING HOMES IS MUCH LESS THAN THE COST
TO SOCIETY FOR SUCH PROGRAMS AS SMOKE DETECTORS AND SEAT BELTS
#Telephone conversation, Mothers Against Drunk Driving Hotline
representative, 1989 data.
##Risk table courtesy Porter Consultants, Inc., Ardmore, PA.
###Telephone conversation, Blue Cross/Blue Shield representative.
-------
(i.e., RADON, $15,000-47,000 PER LIFE SAVED; SEAT BELTS AND SMOKE
DETECTORS, $250-600,000 PER LIFE SAVED; OTHER ENVIRONMENTAL
PROGRAMS, $500,000-7,000,000 PER LIFE SAVED) (11,12).
A Health Physics Society policy-maker suggested that public
money spent on radon would be better spent on feeding starving
Africans or housing the homeless. This may be true, but it is
also naive, as is telling a child to finish his/her dinner
because there are starving children in the world. Just as
that child's unfinished food would not be used to feed
starving children, money that could have been spent on radon
is not going to be spent where it "gets the most bang for the
buck." No, that money will be spent on a different
environmental health hazard that has not killed as many people
as radon. Radon is a relatively inexpensive health threat to
test for and remediate. Certainly, spending money to test for
and remediate radon is a better "deal" than all of this
country's other radiation protection programs.
GOVERNMENT ACTION
THE INDOOR RADON ABATEMENT ACT SET A NATIONAL GOAL TO REDUCE INDOOR
RADON LEVELS, BUT NO REGULATORY LIMIT. DESPITE WIDESPREAD
AVAILABILITY OF TESTING AND MITIGATION SERVICES, LESS THAN 3% OF
HOMES, LESS THAN 1% OF WORKPLACES, AND FEW SCHOOLS HAVE BEEN
TESTED (12) BECAUSE THERE ARE NO REQUIREMENTS OR INCENTIVES TO DO
SO.
The EPA, OSHA, and most states have refused to enforce maximum
permissible levels for radon. EPA was directed to set maximum
limits for radon in water by 1987, but has yet to do so. Many
states still deny that buildings in their state have elevated
radon levels and are a health risk. Those states that do have
regulatory programs often decrease the amount of testing and
mitigation, due to the high cost burden to radon companies to
fully subsidize the state program, something that is
unprecedented for a public health issue of this magnitude.
IN SWEDEN, ONLY WHEN THE NATIONAL GOVERNMENT BECAME INVOLVED BY
SETTING REGULATIONS AND MAXIMUM LIMITS, DID THE MASS MEDIA AND
POLITICIANS SHOW INCREASED INTEREST IN THEIR RADON PROBLEM. NOW
53% OF EXISTING HIGH RADON HOMES HAVE BEEN REMEDIATED, AND AN
IMPRESSIVE 95% OF NEWLY BUILT HOUSES ARE BELOW THE REGULATED
LIMITS (13).
Other major countries of the world are moving to aggressively
address the radon issue through regulation. The Atomic Energy
Control Board in Canada has set annual exposure limits for
radon, for both occupational exposures and the public (14).
Under the Euratom Treaty, the Commission of the European
Communities has recommended maximum indoor radon levels for
-------
^ ^ „ Tr»iand Germany, and the United Kingdom
its member state . . . rectulatory limits. Only the U.S. lags
have all adopte
-------
health threats, while few respondents ranked TOXICA in the last
three (Figure 5).
A strong majority of all respondents felt that more Federal
funds should be spent on TOXICA than on AIDS, maximum regulatory
levels should be set for TOXICA, and testing should be required by
the Federal government (Figure 6). Conclusion: TOXICA is
perceived as a significant health threat, while radon is not.
More extensive research is now proposed, including:
1. Using a larger sample number, and cross-section the U.S.,
in order to better approximate overall public perception.
2. Gauging the response when the TOXICA name for the
contaminant is changed to something more innocuous.
3. Effect on perception of natural or man-made risks.
4. Determining public response to funding considerations. Do
attitudes change if homeowners have to pay for TOXICA, or
if other government programs must be cut in order to fund
a TOXICA program?
5. What different communication styles are most effective?
In what way should information be presented in order to
generate public awareness?
SUMMARY
Radon poses a greater health risk than any other environmental
pollutant. While Federal agencies have been tip-toeing around the
issue (so as not to overly alarm the public), more people in the
U.S. die each year from radon than from most other "scary" risks,
including the AIDS virus. A public opinion survey shows that radon
by another name is thought to be dangerous. A key point to note is
that people also feel that the government would take the necessary
steps to protect them if radon were really dangerous.
A new approach to informing the public is necessary; perhaps a
little fear would prompt some action. Should not the public be
concerned (upset/disturbed) if an American dies every 20 minutes
from a preventable disease?
Regulation is needed. The U.S. lags far behind other leading
industrialized nations in addressing the radon issue. From a cost
effectiveness standpoint, a fraction of the money currently spent
to protect the public from possible nuclear power plant accidents
would save many more lives if spent on solving the radon problem.
It is hoped that this study's information will be used for
public information, to influence government policy and spending,
and to inform those in medical and other health related fields.
If the information is shocking, if it makes people feel
uncomfortable, so much the better. A spark of controversy may wake
people up and make them pay attention to this serious health issue.
-------
The work described in this paper was not funded by the U.S.
Environmental Protection Agency and therefore the contents*do not
necessarily reflect the views of the Agency and no official
endorsement should be inferred.
-------
REFERENCES
1. Mossman, K.L. Nuclear literacy. Health Phys. 58:639-643;
1990.
2. Fisher, A. Radon risk communication research: practical
lessons. Air and Waste. To be published 1990.
3. Schmidt, A., et al. EPA's approach to assessment of radon
risk. In: EPA international radon symposium. Atlanta, GA;
February, 1990.
4. Lamarre, B.L. Radon in water aeration system operational
performance. In: EPA international radon symposium. Atlanta, GA;
February 1990.
5. Fit to Drink? Consumer Reports. January 1990.
6. U.S. Department of Health and Human Services, Centers for
Disease Control. HIV/AIDS surveillance report. Washington, DC;
April 1990.
7. Kerr, R.A. Indoor radons the deadliest pollutant. Science.
240:606-608; 1989.
8. Cassens, B.J., ed. Preventive medicine and public health.
Chapter 13. New York: John Wiley and Sons; 1987.
9. National Institute on Drug Abuse. Data from the Drug Abuse
Warning Network (DAWN). Series 1, No. 8; Rockville, MD; 1989.
10. US Environmental Protection Agency. Report to Congress on
indoor air quality, Vol. II, assessment and control of indoor air
pollution. EPA/400/1-89/001C: 5-9, 5-14; 1989.
11. Strom, D.J.; Mallon, Jr., J.B. A cost-effectiveness
comparison of private-sector radon remediation with traditional
radiation protection activities. In: EPA international radon
symposium. Atlanta, GA; February 1990.
12. EPA's radon action program: accomplishments and future
challenges. In: EPA international radon symposium. Atlanta, GA;
February 1990.
13. Swedjemark, G.A., and Makitalo, A. Recent Swedish experiences
in Rn-222 control. Health Phys. 58:453-460; 1990.
14. Bhawani, P. Radon in buildings. Canadian Centre for
Occupational Health and Safety; February 1989.
15. O'Riordan, M.C. Europe moves on radon. Health Phys. 58:759;
1990.
-------
This is side one. Please begin on this side.
SI] K V E Y/Q UESTK )NN AIR K
r iiion regarding health threats. Every clay we read about acid rain, high blcxnl pressure.
We are constantly being bombarded wllh(|()CS lhjs .|f|CC, way wc think? We're uying to find out. Tliis survey is being
assault rifles, alcohol, drunk driving anil the rc. crn)inchow sjgnincantncw inlori nation acts locliange an individual's opinion. Your
sent toyonas part ol a study which is ;ii lem j>i ^ ()<| o0VL.rn incut policy. The survey is divided into two pans. Part One, on this page,
answers will be used to help influence legisla 101 . ^ ^ askcd ,0 rank> m (he order you believe is most imponam, the seriousness
lists 12 different health and environment;:Yo'he^east). On the reverse side is a similar list. This one, however, imagines that a new eu-
ol each threat. (1 causes the most deaths, l »c • ¦ ;^kcd ^ ry|e (hc re|aljvc ,|aiu,cr of each threat, tins time including
viroiinicni.il threat. TOXICA, has been discovered. You a.c .,tai
TOXICA among diem. — ' " ~ ~~
,,, h , ?• urording to your perceptions of deaths per year in the United Sates (Ml=.nosi deaths per yea,,.
Please rank these risks I through 12 according y
1(..n ASBESTOS
HANDGUNS U'AU " ~
I '('ITS D1()X,NS
AIDS VIRUS ll''
DRUNK DRIVING SMOKING
DRUG AHUSIv_ —
NUC1 EAR l'OWER, ALCOHOl
KADON 1NU
Please check your feelings Mow:
1 believe that the Federal Government should spend more money on eliminating all of the environmental and health
dangers listed above only the top three six. nine none
I believe thai the Federal Government should regulate maximum allowable levels of all of the environmental and health
dangers listed above only the top three six. nine none
I believe that the Federal Government should require all citizens to participate in safety programs designed to eliminate the
environmental and health hazards from homes, schools and workplaces. Yes No Sc
Please tuni this form over a in! complete the other side.
When you have completed this survey, please fold it so that the Environmental Risk Survey address is showing Staple the
survey and drop it in the mail. Thank you for your participation in this survey. If you desire a copy of the survey results please send
a self-addressed, stamped envelope to the address on the other side. Results will be available in the fall of 1990. 1
FIGURE 1
-------
This is Side Two. Please begin on Side One.
Part Two: Ilow does the introduction of new information affect your attitude about deaths per year?
A new environmental threat has been discovered. The EnvironmcnUil Protection Agency has named it TOXICA. In less
than a year, it has been discovered that TOXICA:
---Kills more Americans each year than the AIDS virus;
---Is naturally occurring (not man-made), and is found in homes, schools and workplaces;
---Kills one American every 20 minutes;
---Kills more Americans every year than Asbestos, Lead, Dioxins, and PCB's combined;
--Can be easily abated or removed lor about the same cost to society as installing smoke detectors in
all homes.
Please re-rank these risks 1 through 13 according to your perception of deaths per year in the United Suites (#1 = most deaths
per year). Remember to utke the environment)! threat TOXICA into account in your deliberations.
HANDGUNS 8 17,000
l.FAD
10
7
DIOXINS
13
0
AIDS VIRUS 7 19 ' 000
pCB's
1 2
0
RADON
(6) 5*
21 ,000
DRUG ABUSE 4 ?4,000
DRUNK DRIVING
3
25 ,000
ASBESTOS
9
189
TOXICA UI 6JL
NUCLEAR POWER
11
1
ALCOHOL
2
100,000
SMOKING 1 120,000
Please check your feelings l>elow:
I believe that the Federal Government should spend more money on eliminating all of the environmental anil health
dangers listed above only the lop three six nine none
1 believe that the Federal Government should regulate maximum allowable levels of all of the environmental and health
dangers listed above only the top three six nine none
I believe that the Federal Government should require all citizens to participate in safety programs designed to eliminate these
environmental and health hazards from homes, schools and workplaces. Yes No
1 believe the Federal Government should spend more money on TOXICA than on AIDS. Yes No
I believe the Federal Government should regulate maximum allowable levels of TOXICA. Yes No .
I believe the Federal Government should require all homes, schools and workplaces to be tested lor TOXICA levels.
Yes No
BUSINESS REPLY MAIL
FIRST-CLASS MAIL PERMIT NO. 0065 COOPERSBURG, PA
NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES
POSTAGE WILL BE PAID BY ADDRESSEE
Environmental Survey
P.O. Box 288
Coopersburg, PA 18036-9990
FIGURE 2
-------
100
100%
67
50%
42
40
33
12
Stale Radiation Random Indiana Eastern PA Doctors Random Eastern PA
Radon Companies
Total
i I Ranked Radon in Top 3 ^ Ranked Toxica In Top 3
Figure 3
-------
100%
73
50%
33
Radon Cmp?"1- Stole Radiation Random Indiana Eastern PA Doctors Random Eastern PA
Total
M Ranked Radon Number 1 ~ Ranked Toxica Number 1 ^ Ranked Toxica within *1-2 of Radon
Figure 4
-------
100%
50%-
42
14
17
27
50
70
10
67
<33
I
Total Radon Companies State Radiation Random Indiana Eastern PA Doctors Random Eastern PA
I I Ranked Radon in Last 3
Ranked Toxica in Last 3
Figure 5
-------
100100
100%
Total Radon Companies State Radiation Random Indiana Eastern PA Doctors Random Eastern PA
~The Government should ¦¦ The Government should PZ/iThe Government should require all
spend more money on H regulate maximum allowable \zA homes, schools, and workplaces
TOXICA than on AIDS. levels of TOXICA. to be tested for TOXICA levels.
Figure 6
-------
II-6
TITLE: Estimated Levels of Radon from Absorbed Polonium 210 in Glass
AUTHOR: Hans Vanmarcke, Belgium
This paper was not received in time to be included in the
preprints and the abstract was not available. Please check your
registration packet for a complete copy of the paper.
-------
EXPANDED AND UPGRADED TESTS OF THE LINEAR-NO THRESHOLD THEORY FOR
RADON-INDUCED LUNG CANCER
By: Bernard L. Cohen
University of Pittsburgh
Pittsburgh, PA 15260
ABSTRACT
BEIR-IV gives lung cancer risks vs. radon exposure, R, for smokers and non-smokers.
Summing these over the population gives the mortality rate, m, as a function of R and S, the
fraction of the population that smokes. From data on R and S, m(BEIR) can be calculated for
each state and compared with observed values, m(obs). Their ratio, m(BEIR)/m(obs), increases
rapidly with increasing R, indicating that the R-dependence of m(BEIR) is much too strong; in
fact, if this R-dependence is reduced to zero, a large discrepancy remains. All attempts to
explain the discrepancy fail, and it is shown to apply to all other recognized theories.
Using counties rather than states gives 20 times as many recognized data points, but is
limited by the lack of smoking information. Multiple regression is used involving 17 potential
socioeconomic confounding factors. The slope of m vs. R is negative, a sharp discrepancy with
the predicted strong positive slope. Data are stratified and segmented in over a hundred
different ways, but the large discrepancy is always found.
The limitations of this county study due to the fact that it is an "ecological study" are
investigated. It is shown that they are not nearly strong enough to explain the discrepancy.
-------
2
A. A MATHEMATICALLY RIGOROUS TEST OF THE BEIR-IV AND OTHER RISK
ESTIMATES
Table 2-4 of the BEIR-IV Report gives the risk of lung cancer to smokers, r„ and to non-
smokers, rn, as
(la)
rra,*bJi (lb)
r,=a,tb,R
where R' is their annual radon exposure, and as, a„, bs, and bn are constants. The number of
deaths expected in a state each year, N, and Nn, is obtained by summing (1) over all persons in
the state, p smokers and q non-smokers, which gives
yr'
N=pas+pbs( )=pas+pbjl
&
Nn=qan+qbn(-—)=qan+qbHR
where R is the average radon exposure, assumed here to be equal for smokers and non-smokers.
The state mortality rate, m, is the total number of deaths per year divided by the population,
Ns+Nn pas+qan pbs+qb
m= + R
p+q p+q p+q
or in terms of the fraction of the population that smokes, S = p/(p + q)
m=Sas+(l-S)an+[Sbs+a-S)bn]R (2)
Averaged over each person's lifetime, the annual risk is the lifetime risk, given in Table
2-4, divided by the life expectancy given on p. 55 of BEIR-IV, which yields (in units of 10"5yl)
as=178, aN=15.9, bs = 17.8, bN=1.75 for males, and as=76.7, aN=7.9, bs=8.4, bN=0.87 for
females, with R measured in units of Ro=37 Bq m'3 (=1.0 pCi L'1) = 0.2 WLM y1 (WLM
= working level months).
Values of S for each state are available from the Bureau of Census 1985 Current
Population Survey of 114,000 persons, and mean radon levels for each state are available from
the University of Pittsburgh Data File. Thus, values of m, m(BEIR-IV), can be calculated for
each state. These can then be compared with the actual (observed) age-adjusted lung cancer
rates, m(obs), for which we use the EPA compilation for 1970-1979. For purposes of
discussion, we consider fits of m(BEIR-IV) and m(obs) vs R to
m=a+bR (3a)
and their ratios vs. R to
sS5Lm.ji.Bit <3b)
m(obs)
-------
3
where a, b, A and B are adjustable constants.
