Radon Awareness and Policy Perspectives on Testing and Mitigation

One in three homes in Utah (USA) contains dangerous levels of radon. Except for a radon mitigation certification law, Utah’s radon laws are nonexistent. To determine public perception of state policies on radon testing and mitigation, a social cognitive theory-based 52-item questionnaire was administered to residents (N = 307) who visited the Utah County Health Department (UCHD) during the study period. Respondents were divided into an Environmental Health Group (n = 110), who purchased a radon kit, and Vital Records Control Group (n = 197), who filed/obtained birth/death certificates at UCHD. Ninety percent responded they had never tested their homes for radon, and 99% were not aware of state policies regarding radon. Support for various radon policies was significantly associated with older age (odds ratios (OR): 0.37–0.52), being female (OR: 2.60–7.79), lower annual family income (OR: 2.27), and theoretical constructs of behavioral modeling (OR: 2.31–2.55) and risk perception (OR: 2.55–3.71). To increase awareness, testing, and remediation, respondents suggested increasing public education/awareness, requiring testing in homes, businesses, and public buildings, and increasing access to testing. Multi-sectoral radon risk reduction programs could incorporate behavioral modeling and risk perception as components to create a radon testing and mitigation culture in Utah.

The efficacy of public health information for encouraging radon gas awareness and testing varies by audience age, sex and profession

Radioactive radon inhalation is a leading cause of lung cancer and underlies an ongoing public health crisis. Radon exposure prevention strategies typically begin by informing populations about health effects, and their initial efficacy is measured by how well and how fast information convinces individuals to test properties. This communication process is rarely individualized, and there is little understanding if messages impact diverse demographics equally. Here, we explored how 2,390 people interested in radon testing differed in their reaction to radon's public health information and their subsequent decision to test. Only 20% were prompted to radon test after 1 encounter with awareness information, while 65% required 2–5 encounters over several months, and 15% needed 6 to > 10 encounters over many years. People who most delayed testing were more likely to be men or involved in engineering, architecture, real estate and/or physical science-related professions. Social pressures were not a major factor influencing radon testing. People who were the least worried about radon health risks were older and/or men, while negative emotional responses to awareness information were reported more by younger people, women and/or parents. This highlights the importance of developing targeted demographic messaging to create effective radon exposure prevention strategies.

Radon in Schools: A Review of Radon Testing Efforts in Canadian Schools

Radon, a known carcinogen, becomes a health risk when it accumulates inside buildings. Exposure is of particular concern for children, as their longer life expectancy increases their lifetime risk of developing cancer. In 2016, 5.5 million students were enrolled in Canadian elementary and secondary schools. With no national policy on radon testing in schools, children may be at risk from radon exposure while attending school and school-based programs. This study explored radon testing efforts in publicly funded Canadian schools and summarizes where testing programs have occurred. Radon testing in schools was identified through a systematic qualitative enquiry, surveying members from different levels of government (health and education) and other stakeholders (school boards, research experts, among others). Overall, this research found that approaches to radon testing varied considerably by province and region. Responsibility for radon testing in schools was often deferred between government, school boards, building managers and construction parties. Transparency around radon testing, including which schools had been tested and whether radon levels had been mitigated, also emerged as an issue. Radon testing of schools across Canada, including mitigation and clear communication strategies, needs to improve to ensure a healthy indoor environment for staff and students.

Social Determinants of Health, Environmental Exposures and Home Radon Testing

Home radon testing is a primary lung cancer prevention strategy, yet the majority of Americans have not tested their home. This descriptive, ecological study uses 54,683 observed radon values collected in Kentucky homes from 1996 to 2016 to examine the association of county-level social determinants of health and environmental exposures on home radon testing rates. Multivariate linear regression analysis indicates that as median home value, rurality, and radon risk potential increased, counties experienced an increase in annual home radon testing rates. As adult smoking prevalence increased, counties experienced a decrease in annual rates of residential radon testing. These findings indicate that counties with low median home values, high adult smoking prevalence, and high incidence of lung cancer may benefit most from prevention interventions aimed at promoting home radon testing, adopting radon- and smoke-free home policies, and integrating radon risk reduction messaging into tobacco cessation and lung cancer screening programs.

High School Students as Citizen Scientists to Decrease Radon Exposure

Residents in rural Kentucky (KY) and suburban Ohio (OH) expressed concerns about radon exposure and lung cancer. Although 85% of lung cancer cases are caused by tobacco smoke, radon exposure accounts for 10–15% of lung cancer cases. Academic and community members from the University of KY and the University of Cincinnati developed and pilot-tested a family-centered, youth-engaged home radon testing toolkit. The radon toolkit included radon information, and how to test, interpret, and report back findings. We educated youth as citizen scientists and their teachers in human subjects protection and home radon testing using the toolkit in the classroom. Youth citizen scientists explained the study to their parents and obtained informed consent. One hundred students were trained in human subjects protection, 27 had parental permission to be citizen scientists, and 18 homeowners completed surveys. Radon values ranged from < 14.8 Bq/m3 to 277.5 Bq/m3. Youth were interested and engaged in citizen science and this family-centered, school-based project provided a unique opportunity to further the healthy housing and quality education components of the Sustainable Development Goals for 2030. Further research is needed to test the impact of student-led, family-centered citizen science projects in environmental health as part of school curricula.

Analysis of Radon Awareness and Disclosure Policy in Kentucky: Applying Kingdon’s Multiple Streams Framework

The purpose of this article is to analyze radon awareness and disclosure policy proposed during the 2018 Kentucky General Assembly using Kingdon’s Multiple Stream Framework. Radon gas is the second leading cause of lung cancer. Exposure to radon occurs largely in the home. The proportion of homeowners who have completed radon testing remains low, and home radon testing is voluntary in most states. The Environmental Law Institute recommends states enact policies to promote radon awareness and testing. The most common radon awareness policy mandates radon disclosure during a real estate transaction. A bill to mandate radon disclosure during a real estate transaction was proposed during the 2018 Kentucky General Assembly but was met with opposition and was not filed. As a policy alternative, an administrative regulation to amend the Form for Seller’s Disclosure of Conditions was proposed to the Kentucky Real Estate Commission. Administrative regulations set forth by government regulatory agencies are equally enforceable and may be a more politically feasible alternative to enacting public policy. Nurses are positioned to promote the health of patients and populations. Nurses advocating for radon control legislation and/or administrative regulations may push radon control policy higher on the governmental decision agenda leading to policy change to decrease the development of lung cancer.