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; C013 Group, Health Research Institute of Santiago de Compostela (Instituto Investigación Sanitaria de Santiago de Compostela/IDIS), Santiago de Compostela, Spain.
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; C013 Group, Health Research Institute of Santiago de Compostela (Instituto Investigación Sanitaria de Santiago de Compostela/IDIS), Santiago de Compostela, Spain.
Environ Res. 2021 Aug;199:111372. doi: 10.1016/j.envres.2021.111372. Epub 2021 May 27.
Lung cancer has the highest cancer mortality rate in developed countries. The principal risk factor for lung cancer is tobacco use, with residential radon being the leading risk factor among never smokers and the second among ever smokers. We sought to estimate mortality attributable to residential radon exposure in Spain and its Autonomous Regions, with correction for dwelling height and differentiation by tobacco use. We applied a prevalence-based method for estimating attributable mortality. For estimations, we considered exposure to radon in the different Autonomous Regions corrected for dwelling height, using the National Statistics Institute Housing Census and prevalence of tobacco use (never smokers, smokers and ex-smokers). The results showed that 3.8% (838 deaths) of lung cancer mortality was attributable to radon exposure of over 100 Bq/m, a figure that rises to 6.9% (1,533 deaths) when correction for dwelling height is not performed. By Autonomous Region, the highest population attributable fractions, corrected for dwelling height, were obtained for Galicia, Extremadura, and the Canary Islands, where 7.0, 6.9, and 5.5% of lung cancer mortality was respectively attributable to radon exposure. The greatest part of the attributable mortality occurred in men and among smokers and ex-smokers. Residential radon exposure is a major contributor to lung cancer mortality, though this contribution is highly variable among the different territories, indicating the need for targeted prevention policies. Correction of estimates for dwelling height is fundamental for providing reliable estimates of radon-attributable mortality.
在发达国家，肺癌的癌症死亡率最高。肺癌的主要危险因素是吸烟，而对于从不吸烟者来说，住宅氡是导致肺癌的首要危险因素，对于曾经吸烟者来说则是第二大危险因素。我们试图评估住宅氡暴露对西班牙及其自治区的死亡率的归因，并对居住高度进行校正，同时对吸烟状况进行区分。我们应用了一种基于患病率的方法来估计归因死亡率。在进行估计时，我们考虑了不同自治区中住宅高度校正后的氡暴露情况，使用了国家统计局住房普查和吸烟流行率（从不吸烟者、吸烟者和戒烟者）。结果表明，3.8%（838 人死亡）的肺癌死亡率归因于氡暴露超过 100 Bq/m3，而当不进行居住高度校正时，这一数字上升至 6.9%（1533 人死亡）。按自治区划分，在进行居住高度校正后，加利西亚、埃斯特雷马杜拉和加那利群岛的人群归因分数最高，分别有 7.0%、6.9%和 5.5%的肺癌死亡率归因于氡暴露。归因死亡率的大部分发生在男性和吸烟者及戒烟者中。住宅氡暴露是导致肺癌死亡率的一个主要因素，但在不同地区之间存在很大差异，这表明需要采取有针对性的预防政策。对居住高度进行估计的校正对于提供可靠的氡归因死亡率估计至关重要。