The ratio m(BEIR-IV)/m(obs) plotted vs the mean radon level, R, has a positive slope
B differing from zero by 7.7 and 7.8 SD for males and females respectively. This means that
the positive slope of m vs R given by the theory is far too strong. To break the problem into
its components, a plot of m(BEIR-IV) vs R is fit by a line with slope, b, given by b = 3.8 ±
1.9 for males and 2.5 ± 0.77 for females, while a plot of m(obs) vs R is fit by a line with
negative slope, b = -9.8 ± 2.1 for males and -2.6 ± 0.6 for females.
In principle, at least, our derivation of (2) was by rigorous mathematics and therefore
not subject to the problems in epidemiological studies. In fact our treatment is basically a simple
application of "the scientific method": a theory makes a prediction which is tested by
observation; if they do not agree, the theory must be modified or abandoned.
In practice, there are several "loose ends" that must be considered. The principal one
is migration—correcting for this changes the slope B from 0.30±0.039 (1 SD) to 0.28±0.040
for males, and from 0.64±0.082 to 0.595±0.082 for females. If the retirement states FL, CA,
and AZ are removed from the data base, B becomes 0.28±0.042 for males and 0.56±0.092 for
females. Correcting for migration does very little to reduce the discrepancy.
Other loose ends are validity of the data which has been treated elsewhere, and which
will be finally settled by the National Radon Survey; use of 1970-79 lung cancer statistics with
1985 statistics on smoking, while BEIR-IV risks are based on 1981-84 lung cancer data, which
will be largely settled when more recent lung cancer statistics become available; and assuming
average radon exposure is the same for smokers and non-smokers, which is corrected for
elsewhere.
We conclude that the discrepancy with BEIR-IV is real and very large. It is shown that
this discrepancy is not appreciably reduced by using other risk estimates, or by considering
effects of potential confounding socioeconomic factors (pcf).
B. MULTIPLE REGRESSION ANALYSIS OF DATA ON U.S. COUNTIES
There is a great advantage in using counties rather than states in this type of study since
data are available on 913 counties vs. only 47 states (excluding AZ, CA, FL). This allows
inclusion of many more pcf and gives much better statistical certainty. It has the disadvantage
that data are not available on smoking frequency by counties, so the "mathematically rigorous"
test cannot be made. But smoking in the state, S', is used as a pcf; hopefully the socioeconomic
pcf will largely represent the variations within the state.
In multiple regression, we seek the best fit to
(4)
m=a+bR+clFl+c2F2+...+cl7Fl7+cj!
where F,, F2,—, F17 are the values of 17 selected socioeconomic pcf, and a, b, c; are constants
determined by fitting the data. With 913 sets of data, 20 constants is not excessive for high
statistical significance.
In fitting the data, S' is the most important variable and c, is positive as expected.
However, the values of b in (4) are quite insensitive to whether or not S' is included: -1.59 ±
0.37 vs. -1.63 ± 0.39 for males, and -0.62 ± 0.13 vs. -0.67 ± 0.13 for females. This
-------
4
indicates that the other pcf act as surrogates for smoking. Since smoking is well known to be
the most important factor in causing lung cancer, this suggests that the number and variety of
pcf is sufficient to act as surrogates for any other pcf that has not been included.
The most important aspect of the above is the values of b which differ from the BEIR-IV
prediction (corrected for migration) 4-4.5 for males and +1:1 for females by 16 and 13 standard
deviations respectively. This is a tremendous discrepancy between theory and observation.
Extensive studies were made of effects of stratifying the data into sub-groups. Data were
stratified into quintiles on the basis of each of the socioeconomic pcf in turn and a complete
multiple regression analysis was done on each quintile. For these (17 pcf x 5 quintiles x 2
sexes =) 170 analyses, 94% had negative values of b and the largest positive b was less than
30% of the BEIR prediction. The average value of b was-1.18 for males and -0.56 for females,
For the 5 quintiles generated by stratifying on a single pcf, in all cases the average b was
negative, and never smaller than-0.88 for males and -0.40 for females. The slope b is negative
if we confine our attention only to the big city counties or only to the most rural counties, only
to the highest income or only to the lowest income counties, only to counties with the oldest
median age or only to the counties with the youngest median age, etc., etc.
When the data are stratified on geography, a substantial change results: the average
value of b for all geographic areas is reduced to zero. That is, the negative slopes are explained
by a systematic negative relationship between m and R for the regions of the nation. This
relationship cannot be explained by smoking patterns, and no other explanation is easy to
concoct. It might be due only to chance, since there are only 7 regions, in which case this
regional correlation is not significant. But even a zero value of b represents a very large
discrepancy with theory.
In the remainder of this study, stratification on geography was retained. Finer
stratification on geography was tried by analyzing the data separately or each of the 18 states
in which we have data on at least 20 counties. (The number of pcf must be dramatically reduced
for this.) The average values of b were -0.11 for males and -0.46 for females.
Double stratification was tried by stratifying the data for each national region on the basis
of each important socioeconomic pcf in turn. The b values averaged over strata and regions for
each of these stratifications was essentially the same as those obtained from stratification by
regions only.
As a check on the validity of our radon data, similar studies were carried out using data
from the EPA surveys in the 22 states for which they were available. It was assumed that
exposures were 0.5 times basement measurements. The slopes b for the entire data set and for
individual states were essentially the same as those obtained by analyzing our data for the same
22 states.
In summary, we find a gross and statistically undisputable discrepancy between the
predictions of BEIR-IV and observed lung cancer rates in U.S. counties; the theory predicts a
substantial increase in lung cancer mortality with increasing radon exposure, while observations
corrected for smoking and a wide variety of potential socioeconomic confounding factors
indicates a decrease, or after allowance for a systematic geographical effect which is not
understandable, a null dependence.
-------
5
C. PROBLEMS ARISING FROM THE FACT THAT OUR STUDY OF COUNTIES IS
AN ECOLOGICAL STUDY
Our study of counties outlined in Sec. B is what epidemiologists call an "ecological
study," and there is a large literature on the hazards and shortcomings of ecological studies.
One such problem is that an ecological study of large groups of people ignores the fact that only
small sub-groups may be at risk-effectively the wrong people are being studied-but it has been
shown that this problem does not apply to a linear-no threshold theory. The other normally cited
problem is that ecological studies are especially susceptible to confounding relationships. We
consider that problem here.
We assume that Eq. (2) is the true relationship, and consider the degree to which an
ecological study based on Eq. (4) fails to give the correct result. In order to understand what
cam be expected from such an ecological study, consider the average value of m, m, for all
counties with a given value of R, say R,. This can be calculated by use of (2). If S is not
correlated with R. the distribution of S-values for those counties is the same as the distribution
for all counties whence,
_____ (5)
where S is the national average value for S, which is known. Since this relationship is valid for
each value of R,, the best fit to all of the data would depend on R in accordance with (5) with
the variable R replacing R,. Thus, b would be
(6)
b~bf+bfi-S)
Since b, and bn are known from the theory and S is known, determining b from an ecological
study and application of (6) gives a test of the theory. Note that even a simple regression of m
on R gives the correct value of b if there is no correlation between R and S.
If there is a strong correlation between R and S. this is no longer valid. For example,
if we consider b, >> bn (actually b, = 10bJ and S=k/R, according to (2), there is no
dependence of m on R, whence an ecological study with simple regression of m on R would give
zero slope, a large discrepancy with (6). This discrepancy would be reduced by a multiple
regression of m on R and S, but clearly (4) is not a good representation of (2) with S=k/R, so
there would still be a substantial discrepancy.
If one examines the literature on the hazards of ecological studies due to confounding,
one finds that they always arise from this type of correlation. Typically the examples given are
based on concocted data involving 3 to 5 data points with these correlations built in. With so
few data points, such correlations can arise by chance — there is nothing wrong with these
examples. However, when there are many hundreds of data points, the possibility of strong
chance correlations becomes vanishingly small. They can only arise from causes that can
hopefully be traced down and evaluated. That is the situation we have here. We will consider
what correlations between R and S are credible, and we will evaluate their effects quantitatively,
using data for males. Since we assume that (2) is the true relationship, we must have values of
S for each county. We derive these by use of models which incorporate variable correlations
between R and S. We use (2) with these S-values to calculate m for each county, and use that
calculated value (rather than the observed value) of m in our regression analysis. We then
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6
investigate the degree to which the b-value obtained from the regression analysis compares with
that for no correlation between R and S. These calculations are done with our 913 county data
file using the R and socioeconomic pcf-but not the observed m or S'—for each county.
Our first model, which includes our estimate of the realistic situation, derived from our
other studies, involves the following effects:
(1) Urban areas have more smoking and hence about 20% more lung cancer than
rural areas, but urban houses have about 25% lower radon levels.
(2) Houses of smokers have about 10% lower radon levels than houses of non-
smokers.
(3) It is believed that X% of lung cancer is due to air pollution, and areas with high
air pollution have about 30% lower radon levels than areas of low air pollution.
EPA estimates as a national average X = 1.5%, but we take X=25% for smokers
and 75 % for non-smokers in order to have an appreciable effect. This effect is
treated as an add-on, independent of R, S, or m.
The mathematics is complicated by including four groups, rural and urban smokers and
non-smokers, rather than two (smokers and non-smokers) as in the derivation of (2), but the
calculation is straightforward. We call the numerical estimates given above the "index values."
With no correlations, b=4.59; with index values, b=3.92; with 2, 4, 6, and 10 times the index
values b=3.08, 1.70, 0.82, and -0.06 respectively.
We conclude that the realistic effects we have introduced reduce the positive value of b
predicted by the theory by only 15%. In order to reduce b to zero, which is the maximum
observed value, all of these effects would have to be 10 times larger than we know them to be.
There could be other confounding effects, but after years of study, we have found none
that are comparable to these, let alone 10 times stronger.
Our second model, run on our file for states, explores the effect of an unrealistically
strong direct correlation between R and S, given by
(7)
S=0A-02r/N v '
where r is the ranking of the state by radon level, R, and N is the total number of states. The
constants reflect the fact that smoking frequencies for states are all in the range 0.2 to 0.4 for
males. We use (7) to calculate m, which is then used in the regression analyses.
With this very strong negative correlation between R and S, a single regression of m on
R gives a very negative slope, b=-9.1. But a double regression on R and S, fitting the data to
m=a+bR+cS
gives b = +3.2. If we let S be the same for all states, there is no correlation between R and S
and either single or double regression gives b = +4.3.
We see that even this highly unrealistically strong correlation between R and S removes
only a small fraction of our discrepancy.
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7
SUMMARY
A plot of lung cancer mortality rate, m, vs. radon exposure, R, for various states or
counties shows a strong tendency to decrease with increasing R whereas theories lead one to
expect a substantial increase with increasing R. The discrepancy in slope of the best fit line is
many orders of magnitude. Our purpose is to try to understand this discrepancy.
The BEIR-IV theory gives risks to individuals, differing for smokers and non-smokers.
When these are summed over the population, one obtains predictions of the lung cancer mortality
rates as a function of R and S, the fraction of the population that smokes. Since R and S are
known for each state, the theory can be tested directly on those data. It fails drastically; the
dependence on S is not nearly strong enough to change the dependence on R from strongly
positive to strongly negative. In principle, at least, this study is mathematically rigorous, and
hence not subject to the normal problems of epidemiology. It is shown that any theory which
gives a risk to individuals increasing with R, and with smoking as the only other variable,
encounters this same discrepancy with observation. All known theories fit this description.
An alternative test is to use data for counties, which has the advantage of 20 times as
many data points, but the disadvantage of being an ecological study because smoking data are
not available for counties. The problem is treated by multiple regression analysis involving 17
socioeconomic potential confounding factors (pcf). The result gives a slope of m vs. R with
negative slope differing from the substantial positive slope predicted by BEIR-IV by 15 S.D.
The data are stratified in various ways, but similar discrepancies are found for all individual
subsets of the data. The validity of the data is tested by comparing with similar analyses of EPA
data, and good agreement is found.
Since this is an ecological study, the problems ascribed to ecological studies are
examined, and it is shown that the only ones applicable here would be due to correlations
between R and S. From other studies, there is substantial information about such correlations,
but when this information is applied, the discrepancy is reduced by only 15%, and all effects
would have to be 10 times larger to remove the discrepancy. Even an unrealistically strong
direct correlation between R and S removes only one-third of the discrepancy.
If this discrepancy between theory and observation cannot be explained, the only rational
alternative is to abandon the linear-no threshold theory, recognizing that it grossly over-estimates
the cancer risk from low level radiation.
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Session II:
Radon-Related Health Studies --PANEL
"Risk Communication"
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TITLE: Apathy vs. Hysteria, Science vs. Drama: What Works in Radon
Risk Communication
AUTHOR: Sandman
This paper was not received in time to be included in
preprints and the abstract was not available. Please check
registration packet for a complete copy of the paper.
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II - 9
AMERICAN LUNG ASSOCIATION'S RADON PUBLIC INFORMATION PROGRAM
by: Leyla Erk McCurdy
American Lung Association
1726 M Street, NW, Suite 902
Washington, DC 20036-4502
ABSTRACT
The American Lung Association (ALA), the nation's oldest
voluntary health organization, is dedicated to the conquest of lung
disease and the promotion of lung health. The objective of the ALA
Radon Public Information Program is to reduce public exposure to
elevated indoor radon levels through an implementation of
grassroots-based radon public awareness campaigns. The program
which is funded by a grant from the U.S. Environmental Protection
Agency, was initiated in December 1989 and the first phase which
includes 22 local American Lung Associations will continue until
May, 1991. In September 1990, the program was expanded to 40 local
ALA's, in order to implement more public information programs
during National Radon Action Week, October 14-20, 1990. Activities
implemented by the local ALAs include distribution of free or
reduced radon kits; elementary and secondary school programs; media
meetings; TV news series, talk shows, feature stories; radio PSA's
and talk shows; articles and feature stories in the print media;
conferences; workshops; displays at fairs and other exhibitions;
distribution of radon fact sheets through libraries and utility
company mailings; video distribution through video chains and
libraries. The local Lung Associations also serve as local
promoters for the EPA/Advertising Council Radon Public Service
Announcement Campaign. This paper will describe the American Lung
Association's activities in communicating the radon health risk to
the public and will discuss the initial results of the program.
This paper has been reviewed in accordance with the U.S.
Environmental Protection Agency's peer and administrative review
policies and approved for presentation and publication.
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AMERICAN LUNG ASSOCIATION'S RADON PUBLIC INFORMATION PROGP&M
TNTROnilCTIQN
• Tiirirf R^soci&tion (ALA) , th6 nations oldGSt
The American .g . ¦ dedicated to the conquest of lung
voluntary health organiza _ health. Utilizing the scientific
disease and the^romotion^of th/ organization's
expertise of the Am ALA has been pursuing its mission of
preventionCand"control of lung disease through education, advocacy
and research.
t _iiccnriation is a unique national voluntary
The American Lung organization and many organizations at
health agency. It ddition to the National Association, ALA
the same time. of 131 affiliated local American Lung
consists of a throughout the United States. With the
Associations distri . 0ffices the total number of Lung
inclusion of .J™**11 Each Lung Ass0ciation is responsible for
Associations is 26 . territory they serve. This way they
implementing programs ams for the particular needs of their
are able to tall®r the local Lung Association officials are also
community. bince which thev serve, they not only understand
tS area', thly also know how to
the needs of we P Pmhis uniaue organizational structure of the
communicate with thenu ^This , it possible to lmpleInent
TrZrt™ at the grass-roots levei, is one of the key factors for
a successful risk communication.
P^now pnRT.TC EPTTr&TTON PROGRAM
Ac air- noilution became recognized as a threat to lung health.
As air pollu informing the public about the
Va health effects associated with air pollution in both the
adverse health e . t since the mid 1980's, when indoor
outdoor and mdoo a s'erious health risk issue for the
radon ™LA has placed particular emphasis on developing
general public, aua activities related to radon. Many
public information iationg become sources of information
of the local Lung A t radon it's detection and reduction,
for their local pres; and the broadcast media have
m many instances local Lung Associations in
communicating the ^dcm risk to their readers and viewers.
In Oecember 1939 MA, ^
Environmental Protec ts radon public awareness campaign
develop and implement a grass root.» » P indoor radon levels.
in order to reduce public ensure to proposals f()r pubu
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elevated indoor radon exposures and to encourage public action for
testing and mitigation. 22 Lung Associations were awarded grants
to implement local radon public awareness campaigns.
A list of these American Lung Associations is given in Figure
I.
The geographic distribution of the States where these Lung
Associations are located is shown in Figure II.
The program was initiated in December 1989 and will continue
until May 1, 1991. Since the program is not completed yet, only
initial results are available at this time.
Although each of the Lung Association programs are unique in
their implementation, there are several common threads: Five Lung
Associations are implementing school education programs. ALA of
Maine and ALA of Southeastern Massachusetts have targeted high
school students. Norfolk Country-Newton Lung Association (MA) and
ALA of Essex County (MA) have concentrated on fifth grade students,
whereas ALA of Mid-Ohio is educating seventh grade students.
