Study examines increase in lung cancer risk from combined radon and tobacco smoke exposure

In the words of Dr. Ellen Hahn, professor in the University of Kentucky's colleges of nursing and public health, Kentucky has the "triple crown of lung cancer" - the country's highest rate of smoking combined with high rates of second-hand smoke exposure and high levels of radon exposure.

Nationally, has the highest mortality rates of all cancers. While the relationship between tobacco smoke and lung cancer is well known, there is less awareness among the general public about the dangers of radon exposure. In the United States, radon exposure is the second leading cause of lung cancer, behind smoking. Second-hand smoke exposure is the third leading cause.

And, if you're exposed to radon and tobacco smoke, either through personal use or second-hand smoke, your risk of lung cancer increases tenfold. Hahn's current study, FRESH (Freedom from Radon Exposure and Smoking in the Home), examines the synergistic risk between tobacco smoke and radon exposure and whether risk can be reduced through dual home screening and subsequent interventions.

Radon is a radioactive soil gas that is colorless, odorless, and tasteless. It enters buildings through the foundation and plumbing and becomes trapped in indoor spaces. When inhaled, radon causes immediate DNA damage before decaying into lead, which might stay in the body for decades. According to UK's Clean Indoor Air Partnership, exposure to radon is associated with an estimated 15,400 to 21,800 lung cancer cases in the United States each year, an estimated 3-14 percent of the total cases. Most radon-induced lung cancers are thought to be associated with low to moderate radon concentrations.

In Kentucky, radon exposure is variable but high, with about 40 percent of homes estimated to have radon exposure. The Clean Indoor Air Partnership reports that in Northern Kentucky, 19 percent of tested homes were at or above safe levels (4 pCi/L) in 2000-2004, compared with only 7 percent nationally.

"The whole state is in a high risk area for radon, according to the EPA," said Hahn.

She says that there's a myth that if you don't have a basement, you can't have radon exposure. The truth is that any type of building can have radon exposure, and her research indicates that there are high levels of radon in both urban and rural areas in Kentucky.

Unlike tobacco smoke exposure, which is observable and also detectable in hair and fingernails, radon exposure is only detectable through testing of indoor spaces, which is cost-effective and easy. If a building has unsafe levels of radon exposure, the radon can be mitigated from the soil by a certified mitigation specialist. Because there is no known safe level of exposure to radon, the Environmental Protection Agency recommends that Americans consider fixing their homes for between above 4.0 pCi/L. The mitigation process, however, can be expensive, ranging from $1,200 t o $2,500 depending on the size of a home.

Hahn's current FRESH study, originally supported by pilot funding from the UK Markey Cancer Center, UK College of Nursing, UK Got Grants Program and now supported by an R01 grant from the National Institutes of Health, aims to prevent lung cancer by addressing the dual risk of radon and tobacco smoke exposure in homes through testing for exposure and encouraging risk reduction actions, including smoking outside (rather than inside) and radon mitigation. The study is still enrolling participants, and more information is available by calling 859-323-4587 or emailing

In addition to individuals taking action to test their homes and adopt behaviors to promote clean indoor air, Hahn hopes that more policy-level changes can help protect people from radon exposure. She points out that Kentucky has only two laws related to radon: that if a home has been tested for radon the results must be disclosed in a sale, and that only certified professionals can perform radon mitigation services. There are no laws in Kentucky obligating radon testing for single family homes or multi-unit residences, schools, or business, and no laws mandating radon-resistant construction of new homes, which costs around half as much as mitigation.

"The radon laws nationally are pretty weak," she said. "There are some states that lead the pack, like Illinois, because people have advocated for laws there. But I think it's just a matter of the policy keeping up with the science. It's not until relatively recently that the science of radon risk has been indisputable. But we know now that it's a leading cause of lung cancer and we need to disseminate that information."

Hahn also sees federal tax incentives for energy efficiency as a potential model for radon testing and mitigation.

For now, though, it's up to individuals to test their homes and pay for mitigation if necessary. Many local health departments have radon programs and provide free radon test kits. Most testing is short term, lasting 3-7 days, and as easy as setting the testing envelope on a bookshelf. Long term tests of 90 days are encouraged if tobacco smoking occurs in the home. County radon coordinators can provide test kits, and the Kentucky State Radon Program offers free radon test kits in counties without an established radon program. Radon test kits can also be purchased at local home improvement stores for $15-$25. The tests are then mailed, usually free of charge, for processing, and the lab mails or emails the results. Certified radon mitigation professionals can be found at

"There's so much you can do to prevent lung cancer," Hahn said. "But with , you can't fix it if you don't know you have a problem."

