Lowering the UK domestic radon Action Level to prevent more lung cancers—is itcost-effective?

Abstract

Case studies have shown that radon gas can accumulate within domestic properties atsufficiently high levels that it can cause lung cancer, and recent studies havesuggested that this risk remains significant below the UK domestic Action Level of200 Bq m−3. Raised radon levels can be reduced by engineering measures, and it has been shown thatdomestic radon remediation programmes in UK Affected Areas can result in reduced risksto the population and can be cost-effective. We consider here the benefits and costs of thedomestic radon remediation programme in Northamptonshire, UK, and considerthe implications for that programme of reducing the UK Action Level below itspresent value. A radon remediation programme based on an Action Level above200 Bq m−3 will cost less and will target those most at risk, but will be less cost-effective and will lead to higherresidual dose and greater risk of cancer in the remaining population. Reducing the Action Level below200 Bq m−3 will prevent more cancers, but at significantly higher cost. It will also be lesscost-effective, because remediation of a significant number of houses withmoderate radon levels will provide only a modest health benefit to occupants.Overall, a completed radon remediation programme of the type implemented inNorthamptonshire is most cost-effective for an Action Level between 200 and300 Bq m−3. The implications for future health policy are discussed.