ALA of Chicago (IL) , ALA of Southwest Indiana and ALA of
Northeast Indiana have completed very successful campaigns, where
a TV-series on radon was accompanied by radon test kit distribution
to the public.
Two Lung Associations, ALA of North Dakota and ALA of
Philadelphia and Montgomery County (PA) have chosen to request the
cooperation of the utility companies in order to reach their target
groups. In these areas radon information was inserted with the
monthly utility bills.
Almost all the Lung Associations have distributed radon
testing kits and/or radon information pamphlets and have set up
displays at fairs, exhibitions or shopping malls. They have also
made presentations on radon for community groups and professional
organizations. Each Lung Association has put a particular emphasis
on the media component of the public information campaign. They
have sent press releases and public service announcements to the
media, written letters to the editors, and they have contacted
their television and radio stations for possible programs on radon.
As a result of these efforts many newspaper articles were printed,
Lung Association spokespersons appeared on television and radio
talk shows and several television stations aired radon news
stories.
The Lung Associations also serve as the local promoters for
the EPA - Advertising Council radon campaign which was launched in
October 1989 in 29 states and later was expanded to 33 states.
This is a multimedia campaign with television, radio and print
public service announcements, billboards, transit cards and direct
mail brochures. Lung Associations have contacted their local radio
and TV stations, print media, local transit authorities and
billboard companies to promote the radon public service
-------
announcements. The efforts of the Lung Associations at the local
level are effective in enhancing the impact of the Advertising
Council's national radon campaign.
^ u-?0 1990 which was designated as National
Radon^Act ion Week by e— t^I
funding from U.S. EPA.
TTT i-i sts the Lung Associations which joined the ALA
radon public information program during National Radon Action Week.
The geographic distribution of the states where these Lung
Associations are located is shown m Figure IV.
i -r,->*nrs jpfion Week as a "hook", the Lung
Using N^°ngUCCessful in reaching the public through their
Associations were ss media and through other communication
local print and electronic at malls, fairs, and public
channels such a . tion programs for community groups ;
buildings; radon education J>r g^^ ^ 0Mpalgns- Lmg
elementary school P 91 t t kits available to the public at
Associations also made radon^ test ki^^ ^ ^ ^
a discounted pricei y_ about 15j0oo radon test kits were sold
" m?fin th^ Phi Jlelphiaarea during the month of October, with the
cooperation of a local department store chain.
mNrr.nsioN
mitial results of the ALA Radon Public Information Prograa
. J. H ih.t SJass-roots public education is one of the crucial
in o^nts for radon risk communication. A significant reduction
components for ra increased public awareness, testing and
in radon risk through^ncreased PoUective impaot of ef£ective
mitigation can state Agencies, participation by the
programs by Feaer responsive radon testing and mitigation
fS^ry'in"^ t^caTpTuc education programs of the type
implemented by the American Lung Association.
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ALA of Atlanta
ALA of Chicago
ALA of Idaho
ALA of Southwest Indiana
ALA of Northeast Indiana
ALA of Iowa
ALA of Kansas
ALA of Maine
ALA of Essex County, Massachusetts
Norfolk County-Newton Lung Association, Massachusetts
ALA of Southeastern Massachusetts
ALA of Southeast Michigan
ALA of Michigan
ALA of Hennepin County, Minnesota
ALA of Mid-Ohio
ALA of Montana
ALA of North Dakota
ALA of Delaware and Chester Counties, Pennsylvania
ALA of Lancaster and Berks Counties, PA
ALA of Philadelphia and Montgomery Counties, Pennsylvania
ALA of Tennessee
ALA of Virginia
riGURE It American Lung Associations (ALA) participating in the
Radon Public Information Program
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FIGURE II:
States where ALAS participating in the Radon Public Information Program
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ALA of Arkansas
ALA of the Valley Lode Counties, CA
ALA of Los Angeles County, CA
ALA of Delaware
ALA of Illinois
ALA of Central Illinois
ALA of North Central Illinois
ALA of Western Massachusetts
ALA of Minnesota
ALA of Eastern Missouri
ALA of Western New York
ALA of New York State
ALA of Green Country Oklahoma
ALA of Central Pennsylvania
The Rhode Island Lung Association
ALA of Virginia - Blue Ridge Region
ALA of West Virginia
FIGURE III: American Lung Associations (ALA) which joined th«
Radon Public Information Program during
Radon Action Week
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FIGURE IV: States where ALAs implementing Radon Action Week Activities are located
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11-10
TITLE: Ad Council Radon Campaign Evaluation
AUTHOR: Mark Dickson and Dennis Wagner, EPA - Office of Radiation Programs
This paper was not received in time to be included in the
preprints so only the abstract has been included. Please check
your registration packet for a complete copy of the paper.
In October 1989, the Ad Council and EPA launched an
advertising campaign to motivate people to test their homes for
radon. TBWA, a New York advertising agency, developed
television, radio, and print public service announcements (PSAs)
that have been distributed to media outlets in 33 states. Since
then, the Radon Campaign has been extensively evaluated.
This evaluation includes six major components. First, radio
and television public service directors were surveyed to assess
how much air time the PSAs are receiving. A sophisticated media-
test of the television PSA was also conducted to better determine
the impact and effectiveness of its message and approach.
Further, the national radon hotline is being monitored monthly,
and hotline callers have been surveyed to determine whether the
follow-up direct marketing brochures are motivating testing.
People who have tested their homes have also been surveyed to
determine whether elevated levels are being reduced* Finally,
periodic nationwide surveys have been conducted to measure
changes in public awareness and action on radon during the
campaign.
This paper will outline the research design for each of
these evaluation components and summarize the key findings. The
paper will conclude by outlining how these findings can be useful
in refining and strengthening public outreach efforts to motivate
public action on radon.
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DEVELOPING A COMMUNITY RADON OUTREACH PROGRAM:
A MODEL FOR STATEWIDE IMPLEMENTATION
11-11
by: M. Jeana Phelps, M.Ed.. RT(R)
Radon Program. Radiation Control Branch
Division of Community Safety
Kentucky Cabinet for Human Resources
Frankfort, Kentucky 40621
ABSTRACT
Apathy, lack of consumer interest or urgency to test for
radon is one of the most serious public health challenges facing
the U.S. Environmental Protection Agency and State agencies.
This paper presents a model approach to overcoming public
apathy through a community based radon outreach program. The
model is based on a community network established in Western
Kentucky and two others under development in Jefferson and
Fayette Counties. The model includes community assessment
methods for identifying key volunteers, local radon concerns, and
availability of resources. It also discusses the initiation'and
coordination of a successful implementation. The paper serves as
introductory guidance for state agencies wanting to enlist
community support in promoting radon testing of all schools and
buildings and follow-up actions to reduce elevated levels.
*In this paper the term group will be used to refer to
organizations, associations, or agencies.
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INTRODUCTION
Research released by the U.S. Environmental Protection Agency
indicates that homeowners do not over-react or panic after
receiving information on radon (2.3). Rather, there is a great
apathy about radon as evidenced by the small percentage (51
estimated) of homes that have been tested nationwide. Of the
five percent who have tested, many do not mitigate (2). Only
seven percent of those with results between 4-20 pCi/1 had their
homes mitigated with a retest confirming success (2).
Consumer apathy in regard to radon indicates that the risks
associated with radon are either not being properly communicated
or the risk message is not understood. Risk communication
studies indicate that consumer apathy results from a combination
of these factors; use of ineffective communication media and lack
of consumer internalization and adoption of the message (2,3).
Focus testing of the radon message on randomly selected
populations, indicates that the communicated message must be
prescriptive, personal, and simple (2.3) (Table 1).
TABLE 1: KEYS TO EFFECTIVE RADON COMMUNICATION
• Make message prescriptive rather than informative.
• Eliminate unnecessary information.
• Simplify testing and mitigation guidelines.
• Personalize radon risks.
• Overcome denial of health risks by comparing radon risks to
other common risks.
• Discuss risks to special populations (smokers and children).
• Emphasize low cost, easy testing and availability of proven
effective mitigation methods.'
A community outreach approach allows for specific targeting
of a message to the audience, making the message more relevant to
those hearing it (2,3).
Complex messages such as those dealing with radon health risk
can be more effectively conveyed through personal contact or
through a respected community leader who also brings a sense of
legitimacy to the message (2,3).
In the Iowa Radon Public Awareness Survey (1990) of 588
randomly selected households, most respondents interviewed
(88.6%) had heard about radon and provided correct responses to a
number of questions designed to assess their knowledge about
radon. However, the results indicated that the public may know
about radon, but they do not believe they know very much. Only
sixty-nine people (11.7%) felt they were fairly or very
knowledgeable about radon. Almost two-thirds (65.6%) indicated
that they do not know much about radon. These findings further
reinforce the need to communicate radon health risk to the public.
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The Maryland Radon Risk Communication Research Study (1988)
found the greatest public change with respect to radon awareness
knowledge, attitudes, and testing behavior occurred when people
were exposed to a combination of radon information sources; e.g.,
news media (national and local stations), unsolicited mailings. '
and community outreach activities. The use of informal
communication channels appeared to be an important element in
explaining risk (3).
The importance of community outreach in motivating the public
to change their behavior is also well illustrated in the efforts
of the American Lung Association (anti-smoking). National Highway
Traffic safety Administration (seat-belt restraints), and the
National Cancer Institute (early diagnosis through self
examinations; i.e., skin and breast). From these examples, it
becomes evident that community "grassroots" advocacy or action
groups capable of networking at the national, state, and local
level are essential in influencing consumer attitudes and
behavior in regard to testing for radon and mitigating.
OVERVIEW OF PROGRAM DEVELOPMENT
The Kentucky Radon Outreach Program began about 1985-1986, in
response to telephone inquiries from the public'. With the
release of the 1987-1988, statewide residential radon survey,
outreach activities were expanded to include radon public
awareness programs, a three day radon education program, and
dissemination of the U.S. EPA's radon literature. These early
activities were usually initiated as a result of public need or
request.
Today, the Kentucky Radon Outreach Program consists of a
multitude of diverse and dynamic activities. Instead of waiting
to respond, or be reactive, the outreach program takes a
controlled active approach to disseminating the radon message.
By networking with groups, the radon program is able to extend
its limited staff and resources across the state.
The radon outreach program is guided by three basic
attitudes. These being:
• Recognize every person (contact/telephone inquiry) as a
potential public communicator about radon.
• Accept people where you find them and start from there
to build a working relationship.
• Make use of most peoples' willingness to help.
These are realistic attitudes, since anyone who attempts to
solicit assistance from public and private groups, will soon
learn that radon is not a "priority" for everyone. To build
effective liaisons, one must be flexible and willing to
negotiate. This is especially important when attempting to
establish outreach activities with school officials, home
builders, real estate agents, and others who are often on the
front "firing line" in regard to radon issues.
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Community outreach activities organized through groups, by
nature, generally reach a specific target audience and have
definite measurable objectives (Table 2). Activities for such
groups are often time and content limited; i.e.. a radon
awareness program, one-time literature dissemination, etc.
Although community outreach through specific groups is critical
to talcing the radon message to the public, these groups do not
have the individual capability of addressing community radon
issues. Such issues which encompass schools, daycares, real
estate, new construction, testing availability and a myriad of
others, must involve community leaders and citizens. To bridge
this gap, the radon community action (advisory) committee concept
was established. These committees, consisting of community
leaders, can with assistance from the state radon agency,
coordinate a community-wide response to radon. Therefore, the
Kentucky Radon Outreach model is based on both group specific
activities and community action committee initiatives.
COMMUNITY OUTREACH - GROUP SPECIFIC
Getting started was simple and consisted of four major steps:
1. Determining purpose of radon outreach
2. Listing objectives and sub-tasks
3. Implementing action (work plan)
4. Tracking, analyzing, and evaluating progress
The specific activities involved in each of the major steps
are presented in Table 2. The following represents experiences
and insights gained through this process.
LESSONS LEARNED-GROUP SPECIFIC OUTREACH
The scope of any state's radon outreach program is ultimately
dependent upon the amount of time radon staff can devote to
outreach, staff time is probably more important than project
funding or resources. Staff time is necessary for making the
initial group contact, negotiating the plan of work (outreach
program), and providing ongoing attention and support to "keep
the program on track". Radon staff must also take the lead in
evaluating outreach effectiveness and apply this information to
future program development.
Experience has shown that more staff time is required when
working with purely volunteer groups as compared to groups with
salaried staff. Commitment of staff time to a specific group
outreach program seemed to be reduced once the initial meeting
was conducted and a plan of work (outreach activities) agreed
upon. The plan of work, which lists the objectives and
sub-tasks, serves as a very important blueprint for periodic
tracking and evaluation. (Appendix A)
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Step 1: Determine Purpose
The purpose of the radon outreach program is to promote radon awareness activities that provide citizen's of the
Commonwealth with information about radon, its risks, testing and mitigation strategies to the extent that they
can make informed decisions about radon in regard to their health and well being.
Step 2: List Objectives/Sub-Tasks to reach goals
Considerations
• Budget
• Staff
• Other on-going public information
activities
• Timelines (Flexible/Negoitable)
1.1 Establish community outreach programs through intermediaries (organizations/associations)
who impact special interest groups
• Identify the organizations/associations
• Identify Key Contacts
• Prepare for first meeting
-know the organizations goals, mission, philosophy, etc.
-know if any radon networking has occurred at the national level, ie: American Medical Associations
position on radon, National PTA resolutions, etc.
-Find out, if possible, what interest they may have in radon.
-Be very clear about the desired assistance being sought from the organization, (ideal work plan)
Telephone the contact and arrange for a meeting.
Prepare a meeting agenda.
Meet with contact, introduce the radon program and networking expectations. Negotiate, revise plan.
Set timelines. (Provide contact with literature)
Follow-up meeting with thank you letter and a revised plan of work.
Implement plan of work. (Provide on-going support, assistance, reminders, etc.)
1.2 Establish community radon action committees in designated high potential radon regions or
ommunities
Determine regions (in Kentucky, the four regions with the highest incidence of elevated radon levels
were selected Jefferson, Warren, Fayette, Somerset).
Identify key contacts representing the diverse sectors of the community to serve. (Look to established
radon outreach groups)
Solicit a key contact to serve as committee chairperson.
Assist chairperson in organizing committee, selecting members, etc.
Provide committee with support and resources needed to identify and respond to their community's
needs (Radon staff responsible for providing information about state)
Step 3: Establish tracking and
evaluation measures
Considerations
• Plan of work should serve as tracking guide
• Prepare a written summary of progress
Detrmine timeline intervals for tracking progress and evaluation of the program. Do so with
input from organization contact. (Review plan on a pre-determined schedule)
-Tracking progress provides for the quick identification and correction of problems that might
otherwise delay progress.
Table 2: STEPS IN ESTABLISHING GROUP SPECIFIC RADON OUTREACH PROGRAMS
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A plan of work between the radon program and the University
of Kentucky. Cooperative Extension Service, is illustrated in
Appendix A. It should be noted that an ideal plan of work may be
developed, only to find that some of the activities outlined
cannot be completed. These plans are often adjusted as changes
in the groups' commitment or resources occur.
The most important single step in developing group specific
outreach programs is the selection of the target associations,
organizations, and agencies.(Refer to Appendix B for suggested
groups). It was found that what works in one state with a
particular group may not be successful in another state. For
example, unlike most states, the Kentucky Lung Association has a
very small staff and cannot assume additional responsibilities,
like radon. The Association supports the radon program by
distributing radon literature and is affiliating with The Salt
River Rural Electric Cooperative in organizing a radon testing
campaign. However, the Kentucky Lung Association cannot singly
undertake major radon outreach activities at this time.
Accepting the limitations presented by any group is
difficult; however, acceptance is the key to building strong
networking alliances. It is important to remember that not all
groups have the resources or directives to engage in a full scale
radon outreach program. It has been the Kentucky Radon Program's
approach, to accept the limitations and recognize that the future
may present new unrestricted networking possibilities.
DECISIONS REGARDING GROUP SELECTION
The outreach contacts in Kentucky were initially selected
from two major groups (Table 3 and Appendix B); however, no
agency or organization requesting radon awareness outreach is
ever rejected. (Tips for selecting groups may be found in
Appendix C)
TABLE 3: NETWORKING CONTACTS FOR INITIAL DECISION MAKING
• Groups who have a charge to provide public health awareness
and education programs.
