Workshop Proceedings Radon Prevention and Remediation Workshop Proceedings. Deliverable 17

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1 Workshop Proceedings Radon Prevention and Remediation Workshop Proceedings Deliverable 17 This publication arises from the project Radon Prevention and Remediation (RADPAR) which has received funding from the European Union, in the framework of the Health Programme.

2 RADPAR Workshop Radon Prevention and Remediation Brussels, 23 February 2012 Proceedings 2012

3 Proceedings of the RADPAR Workshop on Radon Prevention and Remediation Brussels, Belgium, 23 February 2012 Editors: John G. Bartzis, Krystallia K. Kalimeri Department of Mechanical Engineering, University of Western Macedonia, Greece RADPAR Workshop Radon Prevention and Remediation 2

4 Organization responsible for the project: University of Western Macedonia (UOWM), Kozani, Greece Project Coordinator: Prof. John G. Bartzis, UOWM Funding: Executive Agency for Health and Consumers (EAHC) of EU Directorate General SANCO in the framework of the Health Programme Work Package Leaders: John G. Bartzis, University of Western Macedonia, Greece (WP1: Coordination of the project, WP2: Dissemination of the results) Hajo Zeeb, BIPS Institute for Epidemiology and Prevention Research GmbH, Germany (WP3: Evaluation of the project) Francesco Bochicchio, Instituto Superiore di Sanità, Italy (WP4: Improving policies and strategies to promote effective radon prevention and remediation) James Mc Laughlin, University of Western Macedonia, Greece (WP5: Improving radon risk communication strategies in the EU) Bernard Collignan, Centre Scientifique et Technique du Bâtiment, France (WP6: Assessment and standardization of radon control technologies) Alastair Gray, University of Oxford, UK (WP7: Analysis of cost effectiveness and health benefits of radon control strategies) Associated Partners: University of Western Macedonia (UOWM), Greece Bundesamt fur Strahlenschutz (BfS), Germany Bremen Institute for Prevention Research and Social Medicine (BIPS, University of Bremen), Germany The Chancellor, Masters and Scholars of the University of Oxford (University of Oxford), UK Centre Scientifique et Technique du Batiment (CSTB), France Institute Superiore di Sanita (ISS), Italy Austrian Agency for Health and Food Safety (AGES), Austria Norwegian Radiation Protection Authority (NRPA), Norway Radiation and Nuclear Safety Authority (STUK), Finland International Bureau for Environmental Studies (IBES), Belgium National Radiation Protection Institute (SURO), Czech Republic Sub-contractors: European Commission, Joint Research Centre, Institute for Health and Consumer Protection, Physical and Chemical Exposure Unit, Ispra, Italy (JRC/IHCP/PCE) Collaborative Partners: Ferid Shannoun, United Nations Scientific Committee on the Effects of Atomic Radiation, Austria Martha Gruson, Federal Office of Public Health, Switzerland Jane Bradley, Health Protection Agency Chilton, UK Ollie Seppanen, Technical University of Helsinki, Finland Luis Quindos Poncela, University of Cantabria, Spain David Fenton, Radiological Protection Institute of Ireland, Ireland Eduardo Oliveira Fernandes, University of Porto, Portugal RADPAR Workshop Radon Prevention and Remediation 3

5 Foreword Radon ( 222 Rn) is a naturally occurring radioactive gas. It constitutes the most important natural radiation exposure in many homes, schools, working places and contributes a great deal to the total natural ionizing radiation dose to world population. IARC (International Agency for Research on Cancer) classifies it as a Group 1 human carcinogen, while WHO (World Health Organization) considers it to be the second cause of lung cancer after cigarette smoking. The RADPAR (Radon Prevention and Remediation) project is part of the Second Programme of Community Action in the Field of Health and within the aegis of the Executive Agency for Health and Consumers (EAHC), of Directorate General SANCO. It is focused on a number of issues related to indoor radon exposure as a public health problem within the framework of EU Member States (MS). The aim of the RADPAR project is to assist in reducing the significant public health burden of radon related lung cancers in EU MS. There are many aspects of radon such as: radon risk communication; policies and strategies to promote effective radon prevention and remediation; assessment and harmonization of radon control technologies; analysis of cost effectiveness and health benefits of radon control strategies. Such issues that are common to all EU MS are in focus at the RADPAR Workshop on Radon Prevention and Remediation. The objectives of this workshop were: - To gain a better understanding of the health risk related to radon existing in the indoor environment and play a key role towards the radon prevention and remediation; - To disseminate the results and the merits of methodology tools of the RADPAR project; - To identify the opportunities for exploitation and dissemination, after the formal completion of the project, by policy makers, health professionals and relevant stakeholders, as well as to receive feedback from them. This workshop had participants from 16 countries and invited speakers from Japan, Germany, Luxembourg, Switzerland, Austria, Belgium and France. The participants were from National Radiation Protection Agencies, from the Academic Community, from Radon and Building Companies, and from National Authorities. During the workshop, presentations on the RADPAR Project were made by the members of the RADPAR Consortium, while after that presentations were made by distinguished invited speakers from the Hirosaki University, the Federal Office for Radiation Protection of Germany, the DG ENER, the World Health Organization (WHO), the International Atomic Energy Agency (IAEA), the Federal Agency for Nuclear Control of Belgium and the Institute for Radiological Protection and Nuclear Safety of France. On behalf of the RADPAR Partners I would like to thank all invited speakers and participants for their participation in the Workshop and contribution to the constructive discussions. RADPAR Workshop Radon Prevention and Remediation 4

6 We would like to thank the European Commission, for giving us the opportunity through its funding, to work on a European scale on such an important issue that is directly related to the European citizen health and well being. We would like also to thank the Federal Agency for Nuclear Control (FANC) of Belgium and particularly Dr. Andre Poffijn for their kindness to host this meeting. Finally I would like to thank the staff of the Environmental Technology Laboratory, Department of Mechanical Engineering, University Of Western Macedonia for their help in preparing this Workshop. John G. Bartzis RADPAR Project Coordinator RADPAR Workshop Radon Prevention and Remediation 5

7 Contents PART 1: THE RADPAR PROJECT The RADPAR (Radon Prevention and Remediation) Project, John G. Bartzis, University of Western Macedonia, Greece Improving policies and strategies to promote effective radon prevention and remediation, Francesco Bochicchio, Istituto Superiore di Sanità, Italy Improving Radon Risk Communication Strategies in the EU, James Mc Laughlin, University College Dublin, Ireland/University of Western Macedonia, Greece Assessment of radon control technologies, Bernard Collignan, Centre Scientifique et Technique du Bâtiment, France Analysis of cost-effectiveness and health benefits of radon control strategies, Alastair Gray, University of Oxford, UK PART 2: PRESENTATIONS FROM INVITED SPEAKERS Construction of natural radiation exposure study network, Shinji Tokonami, Hirosaki University, Japan Health effects of indoor radon, Michaela Kreuzer, Bundesamt fur Strahlenschutz, Germany Requirements on radon in dwellings and workplaces in the proposed new Euratom Basic Safety Standards, Stéphane Calpena, European Commission, DG- ENER-D4, Louxembourg WHO s activities on Radon, Emilie Van Deventer, World Health Organization, Switzerland IAEA Programmes on Reducing Risks from Indoor Radon, Tony Colgan, International Atomic Energy Agency, Austria Novelties in the Belgian radon policy, André Poffijn, Federal Agency for Nuclear Control, Belgium Radon Measurement Standardization (ISO 11665), Roselyn Ameon, Institut de Radioprotection et de Sûreté Nucléaire, France RADPAR Workshop Radon Prevention and Remediation 6

8 PART 1: THE RADPAR PROJECT RADPAR Workshop Radon Prevention and Remediation 7

9 1.1. The RADPAR (Radon Prevention and Remediation) Project, John G. Bartzis, University of Western Macedonia, Greece. Radon is a major contributor to the ionizing radiation dose received by the general population. Soil gas infiltration is recognized as the most important source of residential radon. Epidemiological studies confirm that radon in homes increases the risk of lung cancer in the general population. The proportion of all lung cancers linked to radon is estimated to lie between 3% and 14%.The majority of radon-induced lung cancers are caused by low and moderate radon concentrations rather than by high radon concentrations, because in general less people are exposed to high indoor radon concentrations (WHO, Handbook on Indoor Radon, 2009). There is a need to reduce the overall population risk as well as the individual risk for people living with high radon concentrations. On the other hand, the present study has shown that radon prevention and remediation is quite limited in the European scale The RADPAR project ( ) is part of the Second Program of the European Community Action in the Field of Health and within the aegis of the Executive Agency for Health and Consumers (EAHC), of Directorate General SANCO. It commenced in May 2009 and is coordinated by the University of Western Macedonia, Kozani, Greece. Its partners are from health, radiation protection and related institutions, in 15 European countries. Its main objectives are the following: 1. Improvement of strategies to reduce the EU public health burden from radon. 2. Development of radon risk communication strategies and the creation of an EU radon information web site ( 3. Assessment of cost-effectiveness of radon control strategies in the EU. 4. Design of training courses in radon measurement, prevention, remediation and costeffectiveness. 5. Assessment of potential conflicts between energy conservation in buildings and radon exposure reduction. An account is given of the progress to date towards achieving these objectives. By means of its Deliverables and Recommendations it is expected that the RADPAR project is expected to: heighten awareness both of the public and of decision makers of the health burden of radon in the EU and of the technical means available to control radon. transfer information to new and accession MS where radon control strategies are presently almost non-existent. It is clear that only a joint European effort can provide the necessary experience and diversity of circumstances to provide an insight into the complex radon problem and in how to deal effectively with it. RADPAR Workshop Radon Prevention and Remediation 8

10 The RADPAR (Radon Prevention And Remediation) Project : An Overview J. G. Bartzis Project Coordinator University of Western Macedonia Greece RADPAR is funded by : Executive Agency for Health and Consumers (EAHC) of Directorate General SANCO Health and Consumers RADPAR Workshop Radon Prevention and Remediation 9

11 THE PARTNERSHIP 1. University of Western Macedonia (UOWM), Greece 2. Bundesamt fur Strahlenschutz (BfS), Germany 3. Universitat Bremen (Uni-Bremen), Germany 4. The Chancellor, Masters and Scholars of the University of Oxford (University of Oxford), UK 5. Centre Scientifique et Technique du Bâtiment (CSTB), France 6. Institute Superiore di Sanita (ISS), Italy 7. Austrian Agency for Health and Food Safety (AGES), Austria 8. Norwegian Radiation Protection Authority (NRPA), Norway 9. Radiation and Nuclear Safety Authority (STUK), Finland 10. International Bureau for Environmental Studies (IBES), Belgium 11. National Radiation Protection Institute (SURO), Czech Republic 12. Joint Research Centre (JRC), Italy THE ADVISORY GROUP i.e. The Collaborating Partners a/a Name Organization Country 1 Ferid Shannoun United Nations Scientific Committee on the Effects of Atomic Radiation Austria 2 Martha Gruson Federal Office of Public Health Switzerland 3 Jane Bradley Health Protection Agency UK 4 Ollie Seppanen Technical University of Helsinki Finland 5 Luis Quindos University of Cantabria Spain 6 David Fenton Radiological Protection Institute of Ireland Ireland 7 Eduardo de Oliveira Fernandes University of Porto Portugal RADPAR Workshop Radon Prevention and Remediation 10

12 Background Radon is a major contributor to the ionizing radiation dose received by the general population Soil gas infiltration is recognized as the most important source of residential radon Epidemiological studies confirm that radon in homes increases the risk of lung cancer in the general population. The proportion of all lung cancers linked to radon is estimated to lie between 3% and 14% The majority of radon-induced lung cancers are caused by low and moderate radon concentrations rather than by high radon concentrations, because in general less people are exposed to high indoor radon concentrations SOURCE: WHO HANDBOOK ON INDOOR RADON, A PUBLIC HEALTH PERSPECTIVE (2009) Radon levels and Remediation in EU Countries Source: RADPAR Deliverable 13.1 RADPAR Workshop Radon Prevention and Remediation 11

13 Aim of the RADPAR Project The RADPAR project aims to assist in reducing the significant public health burden of radon related lung cancers in EU Member States (MS). Project Specific Objectives Help improve the strategies that are currently in place and reduce the health burden from radon to the EU population; Develop radon risk communication strategies and approaches for different population target groups in the EU; Establish measurement procedures for radon control technologies and sources; Assess the cost-effectiveness of existing and potential radon prevention and remediation strategies in the EU; Design training courses for radon measurement, prevention, remediation, and cost effectiveness analysis; Assess the potential conflicts between energy conservation in buildings and radon exposure reduction. RADPAR Workshop Radon Prevention and Remediation 12

14 RADPAR Tasks & Activities (1) Assessment of the significance of the health burden from radon to the EU population Review and analyses of existing radon control policies and strategies in EU MS Recommendations for the improvement of existing standards, building codes and guidelines for the control of radon in new buildings in MS RADPAR Tasks & Activities (2) Assessment of current radon risk awareness in the EU population Development of communication approaches for different target groups RADPAR Workshop Radon Prevention and Remediation 13

