Introduction

Primary health care providers should assist patients in understanding applicable clinical follow-up instructions as well as preventive strategies to identify and abate increased radon gas exposure.

Chronic exposure to radon and its progeny can cause lung cancer. A physician should then advise patients to have their homes tested for radon. If radon concentrations are at 4pCi/L or higher, the physician should recommend that patients take abatement or remediation actions in their homes to lower both radon levels and potential radon exposures.

Providing existing, authoritative EPA or public health radon remediation resources may help patients take the necessary steps to minimize their radon exposure.

The physician should discuss with the patient exposure risks (i.e., a hazard source that presents an opportunity for uptake into the body) and a completed exposure pathway (i.e., the route between the hazard source and actual uptake into the body). The patient should be counseled about other risk factors such as smoking that increase the risk of developing lung cancer from radon exposure. The Radon Toxicity Patient Education and Care Instruction Sheet may help facilitate this discussion.

Be sure to let your patient know when to return for the next medical appointment.

Self Care

Preventive messages that allow patients to take action to avoid increased radon exposure are important in lung cancer prevention. Provide to your patients guidance on

• Radon testing
• Risks associated with combined exposures to tobacco smoke and radon
• Nutritional practice that support cancer prevention

Supplying the patient with take-home information will increase the likelihood of compliance with instructions from you or your staff.

General preventive messages to reduce the risk of cancer

General preventive messages to prevent lung cancer include

• Stop smoking and avoid second hand smoke.
  • The combination of smoking and radon exposure results in a higher lung cancer risk.
• Eat plenty of fruits and vegetables.
  • Eating a diet high in fruits and vegetables may help protect against lung cancer.
• Consider taking beta carotene supplements.
  • Beta carotene is an organic compound that may help protect against lung cancer. It contributes to the orange color of many different fruits and vegetables. Vietnamese gac (Momordica Cochinchinensis Spreng) and crude palm oil are particularly rich sources, as are yellow and orange fruits such as mangoes and papayas, orange root vegetables such as carrots and yams, green leafy vegetables such as spinach and kale, and sweet potato and sweet gourd leaves.

More lung cancer-prevention information for patients is available at:

http://www.cdc.gov/cancer/lung/basic_info/prevention.htm

http://www.cancer.gov/cancertopics/pdq/prevention/lung/Patient/page2

Preventive Measures to Reduce Exposure to Increased Levels of Radon

Instructions that health care providers can give to those patients with potential exposures to increased radon levels include

• Test your home to identify if the radon level is safe, that is, below 4pCi/L.
  • If the tested radon levels equal or exceed 4pCi/L, advise remediation to reduce radon concentrations to safe levels.

Instructions on When to See a Doctor

Because the clinical presentation of lung cancer may vary among patients, you should advise your patients to seek medical care when they detect the following:

• Shortness of breath
• Persistent cough
• Wheezing
• Hemoptysis
• Chest pain

To monitor for lung cancer, a return medical appointment is indicated if the patient experiences repeated bouts of pneumonia, changes in the shape of the fingertips, and swollen or enlarged lymph nodes (glands) in the upper chest and lower neck.

These symptoms are not specific to radon exposure. Thus patients with such symptoms should be encouraged to seek medical care, especially if they are smokers.

Patient Education Materials

ATSDR has developed educational materials to provide patients with information regarding radon exposure. “The Patient Education and Care Instruction Sheet: Radon Toxicity” is available at; http://www.atsdr.cdc.gov/csem/csem.asp?csem=8&po=18

Progress Check