• Groups whose livelihood or work environment is impacted by
radon issues (other than measurement and mitigation
individuals)
American Lung
Local Health Agencies
Physicians/Dentists
PTA
American Cancer
Extension Service
Hospitals/Health Care Facilities
Allied Health Personnel
Home Builders
Engineera/Architects
School Officials
Real Estate Agents
Home Inspectors
School Maintenance Personnel
Building Managers
Home Relocation Agents
Mortgage Lenders
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IMPLEMENTING GROUP SPECIFIC OUTREACH
After identifying target groups, the next task is to identify
key contacts. State radon staff should find out as much about
the group as possible before preparing a plan of work and making
contact. Such information includes organizational structure,
mission and goals, and how radon intersects with these. These
facts should be used to determine the best approach and message
to use when communicating with the group. The first meeting is
crucial; be prepared to take the following items:
• Meeting agenda-outlining goals/activities between
state agency and group (tentative work plan)
• Fact sheet about radon and the state radon program.
• state residential survey findings.
• Resource pamphlets
• Group specific information (Radon in Schools Pamphlet.
group contacts as needed. bxdxr axso must provxut* u
assistance, and always a THANK YOU.
Evaluation of each project includes a periodic status report
or summary, and a final overview upon completion of the project
with a copy going to all participants. A post-project group
meeting allows review and provides an opportunity to discuss
future outreach activities.
A matrix tracking schedule is being considered as one way to
keep all staff informed about the progress of each outreach
program and to serve as a reminder to take action. (Refer to
Appendix A)
etc).
BUDGET
outreach programs require sufficient funding for staff
V/" *" * « • •• M MA* / W «% V* 4- _
Radon 0ub4.««ivM »a- — -»
and resources; such as printing of U.S. EPA pamphlets/handouts
travel, postage, and long distance telephone calls. Outreach
requires dedicated staff time and unless this is available,
effective outreach programs may not evolve.
equires dedicated staff time and unless this is available.
• • _ - . _ a m «mm « Atf A 1 VO _
Kentucky, outreach activities are being funded by the u.s
te Indoor Radon Grant and state match under the public
information category.
-------
RESULTS
From 1989 to the present, the Kentucky Radon Program has
established many contacts that have resulted in community radon
outreach programs. Some of these are highlighted in Appendix D.
Examples of specific group outreach plans are included as
Appendix E (Rural Electric Cooperative Outreach) and Appendix F
(Jefferson County School District/PTA Outreach).
UNRESOLVED ISSUES
The unresolved issues that seem to be most important relate
to the following:
• How to measure outreach program effectiveness and how to
apply this knowledge to future program development.
• How to determine if programs are cost effective.
• How to negotiate and network with groups who refuse to
acknowledge radon as a serious health threat.
The most important unresolved issue recognized was the actual
limitations of group specific radon outreach programs to be a
mobilizing force within local regions or communities. This issue
is being met by the second objective of the Kentucky Outreach
Model; that being, to establish community radon action committees
in designated high potential radon regions or communities.
INTRODUCTION-COMMUNITY RADON ACTION COMMITTEE
Community radon action committees are a part of the state
radon program's outreach plan. Community radon action committees
consist of members who can identify with the diverse radon issues
facing the community, whereas, group specific radon outreach
programs arfe more concerned with radon issues facing its
membership. Active members of "group" specific outreach programs
are valuable resources, as are elected leaders, public health
officials, and other "very visible" community representatives.
These individuals should be invited to serve on radon action
committees.
GETTING STARTED-ORGANIZING COMMUNITY RADON ACTION COMMITTEES
A decision was made to organize four community radon action
committees during 1990-1991. Because many group specific radon
awareness activities were already being conducted in potentially
high radon areas of the state, these areas became the ideal
setting to locate action committees.
Once the state locations were selected, radon staff began to
identify an organization or individual to take charge of calling
a committee together. This responsibility fits best with an
agency that is already empowered to respond to the health and
well being of the community.
-------
Possible committee organizers may be identified from such
groups as local health, American Lung. American Cancer, extension
service and rural electric cooperatives.
The Warren County Radon Action Committee was organized by a
home economics extension agent from the Warren County Cooperative
Extension office. The Louisville-Jefferson County committee was
organized by the Deputy Director of Environmental Health.
Louisville-Jefferson County Health Department. The committees'
success in addressing radon will not only be contingent upon the
commitment of the chairperson and state staff, but also on the
strength of the selected members and their community visibility.
DEVELOPING A COMMITTEE PROPOSAL
The radon program staff and selected chairperson usually work
together to draft an initial committee proposal (Table 4), select
committee members, and plan the first meeting (Refer to committee
letter. Appendix G).
The sample outline found in Table 2 can be used as a planning
guide when organizing a radon action committee. In Warren
County, faculty from the Center for Mathematics, Science, and
Environmental Education. Western Kentucky University, assisted
the county agent in planning the meeting. The radon staff
supplied state survey data, technical resource manuals, and
evidence of local radon issues reported to the state office.
Since not all committee members begin with a common background in
radon and related issues, it is important to provide an
introduction to radon at the first meeting. Once the committee
is organized and begins to identify and address community radon
issues, the chairpersons' role becomes critical to maintaining
committee momentum in meeting the stated goals. As in the Warren
County committee, the chairperson has appointed sub-committees to
complete specific assignments and report back to the group.
Appendix G illustrates a meeting follow-up and reminder letter.
The outline in Table 4. provides details about the
Louisville-Jefferson County (task force) community action
committee.
LESSONS LEARNED
Organizing and implementing community radon action committees
requires a time commitment and seems to naturally follow group
specific outreach awareness activities. If a committee is formed
in an area where there has been very little radon awareness;
then, this becomes an initial goal of the committee.
Community Radon Action Committees cannot take the place of
state enforced radon regulations (which Kentucky currently does
not have); however, these committees can serve as an impetus to
the development of such regulations. Also, since these
committees consist of community leaders, they may serve as allies
in demanding state action regarding radon.
-------
LOUISVILLE-JEFFERSON COUNTY
RADON TASK FORCE
A LOCAL INITIATIVE PROPOSAL
LOCAL ACTIVITY PROPOSAL
If the issues surrounding radon are to be addressed in an orderly and consistent manner, it is
important that Louisville and Jefferson County develop a local mechanism to plot a course which will
deal with the issues before they become emotionally charged. A time limited task force similar to
the AIDS task force is proposed for this purpose.
The mission of the task force would be to evaluate and make recommendations for action in each of
the following areas:
1. Identify of the extent of problem within Louisville and
Jefferson County to include a review of public education efforts and
the need for additional education/awareness.
2. Review of current processes for testing and mitigation. Such review
would include a determination of the need for professional
certification of persons conducting testing and mitigating.
3. Establish procedures necessary for the prevention of radon problems in new
construction.
4. Determine policy for handling of test results. This includes public dissemination of
information that indicates high potential areas and disclosure of testing information
at the time of property sale or transfer.
In order to get maximum value from the task force, broad-based representation is necessary.
Representation from the following agencies/groups is proposed:
County Government
City Government
Health Department
Parent Teacher Associations
Boards of Education
American Lung Association
Realtors Association
Homebuilders Association
Regional Radon Training Center
Plumbers Association
Am. Industrial Hygiene Assoc.
Cooperative Extension Service
Mortgage Lenders Association
Ky. Hospital Association
Jeff. Co. Medical Society
American Cancer Network
Ky. Radon Association
Louisville Bar Association
Louisville Gas & Electric
Task force members would be invited by the Director of the Jefferson County Department of Health.
Staff support for the task force would be provided by the Health Department, the Radiation Control
Branch and solicited from other participating groups. In January 1991, the Radiation Control Branch
(Radon Program) is sponsoring a radon awareness training session in Jefferson County. Ideally, the
task force could be appointed and have had at least one organizational meeting prior to that
training session.
It is anticipated that the task force would function for approximately 18 months. At the termination
of the project, a final report would be prepared and submitted to the County Judge, Mayor and
Board of Health.
Table 4
Louisville Jefferson County Task Force
-------
SUMMARY
Taking action to test and mitigate structures becomes a
complex issue when the structures are schools, public/state
buildings, daycares, places of employment, property for sale,
water sources, etc. When radon is present in these structures,
the lines of responsibility sometimes become obscure. Radon,
then becomes a community problem not unlike AIDS, Drugs, etc.,
that must be faced by those involved in the community; its'
citizens, and those empowered with public policy decision
making. In Kentucky, the use of community outreach programs and
community action committees has proven to be an invaluable
resource in taking the radon message to citizens. These programs
have been, and will continue to be, used, developed, and refined
in order to meet the Commonwealths' need for radon information
and technical assistance.
ACKNOWLEDGEMENTS
The author would like to acknowledge and thank the many
people in Warren. Jefferson and Fayette counties who have
accepted the challenges of radon risk communication, especially
Radon Chairperson, Clark Bledsoe, Deputy Director,
Louisville-Jefferson County Health Department and Radon
Chairperson. Sandra Proffitt, Home Economics Extension Agent.
Warren County Extension Service. Special thanks to Tamara Guy
for word processing support on this paper.
Without their support, assistance and networking, the
substance of this paper would not be a reality. Also many thanks
to the Kentucky Radiation Control Branch for allowing me the
freedom to take a non-traditional "radiation agency" approach to
the radon program and to USPEA Region IV and Headquarters staff
for always listening to my dreams. Also without funding from the
USEPA State Indoor Radon Grant, many of these activities would
not be a reality.
-------
REFERENCES
1. Johnson. Raymond H. - Radon Risk
Assessment and Risk Communication
The Radon Industry Review. Vol. 2, No. 10
November 1990
2. U.S. Environmental Protection Agency
Office of Radiation Programs, Radon Division
Technical Support Document for the 1990 Citizen's Guide
to Radon (Draft) Washington, D.C. 1990
3. U.S. Environmental Protection Agency, Office of Policy.
Planning, and Evaluation. Program; Evaluation Division.
Region 3/ OPPE/ State of Maryland Radon Risk Communication
Project: An Evaluation of Radon Risk Communication Approaches.
Washington, D.C. - November 1988
4. U.S. Department of Health and Human Services. Making Health
Communication Programs Work; A Planner's Guide. NIH
Publication No. 89-1493, April 1989
5. Conrad. William R. Jr. and William E. Glenn. The Effective
Voluntary Board of Directors. Swallow Press, Athens, Ohio
1983
6. Radon Public Awareness in Iowa, Report on 1990 Survey.
Conducted by the Iowa Department of Public Health.
7. Extension Committee on Organization and Policy/Community
Resource Development - Public Affairs Subcommittee: National
Extension Task Force on Community Leadership. Community
Leadership Development, Implications for Extension. The
Northeast Regional Center for Rural Development, University
Park. PA.
-------
Appendix A
Timeline
Oct/Now
1990
Dec 5, 1990
Dec 1990
ASAP
ASAP
Ongoing
Ongoing
1990 Plan of Work
Extension Service and Kentucky Radon Program
Person
ftrtivitv/Task
Spring 91
Ongoing
March-April
Jeana
Rick
Jeana
Jeana
Dwight
Jeana
Jeana
Starter-Kit Radon literature
to all Districts
Present overview of Radon Program to
Area Directors, UK-Good Bain
Prepare innovative EPA Grant proposal
to provide training to 4-H Youth
Leaders and members. Grant year
Nov 91 - Oct 92
Application to Velma Koostra for
State Homemaker's meeting -
Radon Presentation
Contact Joan Martin, WKU Center for
Math, Science, Env. Edu, regarding
development of a Radon leader's
Guide for use by cooperative
extension agents.
Status (» Pending)
Accomplished
Jeana, Joan, Sue
Bill, others?
Jeana
Jeana
Jeana 6
designated
KET Staff
Jeana
Jeana/Regional
Radon Training
Center
Accomplished
Draft prepared submitted to
EPA by Dec 12th deadline.
*Award notification in Spring
1991.
Accomplished
Scheduled to speak May 17,
1991
*Need to work with Sandra
Proffitt on Presentation.
EPA ok'd use of SIRG grant
funds to be transferred from
Amer. Lung Project for use in
Project.
Talked with Joan 1-7-91 and
will follow-up with letter of
Proposal.
*Will need to review project proposal
and then to schedule a project org.
meeting.
Provide radon training video to UK
Dept. of Ag Communications and to
the 14 CO-OP Ext. Districts.
Radon Awareness through local
Agriculture radio broadcasts.
Determine feasibility of utilizing
cooperative extension agents as
on-site school facilities during
KET-radon statewide broadcast.
*SIRG funds to pay for video
*Explore further with Sue and
Bill
*As we develop KET production
Renew radon literature to districts Upon request
Provide comprehensive-technical
radon training to agents.
*Need to explore waiving
tuition with Ellen Korn.
-------
LOCAL HEALTH AGENCIES
CHAMBER OF COMMERCE
REAL ESTATE AGENTS/BROKERS
STATE REAL ESTATE COMMISSION
CHURCH GROUPS
PHYSICIANS>HEALTH PROVIDERS
BANKERS
BOY-GIRL SCOUTS
STATE & PRIVATE SCHOOL OFFICIALS
CANCER SOCIETY
HOSPITAL VOLUNTEER GROUPS
FRATERNAL & CIVIC ORGANICATIONS
LOCAL EMPLOYERS
BUILDING INSPECTORS/MANAGERS
PARENT-TEACHERS ASSOCIATION
COUNTY EXTENTION AGENTS
HOME BUILDERS
PLUMBING AND AIR CONDITIONING
EDUCATOR'S
ELECTED OFFICIALS
LIBRARY RESOURCES
HABITAT FOR HUMANITY
AMERICAN LUNG
HEALTH ASSOCIATIONS & AUXILIARIES
DAYCARE OPERATORS
HOMEMAKERS
NEIGHBORHOOD ASSOCIATIONS
Appendix B
APPENDIX B. SUGGESTED CONTACTS FOR COMMUNITY OUTREACH
Appendix C
TIPS FOR SELECTING ORGANIZATIONS, AGENCIES OR
ASSOCIATIONS FOR RADON OUTREACH
1. Choose organizations, agencies, or individuals who can reach and influence the desired target
2. Involve representatives from the organizations early in the planning process.
3. Set realistic timelines and deadlines.
4. Allow organizations to personalize and adopt the presented work plan.
5. Ask what they need; i.e., training, resources, support, etc.
6. Help them take responsibility for their activities - but don't do it for them.
7. Provide them with additional local, regional, and national contacts or linkages that they will
perceive as valuable for their ongoing activities.
8. Provide them with information about the radon program and other information, in ready to use
form.
9. Don't overwhelm them with information, give clear simple messages.
10. Track progress and make adjustments as necessary.
11. Provide support, thank you's, and other forms of recognition.
12. Provide written follow-up after the first planning meeting to document tracking and evaluation
progress.
Adapted from "Steps for Involving Intermediaries in Your Program." Making Health
Communication Programs Work. U.S. Department of Health and Human Services, Public Health
Service, National Institute of Health and Office of Cancer Communications, National Cancer
Institute, NIH Publications No. 89-1493, Bethesda, MA 1989.
audience.
-------
Appendix D
KENTUCKY COMMUNITY RADON OUTREACH PROGRAM
AN OVERVIEW (1990-1991)
Organization/Association
Outreach Activities
Kentucky Library Association
Housing Authority of Kentucky
American Luna Association of Kv
Local Health Departments
Home Builders Association of Kv
Jefferson County Medical Society
Kentucky Medical Association
University of Kentucky School 9* Engineering
• "Starter" Package of Radon
Literature sent to 120
public/private libraries. (1991)
• Radon Awareness Program
at Fall State Meeting. (1990)
• Endorse radon program
activities.
• Provide radon literature
through agency networks.
• Assist Salt-River Rural Electric
Co-Op in radon testing campaign.
(1991-1992)
• Distribute radon literature.
• Respond to telephone inquiries.
• Attend radon training.
Assign code committee to review
EPA's pre-construction radon resistant
building techniques.
Radon article in state journal. (1991)
Radon booth at builder's annual
meeting. (1990-1991)
Sponsor radon awareness program at
State meeting. (1991)
Publish radon article in Society
Journal. (1990)
Plan to provide a radon "starter kit*
to all doctors to place in reception
room. (1991-1992 • statewide)
Endorse radon program initiatives.
Network to Auxiliary and to other
county associations.
• Endorse the radon program initiatives
by resolution. (1989-1990)
• Sponsor radon awareness in annual
continuing education. (1990)
"(Starter package includes 25 Citizen's Guides to Radon. What it is and what
about it (1986). Radon Reduction Methods. A Homeowner's Guide (rhird MftinnV
U.S. EPA, RCP and RMP L ist for the State. State Survey Map.) ~ "—L
-------
Appendix D
Organizations/Association
Outreach Activities
Kentucky Kiwanis
Salt River Rural Electric
Rural Electric Co-Op Association
• Radon awareness programs •
Frankfort and Louisville. (1991)
• Publish radon article in magazine.