15 RADPAR Tasks & Activities (3) Assessment of potential conflicts between energy conservation in buildings and radon exposure reduction. Establishment of measurement protocols for radon control technologies. Design of training courses for radon measurement, prevention and remediation. Cost effectiveness and health benefits of radon control strategies RADPAR Tasks & Activities (4) Master Questionnaire (MQ) A MQ was designed and distributed to a wide range of radiation protection authorities and other relevant bodies. Its purpose was to gather information on existing strategies and policies in EU MS; The MQ, which is a most important information gathering tool, has primarily been sent to relevant contact persons in all 27 EU MS; In order to compare EU approaches with international approaches to radon control, the MQ was also distributed to authorities outside of Europe; The IAEA collaboration also used the RADPAR MQ to gather radon information from a number of non EU countries. Responses have been received from 22 EU MS and 7 other countries RADPAR Workshop Radon Prevention and Remediation 14

16 Contents of the MQ Indoor Radon Surveys National Policies on Indoor Radon Control Radon Risk Communication Strategies Training and Education References, Contacts and Any Other Comments RADPAR Tasks & Activities (5) Creation of an EU Radon information web site linked to the DGSANCO Indoor Air Quality web site that will include a database consisting of radon concentrations, health burden on population, existing standards and control policies RADPAR Workshop Radon Prevention and Remediation 15

17 RADPAR website Dissemination of the project results The main dissemination channels that have so far been used are: the RADPAR website ; 6 - monthly project newsletters: All newsletters produced are made available in electronic form at the project s website; printed material: leaflets and flyers distributed at a number of meetings and conferences; results published in journals, forums and conferences; participation in international conferences; theradpar workshop; a mailing list of relevant stakeholders. RADPAR Workshop Radon Prevention and Remediation 16

18 Project Work Plan WP1: Coordination of the project. WP2: Dissemination of the results. WP3: Evaluation of the project. WP4: Developing policies and strategies to promote effective radon prevention and remediation. WP5: Establishment of an EU radon risk communication network. WP6: Assessment and harmonization of radon control technologies in MS. WP7: Analyses of cost effectiveness and health benefits of radon control strategies. RADPAR Recommendations Recommendations on: 1. Radon Policy and Strategy 2. Protocols for Indoor Radon Concentration Measurements 3. Improving Radon Risk Communication 4. Assessment of potential conflicts between energy conservation in buildings and radon exposure reduction 5. Establishment of measurement protocols for radon control technologies 6. Design of training courses for radon measurement, prevention, remediation 7. Analysis of cost effectiveness and health benefits of radon control strategies RADPAR Workshop Radon Prevention and Remediation 17

19 Recommendations Questionnaire A Recommendations questionnaire has been sent to the National Authorities of the EU MS and other European countries The whole process is under way 11 responses have received so far The responses are under assessment Summary Remarks Radon Prevention and Remediation is quite limited in the European scale There is a need to reduce the overall population risk as well as the individual risk for people living with high radon concentrations. It is clear that only a joint European effort can provide the necessary experience and diversity of circumstances to provide an insight into the complex radon problem and in how to deal effectively with it. By means of its deliverables and Recommendations it is expected that the RADPAR project will: heighten awareness both of the public and of decision makers of the health burden of radon in the EU and of the technical means available to control radon. transfer information to new and accession EU MS as well as other countries (in collaboration with IAEA and WHO) where radon control strategies are presently almost non-existent. RADPAR Workshop Radon Prevention and Remediation 18

20 RADPAR Project has already an impact! Unified method for the determination of the radon diffusion coefficient prepared in the framework of RADPAR activities : Currently submitted at ISO level for standardisation (ISO/WD standard); Irish Government is developing a National Radon Strategy for Ireland. RADPAR Project Conclusion and Recommendations is an important input to this strategy; RADPAR Project has already an impact! RADPAR has established a fruitful collaboration with the IAEA Technical Cooperation Program. Already experts from RADPAR have participated in IAEA missions to a number of countries, to assist them in establishing National Radon Strategies. RADPAR Workshop Radon Prevention and Remediation 19

21 Thank you for your attention RADPAR Workshop Radon Prevention and Remediation 20

22 1.2. Improving policies and strategies to promote effective radon prevention and remediation, Francesco Bochicchio, Istituto Superiore di Sanità, Italy. Objectives This work package had two main specific objectives: A) assessing the radon health burden for population of all the EU Member States, on the basis of results of recent epidemiological studies and taking into account smoking habits; B) reviewing the current policies and strategies on radon and prepare recommendations aimed to improve them in order to obtain effective prevention and remediation of radon related risks. Methods A) The health burden from radon was estimated in terms of attributable risk, i.e. the fraction of lung cancers attributable to radon exposure, and the corresponding lung cancer rate. These quantities were calculated for all the 27 EU Member States (and few other European countries) on the basis of the following data: i) representative average radon concentration in dwellings, as evaluated by an ad-hoc review of papers and information collected through questionnaires; ii) Excess Relative Risk evaluated by the European pooling of 13 case-control studies on lung cancer and residential radon; iii) total lung cancer rate in WHO database; iv) smoking habits available in Eurostat database. The combined effect of radon and smoking was evaluated by calculating attributable fraction and lung cancer rate separately for current smokers, former smokers, and never smokers. B) Data on radon policies and strategy were collected through questionnaires (both the RADPAR Master Questionnaire and three specific WP4 questionnaires); moreover, all recent (including drafts) recommendations, regulations and other reports of international organizations (WHO, IAEA, ICRP, European Commission, Nordic Countries) were considered. This information was reviewed and discussed both in general and specific meetings, in order to prepare RADPAR recommendations, which are the results of the collaboration of all RADPAR and collaborating partners. Results and conclusions A) Both the fraction and the annual number of lung cancers attributable to radon were calculated for all the 27 EU Member States and other two European countries. The attributable fraction ranges from 3% to 16% of all the lung cancers. Most of the lung cancers attributable to radon are expected to occur among current and former smokers, due to the combined effects of radon and smoking. This has to be taken into account by coordinating policies against radon and those against smoking. B) A total of specific 66 recommendations on radon policies and strategy were prepared, covering 33 issues groped in 11 arguments. These recommendations take into account the previous experience and evaluation of effectiveness and should be useful for all European countries, regardless their experience on radon. However, a further collaborating effort is needed to provide all EU countries, especially the above mentioned ones, with specific guidelines and protocols to implement these recommendations. The final goal is to reduce the health burden from radon. RADPAR Workshop Radon Prevention and Remediation 21

23 RADPAR Radon prevention and Remediation Improving policies and strategies to promote effective radon prevention and remediation Francesco Bochicchio (Italian National Institute of Health) on behalf of RADPAR-WP4 and collaborating partners Improving policies and strategies to promote effective radon prevention and remediation Outline 1. Health burden for all EU Member States 2. Recommendations on radon policy and strategy 3. Recommendations on measuring radon concentration indoors 4. Next and future activities RADPAR Workshop Radon Prevention and Remediation 22

24 Improving policies and strategies to promote effective radon prevention and remediation Outline 1. Health burden for all EU Member States 2. Recommendations on radon policy and strategy 3. Recommendations on measuring radon concentration indoors 4. Next and future activities Health burden for all EU MS RADPAR Workshop Radon Prevention and Remediation 23

25 Health burden for all EU MS AM of Rn conc. for all the 27 EU MS (+ other 3 European countries) were an ad hoc reviewed (MQ, previous reviews, literature), with particular attention to representativeness ERR (100 Bq/m 3 )=0.16 ( ) was taken from the Eur. pooling of residential case-control studies, and scaled for AM of each country The attributable fraction (i.e. the fraction of lung cancers attributable to radon) was calculated for 27+3 countries (AF= 8%, range 3% 16%) The lung cancer rate attributable to radon was calculated for each country (for male and females) using the mortality data from WHO, averaging over the last available 5 years The correction for year-to-year variations of Rn conc.(to be applied) will have a small impact (a relative reduction of few % of the AF) Health burden for all EU MS (cont.) AFs and LCRs for different smoker categories (current smokers, exsmokers, never smokers) were also calculated for 27+2 countries, on the basis of prevalence data of smoker categories as available in Eurostat relative risk for smoking as evaluated in Europen pooled analysis of epidemiological studies on smoking and lung cancer The greater part of lung cancers attributable to radon will occour among smokers (and, to a minor extent, among former smokers) due to the combined effects of radon and smoking. This is particularly true for males (AF=67% 89% for CS, 10% 29% for ES, 1% 7% for NS). These results are strongly affected by smoking prevalence changes, which occurred over the years, especially in connection with national regulations limiting smoking. RADPAR Workshop Radon Prevention and Remediation 24

26 Improving policies and strategies to promote effective radon prevention and remediation Outline 1. Health burden for all EU Member States 2. Recommendations on radon policy and strategy 3. Recommendations on measuring radon concentration indoors 4. Next and future activities Recommendations on radon policy and strategy Methods 1. Analysis of relevant documents produced by international organisations 2. Review of national information collected through RADPAR questionnaires 3. Discussions during general and specific meetings among experts from several European countries RADPAR Workshop Radon Prevention and Remediation 25

27 Recommendations on radon policy and strategy Relevant documents 1. WHO Handbook on Indoor Radon: A Public Health Perspective (2009) 2. Radiat. Prot. Authorities of the Nordic Countries - Recommendations for radon in dwellings in the Nordic Countries (2009) 3. Euratom Basic Safety Standards (version 29 Sep 2011) 4. International Basic Safety Standards (version 12 Sep 2011) 5. Protection of the public against exposure to ionizing radiation from natural sources (IAEA DS421, draft open for comments on ) 6. ICRP, Radiological protection against radon exposure (draft open for comments on ) Recommendations on radon policy and strategy RADPAR Questionnaires 1. RADPAR Master Questionnaire, Section 2 on National policies on indoor radon control 2. RADPAR WP4 Questionnaire Part A on Strategy of radon concentration measurements 3. RADPAR WP4 Questionnaire Part C on Radon policy/strategy RADPAR Workshop Radon Prevention and Remediation 26

28 Recommendations on radon policy and strategy Review of collected data Recommendations on radon policy and strategy Summary Section 1 of the RADPAR recommendations 65 recommendations dealing with 33 issues grouped in 11 main items Objective of a radon policy (1 recommendation) Overall Strategy (7) National Action Plan (NAP) (7) Preventive measures and remedial actions (16) 1.4 Reference Levels for existing and future dwellings and other buildings (6) Surveys and radon concentration distribution (6) National Radon Database (NRD) (6) Use of radon maps (4) Radon-prone areas and radon-prone buildings (5) Type of regulations (mandatory or recommendatory?) (4) Promoting tools to increase the number of remedial actions (3) RADPAR Workshop Radon Prevention and Remediation 27

29 Recommendations on radon policy and strategy Some main recommendations Objective of a radon policy (1 recommendation) Reduction of both individual risk (i.e. reduce/avoid high Rn levels) and global risk (i.e. reduce average Rn) and finally the number of lung cancers attributable to radon Overall Strategy (7) A comprehensive strategy (developed with all stakeholders), to be implemented by means of National Action Plans (Nat. Radon Programs), involving also local authorities and expertise Coordination with other related programs/activities (cigarette smoking, IAQ, energy saving) National Action Plan (NAP) (7) Roles and responsabilities clearly defined. A single authority acting as coordinator and linkage with other programs would improve effectiveness Effectiveness of each action should be evaluated and verified Recommendations on radon policy and strategy Some main recommendations (2) Preventive measures and remedial actions (16) Preventive measures in all new buildings (considerable renovations, extensions), unless demonstration that it is not cost-effective: very cheap in order to be cost effective for large scaleapplication easy to install (i.e. not requiring specialists) should be properly installed Verification of implementation and of effectiveness, by (mandatory) measuring Rn conc. 1-2 years after construction Verification of long-term effectiveness of preventive/remedial measures Guarante adequate number of trained remediators at local level Standards and protocols for preventive/remedial measures RADPAR Workshop Radon Prevention and Remediation 28

30 Recommendations on radon policy and strategy Some main recommendations (3) 1.4 Ref. Lev. for existing and new dwellings and other buildings (6) Ref. Levels for new buildings should be lower than those for existing ones, thanks to compulsory preventive measure New buildings should be considered those constructed after introduction of compulsory preventive measures New ICRP proposal of a graded approach for workplaces, where as first step the Ref. Levels for workplaces = RL dwellings Surveys and radon concentration distribution (6) Surveys should be generally designed to be representative Check of representativeness should be done on the final sample Radon distribution and maps should be base on representative data only. Recommendations on radon policy and strategy Some main recommendations (4) National Radon Database (NRD) (6) A NRD (or archive) is an important tool to support the National Action Plan, aiming to evaluate/verify effectiveness of actions and the overall reduction of risk It should collect all relevant information (on measurements, preventive measures, remedial actions, etc.) Use of radon maps (4) Radon maps are recommended to be used mainly to support authorities in planning actions for existing dwellings/buildings (and for existing buildings if different preventive measures are implemented for different potential Rn level) Avoid misuse of radon maps in communication with the general population by applying appropriate warnings close to every map RADPAR Workshop Radon Prevention and Remediation 29

31 Recommendations on radon policy and strategy Some main recommendations (5) Radon-prone areas and radon-prone buildings (5) Radon-prone area can be a useful tool to optimize/prioritize the search for radon levels to be reduced However the final goal is not to find radon-prone areas, but to reduce lung cancers Protection from radon should not be restricted to Rn-prone areas only, especially they contains a small fraction of population Type of regulations (4) Both mandatory and recommendatory approaches should be considered for regulations and other actions of NAP, selecting case-by-case the most effective and cost-effective one Although regulations for dwellings are usually recommendatory, a mandatory approach seems to be more effective, feasibile and appropriate for several situations (e.g. rent houses, public buildings, new buildings) Recommendations on radon policies and strategy Preliminar evaluations Evaluations and comments on RADPAR received from 11 countries (up to now) Agreement (5=strong agree, 4=agree, 3=partly agree, 2=disagree, 1=strongly disagree): average (over 65 rec.) = 4.5 (range=1 5) Consideration: (6=already included in nat.policy, 5=strong agree, 4=agree, 3=partly agree, 2=disagree, 1=strongly disagree) average (over 64 rec.) = 4.3 (range=1 6) RADPAR Workshop Radon Prevention and Remediation 30