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Cancer control programs often don't address radon concerns

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Apr 25, 2014
First off Ellen Hahn is only a nurse not a Doctor of medicine. She basically is the lead anti-smoking advocate in Ky. She has kept a low profile these last 2 years after her botched Lexington economic impact study she claimed showed no harm when it did in the raw data she failed to point out. Then we had her E-CIG study where she made outrageous claims that could never be backed up.

Now she has the audacity to claim SHS is the third leading cause of LC in people.

Hahn is also trying to claim a synergistic effect when everybody knows synergism is impossible in the natural environment. The studies of direct smoking and pick the other exposure subject and insert here. Have at times showed higher rates of lesions yet these are cherry picked findings across the gammet of studies done.

Apr 25, 2014
When we look at the actual trends Kentucky's cancer rates are no different than any other states with less smoking prevalence.

As far as cancers go here is where it truly counts:

Lung and Bronchus. Invasive Cancer Incidence Rates and 95% Confidence Intervals by Age and Race and Ethnicity, United States (Table *†‡

Rates are per 100,000 persons. Rates are per 100,000 persons.

Note the age where LC is found…………..OLD AGE group incidence hits the 500/100,000 at age 75-85

AGE it seems is the deciding factor……….

http://apps.nccd....Site=All Cancer Sites Combined&Year=2010&Site=Lung and Bronchus&SurveyInstanceID=1

Apr 25, 2014
The ranking goes for all cancer deaths/mortality:

Per 100,000 population CDC NUMBERS/ smoking rates from tobacco free kids

Kentucky at 207 Adults in Kentucky who smoke* 29.0% (971,000)

Miss. 200 Adults in Mississippi who smoke* 26.0% (579,300)

West Virginia 196 Adults in West Virginia who smoke* 28.6% (420,500)

Louisianna 196 Adults in Louisiana who smoke* 25.7% (888,300)

Arkansas 193 Adults in Arkansas who smoke* 27.0% (601,400)

Alabama 190 Adults in Alabama who smoke* 24.3% (893,100)

Indiana 187 Adults in Indiana who smoke* 25.6% (1,259,300)

Maine 186 Adults in Maine who smoke* 22.8% (241,400)

Missouri 184 Adults in Missouri who smoke* 25.0% (1,149,600)

Delaware 184 Adults in Delaware who smoke* 21.8% (153,100)

South Carolina 182 Adults in South Carolina who smoke* 23.1% (831,200)

As we can see kentucky has the Highest rate but when we look at the map of kentucky cancer it shows us that its the Coal Mining Mountain region that sets Kentuckys state level Higher than all the rest. When we look at the local county levels they are pretty much in line with the rest of the country. Louisville reports roughly 750 cancer cases in 2010 by the chart yet no mention of out of state cases diagnosed there by the local 5 hospitals and cancer treatment done there by far attracting a higher base rate. Possibly inflating the kentucky numbers for louisville itself.

But even without removing the coal mining regions the rate trends precisely with other states..........

Apr 25, 2014
As far as Radon levels go for whats actually considered harmful the EPA is claiming (4 pCi/L) while during the debate period most said 20 pCi/L were safe. The EPA has a long history of lowering safe levels to the point that it destroys jobs and creates fear where no fear ever existed as is the case with second hand smoke. Even the direct smoking claims of disease seem to be nothing more than OLD AGE DISEASES quickly usurped back in the 1950s to be called tobacco related. To this day as Ellen Hahn full well knows they cannot produce one single toxicology study proving end point causation to anything deemed tobacco related.

In fact an 89 year old woman smoking for over 70 years is about to be evicted from here home over not stopping smoking as per edict from public housing authorities. They claim smoking kills you young so how did this woman smoke 2 packs a day for 3 generations and live!

Apr 25, 2014
Then we have the latest study on smokers lungs and transplants of heavy so called smokers for over 20 years. These smoking lungs had better survival rates post-transplant at 3 year terms.

Ive done the math here and this is how it works out with second ahnd smoke and people inhaling it!

The 16 cities study conducted by the U.S. DEPT OF ENERGY and later by Oakridge National laboratories discovered:

Cigarette smoke, bartenders annual exposure to smoke rises, at most, to the equivalent of 6 cigarettes/year.