• Sponsor radon awareness programs
for all employees through safety
program. (1990)
• Provide radon awareness booth at
summer festival in Bardstown. (1990)
• Provide radon literature in display
rack. (On-going)
• Sponsor radon testing service for Co-
op members. (On-going)
• Sponsor radon awareness at
statewide member service meeting.
• Publish radon article in statewide
newletter.
Kv Home Mortgage Association
• Sponsor radon awareness for
association members.
Kv Parent Teachers Association
• Endorse Ky Radon Program initiatives.
• Publish radon information in
Quarterly Association Bulletin.
• Sponsor radon awareness program at
State Convention and Spring Leader
Training.
• Sponsor PTA State and National radon
resolution.
Kv Cooperative Extension Service
Provide radon literature "starter kit'
to 120 service areas for distribution.
Sponsor radon awareness for district
managers.
Support networking at the local level.
Plan to educate all 4-H Youth.
Jefferson County Parent Teachers Association
District 3 PTA (Warren County)
• Coordinate in conjunction with District
Superintendents' Office, a radon
awareness program for all Principals.
Individual schools will then be
empowered to host radon awareness
program for parents and staff.
• Sponsor radon awareness at Fall
Planning Conference. (1990)
-------
Organizations/Association
Appendix D
Outreach Activities
Louisville Gas/Electric
Kentucky Certified Radiation
Operators
Ky Real Estate Commission
Kv Vocational Education
• Utility Bill Radon Insert sent
to 317,000 residents, businesses.(1990)
• Radon articles about testing
and mitigation published in
statewide radiation newsletter. Sent to 5,000
radiation certified operators.
• Provide fifteen radon awareness programs
statewide to licensees of the commission.
(SIRG Grant. 1990)
• Sponsor three day radon training for building
trade, construction faculty. (SIRG Grant, 1990)
• Faculty to infuse radon information into
existing curriculum. (On-going)
-------
Appendix E
SUGGESTIONS
FOR
RURAL ELECTRIC COOPERATIVE COMMUNITY AWARENESS
1. Place radon literature in lobby display rack's
A Citizen's Gude to Radon (OPA-86-004, August 1986)
Radon Reduction Methods, A Homeowner's Guide (RD-681, July 1989)
List of EPA proficient testers (RMP)
List of EPA proficient mitigators (RCP)
(All above are available upon request from radon program)
2. Public radon information in utility bill insert
Refer to sample published by Louisville Gas & Electric Company (January
1990)
3. Publish radon article in rural electric magazine
4. Host a radon awareness education program
Invite members, employees, and the public to attend a radon program
(speakers provided by radon program)
Invite local school officials to provide radon test data about school testing
5. Consider providing radon test kits to service members
Enter into an agreement with an EPA approved radon laboratory.
Cooperative provides order forms to members. Member orders kit
directly from company. Member receives test results directly from the company.
Cooperative receives some percentage of cost for each kit. (refer to handout)
6. Consider conducting radon tests on any home receiving an energy efficient
'tight home' installation from the cooperative
Explore legal liability
Decide on approach
Develop a plan of action to protect the cooperative and citizen(s).
7. Join forces with other community leaders to host a community radon
testing campaign
Local Medical Society Cooperative Extension Agents (Ag & Home Ec)
Lung Association Local Health Department
Daycare Operators Local Government Officials
PTA/Schools Cancer Network Volunteers
-------
COOPERATIVE EXTENSION TO COMMUNITY
RADON COMMUNICATION OUTREACH PROGRAM
Appendix E
Audience
Co-op Extention Agents
Home Ecomonics,
Agriculture, Youth
Type of Communication
Technical-Informational
Resource-Supportive
Motivational
Message
- Radon Update
- Testing Protocols
- Mitigation techniques
- Resources available
- Encourage all agents
to test their homes
and to take action
if elevated levels are
found.
Citizens in Home
Community
Informational (Awareness)
Technical (Advisor or Referral)
Motivational
- Radon threat in
Local Community
- Facts about radon
- How to test for radon
- How to Mitigate a
home to reduce radon
levels
- Who is qualified to
test and/or mitigate
- Which tests are EPA
Approved
- Encourage all citizens
to test their homes for
radon and to take
action if elevated levels
are found.
Method
Distribute Radon
literature to all
agents through UK
Communication
Channels
Invite all agents
to attend one of
the four regional
radon workshops in
Jan-Feb 1991
Establish support
Network between
individual agents and
radon program staff.
Conduct Community
radon awareness
workshops
Speak at Civic
association meetings
Provide radon
literature in Extension
Office.
Host local radon
testing campaigns
Host radon mitigation
demonstration project
-------
Audience Type of Communication
HomemakersClubs Informational (Awareness)
Members Motivational
Youlh Organization Informational (Awareness)
Members Motivational
Appendix E
Message
Radon threat in local
community
Facts about radon
How to test for radon
How to mitigate a
home to reduce radon
levels.
Who is qualified to
test and/or mitigate
Which tests are EPA
approved
Encourage all home-
makers to test their
homes for radon and to
take action if elevated
levels are found.
Method
- Host radon awareness
program at local
homemakers clubs
- Ask homemakers clubs
to promote radon
testing in the
community.
- Provide radon
literature to home-
makers
- Host radon awareness
programs for Youth
Clubs
- Ask youth to
encourage their
parents to test for
radon
- Assist youth in
developing
community radon
projects.
-------
Appendix F
JEFFERSON COUNTY SCHOOL DISTRICT
AND
RADON PROGRAM
1. Work cooperatively to establish a radon comunication outreach program
through the school to parents, staff, and students.
2. Promote the Jefferson County School District radon testing project and the
communication outreach program as a model for other school districts in the
state and the nation.
MODEL COMMUNICATION OUTREACH
Audience
School Administrators Building Maintenance Personnel
Teachers Ancillary School Staff
Parents Parent-Teachers Association
Students
Message
Long-term exposure to elevated levels of rdon gas is associated with increased
risk of developing lung cancer.
Testing for radon gas is easy and mitigation methods are effective.
All homeowners should test their homes. Schools, daycares, public and commerical
buildings should also be tested.
If elevated levels are discovered, action should be taken to reduce the levels.
-------
Appendix F
RADON COMMUNICATION OUTREACH PROGRAM THROUGH SCHOOLS
Audience
Type of Communication
Message
School Administrators
Building Maintenance
Personnel
Technical/Support
and Motivational
• Testing Protocols
- Decision process
after testing
- Mitigation strategies
• Technical assistance
• Public disclosure
- Encourage them to
test their homes
Teachers
Ancillary School Staff
Informational and
Motivational
•Levels of radon in
school, by room
- Mitigation strategy
- Encourage them to
test their homes
Parent-Teacher's
Association
Informational and
Motivational
- Levels of radon in
school, by room
- Mitigation strategy
- PTA can help school
administrators to
reach parents with
radon information
- Encourage them to
test their homes
Parents Informational and -Levels of radon in
Motivational school, by room
-Mitigation strategy
• Encourage them to
test their homes
Students
Informational and
Motivational
- Facts about radon
and indoor air quality
- How to improve air
quality
*Risk Communication Information Provided for Each Group
Method
Kentucky Educational
Television-Radon in
Schools Broadcast
Spring7Fall 1991
- Dissemination of
informational literature
•Presentations through the
Kentucky Education
Association
- Presentation at State
and District Meetings
and Workshops
• Assistance to individual
schools/districts
- PTA host Radon Awareness
Program
-PTA distribute radon info
to parents
- Host testing campaigns
- District/School/PTA
sponsored radon awareness
programs
• Distribution of radon
literature through PTA/
District office
- American Lung Association
lesson on radon in
"Growing Healthy"
curriculum
-Weekly Reader Poster
Contest
-------
Appendix G
KtMOt^T INvTML I. TION R£PLY TO
\^RK t'l Tl RAl t XPtRIMENT STATION
^GOPlRATlVt1 MTtNSIGN StRV ICE
November 16, 1990
Dear Warren County Radon Action Committee Member:
This letter is to serve both as a notice of the next committee meeting
and as a summary of what has been done so far, partly in an effort to keep
absent committee members informed.
January 15. 1991 at 9:30-11:00 a.m. has been set for the next meeting
which will be at the Warren County Extension Office,
At the first meeting on October 15, Jeana Phelps from the Kentucky Radon
Program out of Frankfort was with us giving us an update on the radon situa-
tion nationwide as well as in Kentucky. She distributed packets of litera-
ture, a bumper sticker and a RADON tee-shirt.
Joan Martin and Terry Wilson from WKU distributed radon test kits made
available by the American Lung Association. It has been agreed that people
may obtain these kits for a $2.00 donation to the American Lung Association.
The Warren County Extension Office obtained 500 of the kits from Joan for
distribution to Homemaker Club members and others who may want them.
The rest of the meeting consisted of members getting acquainted with
each other and finding out what our interests and concerns were regarding
radon.
At the November 16 meeting, we continued getting acquainted, as we had
some new committee members, and began discussing our mission statement and
possible goals which we might wish to accomplish.
A sub-committee was formed to congeal our ideas and suggestions into a
format which can be presented at the January 15 meeting for the entire
committee's consideration. Serving on this committee are Terry Wilson as
chairman, Joan Martin, Elaine Simmons and Bill Meinhardt.
(over)
Page 2
Also enclosed is a committee membership list so all members will know
who is involved and to what extent. If you know of others who are interested
in serving on this committee, please feel free to tell them about the next
meeting, or let me know and I will send them a notice.
Thank you very much for your interest and participation. We have a big
job to do, but with coordination and working together we should be able to
accomplish our goal.
Sincerely,
-------
Session II:
Radon-Related Health Studies -- POSTERS
-------
IIP-1
OCCUPATIONAL SAFETY DURING RADON MITIGATTON
FIELD EXPERIENCE AND SURVEY MONITORING RESULTS
Jean-Claude F. Dehmel, CHP
S. Cohen & Associates, Inc.,
McLean, VA 20101
Peter Nowlan
R.F. Simon Company, Inc.
Barto, PA 19504
Eugene Fisher
U.S. Environmental Protection Agency
Office of Radiation Programs
Washington, DC. 20460
ABSTRACT
The U.S. Environmental Protection Agency (EPA) has initiated
a radon mitigation project in homes located in Montclair, West
Orange, and Glen Ridge, New Jersey. In these communities
numerous properties are contaminated with radium tailings which
were initially introduced around homes as backfill and used as
construction materials. In these homes, ambient radon
concentrations are well above the 4 pCi/L EPA guideline. in
support of radon mitigation activities, a comprehensive
occupational health and safety (H&S) monitoring program has been
implemented to assess working conditions. H&S activities include
monitoring airborne concentrations for radon, asbestos, organic
vapors, radioactivity, and total suspended particulates, and
radiation exposures and loose surface alpha contamination levels.
Survey results indicate that all exposures are well within
occupational radiation protection standards and OSHA criteria.
Survey measurement results have been observed to vary depending
upon existing conditions and type of on-going mitigation work.
Typically, average radon levels vary from 0.4 to 32.5 pCi/L;
radiation exposure rates range from 6 to 460 uR/h; surface
contamination is generally below detection limits of 9 to 17
dpm/100 cm2; long-lived radionuclides concentrations are <6.8 x
10-13 uCi/mL; asbestos fiber concentrations vary from <0.002 to
0.016 fibers/cm3; total suspended particulates personnel exposure
limits vary from <0.01 to 0.65 mg/m3; and organic vapors
concentrations range from <0.36 to 13 ppm-TWA for compounds
typically found in caulking compounds and PVC cements.
The work described in this paper was not funded by the U.S.
Environmental Protection Agency and, therefore, the contents do
not necessarily reflect the views of the Agency and no official
endorsement should be inferred.
1
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INTRODUCTION
The installation of radon mitigation systems involves
potential exposures to different types of occupational hazards.
Such hazards include exposure to radon and to those routinely
experienced in light construction and building trades, e.g., home
remodeling and improvement. In the context of this project,
radiological occupational hazards, in addition to radon, include
exposures to elevated ambient radiation levels due to the
presence of soils contaminated with such radionuclides as Ra-226,
U-238, and Th-232, and their decay products. Possible exposure
pathways include ambient radiation, airborne radionuclides (radon
gas, radon daughters, and resuspended particulates), and the
presence of radioactive contamination (in soils and as loose
surface). The installation of radon mitigation systems (e.g.,
subslab) reguires that holes be drilled into concrete floors and
foundation walls in order to tap soil gases and also necessitates
the removal of some soils. Such activities have the potential to
increase exposures and cause the spread of contamination.
The following presents and summarizes health and safety
(H&S) monitoring data and results obtained during the course of
radon mitigation activities conducted in 17 homes (l, 2). H&S
activities include monitoring airborne concentrations for radon,
asbestos fibers, organic vapors, long-lived nuclide particulates,
and total suspended particulates/dusts (TSP), radiation exposure
rates, and loose surface alpha contamination levels.
H&S MONITORING RESULTS
SOIL RADIONUCLIDE CONCENTRATIONS
In these communities, numerous properties are contaminated
with radium tailings which were initially introduced around homes
as a backfill and used as construction materials. The tailings
originated from the extraction and purification process of radium
from uranium bearing ores to produce luminous paints. Tailings
and contaminated soils were discarded in adjacent properties and
used by nearby communities. Previous characterization studies
indicate that surface and subsurface Ra-226 concentrations are on
the order of 1,500 and 4,500 pCi/g, respectively (3). The range
of Th-232 concentration is approximately the same as radium. The
concentrations of U-238 and U-234 are lower, with the highest
concentration being reported at 310 pCi/g.
In support of the field work, several soil samples were
taken and analyzed for the presence of U-238, Ra-226, Th-232, and
K-40. The analyses were performed by GeLi gamma spectroscopy.
The results of such analyses are shown below (Table 1).
2
-------
. 4-v.a soil sample concentrations
The data indicate tha earlier characterizations. For the
approach the results o maximum soil concentrations
radionuclides consUe»d ^"'^^^-226, and 5.9 pci/g for
are 27 pCi/g for 23®'_rentrations of these radionuclides in
Th-232. Backgroun<3 are typically <1.0 pCi/g. The presence
Northern New Jersey soi determined for the purpose of
of naturallywith which to assess the
providing additional raH4ation survey meters. Past experience
response of portable radiation ^survey^ ^ ^ ^ ^ varie^
has shown that exposures rates could be interpreted as
the detection of elev When Ra-226 is present at lower
radium contamination especially when^ 8 contvim that K.40
rssS'var,8;1. ss?« *«,? ^ 7.0 topcVg.
SURFACE CONTAMINATION
enrface contamination was monitored by
The presence of by scanning areas with portable
conducting smear Typically 10 to 20 smears were
alpha ZnS(Ag) surv®X ver contaminated soils were exposed. The
number of^mear^taken and their survey locations were based on
TABLE 1.
Residence
ID No.
MAXIMUM SOIL RADIONUCLIDE CONCENTRATIONS
Radionuclide concentrations* - pCi/g
U-238 Ra-226 Th-232 K-40
1 A-211
4.4
<1.0
8.1
12.0
4.2
9.4
18.0
1 A
2.9
1.6
11.0
13.0
153 C-315
i • t
0 2
1.8
9.4
30 F-142
32 F-143
7 • «
16.0
A 6
2.1
2.1
7.0
9.7
6 J-242
8 J-243
1 • V
10.0
2.0
5.9
9.2
15.0
21 L-321
<1.0
2.2
<0.5
2.4
27.0
24.0
21.0
1 7
1.6
10.0
26 L-322
53 N-163
X • *
2.9
1 1
0.8
2.2
8.8
13.0
56 N-164
64 N-166
66 N-167
26 V-173
> n
2.6
1.6
1.6
2.1
9.2
9.2
9.7
11.0
28 V-174
37 V-178
<2.0
13.0
J • r
6.7
1.9
7.3
Soil sample analyses performed by GeLi gamma spectroscopy
Concentrations results are expressed for dry weights.
3
-------
the results of direct reading radiation survey meters and the
type of intrusive activities being conducted. All smears were
counted for five minutes using a bench-top alpha ZnS(Ag) counter
in order to resolve the maximum contamination limit of 20 dpm/100
cm2. The results of such analyses are shown below (Table 2).
The data indicate that all results, except for a few, are below
the maximum contamination limit.
In a few instances, smear results were found to hover about
the limit of 20 dpm/100 cm2. When those smears were recounted,
typically 2 to 3 later hours, all results fell within the
instrumentation's lower limit of detection, indicating that the
initial activity was due to radon decay products. This
conclusion was also confirmed by submitting such smears to more
rigorous laboratory analyses.