32 Improving policies and strategies to promote effective radon prevention and remediation Outline 1. Health burden for all EU Member States 2. Recommendations on radon policy and strategy 3. Recommendations on measuring radon concentration indoors 4. Next and future activities Recommendations on protocols for indoor radon concentration measurements RADPAR Questionnaires 1. RADPAR WP4 Questionnaire Part A on Strategy of radon concentration measurements 2. RADPAR WP4 Questionnaire Part B on Protocols for radon concentration measurements RADPAR Workshop Radon Prevention and Remediation 31

33 Recommendations on protocols for indoor radon concentration measurements Summary Section 2 of the RADPAR recommendations A total of 17 recommendations, dealing with 10 issues grouped in 2 main items Indoor Radon concentration measurements for assessing the long-term average and comparing with reference levels (14) Other measurements for different purposes (3) Recommendations on protocols for indoor radon concentration measurements List of issues Indoor Radon concentration measurements for assessing the long-term average and comparing with reference levels (14) Aim Situations Measurement duration and period (5) Rooms to be monitored Detector position in the room Detector response (2) Measurement result evaluation and reporting (2) Metrology and accreditation systems and QA/QC procedures Other measurements for different purposes (3) Indicative measurements (2) Radon diagnosis for remedial actions RADPAR Workshop Radon Prevention and Remediation 32

34 Recommendations on protocols for indoor radon concentration measurements Some considerations Recommendations cover issues generally not included in ISO standards Attention to variability related to measurements duration and period QA/QC require detailed protocols (EU guidelines?) and collaboration among countries Recommendations on protocols for indoor radon concentration measurements Preliminar evaluations Evaluations and comments on RADPAR received from 11 countries (up to now) Agreement (5=strong agree, 4=agree, 3=partly agree, 2=disagree, 1=strongly disagree): average (over 17 rec.) = 4.4 (range=1 5) Consideration: (6=already included in nat.policy, 5=strong agree, 4=agree, 3=partly agree, 2=disagree, 1=strongly disagree) average (over 17 rec.) = 4.7 (range=1 6) RADPAR Workshop Radon Prevention and Remediation 33

35 Improving policies and strategies to promote effective radon prevention and remediation Outline 1. Health burden for all EU Member States 2. Recommendations on radon policy and strategy 3. Recommendations on measuring radon concentration indoors 4. Next and future activities Next and future activities 1. Health burden: publication of evaluations for all EU MS 2. Radon policies and strategies (proposals): Coordinated action in the next few months during the last development phase of Euratom Directive on BSS, aimed to harmonize BSS with the new ICRP recommendation on Radiological protection against radon exposure radon Collaboration with (support to) IAEA, WHO, EC to prepare guidelines to implement these recommendations as well as the forthcoming Eur. Dir. on BSS (particularly on preparing and implementing a National Radon Plan) RADPAR Workshop Radon Prevention and Remediation 34

36 WP4 partners Improving policies and strategies to promote effective radon prevention and remediation Contributors AGES (Austria): Wolfgang Ringer BfS (Germany): Michaela Kreuzer, Bernd Grosche ISS (Italy): Francesco Bochicchio, Gennaro Venoso, Sara Antignani SURO (Czech Rep): Jiri Hulka, Ivana Fojtikova, Katerina Rovenska, Ladislav Tomášek, Josef Thomas UOWM (Greece): John Bartzis, Krystallia Kalimeri, James McLaughlin Other RADPAR partners, including BIPS (Germany): Hajo Zeeb STUK (Finland): Hannu Arvela, Olli Holmgren Collaborating partners, including HPA (UK): Jane Bradley NPII (Ireland): David Fenton OFSP (Switzerland): Martha Gruson Last (but not least): all responders to questionnaires Thank you for your attention RADPAR Workshop Radon Prevention and Remediation 35

37 1.3. Improving Radon Risk Communication Strategies in the EU, James Mc Laughlin, University College Dublin, Ireland/University of Western Macedonia, Greece. It has been estimated that exposure to radon, which is a Group 1 human carcinogen, is implicated in approximately deaths from lung cancer each year in EU Member States. To reduce the EU public health burden from radon an integrated radon policy and strategy is required. An important component of such a strategy should be a radon risk communication strategy directed both at the public and also at decision makers at local and national level. The main objectives of this communication strategy are to raise awareness of radon health effects, to stimulate radon testing and where necessary remediation of existing dwelling and to encourage the introduction of preventative measures in future dwellings. Work Package 5 (WP5) of the RADPAR project gathered and analysed information on existing radon risk communication activities in both EU and in two non-eu European countries. It was also involved in a number of radon awareness surveys. Based on this work and on the principles of risk communication WP5 developed a number of recommendations aimed at improving the effectiveness of radon risk communication. In this presentation these recommendations are described. RADPAR Workshop Radon Prevention and Remediation 36

38 Improving Radon Risk Communication Strategies in the EU Presented on behalf of RADPAR WP 5 by : James Mc Laughlin University College Dublin /University of West Macedonia WP 5 Working Group : Dieter Schlesinger and Bernd Grosche, BfS, Neuherberg. Jean Klerkx, IBES, Brussels. Francesco Bochicchio, ISS, Roma. Jiri Hulka, Ivana Fojtikova and Katerina Rovenska, SURO, Praha. John Bartzis, Krystallia Kalimeri and James Mc Laughlin, University of Western Macedonia, Kozani. SEVEN CARDINAL RULES FOR EFFECTIVE RISK COMMUNICATION (Corvello 2011) 1. People have the right to have a voice and participate in decisions that affect their lives. 2. Plan and tailor Risk Communication strategies to goals, audiences and channels. 3. Listen to your audience. 5. Coordinate and collaborate with credible sources of information and trusted voices. 6. Plan for media influence. 7. Speak clearly and with compassion. 4. Be honest and transparent. RADPAR Workshop Radon Prevention and Remediation 37

39 Nota bene Your audience will want to know that you care before they care about what you know. STAGES IN RISK REDUCTION FOR EXISTING HOMES RISK COMMUNICATION TESTING OF HOMES REMEDIATION RISK REDUCTION RADPAR Workshop Radon Prevention and Remediation 38

40 MAIN OBJECTIVES OF RADON RISK COMMUNICATION RAISE STAKEHOLDER AWARENESS ENCOURAGE HOME TESTING AND REMEDIATION STIMULATE SUPPORT FROM DECISION MAKERS BARRIERS EXIST AT EACH STAGE OF THOUGHT PROCESS * HIGH RISK LOW RISK 1 Low Awareness Know a little Don t know enough to be worried too much 2 No Experience Personal or otherwise But aware of local issues 3 No Urgency Long term risk No public health risk(government Issue) Any decision can be put off No Proof No direct link with lung cancer Who is affected? Credibility Issue 4 5 Money making scam Not overtly backed by government/ officials 6 Full cost of total process (test & remediation) Full implications of test? Cost /disruption of remediation Who will pay for it? 7 Lack of government backing or declaration If this is serious Official outcry/ warning? TV campaigns? Free tests (* Source : RPII ) RADPAR Workshop Radon Prevention and Remediation 39

41 17% 14% 28% 30% 29% 37% 38% 43% 52% 57% 59% 65% 72% 79% 79% Recommendation No. 1 Radon Awareness Surveys (RAS) should be an essential component of a risk communication strategy What health problems do you expect to be induced by radon? 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% lung cancer skin problems heart disease diarrhoea migraine Germany Czech Republic Switzerland RADPAR Workshop Radon Prevention and Remediation 40

42 Recommendation No. 2 Identify target audiences and tailor communication information accordingly TARGET AUDIENCES PUBLIC DECISION MAKERS TRUSTED SOURCES INDUSTRY GENERAL PUBLIC SCHOOLS COLLEGES NGOS POLITICANS LOCAL GOVT. CENTRAL GOVT. FINANCIAL ORGS. PHYSICIANS PHARMACISTS TEACHERS MEDIA BUILDING PROFESSIONALS. `R MANUFACTURERS REMEDIATORS RADPAR Workshop Radon Prevention and Remediation 41

43 RADON INFORMATION MESSAGES SHOULD STRESS ADVANTAGES TO THE TARGET AUDIENCES TO THE PUBLIC : Testing may identify that your family is at risk. This health risk can be easily reduced. TO ELECTED REPRESENTATIVES/POLITICIANS AND GOVERNMENT AGENCIES : Reduction in the public health burden associated with radon may be cost-effective TO FINANCIAL INSTITUTIONS : The value of homes can be adversely affected by high radon levels. Prevention and remediation is cost-effective. TO INDUSTRY : There are employment and profit opportunites in radon prevention and remediation. Recommendation No. 3 Keep messages simple but accurate in particular when communicating with the public RADPAR Workshop Radon Prevention and Remediation 42

44 Examples of Effective Radon Messages Radon Causes Lung Cancer Radon is a Radioactive Gas present in Homes Radon is easy to measure You can easily protect your family from radon Source : WHO Radon Handbook 2009 Recommendation No.4 Appropriate communication channels should be used to communicate information RADPAR Workshop Radon Prevention and Remediation 43

45 COMMUNICATION CHANNELS MEDIA : Newspapers, Magazines, Radio, TV, Food packaging. TRUSTED SOURCES : Physicians, Pharmacists, Educationalists MEETINGS/EVENTS : Radon Forums, Focus Groups, Trade Fairs, Public Events PROFESSIONAL LITERATURE : For Builders, Architects, Engineers, Manufacturers. : Radon and Social Media Content of Twitter News concerning the term Radon 10% 4% 1% 26% general description of radon content without concerning the filed of radiation protection information concerning upcoming radon events 11% regional radon examples radon warning and call to get a radon test done 11% 13% information concerning lung cancer information concerning radon testing kits 12% N= 438; bis % information concerning radon in building materials Information concerning medical treatments RADPAR Workshop Radon Prevention and Remediation 44

46 Recommendation No.5 Radon Focus Groups and attention to regional characteristics should be used to assess and improve communication effectiveness Recommendation No. 6 Dissemination of radon risk information should be endorsed by well known national and local health and environmental agencies. RADPAR Workshop Radon Prevention and Remediation 45

47 Recommendation No. 7 If possible radon information campaigns should be linked to other health or environmental campaigns. Recommendation No.8 The services of a good professional marketing company should be considered in the design and execution of radon communication campaigns RADPAR Workshop Radon Prevention and Remediation 46

48 Recommendation No.9 Educate health officials, professional groups and the media regarding radon, its risks and its control. Recommendation No. 10 Regular assessment of information campaigns on radon RADPAR Workshop Radon Prevention and Remediation 47

49 Recommendation No. 11 Stakeholders should be integrated into communication campaigns. Recommendation No. 12 A health marketing approach should be part of risk communication campaigns. RADPAR Workshop Radon Prevention and Remediation 48

50 Go raibh maith agaibh Thank you for your attention RADPAR Workshop Radon Prevention and Remediation 49

51 1.4. Assessment of radon control technologies, Bernard Collignan, Centre Scientifique et Technique du Bâtiment, France. Context and objectives The main source of indoor radon in buildings is the subjacent soil gas with building materials in most cases making a smaller contribution. The level of radon in a building is, however, to a large extent influenced by the building characteristics and its usage. Critical building parameters are, for example, coupling to the ground, leakage distribution of the building envelope, type of heating/ventilation systems and occupant living comfort preferences. Present methods for radon reduction in existing buildings and radon prevention in new buildings have been developed over the last twenty years in particular for standard houses. While most techniques using sumps and barriers should work in principle, the limited evidence presently available has shown there is considerable variability in their effectiveness. Bad installation and poor adherence to the relevant building code guidelines are major contributors to this problem in some MS. In recent years, rising ecological awareness and rising energy costs have stimulated the development of so-called low energy and passive houses. It can be expected that these types of houses will represent an ever increasing proportion of the new housing stock. However, certain construction, heating and ventilation techniques used in these houses have the potential to lead to high indoor radon levels. On the other hand, remediation techniques such as enhance air renewal or using fans could have a negative impact on energy consumption. Since the prevention of high radon levels in new buildings is an important component of any national radon strategy, it is essential to thoroughly evaluate the effect of new construction methods on the indoor radon level. Examples of potential problematic construction features, with respect to radon exposure are reduction in air renewal by new thermal regulations, heat exchange systems, permeable construction materials etc. In order to evaluate the above problems with radon control, to reduce potential conflicts between energy saving construction and radon reduction and to form building professionals, the following objectives were carried out in this work package. 1. Assessment of potential conflicts between energy conservation in buildings and radon exposure reduction. 2. Establishment of measurement protocols for radon control technologies. 3. Design of training courses for radon measurement, prevention, remediation, and cost effectiveness analysis. To reach these objectives, the work undertaken had been at first to elaborate a specific questionnaire, sent to RADPAR partners and other European countries to state on current practices. Bibliography on each topic had also been realized associated with some specific studies. Analysis of all this material had been conducted. At the end, recommendations on each topic had been proposed. RADPAR Workshop Radon Prevention and Remediation 50

