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  • UV and ionizing radiation

    v1.3 uv 150

    Some radiation can cause health effects.

    Solar radiation is beneficial for our body as a source of vitamin D, however excessive exposure may pose a threat to health. Ultraviolet (UV) radiation causes premature ageing of the skin and may lead to the development of malignant melanoma.

    Radon is a gas emitted by certain types of soil and building materials, which can cause lung cancer.


    Worldwide, the incidence of melanoma has been increasing, also in younger age groups. Children are those most at risk from excess exposure to UV radiation, due to still developing skin protection mechanisms and long time available for developing a skin tumor. Moreover, many people increase their exposure through artificial sources in solariums. Raising awareness and encouraging skin protection are the most effective preventive strategies.

    Radon in soil or in building materials is the most important source of exposure to ionizing radiation from environmental sources, which can lead to development of lung cancer.

    ENHIS information

    UV and ionizing radiation policy in the pan-European Region: information and assessment

    The indicators below describe pressure, exposure, health effects and action for the issue under scrutiny. Indicator-based assessments cover all countries in the WHO European Region and provide information on the environment and health context, the policy relevance and context, as well as suggestions for further monitoring. When available, case studies of health impact assessment (HIA) are also presented.


    Indicator-based assessments

    Chart data

    Database

    HIA case study

    Incidence of childhood leukaemia

    X

    Incidence of melanoma in people aged under 55 years

    X

    Policies to reduce the excessive exposure of children to ultraviolet radiation

    X

    Radon levels in dwellings

    X

    X

    These indicators contribute to monitoring the health effects of environmental exposures towards the achievement of four priorities goals for the pan-European Region (so called regional priority goals, RPGs) set by the Fourth Ministerial Conference on Environment and Health in 2004, and on which the 53 Member States of WHO/Europe have committed to take action.

    For the definition and other details about each indicator, please read the metadata section within the assessment and read the information on indicator methodology.

    11 January 2008
    UV and ionizing radiation
    Policies to reduce the exposure of children to ultraviolet radiation
    Excel_ENHIS_datasheetFS4.8

    4.8. Policies to reduce the excessive exposure of children to ultraviolet radiation

    Fig. 1. Degree of implementation of action to reduce expusure of the population to UVR in 26 countries in the WHO European Region, 2006

    country

    UVA1M

    Albania

    1

    Georgia

    1

    Poland

    1

    Slovenia

    1

    Uzbekistan

    1

    Bulgaria

    2

    Estonia

    2

    Greece

    2

    Italy

    2

    Netherlands

    2

    Romania

    2

    Belgium

    3

    Czech Republic

    3

    Croatia

    3

    Hungary

    3

    Austria

    4

    France

    4

    Lithuania

    4

    Spain

    4

    Finland

    5

    Portugal

    5

    Slovakia

    5

    Sweden

    6

    TFYR Macedonia*

    6

    Belarus

    7

    Malta

    7

    4.8. Policies to reduce the excessive exposure of children to ultraviolet radiation

    Fig. 2. Action to reduce the excessive exposure of children to UVR in 26 countries in the WHO European Region, 2006

    e. Existence of laws to promote shade structures in public places

    f. Existence during the two last years of campaigns to promote shade structure in public places

    h. Existence during the two last years of state campaigns to raise awareness of sun dangers among tourists in tourist agencies

    d. Existence of sun protection programs in schools

    g. Existence of laws to regulate use of sun beds among children and teenagers

    a. Existence during the two last years of campaigns to improve behaviors to protect children against UV on TV or radio

    b. Existence of a national specific website dedicated to UV exposure and skin cancer prevention

    c. Existence of a daily solar UV Index reported through meteorological office or at TV during summer

    negative

    92,31%

    84,62%

    76,92%

    65,38%

    57,69%

    38,46%

    34,62%

    19,23%

    middle

    11,54%

    26,92%

    11,54%

    42,31%

    positive

    7,69%

    15,38%

    23,08%

    23,08%

    15,38%

    50,00%

    65,38%

    38,46%


    11 January 2008
    UV and ionizing radiation
    Radon levels in dwellings
    Excel_ENHIS_datasheetFS4.6

    4.6 Radons levels in dwellings, May 2007, http://www.enhis.org

    Fig. 1. Estimated annual mean radon levels in dwellings, selected European countries

