The Perceived Health Risks of Indoor Radon Gas and Overhead Powerlines: A Comparative Multilevel Approach

Radon and overhead powerlines are two radiation risk cases that have raised varying levels of concern among the general public and experts. Despite both involving radiation—a typically feared and unseen health hazard—individuals' perceptions of the two risk cases may invoke rather different factors. We examined individual and geographic-contextual factors influencing public perceptions of the health risks of indoor radon gas and overhead powerlines in a comparative research design, utilizing a postal questionnaire with 1,528 members of the general public (response rate 28%) and multilevel modeling techniques. This study found that beliefs about the two risk cases mainly differed according to the level of "exposure"—defined here in terms of spatial proximity. We argue that there are two alternative explanations for this pattern of findings: that risk perception itself varies directly with proximity, or that risk is more salient to concerned people in the exposed areas. We also found that while people living in high radon areas are more concerned about the risks of indoor radon gas, they find these risks more acceptable and have more trust in authorities. These results might reflect the positive effects of successive radon campaigns in high radon areas, which may have raised awareness and concern, and at the same time may have helped to increase trust by showing that the government takes the health risks of indoor radon gas seriously, suggesting that genuine risk communication initiatives may have positive impacts on trust in risk management institutions.     

Technical and Democratic Values in Risk Analysis1

So, we can argue that the lay public are not fools in their attitudes about risk. That nonexperts should show more concern over hazardous waste facilities in their neighborhoods than radon levels in their homes is not a sign of irrationality (because aggregate and individual risks are greater from the radon), but simply a sign that nonexperts are working from a different set of criteria. These criteria are incorporated in what I call the democratic model. The democratic model evaluates risk based on its social and political consequences, such as possible disruption in the social fabric or a loss of communality. Lay criteria for assessing the impact of risk decisions are not explicit, like the those of the risk analyst, but are embedded in cultural values. Similarly, lay evaluations of risk incorporate substantive and procedural democratic values, such as the acceptability of processes for making decisions, the ethics of the distribution of risk, and the capacity to control a source of risk in the community's interests. Finally, the democratic model relates judgments about risks to the competence (Can we trust them?) and the legitimacy (Should we trust them?) of the social institutions that impose and control those risks. The public's judgments about risk are not inferior, but different, and arguably richer than those of the experts.     

Review of Radon and Lung Cancer Risk

Radon, a long-established cause of lung cancer in uranium and other underground miners, has recently emerged as a potentially important cause of lung cancer in the general population. The evidence for widespread exposure of the population to radon and the well-documented excess of lung cancer among underground miners exposed to radon decay products have raised concern that exposure to radon progeny might also be a cause of lung cancer in the general population. To date, epidemiological data on the lung cancer risk associated with environmental exposure to radon have been limited. Consequently, the lung cancer hazard posed by radon exposure in indoor air has been addressed primarily through risk estimation procedures. The quantitative risks of lung cancer have been estimated using exposure-response relations derived from the epidemiological investigations of uranium and other underground miners. We review five of the more informative studies of miners and recent risk projection models for excess lung cancer associated with radon. The principal models differ substantially in their underlying assumptions and consequently in the resulting risk projections. The resulting diversity illustrates the substantial uncertainty that remains concerning the most appropriate model of the temporal pattern of radon-related lung cancer. Animal experiments, further follow-up of the miner cohorts, and well-designed epidemiological studies of indoor exposure should reduce this uncertainty.     

Radon Risk Information and Voluntary Protection: Evidence from a Natural Experiment

This study examines the perceived risks and mitigating behavior of Maine households who received new information on their exposures to significant health risks from indoor radon. The observed responses of these households illustrate conceptual issues related to designing an effective risk information program. Despite the involvement of generally well-motivated homeowners and well-intentioned researchers and government officials, we conclude that the risk information approach used in Maine failed to induce appropriate, cost-effective voluntary protection. The results indicate that, after receiving radon test results, information on associated health risks, and suggestions on how to reduce exposures: perceived risks tended to understate objective risks by orders of magnitude, and there was no statistically significant relationship between mitigating behavior and objective risks. These results suggest that the formation of risk perceptions and subsequent behavioral adjustments involve complex interactions among information, contextual, socioeconomic, and psychological variables. Therefore, government programs that seek to reduce health and safety risks with information programs, instead of using more conventional enforced standards, must be crafted very carefully to accommodate this complex process.     