52 WP 6 Assessment of radon control technologies Working Group: RADPAR Radon prevention and Remediation Bernard Collignan (CSTB, France) - Olli Holmgren and Hannu Arvela ( STUK, Finland) - Martin Jiranek ( CTU, Czech republic) - Wolfgang Ringer (AGES, Austria) And other partners of RADPAR program Bernard Collignan CSTB, France RADPAR, WP 6. Assessment of radon control technologies Context: Main source of indoor radon: the subjacent soil gas Level of radon in a building influenced by its characteristics and usage. Considerable variability in the effectiveness of building radon protection: bad installation and poor adherence to the relevant guidelines Development of low energy and passive houses: potential to lead to high indoor radon levels. Remediation techniques: could have a negative impact on energy consumption. Essential: To evaluate the effect of new construction methods on the indoor radon level, To characterise products used for building protection, To train building professionals Bernard Collignan CSTB, France RADPAR Workshop Radon Prevention and Remediation 51

53 Objectives: RADPAR, WP 6. Assessment of radon control technologies WP 6.1: Assessment of potential conflicts between energy conservation in buildings and radon exposure reduction. WP 6.1.1: Analysis and assessment of current technologies (Hannu Arvela, Olli Holmgren - STUK) WP 6.1.2: Potential conflicts between radon protection and energy (Wolfgang Ringer - AGES) WP 6.2: Establishment of measurement procedures for radon control technologies (Martin Jiránek - CTU) WP 6.3: Design of training courses for radon measurement, prevention, remediation (Bernard Collignan - CSTB). Bernard Collignan CSTB, France RADPAR, WP 6. Assessment of radon control technologies Method for each objective: Elaboration of a specific Questionnaire, sent to RADPAR partners and other european countries to state on current practices Bibliography Specific studies Elaboration of recommendations Bernard Collignan CSTB, France RADPAR Workshop Radon Prevention and Remediation 52

54 RADPAR, WP 6. Assessment of radon control technologies WP 6.1: Potential conflicts between energy conservation and radon control (Deliverable 13) Seven documents associated to this deliverable: D13/1. Assessment of current techniques used for reduction of indoor concentration in existing and new houses D13/2. Energy saving construction (low energy / passive houses) and indoor radon exposure Compilation and assessment D13/3. Survey of Construction Technologies in Low Energy and Passive Houses in Europe D13/4. Heating and Ventilation Systems in Low Energy and Passive Houses in Europe D13/5. Measurement and Analysis of Radon in Selected Passive Houses in Austria D13/6. Review of Low Energy Construction, Pressure Conditions and Indoor Radon in Finnish Residential Buildings D13/7. Radon and Energy Efficient Construction: Assessment and Recommendations Bernard Collignan CSTB, France RADPAR, WP 6. Assessment of radon control technologies WP 6.1: Potential conflicts between energy conservation and radon control Main conclusions Assessment of current techniques used for reduction of indoor concentration in existing and new houses: Active sub-slab depressurization (SSD) most efficient remediation and prevention method reduction of radon concentration by % Passive system: up to 50 % reduction Other methods less efficient, typically < 60 % improving ventilation and sealing Qualitative impact on energy consumption Active SSD: increases energy consumption (electrical fan & cooling of foundation) Improving ventilation: increases energy consumption due to increasing of air exchange unless a heat recovery is used Sealing entry routes: decreases energy consumption through reduction of cold air leakage from ground synergetic goals with low and passive energy construction Bernard Collignan CSTB, France RADPAR Workshop Radon Prevention and Remediation 53

55 RADPAR, WP 6. Assessment of radon control technologies WP 6.1: Potential conflicts between energy conservation and radon control Main conclusions (followed) Low energy and passive houses Increasing importance in new construction and in renovation market. Main characteristics: highly airtight building envelope, mechanical ventilation systems, and high quality insulation Combination of a highly airtight building envelope (including foundations) and a controlled mechanical ventilation system low indoor radon levels. Attention should be paid to a successful implementation Certain features may cause high radon levels: untight earth tubes of a ground-coupled heat exchanger, deterioration of the air tightness of penetrations through the foundations, pressure misbalances due to ventilation system bad design of air intakes (e.g. air wells). Bernard Collignan CSTB, France RADPAR, WP 6. Assessment of radon control technologies WP 6.1: Potential conflicts between energy conservation and radon control Main conclusions (followed) Verification of the indoor radon concentration with radon measurements should be undertaken: - In new construction, - After substantial modifications of the building or ventilation system, particularly in radon prone areas Next step: To develop information for consultants, manufacturers, building professionals and public for a relevant appropriation. Bernard Collignan CSTB, France RADPAR Workshop Radon Prevention and Remediation 54

56 RADPAR, WP 6. Assessment of radon control technologies WP 6.2: Establishment of measurement procedures for radon control technologies (Deliverable 15) Main conclusions No international standard for testing of materials used in radon reduction systems. First priority for European standardization: Determination of radon diffusion coefficient of radon barrier materials (membranes, sealants) In five European countries (Ireland, Czech Republic, Germany, Norway and Sweden): existence of national standards or test methods Around five laboratories in Europe able to measure radon diffusion coefficient using different test methods different values can be found for the same material. Elaboration of a uniform European method or standard helpful to ensure reproducibility and repeatability of results. Unified method for the determination of the radon diffusion coefficient prepared in the framework of RADPAR activities. Currently submitted at ISO level (ISO/WD standard) Bernard Collignan CSTB, France RADPAR, WP 6. Assessment of radon control technologies WP 6.2: Establishment of measurement procedures for radon control technologies (Deliverable 15) Main conclusions (followed) A proper implementation of membranes and sealants is a key factor of their efficiency Other properties of membranes should also be assessed Existence of international standards to test these properties Property Standard Tensile strength EN ISO 527-3/5, EN , 2 Elongation at break EN ISO 527-3/5, EN , 2 Shear resistance of transversal joint EN , 2 Tear resistance EN , 2 Impact strength EN Dead load resistance EN , 2 Low temperature flexibility EN 495-5, EN 1109 Influence of artificial ageing on flexibility EN 1296 Thermal stability EN 1110 Root resistance pren Resistance to microorganisms EN ISO 846 (640780) Water vapour transmission EN 1931 Water tightness EN 1928 Other components used in building protection (fans, air cleaners, ducts, pipes) not especially designed for this use. Existing tests sufficient to assess their performances. Bernard Collignan CSTB, France RADPAR Workshop Radon Prevention and Remediation 55

57 RADPAR, WP 6. Assessment of radon control technologies WP 6.3: Design of training courses for radon measurement, prevention, remediation for professionals (Deliverable 8) Main conclusions for Questionnaire analysis Most of countries involved in RADPAR program propose courses for professionals Organisation could be very different depending on countries and their progress in legislation Sometimes linked with professional accreditation, content is more consistent and duration is longer, with better attendance and efficiency Difficult to mix courses with specialised radon measurement techniques (beyond screening knowledge) and building protection techniques: different target and competences Seems to be more efficient to have separate courses with overview on other topic Difficulties to convince building professionals to follow up courses (weak marketing incentives) Improvement of professional practices is observed in countries where courses are well running Few countries propose courses integrated to student education Generally integrated to more global session like indoor air quality course should be accentuated to have future building professionals aware on radon prevention and control Bernard Collignan CSTB, France RADPAR, WP 6. Assessment of radon control technologies WP 6.3: Design of training courses for radon measurement, prevention, remediation for professionals (Deliverable 8) Main conclusions for frame of professional courses To give global frame which could be adapted depending on advancement of radon management. Choice to separate courses for radon measurement and for building protection Different options could be chosen: - Global course - Shorter duration - Separate days - Inclusion of theoretical and practical exercises - Using courses for accreditation of actors - Adequate knowledge for authorities who have to verify the application of regulation For building protection, technical solutions should be adapted to local construction specificities List of course material available provided Bernard Collignan CSTB, France RADPAR Workshop Radon Prevention and Remediation 56

58 RADPAR, WP 6. Assessment of radon control technologies WP 6.3: Design of training courses for radon measurement, prevention, remediation for professionals (Deliverable 8) Basic frame for radon measurement courses (2/3 days) Generalities on radon: Basics of radioprotection, link with radon geology, mapping... Health effect of radon Legislation related to the radon issue Transport of radon into building Basics of building protection Exposition of population to radon Measurement principles, devices and techniques Passive measurements for screening into buildings Other measurements in air, in water, in building materials Objectives and Protocols for different measurements into buildings Protocol writing, methodology of results evaluation Theoretical and practical exercises: working group for case studies, measurements in buildings Examination Bernard Collignan CSTB, France RADPAR, WP 6. Assessment of radon control technologies WP 6.3: Design of training courses for radon measurement, prevention, remediation for professionals (Deliverable 8) Basic frame for building protection courses (2/3 days) Generalities on radon: geology, mapping... Health effect of radon Exposition of population to radon Legislation related to the radon issue Basics of radon measurements into buildings Radon into buildings: general points, sources and entry routes of radon, causes of radon entry. Generalities on building: Presentation of building types, basement typologies Air permeability of building and stack effect Ventilation of building and Indoor Air Quality Heating and ventilation systems Principles of building protection Prevention for new buildings: Legal prescription, Conception of prevention, Examples of integration, Products and systems Remediation for existing buildings: Legal prescription, Building diagnosis, Adaptation and integration of remediation, Examples of building remediation, Dealing with difficult buildings Theoretical and practical exercises for new and existing buildings: working group for case studies, visit of buildings Examination Bernard Collignan CSTB, France RADPAR Workshop Radon Prevention and Remediation 57

59 RADPAR, WP 6. Assessment of radon control technologies WP 6.3: Design of training courses for radon measurement, prevention, remediation for professionals (Deliverable 8) Main conclusions For a successful development of public protection against radon, three following topics should be developed jointly: Regulation Communication to public Professional improvement Training course for professional: key point to develop practices, should be linked with professional improvement and more generally the development of regulation and communication to public. Bernard Collignan CSTB, France RADPAR, WP 6. Assessment of radon control technologies Thank you for your attention Bernard Collignan CSTB, France RADPAR Workshop Radon Prevention and Remediation 58

60 1.5. Analysis of cost-effectiveness and health benefits of radon control strategies, Alastair Gray, University of Oxford, UK. Introduction and methods: The objective of work package 7 was to assess the costeffectiveness of existing and potential radon prevention and remediation strategies in the EU. The analyses followed the methods widely accepted as appropriate for the evaluation of health interventions: that is, cost-effectiveness analysis. Two main questions were addressed: 1) the cost-effectiveness of incorporating basic radon prevention measures in all new houses, and in targeted areas with high radon levels? 2) the cost-effectiveness of remediation programmes in existing houses in targeted areas. Cost-effectiveness was evaluated using an updated version of a previously published spreadsheet-based model. Data: Parameter estimates for the model were obtained for Finland, Ireland, Norway and the UK. These included data on age/sex structure, smoking rates, life tables, radon levels, the costs of preventive and remedial actions, and uptake rates. Results: For basic measures in all new homes, the cost per Quality Adjusted Life Year (QALY) gained was 34,110 in Finland, 38,308 in Norway, 9,382 in Ireland, and 23,727 in the UK. The cost per QALY gained of targeted remediation policies was 31,873 in Finland, 33,200 in Ireland, 23,353 in Norway and 56,160 in the UK. Cost-effectiveness was better by a factor of approximately 10 for smokers compared to non-smokers, due to their higher lung cancer risk. Conclusions: Radon prevention & remediation policies should be developed and evaluated with reference to cost-effectiveness evidence. Basic measures in all new homes are probably cost-effective, and these could be incorporated in national building codes. Policies on more elaborate measures in new homes need guidance from cost-effectiveness evidence. It is often expensive to find existing homes with high radon levels and persuade owners to act. Lifetime remediation costs can also be quite high, particularly if active measures such as fans are required. As a result the cost-effectiveness of such policies are often borderline, and they should be carefully targeted. Smoking status is a key influence on cost-effectiveness, and radon remediation policies need to acknowledge this and link to smoking cessation campaigns. RADPAR Workshop Radon Prevention and Remediation 59

61 Radon Prevention and Remediation RADPAR Work package 7: cost-effectiveness Alastair Gray University of Oxford, UK on behalf of the WP7 partners WP7: main objective To assess the cost-effectiveness of existing and potential radon prevention and remediation strategies in the EU To improve the effectiveness of radon control strategies by Development of a cost-effectiveness model Design of training course/manual for using model to evaluate cost-effectiveness of radon policies RADPAR Workshop Radon Prevention and Remediation 60

62 Economic evaluation of radon prevention and remediation Rationale: radon prevention and remediation mainly about health risks / benefits lung cancer Wide consensus on methodology for evaluation of health interventions: cost-effectiveness analysis Quantify additional costs of policy compared to alternative Quantify additional health benefits in common units Lung cancer cases, life years, quality adjusted life years (QALYs) Calculate cost of the health benefits.good value? Radon programmes suitable for application of same methods NW The cost-effectiveness plane Intervention more costly NE Maximum acceptable incremental cost-effectiveness ratio ICER..? Existing policy dominates Intervention more effective but more costly Intervention less effective C Intervention more effective Intervention less effective but less costly Intervention dominates SW Intervention less costly SE RADPAR Workshop Radon Prevention and Remediation 61

