]]]]]]]]]]]]]    "INDOOR RADON AND ITS HAZARDS"       [[[[[[[[[[[[[[[
 Edited by David Bodansky, Maurice A. Robkin, and David R. Stadler.
 University of Washington Press, Seattle and London, 1987, pp. 147,
                     $9.95 paper, $20 cloth.

         Reviewed by Jane Orient, M.D. (Freeman 85716ORIE)

     Untold thousands of Americans are daily exposed, in their
own homes, to levels of radiation that would cause regulatory
agencies to shut down a uranium mine or a nuclear power plant.
The average annual dose due to indoor radon is about 300 mrem,
compared with 200 mrem from all other sources combined.  The
level proposed as a target for remedial action is 800 to 4000
mrem/yr.  In contrast, the total individual (nonoccupational)
exposure limit for Department of Energy facilities is 100
     This book explains the mechanism for generation and
accumulation of radon; describes methods for measuring and
reducing its concentration; and examines critically the basis for
the Environmental Protection Agency's estimate that as many as
20,000 lung cancers per year can be attributed to this naturally
occurring substance.  Given the uncertainties involved in
extrapolating from studies of uranium miners who experienced very
high doses, as well as the probable synergism of radiation and
smoking, the authors conclude that the actual number of cancers
due to radon might be well below the EPA's lower estimate of
5,000 per year.
     The discussion of the difficult problem of converting units
from picocuries to working level months to effective dose in
mrem or mSv was especially useful.
     The authors note the inconsistencies in the regulatory
approach and in popular reaction to various radiation hazards
(apparently depending on whether or not they can be blamed on
technology).  For example, the average individual long-term
radiation dose to residents of the western USSR due to the
Chernobyl catastrophe, including that from ingestion of
contaminated foods, is approximately 16 mrem/yr, less than one-
tenth of the estimated average annual effective dose equivalent
from indoor radon in the US.  While many persons clamor to reduce
dependence on nuclear energy (or to destroy the industry
entirely), no remedial action of any kind is required in the
event that conservation measures increase the indoor radon level.
     The goal of reducing exposures to ALARA ("as low as
reasonably achievable") has a very different meaning when applied
to industry and to houses with high radon levels.  The book cites
a National Council on Radiation Protection report:  "It is
desirable to minimize the impact by placing the remedial action
level [for indoor radon] at a point where as few buildings as
possible require remedial action" [emphasis added].
     While the authors allude to the importance of social,
financial, and civil liberties concerns, they tend to understate
the profound political implications of their analysis.  For
example, they do not mention that the cost of preventing a
single hypothetical cancer death in the remote future through
stringent standards for high-level radioactive waste management
(as opposed to random burial with simple precautions) is about
$220 million.  Regulatory ratcheting of standards for nuclear
power plants may cost as much as $2.5 billion per life saved,
while condemning 1000 extra Americans to an early death every
time a utility elects to build a coal-burning plant instead.
(These estimates were made by Bernard L. Cohen, an authority
quoted by these authors.)  Yet reducing radon levels in homes may
be considered unacceptably expensive.
     The authors' calm, reasoned response to the hazard of indoor
radon may seem complacent and even irresponsible to some
physicians, who have called radioactive wastes (especially at
Rocky Flats and the Savannah River plant) a "health and safety
emergency."  Yet the authors make a persuasive case for
maintaining scientific skepticism about the actual importance of
low-level radiation as a cause of cancer, and for keeping the
risk in perspective, as by comparisons with other ubiquitous
     Now that lawyers, real-estate developers, and legislators
have become aware of the radon problem, physicians can expect to
be asked more questions on the subject.  Although this book is
not easily accessible to the layman, its careful, well-documented
discussion of all the important technical issues will be
invaluable to those with a serious interest in radiation hazards.

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