Radon, an invisible killer in Canadian homes: perceptions of Ottawa-Gatineau residents

Abstract

Objectives

Canadians have reason to care about indoor air quality as they spend over 90% of the time indoors. Although indoor radon causes more deaths than any other environmental hazard, only 55% of Canadians have heard of it, and of these, 6% have taken action. The gap between residents’ risk awareness and adoption of actual protective behaviour presents a challenge to public health practitioners. Residents’ perception of the risk should inform health communication that targets motivation for action. In Canada, research about the public perception of radon health risk is lacking. The aim of this study was to describe residents’ perceptions of radon health risks and, applying a theoretical lens, evaluate how perceptions correlate with protection behaviours.

Methods

We conducted a mixed online and face-to-face survey (N = 557) with both homeowners and tenants in Ottawa-Gatineau census metropolitan area. Descriptive, correlation, and regression analyses addressed the research questions.

Results

Compared to the gravity of the risk, public perception remained low. While 32% of residents expressed some concern about radon health risk, 12% of them tested and only 3% mitigated their homes for radon. Residents’ perceptions of the probability and severity of the risk, social influence, care for children, and smoking in home correlated significantly with their intention to test; these factors also predicted their behaviours for testing and mitigation.

Conclusion

Health risk communication programs need to consider the affective aspects of risk perception in addition to rational cognition to improve protection behaviours. A qualitative study can explore the reasons behind the gap between testing and mitigation.

Résumé

Objectifs

Les Canadiens ont de bonnes raisons de se préoccuper de la qualité de l’air intérieur, car ils passent plus de 90 % de leur temps à l’intérieur. Bien que le radon domiciliaire (RD) cause plus de décès que tout autre risques environnementaux, seulement 55 % des Canadiens en ont déjà entendu parler, et d’entre eux seulement 6 % ont pris des mesures concrètes pour l’éradiquer. L’écart entre la sensibilisation aux risques et la prise de mesures de protection réelles par les résidents constitue un défi pour les professionnels de la santé publique. La perception des résidents face aux risques associés au RD devrait guider la communication en matière de santé pour cibler la motivation. Au Canada, très peu d’études portant sur les perceptions de la population face aux risques associés au RD ont été réalisées. Le but de cette étude est de décrire les perceptions qu’entretiennent les occupants de bâtiments résidentiels face aux risques pour la santé associée au RD et évaluer comment ces perceptions sont corrélées aux comportements de protection, notamment en appliquant la théorie de la motivation et de la protection.

Méthodes

Nous avons réalisé une enquête mixte en ligne et en personne (n = 557) auprès de propriétaires et de locataires de la région d’Ottawa-Gatineau. Des analyses descriptives, corrélationnelles et des analyses de régressions ont été effectuées en fonction de nos questions de recherche.

Résultats

En comparaison à la gravité des risques, les perceptions du public demeurent faibles. Bien que 32 % des résidents ont exprimé des préoccupations au sujet du danger que représente le radon pour la santé, seulement 12 % d’entre eux ont réalisé des tests à domicile et seulement 3 % ont pris des actions concrètes pour réduire les risques. Les perceptions des résidents quant à la probabilité et à la gravité des risques du RD sur leur santé, l’influence sociale, les soins prodigués aux enfants, ainsi que le tabagisme à la maison étaient significativement corrélées avec leur intention de réaliser un test. Ces facteurs ont également prédit leurs comportements en lien avec l’utilisation du test et les actions entreprises pour diminuer les risques.

Conclusion

Les programmes de communication sur les risques du RD sur la santé doivent tenir compte des aspects affectifs associés à la perception des risques, en plus de tenir compte du niveau de connaissances pour améliorer les comportements de protection. Une recherche de nature qualitative serait nécessaire pour explorer les raisons qui expliquent l’écart entre le taux d’utilisation des tests de détection et les actions concrètes pour diminuer les risques.

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References

  1. Boer, H., & Seydel, E. R. (1996). Protection motivation theory. In M. Connor & P. Norman (Eds.), Predicting health behavior. Buckingham: Open University Press.

    Google Scholar 

  2. Briggs, D., Abellan, J. J., & Fecht, D. (2008). Environmental inequity in England: small area associations between socio-economic status and environmental pollution. Social Science & Medicine, 67(10), 1612–1629.