63 What is viewed as costeffective? Depends on level of national wealth, size of budget, and willingness to pay of decision makers US: c. 37,500 per QALY gained gained UK: c. 25,000/QALY Finland, Norway, Ireland: c ,000/QALY? Note: decisions not just about cost-effectiveness. Also need to consider fairness/equity, etc Process: spreadsheet-based model Outcomes Calculate radon level in homes before & after action Calculate lifetime lung cancer risk before & after action, from age/sex specific rates, adjusted for smoking status and competing risks Estimate QALYs gained, using: - average no. in home - mean age at lung cancer death, adjusted for sex, smoking status - age/sex specific quality of life Costs Calculate costs of finding homes, using radon level, test acceptance & remediation rates Calculate costs of prevention / remediation measures Calculate costs / savings of averted lung cancer cases, added life expectancy Calculate cost-effectiveness One-way (and probabilistic) sensitivity analyses RADPAR Workshop Radon Prevention and Remediation 62

64 2 main questions agreed 1. What is cost-effectiveness of incorporating basic radon prevention measures in all new houses? a) & what if basic radon prevention measures are targeted in areas with high radon levels? 2. What is the cost-effectiveness of remediation programmes in existing houses in targeted areas? Illustrate model using costeffectiveness results from: Finland: Tuomas Valmari Norway: William Standring and Terje Strand Ireland: David Fenton and David Pollard UK: Alastair Gray RADPAR Workshop Radon Prevention and Remediation 63

65 Parameter inputs: basic prevention strategy in new homes Whole country High radon areas Finland Norway Ireland UK Finland Norway Ireland UK Reference level, Bq/M Arithmetic mean radon level in area of interest in Bq/M 3, adjusted for measurement error Percent of homes over Reference Level Percentage reduction in radon from prevention measures 17.2% 8.38% 8.46% 0.44% 48.3% 36.42% 20.60% 3.00% 57% 50% 50% 50% 57% 50% 50% 50% Average household size , , Cost of installing membrane/other basic measures Health Service annual per capita expenditure on all other health care during added life expectancy Mean Health Service/hospice treatment cost per lung cancer case 7,817 7,817 4,000 7,817 7,817 7,817 4,000 7,817 16,840 16,840 20,200 16,840 16,840 16,840 20,200 16,840 Baseline results: basic prevention measures in new homes Whole country High radon areas Finland Norway Ireland UK Finland Norway Ireland UK Lifetime cumulative lung cancer risk (%) Initial Post-prevention Lung cancer cases averted per 1000 houses Total life years gained Total QALYs gained Radon prevention cost 1, , Lung cancer treatment costs averted Health care costs of added life expectancy Incremental cost per QALY gained 34,110 38,308 9,382 23,727 24,935 18,772 6,876 14,546 RADPAR Workshop Radon Prevention and Remediation 64

66 Basic prevention measures in new homes: by smoking status Whole country High radon areas Finland Norway Ireland UK Finland Norway Ireland UK Lifetime cumulative lung cancer risk (%): Initial Never smokers only Current smokers only Post-prevention Never smokers only Current smokers only Lung cancer cases averted per 1000 homes: Never smokers only Current smokers only Incremental cost per QALY gained Never smokers only 117, ,659 40, ,335 65,725 72,354 25,056 49,964 Current smokers only 13,037 17,511 4,029 12,926 10,447 10,131 3,108 9,467 Basic prevention measures in new homes: sensitivity analysis (Finland) RADPAR Workshop Radon Prevention and Remediation 65

67 Parameter inputs: remediation of existing homes Whole country High radon areas Norway Ireland Finland Norway Ireland UK Reference level, Bq/M % of homes over Reference Level 8.4% 8.4% 23.2% 36.42% 20.6% 5.0% % of homes accepting invite to test 67% 2% 4% 67% 2% 30% Proportion of homes found over 25% 25% 55% 25% 25% 20% action level that decide to remediate Percentage reduction obtained by 80% 92% 52% 80% 92% 85% remediation measures Unit cost of radon test Full remediation cost per household 2,568 4,232 2,921 2,568 4,232 1,545 Baseline results: remediation of existing homes Incremental cost per QALY gained Whole country High radon areas Norway Ireland Finland Norway Ireland UK 45,270 59,800 31,873 23,353 33,200 56,160 And by smoking status Whole country High radon areas Norway Ireland Finland Norway Ireland UK Incremental cost per QALY gained Never smokers only 243, ,685 89, , , ,931 Current smokers only 20,579 23,268 12,677 12,050 13,230 25,880 RADPAR Workshop Radon Prevention and Remediation 66

68 Conclusions and recommendations: New homes Radon prevention & remediation policies should make reference to cost-effectiveness evidence RADPAR analyses suggest that basic measures in all new homes probably cost-effective could be incorporated in national building codes Policies on more elaborate measures: need guidance from cost-effectiveness evidence Conclusions and recommendations: Existing homes Often expensive to find homes & persuade owners to act. Lifetime remediation costs quite high. So cost-effectiveness often borderline: Need careful targeting Need to find ways of improving uptake Smoking status a key influence on cost-effectiveness Radon remediation policies need to acknowledge this, and link to smoking cessation campaigns Thank you! RADPAR Workshop Radon Prevention and Remediation 67

69 PART 2: PRESENTATIONS FROM INVITED SPEAKERS RADPAR Workshop Radon Prevention and Remediation 68

70 2.1. Construction of natural radiation exposure study network, Shinji Tokonami, Hirosaki University, Japan. A new project entitled Construction of natural radiation exposure study network was adopted in the Program of Promotion of International Joint Research under the Special Coordination Funds for Promoting Science and Technology operated by the Ministry of Education, Culture, Sports, Science and Technology of Japan in Eight institutions are being involved in this project and the project will continue until March, The aims of the project are to assess the dose for natural radiation exposures using state-of-the-art measurement techniques in four Asian countries (China, India, Korea and Thailand) and their outcomes will be distributed worldwide. Conventional measurement techniques will be improved and be optimized. More scientific data and results will be obtained throughout this project. In particular, the following advanced technologies for inhalation exposures will be introduced: (1) Discriminative measurements of radon ( 222 Rn) and thoron ( 220 Rn) gases 1), 2), (2) Evaluation of thoron decay products concentration 3), (3) Simple but effective particle size distribution measurements. RADPAR Workshop Radon Prevention and Remediation 69

71 Construction of Natural Radiation Exposure Study Network Shinji Tokonami Hirosaki University Circumstances in Asia China: Many people live in cave dwellings at Chinese loess plateau. Possibility of high radon exposure Korea: National radon survey is being carried out. Understanding of radon and thoron exposure aspects (radon and thoron prone area) Thailand: Social problems on Natural Occurring Radioactive Materials (NORM) in mineral processing plants. India: High background radiation areas Monazite and zircon sands (major contributors) Feasibility study of health effects among population exposed to thorium and other NORMs RADPAR Workshop Radon Prevention and Remediation 70

72 Aims of the project Dose assessment for natural radiation exposures using state-of-the-art measurement techniques in four Asian countries (China, India, Korea and Thailand) Health effects will be considered Outcomes will be distributed to the world. Appeal for measurement technologies Contribution to international standard Structure of NRE network (5) National Institute of Radiological Protection, China (2) Nagoya University (7) Chulalongkorn University, Thailand (3) University of Ryukyus (1) National Institute of Radiological Sciences (& Hirosaki University) (4) Kagoshima University (8) H.N.B. Garhwal University, India (6) Korea Institute of Nuclear Safety, South Korea Construction of natural radiation exposure study network RADPAR Workshop Radon Prevention and Remediation 71

73 Advanced technologies for inhalation exposures Discriminative measurements of radon( 222 Rn) and thoron( 220 Rn) gases Control of air exchange rate of the monitor Evaluation of thoron decay products concentration Deposition rate measurements Particle size distribution measurements Such information needed for accurate dose assessment Improvement of present technique for field use Expected Outcomes New scientific findings on -Level and behavior of thoron in the environment -Actual situation of exposures due to NORM Revision of lung cancer risk associated with radon -Radiation protection system to be reconsidered Standardization of exposure assessment of NORM for future epidemiological studies -Precise risk assessment on the basis of precise dosimetry RADPAR Workshop Radon Prevention and Remediation 72

74 Functions of domestic participants Standardization of measurement techniques National Institute of Radiological Sciences/Hirosaki University Calibration exercises and detector performance tests using radon/thoron reference chambers Internal exposure assessment Nagoya University External exposure assessment University of Ryukyus Health effects/epidemiology Kagoshima University Research programs under the project China: Epidemiological survey at Chinese loess plateau and other high background radiation areas Korea: Radon and thoron survey in the central part of South Korea Thailand: NORM survey in Thailand India: Environmental radioactivity and feasibility study of health effects among inhabitants in high background radiation areas RADPAR Workshop Radon Prevention and Remediation 73

75 Actions performed in FY2009 Month July August September October November December January February March Action Discussion and Preliminary survey in Korea Discussion and Preliminary survey in Thailand IEC meeting in Yokohama, Japan 1 st Project meeting at NIRS, Japan Intercalibration at PTB in Germany Discussion and Preliminary survey in India Field survey in Thailand (Bangkok) Field survey in Thailand (Phuket) Field survey in India IEC intermediate meeting in Saclay, France ISO intermediate meeting in Paris, France Setup of radon/thoron chamber in Thailand (Bangkok) Actions performed in FY2010 Month April May June July August September October November December January Action Field survey in India International thoron workshop in Japan ISO meeting in Korea Field survey in India Field survey in China Setup of reference chamber in Thailand IEC meeting in USA 2 nd Project meeting in India (7HLNRRA) ISO intermediate meeting in Paris Field survey in Thailand (cosmic radiation) February March RADPAR Workshop Radon Prevention and Remediation 74

76 Planned schedule in FY2011 Month April May June Action (ISO meeting in Canada: planned) (IEC intermediate meeting in Italy) July August September October November December (3 rd Project meeting in Thailand: planned) Field work in China January February March ISO meeting in France IEC meeting in Germany 3 rd Project meeting in Japan International symposium on Natural Radiation Exposure and low dose radiation epidemiology in Japan International Thoron Workshop INTERNATIONAL WORKSHOP on the "ENVIRONMENTAL THORON AND RELATED ISSUES" and "Thoron Intercomparison of Active Methods" May 19th 22nd, 2010 NIRS, Chiba, Japan 70 participants from 17 countries RADPAR Workshop Radon Prevention and Remediation 75

77 International Thoron Workshop SUMMARY: 8 Invited papers 28 Regular papers Studies in 8 papers have been partialy supported by the grant-in-aid Construction of Natural Radiation Exposure Study Network from the Special Coordination Funds for Promoting Science and Technology of Minsirty of Educatrion, Culture, Sports, Science and Technology. Development of simplified reference radon/ thoron chambers for calibration of passive detectors in Thailand Radon/Thoron chambers Inner volume: Tn:50 L ; Rn:100 L Chamber Material: Stainless steel Thoron gas source: lantern mantle Radon gas source: a dry powder of Radium-226 (it is a reference source of Pylon company) Temperature: 30 C Relative humidity: 50 % Calibration conditions: Low conc. 500 kbq m -3 h Medium conc kbq m -3 h High conc kbq m -3 h RADPAR Workshop Radon Prevention and Remediation 76

78 26/07/ :00 26/07/ :00 27/07/ :00 27/07/ :00 28/07/ :00 28/07/ :00 29/07/ :00 29/07/ :00 30/07/ :00 30/07/ :00 31/07/ :00 EERC Bq/m3 out-in temp China survey -Measurement data- The high value of 800 Bq m -3 Radon concentration was measured in the cave using RAD7 and AlphaGUARD Thoron concentration of 700 Bq m -3 was observed in the cave using RAD7 EERC of 700 Bq m -3 was registered using PIPS monitor China survey - Time variation of EERC EERC out-in temp time RADPAR Workshop Radon Prevention and Remediation 77

79 Frequency Case control study for radon in China Case (n=70) Control (n=106) Cont_indiv (n=166) Ave.: 60.9, 58.8, 59.0 S.D.: 36.9, 38.7, 36.3 Median: 55.5, 48.6, Radon concentration [Bq m -3 ] Korea survey MISSION under JST Project Rn/Tn Survey at high Rn/Tn Survey Rn/Tn in central part of Korea Survey Rn/Tn around registered uranium mining lot area Preliminary study of Rn Epidemiology Results survey I Concentration distribution of Radon in room is almost uniform within 4% standard deviation Concentration distribution of Thoron in room is not uniform, need to study more Concentration distribution of Thoron-P in room is not uniform, need to study more RADPAR Workshop Radon Prevention and Remediation 78

80 Korea survey Results of Preliminary study (winter season) survey II Areas Goesan-Kun (15), Chungbuk province Yeongdong-Kun (1), Chungbuk province Preliminary results (winter) Radon Thoron 48-2,440 ND - 1, ND Dong-Ku (3), Daejeon 64-2,220 ND Keumsan-Kun (7), Chungnam province 53-1,080 ND ( ) : Number of Measurement point Intercomparisons for standardization Portugal 3% Poland 15% Romania 3% Spain Vietnam 3% 3% Brazil 6% Canada 3% China Czech Rep. 3% 3% France 3% Germany 6% Hungary 3% Countries: 18 Laboratories: 33 Rn part: 33 labs Malaysia 3% Luxembourg 3% Japan 15% Italy 15% India 6% Ireland 3% Tn part: 17 labs RADPAR Workshop Radon Prevention and Remediation 79

