Abstract
Radioactive radon gas inhalation is a major cause of lung cancer worldwide and is a consequence of the built environment. The average radon level of properties built in a given period (their ‘innate radon risk’) varies over time and by region, although the underlying reasons for these differences are unclear. To investigate this, we analyzed long term radon tests and buildings from 25,489 Canadian to 38,596 Swedish residential properties constructed after 1945. While Canadian and Swedish properties built from 1970 to 1980s are comparable (96–103 Bq/m3), innate radon risks subsequently diverge, rising in Canada and falling in Sweden such that Canadian houses built in the 2010–2020s have 467% greater radon (131 Bq/m3) versus Swedish equivalents (28 Bq/m3). These trends are consistent across distinct building types, and regional subdivisions. The introduction of energy efficiency measures (such as heat recovery ventilation) within each nation’s build codes are independent of radon fluctuations over time. Deep learning-based models forecast that (without intervention) the average Canadian residential radon level will increase to 176 Bq/m3 by 2050. Provisions in the 2010 Canada Build Code have not significantly reduced innate radon risks, highlighting the urgency of novel code interventions to achieve systemic radon reduction and cancer prevention in Canada.
Highlights
Lung cancer in people who have never smoked is the 7th leading cause of cancer-linked death on Earth, and its prevalence is increasing[1,2,3,4,5]
North American residential radon exposure has worsened over time, while the opposite trend has taken place in Nordic c ountries[15,16,19,21,22,23,24]
As 70% of the housing stock necessary to deliver on population growth projections for 2050 has yet to be built[28,29], it is imperative to understand the etiology of evolving radon exposure trends in order to develop timely interventions to avoid a deepening public health crisis of never-smoker lung cancer in hard-hit regions
Summary
Lung cancer in people who have never smoked is the 7th leading cause of cancer-linked death on Earth, and its prevalence is increasing[1,2,3,4,5]. Sweden reported 4325 new lung cancers in 2019 and, adjusting for population and age profiles, this means that Canada’s annual rate of new lung cancers is currently 163% greater than that of Sweden, at 28.9 versus 17.7 new age-adjusted cases per 100,000 people per y ear[25] These differences are unlikely to be explained by regional tobacco smoking rates, which are comparable at 11–13%, and have fallen in both countries with similar trajectories over recent decades[26,27]. We compared twentieth to twenty-first century build practices, energy efficiency provisions, radon control technology and related policies for both regions, to discern possible causative factors in diverging radon exposure trends
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