OFFICE OF

THE ADMINISTRATOR
               UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
                   '       WASHINGTON, D,C, 20460



 September 9, 1988                   SAB-RAC-88-G42


Honorable Lee M.  Thomas
Administrator
U. S. Environmental Protection Agency
401 M Street SW
Washington,  DC 20460

Dear Mr. Thomas:

     The Dose and  Risk Subcommittee  of the  Science  Advisory
Board's Radiation Advisory Committee has completed•its review of
the  Office  of Radiation  Programs1  Radon  Risk Estimates.   This
review  was  requested on  May 25,  1988  by  the Director  of the
Office of Radiation Programs and was conducted on June 20,  1988,
at  an  open  meeting  in Washington, DC,  at  which  Dr.  Douglas
Chambers of  SENES  Consultants and  Dr.  Leonard Hamilton  of the
Broofchaven  National Laboratory  presented  oral  and  written
comments  on  behalf  of  the  public.   Because   the Office  of
Radiation Programs is considering using its  new estimate as part
of the technical basis for the revised radionuclides NESHAP, the
Science Advisory Board was asked  to respond  as  early  as possible.

     The Office  of Radiation Programs1 proposed  risk estimate,
based upon an adjusted BEIR-IV model, consists  of  a range of 120-
750 fatal lung cancers per million working level  months of  radon
exposure with a  central estimate  of   300,    The Environmental
Protection  Agency's  current central  value  is  460  fatal lung
cancers per million working level months of  radon  exposure with a
range  of  230-920,    For  radon  exposure,  risk to  the  lung  is
considered the only relevant cancer risk,

     Three important technical consensus  reports  on radon  risks
are of potential use to the Agency;  (1)  ' the  1987 International
Commission  on 'Radiological  Protection's  Report  entitled  "Lung
Cancer Risks from Indoor EKposures  to Radon  Daughters"  (ICRP 50};
(2)  the  1988 report  of the  National  Academy of  Sciences'
Committee on the Biological Effects of  Ionizing Radiation Report
entitled "Health Risks  oŁ Radon and other  Internally  Deposited
Alpha-emitters"  (BEIR-IV) ;  and  (3)  the  1984  report  of the
National Council on Radiation Protection and Measurements1 Report
78  entitled  "Evaluation  of Occupational  and Environmental
Exposures to  Radon and  Radon Daughters  in the  United  states"
(NCRP 78). None of these reports  is clearly  pre-eminent;  each has
its  strengths and  limitations.   These  limitations  reflect the
uncertain state  of our  knowledge   in  particular areas  and the

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consequent legitimate basis for differences  in the  interpretation
of the   limited  data  available.   Of   the  three  reports cited,
ICRP 50 and  BEIR-IV appear to have the  greater  utility for the
Agency.    Both use the  relative  risk  projection model  arid
generally  their  projections  are  quite  similar.    Their models
differ in  certain ways, however;  for  example,   BEIR-IV,  in its
projections diminishes  the  excess  relative  risk  with time since
exposure,  whereas ICRP 50  uses a constant excess  relative risk,

     The Dose and Risk  Subcommittee does not  recommend that the
Agency attempt to develop  still another model for radon  and radon
daughter risk  estimation  and projection; there  is not time nor
sufficient personnel  to do it  better than  existing  technical
consensus  groups  have  done  before the  radionuclides  NESHAP is
scheduled to be published in final form.  Moreover, such a model
would not have the weight  of authority  of the consensus  documents
since it  could not be  scrutinized carefully by the  scientific
community.   Instead the Agency should use the ICRP  50 and BEIR-IV
reports to determine the range of risk estimates that exists, to
identify the ambiguities in the data on which-the  risk  estimates
rest, to determine  the , consequences of  the projecting of these
risks to a lifetime,  and  to understand the  uncertainties of the
models.    The  ICRP  50  and BEIR-IV projection  values  could be
averaged to  provide a  central estimate except  where  there are
good reasons to  prefer  one result to  the other.   One  such  case
may  be  risks  to children  as the  BEIR-IV  report is  primarily
concerned with a working population, whereas  the  ICRP  50 report
attempted  to  address  risks to the  general  population  whose
susceptibility to  cancer may  differ  by  age  at exposure.   The
Subcommittee  suggests that  the   risk estimate   used in  the
projection of  the  lifetime risks with  the  BEIR-IV model be the
BEIR estimate  basedi  on the  internal  rather than the  external
comparisons, but strongly urges  that  the description of the
projections be tempered by a discussion of the limitations of the
epidemiological data.

