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Research Letter | Public Health
Introduction
Supplemental contentRadon 222 is the leading cause of lung cancer in nonsmokers. 1 Children’s lung cancer risk from radon exposure may be up to 3-fold higher than adults exposed to the same radon amount. 1 Indoor spaces can have elevated radon levels due to lower particle dispersion. 2 Pennsylvania
Author affiliations and article information are listed at the end of this article.has the third-highest US average indoor radon levels. 3 In Pennsylvania, schools are not required to test for radon, despite Environmental Protection Agency (EPA) recommendations. Radon mitigation reduces indoor radon exposure after radon testing detects elevated radon. The EPA recommends radon mitigation at 4 pCi/L, whereas the World Health Organization recommends mitigation at or above 2.7 pCi/L. We estimated children’s annual additional radon and radiation exposure risk from public schools in 5 eastern Pennsylvania school districts.
Methods
This cross-sectional study followed the STROBE reporting guideline. Because we used publicly available deidentified data, no IRB review or patient consent was required. We used average indoor residential basement radon levels (AIRRL) data with spatial resolution based on zip codes to estimate school-based radon and radiation dose exposure to children attending five eastern Pennsylvania school districts. Pennsylvania Department of Environmental Protection (PADEP) collected these data from 1990 to 2022.5
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Using National Center for Educational Statistics district data, we matched the school’s zip code to PADEP average basement radon data for that zip code. To provide clinical context of annual school-based radiation dose, we converted the PADEP average indoor radon level for each zip code from picocurie per liter (pCi/L) to millisieverts (mSv) and millirem (mrem) (eAppendix in Supplement 1). We calculated the projected radiation exposure in mSv and mrem using the 2018 Protection Summary of International Commission on Radiological Protection (ICRP) Recommendations on Radon. We conservatively estimated annual school-based radon radiation exposure based on 1200 hours/school year.2
The statistical analysis was performed from April 21 to June 4, 2024.Results Based on our analyses, all children attending public schools in these 5 eastern Pennsylvania school districts (n = 39 195) may have radon exposure that exceeds the EPA recommended action level of 4.0 pCi/L ( Table , Figure ). Notably, 7651 children (19.5%) were found to attend public schools in zip codes where the AIRRL exceeded 11.0 pCi/L; within this highly exposed group, 3373 (44.1%) were elementary school students. Because of elevated school radon levels, these students may be exposed to additional potential annual radiation dose ranging from 1.37 mSv (136.84 mrem) to 5.98 mSv (598.93 mrem).
Open Access. This is an open access article distributed under the terms of the CC-BY License. JAMA Network Open. 2024;7(12):e2448676. doi:10.1001/jamanetworkopen.2024.48676 (Reprinted) December 3, 2024 1/4Downloaded from jamanetwork.com by Brian Yang on 12/03/2024