Barbosa-Lorenzo Raquel, Ruano-Ravina Alberto, Ramis Rebeca, Aragonés Nuria, Kelsey Karl T, Carballeira-Roca Consuelo, Fernández-Villar Alberto, López-Abente Gonzalo, Barros-Dios Juan M
a Department of Preventive Medicine & Public Health , University of Santiago de Compostela , Santiago de Compostela , Spain.
b Preventive Medicine and Public Health Unit , Monforte de Lemos Local Hospital , Monforte de Lemos , Spain.
Int J Radiat Biol. 2017 Feb;93(2):222-230. doi: 10.1080/09553002.2017.1238526. Epub 2016 Nov 17.
Radon is a human lung carcinogen but it might be linked with other respiratory diseases. We aimed to assess the relationship between residential radon exposure and COPD (chronic obstructive pulmonary disease) prevalence and hospital admissions at a municipal level.
We designed an ecological study where we included those municipalities with at least three radon measurements. Using mixed Poisson regression models, we calculated the relative risk (RR) for COPD for each 100 Bq/m of increase in radon concentration and also the relative risk for COPD using a cut-off point of 50 Bq/m. We did not have individual data on cigarette smoking and therefore we used a proxy (bladder cancer standardized mortality rate) that has proved to account for tobacco consumption. We performed separate analyses for sex and also sensitivity analysis considering age and rurality.
A total of 3040 radon measurements and 49,393 COPD cases were included. The relative risk for COPD prevalence was 0.95 (95% CI: 0.92-0.97) while for hospital admissions the RR was 1.04 (95% CI: 1.00-1.10) for each 100 Bq/m. Relative risks were higher for women compared to men. Using a categorical analysis with a cut-off point of 50 Bq/m, the RR for COPD prevalence was 1.06 (95% CI: 1.02-1.10) and for hospital admissions it was 1.08 (95% CI: 1.00-1.17) for women living in municipalities with more than 50 Bq/m. All risks were also higher for women. No relevant differences were observed for age, rurality or other categories for radon exposure.
While the influence of radon on COPD prevalence is unclear depending on the approach used, it seems that residential radon might increase the risk of hospital admissions in COPD patients. Women have a higher risk than men in all situations. Since this is an ecological study, results should be interpreted cautiously.
氡是一种人类肺癌致癌物，但它可能与其他呼吸系统疾病有关。我们旨在评估市级层面住宅氡暴露与慢性阻塞性肺疾病（COPD）患病率及住院率之间的关系。
我们设计了一项生态研究，纳入了至少有三次氡测量值的城市。使用混合泊松回归模型，我们计算了氡浓度每增加100 Bq/m³时COPD的相对风险（RR），以及使用50 Bq/m³的临界值时COPD的相对风险。我们没有关于吸烟的个体数据，因此我们使用了一个已被证明可反映烟草消费情况的替代指标（膀胱癌标准化死亡率）。我们对性别进行了单独分析，并考虑年龄和农村地区进行了敏感性分析。
共纳入了3040次氡测量值和49393例COPD病例。氡浓度每增加100 Bq/m³时，COPD患病率的相对风险为0.95（95%可信区间：0.92 - 0.97），而住院率的RR为1.04（95%可信区间：1.00 - 1.10）。女性的相对风险高于男性。使用临界值为50 Bq/m³的分类分析，居住在氡浓度超过50 Bq/m³城市的女性中，COPD患病率的RR为1.06（95%可信区间：1.02 - 1.10），住院率的RR为1.08（95%可信区间：1.00 - 1.17）。所有风险女性也更高。在年龄、农村地区或其他氡暴露类别方面未观察到相关差异。
虽然根据所采用的方法，氡对COPD患病率的影响尚不清楚，但住宅氡似乎可能增加COPD患者的住院风险。在所有情况下，女性的风险都高于男性。由于这是一项生态研究，结果应谨慎解释。
