Objective To determine the risk of lung cancer associated with exposure at home to the radioactive disintegration products of naturally occurring radon gas Design Collaborative analysis of individual data from 13 case-control studies of residential radon and lung cancer. Setting Nine European countries. Subjects 7148 cases of lung cancer and 14 208 controls. Main outcome measures Relative risks of lung cancer and radon gas concentrations in homes inhabited during the previous 5-34 years measured in becquerels (radon disintegrations per second) per cubic metre (Bq/m 3 ) of household air. Results The mean measured radon concentration in homes of people in the control group was 97 Bq/m 3 , with 11% measuring > 200 and 4% measuring > 400 Bq/m 3 . For cases of lung cancer the mean concentration was 104 Bq/m 3 . The risk of lung cancer increased by 8.4% (95% confidence interval 3.0% to 15.8%) per 100 Bq/m 3 increase in measured radon (P = 0.0007). This corresponds to an increase of 16% (5% to 31%) per 100 Bq/m 3 increase in usual radon-that is, after correction for the dilution caused by random uncertainties in measuring radon concentrations. The dose-response relation seemed to be linear with no threshold and remained significant (P = 0.04) in analyses limited to individuals from homes with measured radon < 200 Bq/m 3 . The proportionate excess risk did not differ significantly with study, age, sex, or smoking. In the absence of other causes of death, the absolute risks of lung cancer by age 75 years at usual radon concentrations of 0, 100, and 400 Bq/m 3 would be about 0.4%, 0.5%, and 0.7%, respectively, for lifelong non-smokers, and about 25 times greater (10%, 12%, and 16%) for cigarette smokers. Conclusions Collectively, though not separately, these studies show appreciable hazards from residential radon, particularly for smokers and recent ex-smokers, and indicate that it is responsible for about 2% of all deaths from cancer in Europe.

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A representative national survey on population exposure to radon in Italian dwellings was carried out from 1989 to 1994, with the co-operation of the National Health Service. The measurements were performed by 19 Regional Laboratories, all using the same techniques and protocols. A stratified, two-stage sampling procedure was used to sample families. The sampled families were approached door-to-door to maximize response. To optimize the quality of the measurements, two dosimeters, each containing two alpha track detectors, were placed together in one room (typically the bedroom) for two consecutive 6-mo periods. The distribution of annual radon concentration was derived from measurements in 4,866 dwellings. The average value is 75 Bq m(-3) and the fractions of dwellings above the reference levels of 150, 200, 400, and 600 Bq m-3 are 8.7%, 4.7%, 1.0%, and 0.2%, respectively. The geometric mean is 57 Bq m-3 while the geometric standard deviation is 2.0. The average values in the Italian Regions fall within the 20-120 Bq m-3 range. When the average radon concentration is examined vs. story, building materials seem to play a significant role. The average lifetime risk of lung cancer for chronic radon exposure of Italian population at home would be about 5 x 10(-3), using the risk factor proposed by the ICRP in 1993.

On average, radon concentrations are substantially higher in schools in villages than in schools located in towns (double,on average). Annual radon concentrations exceeding 300 Bq/m3 were found in 5% of primary schools (generally on ground floors of schools in villages). The considerable variability of radon concentration observed between and within floors indicates a need to monitor concentrations in several rooms for each floor. A single radon detector for each room can be used provided that the measurement error is considerable lower than variability of radon concentration between rooms.