    Article  Google Scholar 

  3. Butler, K.M., Rayens, M.K., Wiggins, A.T., Rademacher, K.B., Hahn, E.J. (2017). Association of smoking in the home with lung cancer worry, perceived risk, and synergistic risk. In: Oncology nursing forum. NIH Public Access. p. E55.

  4. Dowdall, A., Fenton, D., & Rafferty, B. (2016). The rate of radon remediation in Ireland 2011-2015: establishing a baseline rate for Ireland’s National Radon Control Strategy. Journal of Environmental Radioactivity, 16(2–163), 107–112. https://doi.org/10.1016/j.jenvrad.2016.05.001 (Accessed February 15, 2018).

    CAS  Article  Google Scholar 

  5. Farris, S. G., DiBello, A. M., Bloom, E. L., & Abrantes, A. M. (2018). A confirmatory factor analysis of the smoking and weight eating episodes test (SWEET). International Journal of Behavioral Medicine [Internet]. https://doi.org/10.1007/s12529-018-9717-0 (Accessed April 23, 2018).

  6. Field, R. W., Kross, B. C., & Vust, L. V. J. (1993). Radon testing behavior in a sample of individuals with high home radon screening measurements. Risk Analysis, 13, 441–447. https://doi.org/10.1111/j.1539-6924.1993.tb00744.x (Accessed March 16, 2017).

    PubMed  CAS  Article  Google Scholar 

  7. Glodstein, S. L., DiMarco, M., Painter, S., & Ramos-Marcuse, F. (2018). Advanced practice registered nurses attitudes toward suicide in the 15- to 24-year-old population. Perspectives in Psychiatric Care [Internet]. https://doi.org/10.1111/ppc.1227 (Accessed April 23, 2018).

  8. Hahn, E. J. (2014). Residential radon testing intentions, perceived radon severity, and tobacco use. Journal of Environmental Health, 76(6), 42–47.

    PubMed  Google Scholar 

  9. Hahn, E. J., Adkins, S. M., Wright, A. P., et al. (2014). Dual home screening and tailored environmental feedback to reduce radon and second-hand smoke: an exploratory study. Journal of Environmental Health, 76(6), 156.

    PubMed  Google Scholar 

  10. Hampson, S. E., Andrews, J. A., Barckley, M., Lee, M. E., & Lichtenstein, E. (2003). Assessing perceptions of synergistic health risk: a comparison of two scales. Risk Analysis, 23(5), 1021–1029.

    PubMed  Article  Google Scholar 

  11. Health Canada. (2014). Radon: reduction guide for Canadians. Available at: www.hc-sc.gc.ca/ewh-semt/alt_formats/pdf/pubs/radiation/radon_canadians-canadiens/radon_canadians-canadien-eng.pdf (Accessed November 11, 2017).

  12. Henderson, S. B., Kosatski, T., & Barn, P. (2012). How to ensure that national radon survey results are useful for public health practice. Canadian Journal of Public Health, 103(3), 231–234.

    PubMed  Article  Google Scholar 

  13. Hevey, D. (2017). Radon risk and remediation: a psychological perspective. Frontiers in Public Health, 5. https://doi.org/10.3389/fpubh.2017.00063 (Accessed March 15, 2017).

  14. Hill, W. G., Butterfield, P., & Larsson, L. S. (2006). Rural parents’ perceptions of risks associated with their children’s exposure to radon. Public Health Nursing, 23(5), 392–399.

    PubMed  Article  Google Scholar 

  15. Huntington-Moskos, L., Rayens, M. K., Wiggins, A., & Hahn, E. J. (2016). Radon, secondhand smoke, and children in the home: creating a teachable moment for lung cancer prevention. Public Health Nursing, 33(6), 529–538.

    PubMed  Article  Google Scholar 

  16. Klepeis, N. E., Hughes, S. C., Edwards, R. D., Allen, T., Johnson, M., Chowdhury, Z., et al. (2013). Promoting smoke-free homes: a novel behavioral intervention using real-time audiovisual feedback on airborne particle levels. PLoS One, 8, e73251. https://doi.org/10.1371/journal.pone.0073251 (Accessed February 12, 2018).

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  17. Krewski, D., Lemyre, L., Turner, M. C., Lee, J. E. C., Dallaire, C., Bouchard, L., et al. (2006). Public perception of population health risks in Canada: health hazards and sources of information. Human and Ecological Risk Assessment, 12(4), 626–644.