TABLE 2. TYPICAL ALPHA SURFACE CONTAMINATION LEVELS
Surface contamination
levels* - dpm/100 cm2
Results at or
Results above
Residence
below the lower
the lower limit
ID No.
limit of detection
of detection
1 A-211
<11.9
2 A-212
< 9.4
145 C-312
<12.2
153 C-315
<12.2
30 F-142
<11.9
32 F-143
<11.9
6 J-242
< 9.4
8 J-243
< 9.4
21 L-321
<13.2
15.3
26 L-322
<13.2
53 N-163
<13.2
56 N-164
<17.1
64 N-166
<11.9
66 N-167
<14.1
26 V-173
< 9.4
28 V-174
<11.9
37 V-178
<10.4
13.1 - 25.0
* Analyses were performed by gross alpha counting using a
ZnS(Ag) counter/ratemeter. Contamination results are for
smears or wipes taken over an area of 100 cm2, ca 4" x 4".
4
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RADIATION EXPOSURE RATES
Ambient radiation exposure levels were monitored in all work
areas, including basements, lowest ground floors, crawl spaces,
and outdoor areas requiring access or where work was being
performed. Measurements were made using portable Nal(Tl)
micro-R-meters. Survey measurement points included ambient areas
at one meter above the floor or ground, and on contact with
floors, foundation walls, and soil. The results of such surveys
are shown below (Table 3) . The data indicate that ambient
exposure rates vary greatly, typically up to 10 times above the
ambient background level of 8 to 9 uR/hr. Any measurement
results in excess of twice background is generally considered to
be anomalous. Contact radiation levels were shown to vary even
more significantly, ranging from about 15 to 460 uR/hr. In terms
of characterizing radiation doses, ambient radiation levels are
more representative of personnel exposures than contact
measurements. Exposures to higher contact radiation levels, when
they did occur, were of relatively brief durations.
RADON CONCENTRATIONS
Radon concentration levels were measured using continuous
radon monitoring equipment. Radon levels were printed hourly
during the course of the work. All general work areas and zones
were ventilated using portable ventilation systems and vacuum
cleaners, respectively. Ventilation systems introduced fresh air
from the outside and vacuum cleaner exhausts were discharged
outdoors. Radon monitoring results are shown below (Table 4) .
The data indicate that average and maximum ambient radon
concentration levels were typically less than 5 pCi/L and as high
as 66 pCi/L, respectively. In one instance, basement radon
levels shot up to 66.1 pCi/L over a four hour period in spite of
the on-going active ventilation. This sudden radon excursion was
corrected by pressurizing the basement instead.
LONG-LIVED PARTICULATE RADIONUCLIDES
Air samples were taken to assess ambient airborne
radionuclide concentrations whenever intrusive work or sampling
activities were in progress. Monitoring involved taking air
samples through 47 mm glass fiber filters. Sample durations
typically reflected the length of on-going work activities, up to
9 hours per day, and a nominal sampling flow rate of 40 LPM. All
filters were counted for ten minutes using a bench-top alpha
ZnS(Ag) counter in order to resolve the concentration limit of
4.4 E-12 uCi/mL for total gross alpha.
5
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TABLE 3. AMBIENT AND CONTACT RADIATION EXPOSURE RATES
Range of radiation exposure rates* - uR/hr.
Ambient radiation Contact radiation
Residence exposure rates at exposure rates on
ID No. waist height (1 m.) ground and floor
1 A-211
10
25
10
32
2 A-212
7
-
20
7
-
32
145 C-312
10
-
190
11
-
460
153 C-315
11
-
17
14
-
26
30 F-142
10
-
90
11
-
150
32 F-143
13
-
75
12
-
200
2 J-241
8
-
20
8
—
34
6 J-242
9
-
23
9
—
36
8 J-243
6
-
12
7
-
18
21 L-321
7
-
11
8
-
13
26 L-322
7
-
12
9
—
14
27 L-S27
7
-
12
7
—
15
53 N-163
8
-
13
9
-
14
56 N-164
10
-
15
10
-
30
64 N-166
15
-
80
13
-
240
66 N-167
20
-
50
15
—
100
26 V-173
8
-
18
9
-
28
28 V-174
8
-
60
8
—
140
37 V-178
10
34
10
-
40
meter. Results represent range of exposures rates routinely
observed in basements or lowest floor levels, and outdoors
in areas such as sidewalks, yards, and drive and walkways.
The filters were counted again, typically 2 to 3 hours later, to
discern the presence of long-lived radionuclides from radon decay
products. The results of such sampling surveys are shown below
(Table 5). The data indicate that airborne concentrations were
typically below the instrumentation's lower limit of detection,
about <6.8 E-13 uCi/mL. This conclusion was also confirmed by
subsequently subjecting air sample filters to more rigorous
laboratory analyses.
6
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TABLE 4. RANGE OF RADON CONCENTRATION LEVELS
Residence
ID No.
Typical radon
concentration
levels* - pCi/L.
Average
Low
High
1 A-211
1.0
0.4
1.7
2 A-212
1.0
0.1
2.4
145 C-312
2.7
2.4
3.9
153 C-315
0.4
0.4
1.2
30 F-142
4.3
2.8
7.2
32 F-143
1.5
0.4
2.7
6 J-242
0.9
0.3
1.8
8 J-243
0.7
0.3
1.7
21 L-321
2.7
1.0
11.8
26 L-322
0.6
0.1
1.2
53 N-163
1.9
0.1
4.7
56 N-164
1.7
0.1
23.4
64 N-166
32.5
2.8
66.1
66 N-167
1.2
0.9
3.5
26 V-173
3.4
1.1
15.1
28 V-174
2.3
1.0
2.6
37 V-178
1.3
0.9
1.7
* Measurements taken using portable Femto-Tech Model R210F
radon monitors equipped with continuous data recorders.
Results were printed out hourly to monitor levels. Radon
concentrations represent ambient levels in basements or lowest
ground floors measured with on-going active ventilation.
TOTAL SUSPENDED PARTICULATES (TSP)
Some work activities, such as drilling, grinding, etc, have
the potential to generate airborne suspended particulates (TSP).
The air sampling program and system described above were also
used to assess the presence of TSP in the work environment. All
filters were pre-weighed before being used and then weighed again
when sampling was completed. Both weighings were performed using
a laboratory micro-balance. The associated airborne dust
concentrations are shown in above (Table 5) . The data indicate
that all results are below the OSHA limit of 10 mg/m3 (4) . The
highest and lowest measurable TSP concentrations observed were
0.65 and 0.04 mg/m3, respectively.
7
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TABLE 5. GROSS ALPHA AIRBORNE RADIONUCLIDE AND TOTAL SUSPENDED
PARTICULATE CONCENTRATIONS
Airborne concentrations*
Residence Gross alpha Suspended
ID No. Sampling concentrations Particulates
time (hr.) (uCi/mL)& (mg/m3)#
1 A-211
6.9
<4.OE-13
0.17
2 A-212
7.9
<5.2E-13
0.26
145 C-312
8.5
<6.5E-13
no data
153 C-315
6.7
<2.4E-13
<0.03
30 F-142
7.1
<6.8E-13
<0.01
32 F—143
7.7
<5.5E-13
0.18
6 J-242
6.9
<2.1E-13
<0.03
8 J-243
5.2
<1.5E-12
<0.03
21 L-321
8.0
<4.7E-13
0.15
26 L-322
6.5
<4.3E-13
0.15
53 N-163
7.7
<4.8E-13
0.16
56 N-164
8.5
<3.9E-13
<0.02
64 N-166
8.8
<4.8E-13
0.04
66 N-167
8.3
<3.8E-13
0.20
26 V—173
9.0
<4.5E-13
0.65
28 V—174
8.0
<1.9E-13
<0.02
37 V-178
8.9
<3.2E-13
0.09
* Measurements taken using a portable sampling pump and 47 mm
glass fiber filters. Sampling flow rate is typically 40 LPM.
Air concentrations represent ambient levels in basements
or lowest floors measured with on-going active ventilation.
Sampling times represent typical duration of intrusive
work which could result in the generation of elevated
airborne suspended dust and radioactivity concentrations.
A single filter was used to simultaneously assess the presence
of both long-lived particulate nuclides and total dust.
& Filter samples were analyzed first for gross alpha activity
using a ZnS(Ag) alpha scaler at the work site and then
subjected to laboratory GeLi gamma spectroscopic analyses.
# Filters were pre-weighed before being used and weighed again
after sampling was completed. Both weighings were performed
using a micro-balance under laboratory conditions.
8
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FIBER (ASBESTOS) CONCENTRATIONS
since the work was performed in homes which are known to
have asbestos containing Materials (ACM),air samples were taken
to deterreine the presence of airborne fibers in all work areas.
Samples^Jere taken by drawing thr»9h a^S ^open cassette
andhanalvticaiemethods were'based on OSHA approved methods (NIOSH
7400 ^ Phase Contrast Microscopy) (5) . Sampling durations and
floS rates were adjusted to reflect the constraints of the NIOSH
now rates wete j loadings. The airborne fiber
procedure f°5 shown below (Table 6). The data indicate that
concentrations are shown Deiow \ ia»i« ' fiber/cm3 8-hr TWA
all results are below the OSHA limit of 0.2 rioer/cm , « ...1WA
m it should be noted that PCM resolves all fibers with a
sp-i"c aspect ratio (length -d d.ameter, whether they are
SS;s°S one sample ^ith the highest fiber density .<43.3 f/»2,
noers, one fliri.her analysis (transmission electron
was subjected results revealed that a fewer number
ofnon^sbe'stos fibe'ri were Measured (14.4 f/mm2>. Such fibers
were^ identified to be gypsum, cellulose, and material containing
calcium.
ORGANIC VAPOR CONCENTRATIONS
The installation of radon mitigation systems require the use
f r-zniiicina and sealing compounds, sealing foams, and PVC pipe
cLents As thes^ compounds are applied, and during the curing
cements. as uims reieased in the work environment. in
o?d«Sto °ars9saenss personnel exposures to such chemical compounds,
order to assess p fnassive diffusion) were worn by
?r^v^.ijnVsaPOinvolved in applying caulks, sealants, and PVC
individuals^ involved[ in for the duration of these
activities ^since such functions are typically of short duration
^2 to 4 hours). The monitors were supplied and analyzed by 3H
The oraanic vapor concentration results are shown below
The selection of organic compounds to be analyzed by
Ml vw based on the information contained in the MSDS supplied
was oaseu uu The orqanic vapor concentration
with such P"l"C\8eVels in 111 work areas routinely
results represen p . tallat^on cf radon mitigation systems,
accessed to support selects compounds, ambient
The data indicate that tor t permissible exposure
??n??f?nV°J?GIH threshold limit values (4, 8). The highest
limits and ACGIH thresnoiocentrations was due to methyl ethyl
ketoST (MEK^at 13 ppm. The corresponding 8-hour TWA limit is
200 ppm.
9
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TABLE 6. FIBERS (ASBESTOS) CONCENTRATION LEVELS
Airborne fibers concentration levels* - f/cm3
Residence
ID No. fibers/cm3 fibers/mm2
1
A-211
<0.005
12.7
2
A-212
<0.005
10.2
13
A-112
<0.005
16.6
120
C-311
<0.005
33.1
153
C-315
<0.005
28.0
14
E-121
0.012
62.4
26
F-173
<0.005
29.3
30
F-142
0.007
19.1
32
F-143
0.016
43.3
PCM
32
F-143
<0.003
14.0
TEM
6
J-242
<0.005
19.1
8
J-243
<0.006
30.6
21
L-321
<0.005
0.0
26
L-322
0.011
28.0
27
L-S27
<0.005
30.6
25
M-251
0.007
25.5
46
N-161
<0.002
0.0
53
N-163
<0.005
8.9
56
N-164
0.007
24.2
58
N-168
0.007
33.1
64
N-166
<0.005
12.7
66
N-167
<0.005
34.4
33
R-341
0.006
31.8
55
R-343
<0.005
24.2
26
V-173
0.008
29.3
28
V—174
0.012
24.2
35
V-177
<0.005
15.3
37
V-178
<0.005
11.5
* Fiber concentrations represent ambient levels in basements or
lowest floor levels measured with on-going active ventilation.
Measurements were taken using a portable sampling pump and 25
mm MCE filters in open face cassettes. MCE filters were
analyzed by NIOSH method 7400 - PhaSe Contrast Microscopy (5).
* One sample, 32 F-143, was also analyzed via transmission
electron microscopy (TEM) using U.S. EPA Level II Method (6).
Analysis was performed following the results of the PCM
analysis. The same sample was used for the TEM analysis.
10
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TABLE 7. ORGANIC VAPOR MONITOR CONCENTRATION LEVELS
Typical organic vapor concentrations* - ppm
Residence Work Organic Vapor
ID No activity compounds concentrations limit
53
N-163
Sealing &
MEK
<
1.00
200
caulking
Toluene
<
0.84
100
Xylene
<
0. 66
100
64
N-166
PVC
MEK
13.0
cementing
Cyclohexanone
0.53
25
66
N-167
PVC
MEK
6.55
cementing
Toluene
<
0.43
Cyc1ohexanone
<
0.49
66
N-167
Sealing &
Toluene
<
0.56
caulking
Perchloro-
ethylene
<
0.36
25
P. Glycol
mono methyl
ethyl acetate
<
0.46
5#
37
V-178
Sealing &
Acetone
<
2.30
75
caulking
MEK
<
1.83
Xylene
<
1.21
* Measurements taken using 3M Model 3510 passive diffusion
organic vapor monitors issued to personnel. Selection of
organic compounds was based on information provided in MSDS
supplied with commercial products routinely used in radon
mitigation. Organic vapor concentrations represent exposure
levels in all work areas routinely accessed to support the
installation of radon mitigation systems with on-going active
ventilation in the lowest ground floors and normal ventilation
in the remaining upper floors.
& TWA limits reflect OSHA permissible exposure limits (PEL) (4).
# Based on ACGIH threshold limit values (TLV) (8).
11
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CONCLUSIONS AND RECOMMENDATIONS
CONCLUSIONS
The results shown above indicate that all personnel
exposures were well within recognized radiation protection
standards as well as project administrative limits. The adopted
radiation exposure limit for this project was set at 500 mrem,
same as for the general public, as opposed to 5,000 mrem for
occupationally exposed radiation workers. Furthermore, an action
level of 100 mrem was established for the purpose of assessing
on-going work activities and associated radiation exposures.
Dosimetry results from radiation badges (TLDs) revealed that
monthly exposures were below the TLD's response level of 10 mrem
for X and gamma rays (9) . Personnel radon exposures were
monitored by using alpha track etch detectors (ATDs) (10). ATD
radon concentration results ranged from 0,3 to 5.2 pCi/L.
Cumulative radon exposures ranged from 30 to 104 pCi-days/L for
one month monitoring periods. Exposures to airborne long-lived
particulate radionuclides, total suspended solids, asbestos
fibers, and organic vapors were well within the applicable OSHA
permissible exposure limits.
RECOMMENDATIONS
The H&S monitoring results revealed that by adopting simple
protective measures, personnel exposures can be maintained well
below occupational standards and, in some instances, at the
threshold of measurement detection limits. Some of the applied
protective measures include working in well ventilated areas,
judicious use of local exhaust ventilation at the source of
contaminants, application of dust suppression techniques, use of
¦the functional sections of a mitigation system to minimize radon
exposures and resuspended particulates while completing its
installation, use of containment methods to minimize the spread
of contaminants, and restricting personnel traffic in work areas.
The use of monitoring equipment has shown to be also helpful in
•the detection of trends in ambient radiation exposure rates and
levels of contaminants. Routine surveillance of all work
activities has also allowed the timely detection of potentially
problematic situations. The radon concentration excursion and
interpretation of radon decay products to alpha surface
contamination were two such examples. In both instances, simple
monitoring and measurement techniques were applied to identify
and correct the situation. Excluding the presence of
contaminated soils, these H&S monitoring results indicate that
such protective measures and monitoring methods can also be
applied in the installation of radon mitigation systems under
conventional conditions.
12
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REFERENCES
S. Cohen & Associates, Inc. Work Plan - House Evaluation
Program Applied to Superfund Sites - Montclair, West Orange,
and Glen Ridge, New Jersey, prepared for the U.S.
Environmental Protection Agency, Office of Radiation
Programs under contract No. 68D90170, Work Assignment No.
1-39, May 1990
S. Cohen & Associates, Inc. Health and Safety Plan - House
Evaluation Program Applied to Superfund Sites - Montclair,
West Orange, and Glen Ridge, New Jersey, prepared for the
U.S. Environmental Protection Agency, Office of Radiation
Programs under contract No. 68D90170, Work Assignment No.
1-39, May 1990
Camp Dresser & McKee, Inc. Supplemental Feasibility Study
for the Montclair/West Orange and Glen Ridge Radium Sites,
Vol. 4, prepared for the U.S. Environmental Protection
Agency, Region II, Edison, NJ, April 3, 1989.
Occupational Safety and Health Administration, Air
Contaminants - Permissible Exposure Limits, Title 29, Code
of Federal Regulations, Part 1910.1000, OSHA 3112, 1989.