Lay Understanding of Synergistic Risk: The Case of Radon and Cigarette Smoking

The combination of radon and smoking produces a synergistic risk of lung cancer. Lay understanding of this risk was examined from the perspectives of mental models theory, the psychometric approach to risk perception, and optimistic bias. As assessed by interview, participants ( N = 50) had more extensive mental models for the risks of smoking than for the risks of radon or the combination of radon and smoking; 32% knew little or nothing about radon. Despite reading an informational brochure, their risk-perception ratings of the three hazards showed no perception of the synergy between smoking and radon risk, although the combined hazard was rated as less familiar but more controllable than the average of the single hazards ( p < .01). No evidence of optimistic bias for the health consequences of radon, or the combination of radon and smoking was observed. Participants appeared to be combining the single-hazard risks subadditively to arrive at their combined-hazard risk perceptions. Further research on the integration of perceived risks would be beneficial for designing optimal communications about synergistic risk.     

Risk assessment methodologies for passive smoking-induced lung cancer

Risk assessment methodologies have been successfully applied to control societal risk from outdoor air pollutants. They are now being applied to indoor air pollutants such as environmental tobacco smoke (ETS) and radon. Nonsmokers' exposures to ETS have been assessed based on dosimetry of nicotine, its metabolite, continine, and on exposure to the particulate phase of ETS. Lung cancer responses have been based on both the epidemiology of active and of passive smoking. Nine risk assessments of nonsmokers' lung cancer risk from exposure to ETS have been performed. Some have estimated risks for lifelong nonsmokers only; others have included ex-smokers; still others have estimated total deaths from all causes. To facilitate interstudy comparison, in some cases lung cancers had to be interpolated from a total, or the authors' original estimate had to be adjusted to include ex-smokers. Further, all estimates were adjusted to 1988. Excluding one study whose estimate differs from the mean of the others by two orders of magnitude, the remaining risk assessments are in remarkable agreement. The mean estimate is approximately 5000 +/- 2400 nonsmokers' lung cancer deaths (LCDSs) per year. This is a 25% greater risk to nonsmokers than is indoor radon, and is about 57 times greater than the combined estimated cancer risk from all the hazardous outdoor air pollutants currently regulated by the Environmental Protection Agency: airborne radionuclides, asbestos, arsenic, benzene, coke oven emissions, and vinyl chloride.     

Insights into the Societal Risk of Nuclear Power Plant Accidents

The elements of societal risk from a nuclear power plant accident are clearly illustrated by the Fukushima accident: land contamination, long‐term relocation of large numbers of people, loss of productive farm area, loss of industrial production, and significant loss of electric capacity. NUREG‐1150 and other studies have provided compelling evidence that the individual health risk of nuclear power plant accidents is effectively negligible relative to other comparable risks, even for people living in close proximity to a plant. The objective of this study is to compare the societal risk of nuclear power plant accidents to that of other events to which the public is exposed. We have characterized the monetized societal risk in the United States from major societally disruptive events, such as hurricanes, in the form of a complementary cumulative distribution function. These risks are compared with nuclear power plant risks, based on NUREG‐1150 analyses and new MACCS code calculations to account for differences in source terms determined in the more recent SOARCA study. A candidate quantitative societal objective is discussed for potential adoption by the NRC. The results are also interpreted with regard to the acceptability of nuclear power as a major source of future energy supply.     

Protective Responses to Household Risk: A Case Study of Radon Mitigation

This study analyzes the effectiveness of a mass-media radon information and testing campaign conducted in the Washington, D.C. area in the winter of 1988. Although an impressive number of test kits (approximately 100,000) were sold, the ultimate mitigation rates resulting from the campaign were extremely low. Analyses show that low mitigation rates cannot be explained by postulating that people's responses to radon are insensitive to the level of objective risk. They may instead be due to characteristics of the protective response required to reduce radon risk. Radon may be thought of as one of a family of household risks which have risk response profiles that make them particularly difficult for people to manage and remediate. Traditional information campaigns for such risks are likely to be ineffective; instead, they may require regulatory strategies or programs which provide active guidance and assistance.     

