Gray Alastair, Read Simon, McGale Paul, Darby Sarah
Health Economics Research Centre, Department of Public Health, University of Oxford, Oxford OX3 7LF.
BMJ. 2009 Jan 6;338:a3110. doi: 10.1136/bmj.a3110.
To determine the number of deaths from lung cancer related to radon in the home and to explore the cost effectiveness of alternative policies to control indoor radon and their potential to reduce lung cancer mortality.
Cost effectiveness analysis.
United Kingdom.
Epidemiological data on risks from indoor radon and from smoking, vital statistics on deaths from lung cancer, survey information on effectiveness and costs of radon prevention and remediation.
Estimated number of deaths from lung cancer related to indoor radon, lifetime risks of death from lung cancer before and after various potential interventions to control radon, the cost per quality adjusted life year (QALY) gained from different policies for control of radon, and the potential of those policies to reduce lung cancer mortality.
The mean radon concentration in UK homes is 21 becquerels per cubic metre (Bq/m(3)). Each year around 1100 deaths from lung cancer (3.3% of all deaths from lung cancer) are related to radon in the home. Over 85% of these arise from radon concentrations below 100 Bq/m(3) and most are caused jointly by radon and active smoking. Current policy requiring basic measures to prevent radon in new homes in selected areas is highly cost effective, and such measures would remain cost effective if extended to the entire UK, with a cost per QALY gained of pound11,400 ( euro12 200; $16,913). Current policy identifying and remediating existing homes with high radon levels is, however, neither cost effective (cost per QALY gained pound36,800) nor effective in reducing lung cancer mortality.
Policies requiring basic preventive measures against radon in all new homes throughout the UK would be cost effective and could complement existing policies to reduce smoking. Policies involving remedial work on existing homes with high radon levels cannot prevent most radon related deaths, as these are caused by moderate exposure in many homes. These conclusions are likely to apply to most developed countries, many with higher mean radon concentrations than the UK.
确定家庭中与氡相关的肺癌死亡人数，并探讨控制室内氡的替代政策的成本效益及其降低肺癌死亡率的潜力。
成本效益分析。
英国。
关于室内氡和吸烟风险的流行病学数据、肺癌死亡的人口统计数据、氡预防和治理的有效性及成本的调查信息。
估计与室内氡相关的肺癌死亡人数、各种控制氡的潜在干预措施前后肺癌死亡的终生风险、不同氡控制政策每获得一个质量调整生命年（QALY）的成本，以及这些政策降低肺癌死亡率的潜力。
英国家庭中氡的平均浓度为每立方米21贝克勒尔（Bq/m³）。每年约有1100例肺癌死亡（占所有肺癌死亡人数的3.3%）与家庭中的氡有关。其中超过85%源于氡浓度低于100 Bq/m³，且大多数是由氡和主动吸烟共同导致的。当前要求在选定地区的新建房屋中采取基本措施预防氡的政策具有很高的成本效益，如果推广至整个英国，这些措施仍将具有成本效益，每获得一个QALY的成本为11400英镑（12200欧元；16913美元）。然而，当前识别并治理现有高氡水平房屋的政策既不具有成本效益（每获得一个QALY的成本为36800英镑），也无法有效降低肺癌死亡率。
要求在英国所有新建房屋中采取基本氡预防措施的政策将具有成本效益，并且可以补充现有的控烟政策。涉及对现有高氡水平房屋进行补救工作的政策无法预防大多数与氡相关的死亡，因为这些死亡是由许多家庭中的中度暴露引起的。这些结论可能适用于大多数发达国家，其中许多国家的平均氡浓度高于英国。