National Institute for Occupational Safety and Health,
NIOSH Method 7400, Fibers, 2/15/84, Cincinnati, OH.
Yamate, G., Agarwal, S.C., and Gibbons, R.D. Methodology for
the Measurement of Airborne Asbestos by Electron Microscopy,
Draft Report, U.S. Environmental Protection Agency, Office
of Research and Development, Washington, DC, 1984.
Occupational Health & Safety Products Division, Organic
Vapor Monitors #3500/3510 - Instruction and Use Manual, 3M,
St. Paul, MN.
American Conference of Governmental Industrial Hygienist,
Threshold Limit Values for Chemical Substances and Physical
Agents and Biological Exposure Indices, 1990-1991,
Cincinnati, OH.
Tech/Ops Landauer, Inc. Gardray TLD Dosimetry, Radiation
Dosimetry Reports, 6/30/1990 to 11/30/1990, Glenwood, IL.
Tech/Ops Landauer, Inc. Radon DDOS ATDs, Radon Monitoring
Reports, 4/3/1990 to 11/12/1990, Glenwood, IL.
13
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IIP-2
TITLE: Consumer Cost/Benefit Analysis of Radon Reductions in 146 Homes
AUTHOR: Kenneth D. Wiggers, American Radon Services, Ltd.
This paper was not received in time to be included in the
preprints so only the abstract has been included. Please check
your registration packet for a complete copy of the paper.
An exposure period of 70 years with 75% house occupancy was assumed. A total of 146
homes were mitigated with an average reduction of 11.7 pCi/L per home. Each house was
assumed to have 2.6 occupants. A cost of $21,285 was used for direct medical costs and
$99,532 was used for lost earnings (productivity costs) for estimating the economic impact
of avoiding (or developing) lung cancer (from the Pilot Study on Indoor Air Quality. CCMS
Alport #1831.
Using the above assumptions and hard data, 18.8 expected excess lung cancer deaths were
averted at a cost of $12,590 per person. The "net savings" per death averted is the sum of
the benefits ($21,285 + $99,532) minus the costs ($12,590) for a net savings of $108,227 per
ff»rh of the 18.8 deaths averted. The net societal savings of installing radon mitigation
gystems in these 146 homes is estimated to be $2,034,668 (18.8 deaths averted x $108,227
net savings per death averted). The net lifetime benefit per household equals $13,936
($2,034,668 divided by 146 homes). The average cost of radon diagnostics and mitigation
^as $1,624 per house; lifetime benefits per household ($13,936) exceeds short-term
Installation costs ($1,624) by $12,312. The $1,624 "investment" would be equivalent to the
$12,312 in 29 years at 1% interest.
-------
IIP—3
THE EFFECT OF PASSIVE CIGARETTE SMOKE ON WORKING LEVEL
EXPOSURES IN HOMES
by: Raymond H. Johnson, Jr., Certified Health Physicist, and
Randolph S. Kline, Laboratory Supervisor
Key Technology, Inc., P.O. Box 562
Jonestown, PA 17083
Eric Geiger, Certified Health Physicist, and
Augustine Rosario, Jr., Laboratory Director
Radon QC, 2857 Nazareth Road,
Palmer, PA 18043
ABSTRACT
Numerous studies have evaluated the combined effects of cigarette smoke and in-
halation of radon decay products on the risk of lung cancer to smokers. In 1988 the
National Academy of Sciences concluded that the risk of lung cancer is about 10 times
greater for smokers than for nonsmokers at the same Working Level exposures. How-
ever, very little attention has been given to the effects of passive cigarette smoke and
radon decay product exposures to nonsmokers. Preliminary studies (presented by the
authors at the annual conference of the American Association of Radon Scientists and
Technologists - Oct. 4-6, 1990) showed that even a single cigarette drastically increased
the Working Level exposures in homes. Consequently, a cigarette smoker not only in-
creases his/her own risk, but may also increase the risk to all occupants of the same dwell-
ing due to an increase in Working Level exposures.
This paper presents the results of additional measurements to evaluate the effects of
typical cigarette smoking patterns in a home. The study simulated the smoking habit of
approximately a one pack a day smoker. Continuous measurements were made on radon
gas levels, Working Levels, and corresponding equilibrium ratios. Working Levels were
found to increase rapidly after lighting of cigarettes and to remain elevated for several
hours. Cigarette smoke provides a significant source of aerosols for attachment of radon
decay products in homes. Furthermore, the airborne particles from cigarette smoke
remain in the air for many hours after the visible smoke has dissipated. Consequently, the
increase in Working Levels and equilibrium ratios persists long after the smoking stops.
-------
Since the risk of exposure to radon decay products is also significantly affected by
the fraction of unattached polonium-218, then additional studies are recommended to
evaluate unattached fractions, as well as aerosol concentrations and particle size distribu-
tions. This paper confirms the potential risks to nonsmokers from increases in Working
Levels due to passive smoke in homes and points to needs for further studies to document
other risk factors.
INTRODUCTION
The connection between exposure to radon decay products and subsequent lung can-
cers in uranium miners has been studied since the early 1950's. Continuing studies of
uranium miners in the United States, Czechoslovakia, Sweden, and Canada have con-
firmed that uranium miners develop more lung cancers than other types of miners or the
general population according to a 1984 report by the National Committee on Radiation
Protection and Measurements (1). These studies indicate that about 10 additional lung can-
cers occur per year for each Working Level Month (WLM) exposure to one million per-
sons. The 1988 report of the Committee on the Biological Effects of Ionizing Radiation
(BEIRIV) concluded that lifetime exposures to radon decay products could result in an
additional 350 lung cancer deaths for each million person WLM (2). The Environmental
Protection Agency estimates that 20,000 lung cancer deaths a year may be caused by ex-
posures to radon decay products in homes (3).
The connection between cigarette smoking and lung cancer is also well docu-
mented. Kabat (4) shows that, among lung cancer deaths in five countries, 83 -94% are
due to cigarette smoking by men and 57-80% by women. In the United States the Sur-
geon General reported 106,000 lung cancer deaths among smokers in 1986. The National
Academy of Sciences (5) also evaluated the risk to nonsmokers from passive exposure to
tobacco smoke, usually from a smoking spouse. This study found an increase in risk of
about 34% compared to nonsmokers without exposure to tobacco smoke. Cigarette smok-
ing is clearly the primary cause of lung cancer in the U.S.
Since radon decay products are also clearly a cause of lung cancer, the question
arises on how these two causes may combine. BEIR IV concluded that smokers have
about 10 times greater risk than nonsmokers for the same WLM exposures. This study
determined that the combined effect of cigarette smoke and radon decay products is syner-
gistic. The two effects combine multiplicatively rather than additively. This means the
combined effects are worse than the sum of the two risks alone. Recognizing that
cigarette smoke drastically increases the radon lung cancer risk to smokers also raises ques-
tions about the combined effects on nonsmokers who are passively exposed to environmen-
tal tobacco smoke.
-------
EFFECT OF CIGARETTE SMOKE ON INDOOR AIR
A review of studies done by A.C. George (1) indicates that even one cigarette will
profoundly increase the concentration of airborne particles. In fact, any human activity
will increase the particle concentration several fold over the normal quiescent value. The
fumes from cooking, burning of candles or incense, spraying of aerosols, ultrasonic
humidifiers, or other similar activities will also increase the concentration of particles in
air (1). Conversely, air conditioning or air cleaning systems that remove particulates by
filtration or electrostatic precipitation will reduce indoor aerosol concentrations. For ex-
ample, Moeller (6) indicates that a fan to circulate the air plus a positive ion generator will
reduce aerosols and the airborne concentration of radon decay products by 90 to 95 per-
cent. The lowest concentration of airborne particles likely to exist in homes is in the or-
der of 1,000 to 10,000 particles per cubic centimeter.
Any activity that changes aerosol concentrations will also affect the equilibrium
ratio between radon gas and radon decay product concentrations. The quantity of decay
products in the air and the equilibrium ratio go up as the aerosol concentration goes up.
This is because airborne radon decay products are mostly attached to aerosols. Decay
products that do not attach to aerosols (the unattached fraction) tend to quickly plateout on
walls and other surfaces and are removed from the air. As the aerosol concentration goes
up, there are more particles for attachment of radon decay products which then remain in
the air longer that those that are unattached.
The quantity of radon decay products in the air is normally measured in terms of
Working Levels. Working Levels are commonly measured by collecting airborne dust and
associated radon decay products on a filter and measuring the collective alpha particle
emissions. Consequently, for a given radon concentration, the measured Working Levels
tend to increase with increasing aerosol concentrations and increasing equilibrium ratios,
both of which are likely to increase with the introduction of cigarette smoke into the air as
noted above. Since Working Levels are the primary measure of exposure to radon decay
products and corresponding lung cancer risk, anything that affects Working Levels may
also affect estimates of lung cancer risk. Therefore, increases in Working Levels due to
cigarette smoke could increase risk of lung cancer for any concentration of radon.
EFFECT OF CIGARETTE SMOKE ON WORKING LEVELS
Initial studies of the effect of cigarette smoke on Working Levels were conducted
by Eric Geiger at Radon QC in 1988 (7). A single cigarette was burned in a radon cham-
ber while Working Levels were measured hourly. The Working Levels were found to in-
crease significantly while the radon gas concentration remained about the same. These
-------
observations confirmed the work of other investigators. Namely, cigarette smoke in-
creases aerosol concentrations and Working Levels. Discussion of these observations
among the authors in the spring of 1990, however, led to several questions. First of all,
what do we know about levels of cigarette smoke and Working Levels in homes?
Secondly, what is known about the lung cancer risk to occupants in homes where the
Working Levels are affected by cigarette smoke?
Numerous studies are reported that evaluate the combined effects of cigarette
smoke and exposure to radon decay products in terms of risk to the smoker. However,
little research has been done that considers the effects on nonsmoking occupants of homes
due to increased Working Levels attributed to cigarette smoke.
PURPOSE OF THIS STUDY
This paper has three purposes. One is to highlight the fact that cigarette smoking
may increase the lung cancer risk from exposure to radon decay products for all occupants
of a smoker's home. The second is to present preliminary findings on Working Level
measurements related to cigarette smoke in a radon chamber and in typical homes.
Thirdly, this paper identifies several needs for further research to answer questions about
risks to all occupants related to cigarette smoking in the home or other buildings.
MEASUREMENT TECHNIQUES
This paper presents the results of four sets of measurements. One study was con-
ducted in a radon chamber at Radon QC, two studies were done in the basements of typi-
cal homes; one in Nazareth, PA and the other in Bethlehem, PA., a final study was done
in the living room of a home in Rockville, MD.
Radon Chamber - The study was conducted in the Red Chamber at Radon QC.
This chamber has the highest radon levels of the three chambers available for radon and
radon decay product calibrations at Radon QC. The Red Chamber is a walk-in room
about five feet by nine feet with an eight-foot ceiling. It is equipped with calibration ports
and a viewing window. This chamber normally runs at radon levels from 200 to 600
pCi/L. The radon and decay product levels are constantly monitored with a continuous
radon monitor, continuous working level meter, and an alpha spectrometer. The chamber
is operated at slight negative pressure and cigarette smoke was drawn in through one of
the calibration ports.
-------
Nazareth House - This is a SO year old wood frame house with a full basement.
The basement is approximately 31 feet by 26 feet with concrete walls and a concrete floor.
One corner of the basement, about 19 feet by 12 feet, is partitioned off leaving an open
L-shaped area where the experiment was conducted. No one in this house smoked
cigarettes.
Bethlehem House - This is a one year old house with an open basement area of
about 43 feet by IS feet. The basement has concrete floors and walls. A person in this
house is a heavy smoker.
Rockville House - This is a two story colonial all masonry house (cinder block and
brick) on a concrete slab without a basement. The experiment was conducted in the living
room, which is about 15 feet by 20 feet. The living room is connected by an open
archway to an adjoining dining room. The open area of the two rooms is about 15 feet by
35 feet. Entrances to both rooms were closed with bifold doors.
INSTRUMENTATION
In each study measurements of radon gas and radon decay products were made
hourly. Working Level measurements were made with an Eberline model WLM-1A.
This detector draws an air sample through a filter at a flow rate of 0.10 to 0.18
liters/minute. Alpha particle emissions from the aerosols trapped on the filter are
measured with a silicon diffused junction alpha detector. Both radon (radon-222) and
thoron (radon-220) decay products are measured. The thoron contribution is estimated by
observing the decay rate after the sampler is shut off. Equilibrium between radon and
decay products was calculated assuming that only radon-222 was measured. Accuracy of
this detector is related to the sampling time, calibration of the flow rate, and calibration of
counting efficiency.
Radon gas samples were measured with an Eberline model RGM-3 continuous
radon monitor. Air is drawn at 6 liters/minute through a filter to remove particulates
before counting alpha emissions with a zinc sulfide phosphor. This instrument will
measure alpha emissions from both radon and thoron. However, the 56 second half-life of
thoron should prevent very much getting into the detector. We calculated the
radon/decay product equilibrium assuming that all the alpha emissions came from radon-
222.
Since both the radon gas and decay product monitors are used primarily for deter-
mining levels in the radon chambers at Radon QC. these instruments are intercalibrated
quarterly with the Environmental Measurements Laboratory (EML) of the Department of
Energy.
-------
CIGARETTE SMOKE
Cigarette smoke was introduced into each room by lighting a 100 mm filtered
cigarette and allowing it to burn in a cup or ashtray. The cigarettes were not smoked by
anyone, but simply allowed to burn by themselves. The cigarettes required about 10
minutes to burn. The burning cigarettes were placed about three feet from an outside wall
and were about 12 to 15 feet from the measuring instruments. In the Nazareth and Beth-
lehem houses a single cigarette was burned each 24 hours. In the Rockville house an
attempt was made to simulate a typical smoking pattern of a one pack a day smoker.
Approximately two packs of cigarettes were burned in this house between a Friday night
and Sunday night of the experiment.
RESULTS
RADON CHAMBER STUDY
The data on the effect of cigarette smoke in the Red Chamber at Radon QC are
shown in Figure 1 and Table 1. Two readings collected before introducing cigarette
smoke into the chamber showed radon at about 310 pCi/L and Working Levels at about
0.4. This gave an equilibrium of about 14%. After burning one cigarette, the Working
Levels went up to 2.2 and the equilibrium went up to 71 %. These increases took about
four hours due to the time needed for ingrowth of decay products to reach a new equi-
librium. The increases also persisted for many hours, such that even 24 hours later the
Working Level was still at 1.14 (more than double the original level) and the equilibrium
was at 24% (nearly double the initial level). The burning of a second cigarette caused the
Working Levels to move up to about 2.4 and stay there for several hours.
The main observation from this radon chamber study was that the smoke from a
single cigarette drastically increased the concentration of radon decay products in the air as
measured by Working Levels. Furthermore, the increased levels persisted for more than
24 hours, long after any visible evidence of cigarette smoke was gone. Two factors could
account for these observations. One is that the radon chamber has a relatively low ventila-
tion rate. Secondly, the air in this chamber is relatively low in aerosol concentration as
indicated by the low percent equilibrium before starting the experiment. Since both of
these factors could be substantially different in typical homes, the next part of the study
was to repeat the cigarette experiment in homes.
-------
Cigarette
Cigarette
o>
Cigarette
1.0
Cigarette
500
Cigarette
400
Cigarette
300
1800
2400
1200
0600
0600
1200
5/18/90 5/19/90
Figure 1. Effect of passive smoke on working levels - Red Chamber, Radon QC
-------
TABLE 1. EFFECT OF PASSIVE SMOKE ON WORKING LEVELS-
RED CHAMBER - RADON QC
Time Radon Daughters Radon Gas
WL pCi/L
5/18/90 0600 0.45 304
0700 0.44 317
0705 Burned One Cigarette*
0800 0.57 318
0900 1.34 323
1000 2.02 319
1100 2.23 314
1200 2.13 320
1300
1400
1500
1600
1700
1800
1900
2000
2100
2200
2300
2400
5/19/90 0100
0200
0300
0400
0500
0600
2.17
2.14
2.10
2.11
2.14
2.14
2.14
2.14
2.09
2.01
1.90
1.78
1.67
1.58
1.48
1.39
1.30
1.22
328
322
328
382
374
376
378
432
455
457
455
457
457
465
469
473
476
479
0700 1.14 473
0705 Burned One Cigarette*
0800 1.13 409
0900 1.52 397
1000 2.92 398
1100 2.11 410
1200 2.23 423
1300 2.34 442
1400 2.42 440
1500 2.42 450
1600 2.45 451
Equilibrium
%
15
14
18
41
63
71
67
66
66
64
55
57
57
57
50
46
44
42
39
37
34
32
29
27
25
24
28
38
48
51
53
53
55
54
54
* Marlboro 100 Filter Cigarette
-------
NAZARETH HOUSE
The data gathered on the effects of passive smoke in this house are shown in
Figure 2 and Table 2. As observed in the radon chamber, after a cigarette was burned the
Working Levels and percent equilibrium both increased for several hours. After about six
hours both of these effects began decreasing. Presumably these decreases are due to dilu-
tion from the normal ventilation in the basement area. Two other observations were noted
in this house. One was the normal diurnal variation in radon gas concentrations. The
other was that the percent equilibrium increased substantially in the six hours before the
burning of a cigarette. This would indicate that some other source of aerosol was intro-
duced into the basement air prior to the cigarette experiment. Since this increase occurred
between 9 a.m. and 3 p.m., it follows the typical pattern related to normal daytime ac-
tivities in a home, although we cannot attribute a specific cause to the increase.