Risk Perceptions Toward Drinking Water Quality Among Private Well Owners in Ireland: The Illusion of Control

In rural areas where no public or group water schemes exist, groundwater is often the only source of drinking water and is extracted by drilling private wells. Typically, private well owners are responsible for the quality and testing of their own drinking water. Previous studies indicate that well owners tend to underestimate the risks of their well water being contaminated, yet little is known about why this is the case. We conducted a qualitative study by interviewing private well owners in Ireland to investigate their beliefs surrounding their water quality, which, in turn, inform their risk perceptions and their willingness to regularly test their water. Based on our findings we designed a theoretical model arguing that perceived control is central in the perceived contamination risks of well water. More specifically, we argue that well owners have the illusion of being in control over their water quality, which implies that people often perceive themselves to be more in control of a situation than they actually are. As a result, they tend to underestimate contamination risks, which subsequently impact negatively on water testing behaviors. Theoretical and practical implications are highlighted.     

Opportunities and Impediments for Risk-Based Standards: Some Views from a Workshop

Techniques for performing scientific risk assessments for a wide variety of chemical and radiological hazards present in the environment and workplace are available. Speakers at a workshop sponsored by the Environmental and Public/Occupational Health Standard's Steering Group addressed both the state-of-the-art in risk assessment and areas of difficulty that require further research. The Steering Group concluded that within the limits of the available data, risk-assessment techniques are a useful tool in decision-making. In the past, many government agencies have not been effective either in listening to public concerns or in communicating technical or scientific information about risks. This has been true at all levels of government. Workshop speakers discussed some ways that government agencies can more effectively communicate with the public. The Steering Group concluded that major efforts must be made to ensure that two-way communication takes place. Thus the results of the workshop show that effective management of risk requires both a scientific assessment of risk and a responsive consideration of the public's perception of risk. Intensive efforts must be made to ensure that effective two-way communication takes place between members of the public and the appropriate government agencies.     

Radon Testing Behavior in a Sample of Individuals with High Home Radon Screening Measurements

Although radon exposure has been identified as the second leading cause of lung cancer, fewer than 6% of U.S. homeowners test their homes for radon. This report examines participants'follow-up radon testing behavior subsequent to receiving an initial screening radon level greater than 20 pCi/L. Sixty-two participants in the Iowa State-Wide Rural Radon Screening Survey who had radon screening measurements over 20 pCi/L were questioned by phone survey 3 months after receipt of their radon screening result to assess: whether participants were aware of radon's health risk; if participants recalled the radon screening results; how participants perceived the relative health risk of radon and whether participants planned follow-up radon testing. Only 19% of the respondents specifically identified lung cancer as the possible adverse health outcome of high radon exposure, and the majority of participants underestimated the health risks high radon levels pose when compared to cigarettes and x-rays. In addition, less than one third (29%)of the participants actually remembered their radon screening level within 10 pCi/L 3 months after receiving their screening results. Only 53% of the individuals correctly interpreted their screening radon level as being in the high range, and only 39% of the participants planned follow-up radon measurements. Receipt of radon screening test results indicating high radon levels was not an adequate motivational factor in itself to stimulate further radon assessment or mitigation. Our findings suggest that free radon screening will not result in a dramatic increase in subsequent homeowner initiated remediation or further recommended radon testing.     

The Politicization of Risk: Party Cues,Polarization, and Public Perceptions of Climate Change Risk

Previous research shows that public perceptions of climate change risk are strongly related to the individual willingness to support climate mitigation and adaptation policy. In this article, I investigate how public perceptions of climate change risk are affected by communications from political parties and the degree of polarization among them. Specifically, using survey data from Sweden, Norway, Australia, and New Zealand, I study the relationship between party source cues, perceived polarization, and public perceptions of climate change risk. The results reveal a positive relationship between party cues and perceptions of climate change risk, indicating that individuals adjust their risk perceptions to align with their party preference. Furthermore, a negative relationship between perceived polarization and individual risk perceptions is also discovered, showing that individuals tend to be less concerned with climate change the more polarization they perceive. However, the effect of perceived polarization is found to be limited to more abstract perceptions of risk, while being unrelated to perceptions of concrete risks. Even with some contextual variance, the results generally hold up well across the four countries.     

Using the CAUSE Model to Understand Public Communication about Water Risks: Perspectives from Texas Groundwater District Officials on Drought and Availability

Public communication about drought and water availability risks poses challenges to a potentially disinterested public. Water management professionals, though, have a responsibility to work with the public to engage in communication about water and environmental risks. Because limited research in water management examines organizational communication practices and perceptions, insights into research and practice can be gained through investigation of current applications of these risk communication efforts. Guided by the CAUSE model, which explains common goals in communicating risk information to the public (e.g., creating Confidence, generating Awareness, enhancing Understanding, gaining Satisfaction, and motivating Enactment), semistructured interviews of professionals (N = 25) employed by Texas groundwater conservation districts were conducted. The interviews examined how CAUSE model considerations factor in to communication about drought and water availability risks. These data suggest that many work to build constituents’ confidence in their districts. Although audiences and constituents living in drought‐prone areas were reported as being engaged with water availability risks and solutions, many district officials noted constituents’ lack of perceived risk and engagement. Some managers also indicated that public understanding was a secondary concern of their primary responsibilities and that the public often seemed apathetic about technical details related to water conservation risks. Overall, results suggest complicated dynamics between officials and the public regarding information access and motivation. The article also outlines extensions of the CAUSE model and implications for improving public communication about drought and water availability risks.     