    United Kingdom

    20

    Min

    20

    Netherlands

    23

    33% percentile

    48.88

    Romania

    45

    median

    56.5

    Poland

    49

    66% percentile

    88.38

    Germany

    50

    Max

    140

    France

    63

    Spain

    90

    Austria

    97

    Finland

    120

    Czech Republic

    140

    4.6 Radons levels in dwellings, May 2007, http://www.enhis.org

    Fig. 2. Estimated proportion of dwellings with radon levels >= 200 Bq. / m**3, selected European countries

    Netherlands

    0.3

    Min

    0.3

    United Kingdom

    0.5

    33% percentile

    3.455

    Poland

    2

    median

    5.95

    Germany

    3.5

    66% percentile

    8.35

    Hungary

    5.9

    Max

    18

    Spain

    6

    France

    8.5

    Austria

    12

    Finland

    12.3

    Czech Republic

    18

    4.6 Radons levels in dwellings, May 2007, http://www.enhis.org

    Fig. 3. Estimated proportion of dwellings with radon levels >= 400 Bq. / m**3, selected European countries

    Netherlands

    0.0001

    Min

    0.0001

    United Kingdom

    0.1

    33% percentile

    0.788

    Poland

    0.4

    median

    1.5

    Hungary

    0.8

    66% percentile

    2

    Germany

    1

    Max

    4

    Spain

    2

    France

    2

    Czech Republic

    3

    Finland

    3.6

    Austria

    4



    11 January 2008
    UV and ionizing radiation
    Incidence of melanoma in people aged under 55 years
    Excel_ENHIS_datasheetFS4.2

    Incidence of melanoma in people aged under 55 years, May 2007, http://www.enhis.org

    Fig.1. Age-standarddized rates of melanoma incidence in people aged under 55 years, selected Eureopean countries, 2002

    Melanoma of skin-Male (age 0-54)M

    Males

    Females

    Greece

    1.6

    2.0

    Bulgaria

    2.4

    2.1

    Romania

    2.2

    2.4

    Latvia

    1.5

    2.5

    Portugal

    2.1

    2.6

    Poland

    2.2

    2.7

    Slovakia

    3

    3.1

    Hungary

    3.1

    3.6

    Spain

    3.4

    3.7

    Estonia

    2.3

    4.1

    Italy

    4.9

    4.6

    Finland

    4.1

    5.0

    Czech Republic

    4.1

    5.8

    Germany

    4.7

    5.9

    Slovenia

    5.5

    5.9

    Ireland

    3.3

    6.1

    United Kingdom

    4.1

    6.8

    Lithuania

    1.6

    7.1

    Sweden

    5.9

    8.6

    France

    4.8

    8.9

    Netherlands

    6.4

    9.2

    Denmark

    6.9

    9.8

    Austria

    6.1

    10.0

    Norway

    9.1

    10.5

    Switzerland

    6.3

    10.9

    Iceland

    5.5

    16.4

    Incidence of melanoma in people aged under 55 years, May 2007, http://www.enhis.org

    Fig.2. Time trends of melanoma incidence in Norway and Sweden, 1953-1997

    CI5 volume

    Norway, males, 0-54 years

    Norway, females, 0-54 years

    Norway, males, 55-85+ years

    Norway, females, 55-85+ years

    Sweden, males, 0-54 years

    Sweden, females, 0-54 years

    Sweden, males, 55-85+ years

    Sweden, females, 55-85+ years

    1953-1957

    1.29

    1.53

    4.98

    5.54

    0

    0

    0

    0

    1958-1962

    2.04

    2.31

    7.52

    6.86

    1.87

    2.15

    7.58

    6.65

    1963-1967

    2.86

    3.47

    9.93

    8.89

    2.48

    3.15

    9.36

    8.7

    1968-1972

    4.23

    4.79

    12.1

    10.83

    3.37

    4.42

    13.66

    14.25

    1973-1977

    5.42

    7.73

    18.87

    16.45

    4.21

    4.95

    18.98

    17.11

    1978-1982

    6.21

    8.1

    23.89

    23.75

    4.76

    6.89

    25.63

    22.41

    1983-1987

    6.95

    10.39

    31.12

    31.62

    6.36

    8.43

    36.68

    28.95

    1988-1992

    8.91

    11.85

    47.16

    38.63

    7.18

    10.66

    48.3

    36.49

    1993-1997

    8.09

    11.96

    54.51

    45.42

    7.06

    10.79

    55.63

    42.2


    11 January 2008
    UV and ionizing radiation
    Incidence of childhood leukaemia
    Excel_ENHIS_datasheetFS4.1

    Incidence of childhood leukaemia,May 2007,http://www.enhis.org

    fig. 1 . Standardized estimates of leukemia in children aged under 15 years, selected countries, 1970-1999

