The Radon Project: A Study in Environmental Hazard Education

The Environmental Protection Agency estimates that numerous lung cancer deaths result every year due to radon (a naturally- occurring radioactive soil gas) exposure. The federal government has recommended that all homeowners test their homes and that those testing above 4 picocuries per liter (pCi/l) take action to correct their radon problem (Doyle, et. al., 1991).Unfortunately, although actively promoting radon as a health risk, the federal government has taken a limited role in"cleaning up" this hazard. This is primarily due to three reasons:

1. the radon hazard occurs naturally, therefore, there is no one to "regulate";

2. the problem occurs in the private home which has traditionally escaped federal regulation; and

3. the hazard occurs in varying degrees in different places, thereby making generalizations difficult (Makofske & Edelstein, 1988).

In addition, public perception of radon as a hazard is affected by the fact that radon is invisible and odorless, giving no sensory stimulus. Health risks of radon are long-term, with no short-term symptoms of exposure. Finally, there is no "villain" to blame for a naturally-occurring hazard.

To reduce radon as a health threat, a public education program is needed to increase the perception and saliency of radon as a health risk and to promote and motivate both radon testing and follow-up mitigation (structural and other changes that reduce radon levels). In concurrence with this, the federal government established a policy of allocating grant money to private agencies in high radon areas to promote radon education and testing programs. Thus, "The Radon Project" was conducted by the Virginia Citizens Consumer Council (VCCC) under a federal grant from the U.S. Environmental Protection Agency to the Consumer Federation of America. In turn, the VCCC worked with the Virginia Cooperative Extension (VCE) and the Virginia Association for Family and Community Education (VAFCE), formerly Virginia Extension Homemakers Clubs.

In Fall of 1992, eight pilot counties in the high radon risk Appalachian and Piedmont regions of Virginia were targeted for an educational program emphasizing radon testing. While utilizing the Cooperative Extension network established in each county, the objectives of "The Radon Project" were:

1. to increase public education about the importance of radon testing;

2. to sell low-cost radon test kits; and

3. to conduct a follow-up survey of people who bought test kits to find out what they did after testing their homes.

The project was to be led by the volunteer VAFCE organizations, each receiving $2 per kit sold as a fund raising and participation incentive. Although all counties received the same training and materials, provided by VCCC and VCE staff, actual program delivery was at the discretion of the local VAFCE organization. As can be expected with a largely volunteer endeavor, there was considerable variation in program implementation among counties. The time and effort put into the project by the local VAFCE clubs was quite varied. For example, some of the counties employed a variety of marketing techniques (newspaper advertisements, television broadcasts, county fairs, and Extension newsletters, for example). However, other counties employed very few techniques (such as only newspaper advertisements).

A proportional random sample was drawn from the 412 homes identified as at-risk (above 4 pCi/l) and 100 households were interviewed by telephone. Interviews were conducted in the Fall of 1993, six months to one year after the household had purchased a radon test kit.

The respondents were equally divided between male and female with a median age of almost 44 years. The education level was high with 63% having completed undergraduate or graduate degrees. Almost all (99%) were homeowners, and 47% were two member households.

In order to preserve privacy, individual radon test scores were not reported to the researcher. Therefore, radon test levels were identified by recall of the respondents, as follows:

The remaining 14% did not remember that their radon level was over 4 pCi/l, although that was a requirement to be in the sample pool.

Despite the fact that all households were identified as at- risk, and had been motivated to test their homes, only 41% of the respondents actually believed that their home had a radon problem. Further, 46% believed their home did NOT have a radon problem. Women (49%) tended to be more likely to perceive radon as a problem than men (33%). Likewise, people with a college education (43%) were more likely to perceive a radon problem than those with a high school education (29%). The presence of children in the household did not really affect the perception of the radon problem (43% for households with children, 40% for those without).

Perception of a radon problem is assumed to be necessary for a household to take mitigation action. However, of the respondents who believed they had a radon problem, only 63% had taken ANY action to deal with the radon problem, with retesting being the most common action. Therefore, further analysis sought to understand what motivates a response to the radon hazard. Four variables were considered:

1. SOCIAL INFLUENCE, measured by assessment of the media messages and educational campaigns conducted in the respondents' county;

2. OBJECTIVE RISK, measured by the radon level measured in the home;

3. PERCEIVED RISK, measured by the respondent's sense of the seriousness of radon as a health threat; and

4. WORRY, measured by the respondent's reported levels of worry about the radon problem in their home.

Cross-tabulation tables and testing for association through the use of the gamma function were used to determine significant associations for the listed variables. OBJECTIVE RISK was found to be significant, with respondents with high radon test reports (over 10 pCi/l) being more likely to take action to respond to the hazard. PERCEIVED RISK also was found to have a significant association, with higher perceived risk associated with greater response to the radon hazard. Other variables were not significant. From the perspective of Extension educators, it is particularly important to note that the social influence variable, measuring the educational campaign, was not significant.

The evaluation of the pilot stage of "The Radon Project" clearly shows the difficulties in radon education. Despite a public education campaign, radon was not broadly perceived as a health threat. This is indicated by the large number of households:

• who did not complete the radon testing after purchase of a test kit;

• who did not perceive radon as a problem in the face of objective evidence; and

• who did not take action to mitigate their radon problem.

The primary objective of this project was testing, with mitigation as a secondary objective. Therefore, even among those who perceived the radon problem, mitigation was limited. In retrospect, the emphasis on testing may have been faulty. Testing, or even purchase of a test kit, may introduce a complacency that the household has "done something" about radon. In addition, general comments made by study participants at the end of the interview indicated that confusion about mitigation techniques, the resource cost of mitigation, and lack of perception of radon as a "big" problem, all contributed to the apathy about radon reduction action.

As a result of this study, greater and more focused public education about radon as a health threat and the accomplishment of radon mitigation is recommended. Focus is needed on:

1. increasing the saliency of the health threat of radon; and

2. developing the concept of testing to mitigation as a continuum of action to be taken to address a radon problem.

The public needs to understand radon is a health threat, especially in high risk areas or populations. Further, individual citizens must be responsible to identify, through testing, their level of risk; and, if at risk, to take action to reduce that risk.

Radon is a unique environmental threat in that it cannot be perceived, sensed, or experienced. Accepting the saliency of the threat, and thus the need for action, must come from a trust in the accuracy and credibility of the information source. Extension has the potential to be that source, but may need to work through more direct and focused programming with at-risk audiences, and less with awareness methods, such as public media.

Testing for radon would appear to be an objective method to identify a radon risk. However, lacking effective education on the saliency of the radon threat, this study found that a test was often inadequate to create a risk perception. Extension education programs need to focus on reduction of the radon risk, with testing as a tool or method to begin the process. Risk reduction education needs to emphasize health and safety, economic benefit, and realistic and workable mitigation procedures. Radon risk reduction education may also need to address building, contracting or repair businesses and services, and real estate agents to increase the availability of mitigation assistance.

The radon education program in Virginia is ongoing, refocused, and revised as a result of what was learned in this pilot project.

Doyle, J.K., McClelland, G.H., Schulze, W.D., Elliott, S.R., & Russell, G.W. (1991). Protective response to household risk: A case study of radon mitigation. Risk Analysis, 11, 121 - 134.

Makofske, W.J. & Edelstein, M.R. (1988). Radon and the environment. Park Ridge, NJ: Noyes.