Effects of Surface Material,Ventilation, and Human Behavior on Indirect Contact Transmission Risk of Respiratory Infection

Infectious particles can be deposited on surfaces. Susceptible persons who contacted these contaminated surfaces may transfer the pathogens to their mucous membranes via hands, leading to a risk of respiratory infection. The exposure and infection risk contributed by this transmission route depend on indoor surface material, ventilation, and human behavior. In this study, quantitative infection risk assessments were used to compare the significances of these factors. The risks of three pathogens, influenza A virus, respiratory syncytial virus (RSV), and rhinovirus, in an aircraft cabin and in a hospital ward were assessed. Results showed that reducing the contact rate is relatively more effective than increasing the ventilation rate to lower the infection risk. Nonfabric surface materials were found to be much more favorable in the indirect contact transmission for RSV and rhinovirus than fabric surface materials. In the cases considered in this study, halving the ventilation rate and doubling the hand contact rate to surfaces and the hand contact rate to mucous membranes would increase the risk by 3.7–16.2%, 34.4–94.2%, and 24.1–117.7%, respectively. Contacting contaminated nonfabric surfaces may pose an indirect contact risk up to three orders of magnitude higher than that of contacting contaminated fabric surfaces. These findings provide more consideration for infection control and building environmental design.     

Assessment of the Effectiveness of Radon Screening Programs in Reducing Lung Cancer Mortality

The present study was aimed at assessing the health consequences of the presence of radon in Quebec homes and the possible impact of various screening programs on lung cancer mortality. Lung cancer risk due to this radioactive gas was estimated according to the cancer risk model developed by the Sixth Committee on Biological Effects of Ionizing Radiations. Objective data on residential radon exposure, population mobility, and tobacco use in the study population were integrated into a Monte‐Carlo‐type model. Participation rates to radon screening programs were estimated from published data. According to the model used, approximately 10% of deaths due to lung cancer are attributable to residential radon exposure on a yearly basis in Quebec. In the long term, the promotion of a universal screening program would prevent less than one death/year on a province‐wide scale (0.8 case; IC 99%: –3.6 to 5.2 cases/year), for an overall reduction of 0.19% in radon‐related mortality. Reductions in mortality due to radon by (1) the implementation of a targeted screening program in the region with the highest concentrations, (2) the promotion of screening on a local basis with financial support, or (3) the realization of systematic investigations in primary and secondary schools would increase to 1%, 14%, and 16.4%, respectively, in the each of the populations targeted by these scenarios. Other than the battle against tobacco use, radon screening in public buildings thus currently appears as the most promising screening policy for reducing radon‐related lung cancer.     

EDB: A Case Study in Communicating Risk

This is a report on the Environmental Protection Agency's (EPA's) efforts to communicate with the public about the risks of ethylene dibromide (EDB), what the agency said it was doing about these risks and what information the public actually received through television and newspapers. Although special in many ways, the EDB case illustrates the problems that regulatory agencies have when they must take regulatory action and assure the public that the risks in question are being dealt with adequately. It also illustrates issues that the press faces. Above all, it illustrates the barriers to communication presented by the different perspectives of regulatory agencies and individuals and the types of information they each are most interested in.     

The Interplay of Science, Values, and Experiences Among Scientists Asked to Evaluate the Hazards of Dioxin, Radon, and Environmental Tobacco Smoke

