© 1995 by Oxford University Press
Journal of the National Cancer Institute, Vol. 87, No. 11, 817-827,
June 7, 1995
© 1995 Oxford University Press
Lung Cancer in Radon-Exposed Miners and Estimation of Risk From Indoor Exposure
*Epidemiology and Biostatistics Program Division of Cancer Etiology, National Cancer Institute, Bethesda, Md.
Department of Occupational Medicine, Uppsala University Sweden
National Institute for Occupational Safety and Health Cincinnati, Ohio
National Cancer Institute of Canada, Epidemiology Unit, University of Toronto Ontario
Center of Radiation Hygiene, National Institute of Public Health 
robárova, Prague, Czech Republic
Health and Safety Unit, Research and Regulation Branch Ontario Ministry of Labour, Toronto
Surveillance and Risk Assessment Division, Department of National Health and Welfare Ottawa, Ontario
Woking Surrey, U.K.
Department of Epidemiology, School of Hygiene and Public Health, The Johns Hopkins University Baltimore, Md.
Laboratory of Epidemiology and Health Detriment Analysis, Institute of Protection and Nuclear Safety Fontenay aux Roses, France
Department of Community Medicine, University of Adelaide South Australia
Institute of Labor Protection Yunnan Tin Corporation, China National Nonferrous Metals Industry Corporation, Gejiu City, Yunnan Province, People's Republic of China
Department of Statistics, University of Oregon Corvallis
Jay H. Lubin, Ph.D., National Institutes of Health, 6130 Executive Blvd., EPN/403, Bethesda, MD 20892-7368
BACKGROUND: Radioactive radon is an inert gas that can migrate from soils and rocks and accumulate in enclosed areas, such as homes and underground mines. Studies of miners show that exposure to radon decay products causes lung cancer. Consequently, it is of public health interest to estimate accurately the consequences of daily, low-level exposure in homes to this known carcinogen. Epidemiologic studies of residential radon exposure are burdened by an inability to estimate exposure accurately, low total exposure, and subsequent small excess risks. As a result, the studies have been inconclusive to date. Estimates of the hazard posed by residential radon have been based on analyses of data on miners, with recent estimates based on a pooling of four occupational cohort studies of miners, including 360 lung cancer deaths.
PURPOSE: To more fully describe the lung cancer risk in radon-exposed miners, we pooled original data from 11 studies of radon-exposed underground miners, conducted a comprehensive analysis, and developed models for estimating radon-associated lung cancer risk.
METHODS: We pooled original data from 11 cohort studies of radon-exposed underground miners, including 65000 men and more than 2700 lung cancer deaths, and Tit various relative risk (RR) regression models.
RESULTS: The RR relationship for cumulative radon progeny exposure was consistently linear in the range of miner exposures, suggesting that exposures at lower levels, such as in homes, would carry some risk. The exposure-response trend for never-smokers was threefold the trend for smokers, indicating a greater RR for exposure in never-smokers. The RR from exposure diminished with time since the exposure occurred. For equal total exposure, exposures of long duration (and low rate) were more harmful than exposures of short duration (and high rate).
CONCLUSIONS: In the miners, about 40% of all lung cancer deaths may be due to radon progeny exposure, 70% of lung cancer deaths in never-smokers, and 39% of lung cancer deaths in smokers. In the United States, 10% of all lung cancer deaths might be due to indoor radon exposure, 11% of lung cancer deaths in smokers, and 30% of lung cancer deaths in neversmokers. This risk model estimates that reducing radon in all homes exceeding the U. S. Environmental Protection Agency's recommended action level may reduce lung cancer deaths about 2%–4%. These estimates should be interpreted with caution, because concomitant exposures of miners to agents such as arsenic or diesel exhaust may modify the radon effect and, when considered together with other differences between homes and mines, might reduce the generalizability of findings in miners. [J Natl Cancer Inst 87:817–827, 1995]
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