Abstract
BackgroundAlthough exposure to UV radiation is the major risk factor for skin cancer, theoretical models suggest that radon exposure can contribute to risk, and this is supported by ecological studies. We sought to confirm or refute an association between long-term exposure to residential radon and the risk for malignant melanoma (MM) and non-melanoma skin cancer (NMSC) using a prospective cohort design and long-term residential radon exposure.MethodsDuring 1993–1997, we recruited 57,053 Danish persons and collected baseline information. We traced and geocoded all residential addresses of the cohort members and calculated radon concentrations at each address lived in from 1 January 1971 until censor date. Cox proportional hazards models were used to estimate incidence rate-ratios (IRR) and confidence intervals (CI) for the risk associated with radon exposure for NMSC and MM, and effect modification was assessed.ResultsOver a mean follow-up of 13.6 years of 51,445 subjects, there were 3,243 cases of basal cell carcinoma (BCC), 317 cases of squamous cell carcinoma (SCC) and 329 cases of MM. The adjusted IRRs per 100 Bq/m3 increase in residential radon levels for BCC, SCC and MM were 1.14 (95% CI: 1.03, 1.27), 0.90 (95% CI: 0.70, 1.37) and 1.08 (95% CI: 0.77, 1.50), respectively. The association between radon exposure and BCC was stronger among those with higher socio-economic status and those living in apartments at enrollment.Conclusion and ImpactLong-term residential radon exposure may contribute to development of basal cell carcinoma of the skin. We cannot exclude confounding from sunlight and cannot conclude on causality, as the relationship was stronger amongst persons living in apartments and non-existent amongst those living in single detached homes.
Highlights
Radon gas is a radioisotope which has a 3.8 day half-life
The adjusted incidence rate-ratios (IRR) per 100 Bq/m3 increase in residential radon levels for basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and MM were 1.14, 0.90 and 1.08, respectively
Long-term residential radon exposure may contribute to development of basal cell carcinoma of the skin
Summary
Radon gas is a radioisotope which has a 3.8 day half-life. Radon-222 gas arises from the radioactive decay of radium-226, present throughout the earth’s crust and in many building materials. The main source of radon in buildings is gas released from the earth underneath and entering the house through cracks in the foundation. Radon gas builds up indoors and main predictors of radon concentrations in Danish buildings include type of soil, basement or not, ventilation rates and type of house (apartment or single-detached home). Exposure to radon and progeny such as the alpha emitters polonium-218 and polonium-214 [3], has been classified as a human carcinogen [4] and evidence of a link between radon and risk for lung cancer come both from studies of miners exposed to relatively high concentrations and from studies of the general population exposured to radon in the home [5]. We sought to confirm or refute an association between long-term exposure to residential radon and the risk for malignant melanoma (MM) and non-melanoma skin cancer (NMSC) using a prospective cohort design and long-term residential radon exposure.
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