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Previous Volume 330:159-164 January 20, 1994 Number 3 Next

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ABSTRACT

Background Residential radon is the principal source of exposure to ionizing radiation in most countries. To determine the implications for the risk of lung cancer, we performed a nationwide case-control study in Sweden.

Methods The study included 586 women and 774 men 35 to 74 years of age with lung cancer that was diagnosed between 1980 and 1984. For comparison, 1380 female and 1467 male controls were studied. Radon was measured in 8992 dwellings occupied by the study subjects at some time since 1947. Information on smoking habits and other risk factors for lung cancer was obtained from questionnaires.

Results Radon levels followed a log-normal distribution, with geometric and arithmetic means of 1.6 and 2.9 pCi per liter (60.5 and 106.5 Bq per cubic meter), respectively. The risk of lung cancer increased in relation to both estimated cumulative and time-weighted exposure to radon. In comparison with time-weighted average radon concentrations up to 1.4 pCi per liter (50 Bq per cubic meter), the relative risk was 1.3 (95 percent confidence interval, 1.1 to 1.6) for average radon concentrations of 3.8 to 10.8 pCi per liter (140 to 400 Bq per cubic meter), and it was 1.8 (95 percent confidence interval, 1.1 to 2.9) at concentrations exceeding 10.8 pCi per liter. The estimates of risk were in the same range as those projected from data in miners. The interaction between radon exposure and smoking with regard to lung cancer exceeded additivity and was closer to a multiplicative effect.

Conclusions Residential exposure to radon is an important cause of lung cancer in the general population. The risks appear consistent with earlier estimates based on data in miners.

Source Information

From the Institute of Environmental Medicine, Karolinska Institute, Stockholm (G.P., F.L., M.S.); the Swedish Radiation Protection Institute, Stockholm (G.A., A.E., H.M., G.A.S.); the Department of Occupational and Environmental Medicine, University Hospital, Linkoping (O.A., G.D.); Bjerking Ingenjorsbyra, Uppsala (B.C.); and the Department of Oncology, University Hospital, Umea (L.D.) -- all in Sweden.

Address reprint requests to Dr. Pershagen at the Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Box 210, S-171 77 Stockholm, Sweden.

Full Text of this Article

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N Engl J Med 1994; 330:1684-1685, Jun 9, 1994. Correspondence

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