title: Lung cancer risk from radon in Ontario, Canada: how many lung cancers can we prevent?
abstract: OBJECTIVE
  To calculate the burden of lung cancer illness due to radon for all thirty-six health units in Ontario and determine the number of radon-attributable lung cancer deaths that could be prevented.
  
  
  METHODS
  We calculated the population attributable risk percent, excess life-time risk ratio, life-years lost, the number of lung cancer deaths due to radon, and the number of deaths that could be prevented if all homes above various cut-points were effectively reduced to background levels.
  
  
  RESULTS
  It is estimated that 13.6 % (95 % CI 11.0, 16.7) of lung cancer deaths in Ontario are attributable to radon, corresponding to 847 (95 % CI 686, 1,039) lung cancer deaths each year, approximately 84 % of these in ever-smokers. If all homes above 200 Bq/m(3), the current Canadian guideline, were remediated to background levels, it is estimated that 91 lung cancer deaths could be prevented each year, 233 if remediation was performed at 100 Bq/m(3). There was important variation across health units.
  
  
  CONCLUSIONS
  Radon is an important contributor to lung cancer deaths in Ontario. A large portion of radon-attributable lung cancer deaths are from exposures below the current Canadian guideline, suggesting interventions that install effective radon-preventive measures into buildings at build may be a good alternative population prevention strategy to testing and remediation. For some health units, testing and remediation may also prevent a portion of radon-related lung cancer deaths. Regional attributable risk estimates can help with local public health resource allocation and decision making.
authors: Public Health Ontario, 300-480 University Ave., Toronto, ON, M5G 1V2, Canada, emily.peterson@oahpp.ca.
authors: Emily
authors: E
authors: Peterson
authors: Amira
authors: A
authors: Aker
authors: JinHee
authors: J
authors: Kim
authors: Ye
authors: Y
authors: Li
authors: Kevin
authors: K
authors: Brand
authors: Ray
authors: R
authors: Copes
mesh_terms: D004307:Dose-Response Relationship, Radiation; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis / Q000517:prevention & control; D005260:Female; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009010:Monte Carlo Method; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D009864:Ontario / Q000453:epidemiology; D011848:Radioactive Pollutants / Q000506:poisoning; D011886:Radon / Q000506:poisoning*; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D012907:Smoking; D016019:Survival Analysis; D015996:Survival Rate
chemical_list: D011848:Radioactive Pollutants; D011886:Radon
references: Epidemiology. 2005 Mar;16(2):137-45
references: 15703527
references: PLoS One. 2011;6(7):e21704
references: 21818262
references: Environ Health Perspect. 1995 Dec;103(12):1144-9
references: 8747021
references: BMJ. 2009 Jan 06;338:a3110
references: 19129153
references: Environ Int. 2006 May;32(4):435-43
references: 16436295
references: Risk Anal. 2005 Apr;25(2):253-69
references: 15876202
references: Risk Anal. 2008 Oct;28(5):1221-30
references: 18761730
references: Health Phys. 2007 May;92(5):425-31
references: 17429300
references: Environ Int. 2011 Feb;37(2):375-82
references: 21109305
references: Radiat Prot Dosimetry. 2008;130(1):8-13
references: 18583373
references: Radiat Prot Dosimetry. 2009 Aug;135(4):243-55
references: 19622543
references: J Cancer Educ. 2012 Jun;27(3):566-72
references: 22467225
references: Am J Public Health. 2013 Mar;103(3):443-7
references: 23327258
references: Radiat Prot Dosimetry. 2012 Nov;152(1-3):9-13
references: 22874897
references: Am J Public Health. 1996 Sep;86(9):1222-7
references: 8806372
references: Health Policy. 2011 Sep;102(1):81-8
references: 21030106