Environmental/Occupational Exposure to Radon and Non-Pulmonary Neoplasm Risk: A Review of Epidemiologic Evidence

Abstract

Although Radon (Rn) is a known agent for lung cancer, the link between Rn exposure and other non-pulmonary neoplasms remains unclear. The aim of this review is to investigate the role of Rn in the development of tumors other than lung cancer in both occupational and environmental exposure. Particularly, our attention has been focused on leukemia and tumors related to brain and central nervous system (CNS), skin, stomach, kidney, and breast. The epidemiologic literature has been systematically reviewed focusing on workers, general population, and pediatric population. A weak increase in leukemia risk due to Rn exposure was found, but bias and confounding factors cannot be ruled out. The results of studies conducted on stomach cancer are mixed, although with some prevalence for a positive association with Rn exposure. In the case of brain and CNS cancer and skin cancer, results are inconclusive, while no association was found for breast and kidney cancers. Overall, the available evidence does not support a conclusion that a causal association has been established between Rn exposure and the risk of other non-pulmonary neoplasms mainly due to the limited number and heterogeneity of existing studies. To confirm this result, a statistical analysis should be necessary, even if it is now not applicable for the few studies available.

Global disease burden and trends of leukemia attributable to occupational risk from 1990 to 2019: An observational trend study

“…For one thing, the DALYs and death rates of leukemia will increase with age, so the DALYs and death rates of the elderly will be higher than that of young adults. For another, if the elderly were exposed to toxic and harmful substances such as formaldehyde and benzene during adolescence, these substances will not immediately cause reactions after exposure but will slowly accumulate in the body, and symptoms will slowly emerge with age ( 46 , 47 ). Our findings call for an urgent need to accelerate efforts to reduce leukemia attributable to the occupational risk burden in elderly people.…”

Radon-222 Brain Dosimetry

“…Reviews of published epidemiology for non-pulmonary neoplasm risk include seven studies of workers, mostly underground miners, and five studies for the general population. They conclude from all studies that the available evidence does not support that a causal association has been established between 222 Rn exposure and the risk of other non-pulmonary neoplasms mainly due to the limited number and heterogeneity of existing studies (Mozzoni et al 2021; Gómez-Anca and Barros-Dios 2020).…”

Occupational exposure monitoring for radon in various manufacturing workplaces and underground public-use facilities in Korea

“…remains limited. [22][23][24][25][26][27][28] Considering the health effects of radon exposure, many domestic experts in the elds of environmental health and industrial hygiene conducted several studies of occupational exposure assessment at various workplaces, such as building material manufacturing sites and offices, 29 fertilizer, gypsum board and cement manufacturing sites, 30 sites that employ manufacturing processes using monazite, 11 and Seoul and other metropolitan subway stations. [31][32][33][34] Based on the study results, these studies have tried to understand the current status and characteristics of occupational radon exposure and develop more effective preventive measures for reducing the radon exposure levels at workplaces exceeding the occupational exposure limits (OELs).…”