Is environmental radon gas associated with the incidence of neurodegenerative conditions? A retrospective study of multiple sclerosis in radon affected areas in England and Wales

Christopher J. Groves-Kirkby, Antony R. Denman, Jackie Campbell, Robin G.M. Crockett, Paul S. Phillips, Stephen Rogers

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Abstract

To test whether an association exists between radon gas concentration in the home and increased multiple sclerosis (MS) incidence, a retrospective study was undertaken of MS incidence in known areas of raised domestic radon concentration in England and Wales, using The Health Improvement Network (THIN) clinical research database.The study population comprised 20,140,498 person-years of clinical monitoring (males: 10,056,628: 49.93%; females: 10,083,870: 50.07%), representing a mean annual population of 2.5 million individuals. To allow for the possible latency of MS initiation following exposure, data extraction was limited to patients with at least five years registration history with the same GP practice before first diagnosis. Patient records were allocated to one of nine radon concentration bands depending on the average radon level in their postcode sector.MS incidence was analysed by searching for patients with first MS diagnosis over the eight calendar years 2005-2012 inclusive. 1512 new MS cases were diagnosed, 1070 females, 442 males, equivalent to raw incidence rates of 7.51, 10.61 and 4.40 per 105person-years respectively, comparable to previously reported results. Of these new cases, 115 could be allocated to one of the radon bands representing high radon areas.Standardising to the UK 2010 population, excess relative risk (ERR) figures for MS were calculated for each radon band. Linear regression of ERR against mean band radon concentration shows a positive gradient of 0.22 per 100 Bq·m-3(R2= 0.25, p = 0.0961) when forced through the origin to represent a linear-no-threshold response. The null hypothesis falls inside the 95% confidence interval for the linear fit and therefore this fit is not statistically significant. We conclude that, despite THIN sampling around 5% of the population, insufficient data was available to confirm or refute the hypothesised association between MS incidence and radon concentration.
Original languageEnglish
Pages (from-to)1-14
Number of pages14
JournalJournal of Environmental Radioactivity
Volume154
Early online date23 Jan 2016
DOIs
Publication statusPublished - 1 Apr 2016

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Radon
Wales
England
Multiple Sclerosis
Retrospective Studies
Gases
Incidence
Population
Health
Linear Models
History
Databases
Confidence Intervals

Keywords

  • Clinical extraction database
  • Multiple sclerosis
  • Radon
  • Retrospective population-based study

Cite this

@article{21bfe587fe484fbea27fac2ffd882ac7,
title = "Is environmental radon gas associated with the incidence of neurodegenerative conditions? A retrospective study of multiple sclerosis in radon affected areas in England and Wales",
abstract = "To test whether an association exists between radon gas concentration in the home and increased multiple sclerosis (MS) incidence, a retrospective study was undertaken of MS incidence in known areas of raised domestic radon concentration in England and Wales, using The Health Improvement Network (THIN) clinical research database.The study population comprised 20,140,498 person-years of clinical monitoring (males: 10,056,628: 49.93{\%}; females: 10,083,870: 50.07{\%}), representing a mean annual population of 2.5 million individuals. To allow for the possible latency of MS initiation following exposure, data extraction was limited to patients with at least five years registration history with the same GP practice before first diagnosis. Patient records were allocated to one of nine radon concentration bands depending on the average radon level in their postcode sector.MS incidence was analysed by searching for patients with first MS diagnosis over the eight calendar years 2005-2012 inclusive. 1512 new MS cases were diagnosed, 1070 females, 442 males, equivalent to raw incidence rates of 7.51, 10.61 and 4.40 per 105person-years respectively, comparable to previously reported results. Of these new cases, 115 could be allocated to one of the radon bands representing high radon areas.Standardising to the UK 2010 population, excess relative risk (ERR) figures for MS were calculated for each radon band. Linear regression of ERR against mean band radon concentration shows a positive gradient of 0.22 per 100 Bq·m-3(R2= 0.25, p = 0.0961) when forced through the origin to represent a linear-no-threshold response. The null hypothesis falls inside the 95{\%} confidence interval for the linear fit and therefore this fit is not statistically significant. We conclude that, despite THIN sampling around 5{\%} of the population, insufficient data was available to confirm or refute the hypothesised association between MS incidence and radon concentration.",
keywords = "Clinical extraction database, Multiple sclerosis, Radon, Retrospective population-based study",
author = "Groves-Kirkby, {Christopher J.} and Denman, {Antony R.} and Jackie Campbell and Crockett, {Robin G.M.} and Phillips, {Paul S.} and Stephen Rogers",
year = "2016",
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language = "English",
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pages = "1--14",
journal = "Journal of Environmental Radioactivity",
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Is environmental radon gas associated with the incidence of neurodegenerative conditions? A retrospective study of multiple sclerosis in radon affected areas in England and Wales. / Groves-Kirkby, Christopher J.; Denman, Antony R.; Campbell, Jackie; Crockett, Robin G.M.; Phillips, Paul S.; Rogers, Stephen.

In: Journal of Environmental Radioactivity, Vol. 154, 01.04.2016, p. 1-14.

Research output: Contribution to journalArticleResearchpeer-review

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AB - To test whether an association exists between radon gas concentration in the home and increased multiple sclerosis (MS) incidence, a retrospective study was undertaken of MS incidence in known areas of raised domestic radon concentration in England and Wales, using The Health Improvement Network (THIN) clinical research database.The study population comprised 20,140,498 person-years of clinical monitoring (males: 10,056,628: 49.93%; females: 10,083,870: 50.07%), representing a mean annual population of 2.5 million individuals. To allow for the possible latency of MS initiation following exposure, data extraction was limited to patients with at least five years registration history with the same GP practice before first diagnosis. Patient records were allocated to one of nine radon concentration bands depending on the average radon level in their postcode sector.MS incidence was analysed by searching for patients with first MS diagnosis over the eight calendar years 2005-2012 inclusive. 1512 new MS cases were diagnosed, 1070 females, 442 males, equivalent to raw incidence rates of 7.51, 10.61 and 4.40 per 105person-years respectively, comparable to previously reported results. Of these new cases, 115 could be allocated to one of the radon bands representing high radon areas.Standardising to the UK 2010 population, excess relative risk (ERR) figures for MS were calculated for each radon band. Linear regression of ERR against mean band radon concentration shows a positive gradient of 0.22 per 100 Bq·m-3(R2= 0.25, p = 0.0961) when forced through the origin to represent a linear-no-threshold response. The null hypothesis falls inside the 95% confidence interval for the linear fit and therefore this fit is not statistically significant. We conclude that, despite THIN sampling around 5% of the population, insufficient data was available to confirm or refute the hypothesised association between MS incidence and radon concentration.

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