A critical evaluation of the cost-effectiveness of radon protection methods in new homes in a radon Affected Area of England

In the UK, building new homes in areas prone to radon gas is currently subject to regulations that require installation of radon-proof membranes. These membranes are not, however, the only way to protect residents of new homes against radon's potential to cause lung cancer. Alternative regulatory regimes can be constructed that would achieve the same end.The purpose of this paper is to examine the cost-effectiveness of four alternative regimes and so determine if building regulations for new homes could be altered to protect residents from the effects of radon more cost-effectively than at present. In addressing this question, the paper also contributes to the wider debate on how best to reduce the effect on public health of exposure to radon.The measure of cost-effectiveness used, cost per quality-adjusted life-year gained, is determined from radon test results obtained in properties in Brixworth, England, UK, a radon Affected Area. Confidence intervals for the cost-effectiveness estimates are also derived using bootstrap techniques.The central estimates of cost-effectiveness range from £2870 per quality-adjusted life-year gained for the most cost-effective of the alternative regimes to £6182 for the current regime. These results suggest that alternative regimes may be more cost-effective in tackling the radon problem. A definitive assessment of the most suitable to adopt will require extensive negotiation between government departments, the construction industry, and other interested parties to ensure acceptance of any new regime. The paper offers suggestions for future research that should help in the process of identifying the key features of a new regulatory approach.     

Ocean fertilization for geoengineering: A review of effectiveness,environmental impacts and emerging governance

Dangerous climate change is best avoided by drastically and rapidly reducing greenhouse gas emissions. Nevertheless, geoengineering options are receiving attention on the basis that additional approaches may also be necessary. Here we review the state of knowledge on large-scale ocean fertilization by adding iron or other nutrients, either from external sources or via enhanced ocean mixing. On the basis of small-scale field experiments carried out to date and associated modelling, the maximum benefits of ocean fertilization as a negative emissions technique are likely to be modest in relation to anthropogenic climate forcing. Furthermore, it would be extremely challenging to quantify with acceptable accuracy the carbon removed from circulation on a long term basis, and to adequately monitor unintended impacts over large space and time-scales. These and other technical issues are particularly problematic for the region with greatest theoretical potential for the application of ocean fertilization, the Southern Ocean. Arrangements for the international governance of further field-based research on ocean fertilization are currently being developed, primarily under the London Convention/London Protocol.     

The costs and benefits of radon remediation programmes in existing homes: case study of action level selection

Radon gas can be present within buildings at sufficiently high levels that it becomes a health risk. Such levels can be reduced, and so radon remediation programmes in the home in UK Affected Areas should result in reduced risks to the population. This paper considers the benefits and costs of the domestic radon remediation programme in Northamptonshire, UK, and considers the implications of the choice of Action Level, in view of the adoption of different levels in many countries. A programme with a higher Action Level will cost less, and target those most at risk, but will be less cost effective. In addition, a higher Action Level leaves a higher residual dose and risk to the remaining population. Such doses are higher than and inconsistent with the radiation dose limits for the general public in the EU Basic Standards Directive.     

A critical comparison of the cost-effectiveness of domestic radon remediation programmes in three counties of England

Radon remediation programmes in domestic dwellings were carried out in five areas, from three counties of England, and the total costs obtained. A single company, which abided by the Code of Practice of the Radon Council of Great Britain, carried out the remediation. The dose savings from the programmes were calculated and used to estimate the number of lung cancers averted. The data obtained allowed the cost-effectiveness of the remediation programmes in each area to be calculated. The remediation programmes in three areas (Northants 2, 3 and North Oxfordshire) were cost-effective whereas those in two areas (Northants 1 and North Somerset) were not. To be cost-effective, the Northants I and North Somerset areas would need to increase the number of householders that carried out remediation, if they were over the UK Action Level. Health policy makers should concentrate their resources on communities in areas where there is a significant proportion of dwellings above the UK Action Level and where the number of properties being remediated is low.     

A cost-effectiveness analysis of radon protection methods in domestic properties: a comparative case study in Brixworth, Northamptonshire, UK

Building regulations in the UK have since 1992 required that radon-proof membranes be installed in new domestic properties to protect residents against the adverse effects of radon. This study compares the cost-effectiveness of the current regulatory regime with an alternative that would entail new properties being tested for radon after construction, and being remediated if necessary. The alternative regime is found to be more cost-effective for a sample of properties in Brixworth, Northamptonshire, UK. For this regime, the central estimate of cost per quality-adjusted life-year gained, the measure of cost-effectiveness used, is 2869 pounds compared to 6182 pounds for installing membranes, results suggesting a case for re-examining the current regulations on radon protection in new properties. Pilot studies will, however, be needed to consider how different means of protecting residents of new properties against radon might operate in practice and to provide improved evidence on their relative cost-effectiveness.     

