Thursday, August 14, 2008

Clinical Pediatrics
DOI: 10.1177/0009922807303553
2008; 47; 726
Clin Pediatr (Phila)
Sue Abell and John L. Ey

Radon Risks
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Radon Risks
Sue Abell, MD
whether soil, rock, or water. Cracks in foundations
or in basements, floor–wall joints, mortar joints, and
loose-fitting pipe penetrations can all allow radon to
enter your home. Once inside, radon levels can
become concentrated because of limited ventilation.
Levels of radon gas outdoors are quite low,
approximately 0.4 picoCuries per liter (0.4 pCi/L). If
the level inside your house was that low, you would
have very little to worry about. Unfortunately, many
homes have levels significantly higher than that. For
that reason, the Surgeon General’s office of the US
Public Health Service and the Environmental
Control Agency have both stated that radon is among
the most serious environmental hazards we face.
Should you buy that radon test kit? Absolutely.
There is just no way to know the radon level in your
home without testing. Even if all of your neighbors
tested and found low levels, your home’s level could
still be dangerously high. I would recommend buy-
ing one of the long-term kits, which more accurately
represent your home’s average radon level. These
kits remain in your home for more than 3 months
and then are sent to a lab for testing. Short-term kits
are available, which will give you a quicker answer,
but high results on one of these should be confirmed
by at least a repeat short-term test or by a long-term
test before you take action.
The actions needed to solve the problem would
vary depending on your situation but might include
depressurization to vent the air from under the
house, as well as fixing the structural problems that
allowed radon to enter in high amounts. The even-
tual goal will be for homes to have no greater radon
levels than the outdoor environment. However, at
the present time we do not have the technology to
achieve that. It is possible, though, to reduce radon
levels to below 2 pCi/L (and sometimes to below 1.3
pCi/L), levels at which the risk of lung cancer is felt
to be relatively low.
Dear Dr Sue:
Recently I’ve seen a couple of articles in maga-
zines about testing your home for radon. I’ve already
installed a carbon monoxide monitor, and I’m the
only person I know who has one. Is this something I
really need or is it just a scare tactic to sell a prod-
uct? I have three small children, or I probably would
just ignore the whole thing.
Dear Parent:
Please don’t ignore it! Radon really is something
that you should test for and should do something
about if your home shows high levels. It isn’t a rare
problem either; approximately one out of every 15
homes in the United States is expected to show high
levels. In 2006 the Environmental Protection Agency
(EPA) designated January as the first annual National
Radon Action Month to try to educate the public
about this very real danger.
Why do we care? Because it is estimated that
radon exposure is the second leading cause of lung
cancer, right behind cigarette smoking. (Secondhand
smoke comes in third.) It is believed that about
16000 to 20000 deaths yearly are directly attributable
to radon exposure, mostly through the development
of lung cancer.1Your children may be at greater risk
than you are because children breathe faster than
adults, thus possibly depositing more radon on their
lungs over the same time period.
What is radon? Radon is a gas that can’t be
smelled, tasted, or seen. It is present naturally in
soils, rocks, underground water, and air. It is pro-
duced by the natural breakdown of the radioactive
radium-236 in soil and rocks, and it breaks down
further to decay products that are also radioactive.
These particles can then be inhaled.
Radon gets into your home through any space
that is in contact with ground sources of radon,
Clinical Pediatrics
Volume 47 Number 7
September 2008 726-727
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Ask Dr Sue / Sue Abell 727
Below is a summary of the steps the EPA rec-
ommends you to take.2(They are assuming that you
are running a short-term test first.)
1. If the short-term test result is 4 pCi/L or higher,
conduct a follow-up test to confirm the results.
2. Follow-up with either a long-term test or a second
short-term test.
For a better understanding of the home’s year-round
average radon level, take a long-term test. If results are
needed quickly, take a second short-term test.
The higher the initial short-term result, the more
certain the homeowner can be to conduct a short-
term rather than a long-term follow-up test. If the
first short-term test result is several times the action
level—for example, about 10 pCi/L or higher—a
second short-term test should be taken immediately.
3. If the long-term follow-uptest result is 4 pCi/L
or more, fix the home.
If the homeowner followed up with a second
short-term test: the higher the short-term results,
the more certain the homeowner can be that the
home should be fixed. The homeowner should con-
sider fixing the home if the average of the first and
second test is 4 pCi/L or higher.
Test kits can be obtained from local department
stores or can be ordered online (often with free ship-
ping). Look for kits that are EPA approved. They may
vary in price from about $10 for a short-term kit to
$25 to $30 for a long-term kit (see for
an Alpha Track Test kit—long-term test—for $24.95
with free shipping).
For more information, you can contact EPA’s
Indoor Air Quality Information Clearinghouse at
1-800-438-4318 and ask for publications about radon.
The Web site, listed as number 2 in the references
below, also has maps showing the typical radon levels
in your area (remember, you can’t assume yours is
the same). The same site includes state-by-state
contact information and worthwhile links.
Editorial Comment
In this radon exposure article, Dr Sue steered us
away from the mistake of ignoring what may well be
a dangerous problem in our own homes as well as
our patients. The busy pediatrician is often hard
pressed to cover all of the safety instructions that are
important in each well-child visit. These instruc-
tions should include the importance of buckling up,
wearing helmets when biking or skate boarding,
installing smoke and carbon monoxide detectors, and
now radon testing. However, we should be aware
that radon can pose a serious health risk including
being the second leading cause of lung cancer. This
review provides us with useful information on the
hows and whys of doing a radon detection test in
your home. For those who have high levels detected
from a reliable test you need to find a reputable fixer
and this column lists possible sources for help
including the EPA’s 800 number.
John L. Ey, MD
2. Radon—A physician’s guide: The health threat with a
simple solution. Available at:

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