A bartender would have to work in second hand smoke for 2433 years to get an equivalent dose.

Then the average non-smoker in a ventilated restaurant for an hour would have to go back and forth each day for 119,000 years to get an equivalent 20 years of smoking a pack a day! Pretty well impossible ehh! .

Certainly we find second hand smoke was never a threat to anyone and the anti-smoking laws are based upon bigotry.

Apr 25, 2014
If anyone seriously looked at the actual chemical make up of second hand smoked theyd be laughing to high heaven at even a mention of it causing anything but odor annoyance to the most bigoted of people.

Yet a simple look at the chemistry shows us that its:

About 90% of secondary smoke is composed of water vapor and ordinary air with a minor amount of carbon dioxide. The volume of water vapor of second hand smoke becomes even larger as it quickly disperses into the air,depending upon the humidity factors within a set location indoors or outdoors. Exhaled smoke from a smoker will provide 20% more water vapor to the smoke.

4 % is carbon monoxide.

6 % is those supposed 4,000 chemicals to be found in tobacco smoke. Unfortunatley for the smoke free advocates these supposed chemicals are more theorized than actually found.What is found is so small to even call them threats to humans is beyond belief.Nanograms,picograms and femptograms......
(1989 Report of the SG pg. 80.)

Apr 25, 2014
Synergy Still Controversial

Synergy is an integral part of our methodology. A majority of scientists support the concept of a radon/tobacco smoke synergistic interaction that is more than additive; we used the conservative 10-fold estimate. Apart from the documentation of synergy between radon and tobacco smoke, however, synergy is largely ignored or virulently contested

Work in the laboratory of endocrinologist John McLachlan at Tulane University, reported by Steven Arnold and others (Science, 7 June 1996, p. 1489) found dramatic synergistic interaction between "hormonelike" chemicals in the environment. They reported that when two pesticides were tested together, their estrogenic activity shot up 160 to 1600 fold. They also found five-fold synergy with polychlorinated biphenyls (PCBs), which would have profound environmental implications.

The reaction to the work at Tulane was swift and aggressive. Few papers provoke the kind of response that followed in the scientific community. New studies were promptly done that failed to replicate the synergistic results found by McLachlan. In an unusual move, Dr. McLachan withdrew the synergy paper. From press reports one might conclude that synergy was proven not to exist. However, in the retraction letter that appeared in the July 25th issue of Science (1996) it is clear that the basic idea of synergy was not withdrawn, but rather the pronounced levels initially reported.

Apr 25, 2014
The U.S. national annual background dose for humans is approximately 360 mrem. A mrem, or millirem, is a standard measure of radiation dose. Examples of radiation doses from common medical procedures are:

Chest x-ray (14 x 17 inch area) - 15 mrem

Dental x-ray (3 inch diameter area) - 300 mrem

Spinal x-ray (14 x 17 inch area) - 300 mrem

Thyroid uptake study – 28,000 mrem to the thyroid

Thyroid oblation - 18,000,000 mrem to the thyroid

Average Annual Total
361 mrem/year

Tobacco (If You Smoke, Add ~ 280 mrem)

Not quite 1 dental xray for a whole years smoking ehh!


Thyroid oblation - 18,000,000 mrem to the thyroid /shrinking the thyroid

Tobacco (If You Smoke, Add ~ 280 mrem)

18,000,000 / 280 = roughly 64,000 years of equivalent years of smoking!



Apr 26, 2014

Dorothy Howe, 100, puts her longevity down to cigarettes and whisky.

Smoker Dorothy Howe has reached 100 - despite puffing through nearly half a million cigarettes in her lifetime.

The former secretary has smoked 15 a day since her first drag at 16, costing £193,000 at today's prices.

She says the killer habit is the key to her long life – plus a regular drop of whisky.

Widow Dorothy, of Saltdean, East Sussex, said: "I'm alive and can lift my elbows."

"When I started smoking, they cost 11d for 20.

"I keep saying I'll quit when they put the prices up, but that's not going to happen now."

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Apr 26, 2014
The Futile Crackdown
Philip E. Ross, 10.18.99

GOVERNMENTS, DECREEING zero tolerance of drugs, have 400,000 drug offenders in this country in jail. Mothers Against Drunk Driving persuades legislators to raise the drinking age and now wants to restrict advertising of alcohol. The Justice Department concocts a convoluted theory about how tobacco vendors deplete federal coffers and sends them a bill for $20 billion a year.