    Country incidence

    Participating areas average

    Romania

    31.3

    42.4

    Portugal

    32.2

    42.4

    Poland

    32.3

    42.4

    Czech Republic

    36.8

    42.4

    Slovenia

    37.1

    42.4

    Hungary

    37.9

    42.4

    Slovakia

    37.9

    42.4

    Lithuania

    38.2

    42.4

    Serbia and Montenegro (Serbia)

    38.2

    42.4

    Bulgaria

    39.6

    42.4

    Belarus

    40

    42.4

    Estonia

    40

    42.4

    Iceland

    40.1

    42.4

    Netherlands

    40.7

    42.4

    United Kingdom

    41

    42.4

    Spain

    41.1

    42.4

    Ireland

    41.2

    42.4

    France

    41.3

    42.4

    Turkey

    41.4

    42.4

    Sweden

    41.7

    42.4

    Germany

    44.8

    42.4

    Malta

    45

    42.4

    Norway

    45.7

    42.4

    Denmark

    47.3

    42.4

    Switzerland

    48.3

    42.4

    Finland

    50.8

    42.4

    Italy

    53.9

    42.4


    11 January 2008
    Radon levels in dwellings
    Date of entry: 8 May 2007

    This summary presents an assessment of the estimated radon levels and proportion of dwellings with annual mean levels of radon above 400 Bq.m-3 for existing dwellings and above 200 Bq.m-3 for future dwellings in 11 European countries.


    Key message

    Average radon levels in dwellings vary widely within and between countries. In most countries the world average of 40 Bq.m-3 is exceeded (1). Countries with mainly sedimentary soils (e.g. Germany, the Netherlands, Poland and the United Kingdom) present lower or equivalent averages, whereas those with old granite soils (e.g. Austria, the Czech Republic and Finland) are more prone to radon emissions. If a common action level of 200 Bq.m-3 were to be defined, Austria, the Czech Republic and Finland would have to take remedial measures for more than 10% of the houses, as against under 3.5% in countries with sedimentary soil.


    Figures

    Presentation of data

    Fig. 1 shows the estimated arithmetic mean of indoor radon in each country, based on a review of national surveys carried out by the European Commission Joint Research Centre (JRC). There is almost 10 times the difference between the minimum (20 Bq.m-3), found in the Netherlands and the United Kingdom, and the maximum (120–140 Bq.m-3) reported for the Czech Republic and Finland. The maps also display those countries with insufficient or unreliable data.

    Fig. 2 and 3 show the percentage of radon measurements higher than 200 Bq.m-3 and 400 Bq.m-3. The countries with the highest mean radon levels also have the highest percentage of housing stock above these levels, indicating a higher proportion of houses requiring remedial action.

    Fig 1. Estimated annual mean radon levels in dwellings, selected European countries

    fig1 4.6

    Source: Dubois (2).

    Fig. 2. Estimated proportion of dwellings with radon levels ≥200 Bq.m-3, selected European countries

    fig2 4.6

    Source: Dubois (2).

    Fig. 3. Estimated proportion of dwellings with radon levels ≥400 Bq.m-3, selected European countries

    fig3 4.6

    Source: Dubois (2).

    Download Excel sheet with Figure Data

    Rationale

    The presence of radon in dwellings is an important indicator of the exposure of the population at the beginning and in the course of the process of reducing indoor radon. Considering the linear exposure/response relationship between radon and lung cancer risk, the arithmetic mean is the most relevant indicator to assess the impact on public health.

    The radon action levels of 200 and 400 Bq.m-3 allow for international comparisons, since most of the countries comply with the European guideline of 400 Bq.m-3 for existing houses and 200 Bq.m-3 for future dwellings.

    The 200 Bq.m-3 measurement enables a reliable comparison of the proportion of houses that exceed this level in different geographical areas since it is less sensitive to variability from the size of the samples than the 400 Bq.m-3 measurement.