81 REF Intercomparison and standardization experiments Summary of International Intercomparsion ,00 2,50 2,00 1,50 1,00 0,50 0,00 A B1 B2 C D E F G1 G2 H I J K L1 L2 M N O P1 P2 Q R T1 T2 T3 S U V W X Y Z AA BB CC CC DD EE FF1 FF2 GG HH II 1 2 Rn Low 1, 1, 1, 0, 0, 0, 1, 1, 0, 1, 1, 2, 2, 1, 0, 0, 1, 1, 1, 0, 0, 0, 1, 0, 0, 2, 1, 2, 0, 0, 0, 0, 0, Rn High 1, 1, 0, 1, 0, 0, 1, 0, 1, 0, 1, 0, 0, 1, 0, 0, 1, 0, 0, 1, 1, 1, 0, 0, 1, 0, 0, 0, 0, 1, 0, 0, 1, 1, Tn Low 0, 0, 0, 1, 1 1 1, 1, Tn High 0, 0, 1, 1, 1, 1, 1, 1 ISO/IEC international standard Revision of IEC standard IEC : Specific requirements for 222 Rn and 220 Rn measuring instruments New Work Item Proposal of ISO standard ISO 16641: Thoron( 220 Rn) measurement methodogy RADPAR Workshop Radon Prevention and Remediation 80

82 Goals and future directions Based on our outcomes, Present and publish more scientific data and results to international communities Contribution to UNSCEAR and ICRP Proposal of International standard (ISO/IEC) Expansion of the network RADPAR Workshop Radon Prevention and Remediation 81

83 2.2. Health effects of indoor radon, Michaela Kreuzer, Bundesamt fur Strahlenschutz, Germany. Based on the results of miner studies, the IARC classified radon as human lung carcinogen already in Since then a series of epidemiological studies on residential radon and lung cancer have been carried out in Europe, North America and China to directly assess the radon-related lung cancer risk. These studies provided convincing evidence of an increased lung cancer risk causally associated with radon, even at levels commonly found in buildings. The risk of lung cancer increases proportionally with the radon concentration with no evidence of a threshold. Even at radon concentrations below 200 Bq/m 3 a statistically significant relationship is present. Radon is the second most important cause of lung cancer after smoking in many countries. The absolute risk for lung cancer due to radon is much higher in people who smoke, or who have smoked in the past, than in lifelong non-smokers. It is estimated that radon in homes accounts for about 3 to 15% of all lung cancer deaths in European member states, depending on the average radon concentration in the country and the method of calculation. The majority of radon-induced lung cancer deaths occur at low and moderate radon levels rather at high radon levels, because in general only few people were exposed to high indoor radon concentrations. Other health effects than lung cancer have not consistently be demonstrated. There is only suggestive evidence for an increased risk of some cancers, in particular the extrathoracic airways and leukemia. RADPAR Workshop Radon Prevention and Remediation 82

84 Health effects of indoor radon Dr. Michaela Kreuzer Federal Office for Radiation Protection (BfS) Neuherberg, Germany RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 1 Evidence on health effects 1556 Unusually high mortality from respiratory disease among underground miners in Central Europe observed 1960 First epidemiological studies of miners 1988 Radon classified as human carcinogen by IARC, Lyon 1994 Joint analyses of 11 miner studies published by Lubin et al. RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 2 RADPAR Workshop Radon Prevention and Remediation 83

85 Relative risk of death from lung cancer by cum. radon exposure in miners Lubin et al Linear trend without threshold Is there an increased risk in the general population at the much lower radon levels at home? Extrapolation from miner studies to general population is difficult Indoor range (Lifelong 100 Bq/m 3 40 WLM) RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 3 Studies on indoor radon and lung cancer Need for direct evidence from residential studies In the 1980s and 1990s various case-control studies were conducted in Europe, North America and China Retrospective assessment of the radon concentration in homes occupied 5-35 years prior to diagnose or interview Collection of detailed information on smoking and other potential confounders RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 4 RADPAR Workshop Radon Prevention and Remediation 84

86 Excess Relative Risk per 100 Bq/m 3 in published single studies 0,8 0,6 0,4 0,2 0-0,2 Canada Shenyang Germany-West Connecticut Utah France Missouri I Missouri II UK Germany-East Czech Republic Sweden I Finland Italy Iowa Gansu Austria New Jersey Sweden II Italy II Sweden III Finland II Spain 1,5 RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 5 Pooling of individual residential radon studies Europe (Darby et al. 2005, 2006): cases, controls North America (Krewski et al. 2005, 2006) cases, controls China (Lubin et al. 2004) cases, controlsn RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 6 RADPAR Workshop Radon Prevention and Remediation 85

87 Relative Risk (95% CI) Scand J Work Environ Health 2006; 32 suppl 1: 1-80 British Medical Journal 2005; 330: Risk of lung cancer according to measured radon 3 2,5 2 1,5 ERR per 100 Bq/m 3 = 8.4 % 95% CI = 3% - 16% 1 RR = 1 0, Radon (Bq/m³) Relationship approximately linear without evidence for threshold RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 8 RADPAR Workshop Radon Prevention and Remediation 86

88 Relatives Risiko (95% CI) Risk of lung cancer according to radon below recommended action levels? 3 2,5 < 200 Bq/m 3? 2 1,5 1 RR = 1 0, Radon (Bq/m³) RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 9 Risk of lung cancer according to radon Restriction of data to individuals with radon concentration below 200 Bq/m 3 Radon in Number RR 95 % CI Bq/m 3 Cases Controls < 100 5,183 10, ,296 2, Total 6,479 12,659 ERR per 100 Bq/m 3 = 14 % 95 % CI: 0.4%- 30% RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 10 RADPAR Workshop Radon Prevention and Remediation 87

89 Is there an increased risk of lung cancer among lifetime never-smokers? Does it differ from that of current smokers or ex-smokers? RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 11 Risk of lung cancer according to radon by smoking status 3 ERR = 11 % 3 ERR = 8 % 3 ERR = 7 % 2,5 2,5 2, ,5 1,5 1, , , , Lifelong non-smoker Ex-smoker Current smoker RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 12 RADPAR Workshop Radon Prevention and Remediation 88

90 What is the effect of uncertainty in the assessment of past radon concentration? - Year-to-year variation in radon concentrations - Missing radon concentrations - Measurement error of detectors, etc.. Underestimation of the true risk RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 13 Risk with and without adjustment for uncertainties in exposure Study ERR/ 100 Bq/m 3 95% CI. EUROPE (without) Regression calibration NORTH AMERICA (without) > 25 years covered by measurement CHINA (without) > 30 ys in current residence RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 14 RADPAR Workshop Radon Prevention and Remediation 89

91 Cumulative risk of lung cancer death by 75 years by radon for current smokers and lifelong non-smokers (Darby et al. 2005) Radon concentration in Bq/m 3 Deaths per 1000 lifelong nonsmokers Deaths per 1000 current smokers A smoker of cig/day has 25fold higher risk of lung cancer than a lifelong nonsmoker; ERR per 100 Bq/m 3 = 16% 80 % risk for ex-smokers (< 10 ys) RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 15 Health burden from radon Radon accounts for 3% to 15% of all lung cancer deaths in EU member states (RADPAR) The majority of them occur below 200 Bq/m 3 RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 16 RADPAR Workshop Radon Prevention and Remediation 90

92 Radon and diseases other than lung cancer Doses from radon to the lung and respiratory tract are by a factor of 100 to 1000 higher than for other organs WHO Guidelines for indoor air quality (2010): There is suggestive evidence of an association with other cancers, particular for extra thoracic airways (larynx, pharynx, nose) and leukemia RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 17 Summary - I Epi-studies confirm that radon in homes increases the risk of lung cancer in the general population. The proportion of all lung cancers linked to radon is estimated to lie between 3% and 14% Radon is the second most important cause of lung cancer after smoking in many countries. Radon is much more likely to cause lung cancer in people who smoke, or who have smoked in the past, than in lifelong non-smokers. WHO Handbook on indoor radon 2009 RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 18 RADPAR Workshop Radon Prevention and Remediation 91

93 Summary - II There is no known threshold concentration below which radon exposure presents no risk Even low concentrations can result in a small increase in risk of lung cancer The majority of radon-induced lung cancers are caused by low and moderate radon concentrations rather than by high radon concentrations WHO Handbook on indoor radon 2009 RADPAR Meeting, Brussels, , Dr. Michaela Kreuzer 19 RADPAR Workshop Radon Prevention and Remediation 92

94 2.3. Requirements on radon in dwellings and workplaces in the proposed new Euratom Basic Safety Standards, Stéphane Calpena, European Commission, DG-ENER-D4, Louxembourg. The 1996 EU directive did mention radon in workplaces but disregarded radon exposure in dwellings, for which there already was a Commission Recommendation. Since then, the European Commission has decided to review these standards. New requirements regarding Radon will enter into force, probably in 2013, with the adoption of a revised version of the EU-BSS. One of the main requirements dealing with radon will be that Member states are to establish an action plan to manage longterm risks from radon exposure in dwellings and at workplaces for any source of radon ingress including soil, building materials and drinking water (new EU BSS article 103). This action plan shall include the following: 1. Strategy for conducting surveys of indoor radon concentrations, for the management of measurement data (national radon database) and for the establishment of other parameters (soil and rock types, soil gas concentration, permeability and radium-226 content of rock or soil). 2. Available data and criteria used for the delineation of radon-prone areas or for the identification of radon-prone buildings. 3. Identification of types of buildings with public access and workplaces, e.g. schools, underground workplaces or spas, where measurements are needed, based on a risk assessment including occupancy hours. 4. The basis for the establishment of reference levels for existing dwellings, workplaces, buildings with public access and for new buildings. 5. Assignment of responsibilities (governmental and non-governmental), coordination mechanisms and available resources for implementation of the action plan. 6. Strategy for reducing radon exposure in dwellings, particularly in radonprone areas. 7. Strategy, including methods and tools, for preventing radon ingress in new buildings, including identification of building materials with significant radon exhalation. 8. Schedules for audits and reviews of the action plan. 9. Strategy for communication to increase public awareness and inform local decision makers of the risks of radon in relation to smoking. 10. Where appropriate, guidance on methods and tools for measurements and remedial actions. Criteria for the accreditation of measurement and remediation services shall also be considered. 11. Where appropriate, provision of financial support for radon surveys and for remedial action, in particular for private dwellings with very high radon concentrations. 12. Long-term goals in terms of reducing lung cancer risk attributable to radon exposure (for smokers and non-smokers). National authorities will have to establish reference levels taking into account prevailing economic and societal circumstances and apply the process of optimisation of protection in their country. The new BSS proposes to establish national reference levels not exceeding: RADPAR Workshop Radon Prevention and Remediation 93

95 200 Bq/m 3 for new dwellings and new public buildings. 300 Bq/m 3 for existing dwellings and public buildings Bq/m 3 for workplaces and low occupancy public buildings. In workplaces, if such national reference levels are still exceeded despite remedial actions to reduce Radon, appropriate requirements for occupational exposure shall apply. RADPAR Workshop Radon Prevention and Remediation 94

96 Requirements on Radon in dwellings and workplaces. European Commission Radiation Protection Participation in RADPAR Brussels, 23/02/2012 Euratom Basic Safety Standards EC-DG-ENER-D4 Stéphane Calpéna Indoor exposure to radon in existing BSS was to be improved Exposure to radon in dwellings is not included in the scope Radon in workplaces is rather poor Title VII (Natural Radiation Sources) deals only with an identification of work activities of concern No specific requirements on building materials EC-DG-ENER-D4 Stéphane Calpéna RADPAR Workshop Radon Prevention and Remediation 95

97 EC Recommendation on indoor exposure to radon (90/143/Euratom 21/02/1990) To develop criteria for identifying regions, sites and building characteristics likely to cause high indoor radon levels To inform the population on the radon risk To ensure quality and reliability of annually-averaged measurements of Radon To establish a system for reducing any exposure to indoor radon concentrations and to apply principle of optimisation EC-DG-ENER-D4 Stéphane Calpéna EC Recommendation on indoor exposure to radon (90/143/Euratom 21/02/1990) Reference level for existing buildings 400 Bq/m 3 (equivalent to 20 msv / year according to 90/143) Design level for the construction of new buildings 200 Bq/m3 Remedial or preventive actions if reference levels are exceeded. EC-DG-ENER-D4 Stéphane Calpéna RADPAR Workshop Radon Prevention and Remediation 96

98 EC Recommendations for the implementation of title VII of the EU BSS (RP ) Concentrate on highest exposures, and where actions are most likely to be effective. Surveys of radon exposure in different types of workplaces Action Levels for radon: Bq/m 3 When radon concentrations remain above the Action Level the principles of BSS should apply (controlled areas, monitoring and dose limits) Information and advice to employers on remedial actions EC-DG-ENER-D4 Stéphane Calpéna EC radiological protection principles concerning the natural radioactivity of building materials (RP ) Calculation of the following index and industrial activities to notify to the regulatory authority when I > 1 I = C 226 Ra /300 + C 232 Th /200 + C 40 K /3000 Radon exhalation: When gamma doses are limited to levels below 1mSv/y, the 226 Ra concentration in the materials is limited, in practice, to a level which is unlikely to cause indoor radon concentrations exceeding (200 Bq/m3). EC-DG-ENER-D4 Stéphane Calpéna RADPAR Workshop Radon Prevention and Remediation 97

