title: Residential radon and birth defects: A population-based assessment.
abstract: BACKGROUND
  Associations have been reported between maternal radiation exposure and birth defects. No such studies were found on radon. Our objective was to determine if there is an association between living in areas with higher radon levels and birth defects.
  
  
  METHODS
  The Texas Birth Defects Registry provided data on all birth defects from 1999 to 2009 from the entire state. Mean radon levels by geologic region came from the Texas Indoor Radon Survey. The association between radon and birth defects was estimated using multilevel mixed effect Poisson regression.
  
  
  RESULTS
  Birth defects overall were not associated with residential radon levels. Of the 100 other birth defect groups with at least 500 cases, 14 were significantly elevated in areas with high mean radon level in crude analyses, and 9 after adjustment for confounders. Cleft lip with/without cleft palate had an adjusted prevalence ratio of 1.16 per 1 picoCurie/liter (pCi/L) increase in exposure to region mean radon, 95% confidence interval, 1.08-1.26. Cystic hygroma / lymphangioma had an adjusted prevalence ratio of 1.22 per 1 pCi/L increase, 95% confidence interval, 1.02-1.46. Other associations were suggested but not as consistent: three skeletal defects, Down syndrome, other specified anomalies of the brain, and other specified anomalies of the bladder and urethra.
  
  
  CONCLUSIONS
  In the first study of residential radon and birth defects, we found associations with cleft lip w/wo cleft palate and cystic hygroma / lymphangioma. Other associations were suggested. The ecological nature of this study and multiple comparisons suggest that our results be interpreted with caution.
authors.affiliation: Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Langlois
authors.affiliation: Division of Clinical and Translational Sciences, Department of Internal Medicine, Medical School, and Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: MinJae
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Lupo
authors.affiliation: Division of Clinical and Translational Sciences, Department of Internal Medicine, Medical School, Division of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, and Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Rahbar
authors.affiliation: Radiation Branch, Texas Department of State Health Services, Austin, Texas.
authors.forename: Ruben K
authors.initials: RK
authors.lastname: Cortez
mesh_terms: D000328:Adult; D002971:Cleft Lip / Q000453:epidemiology*; D002972:Cleft Palate / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008202:Lymphangioma / Q000453:epidemiology*; D018191:Lymphangioma, Cystic / Q000453:epidemiology*; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D015995:Prevalence; D000069079:Radiation Exposure / Q000009:adverse effects*; D011886:Radon / Q000009:adverse effects*; D012042:Registries; D012044:Regression Analysis; D013781:Texas / Q000453:epidemiology
chemical_list: D011886:Radon
keywords: Radon; Texas; birth defects; cleft lip; malformations; radiation
references.citation: Radiat Res. 1990 Apr;122(1):1-11
references.pmid: 2320718
references.citation: Birth Defects Res A Clin Mol Teratol. 2015 Apr;103(4):243-54
references.pmid: 25820072
references.citation: Paediatr Perinat Epidemiol. 2010 Mar;24(2):200-8
references.pmid: 20415777
references.citation: Occup Environ Med. 1996 Feb;53(2):73-9
references.pmid: 8777454
references.citation: J Radiat Res. 2001 Mar;42(1):1-10
references.pmid: 11393885
references.citation: Am J Med Genet A. 2010 Jun;152A(6):1594-8
references.pmid: 20503344
references.citation: Tex Med. 2008 Dec 01;104(12):56-63
references.pmid: 19065472
references.citation: Birth Defects Res A Clin Mol Teratol. 2003 Mar;67(3):193-201
references.pmid: 12797461
references.citation: BMJ. 1994 Jul 16;309(6948):158-62
references.pmid: 8044094
references.citation: Int J Epidemiol. 1999 Oct;28(5):941-8
references.pmid: 10597995
references.citation: J Nucl Med. 1968 Sep;9(9):471-7
references.pmid: 5747864
references.citation: Pediatrics. 1952 Dec;10(6):687-93
references.pmid: 13003418
references.citation: Proc Natl Acad Sci U S A. 1977 Aug;74(8):3523-7
references.pmid: 269410
references.citation: Teratology. 2002;66 Suppl 1:S3-6
references.pmid: 12239736
references.citation: Teratology. 1999 Apr;59(4):182-204
references.pmid: 10331519
references.citation: South Med J. 2007 Jun;100(6):560-9
references.pmid: 17591309
references.citation: J Clin Oncol. 2002 May 15;20(10):2506-13
references.pmid: 12011129
references.citation: Nature. 2009 Jul 16;460(7253):400-4
references.pmid: 19553938
references.citation: Theriogenology. 2013 Jul 1;80(1):18-23
references.pmid: 23623167
references.citation: Acta Ophthalmol (Copenh). 1968;46(3):352-4
references.pmid: 4974456
references.citation: Stem Cells. 1997;15 Suppl 2:255-60
references.pmid: 9368311
references.citation: Radiat Res. 1999 Dec;152(6 Suppl):S149-53
references.pmid: 10564958
references.citation: Congenit Anom (Kyoto). 2013 Sep;53(3):127-30
references.pmid: 23998266
references.citation: Birth Defects Res A Clin Mol Teratol. 2007 Nov;79(11):798-805
references.pmid: 17990341
references.citation: Paediatr Perinat Epidemiol. 1993 Apr;7(2):121-51
references.pmid: 8516187
references.citation: J Epidemiol Community Health. 1995 Apr;49(2):164-70
references.pmid: 7798045
references.citation: J Expo Sci Environ Epidemiol. 2006 Nov;16(6):538-43
references.pmid: 16736057
references.citation: Cell Mol Biol (Noisy-le-grand). 2002 Jun;48(4):423-6
references.pmid: 12064450
references.citation: Reprod Toxicol. 2007 Nov-Dec;24(3-4):289-95
references.pmid: 17706919
references.citation: Radiat Res. 1997 Mar;147(3):321-8
references.pmid: 9052678
references.citation: Am J Epidemiol. 1977 May;105(5):488-95
references.pmid: 871121
references.citation: Am J Epidemiol. 1988 Feb;127(2):226-42
references.pmid: 3276166
references.citation: Radiat Environ Biophys. 2011 May;50(2):325-8
references.pmid: 21369823
references.citation: Birth Defects Res A Clin Mol Teratol. 2016 Jul;106(7):563-72
references.pmid: 27001904
references.citation: Am J Hum Genet. 1990 Jun;46(6):1053-72
references.pmid: 2339701