    Health and environment context

    Radon is a radioactive gas coming from soils (mainly granites) and accumulating in houses. Radon concentration in air is measured as the number of transformations per second in a cubic metre of air (Bq.m-3). One Becquerel corresponds to the transformation (disintegration) of one atomic nucleus per second.

    Radon contributes up to 40% of the dose of ionizing radiation received by the population. Studies of cohorts of uranium miners clearly show a linear relation between exposure to radon and risk of lung cancer (3,4). This relation is modified by age, time since exposure and duration of exposure. Pooled analyses of key studies in China, Europe and North America have confirmed that radon in homes contributes substantially to the occurrence of lung cancers worldwide. On the basis of these studies, the International Agency for Research on Cancer (IARC) and the US National Toxicology Program have classified radon as a human carcinogen. There is also discussion of plausible leukemogenicity of radon (5).

    Recent findings from case-control studies on lung cancer and exposure to radon in homes completed in many countries allow for substantial improvements in risk estimates and, by pooling the studies, for further consolidation of knowledge. The consistency of the findings from the latest European and North American pooled studies clearly points to a need for global action (6,7). The recent pooled analysis of key European studies estimated that the risk of lung cancer increases by 16% per 100 Bq.m-3 increase in radon concentration. The dose–response relation seems to be linear without evidence of a threshold, meaning that the lung cancer risk increases proportionally with increasing radon exposure. Furthermore, the new results show that if a threshold exists, it should not be higher than 150 Bq.m-3.

    With these results and an estimated exposure mean for 29 European countries of 59 Bq.m-3, 9% of deaths from lung cancer per year in Europe were estimated to be attributable to exposure to indoor radon. The pooling studies agree on the magnitude of the risk estimates.

    In order to reduce the disease burden associated with radon, it is important that national authorities use methods and tools based on solid scientific evidence and sound public health policy. Mapping and distribution indicators can help to assess the level of burden yet to be expected for radon effects. Most countries have adopted national radon programmes to identify zones of higher concentration and provide information to the public.

    On the base of the new epidemiological results, WHO has developed a programme on public health aspects of radon exposure (8). This project is one of the high priority activities of the WHO radiation programme.


    Policy relevance and context

    There is no regulation or directive in Europe concerning radon. Instead, in 1990 the European Commission issued recommendation 90/143/Euratom on the protection of the public against indoor exposure to radon. This recommendation defined 400 Bq.m-3 as the level for considering remedial action in existing dwellings and 200 Bq.m-3 as the reference level for new dwellings (9). It has served as a reference for the development of policies against radon exposure in many countries. Although the recommendation sets the framework policy on indoor radon, there are diverse approaches in Europe: some countries do not have any regulations and many others have adopted an indoor radon level within the range 200–400 Bq.m-3 as the level for action or the reference level for new buildings. Only a few responsible authorities have developed detailed legislation specifying levels above which financial support for mitigation can be provided.

    Radon levels in indoor air can be lowered in a number of ways, from sealing cracks in floors and walls to increasing the ventilation rate of the building. Under-floor sump and extraction methods are considered to be the most efficient. Prevention of radon exposure in new buildings can be implemented through appropriate provisions in the construction phase. National building codes cover the issue of exposure to natural radiation in building construction and ventilation sections.

    In addition, all European Union member states already have or are drawing up provisions for implementing basic safety standards for the health protection of the general public, and workers in particular, in case of a significant increase in exposure due to natural radiation sources (including radon) in work places, as laid down in Title VII of Council Directive 96/29/Euratom (10).

    In 2006, the JRC launched the Radioactivity Environmental Monitoring (REM) project (11) with the aim of improving the collection, evaluation and harmonization of environmental radioactivity concentrations and the modelling of the migration of radioactivity in the environment. A central activity of REM is the monitoring and mapping of indoor radon (12).

    In 1995, WHO set up the International Radon Project (8) in which over 20 countries have formed a network of partners to identify and promote programmes that reduce the health impact of radon. The Project will review recommendations for levels of action and provide evidence-based recommendations for radon policies and radon programmes in countries. The project will also develop tools for radon communication.


    Assessment

    There are clearly huge differences between countries in terms of exposure to radon in dwellings in Europe. Countries with mainly sedimentary soils have low radon gas concentrations indoors. In our sample this concerns Germany, the Netherlands, Poland and the United Kingdom. Countries with large amounts of granite or uranium-rich soils generally have very high levels of radon.

