Lung cancer risk from radon: Analysis of cross-sectional data to identify disparities in testing and mitigation in Southern Illinois

Background: Southern Illinois is a rural area with high poverty rates.  Age-adjusted lung cancer incidence rates are significantly higher than the state average.  The area is considered a moderate risk for radon, the second-leading cause of lung cancer, yet very few residences in the area have been tested, with seven counties reporting no tests from 2003-2011.  Factors in the area which compound the risk for developing lung cancer include high smoking prevalence and possible occupational exposures (e.g., mining).  For most Southern Illinoisans, radioactive, colorless, odorless, tasteless radon gas remains undetected despite national and state educational outreach campaigns.  Increasing radon mitigation is a national priority in Healthy People 2020.  This study seeks to identify characteristics related to testing and mitigation behavior.  Methods: Data from the Illinois Environmental Management Agency Radon Program (2003-2011) and the National Health Interview Survey (NHIS) radon awareness data from the 1990, 1991, 1993, 1994, and 1998 supplements will be used to calculate prevalence of testing and mitigation.  Data will also be compared to the Agency for Toxic Substances and Disease Registry (ATSDR) Social Vulnerability Index (SVI) for demographic risk factors, including housing types, to identify vulnerable areas.  Results:  Characterization of households in Southern Illinois most likely to test for radon, as well as those who initiate mitigation. Conclusions:  Identifying characteristics of those who test and mitigate, as well as those least likely to test, may inform policy and outreach efforts.