99 BSS RECAST Several EU Directives were merged and consolidated: Basic Safety Standards (workers, general public): 1996 Patients/Medical Directive: 1997 Informing the public on measures in the event of a radiological emergency: 1989 Outside Workers: 1990 High Activity Sealed Sources: 2003 AND RADON RECOMMENDATION 90/143/EURATOM was added EC-DG-ENER-D4 Stéphane Calpéna BSS RECAST Was a great opportunity to take on board natural radiation sources and especially: Planned exposure from new sources or new pathways of exposure resulting from: industrial activities processing naturally occurring radioactive materials (NORM) operation of aircraft Existing exposure: INDOOR RADON (ingress from soil) building materials and its index (gamma exposure, RADON EXHALATION) EC-DG-ENER-D4 Stéphane Calpéna RADPAR Workshop Radon Prevention and Remediation 98

100 New BSS: Radon action plan (art. 103) Member States shall establish an action plan to manage long-term risks from radon exposures in dwellings, buildings with public access and workplaces for any source of radon ingress, whether from soil, building materials and water. The action plan shall take into account the issues specified set out in Annex XVI EC-DG-ENER-D4 Stéphane Calpéna Radon action plan s content (New BSS Annex XVI) 1. Surveys and national radon database 2. Criteria for the identification of radon-prone buildings 3. Identification of types of buildings with public access and workplaces where measurements are needed 4. Establishment of reference levels for existing dwellings, workplaces, buildings with public access and for new buildings. 5. Assignment of national responsibilities, coordination mechanisms and available resources for implementation of the action plan. 6. Strategy for reducing radon exposure in dwellings, particularly in radon-prone areas. 7. Strategy, including methods and tools, for preventing radon ingress in new buildings, including identification of building materials with significant radon exhalation. EC-DG-ENER-D4 Stéphane Calpéna RADPAR Workshop Radon Prevention and Remediation 99

101 Radon action plan s content (New BSS Annex XVI) 8. Schedules for audits and reviews of the action plan. 9. Strategy for communication to increase public awareness and inform local decision makers of the risks of radon in relation to smoking. 10. Where appropriate, guidance on methods and tools for measurements and remedial actions. Criteria for the accreditation of measurement and remediation services shall also be considered. 11. Where appropriate, provision of financial support for radon surveys and for remedial action, in particular for private dwellings with very high radon concentrations. 12. Establishment of long-term goals in terms of reducing lung cancer risk attributable to radon exposure (for smokers and non-smokers). EC-DG-ENER-D4 Stéphane Calpéna Radon in workplaces Art.37.1.c Radiological surveillance of the working environment shall comprise, where appropriate the measurement of Radon concentrations in workplaces. Art.41.5 To remove background external radiation or Radon ingress from soil for industries processing NORM. EC-DG-ENER-D4 Stéphane Calpéna RADPAR Workshop Radon Prevention and Remediation 100

102 Radon in workplaces Art (reference level) The national reference level (NRL) not to exceed 1000 Bq/m³ at work Art (measurement) Radon measurement at ground floor or at basement level for identified workplaces and in radon-prone areas Art (optimisation) Remedial action if the NRL is exceeded Art (if Radon > NRL) All planned exposure requirements to be applied And occupational dose < 20 msv a year EC-DG-ENER-D4 Stéphane Calpéna Radon in dwellings and public buildings Art NRLs shall not exceed: 200 Bq/m³ for new dwellings and public buildings 300 Bq/m³ for existing dwellings 300 Bq/m³ for public buildings or 1000 Bq/m³ if occupancy time is low. Art If NRLs are exceeded then to encourage radon-reducing measures Art Building codes to prevent Radon ingress from soil and building materials EC-DG-ENER-D4 Stéphane Calpéna RADPAR Workshop Radon Prevention and Remediation 101

103 MERCI EC-DG-ENER-D4 Stéphane Calpéna RADPAR Workshop Radon Prevention and Remediation 102

104 2.4. WHO s activities on Radon, Emilie Van Deventer, World Health Organization, Switzerland. RADPAR Workshop Radon Prevention and Remediation Federal Agency for Nuclear Control, Brussels February 23, 2012 WHO's Activities on Radon Dr Emilie van Deventer Team Leader, Radiation Programme Department of Public Health and Environment RADPAR Workshop, 23 Feb 2012, Brussels Ferid Shannoun Department of Public Health and Environment World Health Organization Function: act as the UN directing and coordinating authority on international health work Objective: attainment by all peoples of the highest possible level of health Definition: "HEALTH is a state of COMPLETE physical, mental and social well-being and not merely the ABSENCE of disease or infirmity" (Constitution, 1948) RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 103

105 Ministries of Health (193 Member States) 6 regional offices 147 country offices IARC (Lyon) RADPAR Workshop, 23 Feb 2012, Brussels WHO's core functions 1. Articulate ethical and evidence-based policy positions 2. Setting norms and standards, and promoting and monitoring their implementation 3. Shaping the research agenda, and stimulating the generation, translation and dissemination of valuable knowledge 4. Providing technical support, catalysing change and developing sustainable institutional capacity 5. Monitoring the health situation and assessing health trends 6. Providing leadership on matters critical to health and engaging in partnerships where joint action is needed RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 104

106 These core functions encompass Radiation Protection 1. Articulate ethical and evidence-based policy positions 2. Setting norms and standards, and promoting and monitoring their implementation 3. Shaping the research agenda, and stimulating the generation, translation and dissemination of valuable knowledge 4. Providing technical support, catalysing change and developing sustainable institutional capacity 5. Monitoring the health situation and assessing health trends 6. Providing leadership on matters critical to health and engaging in partnerships where joint action is needed RADPAR Workshop, 23 Feb 2012, Brussels Radiation and environmental health Natural existing exposures e.g. radon Chronic exposures from past accidents/conflicts Chernobyl, DU Emergency prep. & response (accidents, deliberate events) Planned exposures medical, occupational Non-Ionizing (EMF, UV) RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 105

107 WHO Partners in Radiation Protection International Organizations National Authorities NGOs Collaborating Centres RADPAR Workshop, 23 Feb 2012, Brussels Chronology of WHO Actions on Radon. 1979: A WHO/EURO working group on indoor air quality first drew attention to the health effects from residential radon exposures 1988: IARC classified Radon as a human carcinogen 1993: An international workshop on indoor radon, organized by WHO, considered for the first time a unified approach to control radon exposures and advised on communication of associated health risks. 2005: WHO established the International Radon Project to identify effective strategies for reducing the health impact of radon and raise awareness about the consequences of radon exposures RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 106

108 WHO International Radon Project (IRP) Established in 2005: launch and first expert meeting in Geneva Scope: A global project, with key international and national partners Purpose: To reduce the population disease burden due to indoor radon Forum for international scientific and policy exchange: Several meetings with ~ 100 scientists and radon experts RADPAR Workshop, 23 Feb 2012, Brussels WHO IRP Partners Albania Argentina Austria Belgium Brazil Bulgaria Canada China Czech Republic Finland France Georgia Germany Greece Hungary India Ireland Italy Japan Lithuania Luxembourg Norway Poland Romania Russian Federation Serbia Slovenia South Korea Spain Sweden Switzerland Turkey USA Ukraine United Kingdom RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 107

109 RADPAR Workshop, 23 Feb 2012, Brussels WHO Handbook on Indoor Radon (2009) Structure Introduction 1. Health Effects of Radon 2. Radon Measurements 3. Prevention and Mitigation 4. Cost-Effectiveness 5. Radon Risk Communication 6. National Radon Programmes Key messages for each chapter RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 108

110 WHO Handbook on Indoor Radon (2009) (cont'd) Does NOT aim to replace international radiation protection standards or regulations Conduct national radon surveys Trying to get a representative overview of radon in a country, not only from high-radon areas Link with tobacco control and indoor air quality activities Implement building regulations (New buildings) Set national reference level RADPAR Workshop, 23 Feb 2012, Brussels Since then RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 109

111 IARC Monograph Vol. 100, Part D (2011) "The Working Group reaffirmed the conclusion reached in the earlier IARC evaluations that radon contributes to the increased lung cancer risk " RADPAR Workshop, 23 Feb 2012, Brussels Working with Partners ICRP TG 81 Report in setting recommendations for the protection of public and workers against radon exposure IAEA Safety Guide DS421 (Protection of the public against indoor exposure to natural sources of radiation) IAEA Regional Workshop on Reducing Risks from Indoor Radon (Nov. 2010, Geneva) EC RADPAR Project International Basic Safety Standards (2011) RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 110

112 International Basic Safety Standards (BSS) The BSS mark the culmination of efforts towards global harmonization of radiation safety requirements RADPAR Workshop, 23 Feb 2012, Brussels Chapter 5: Existing Exposure Situations (BSS 2011) Indoor radon Requirement 50: Public exposure due to radon indoors The government shall provide information on levels of radon indoors and the associated health risks and, if appropriate, shall establish and implement an action plan for controlling public exposure due to radon indoors. Requirement 52: Exposure in workplaces The regulatory body shall establish and enforce requirements for the protection of workers in existing exposure situations. Exposure due to radon in workplaces RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 111

113 WHO to support implementation of BSS in Member States The completion of the revision process of BSS was announced during the World Health Assembly held at Geneva in May Technical Briefing on Fukushima NPP accident at the 64 th WHA, Geneva, 17 May 2011 "WHO will continue supporting Member States for the implementation of BSS, to improve protection of patients, workers and general public". RADPAR Workshop, 23 Feb 2012, Brussels Communication on Radon using WHO channels WHO Guidelines Indoor Radon Indoor Air Quality Dampness and Mould Guidelines for Drinkingwater Quality Selected pollutants RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 112

114 Communication on Radon Building Professionals Appropriate communication to raise awareness on radon exposures with focus on the building sector Better training and education of building professionals Development of training tools with the involvement of building professionals for better mitigation and prevention RADPAR Workshop, 23 Feb 2012, Brussels Communication on Radon Building Professionals WHO meeting, Nov 2010, Geneva To take stock of national experiences consolidate information received from the different countries into workable interventions for both technical and communication best practices. To identify and involve representatives of building professionals What next? RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 113

115 New Opportunities to Disseminate Radon Messages Changing the perception Radon is a nuisance Radon is an opportunity Energy Conservation vs. Radon Control Different channels and stakeholders for communicating about radon Different ministries Different private sectors RADPAR Workshop, 23 Feb 2012, Brussels Conclusion WHO aims to inform and raise public and political awareness about the risks of exposure to radon and to emphasize primary prevention The IRP has provided multiple opportunities for cooperation with European countries on topics related to radon Collaboration with national and international partners, in particular the EC, is key to better use resources and to avoid duplication Increased involvement of building professionals is essential, through better communication, training and education RADPAR Workshop, 23 Feb 2012, Brussels RADPAR Workshop Radon Prevention and Remediation 114

116 WHO has welcomed the EC project on Radon Prevention and Remediation (RADPAR), and is keen to contribute to dissemination of its results These will hopefully provide a new opportunity to expand these achievements to a global dimension RADPAR Workshop Radon Prevention and Remediation 115

117 2.5. IAEA Programmes on Reducing Risks from Indoor Radon, Tony Colgan, International Atomic Energy Agency, Austria. The fifth edition of the Basic Safety Standards (BSS) has recently been established as Part 3 of the General Safety Requirements of the IAEA Safety Standards Series. The BSS are relevant to all facilities and activities which may give rise to exposure to ionizing radiation, as well as to existing or unregulated radiation risks, such as risks due to radiation of essentially natural origin, including exposure due to radon in dwellings and workplaces. With regard to public exposure due to radon indoors, the BSS require that general information on radon, including information on health risks and the synergy with smoking, be made available to the public and other interested parties. Countries are also required to determine whether an action plan for controlling exposure due to radon indoors is necessary, and, if so, to establish and implement such an action plan. Guidance material to assist with the implementation of these requirements is currently being developed. The IAEA assists its Member States with the implementation of the BSS through its Technical Cooperation Programme. Support for work on radon has recently been provided through regional projects aimed at reducing public exposure. There is an increasing interest among Member States in reducing risks from indoor radon and the IAEA works closely with both the WHO and RADPAR in meeting these needs. RADPAR Workshop Radon Prevention and Remediation 116

118 RADPAR Brussels 23 February 2012 IAEA Programmes on Reducing Risks from Indoor Radon Tony Colgan Head, Radiation Protection Unit IAEA International Atomic Energy Agency Contents IAEA Safety Standards Basic Safety Standards Requirements and Guidance on Radon Assistance to Member States IAEA RADPAR, Brussels, February 2012 RADPAR Workshop Radon Prevention and Remediation 117

119 IAEA Safety Standards Safety Fundamentals high level underlying principles Safety Requirements specify obligations and responsibilities ( shall statements) Safety Guides recommendations to support requirements ( should statements) based on international best practices IAEA RADPAR, Brussels, February 2012 IAEA Safety Standards IAEA Safety Standards are developed in close consultation with Member States and with representatives of relevant international organizations 4 Safety Standards Committees: - waste, radiation protection, transport & nuclear safety Consultants meetings and technical meetings Consultation with Member States (120 days) Approval by Commission on Safety Standards and Board of Governors IAEA RADPAR, Brussels, February 2012 RADPAR Workshop Radon Prevention and Remediation 118

120 Development of safety standards Outline and work plan Preparation by the Secretariat Review by the committees and the Commission on Safety Standards Drafting and revision of safety standard by the Secretariat and consultants Review by the safety standards committee(s) Member States Endorsement by the Commission on Safety Standards SF and SRs: approval by Board SGs: approval by DG Establishment by the IAEA Director General or the Board Publication IAEA RADPAR, Brussels, February 2012 IAEA Safety Standards the BSS Regulatory infrastructure Occupational and public exposure from practices Safety of sources Safety of radioactive waste Medical exposure Existing exposure Emergency preparedness Rehabilitation Basis for safe transport The essential protection and safety requirements of the BSS underpin all circumstances of exposure to radiation IAEA RADPAR, Brussels, February 2012 RADPAR Workshop Radon Prevention and Remediation 119

