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Radon and Healthy Housing: What’s Happening Now, What’s in Store for the Future Bill Long US EPA

Radon and Healthy Housing: What’s Happening Now, What’s in Store for the Future Bill Long US EPA. Acknowledgements. Antonio Neri MD, MPH Medical Epidemiologist CDC Comprehensive Cancer Control Branch R. William Field, PhD, MS Professor, Department of Occupational and Environmental Health

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Radon and Healthy Housing: What’s Happening Now, What’s in Store for the Future Bill Long US EPA

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  1. Radon and Healthy Housing: What’s Happening Now, What’s in Store for the Future Bill Long US EPA

  2. Acknowledgements • Antonio Neri MD, MPH • Medical Epidemiologist • CDC Comprehensive Cancer Control Branch • R. William Field, PhD, MS • Professor, Department of Occupational and Environmental Health • Department of Epidemiology, College of Public Health, University of Iowa • Phil Jalbert • US EPA radon program

  3. 4 day Radon-222 a,g 3 min Polonium-218 a,g 27 min Lead-214 b,g 20 min Bismuth-214 b,g 0.2 ms Polonium-214 a,g Lead-210 22 yrs b,g Bismuth-210 5 day b,g Polonium-210 138 day a,g Lead-206 Stable Radon Decay Products Po-218 and Po-214 deliver the majority of radiation dose to the lung.

  4. Ionizing radiation can directly and indirectly damage DNA Free radical formation Alpha Particle Double –strand DNA breaks Defects in tumor suppressor genes – p53 At risk individuals–GSTM1 (glutathione S-transferase M1)

  5. Reading Prong

  6. From NCRP Report No. 160, “Ionizing Radiation Exposure of the Population of the United States” (2009)

  7. U.S. Radon Potential • Based on geology and surveys • Expected closed building radon (pCi/L): • Zone 1: 4.0 and above • Zone 2: between 2.0 & 4.0 • Zone 3: 2.0 and lower EPA Radon Action Level 4 pCi/L

  8. National Academy of SciencesBEIR VI 1999 • Risk estimates based primarily on radon-exposed miners • Estimated 18,600 lung cancer deaths each year in the U.S. from residential radon exposure

  9. BEIR VI Conclusions • Serious public health problem • Second-leading cause of lung cancer • No evidence of a threshold • Effects of Radon & Smoking more powerful in combination • Radon contributed to 15K or 21K US lung cancer deaths in 1995 [2,100 or 2,900 in never smokers]. • Reduction of residential radon levels above 4 pCi/L could prevent approx. 1/3 of the annual deaths

  10. Residential Radon Case-Control Around the World European Studies 13 Studies from 9 Countries • Austria • Czech Republic • Finland [nationwide] • Finland [south] • France • Germany [eastern] • Germany [western] • Italy • Spain • Sweden [nationwide] • Sweden [never smokers] • Sweden [Stockholm] • United Kingdom • Total 7,148 cases and 14,208 controls North American Studies • 7 Studies from 2 countries: • New Jersey • Winnipeg • Missouri I [non-smoking women] • Missouri II [women] • Iowa • Connecticut • Utah-South Idaho • Total 3,622 cases and 4,966 controls

  11. In 2003, the EPA updated the BEIR VI risk estimates to 21,000 radon-related lung cancer deaths each year in the United States. http://www.epa.gov/radon/risk_assessment.html

  12. EPA Radon Assessment Results • Modified & extended the NAS BEIR VI report [consultation with SAB and NAS panel members] • Best estimate of US population risk in homes is about 21,000 lung cancer deaths per year. [At US average indoor radon conc.] • Current Risks at Action Level • Smokers 6/100 • Never Smokers 7/1000

  13. Cancer Statistics 2014 CA: A Cancer Journal for CliniciansVolume 64, Issue 1, pages 9-29, 7 JAN 2014 DOI: 10.3322/caac.21208http://onlinelibrary.wiley.com/doi/10.3322/caac.21208/full#caac21208-fig-0001

  14. CANCER MORTALITY – 2014

  15. CANCER MORTALITY – 2014

  16. Toxic Substances Control Act (TSCA)Title III (1988)Indoor Radon Abatement Act (IRAA) • Section 306. Grant Assistance to States for Radon Programs • Governor Designates the Recipient • Recipient can be a Department, Agency or State Institution, e.g., University • EPA Responsibilities Delegated to Regional Administrators & Assistant Administrator for OAR

