School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Radiation Protection Bureau, Health Canada, Ottawa, Ontario, Canada.
Environ Health Perspect. 2018 May 31;126(5):057009. doi: 10.1289/EHP2503. eCollection 2018 May.
Radon is the second most important cause of lung cancer, ranked by the World Health Organization as the fifth leading cause of mortality in 2010. An updated database of national radon exposures for 66 countries allows the global burden of lung cancer mortality attributable to radon to be estimated.
Our goal was to estimate the global population attributable burden of lung cancer mortality in 2012 from residential radon.
Estimates of the population attributable risk (PAR) of lung cancer mortality from radon were determined using the attributable fraction approach, using three models for excess relative risk of lung cancer from radon.
The estimates of the median PAR of lung cancer mortality from residential radon in 2012 for the 66 countries having representative national radon surveys were consistent, as 16.5%, 14.4%, and 13.6% for the exposure-age-concentration (EAC) model (BEIR VI), the Hunter model, and the Kreuzer model, respectively. The mean PAR using the EAC model ranged from 4.2% (95% CI: 0.9, 11.7) for Japan, to 29.3% (95% CI: 22.9, 35.7) for Armenia, with a median for the 66 countries of 16.5%. Radon-attributable lung cancer deaths for all 66 countries totaled 226,057 in 2012 and represent a median of 3.0% of total cancer deaths.
Consistent findings between the three models used to estimate excess relative risks of lung cancer from radon, and between the attributable fraction methodology and the life table analysis, confirm that residential radon is responsible for a substantial proportion of lung cancer mortality worldwide. https://doi.org/10.1289/EHP2503.
氡是肺癌的第二大主要病因,世界卫生组织将其列为 2010 年第五大致死原因。一个更新的 66 个国家的国家氡暴露数据库允许估计归因于氡的全球肺癌死亡率负担。
我们的目标是估计 2012 年住宅氡导致的全球肺癌死亡率的人群归因负担。
使用归因分数法,使用氡导致肺癌超额相对风险的三个模型,确定肺癌死亡率归因于氡的人群归因风险(PAR)估计值。
在有代表性的国家氡调查的 66 个国家中,2012 年住宅氡导致肺癌死亡率的中位数 PAR 估计值是一致的,分别为暴露-年龄-浓度(EAC)模型(BEIR VI)、Hunter 模型和 Kreuzer 模型的 16.5%、14.4%和 13.6%。使用 EAC 模型的平均 PAR 范围从日本的 4.2%(95%CI:0.9,11.7)到亚美尼亚的 29.3%(95%CI:22.9,35.7),66 个国家的中位数为 16.5%。2012 年,所有 66 个国家的氡归因肺癌死亡人数总计为 226057 人,占癌症总死亡人数的中位数为 3.0%。
用于估计氡导致肺癌超额相对风险的三个模型之间、归因分数方法与寿命表分析之间的一致发现,证实住宅氡是全球范围内导致大量肺癌死亡的原因。https://doi.org/10.1289/EHP2503.