The Working Level monitor in this house also recorded an 8% contribution of
thoron decay products to the Working Level measurements. This would account for per-
cent equilibrium values greater than 100%. This observation confirms a 1988 report by
the NCRP which notes that indoor air can have significant amounts of the thoron decay
product, lead-212 (4).
BETHLEHEM HOUSE
Two cigarettes were burned in the basement of this house at a 24 hour interval as
noted in Figure 3 and Table 3. After the first cigarette, both the Working Levels and the
percent equilibrium increased as noted in the Nazareth House. However, the Working
Levels began decreasing within three hours. The percent equilibrium continued to in-
crease for six hours. After burning a second cigarette on the next day the Working Levels
dropped, although there was a general increase in the percent equilibrium. The decrease
in Working Levels may be attributed to the decrease of radon concentration by a factor of
two in the twelve hours following the cigarette burning.
This house also had a 13% contribution from thoron decay products to the Work-
ing Level measurements. Therefore, the lowest equilibrium value was 62%. Several
times the equilibrium ratio went over 100%. The data in Table 3 (Continued) show that
during the night of July 3-4, 1990, the equilibrium went up to 121 %. We cannot account
for this increase, although it would appear to be related to an increase in aerosol concentra-
tion. The overall high levels of percent equilibrium in this home could be due to regular
cigarette smoking by an occupant. Since the percent equilibrium began increasing after 6
p.m., the increase could be due to smoking in the early evening hours.
-------
£ 100
Cigarette
40
0.075
0.06
0.045
Cigarette
0.03
Ql
Cigarette
T3
1230
1830
0030
0630
1230
6/19/90 6/20/90
Figure 2. Effect of passive smoke on working levels - Nazareth House
-------
TABLE 2.
EFFECT OF PASSIVE SMOKE ON WORKING LEVELS -
NAZARETH HOUSE
Time
6/19/90 0930
1030
1130
1230
1330
1430
1530
1530
1630
1730
1830
1930
2030
2130
2230
2330
6/20/90 0030
0130
0230
0330
0430
0530
0630
0730
0830
0930
1030
1130
1230
1330
1430
1530
Radon Daughters Radon Gas Equilibrium
WL pCi/L %
0.021 7.43 28
0.050 8.87 56
0.058 7.01 82
0.058 6.13 95
0.053 6.24 85
0.054 5.48 99
0.050 6.86 73
Burned One Cigarette*
0.054 6.59 82
0.063 6.66 95
0.069 6.72 103
0.057 7.77 73
0.061 8.61 71
0.066 8.74 76
0.067 9.59 70
0.071 10.13 70
0.066 10.16 65
0.066 9.66 68
0.060 974 62
0.057 966 59
0.052 9.24 56
0.049 9.24 53
0.049 8.70 56
0.050 8.33 60
0.050 7.77 64
0.047 7.48 63
0.046 7.40 62
0.047 6.70 70
0.046 6.24 74
0.045 6.07 74
0.046 5.69 81
0.030 5.74 52
* Marlboro 100 Filter Cigarette
-------
Cigarette
Cigarette
« 0.055
o
0.045
Cigarette
Cigarette
1237
0037
0637
0637
1837
0637
1837
0037
1237
7/1/90 7/2/90 7/3/90
Figure 3. Effect of passive smoke on working levels - Bethlehem House
-------
TABLE 3. EFFECT OF PASSIVE SMOKE ON WORKING LEVELS-
BETHLEHEM HOUSE
7/1/90
7/2/90
Time
Radon Daughters
Radon Gas
Equilibrium
WL
pCi/L
%
0537
0.044
5.17
85
0637
0.044
5.56
79
0737
0.046
5.66
81
0837
0.047
6.16
76
0837
Burned One Cigarette*
0937
0.048
6.26
77
1037
0.050
5.99
83
1137
0.049
5.14
95
1237
0.045
4.80
94
1337
0.045
4.67
96
1437
0.045
4.48
100
1537
0.045
4.48
100
1637
0.045
4.76
95
1737
0.049
5.14
94
1837
0.048
5.35
90
1937
0.048
5.20
92
2037
0.051
5.40
94
2137
0.052
6.64
78
2237
0.051
6.57
78
2337
0.053
6.64
80
0037
0.053
6.80
78
0137
0.052
7.00
74
0237
0.050
7.40
68
0337
0.050
7.06
71
0437
0.050
7.42
67
0537
0.050
7.31
68
0637
0.048
7.46
64
0737
0.050
7.41
67
0737
Burned One Cigarette"
0837
0.048
7.30
66
0937
0.042
6.81
62
1037
0.041
6.13
67
1137
0.041
5.48
75
1237
0.038
5.30
72
1337
0.038
5.16
74
1437
0.037
4.84
76
1537
0.039
4.64
84
1637
0.035
4.59
76
1737
0.035
4.47
78
* Marlboro 100 Filter Cigarette
-------
TABLE 3. EFFECT OF PASSIVE SMOKE ON WORKING LEVELS -
BETHLEHEM HOUSE (Continued)
Time
7/2/90 1837
1937
2037
2137
2237
2337
7/3/90 0037
0137
0237
0337
0437
0537
0637
0737
0837
0937
1037
1137
1237
1337
1447
1537
1637
1737
1837
1937
2037
2137
2237
2337
7/4/90 0037
0137
0237
0337
0437
0537
Radon Daughters Radon Gas Equilibrium
WL pCi/L %
0.034 4.20 81
0.032 3.70 86
0.029 3.49 83
0.029 3.25 89
0.028 3.46 81
0.029 3.43 85
0.032 3.62 88
0.033 3.87 85
0.036 4.14 87
0.043 4.65 92
0.043 5.16 83
0.046 5.68 81
0.049 5.85 84
0.049 6.30 78
0.048 6.30 76
0.050 5.75 87
0.051 5.32 96
0.048 5.30 91
0.044 4.86 91
0.040 4.28 93
0.035 3.69 95
0.033 3.14 105
0.030 2.89 104
0.027 2.81 96
0.022 2.70 81
0.023 2.18 106
0.023 2.02 113
0.023 2.05 112
0.024 1.99 121
0.027 2.32 116
0.029 2.78 104
0.033 3.30 100
0.035 3.59 97
0.040 3.98 100
0.044 4.56 96
0.045 4.45 101
-------
ROCKVILLE HOUSE
The first observation of note in this house is that the radon gas levels varied widely
during the 65 hours of the study, as shown in Figure 4 and Table 4. Initial levels of about
8 pCi/L at midday on Friday, January 11, 1991, rose to a high of about 22 pCi\L on Satur-
day morning and gradually decreased again to about 2.1 pCi\L on Sunday afternoon. We
believe this ten-fold variation in radon levels was likely due to changes in weather condi-
tions. On Friday morning a new wet snow fell on already snowcovered and frozen
ground. The wet snow then changed to heavy rain during the day on Friday, while the
outdoor temperatures increased from about 30 up to 40 degrees Fahrenheit. The clouds
cleared on Saturday with cooler temperatures and sunshine through Sunday.
The wide variation in radon levels during this experiment also serve to highlight
two other factors regarding radon measurements. One is that any readings taken during
the day on Friday would have shown unusually high radon levels that are probably not
typical for this house. This is another indication that short term measurements of a few
hours, or even 24 hours, may give radon levels that are not representative of average con-
ditions. The other factor has to do with how well charcoal canisters measure radon when
the levels vary widely during the exposure period. Eight open-face charcoal canisters
were placed in pairs around the living room for 72 hours to measure radon during the
same time as the continuous radon monitor. The two canisters next to the continuous
monitor gave an average reading of 4.4 pCi/L compared to an average of hourly readings
of 7.69 pCi/L. Apparently, the canisters were affected more by the radon levels at 2 to 4
pCi/L during the last 24 hours of exposure than the levels of 8 to 20 pCi/L during the first
day of exposure. Another observation of note also was that the six canisters placed nearer
to the outside walls of the living room gave readings of 12 to 27 percent higher than the
canisters near the inside wall next to the continuous monitor. Therefore, placement of
canisters can also affect the readings substantially.
The times and the number of cigarettes burned are given in Table 4. We began
lighting cigarettes on Friday evening to represent smoking after dinner and during the eve-
ning such as might occur while watching television. One or two cigarettes were lighted in
the morning as typical of someone having a cigarette after breakfast. No other cigarettes
were burned during the day on Saturday. Eight cigarettes were burned between 7:15 pm
and 9:15 pm that night. On Sunday, six cigarettes were burned near noontime and
another ten that evening to conclude the experiment. At most times, two cigarettes were
burned at the same time to represent two people smoking together.
As in the other homes, both the Working Levels and the percent equilibrium in-
creased significantly following the burning of each cigarette. These parameters remained
-------
80
60
20
0.06
0.04
0.02
Average of Hourly Reading* - 7.69
Charcoal Canister - 4.40
1800 2400 0600 1200 1800 2400 0600 1200 1800 2400 0600
1/11/91 1/12/91 1/13/91
Figure 4. Effect of passive smoke on working levels - Rockville House
-------
TABLE 4. EFFECT OF PASSIVE SMOKE ON WORKING LEVELS -
ROCKVILLE HOUSE
Time Radon Daughters Radon Gas Equilibrium Cigarettes*
WL pCi/L % Burned
1/11/91
1600
0.016
8.10
20
1700
0.016
7.83
20
1800
0.016
7.64
21
1900
0.017
9.00
19
2000
0.026
10.3
25
1
2100
0.044
11.0
40
3
2200
0.061
13.1
47
3
2300
0.074
14.9
50
2400
0.077
17.5
44
1/12/91
0100
0.076
21.0
36
0200
0.073
22.2
33
0300
0.057
22.0
26
0400
0.044
22.1
20
0500
0.044
21.5
20
0600
0.043
20.0
22
0700
0.042
17.5
24
0800
0.048
14.7
33
2
0900
0.057
12.9
44
1000
0.055
11.3
48
1100
0.048
10.2
47
1200
0.036
9.40
39
1300
0.028
9.20
31
1400
0.029
8.49
34
1500
0.026
7.99
33
1600
0.027
7.84
35
1700
0.026
7.75
33
1800
0.023
7.85
29
1900
0.027
7.97
33
3
2000
0.034
7.50
45
3
2100
0.035
7.00
52
2
2200
0.033
6.49
51
2300
0.030
5.42
56
2400
0.028
4.83
58
* Winston 100 Filter Cigarette
-------
TABLE 4. EFFECT OF PASSIVE SMOKE ON WORKING LEVELS -
ROCKVILLE HOUSE (Continued)
Time Radon Daughters Radon Gas Equilibrium Cigarettes4
WL pCi/L % Burned
1/13/91
0100
0.021
4.92
44
0200
0.017
4.83
34
0300
0.013
4.62
28
0400
0.012
4.31
28
0500
0.009
3.92
24
0600
0.008
3.77
21
0700
0.009
3.45
26
2
0800
0.013
3.21
41
0900
0.014
3.05
47
1000
0.013
2.77
45
1100
0.012
2.64
45
2
1200
0.012
2.58
48
4
1300
0.014
2.31
58
1400
0.014
2.06
69
1500
0.013
2.43
54
1600
0.013
2.37
55
1700
0.011
2.52
44
1800
0.011
2.55
43
2
1900
0.013
2.71
48
2
2000
0.015
2.67
57
4
2100
0.017
2.69
62
2
2200
0.017
3.00
56
2300
0.015
2.84
54
2400
1
0.015
2.92
50
1
0100
0.014
3.15
44
0200
0.014
3.15
47
0300
0.012
3.51
35
0400
0.010
3.48
30
0500
0.011
3.58
32
0600
0.009
3.92
22
* Winston 100 Filter Cigarette
-------
elevated for three to six hours after each group of cigarettes. The effects persisted longer
when more cigarettes were lighted in a short time, such as was done in the evenings
during this study. The percent equilibrium values varied from a low of about 20 up to a
high of about 70 after the introduction of cigarette smoke into the air. The lowest equi-
librium values occurred in the morning hours around five or six am. The Working Level
values also increased after each cigarette lighting even though the radon levels were falling
for most of the study after midnight on Friday.
DISCUSSION AND CONCLUSIONS
Both the radon chamber experiment at Radon QC and the measurements in the base-
ments and living areas of typical homes showed that cigarette smoke leads to a significant
increase in Working Levels and percent equilibrium. To the extent that Working Levels
are an indicator of health risk from exposure to radon decay products, the increases ob-
served in this study raise important questions about the increased risk to nonsmokers due
to the presence of passive cigarette smoke. Most studies have focused on the increased
risk to smokers related to combined effects of cigarette smoke and radon decay products.
We suggest that further studies also consider the possibility of increased risk to non-
smokers in the home of a smoker. The risk to occupants of a home with radon at EPA's
guideline level of 4 pCi/1 could be quite different in the home of a smoker in comparison
to a home with no smokers.
The question also arises about the increased risk to smokers. Since cigarette smoke
significantly increases Working Levels and percent equilibrium, then wherever a person is
smoking these parameters are affected. That is to say that smokers create an environment
around them of increased Working Levels wherever they are. Therefore, smokers not
only inhale cigarette smoke, with corresponding risks, but also they inhale an atmosphere
of increased radon decay product concentrations at the same time. Perhaps this is a con-
tributing factor to the increased risk of lung cancer to smokers.
For those who conduct Working Level measurements, these studies also indicate
that technicians making such measurements should not smoke. Otherwise, the Working
Level readings may reflect smoking habits of the technician, or other occupants of a
home, rather than natural Working Levels. These studies also highlighted the need to con-
sider other sources of lung cancer risk in homes, namely the contribution from thoron
decay products.
The work described in this paper was not funded by the U.S. Environ-
mental Protection Agency and therefore the contents do not necessarily
reflect the views of the Agency and no official endorsement should be inferred.
-------
NEEDS FOR FURTHER STUDY
These studies were intended to demonstrate that passive cigarette smoke affects
home occupant's exposures to radon (and thoron) decay products. We understand that in-
creases in aerosol concentration may also reduce the unattached fraction of polonium-218
and that may reduce the intake and retention of decay product alpha energy. We did not
measure unattached fractions. We also did not measure aerosol concentrations or particle
size distribution. For a better assessment of potential health risks from passive smoke fur-
ther studies should consider measurements of home ventilation rates, aerosol concentra-
tion, particle size distribution, and unattached fractions, as well as radon gas concentra-
tion, Working Levels, and percent equilibrium.
REFERENCES
1. National Council on Radiation Protection and Measurements. Evaluation of
Occupational and Environmental Exposures to Radon and Radon Daughters in the
United States, Report No. 78, NCRP, Bethesda, Maryland, 1984. 204 pp.
2. National Academy of Sciences. Health Risks of Radon and Other Internally
Deposited Alpha-emitters. Committee on the Biological Effects of Ionizing
Radiation, BEIR-IV. National Academy Press, Washington, D.C. 1988. 602 pp.
3. U.S. Environmental Protection Agency. A Citizen's Guide to Radon: What It
Is and What To About It. OPA - 86 - 004, USEPA, Washington, D.C. 1986.
14 pp.
4. Kabat, G. Lung cancer related to smoking. In: Proceedings of the
Twenty-fourth Annual Meeting of the National Council on Radiation Protection
and Measurements, Bethesda, Maryland, 1989. p. 65.
5. National Academy of Sciences. Environmental Tobacco Smoke: Measuring
Exposures and Assessing Health Effects. National Academy Press, Washington,
D.C. 1986.
6. Moeller, D.W. Simple approaches to complex problems. Health Physics Society
Newsletter, Vol. XIX, No. 1, Jan. 1991. p. 28.
7. Johnson, R.H., Geiger, E., and Rosario, A. Cigarette smoking increases working
level exposures to all occupants of the smoker's home. In: Proceedings of the
Fourth Annual Conference of the American Association of Radon Scientists and
Technologists. Camp Hill, PA. 1990.
*U.S. GOVERNMENT PIUNTINC OFFICE: 19 9 1 .stl. 1 a >2 0 s e •*
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