To investigate the extent to which personal values and experiences among scientists might affect their assessment of risks from dioxin, radon, and environmental tobacco smoke (ETS), we conducted an experiment through a telephone survey of 1461 epidemiologists, toxicologists, physicians, and general scientists. Each participant was read a vignette designed to reflect the mainstream scientific thinking on one of the three substances. For half of the participants (group A) the substance was named. For the other half (group B), the substance was not named but was identified only as Substance X, Y, or Z. Knowing the name of the substance had little effect on the scientists' evaluation of dioxin, although those who knew the substance to be dioxin were more likely to rate the substance as a serious environmental health hazard (51% vs. 42%, p = 0.062). For radon, those who knew the substance by name were significantly more likely to consider it an environmental health hazard than were those who knew it as substance Z (91% vs. 78%, p less than 0.001). Participants who knew they were being asked about ETS rather than substance X were significantly more likely to consider the substance an environmental health hazard (88% vs. 66%, p less than 0.001), to consider the substance a serious environmental health hazard (70% vs. 33%, p less than 0.001), to believe that background exposure required public health intervention (85% vs. 41%, p less than 0.001), and to believe that above-background exposure required public health intervention (90% vs. 74%, p less than 0.001). These findings suggest that values and experiences may be influencing health risk assessments for these substances, and indicate the need for more study of this phenomenon.     

A Comparative Cancer Risk Evaluation of MTBE and Other Compounds (Including Naturally Occurring Compounds) in Drinking Water in New Hampshire

Methyl tert-butyl ether (MTBE) was added to gasoline in New Hampshire (NH) between 1995 and 2006 to comply with the oxygenate requirements of the 1990 Amendments to the Clean Air Act. Leaking tanks and spills released MTBE into groundwater, and as a result, MTBE has been detected in drinking water in NH. We conducted a comparative cancer risk assessment and a margin-of-safety (MOS) analysis for several constituents, including MTBE, detected in NH drinking water. Using standard risk assessment methods, we calculated cancer risks from exposure to 12 detected volatile organic compounds (VOCs), including MTBE, and to four naturally occurring compounds (i.e., arsenic, radium-226, radium-228, and radon-222) detected in NH public water supplies. We evaluated exposures to a hypothetical resident ingesting the water, dermally contacting the water while showering, and inhaling compounds volatilizing from water in the home. We then compared risk estimates for MTBE to those of the other 15 compounds. From our analysis, we concluded that the high-end cancer risk from exposure to MTBE in drinking water is lower than the risks from all the other VOCs evaluated and several thousand times lower than the risks from exposure to naturally occurring constituents, including arsenic, radium, and radon. We also conducted an MOS analysis in which we compared toxicological points of departure to the NH maximum contaminant level (MCL) of 13 µg/L. All of the MOSs were greater than or equal to 160,000, indicating a large margin of safety and demonstrating the health-protectiveness of the NH MCL for MTBE.     

Judgments of Chemical Risks: Comparisons Among Senior Managers, Toxicologists, and the Public

Nineteen Senior Managers of a major chemical company in the United Kingdom participated in a survey to determine their attitudes, beliefs, and perceptions regarding risks from chemicals. Similar surveys had previously been conducted with toxicologists and members of the general public in the United States and Canada. In general, the Senior Managers tended to judge risks to be quite small for most chemicals. Moreover, they had lower risk perceptions than did members of the British Toxicological Society and even far lower perceptions of risk than a comparison group of members of the Canadian public. The managers held views that were similar to British toxicologists working in industry and government and dissimilar to the views of toxicologists working in academia. The observed differences between views of managers, toxicologists, and the public must be recognized and understood in order to facilitate communication and constructive efforts to manage chemical risks.     

Prioritizing Environmental Health Risks in the UAE

This article presents the results of a comparative environmental risk‐ranking exercise that was conducted in the United Arab Emirates (UAE) to inform a strategic planning process led by the Environment Agency‐Abu Dhabi (EAD). It represents the first national‐level application of a deliberative method for comparative risk ranking first published in this journal. The deliberative method involves a five‐stage process that includes quantitative risk assessment by experts and deliberations by groups of stakeholders. The project reported in this article considered 14 categories of environmental risks to health identified through discussions with EAD staff: ambient and indoor air pollution; drinking water contamination; coastal water pollution; soil and groundwater contamination; contamination of fruits, vegetables, and seafood; ambient noise; stratospheric ozone depletion; electromagnetic fields from power lines; health impacts from climate change; and exposure to hazardous substances in industrial, construction, and agricultural work environments. Results from workshops involving 73 stakeholders who met in five separate groups to rank these risks individually and collaboratively indicated strong consensus that outdoor and indoor air pollution are the highest priorities in the UAE. Each of the five groups rated these as being among the highest risks. All groups rated soil and groundwater contamination as being among the lowest risks. In surveys administered after the ranking exercises, participants indicated that the results of the process represented their concerns and approved of using the ranking results to inform policy decisions. The results ultimately shaped a strategic plan that is now being implemented.