CCSG Pilot: Lung Cancer Prevention Policy: Building Consensus for Radon Control

Stacy R. Stanifer, PhD, APRN, AOCNS Abstract Lung cancer is essentially preventable by lowering cigarette smoking rates and reducing exposure to radon and secondhand smoke. Radon, a naturally occurring environmental carcinogen, is responsible for tens of thousands of radon-induced lung cancer deaths annually, yet exposure to radon is highly avoidable. Comprehensive radon control policies which reduce disparities and eliminate avoidable radon exposure at home, school, or work, can save lives. Yet radon control legislation across the U.S. remains inconsistent, creating unequal protections from the cancer-causing gas and fostering health inequities The scientific premise is that 1) exposure to radon is a known cause of lung cancer; 2) socioeconomic inequalities create disproportionate risks and limit hazard remediation options for lung cancer prevention; and 3) strong, comprehensive radon control policies which address inequities and reduce exposure to the environmental carcinogen can reduce lung cancer risk. This feasibility study will systematically engage former policymakers (N = 29) from Kentucky and each of its 7 contiguous states to document their opinions on the importance, desirability and feasibility of radon control policy alternatives related to radon resistant new construction, mandatory testing and specific disclosure of test results during real estate transactions establishment of financial resources for radon mitigation among low-income populations, mandatory testing and mitigation in schools, and requiring certification for those performing radon measurement and mitigation. Aim 1 will test a novel approach for building consensus about radon control policies among former elected officials in Kentucky and its 7 contiguous states. Using the policy Delphi method, The MCC POP Sciences SRF will assist with inviting former policymakers from 8 states to participate in a survey and key informant interviews to obtain and exchange information and develop consensus on radon control policy. We hypothesize that through the use of the policy Delphi method, we will observe an increase in consensus in favor of radon control policies. Aim 2 will examine differences in policymaker favorability toward radon control policy and state level demographics, radon risk potential, and policymakers’ political ideation and experience with radon testing and mitigation. We hypothesize that policymakers who have personal radon testing or mitigation experience and those in states with higher radon risk potential and greater median home values will be more favorable toward radon control policies. This proposed feasibility study will provide preliminary data for a subsequent larger study of current state level policymakers across the U.S. and will fill a critical gap in cancer prevention research by gaining an understanding of the radon control public policy landscape. The policy Delphi method has the potential to translate science into action by building consensus for radon legislation that will reduce environmental injustice, protect all members of the public from avoidable radon exposure, and ultimately reduce radon- induced lung cancer incidence in the United States.