A study of radon levels in NHS premises in affected areas around the UK

Radon gas contributes a significant fraction of the natural background radiation dose, and in some areas raised levels are found in buildings. both homes and the workplace. Different UK Action Levels apply to homes and the workplace. because of the diurnal variation of radon. This study reviews the results for a number of hospitals throughout England and Wales. and suggests that the likelihood of finding raised radon levels is similar in the workplace and homes in the same area. Radon measurements and consequent remediation of any raised levels are appropriate in all workplaces in radon Affected Areas with over 5% of houses above the UK domestic Action Level of 200 Bq m(-3).     

Lung-cancer reduction from smoking cessation and radon remediation: a preliminary cost-analysis in Northamptonshire, UK

Domestic radon levels in parts of the United Kingdom are sufficiently high as to increase the risk of lung-cancer among residents. Public health campaigns in the county of Northamptonshire, a designated radon Affected Area with 6.3% of homes having average radon levels in excess of the UK Action Level of 200 Bq m(-3), have encouraged householders to test for radon and then, if indicated to be necessary, to carry out remediation in their homes. These campaigns have been only partially successful, since to date only 40% of Northamptonshire houses have been tested, and only 15% of those householders finding raised levels have proceeded to remediate. Those who remediate have been shown to have smaller families, to be older, and to include fewer smokers than the average population, suggesting that current strategies to reduce domestic radon exposure are not reaching those most at risk. During 2004-2005, the NHS Stop-Smoking Services in Northamptonshire assisted 2847 smokers to quit to the 4-week stage, the 15% (435) of these 4-week quitters remaining quitters at 1year forming the subjects of a retrospective study considering whether smoking cessation campaigns contribute significantly to radon risk reduction. Quantitative assessment of the risk of lung-cancer among the study population, from knowledge of the individuals' age, gender, and smoking habits, together with the radon levels in their homes, demonstrates that smoking cessation programmes have significant added value in reducing the incidence of lung-cancer in radon Affected Areas, and contribute a substantially greater health benefit at a lower cost than the alternative strategy of reducing radon levels in the smokers' homes, while they remain smokers. Both radon remediation and smoking cessation programmes are very cost effective in Northamptonshire, with smoking cessation being significantly more cost effective, and these are potentially valuable programmes to drive health improvements through promotion of the uptake or environmental management for radon in the home.     

生态旅游对欧洲意味着什么?

欧洲公园联盟 ( EUROPARC)制定了保护区可持续旅游的欧洲宪章 ,来促进完善的公园管理 .认证 的一个主要条件是保护区应具有一个经与当地的代表旅游、资源保护区和社区利益的利害攸 关者协商而精心制定的可持续旅游战略和行动计划 . 本文阐明了宪章制定的背景和一些有关 的问题及教训 .     

生态旅游对欧洲意味着什么?

欧洲公园联盟 ( EUROPARC)制定了保护区可持续旅游的欧洲宪章 ,来促进完善的公园管理 .认证 的一个主要条件是保护区应具有一个经与当地的代表旅游、资源保护区和社区利益的利害攸 关者协商而精心制定的可持续旅游战略和行动计划 . 本文阐明了宪章制定的背景和一些有关 的问题及教训 .     

The practical use of electrets in a public health radon remediation campaign

As part of a long-term assessment of domestic radon in Northamptonshire, England, a batch of 50 commercially available electrets was deployed for nearly 1,000 exposures, individual exposure periods ranging from one to eight weeks. Responsivity was comparable with that of recently-calibrated Durridge RAD-7 continuously-monitoring equipment. Voltage history analysis indicated mean voltage decay during manufacturers' QA assessment of 0.059+/-0.026 Vday(-1), increasing to 0.114+/-0.073 Vday(-1) during storage to first use and to 0.204+/-0.49 Vday(-1) during inter-deployment storage. At a representative elevated radon concentration of 500 Bqm(-3), the resulting perturbation is 3% over a 7-day deployment; at the typical mean Northamptonshire level of 80 Bqm(-3) it approaches 22%. Each electret can be used for up to 25 measurements, which makes the technology attractive for organisational use. It is not suited for deployment by individual householders.