    The wide variations also lead to very different health impacts in countries. As mentioned before, the overall estimate of lung cancer that can be attributed to radon is approximately 9% for Europe. Based on the methodology used in the European pooling study, attributable risk estimates range from about 3% of lung cancer deaths in the Netherlands or the United Kingdom to 21% in the Czech Republic. The public health gain due to remedial action for levels above 200 Bq.m-3, as well as the cost–effectiveness of such action, would also differ greatly between countries.

    At present it is impossible to assess the time trends of radon. Improvements in insulation techniques in the context of energy crises may have in fact led to an increase in radon levels in dwellings. Action programmes to reduce radon levels in old and new dwellings may have led to a reduction below certain guidelines, or to changes in radon distribution. The current indicator could serve as a starting point for making an initial assessment at the outset of radon programme activities.

    The estimated arithmetic mean in regions or countries would be a good indicator in following up modifications to buildings or other activities aimed at lowering radon levels in dwellings. Monitoring of the proportion of dwellings with radon levels above the point at which action is required will enable the effectiveness of programmes targeted at extreme levels to be evaluated.

    The indicator provides a good picture of the discrepancy concerning radon problems between countries and of the proportion of dwellings with levels above the European guidelines. It thus serves a baseline reference for future comparison. Countries with continuing radon programmes can use the information as interim monitoring results.


    Metadata

    Name: Radon levels in dwellings

    Definition: Estimated annual mean of radon levels in dwellings and proportion of dwellings with levels above 200 Bq.m-3 and 400 Bq.m-3

    Code: RPG4_RadEx1

    Data source

    The information comes from the JRC campaign to collect nationally available information for radon mapping in 34 European countries. The focal points in the country institutions in the relevant radon areas answered a questionnaire produced by the JRC. More information about the database used for each country is available on the European Forum on Radon Mapping web site (12).

    Description of data

    The indicator consists of a presentation per country of three important key values of the distribution of annual radon level in dwellings:

    • estimated arithmetic mean of radon concentration
    • estimated percentage of dwellings with annual mean levels of radon above 200 Bq.m-3
    • estimated percentage of dwellings with annual mean levels of radon above 400 Bq.m-3.

    Method for indicator calculation

    The estimated values are given by institutions which deal with indoor radon and maintain information about radon distribution over the country. The survey reference has been quoted as well as its period, the number of dwellings concerned and the method of sampling (Table 1).

    Note: In the United Kingdom, around 500 000 dwelling measurements have been taken but they were not random and are not used as reference data for the assessment of radon distribution in dwellings.

    Geographical coverage

    Austria, the Czech Republic, Finland, France, Germany, Hungary, the Netherlands, Poland, Romania, Spain and the United Kingdom.

    Period of coverage

    The data were collected in 2005 but the results concern widely differing periods between countries.

    Frequency of update

    Not specified yet.

    Data quality

    It is important to stress that the radon measurements were not made with a standardized protocol in all countries. In some countries the sample was selected randomly on a national basis, so that the results can be directly extrapolated in order to generate estimates. In others, the samples were not randomly selected and corrections were needed to estimate the radon distribution. Some countries relied on information from regional campaigns and did not give precise descriptions of the methodology used to assess the estimated distribution. Direct comparisons between results are, therefore, to be viewed with great caution.

    Radon levels are susceptible to change with modifications to buildings or the renewal of the building stock, or the efficiency of regional or national action programmes. Regular national surveys or targeted surveys of new buildings or buildings of concern are, therefore, necessary to assess the evolution or efficiency of a policy. Coordination between countries is necessary to promote the use of national (and/or regional) survey protocols with a minimum set of standard criteria allowing for direct comparisons. Furthermore, as radon levels are strongly linked to local geological characteristics, the ideal scale to assess and compare radon distribution would be the regional one. Regional mapping based on a standardized assessment protocol could be an excellent tool for making comparisons.

    For more information on meta data and calculation of this indicator, please refer to the methodology .

    Table 1. Sampling table

    Variablee

    Reference survey

    Geographical coverage

    Survey period

    Sampling strategy

    No. of dwellings

    Measuring equipment

    Other measuring technique

    Austria

    Austrian Radon Project

    National

    1991–2002

    Random and representative

    16 000

    SSNTD

    E-PERM

    Czech Republic

    National radon programme

    National

    1984–2004

    Random and representative

    150 000

    LR115, Kodak