Abstract:
After smoking, residential radon is the second risk factor of lung cancer in general population and the first in never-smokers. Previous studies have analyzed radon attributable lung cancer mortality for some countries. We aim to identify, summarize, and critically analyze the available data regarding the mortality burden of lung cancer due to radon, performing a quality assessment of the papers included, and comparing the results from different countries. We performed a systematic scoping review using the main biomedical databases. We included original studies with attributable mortality data related to radon exposure. We selected studies according to specific inclusion and exclusion criteria. PRISMA 2020 methodology and PRISMA Extension for Scoping Reviews requirements were followed. Data were abstracted using a standardized data sheet and a tailored scale was used to assess quality. We selected 24 studies describing radon attributable mortality derived from 14 different countries. Overall, 13 studies used risk models based on cohorts of miners, 8 used risks from residential radon case-control studies and 3 used both risk model options. Radon geometric mean concentration ranged from 11 to 83 Becquerels per cubic meter (Bq/m3) and the population attributable fraction (PAF) ranged from 0.2 to 26%. Studies performed in radon prone areas obtained the highest attributable mortality. High-quality publications reported PAF ranging from 3 to 12% for residential risk sources and from 7 to 25% for miner risk sources. Radon PAF for lung cancer mortality varies widely between studies. A large part of the variation is due to differences in the risk source used and the conceptual description of radon exposure assumed. A common methodology should be described and used from now on to improve the communication of these results.
摘要:
吸烟后,居住氡是普通人群中肺癌的第二危险因素,也是不吸烟者中的第一危险因素。以前的研究已经分析了一些国家的氡可归因于肺癌的死亡率。我们的目标是确定,总结,并批判性地分析有关氡导致的肺癌死亡负担的现有数据,对包括在内的论文进行质量评估,比较不同国家的结果。我们使用主要的生物医学数据库进行了系统的范围审查。我们纳入了与氡暴露相关的归因死亡率数据的原始研究。我们根据具体的纳入和排除标准选择研究。遵循PRISMA2020方法和PRISMA扩展范围审查要求。使用标准化数据表提取数据,并使用定制的量表评估质量。我们选择了24项研究,描述了来自14个不同国家的氡归因死亡率。总的来说,13项研究使用了基于矿工群体的风险模型,8个使用了住宅氡病例对照研究中的风险,3个使用了两种风险模型选择。氡几何平均浓度为每立方米11至83贝克勒尔(Bq/m3),种群归因分数(PAF)为0.2至26%。在氡易发地区进行的研究获得了最高的归因死亡率。高质量的出版物报告说,住宅风险源的PAF为3%至12%,矿工风险源的PAF为7%至25%。肺癌死亡率的氡PAF在研究之间差异很大。很大一部分变化是由于所使用的风险源和假定的氡暴露概念描述的差异。从现在开始,应该描述和使用一种通用方法,以改善这些结果的交流。