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    The cost effectiveness of radon mitigation in existing German dwellings - a decision theoretic analysis.
        
        J. Environ. Manage. 91, 2263-2274 (2010)
    
    
    
				Radon is a naturally occurring inert radioactive gas found in soils and rocks that can accumulate in dwellings, and is associated with an increased risk of lung cancer. This study aims to analyze the cost effectiveness of different intervention strategies to reduce radon concentrations in existing German dwellings. The cost effectiveness analysis (CEA) was conducted as a scenario analysis, where each scenario represents a specific regulatory regime. A decision theoretic model was developed, which reflects accepted recommendations for radon screening and mitigation and uses most up-to-date data on radon distribution and relative risks. The model was programmed to account for compliance with respect to the single steps of radon intervention, as well as data on the sensitivity/specificity of radon tests. A societal perspective was adopted to calculate costs and effects. All scenarios were calculated for different action levels. Cost effectiveness was measured in costs per averted case of lung cancer, costs per life year gained and costs per quality adjusted life year (QALY) gained. Univariate and multivariate deterministic and probabilistic sensitivity analyses (SA) were performed. Probabilistic sensitivity analyses were based on Monte Carlo simulations with 5000 model runs. The results show that legal regulations with mandatory screening and mitigation for indoor radon levels >100 Bq/m(3) are most cost effective. Incremental cost effectiveness compared to the no mitigation base case is 25,181 euro (95% CI: 7371 euro-90,593 euro) per QALY gained. Other intervention strategies focussing primarily on the personal responsibility for screening and/or mitigative actions show considerably worse cost effectiveness ratios. However, targeting radon intervention to radon-prone areas is significantly more cost effective. Most of the uncertainty that surrounds the results can be ascribed to the relative risk of radon exposure. It can be concluded that in the light of international experience a legal regulation requiring radon screening and, if necessary, mitigation is justifiable under the terms of CEA.
			
			
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        Publikationstyp
        Artikel: Journalartikel
    
 
    
        Dokumenttyp
        Wissenschaftlicher Artikel
    
 
     
    
    
        Schlagwörter
        Cost Effectiveness Analysis ; Legal Regulations ; Lung Cancer ; Natural Radiation ; Qaly ; Radon ; Relative Risk
    
 
     
    
    
        Sprache
        englisch
    
 
    
        Veröffentlichungsjahr
        2010
    
 
     
    
        HGF-Berichtsjahr
        2010
    
 
    
    
        ISSN (print) / ISBN
        0301-4797
    
 
    
        e-ISSN
        1095-8630
    
 
     
     
     
	     
	 
	 
    
        Zeitschrift
        Journal of Environmental Management
    
 
		
    
        Quellenangaben
        
	    Band: 91,  
	    Heft: 11,  
	    Seiten: 2263-2274 
	    
	    
	
    
 
  
         
        
            Verlag
            Elsevier
        
 
         
	
         
         
         
         
         
	
         
         
         
    
         
         
         
         
         
         
         
    
        Begutachtungsstatus
        Peer reviewed
    
 
     
    
        POF Topic(s)
        30202 - Environmental Health
    
 
    
        Forschungsfeld(er)
        Genetics and Epidemiology
    
 
    
        PSP-Element(e)
        G-505300-001
    
 
     
     	
    
        PubMed ID
        20619957
    
    
    
        Scopus ID
        77955511992
    
    
        Erfassungsdatum
        2010-12-07