Radon Health Impact Assessment and Risk Communication in Sardinia Region&#160;
Authors: Cori Liliana , Cappai Massimo , Dettori Ivana , Loi Natalina , Nurchis Pierpaolo , Sanna Augusto , Serra Grazia , Sirigu Elio , Tidore Marcello , Bianchi Fabrizio 
Published: March 2021

&lt;p&gt;INTRODUCTION&lt;/p&gt;&lt;p&gt;Following the recommendations of the National Prevention Plan, the Sardinia Region Department of Hygiene, Health and Social Security has promoted a programme dedicated to protecting the population from exposure to radon gas. The plan included: radon monitoring activities during a dedicated campaign based on geological mapping; radon Health Impact Assessment, HIA; drafting of &amp;#8220;Guidelines for the construction/renovation of buildings&amp;#8221;; community involvement and a radon risks communication campaign.&lt;/p&gt;&lt;p&gt;OBJECTIVES&lt;/p&gt;&lt;p&gt;To present the development of the HIA based on radon environment monitoring data and the communication process.&lt;/p&gt;&lt;p&gt;METHODS&lt;/p&gt;&lt;p&gt;Radon risk mapping combined the knowledge of geological composition of Sardinia Island and the results obtained by monitoring with dedicated devices.&lt;/p&gt;&lt;p&gt;HIA was implemented calculating cases attributable (CA) to radon exposure, combining the following parameters: Relative Risk (available by literature); mortality rate of lung cancer prevalence/incidence rate (baseline); exposed population size; radon concentration target.&lt;/p&gt;&lt;p&gt;The radon monitoring campaign required a widespread communication activity, while the results communication activity, based on a dedicated plan, involved multiple stakeholders.&lt;/p&gt;&lt;p&gt;RESULTS&lt;/p&gt;&lt;p&gt;On the basis of radon concentration data estimated by ARPAS, the HIA procedure estimated lung cancer deaths attributable to radon in areas of different exposure and throughout Sardinia. In the whole region, with an average concentration of 116 Bq/m3, radon-attributable cases were estimated at 143 out of 832 total expected deaths (attributable fraction 17.2%); in the area most at risk, including 49 municipalities, with an estimated average concentration of 202 Bq/m3, radon-attributable deaths were 13 out of 55 total (attributable fraction 23.6%).&lt;/p&gt;&lt;p&gt;The parameters of the algorithm and the results were presented and discussed with the local working groups.&lt;/p&gt;&lt;p&gt;A specific radon monitoring activity developed in schools helped to focus the efforts on the protection of school goers as vulnerable and susceptible groups. Urgent renovation and improvement activities in school and in other public administration buildings throughout the region were carried out.&lt;/p&gt;&lt;p&gt;Six guided discussions and four training sessions during six months were held to develop HIA and communication activities. A meeting to present the work was held in Nuoro town in October 2019, where information material was distributed and public attention raised around the issue.&lt;/p&gt;&lt;p&gt;The communication process aggregated several stakeholders including: civil servants in the field of health and the environment; public administrators; health professionals committed to spread knowledge about radon-free building.&lt;/p&gt;&lt;p&gt;CONCLUSIONS&lt;/p&gt;&lt;p&gt;The objectives of the regional program were focused to: - protect Sardinian population from radon risk, with special reference to vulnerable and susceptible subjects, particularly radon exposed smokers; - spread knowledge about risks; - inform about the opportunities to reduce risks.&lt;/p&gt;&lt;p&gt;Results indicate that the health of populations living in radon-exposed areas can be significantly improved by reducing exposure to radon and synergistic risk factors. It is essential to strengthen awareness-raising activities using historical and acquired knowledge and to monitor progress in order to reinforce further action, as these activities should be planned for the long term.&lt;/p&gt;