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County-level radon exposure and all-cause mortality risk among Medicare beneficiaries

Yitshak-Sade, Maayan ; Blomberg, Annelise J LU orcid ; Zanobetti, Antonella ; Schwartz, Joel D ; Coull, Brent A ; Kloog, Itai ; Dominici, Francesca and Koutrakis, Petros (2019) In Environment International 130.
Abstract

BACKGROUND: Radon is an inert gas formed from the decay of naturally-occurring materials in the earth's crust. It infiltrates into homes from soil, water, and construction materials. Its decay products are radionuclides, which attach to ambient particles. Residential radon is one of the leading risk factors for lung cancer. The scarce evidence for associations with other mortality causes originates mostly from occupational studies.

METHODS: In a cohort study with 14 years of follow-up (2000-2013), we evaluated the association between chronic radon exposure and all-cause mortality, and explored whether there are subpopulations who are more vulnerable to radon effects. We included 87,296,195 person-years of follow-up from all... (More)

BACKGROUND: Radon is an inert gas formed from the decay of naturally-occurring materials in the earth's crust. It infiltrates into homes from soil, water, and construction materials. Its decay products are radionuclides, which attach to ambient particles. Residential radon is one of the leading risk factors for lung cancer. The scarce evidence for associations with other mortality causes originates mostly from occupational studies.

METHODS: In a cohort study with 14 years of follow-up (2000-2013), we evaluated the association between chronic radon exposure and all-cause mortality, and explored whether there are subpopulations who are more vulnerable to radon effects. We included 87,296,195 person-years of follow-up from all Medicare beneficiaries in the Mid-Atlantic and Northeastern U.S. states. We examined the association between the logarithm of county-averaged radon (ln(Rn)) and mortality and assessed effect modification by chronic conditions.

RESULTS: An interquartile range increase in the ln(Rn) was associated with a 2·62% increase (95% CI 2·52%; 2·73%) in mortality, independent of PM2.5 exposure. Larger mortality risks were observed among individuals with respiratory, cardiovascular and metabolic diseases, with the highest associations observed among those with diabetes (4·98% increase), heart failure (4·58% increase), and chronic obstructive pulmonary disease (4·49% increase).

CONCLUSION: We found an increased risk for all-cause mortality associated with increased radon exposure. The risk was enhanced among susceptible individuals with chronic conditions. We believe this is the first cohort study to identify populations at higher risk for non-malignant health consequences of radon exposure. Due to the limitations in exposure assessment and availability of individual confounders, these findings should be interpreted with caution.

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author
; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Aged, Aged, 80 and over, Air Pollutants, Radioactive/analysis, Cohort Studies, Female, Humans, Male, Medicare, Mortality, Radiation Exposure/analysis, Radiation Monitoring, Radon/analysis, Risk Factors, United States/epidemiology
in
Environment International
volume
130
article number
104865
publisher
Elsevier
external identifiers
  • scopus:85066985365
  • pmid:31200153
ISSN
1873-6750
DOI
10.1016/j.envint.2019.05.059
language
English
LU publication?
no
id
b5a7de12-0fdd-44f9-a6d2-03c6ad7e7bca
date added to LUP
2021-09-09 11:47:57
date last changed
2024-04-20 11:01:21
@article{b5a7de12-0fdd-44f9-a6d2-03c6ad7e7bca,
  abstract     = {{<p>BACKGROUND: Radon is an inert gas formed from the decay of naturally-occurring materials in the earth's crust. It infiltrates into homes from soil, water, and construction materials. Its decay products are radionuclides, which attach to ambient particles. Residential radon is one of the leading risk factors for lung cancer. The scarce evidence for associations with other mortality causes originates mostly from occupational studies.</p><p>METHODS: In a cohort study with 14 years of follow-up (2000-2013), we evaluated the association between chronic radon exposure and all-cause mortality, and explored whether there are subpopulations who are more vulnerable to radon effects. We included 87,296,195 person-years of follow-up from all Medicare beneficiaries in the Mid-Atlantic and Northeastern U.S. states. We examined the association between the logarithm of county-averaged radon (ln(Rn)) and mortality and assessed effect modification by chronic conditions.</p><p>RESULTS: An interquartile range increase in the ln(Rn) was associated with a 2·62% increase (95% CI 2·52%; 2·73%) in mortality, independent of PM2.5 exposure. Larger mortality risks were observed among individuals with respiratory, cardiovascular and metabolic diseases, with the highest associations observed among those with diabetes (4·98% increase), heart failure (4·58% increase), and chronic obstructive pulmonary disease (4·49% increase).</p><p>CONCLUSION: We found an increased risk for all-cause mortality associated with increased radon exposure. The risk was enhanced among susceptible individuals with chronic conditions. We believe this is the first cohort study to identify populations at higher risk for non-malignant health consequences of radon exposure. Due to the limitations in exposure assessment and availability of individual confounders, these findings should be interpreted with caution.</p>}},
  author       = {{Yitshak-Sade, Maayan and Blomberg, Annelise J and Zanobetti, Antonella and Schwartz, Joel D and Coull, Brent A and Kloog, Itai and Dominici, Francesca and Koutrakis, Petros}},
  issn         = {{1873-6750}},
  keywords     = {{Aged; Aged, 80 and over; Air Pollutants, Radioactive/analysis; Cohort Studies; Female; Humans; Male; Medicare; Mortality; Radiation Exposure/analysis; Radiation Monitoring; Radon/analysis; Risk Factors; United States/epidemiology}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Environment International}},
  title        = {{County-level radon exposure and all-cause mortality risk among Medicare beneficiaries}},
  url          = {{http://dx.doi.org/10.1016/j.envint.2019.05.059}},
  doi          = {{10.1016/j.envint.2019.05.059}},
  volume       = {{130}},
  year         = {{2019}},
}