Radon Testing in Northwest Iowa: a Community Engagement Study

Barcey T. Levy, Cynthia Wolff, Jeanette Daly, Yinghui Xu,
Lori Heeren, Paul Niles, Heather Morehead
October 11, 2013
Iowa Cancer Summit
University of Iowa
Departments of Family Medicine and Epidemiology
Akron Mercy Medicine Clinic, Akron, Iowa
 Radon is a colorless, tasteless, radioactive gas
produced from the decay of naturally occurring
uranium, thorium, and radium in the soil.
 The gas enters buildings and decay products are
breathed in.
 High radon levels are present in homes throughout
Iowa, unless steps are taken to prevent it.
 Radon is the second leading cause of lung cancer
overall, estimated to cause 15,000 to 22,000 deaths
How does radon get into your home?
Radon gas rises up
through the soil and is
pulled into a house or
building. It enters a
home or building
through cracks in the
construction joints, gaps
around service pipes or
wires, and sump pits. It
doesn’t matter what
type of foundation your
home has—basement,
crawl space, slab—your
home could have high
levels of radon.
EPA Map of Radon Zones
 Cynthia Wolff, MD, in Akron, Iowa became very interested in
radon after hearing some talks at the Iowa Cancer Summit.
She teamed up with Barcey Levy to write a proposal to the Iowa
Cancer Consortium that was funded.
Dr. Wolff and her office agreed to hand out radon kits to
Kits were obtained from Air Chek, Inc., Mills River, NC.
Medical office staff kept a list of kit numbers and which patients
had them.
Dr. Wolff also agreed to hold forums describing the dangers of
radon and the importance of testing homes for radon.
Individuals taking kits filled out a one-page questionnaire.
Methods (cont’d)
 The investigator developed questionnaire asked
 the age of their home
 years lived there
 whether they had ever tested for radon
 whether they had radon mitigation in the past
 type of heating
 whether their home is well-insulated
 demographics
Methods (cont’d)
 The University of Iowa and the Akron Mercy Medical
Clinic IRBs approved this research.
Data from the questionnaires were double-entered and
This information was linked with the radon result.
If a kit was handed out and not returned, Dr. Wolff’s
office called the subject to remind them to do the
radon testing.
Descriptive statistics and association tests of radon
levels with home characteristics and income level were
done using SAS.
• Over 14 educational community presentations
were held with over 400 individuals attending.
• A total of 746 radon kits were handed out, with
397 radon results received (53.2% return rate).
• 364 kits gave a valid test result (91.7%).
• 346 radon results were valid and could be matched
with a questionnaire.
• Mean radon results were 10.1 pCi/L (SD 8.5).
• Of the 8 radon values above 30 pCi/L, the mean
was 45.5 pCi/L.
 82% of homes had radon results of 4 pCi/L or
higher. 4 pCi/L is the Environmental Protection
Agency action level.
• The mean age of the homes was 54.0 years (SD
• The most common types of heating were gas
(62%), followed by electric (25%), with geothermal
(5%) and wood (4%) much less common.
• 76% considered their home to be well-insulated.
• 16% had tested their homes previously. The mean
level of radon was 13.9 (SD 8.7) pCi/L (for those who
could remember what their previous results were).
Mean age of subjects was 55.3 years (SD 15.2 years).
42% reported an income level below $50,000.
There were no significant differences in radon
level by type of home heating or income level.
Well-insulated homes had a significantly higher
radon levels than those that were less wellinsulated (10.8 vs. 8.2 pCi/L, p<.007)
• Consistent with other studies in Iowa, over 80% of
homes tested had radon levels for which re-testing
or mitigation would be recommended.
• Homes that were well insulated had higher radon
levels than homes that were not.
• Over 50% of radon kits were returned. There
was no charge to patients for the kits. Having a
nominal charge might have helped with the return
• Nearly 92% of individuals had a valid radon
test result, indicating that nearly all were able to
write clearly and follow the instructions.
• Dr. Wolff and her staff conducted over 14 forums
which reached over 400 individuals.
• They set up agreements with banks for lowinterest loans for radon mitigation and compiled a
list of certified radon mitigators.
• Kits were handed out by a very enthusiastic and
dedicated office staff and this might be difficult to
replicate in other office settings.
• All questionnaire information from individuals
taking kits was self-reported. There was no
attempt made to verify the accuracy of the
• Over 80% of homes tested had elevated radon
• As with other types of public health testing,
testing can lead to results which need follow-up
and for which additional costs are incurred.
• This is balanced by the known effects of radon,
which is estimated to cause 400 deaths each year
in Iowa.
• This project provides an excellent example of
community engagement and University outreach.
Dr. Wolff and her Staff
 Iowa Cancer Consortium
 Iowa Department of Public Health
 NCI 1 RC4 CA153493-01
 Akron Mercy Medical Clinic
 The University of Iowa Departments of
Family Medicine and Epidemiology
It could save you or a loved one’s life!

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