Laurentian University, Sudbury, Ontario, Canada.
Northern Ontario School of Medicine, Sudbury, Ontario, Canada.
Chem Biol Interact. 2019 Mar 1;301:81-87. doi: 10.1016/j.cbi.2018.11.012. Epub 2019 Feb 11.
The National Academy of Sciences (USA) conducted an extensive review on the health effects of radon (BEIR VI). This was a well written and researched report which had impact on regulations, laws and remediation of radon in homes. There were a number of problems with the interpretation of the report and three are focused on here. First, most of the radiation dose used to estimate risk was from homes with radon levels below the US Environmental Protection Agency's action level so that remediation had minor impact on total calculated attributable risk. Remediation of the high level homes (i.e., above the action level) would therefore have a minor impact on the calculated "population attributable risk". In individual homes with very high levels of radon, remediation may minimally reduce individual risk. Second, the conclusion communicated to the public, regulators and law makers was "Next to cigarette smoking radon is the second leading cause of lung cancer." This is not an accurate evaluation of the report. The correct conclusion would be: Next to cigarette smoking, high levels of radon combined with cigarette smoking is the second leading cause of lung cancer. In the never-smokers, few cancers could be attributable to radon. Thirdly, there is little question that high levels of radon exposure in mines combined with cigarette smoke and other significant insults in the mine environment produces excess lung cancer. However, the biological responses to low doses of radiation are different from those produced by high levels and low doses may result in unique protective responses (e.g. against smoking-related lung cancer). These three points will be discussed in detail. This paper shows that in contrary to the BEIR VI report, risk of lung cancer from residential radon is not increased and radon in homes appears to be helping to prevent smoking-related lung cancer. Thus, laws requiring remediation of homes for radon are providing little if any public health benefits.
美国国家科学院（USA）对氡的健康影响进行了广泛的审查（BEIR VI）。这是一份写得很好、研究得很透彻的报告，对规范、法律以及住宅氡的补救措施产生了影响。该报告的解释存在一些问题，这里重点关注三个问题。首先，用于估计风险的大部分辐射剂量来自氡水平低于美国环境保护署行动水平的住宅，因此补救措施对总计算归因风险的影响较小。因此，对高水平住宅（即高于行动水平）的补救措施对计算得出的“人群归因风险”的影响较小。在氡含量非常高的个别住宅中，补救措施可能会最小程度地降低个人风险。其次，向公众、监管机构和立法者传达的结论是：“仅次于吸烟，氡是肺癌的第二大主要原因。”这并不是对该报告的准确评估。正确的结论应该是：仅次于吸烟，高水平的氡与吸烟相结合是肺癌的第二大主要原因。在不吸烟者中，很少有癌症可归因于氡。第三，毫无疑问，矿中的高水平氡暴露与香烟烟雾和矿内其他重大刺激因素结合，会导致肺癌增加。但是，低剂量辐射的生物反应与高剂量辐射的生物反应不同，低剂量可能会产生独特的保护反应（例如，对与吸烟有关的肺癌）。这三点将详细讨论。本文表明，与 BEIR VI 报告相反，住宅氡导致肺癌的风险没有增加，而且住宅中的氡似乎有助于预防与吸烟有关的肺癌。因此，要求对住宅氡进行补救的法律几乎没有带来任何公共卫生益处。