What you are witnessing is the New Prohibition. It is the Volstead Act all over again, in different guises. It aims to enforce clean living by edict. And it is almost certain to fail, as greatly as the last Prohibition failed in the 1920s.

These conclusions come from a small band of experts specializing in the history of temperance crusades. The urge to legislate health and sobriety comes in cycles spaced 60 or 80 years apart, they tell us, and the cycle is peaking right now. And yet, perversely, the result may be more tobacco and alcohol consumption a decade or two on.

"Every 80 years or so we come out with all these laws against people's personal, pleasurable pursuits: tobacco, alcohol, meat, sex," says Ruth C. Engs, a professor of applied health science at Indiana University in Bloomington, Ind. and author of Clean Living Movements: American Cycles of Health Reform, due out this winter. "Consumption of drugs, tobacco and alcohol peaked around 1980; the reform laws seem to be peaking now, and that means clear backsliding should occur by 2010."

The up-and-down cycle of addictions seems to have its own natural rhythm related to people's memories of what those addictions did to an earlier generation. But crackdown legislation, far from tempering these swings, probably aggravates them. Look at the paradoxical increase in teenage smoking of the past several years. There may be a certain forbidden-fruit glamour to the cigarette habit. The antitobacco crusade, that is, may be backfiring.

Engs explains the temperance rhythm: In the first third of the cycle, reformers agitate against the reviled behavior, which peaks and begins to decline. Only then--when the horse has fled the barn--does the electorate close the barn door with restrictive laws. In the middle third of the cycle, people either lose interest in the laws or actively rebel against them; this is when it becomes "cool" to flout the law. Engs says that the 4.6% rise in smoking by teenage girls over the past five years suggests that this lax phase is beginning with tobacco, whereas with alcohol the rebound in consumption is still a few years away.

In the last third of the cycle, the police barely enforce the laws still on the books, the banned behavior comes out into the open, and consumption continues to rise, but at a slower pace. Then it peaks, as another generation comes to witness the devastation wrought by drug use. And the cycle begins anew.

The crack-cocaine epidemic followed a course like this, although it took place in quintuple-time. This drug's addictive powers are so great--and its ability to destroy lives so complete--that the up-and-down cycle covered a span of only about a dozen years or so, trailing off in the late 1990s. Urban police departments responded to the epidemic with a wave of arrests that put millions of drug offenders in jail. But the enforcement action did not make crack go away, crack made crack go away.

The cycle is vicious, because most of the time we are overreacting to a previous generation's experiences. The lurching from one extreme to another is particularly exaggerated in America, where it dates back to the Puritan fathers themselves, although versions of it--with respect to alcohol, at least--can be seen in northern European countries, including Britain, Scandinavia and Russia. These colder cultures experience feasts and famines of ethanol, and they make quite a contrast with the southern European countries, which have neither the binges nor the temperance crusades. France, Italy and Greece have integrated wine into normal mealtime consumption since Roman times.

It is striking how pointless the laws against substance abuse generally are by the time they are introduced, how harsh the punishments quickly become, and how total is the switch to tolerance at the end. In each campaign, most of the decline in consumption came before the laws took effect.

There Oughtn't To Be a Law

Apr 26, 2014
The Health and Safety Executive (HSE) could not even produce evidence that passive smoke is significantly harmful inside, this is what they wrote prior to the smoking ban in article 9 OC255/15 9 "The evidential link between individual circumstances of exposure to risk in exempted premises will be hard to establish. In essence, HSE cannot produce epidemiological evidence to link levels of exposure to SHS to the raised risk of contracting specific diseases and it is therefore difficult to prove health-related breaches of the Health and Safety at Work Act". The reason the ban was brought in under the Health Act 2006, and not by the HSE, because no proof of harm was needed with the Health Act 2006, and the HSE have to have proof, seems the DM has lost rational thought about anything smoke related.

Apr 27, 2014
Dose Response. 2006 May 1;3(3):369-90. doi: 10.2203/dose-response.003.03.007.
Test of the linear-no threshold theory: rationale for procedures.
Cohen BL. "In a 1995 paper (Cohen 1995), data on lung cancer mortality rates, m, in 1601 U.S. counties were compared with radon exposure, r, in those counties. These data are displayed in the plot in Fig. 1a, which is explained in the caption. It is evident from that figure that there is a strong and statistically indisputable tendency for lung cancer rates to decrease as radon exposures increase, which is contrary to initial expectations from the fact that radon causes lung cancer."

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