  17. EPA Radon Program 21,000 Radon-related U.S. Lung Cancer Deaths Annually Leading Environmental Cause of Cancer Mortality Long-term Exposure to 1.25 pCi/L Average Indoor Radon Level in U.S. Homes 7,083,000 Homes ≥4pCi/L 2 ways to reduce risk: mitigate high homes; build homes radon-resistant

  18. Radon • Interventions • ≤ $20 / test, $300 – $2,000 remediate • < $250 – $750 to build radon resistant homes • EPA $8 million to state radon programs/yr • education, testing, remediation, policy-related radon activities • Intervention = ↓ exposure • Vent air from under house • Seal basement cracks • Laws • 28 states + DC have laws specific to radon • Req. testing, Req. Disclosure, Voluntary Testing • Radon-Resistant New Construction • Int’l Building Code adoption Website: http://sktelokkalong.co.cc/buy-radon-test-kit

  19. States with Radon-specific Cancer Activities 2005 – 2011 Tribes and Territories with Radon-specific Cancer Plan Activities include: Alaska Native Tribal Healthcare Corporation, Fon du Lac Tribe, Northern Plains Native American Tribal CCC Program, Tohono O'odham Tribe, and Guam. Note that Alaska, Hawaii, and DC do not have radon-specific cancer plan activities

  20. States with Radon-specific Laws in2014 * * Washington, DC has one radon-specific law. The ELI database does not review or track radon laws for tribes

  21. Annual Radon-related Lung Cancer Deaths State 16-20 Draft

  22. Annual Radon-related Lung Cancer Deaths State 17-20 Draft

  23. Progress on Risk Reduction7.1M Homes ≥4pCi/L Mitigate existing homes (2 – 4 pCi/L) • 1,244,000 mitigation systems installed since 1986 • 9,100 lives saved (lung cancer deaths avoided) • 1,542 mitigated homes saves 1 life • Multi-pronged demand/supply strategy (partnerships [ELI, CRCPD, NCSL, NEHA, KSU], PSAs, real estate, home inspection, stakeholder trainings)

  24. State Indoor Radon Grant (SIRG) Program 45 states participating 5 Not Participating (NH, MD, LA, AR, HI) Tribes: FY2013 10 Awards = $304,000 Philip Jalbert 343.9431, Jalbert.Philip@epa.gov http://www.epa.gov/radon/sirgprogram.html

  25. Federal Radon Action Plan • Federal leadership required to accelerate action on radon risk reduction – a key Healthy Homes concern • An example of Inter-Agency Collaboration (USDA, DOD, DOE, EPA, GSA, HHS, HUD, DOI, VA) • A special focus on families and low income communities

  26. Framework for Federal Action: Our Areas of Focus • Demonstrate Importance of radon risk reduction • Provide Incentives to encourage testing and mitigation • Build Demand for testing and mitigation

  27. Key Milestones Tracking Our Progress Nov 2010: Held Federal Radon Summit where agencies agreed to develop the Federal Radon Action Plan Jun 2011: Launched the Action Plan at the Healthy Homes Conference Jan 2012: Released the Action Plan Scorecard Aug 2012: Celebrated one-year anniversary at CDC’s National Cancer Conference in Washington DC Feb 2013: Released the Accomplishments Report in conjunction with the unveiling of the Advancing Healthy Housing – A Strategy for Action. 

  28. Status of Commitments 33 Total Commitments To access Scorecard visit www.epa.gov/radon/action_plan.html

  29. www.epa.gov/radon

  30. Build Demand for Testing & Mitigation • The Department of Housing and Urban Development (HUD) wrote new radon testing and mitigation requirements for their multifamily housing mortgage insurance programs, estimated to reach 105,000 housing units in 2013. • The Environmental Protection Agency (EPA) is investing in 4 new standards of practice. New provisional standard for radon mitigation in multifamily housing released this year. Provide Incentives to Encourage Testing and Mitigation • The Department of Agriculture (USDA) issued new secretary-level guidance to all of its field office housing, community, loan (~301K this year), and public information programs to promote radon mitigation and new construction.

  31. Demonstrate the importance of radon testing & mitigation • The Department of Health and Human Services reported that 27 CDC sponsored state five-year cancer plans now include radon, representing 41% of existing cancer plans. • Of that total, two cancer programs have included radon activities for the first time and two have expanded radon activities within their plans.

  32. Moving Forward: Leadership, Leverage and Visibility WE ARE HERE

  33. Priorities for the Near-term Future • Federal Radon Action Plan (FRAP) • Allied Leaders • Partnerships with NGOs • Standards of Practice • Code adoption • Labelling programs

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