Mphaga Khathutshelo Vincent, Utembe Wells, Mbonane Thokozani P, Rathebe Phoka Caiphus
Department of Environmental Health, Faculty of Health Sciences, Doornfontein Campus, University of Johannesburg, P.O. Box 524, Johannesburg 2006, South Africa.
National Health Laboratory Service, Toxicology and Biochemistry Department, National Institute for Occupational Health, Johannesburg 2000, South Africa.
Heliyon. 2024 Nov 14;10(23):e40439. doi: 10.1016/j.heliyon.2024.e40439. eCollection 2024 Dec 15.
Radon (Rn) is a radioactive gas with well-established carcinogenic properties. It is a significant contributor to natural background ionizing radiation exposure, accounting for over 50 % of human exposure. Prolonged exposure to radon gas has been conclusively linked to various health issues such as lung cancer, leukemia, and Chronic Obstructive Pulmonary Diseases (COPD). Despite this, there is a scarcity of comprehensive studies examining the quality of evidence establishing an association between indoor radon exposure and these health problems.
We performed a systematic review of peer-reviewed research articles to explore the current evidence on the potential association between residential radon exposure and human health, specifically focusing on lung cancer, COPD, and leukemia.
A comprehensive search was conducted on PubMed and Google Scholar using MeSH terms and keywords (). The inclusion criteria focused on studies that analyzed the link between residential radon exposure and lung cancer, leukemia and COPD. We searched for peer-reviewed studies published from 2010 to 2024. Studies carried out in occupational settings were not considered. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to select relevant studies. Reviewers independently collected data, resolving disagreements through discussion. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate evidence quality, and the study was registered with PROSPERO, CRD42024550735.
The evidence indicating an associative or causal link between indoor radon and lung cancer was found to be of high quality or conclusive, particularly with stronger support from case-control studies. The findings for COPD and leukemia were inconclusive, indicating that additional research is necessary to establish a definitive link between residential radon exposure and these health outcomes. These associations was deemed moderate or inconclusive primarily due to methodological shortcomings, conflicting findings and the prevalence of weak study designs and poor exposure data. The existing evidence on the potential connection between residential radon exposure and the risk of COPD and leukemia is currently limited. In order to definitively confirm or disprove this association, more studies are needed. Further research is crucial to elucidate these relationships and to guide the development of effective public health interventions.
The review found that the association between radon exposure and lung cancer was consistent with existing scientific knowledge. However, the evidence for association between indoor radon exposure and COPD was inconclusive. Additionally, evidence linking indoor radon exposure to leukemia was uncertain. Future research should use more robust study designs (cohort and case control studies) and directly measure long-term radon levels to investigate the potential association between residential radon exposure and COPD and leukemia.
氡（Rn）是一种具有明确致癌特性的放射性气体。它是自然本底电离辐射暴露的重要来源，占人类辐射暴露的50%以上。长期接触氡气已被确凿地证明与多种健康问题有关，如肺癌、白血病和慢性阻塞性肺疾病（COPD）。尽管如此，缺乏全面的研究来审视确立室内氡暴露与这些健康问题之间关联的证据质量。
我们对同行评审的研究文章进行了系统综述，以探索关于住宅氡暴露与人类健康之间潜在关联的现有证据，特别关注肺癌、COPD和白血病。
使用医学主题词（MeSH）和关键词在PubMed和谷歌学术上进行了全面搜索。纳入标准侧重于分析住宅氡暴露与肺癌、白血病和COPD之间联系的研究。我们搜索了2010年至2024年发表的同行评审研究。职业环境中开展的研究未被纳入考虑。该综述遵循系统评价和Meta分析的首选报告项目（PRISMA）框架来选择相关研究。评审人员独立收集数据，通过讨论解决分歧。采用推荐分级评估、制定和评价（GRADE）方法来评估证据质量，该研究已在国际前瞻性系统综述注册库（PROSPERO）注册，注册号为CRD42024550735。
发现表明室内氡与肺癌之间存在关联或因果联系的证据质量高或确凿，特别是病例对照研究提供了更强有力的支持。关于COPD和白血病的研究结果尚无定论，这表明需要更多研究来确立住宅氡暴露与这些健康结局之间的明确联系。这些关联被认为是中等程度或尚无定论，主要是由于方法学缺陷、相互矛盾的研究结果以及研究设计薄弱和暴露数据不佳的普遍情况。关于住宅氡暴露与COPD和白血病风险之间潜在联系的现有证据目前有限。为了明确证实或反驳这种关联，需要更多研究。进一步的研究对于阐明这些关系以及指导有效的公共卫生干预措施的制定至关重要。
该综述发现氡暴露与肺癌之间的关联与现有科学知识一致。然而，室内氡暴露与COPD之间关联的证据尚无定论。此外，将室内氡暴露与白血病联系起来的证据也不确定。未来的研究应采用更稳健的研究设计（队列研究和病例对照研究）并直接测量长期氡水平，以调查住宅氡暴露与COPD和白血病之间的潜在关联。
