Ruano-Ravina Alberto, Cameselle-Lago Candela, Torres-Durán María, Pando-Sandoval Ana, Dacal-Quintas Raquel, Valdés-Cuadrado Luis, Hernández-Hernández Jesús, Consuegra-Vanegas Angélica, Tenes-Mayén José Andrés, Varela-Lema Leonor, Fernández-Villar Alberto, Barros-Dios Juan Miguel, Pérez-Ríos Mónica
Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain.
Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain.
Arch Bronconeumol (Engl Ed). 2020 Dec 25. doi: 10.1016/j.arbres.2020.11.015.
COPD is a multifactorial disease which causes considerable mortality and morbidity worldwide. Previous studies assessing the possible relationship between indoor radon exposure and COPD have shown inconclusive results.
A multicentric, hospital-based, case-control study was conducted in a Spanish radon-prone area. COPD cases were confirmed by spirometry and controls were selected due to trivial surgery or procedures not related to tobacco consumption. All participants had to have lived for at least 15 years in the same dwelling. Radon measurements were conducted individually in dwellings using alpha-track detectors. Results were obtained using multivariate logistic regression.
189 cases and 747 controls took part. There was no significant association between residential radon concentrations and COPD onset with a OR of 1.12 (95%CI 0.41-3.06) for individuals exposed to more than 200Bq/m compared to those exposed to less than 50Bq/m. Heavy smokers seem to increase their COPD risk if exposed to higher radon concentrations vs those exposed to lower concentrations. There was a statistically significant synergy index between radon exposure and tobacco consumption, S-index 11.60 (95%CI 3.71-36.26). Indoor radon concentration was higher in never/light smokers with COPD compared to controls.
No association between indoor radon and COPD has been observed. However, there might be some effect modification on the COPD risk in heavy smokers when high radon exposure is present. This is supported by the additive synergy observed. Also, a possible association between indoor radon and COPD onset in never and light smokers needs to be further studied.
慢性阻塞性肺疾病（COPD）是一种多因素疾病，在全球范围内导致相当高的死亡率和发病率。以往评估室内氡暴露与COPD之间可能关系的研究结果尚无定论。
在西班牙一个氡易发地区开展了一项多中心、基于医院的病例对照研究。通过肺功能测定确诊COPD病例，对照组因进行与烟草消费无关的小手术或操作而入选。所有参与者必须在同一住所居住至少15年。使用α径迹探测器在住所中单独进行氡测量。结果通过多变量逻辑回归获得。
189例病例和747名对照参与研究。与氡暴露低于50Bq/m³的个体相比，氡暴露高于200Bq/m³的个体中，住宅氡浓度与COPD发病之间无显著关联，比值比为1.12（95%置信区间0.41 - 3.06）。与暴露于较低氡浓度的重度吸烟者相比，暴露于较高氡浓度时，他们患COPD的风险似乎增加。氡暴露与烟草消费之间存在统计学显著的协同指数，协同指数为11.60（95%置信区间3.71 - 36.26）。与对照组相比，患COPD的从不吸烟/轻度吸烟者的室内氡浓度更高。
未观察到室内氡与COPD之间存在关联。然而，当存在高氡暴露时，可能会对重度吸烟者的COPD风险产生一些效应修饰作用。这得到了观察到的相加协同作用的支持。此外，室内氡与从不吸烟和轻度吸烟者的COPD发病之间可能存在的关联需要进一步研究。
