Izhodišče: Svetovna zdravstvena organizacija je opredelila radon v bivalnem okolju kot enega izmed 19 okoljskih karcinogenov. Radon je poleg tobačnega dima eden izmed najpomembnejših dejavnikov tveganja za razvoj pljučnega raka ter predstavlja približno 10-odstotni delež vseh primerov pljučnega raka. V naši raziskavi smo prvič preučili, kako radon vpliva na pojavljanje pljučnega raka v Sloveniji.

Metode: Za 40-letno obdobje od leta 1978 do leta 2017 so bili na ravni naselij povezani trije viri podatkov: zboleli za pljučnim rakom (Register raka Republike Slovenije), prebivalci (Statistični urad Republike Slovenije) in Radonski zemljevid Slovenije. V modele prostorskega glajenja z Bayesovimi hierarhičnimi modeli je kot pojasnjevalna spremenljivka vključen radon v bivalnem okolju in izračunan pripisljivi delež raka. Relativno tveganje je ocenjeno s standardiziranim količnikom incidence.

Rezultati: V Sloveniji za pljučnim rakom zaradi izpostavljenosti radonu v bivalnem okolju (analiza na ravni naselij) zboli približno 60 oseb letno, kar predstavlja 5 % vseh s to boleznijo. Analiza relativnega tveganja po spolu kaže, da imajo v Sloveniji zaradi izpostavljenosti radonu v bivalnem okolju povečano tveganje pljučnega raka predvsem moški. Ženske, ki bivajo na območjih, bolj obremenjenih z radonom, nimajo povečanega relativnega tveganja za nastanek pljučnega raka.

Zaključek: Izpostavljenost radonu v bivalnem okolju je poleg kajenja med najpomembnejšimi nevarnostnimi dejavniki pljučnega raka v slovenski populaciji. Na območjih, kjer je radona veliko (predvsem južna in jugovzhodna Slovenija), je z javnozdravstvenega vidika ključno izvajanje preventivnih ukrepov, v prvi vrsti pa ozaveščanje in poučevanje prebivalstva o nevarnosti ter možnostih za preprečitev bolezni

Abstract (Eng)

Backgound: Radon in the living environment is classified by the World Health Organization as one of 19 environmental carcinogens, and is, along with tobacco smoke, one of the most important risk factors for the development of lung cancer, accounting for approximately 10% of all lung cancer cases. In our research, we examined for the first time the impact of radon on the occurrence of lung cancer in Slovenia.

Methods: For the 40-year period from 1978 to 2017, three data sources were linked at the level of settlements: lung cancer patients (Cancer Registry of the Republic of Slovenia), residents (Statistical Office of the Republic of Slovenia) and radon map of Slovenia. In spatial smoothing models with Bayesian hierarchical models, radon in the living environment was included as an explanatory variable, and population attributable fraction was calculated. The relative risk was estimated using the standardized incidence rate.

Results: In Slovenia, about 60 people get lung cancer every year due to exposure to radon in the living environment (analysis at the level of settlements), which represents 5% of all people who get this disease. Analysis of the relative risk by gender shows that in Slovenia, mainly men have an increased risk of lung cancer due to exposure to radon in the living environment. Women who live in areas with higher radon exposure do not have an increased relative risk of developing lung cancer.

Conclusion: Along with smoking, exposure to radon in the living environment is one of the most important risk factors for lung cancer in the Slovenian population. In areas where radon concentration is high in the living environment (mainly southern and south-eastern Slovenia), it is crucial from a public health point of view to implement preventive measures, and first and foremost to raise awareness and educate the population about the danger and the possibilities for preventing it..