SPRINGFIELD — Do you know that federal and state guidelines recommend testing your home for the presence of radon? This radioactive gas seeps undetected into homes from the ground, and such indoor exposure over time at elevated levels is the leading cause of lung cancer after smoking and the leading cause of lung cancer among nonsmokers.
“Radon is an odorless, tasteless gas, and people have no idea that it is in their homes. They need to be made more aware of it and the risk it poses,” said Dr. Laki J. Rousou, medical director of the Lung Cancer Screening Program at Mercy Medical Center.
The U.S. Environmental Protection Agency attributes the main source of radon in homes to soil in contact with basement floors and walls. The gas is produced from the natural radioactive decay of uranium, which is present in all rocks and soils.
Some geographical areas have higher-than-average radon levels, but any home can be at risk, according to a recent report from the American Lung Association. The report says 21.8% of radon tests in Massachusetts were at or about the required mitigation level recommended by the EPA.
Get it tested
The Massachusetts Department of Public Health recommends all homes and schools be tested for radon and has comprehensive online information about testing and mitigation at mass.gov/radon. Homeowners may request a free radon test kit from the DPH by calling 800-723-6695, or consider hiring a radon measurement specialist certified by either the National Radon Safety Board or the American Association of Radon Scientists and Technologists’ National Radon Proficiency Program.
Radon mitigation specialists are similarly certified, and specialists can be found by ZIP code on those two sites.
Ed Wagner, a Massachusetts-licensed home inspector, has been testing for radon in homes and commercial buildings since the early 2000s. He encountered skepticism during those early years of testing as a part of real estate transactions, hearing comments about there being “no dead spiders in the basement” to indicate a need for it or radon gas trucks on the street.
He said today that homebuyers, particularly younger ones, are more knowledgeable about radon, and that a much higher percentage want testing done, because they are aware of the effects.
“Information is readily accessible online, and younger people are internet savvy,” said Wagner, who holds certification as a radon measurement specialist from the National Radon Safety Board. “Interest among homeowners is also driven by people working from home, sometimes in basement offices.”
Wagner uses electronic testing instruments that give hourly readings and follows EPA guidelines, which say there should be 12 hours to at least 48 hours of closed-house conditions for minimum testing. Wagner likes to test an additional 48 hours, as the presence of radon gas in a home can be cyclical.
Wagner, whose Easthampton-based Wagner Inspection Inc. tests in all four counties of Western Massachusetts, said he tends to recommend that residents put in a system to reduce radon gas levels in their home “over 50% of the time.” He said that testing specialists often see higher radon levels than what more generalized, often older data might reflect.
Some areas have high levels
The EPA has mapped radon zones across the country that show areas where there is the greatest potential for elevated indoor readings, but he stressed that all homes should be tested.
“You can test one house on a street that could register very high radon levels, while a neighbor’s residence could be very low,” Wagner said. “You don’t know the level in any one individual house, unless you test the home. This is the message I try to push and so has the EPA. It can be a real wake-up call for people but one that can reduce their health risks.”
The indoor concentration of radon gas is measured in picocuries per liter of air, with a picocurie being one-trillionth of a curie, the international unit of measurement of radioactivity.
The EPA recommends that all homes be tested for radon and action taken if the radon concentration is 4 picocuries per liter or higher. It recommends homeowners consider reducing the radon concentrations for homes measuring between 2 pCi/L and 4 pCi/L, as protracted exposure at these concentrations is said to also poses a risk.
The average indoor radon level is estimated to be about 1.3 pCi/L, according to the EPA, and about 0.4 pCi/L of radon is normally found in the outside air, where it dilutes quickly to lower concentrations and is generally not a problem.
What are acceptable levels?
Berkshire Radon Technologies owner Justin Zieminski is certified in both mitigation and measurement and analysis, but concentrates on mitigation in his Cheshire-based business. The majority of his radon reduction work in this state and New York is from real estate transactions, when a home being bought or sold is found to have 4 pCi/L or higher concentrations of the gas.
While every house is “a little different,” Zieminski said the most standard mitigation system, especially in homes with a concrete foundation and stone beneath, is a sub-slab depressurization system in which a hole is core drilled in the basement floor to create a negative pressure field underneath and exhaust the radon to the outside with the help of a fan and indoor or exterior piping.
“This system grabs the gas before it becomes airborne,” Zieminski said. “It is most effective in remediation and is a one-day job.”
A 2018 fact sheet from the Massachusetts DPH estimates that 628 radon-related lung cancers occur annually in Massachusetts, and that 650,000 homes in the state have radon levels that exceed the EPA action guideline of 4 pCi/L. It also estimates that 34,000 homes in Massachusetts have radon levels that exceed 20 pCi/L.
Dr. Laki Rousou is chief of thoracic surgery, chief of robotic surgery and medical director of the Lung Cancer Screening Program at Mercy Medical Center, part of Trinity Health Of New England. (Mercy Medical Center photo)Mercy Medical Center photo
Varying levels
In addition to being of the head of his hospital’s lung cancer screening efforts, Rousou is also the chief of thoracic surgery and chief of robotic surgery at Mercy Medical Center, part of Trinity Health Of New England.
Rousou said he has had a few lung cancer cases that he supposes were caused by radon, as they involved patients with a known exposure history and no history of smoking. He added, however, that exposure to elevated levels of radon in the home over time combined with a history of smoking creates a synergistic risk for lung cancer.
One study published by the Centers for Disease Control and Prevention quotes estimates that put the lifetime risk of radon-induced lung cancer at 62 per 1,000 “ever-smokers” versus 7 per 1,000 new smokers.
While there is annual screening for individuals with a history of smoking that puts them at risk for lung cancer, there are no protocols around radon exposure. Rousou said the “best prevention” is radon testing.
“Testing is the primary prevention and the best prevention,” said Rousou, who would like to see more public service announcements educating people, not only about the risks of domestic radon exposure but also the importance of testing their homes for level of exposure and addressing elevated levels.
Rousou noted that at least 21,000 lung cancer deaths are attributed to radon annually in the U.S.
“If you could prevent half of those 21,000 deaths in this country, you would have done a lot of good,” said Rousou.
Dr. Mary Jo S. Farmer, director of pulmonary hypertension services at Baystate Health, has used the webinar program on radon exposure that the Massachusetts Medical Society has on its website to educate primary care physicians and other medical workers.
She would like to see a question on radon exposure included among the data health care workers take on patients’ histories.
“If we asked about possible exposure in taking a history or if the patient has ever tested for radon, these would be ways we could raise awareness,” Farmer said. “The more education we as providers can do for ourselves and our patients, the better.”
Radon-associated lung cancer is known to have a long latency period, and federal government websites like that of the Agency for Toxic Substances and Disease Registry note many patients exposed to increased levels of radon might be asymptomatic for years.
Since 2015, new one- and two-family homes and townhouses in Worcester, Essex and Middlesex counties have been required to have a passive radon system installed when they are built.
No time like the present
January is National Radon Action Month and a good time to test in New England for radon, as winter heating systems disseminate the gas throughout a home. However, testing kits are available year-round from the Massachusetts Department of Health by calling 800-723-6695 and leaving a call-back number. Both the kits and lab processing of those kits are free and help is given on how to use the kit.
More information is available at mass.gov/radon. Radon mitigation systems can cost around $1,400 depending on the home. The EPA Consumer Guide to Radon Reduction can be found on its website.
The state also has a site on testing the water quality of private wells for contaminants that could include radon at mass.gov.
