Renewing the Fight Against Radon

March 1, 2022

As a certified home inspector, whether you think about it every so often or not, you are out there on the front line saving your customers from all kinds of misfortune—costly losses due to water damage, fire, personal injury, lawsuits, and even the long-term medical consequences of under-appreciated hazards that lurk below our day-to-day radar. Among the latter are the hazards of radon.

What is Radon?

Radon is a naturally occurring radioactive gas that unnaturally concentrates within homes in areas with problematic trace uranium-containing geology. Long-term exposure to elevated radon concentrations can lead to lung cancer. Seasonal and weather dependent indoor/outdoor temperature/pressure differential draws the gas into homes from the soil below.

The EPA’s maps, which you can find at epa.gov, are simply a starting point to understanding the risk. The hazard of radon in homes has only been appreciated since the 1980s, and despite the efforts of government and nonprofits to encourage the testing of homes, many homes have yet to be properly tested.

The Need for Long-Term Monitoring

As important as radon assessments are, there has been confusion over the appropriate roles for short and longer-term measurements. According to a 2019 study by the University of Calgary, there is a R2 = 0.805 correlation between five-day testing and 90+ day testing in central Canada, and there is essentially zero (R2 = 0.011) correlation between five-day winter testing and five-day summer testing. Longer term testing across several seasons is needed for accurate radon assessments.

Radon Exposure is Increasing

Modern homes are built with more efficient and better-sealed moisture barrier membranes and a higher degree of insulation than in the past. Despite the desired improvement in energy efficiency, this has led to a lesser degree of passive ventilation. The same study by the University of Calgary points out that higher footprint homes provide more opportunity for radon intrusion, and low-rise construction promotes greater accumulation in living spaces, as does increased ceiling height. This is especially true in the case of larger basement square footage and taller basement ceilings.

Lifestyle effects are also pointed out: We now spend an estimated 87% of our time indoors, and the use of air conditioning is increasingly prevalent. Frequent opening of windows is consequently now a less common behavior. Necessary to an acceptable energy efficiency, air conditioning recirculates residential air, thus increasing the opportunity for the accumulation of radon in summer months.

The Scourge of Lung Cancer

In the US, 228,820 new cases of lung cancer were diagnosed in 2019, according to the American Cancer Society. The majority of these cases were diagnosed at Stage IV. There can be few symptoms that rise to the level of seeing one’s doctor early enough—a persistent cough, shortness of breath, wheezing, hoarseness, or repetitive episodes of bronchitis or pneumonia are the usual triggers for office visits.

The difficulty in treating lung cancer can be seen in comparing the number of new diagnoses in the US per year to the number of lung cancer deaths in the US per year (135,720 in 2019 according to the American Cancer Society). The National Cancer Institute’s “SEER” database estimates the five-year survival rates of small cell lung cancer and non-small cell lung cancer, independent of stage, at 6% and 24% respectively, the American Cancer Society says.

The EPA has estimated that the number of US lung cancer deaths due to radon is 21,000 per year. Thus, 21,000/135,720 x 100 indicates 15.5% of all lung cancer cases may be attributable to radon.

The EPA has estimated that the number of U.S. lung cancer deaths due to radon is 21,000 per year.

Thus, 21,00/135,720 x 100 indicates 15.5% of all lung cancer cases may be attributable to radon.

In the US, the average lifetime cost of lung cancer diagnosis and treatment is about $282,000 per case, according to an article on healthpayerintelligence.com. There is a wide variation, depending upon the interventions recommended and their effectiveness, but if we take the number at face value, we can estimate an annual cost of radon-induced lung cancer to the US health care system: 228,820 new cases/year x 15.5% x $282,000 = $10 billion/year.

The result is a big number—especially for something that is to some degree preventable. So, who pays? The answer is we all do, through private insurance premiums, through the taxes we pay that support Medicare and Medicaid, and out of our own pockets in the form of deductibles, co-pays, and our charitable contributions.

Screening for Lung Cancer

Since diagnosis of lung cancer is most often made at later stages, to reduce overall costs, low cost non- (or minimally) invasive screening techniques are needed for use prior to the appearance of symptoms. For now, annual low-dose CT scans remain the only approved method for screening of non-symptomatic individuals. Such screening involves the risky exposure to x-ray radiation at a level (1.4 mSv) equivalent to 14 chest x-rays and the false positive rate is significant (356 false positives if 1,000 individuals are screened each year for three years).

Due to its costs and its risks, the Centers for Disease Control and Prevention guidelines are that low-dose CT scans are justified only for past or present heavy smokers in the 55 to 80 age bracket. Private insurance and Medicare pay (more or less) accordingly. Confirmation via visual bronchoscopy and biopsy remains necessary. Thus, for now, early diagnosis remains a difficult proposition, and we must double-down on prevention.

Prevention is Our Best Strategy

In the case of smoking—the leading cause of lung cancer—concerted anti-smoking campaigns have substantially contributed to improved public health. Though messaging on radon has been but a fraction of that devoted to smoking, public awareness of the need for testing our homes for radon is slowly growing.

Legacy testing methods (plastic track detector chips and activated carbon packets) are exposed for a period of time and then sent away to a laboratory for analysis. These are referred to as passive detection methods. Both have made important contributions to prevention, but they are generally deployed only for days to months and thus are mostly used for getting an average result readout. They must also be deployed in a single location.

Newer electronic (“active”) detection devices operate with either semiconductor-based or ion chamber-based detection technology. Both have been engineered into different device incarnations suitable for three essential roles: sniffing devices (meaning the rapid location of hot spots), certified testing devices (meaning devices suitable for professional reporting that can be re-calibrated), and consumer devices (products consumers may use to determine whether their situation warrants calling in a professional).

At both the professional and consumer level, these devices have been engineered for convenient mobile device reporting and the graphical representation of data over time. At the consumer level, these devices are particularly well suited for the long-term visualization of data across multiple seasons and in multiple locations within a home. As such, they make great “leave behinds” after inspections where radon levels are seen to be approaching action levels.

In Conclusion

The home inspector, mindful of it every day or not, has a laudable mission: to save their customers time and money while preventing losses, injury, or even life-threatening health outcomes. That sounds very close to superhero status in our book! And when it comes to all aspects of radon detection, both professional and consumer, we at Ecosense are proud to be a trusted partner in your efforts.

Ecosense is an innovator in the radon monitoring industry—providing people peace of mind through intelligent and highly accurate radon detectors for homes, educational campuses, assisted living centers, community centers, and commercial buildings.

Ecosense is a proud ASHI Affiliate Member.


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