121 Developing BSS Requirements on Radon December 2009, IAEA Headquarters, Vienna IAEA Technical Meeting: Newest Recommendations on Health Effects from Radon The Impact on Regulatory Requirements Chair: Participants: Mr Abel Gonzalez, Argentina approx. 80 experts and national representatives IAEA RADPAR, Brussels, February 2012 Per Caput Annual Dose UNSCEAR 2008 Medical Exposures 0.64 msv (21%) Fallout msv (<1%) Natural Sources 2.4 msv (79%) IAEA RADPAR, Brussels, February 2012 RADPAR Workshop Radon Prevention and Remediation 120

122 Per Caput Annual Doses from Natural Sources UNSCEAR 2008 Ingestion 0.29 msv (12%) Cosmic Radiation 0.39 msv (16%) External Gamma Radiation 0.48 msv (20%) Thoron Inhalation 0.1 msv (4%) Radon Inhalation 1.15 msv (48%) IAEA RADPAR, Brussels, February 2012 BSS Requirements on Radon Requirement 50: Public Exposure due to radon indoors The government shall provide information on levels of radon indoors and the associated health risks and, if appropriate, shall establish and implement an action plan for controlling public exposure due to radon indoors. Key components Information requirements apply regardless of national situation Measurement programme is required (not specifically a national radon survey) Action plan is required if high concentrations are identified/present IAEA RADPAR, Brussels, February 2012 RADPAR Workshop Radon Prevention and Remediation 121

123 BSS Requirements on Radon As part of its responsibilities as required in para. 5.3, the government shall ensure that: (a) information is gathered on activity concentrations of radon in dwellings and other buildings with high occupancy factors for members of the public through appropriate means such as representative radon surveys; (b) relevant information on exposure due to radon and the associated health risks, including the increased risks relating to smoking, is provided to members of the public and other interested parties. IAEA RADPAR, Brussels, February 2012 BSS Requirements on Radon Where significant radon levels are identified from the information gathered..the government shall ensure that an action plan comprising coordinated actions to reduce such levels in both existing and future buildings is established, which include.. The establishment of an appropriate reference level for dwellings not exceeding 300 Bq/m 3 ; The establishment of an appropriate reference level for workplaces not exceeding 1000 Bq/m 3 ; Making all reasonable efforts to reduce radon concentrations and exposures to a level where protection can be considered optimized; Giving priority to reducing radon concentrations in those situations where such action is likely to be most effective; Inclusion of appropriate radon prevention and mitigation measures in building codes to prevent radon ingress and to facilitate potential remediation actions wherever necessary. IAEA RADPAR, Brussels, February 2012 RADPAR Workshop Radon Prevention and Remediation 122

124 Guidance on Implementation Safety Guide: Protection of the Public from Indoor Exposure to Natural Sources of Radiation (DS421) Covers radon, thoron and gamma radiation Discusses responsibilities of the national authority Develops approach to controlling natural radioactivity in building materials (reference level of 1 msv) Addresses radon control from three perspectives: radiation protection, public health and indoor air quality Cross-references and consistency with WHO Guidelines To be sent to Member States for comment in April 2012 IAEA RADPAR, Brussels, February 2012 Assistance to Member States The Technical Cooperation Department of the International Atomic Energy Agency helps to transfer nuclear and related technologies for peaceful uses to countries throughout the world. Training courses Expert missions Fellowships Scientific visits Equipment disbursement The Technical Cooperation Programme provides the necessary skills and equipment to establish sustainable technology in the counterpart country or region. IAEA RADPAR, Brussels, February 2012 RADPAR Workshop Radon Prevention and Remediation 123

125 Assistance to Member States The TC Programme disburses more than US $70 million worth of equipment, services, and training per year in approximately 100 countries and territories which are grouped into four geographic regions: Africa Asia & Pacific Europe Latin America Work on radon is supported through TC projects on the reduction of public exposure. IAEA RADPAR, Brussels, February 2012 Assistance to Member States Example: Bulgaria Nov. 2009: March 2010: May 2011: Nov. 2011: Training course on Setting up and Implementing a National Programme to Reduce Exposure to Radon in Homes. Meeting to discuss key components of a national radon survey. Meeting of the Interdepartmental Committee of Bulgaria on establishing a National Radon Strategy. National Workshop on Reducing Risks from Indoor Radon: the Role of Building Professionals. RADPAR and WHO were involved in all 4 missions to Bulgaria IAEA RADPAR, Brussels, February 2012 RADPAR Workshop Radon Prevention and Remediation 124

126 Previous Workshop November 2010, WHO Headquarters, Geneva Regional Workshop on Reducing Risks from Indoor Radon A Joint IAEA-WHO Indoor Radon Meeting in cooperation with the EC, the Swiss Federal Office of Public Health and UNSCEAR Participants: Topics: Armenia, Bulgaria, Croatia, Estonia, Georgia, Kazakhstan, Lithuania, Former Yugoslav Republic of Macedonia, Malta, Montenegro, Moldova, Serbia, Tajikistan, Ukraine. - the national radon survey - other radon measurement techniques - reducing radon exposure - large scale radon measurement campaigns - communication: public, professionals, decision-makers IAEA RADPAR, Brussels, February 2012 Planned Workshops 2012 Europe Asia IAEA RADPAR, Brussels, February 2012 RADPAR Workshop Radon Prevention and Remediation 125

127 Thank you for your attention IAEA RADPAR, Brussels, February 2012 RADPAR Workshop Radon Prevention and Remediation 126

128 2.6. Novelties in the Belgian radon policy, André Poffijn, Federal Agency for Nuclear Control, Belgium. In the past the radon programme in Belgium focussed mainly on private buildings and on remediation of the high exposed category (> 800 Bq/m³). In the near future prevention and control of radon exposure at work will become priority items. For the control of radon exposure at work the notion of radon risk area has been described in detail and has been extended to be applicable to radon exposure due to former and current NORM activities. For the realisation of the protection against radon in all new dwellings, the Walloon government - competent for the building code - has developed a specific action programme that puts the general objectives for radon as described in the general programme Environment and Health, into practice. As part of the research on the role of radon in the prevalence of other diseases than lung cancer, an etiological study on radon and thyroid cancer has been performed in close collaboration with the Scientific Institute of Public Health and the Belgian Cancer Register. The outcome, a statistically significant correlation, will be investigated as to its biological plausibility. RADPAR Workshop Radon Prevention and Remediation 127

129 Novelties in the radon policy in Belgium André Poffijn Radpar workshop Brussels February Overview At the federal level Geogenic and androgenic risk areas Monitoring in workplaces Completion of geological radon mapping study Study on diseases other than LC Low energy constructions At the regional level Radon action plan Set-up of a radon lab in Wallonia RADPAR Workshop Radon Prevention and Remediation 128

130 At the federal level Geogenic and antrogenic radon risk areas Radon and non LC diseases Geogenic and antrogenic radon risk areas The notion of radon risk area is powerfull tool for controlling all radon exposure situations At home regional & federal competence At work federal competence was not clearly defined in regulation RADPAR Workshop Radon Prevention and Remediation 129

131 Geogenic and antrogenic radon risk areas Detailed study and description of radon risk areas by the FANC in period Published in the Belgian Official Journal of The notion extended from geogenic radon risk area to antropogenic radon risk area to include radon exposure situations from industrial origin (e.a. old phosphogypsum dump sites) Some antropogenic radon risk areas defined at cadastral parcel level Radon and non LC diseases Radon and thyroid cancer and leukemia Collaboration with Institute for Public Health and Cancer Register RADPAR Workshop Radon Prevention and Remediation 130

132 Rn & thyroid cancer incidence in Belgium Study design Ecological study (radon & thyroid data at commune level) Study area : 120 communes (> 20 long term measurements per commune) Reference population: Wallonia Study period: Total population:~ Total number of thyroid cancers in study area: 800 (M: 195 & F:605) is about 51% of total in Wallonia RADPAR Workshop Radon Prevention and Remediation 131

133 Results Pearson correlations Spearman correlations Thyroid p Thyroid p ln(rn) 0, ,0029 0, ,0222 sd[ln(rn)] 0, ,0041 0, ,0065 var[ln(rn)] 0, ,0059 0, ,0065 [ln(rn)]² 0, ,0018 0, ,0136 Pearson correlations Spearman correlations Leukemia p Leukemia p ln(rn) -0, ,4837-0, ,0711 sd[ln(rn)] -0, ,7903-0, ,1695 var[ln(rn)] -0,0287 0,7557-0, ,1695 [ln(rn)]² -0, ,4715-0,1699 0,0636 Discussion Statistical evidence for relation Rn-Thyroid cancer Necessity for biological plausibility High amounts of classical & Berkson error RADPAR Workshop Radon Prevention and Remediation 132

134 At the regional level Radon action Plan Radon lab Radon action plan Action programme environment-health (PARES) Radon = priority action 10 General objectives: Prevention for new constructions and renovations Remediation support for low income category In 2011 CPES stimulated and coordinated (participants from federal, regional, provincial institutes, BBRI, building confederation, association of architects) the transposition of these objectives in operational action plan Document submitted to Walloon government end 2011 RADPAR Workshop Radon Prevention and Remediation 133

135 Major points Site certification for radon (radon potential) Obligation for prevention in all new buildings (technical details to include in building logbook) Training (professionals, ) Improved radon mapping (karst, hydrogeology,...) Extended financial support for remediation Testing of all workplaces belonging to the Walloon government (also e.a. archeological mining sites) Information and sensibilisation Radon lab In the past measurements (majorly) done by NRC Mol and University Gent (Makrofol) Need to set-up a (sustainable) radon lab in Wallonia Realised end 2010 at the institute Hainaut Vigileance Sanitaire (HVS) in Mons (CR-39) RADPAR Workshop Radon Prevention and Remediation 134

136 Quality tests Quality control tests (2011) Side by side tests in 40 houses Laboratory intercomparison in Japan Field intercomparison in Spain Fully operational!! The Belgian Radon family RADPAR Workshop Radon Prevention and Remediation 135

137 RADPAR Workshop Radon Prevention and Remediation 136

138 2.7. Radon Measurement Standardization (ISO 11665), Roselyn Ameon, Institut de Radioprotection et de Sûreté Nucléaire, France. International Standardization Work on the Measurement of Radon in the air Roselyne AMÉON RADPAR Workshop - Radon Prevention and Remediation Brussels 2012 Context Due to the universal presence of Rn and as the Rn exposure is estimated to contribute up to 52% of the total natural internal dose, environmental assessment studies are regularly commissioned to assess the Rn exposure of the public/workers The credibility of such studies relies on the quality and reliability of Rn analysis as well as the sample representativity of the radiological situation. Measurement results has to be comparable to similar measurements performed in other parts of the world The standard-setting approach, based on consensus at the international level, seemed to lend itself to a settlement of technical aspects of potential comparison Two WG of the International Standardization Organization (ISO) are presently drafting standards on the measurement of Rn and its decay products in air and in waters as well as its release into indoor and outdoor environments. RADPAR Workshop - Radon Prevention and Remediation Brussels February 2012 RADPAR Workshop Radon Prevention and Remediation 137

139 International Standardization Organizations Dealing with Radon Measurement Organization of standardization International Electrotechnical Commission (IEC) Equipment standardization IEC : instrumentation of measurement of Rn and its decay products (published) International Standardization Organization (ISO) Measurement methods standardization ISO : measurement of Rn and its decay products in air (under way) ISO : measurement of Rn and its decay products in water (under way) RADPAR Workshop - Radon Prevention and Remediation Brussels February 2012 RADPAR Workshop Radon Prevention and Remediation 138

140 International Standardization Organization ISO TC TC85 Nuclear Energy TC 147 (35P, 52O) Water Quality SC SC SC2 (24P, 6O) Radiological Protection SC SC WG. WG 4 Radiological Measurement WG. WG 17 Radioactivity measurement RADPAR Workshop - Radon Prevention and Remediation Brussels February 2012 Stages of the development of ISO Standards Stage 1: Proposal stage Stage 2: Preparatory stage Stage 3: Committee stage Stage 4: Enquiry stage Stage 5: Approval stage Stage 6: Publication stage Stage 7: Review New work item Working draft Committee Draft Draft Int. Standard Final Draft Int. Standard International Standard Revised International Standard RADPAR Workshop - Radon Prevention and Remediation Brussels February 2012 RADPAR Workshop Radon Prevention and Remediation 139

141 Standardization Work on Radon-222 Measurement in Air TC85-SC2-WG17 D. Calmet, R. Améon, T. Beck, S. Brun, P. De Jong, J.M. Duda, M. Herranz, M. Jiranek, A. Klett, R. Michel, T. Richards, K. Rovenska, C. Schuler, S. Tokonami and M. Woods Measurement of Rn in Air Concerning the risk linked to Rn exposure, as stated by the World Health Organization (WHO), the greatest exposure is due to the inhalation of indoor Rn The standard-setting work of the TC85/SC2/WG17 on Rn measurement in air is intended for persons in charge for the initial characterization of a site with respect to the natural radiation burden as well as to those performing the routine surveillance of Rn activity levels, which includes systematic and periodic inspection of specific sites, such as those in the Rn prone areas 13 States participate in the drafting of the Rn standards in TC85/WG17 RADPAR Workshop - Radon Prevention and Remediation Brussels February 2012 RADPAR Workshop Radon Prevention and Remediation 140