    Article  Google Scholar 

  18. Leech, J. A., Nelson, W. C., Burnett, R. T., et al. (2002). It’s about time: a comparison of Canadian and American time-activity patterns. Journal of Exposure Analysis and Environmental Epidemiology, 12, 427–432.

    PubMed  Article  Google Scholar 

  19. Lorang, P.S. (2001). A conceptualization and empirical assessment of the consumer testing decision process. Dissertation Abstracts. International Journal Humanities Social Science; 61(7-A).

  20. Natural Resources of Canada. (2014). About uranium. Available at: http://www.nrcan.gc.ca/energy/uranium-nuclear/7695 (Accessed January 15, 2018).

  21. Noh, J., Sohn, J., Cho, J., Kang, D. R., Joo, S., Kim, C., & Shin, D. C. (2016). Residential radon and environmental burden of disease among non-smokers. Annals of Occupational and Environmental Medicine, 28(1). https://doi.org/10.1186/s40557-016-0092-5 (Accessed March 20, 2018).

  22. Peterson, E., Aker, A., Kim, J. H., Li, Y., Brand, K., & Copes, R. (2013). Lung cancer risk from radon in Ontario, Canada: how many lung cancers can we prevent? Cancer Causes & Control, 24(11), 2013–2020.

    Article  Google Scholar 

  23. Poortinga, W., Bronstering, K., & Lannon, S. (2011). Awareness and perceptions of the risks of exposure to indoor radon: a population-based approach to evaluate a radon awareness and testing campaign in England and Wales: awareness and perceptions of the risks of exposure to indoor radon. Risk Analysis, 31(11), 1800–1812.

    PubMed  Article  Google Scholar 

  24. Rogers, R. W. (1983). Cognitive and physiological processes in fear appeals and attitude change: a revised theory of protection motivation. In J. Cacioppo & R. Petty (Eds.), Social Psychophysiology. New York: Guilford Press.

    Google Scholar 

  25. Signorelli, C., & Limina, R. M. (2002). Environmental risk factors and epidemiologic study. [article in Italian]. Annali di Igiene, 14(3), 253–262 Available at: PubMed at https://www.ncbi.nlm.nih.gov/pubmed/12162123 (Accessed January 27, 2018).

    PubMed  CAS  Google Scholar 

  26. Spiegel, J. M., & Krewski, D. (2002). Using willingness to pay to evaluate the implementation of Canada’s residential radon exposure guideline. Canadian Journal of Public Health, 93(3), 223–228.

    PubMed  Article  Google Scholar 

  27. Statistics Canada. (2016). Environment fact sheets: radon awareness in Canada. Available at: http://www.statcan.gc.ca/pub/16-508-x/16-508-x2016002-eng.htm (Accessed February 20, 2018).

  28. Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th ed.). Boston: Pearson.

    Google Scholar 

  29. U.S. Environmental Protection Agency. (2012). A citizen’s guide to radon: a guide to protecting yourself and your family from radon. Available at: http://bit.ly/2fBt15k (Accessed December 26, 2017).

  30. Witte, K. (1992). Putting the fear back into fear appeals: the extended parallel process model. Communication Monographs, 59, 329–349. https://doi.org/10.1080/03637759209376276 (Accessed May 18, 2017).

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Acknowledgements

Our thanks to all study participants for taking part. Thank you from Khan (first author) to his co-supervisor, Dr. Samia Chreim, for her valuable feedback; to Drs. Tracey O’Sullivan and Louise Bouchard for their generous guidance; and to colleague Nicole Bergen for pre-review. We thank David Buetti and Émilie Lessar for revising the French abstract. Grateful thanks to Kelley Bush and Deepti Bijlani from Health Canada for reviewing the survey questionnaire and kindly supporting the first author’s community health campaigns.

This article reports the quantitative part of a mixed methods research project conducted for a doctoral dissertation during winter 2018 at the University of Ottawa.

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Correspondence to Selim M. Khan.

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The University of Ottawa’s Institutional Review Board approved the study and data collection protocols (file number: H10-17-03).

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Khan, S.M., Krewski, D., Gomes, J. et al. Radon, an invisible killer in Canadian homes: perceptions of Ottawa-Gatineau residents. Can J Public Health 110, 139–148 (2019). https://doi.org/10.17269/s41997-018-0151-5

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Keywords

  • Air pollution
  • Indoor
  • Radon
  • Risk
  • Perception
  • Canada

Mots-clés

  • Pollution de l’air
  • Radon domiciliaire
  • Perceptions du risque
  • Canada