     The National Council  on Radiation  Protection Report on  radon
and radon daughter products differs from the ICRP  and  BElR-lv  in
a number of  ways.   Specifically these  are:  (a)  NCRP 78 uses  ar.
absolute model for risk projection; (b) NCRP 78 projects the  sar.e
risks  for males and  females,  for different  age  at exposure
groups,  and  for  smokers  and  nonsmokers;   (c)  NCRP presumes  -2
expression of the increased risk until after  the  age of 40,  *rd
(d)  NCRP   78 assumes  that  a loss half-time  (20 years)  exists fcr
the  stem  cells  in  the lung  transformed by  exposure  to  alpr.a
irradiation,  so that  the  cancer risk  diminishes with  time  s:~re
exposure.   Nevertheless, it  should be noted that  the NCR?  "
model,  for non-smokers, leads . to   conclusions within  the  rar.,7^
resulting from the ICRP 50 and BEIR-IV  models.

     Generally speaking,  the  ICRP 50  and  BEIR-IV models  w;;,
lower the  level  of  risk understood to be associated with  radcr.

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exposure somewhat  below  the levels estimated  by  the Agency  in
1985.   No  additional major  technical  assessments  of radon  and
radon daughter risks are  currently underway that would contribute
to the  Agency's understanding of  these risks  in  the next  two
years or so,  but several studies are  in progress  or have  been
recently published  that  will provide  the basis for -an  improved
evaluation  later.  Such studies include an update on the  Ontario
miners,  further   work   with   the  Czechoslovakian  miners,
experimental  studies  of  radon  as  a  cancer  promoter,  and  the
National Cancer Institute sponsored  studies of radon exposure and
lung cancer.

     Besides recommending that the Agency rely on the ICRP 50 and
BEIR-IV  reports,  the  Subcommittee  offers  comments  on  certain
aspects of  the modelling  of  risk.

     The Subcommittee supports the  relative  risk model used  by
ICRP 50 and BEIR-IV because  the experience in Japan clearly shows
that for survivors aged 20 and older at the time of exposure, the
excess  relative  risk of  cancer  changes very,  little with  time
since exposure.  For those under age 20 at the time of exposure,
neither the absolute nor  the relative risk model works very well.
The  atomic  bomb -survivors  were  exposed primarily  to  external,
low-LET radiation at  a high   dose  rate,  not  radon  or  its
daughters;   but  because the  survivors  represent the only well-
studied large  general  population exposed to  radiation,  the
experience   in  Japan  for  predicting  population  risks  is
compelling.

     The Subcommittee endorses the use of a linear model for low-
dose extrapolation  of  risks from radon  exposure' although it is
not  possible to  determine  statistically whether the linear,
linear-quadratic, or quadratic dose-response model  best  fits the
available human  population   studies.   The Ontario  and  Colorado
miner data  sets have a linear-quadratic  quality to them; however,
controlled  experiments in animals exposed  to high-LET radiation
indicate linearity  in  the low-dose range,  and the Subcommittee
places  greater  reliance in these latter findings,  for  the
present, given the limitations  in the human studies.

     The Subcommittee believes that risks established for mining
populations can be transferred to a general population including
the  young,   females, and  nonsmokers  since the levels of exposure
are  similar,  at  least  in some instances.  Although  the  dose to
the  lung  is  determined by the  unattached  fraction   of  the
daughters of radon, and this fraction appears somewhat higher in
homes than   in mines (which  implies a slightly higher dose in rad
or gray in  .the  former than the latter  environment),  the lower
breathing rate, on average,  in  the home  would offset this  effect.
Accordingly, the  Subcommittee  believes the  current state of
knowledge is such  that the  risks established for miners  provide
an acceptable basis to predict  risks for  the general population.

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     With regard to  age,  the Subcommittee recommends that where
there is  a  specific  need to predict risks  from  radon and radon
daughters  in a  young  population,  such  as risks  of  radon  in
schools, "the Agency  should  rely on the ICRP 50  rather than the
BEIR-IV report because children may be  more  susceptible*

     The Subcommittee finds the data on the interrelationship  of
smoking  and radon exposure  to be  complex but  recommends  that
under these circumstances the Agency treat  the interrelationship
as multiplicative at the present time.  If the effects of  smoking
and  exposure  are  additive,   this will  have  the  effect  of
overestimating the  risk,  but  given the  uncertainties  in their
relationship, this would seem the  conservative course  at present.

     In  summary,  the  Subcommittee  endorses the range 'of  risk
estimates proposed by the Office of Radiation Programs.   It  does
recommend that the  Agency not  attempt  to develop still  another
model   for   radon  and  radon  daughter  risk,   estimation  and
projection, but urges the use of the existing technical consensus
reports described above.

     The Subcommittee looks forward to the opportunity to review
the  Background  Information  Document  on  which   the  final
regulations, will be based.

     We appreciate the opportunity to share our views with you
and look forward to a written response  from  the Agency.

                               Sincerely,
                               Norton
                               Chairman,  Executive  Committee
                               Science Advisory  Board
                               William J,  Sc
                               Chairman,  Radiation Advisory Cc T -.--
                               and Dose and Risk Subcommittee
Attachment;   Roster

CCi R. Guimond
    J. Cotruvo

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