Cothern C R
Rev Environ Contam Toxicol. 1990;111:1-60. doi: 10.1007/978-1-4612-3340-4_1.
This review concerns primarily the health effects that result from indoor air exposure to radon gas and its progeny. Radon enters homes mainly from the soil through cracks in the foundation and other holes to the geologic deposits beneath these structures. Once inside the home the gas decays (half-life 3.8 d) and the ionized atoms adsorb to dust particles and are inhaled. These particles lodge in the lung and can cause lung cancer. The introduction to this review gives some background properties of radon and its progeny that are important to understanding this public health problem as well as a discussion of the units used to describe its concentrations. The data describing the health effects of inhaled radon and its progeny come both from epidemiological and animal studies. The estimates of risk from these two data bases are consistent within a factor of two. The epidemiological studies are primarily for hard rock miners, although some data exist for environmental exposures. The most complete studies are those of the US, Canadian, and Czechoslovakian uranium miners. Although all studies have some deficiencies, those of major importance include uranium miners in Saskatchewan, Canada, Swedish iron miners, and Newfoundland fluorspar miners. These six studies provide varying degrees of detail in the form of dose-response curves. Other epidemiological studies that do not provide quantitative dose-response information, but are useful in describing the health effects, include coal, iron ore and tin miners in the UK, iron ore miners in the Grangesburg and Kiruna, Sweden, metal miners in the US, Navajo uranium miners in the US, Norwegian niobian and magnitite miners, South African gold and uranium miners, French uranium miners, zinc-lead miners in Sweden and a variety of small studies of environmental exposure. An analysis of the epidemiological studies reveals a variety of interpretation problem areas. The major and almost universal problem is in estimating exposure levels. In many cases there were no direct measurements of radon or radon progeny and the exposure levels are estimates based on irregular measurements and known levels in nearby mines. Perhaps the most important variable or complicating factor in the determination of the risk due to radon exposure is the confounding factor of exposure to cigarette smoke. The general scientific concensus is that, although the interaction could be somewhere between linear and supramultiplicative, it is likely a combination, and closer to multiplicative. A number of other complexities contribute to the uncertainty in the risk estimates, likely to a lesser degree than those of exposure measurements and cigarette smoke confounding.(ABSTRACT TRUNCATED AT 400 WORDS)
本综述主要关注室内空气中氡气及其子体暴露所导致的健康影响。氡气主要通过房屋地基的裂缝以及其他孔洞从土壤进入家中，到达这些建筑物下方的地质沉积物。一旦进入室内，该气体便会衰变（半衰期为3.8天），电离后的原子吸附在灰尘颗粒上并被吸入。这些颗粒滞留在肺部，可能引发肺癌。本综述的引言部分介绍了氡气及其子体的一些背景特性，这些特性对于理解这一公共卫生问题至关重要，同时还讨论了用于描述其浓度的单位。描述吸入氡气及其子体对健康影响的数据来自流行病学研究和动物研究。这两个数据库得出的风险估计值在两倍的范围内是一致的。流行病学研究主要针对硬岩矿工，不过也有一些关于环境暴露的数据。最完整的研究来自美国、加拿大和捷克斯洛伐克的铀矿矿工。尽管所有研究都存在一些缺陷，但其中最重要的包括加拿大萨斯喀彻温省的铀矿矿工、瑞典的铁矿矿工以及纽芬兰的萤石矿矿工。这六项研究以剂量反应曲线的形式提供了不同程度的详细信息。其他虽未提供定量剂量反应信息，但对描述健康影响有用的流行病学研究包括英国的煤矿、铁矿和锡矿矿工、瑞典格兰斯堡和基律纳的铁矿矿工、美国的金属矿矿工、美国的纳瓦霍铀矿矿工、挪威的铌矿和磁铁矿矿工、南非的金矿和铀矿矿工、法国的铀矿矿工、瑞典的锌铅矿矿工以及各种关于环境暴露的小型研究。对流行病学研究的分析揭示了多个存在解释问题的领域。主要且几乎普遍存在的问题在于估计暴露水平。在许多情况下，没有对氡气或氡子体进行直接测量，暴露水平是基于不定期测量以及附近矿井的已知水平估算得出的。在确定氡气暴露所致风险时，或许最重要的变量或复杂因素是接触香烟烟雾这一混杂因素。科学界的普遍共识是，尽管这种相互作用可能介于线性和超乘性之间，但很可能是一种组合，且更接近乘性。还有一些其他复杂因素导致了风险估计的不确定性，其程度可能比暴露测量和香烟烟雾混杂因素带来的不确定性要小。（摘要截取自400字）
