Lung cancer attributable to indoor radon exposure in France: Impact of the risk models and uncertainty analysis

OBJECTIVE: The inhalation of radon, a well-established human carcinogen, is the principal-and omnipresent-source of radioactivity exposure for the general population of most countries. Scientists have thus sought to assess the lung cancer risk associated with indoor radon. Our aim here is to assess this risk in France, using all available epidemiologic results and performing an uncertainty analysis. METHODS: We examined the exposure-response relations derived from cohorts of miners and from joint analyses of residential case-control studies and considered the interaction between radon and tobacco. The exposure data come from measurement campaigns conducted since the beginning of the 1980s by the Institute for Radiation Protection and Nuclear Safety and the Directorate-General of Health in France. We quantified the uncertainties associated with risk coefficients and exposures and calculated their impact on risk estimates. RESULTS: The estimated number of lung cancer deaths attributable to indoor radon exposure ranges from 543 [90% uncertainty interval (UI), 75-1,097] to 3,108 (90% UI, 2,996-3,221), depending on the model considered. This calculation suggests that from 2.2% (90% UI, 0.3-4.4) to 12.4% (90% UI, 11.9-12.8) of these deaths in France may be attributable to indoor radon. DISCUSSION: In this original work we used different exposure-response relations from several epidemiologic studies and found that regardless of the relation chosen, the number of lung cancer deaths attributable to indoor radon appears relatively stable. Smokers can reduce their risk not only by reducing their indoor radon concentration but also by giving up smoking.