Analysis of Local Decisions Using Hierarchical Modeling, Applied to Home Radon Measurement and Remediation

This paper examines the decision problems associated with measurement and remediation of environmental hazards, using the example of indoor radon (a carcinogen) as a case study. Innovative methods developed here include (1) the use of results from a previous hierarchical statistical analysis to obtain probability distributions with local variation in both predictions and uncertainties, (2) graphical methods to display the aggregate consequences of decisions by individuals and (3) alternative parameterizations for individual variation in the dollar value of a given reduction in risk. We perform cost-benefit analyses for a variety of decision strategies, as a function of home types and geography, so that measurement and remediation can be recommended where it is most effective. We also briefly discuss the sensitivity of policy recommendations and outcomes to uncertainty in inputs. For the home radon example, we estimate that if the recommended decision rule were applied to all houses in the United States, it would be possible to save the same number of lives as with the current official recommendations for about 40% less cost.

[1]  R. Zeckhauser,et al.  A primer for policy analysis , 1978 .

[2]  C Milligan,et al.  Screening for cervical cancer. , 1975, The American journal of nursing.

[3]  S. B. White,et al.  Indoor 222Rn concentrations in a probability sample of 43,000 houses across 30 states. , 1992, Health physics.

[4]  George W. Mushrush,et al.  Variable spacial and seasonal hazards of airborne radon , 1997 .

[5]  W. Viscusi.  Fatal Tradeoffs: Public and Private Responsibilities for Risk , 1992 .

[6]  James Douglas Englehardt,et al.  A Bayesian Benefit‐Risk Model Applied to the South Florida Building Code , 1995 .

[7]  W. Odling-Smee,et al.  Screening for Breast Cancer , 1985, The Lancet.

[8]  Kent B. Barnes,et al.  Indoor radon hazard: a geographical assessment and case study , 1994 .

[9]  J. Neuberger,et al.  Lung cancer risk from residential radon: meta-analysis of eight epidemiologic studies. , 1997, Journal of the National Cancer Institute.

[10]  D A Berry,et al.  One-sided sequential stopping boundaries for clinical trials: a decision-theoretic approach. , 1988, Biometrics.

[11]  S. B. White,et al.  Areas of the United States with elevated screening levels of 222Rn. , 1994, Health physics.

[12]  W J Fisk,et al.  Evaluation of radon mitigation systems in 14 houses over a two-year period. , 1990, Journal of the Air & Waste Management Association.

[13]  U. Epa,et al.  Guiding Principles for Monte Carlo Analysis , 1997 .

[14]  B. Cohen,et al.  Test of the linear-no threshold theory of radiation carcinogenesis for inhaled radon decay products. , 1995, Health physics.

[15]  A. V. Nero,et al.  Joint Analysis of Long-and Short-term Radon Monitoring Data from the Northern U.S. , 1996 .

[16]  J H Lubin,et al.  Cigarette use and the estimation of lung cancer attributable to radon in the United States. , 1995, Radiation research.

[17]  Miron Israeli,et al.  Distribution and Expected Time of Residence for U.S. Households. , 1992, Risk analysis : an official publication of the Society for Risk Analysis.

[18]  S. C. Darby,et al.  Health Risks of Radon and Other Internally Deposited Alpha-Emitters-BEIR IV. , 1989 .

[19]  J M Samet,et al.  A review of ecologic studies of lung cancer and indoor radon. , 1993, Health physics.

[20]  J.C.H. Miles,et al.  Mapping radon-prone areas using house radon data and geological boundaries , 1996 .

[21]  Mitchell J. Small,et al.  Updating Uncertainty in an Integrated Risk Assessment: Conceptual Framework and Methods , 1995 .

[22]  W. E. Hobbs,et al.  Identification and assessment of a small, geologically localized radon hot spot , 1996 .

[23]  Xiao-Li Meng,et al.  POSTERIOR PREDICTIVE ASSESSMENT OF MODEL FITNESS VIA REALIZED DISCREPANCIES , 1996 .

[24]  Richard G. Sextro,et al.  Performance of radon control systems , 1991 .

[25]  A. A. Moghissi,et al.  Risk-based environmental remediation , 1995 .

[26]  John E. Tropman,et al.  Valuing Life: Public Policy Dilemmas , 1982 .

[27]  P N Price,et al.  Predictions and maps of county mean indoor radon concentrations in the mid-Atlantic states. , 1997, Health physics.

[28]  A C Taylor,et al.  The value of animal test information in environmental control decisions. , 1993, Risk analysis : an official publication of the Society for Risk Analysis.

[29]  D. E. Barber,et al.  Comparative dosimetry of radon in mines and homes , 1992 .

[30]  David Vose,et al.  Quantitative Risk Analysis: A Guide to Monte Carlo Simulation Modelling , 1996 .

[31]  Tom Fearn,et al.  Seasonal correction factors for indoor radon measurements in the United Kingdom , 1995 .

[32]  K E Warner,et al.  Effects of residential mobility on individual versus population risk of radon-related lung cancer. , 1995, Environmental health perspectives.

[33]  M. A. Tabatabai,et al.  Radon and Its Decay Products in Indoor Air , 1989 .

[34]  O. Axelson,et al.  Residential radon and lung cancer in Sweden: risk analysis accounting for random error in the exposure assessment. , 1997, Health physics.

[35]  A. G. Scott,et al.  Testing of indoor radon reduction techniques in eastern Pennsylvania: an update. Published paper, May 1985-March 1987 , 1987 .

[36]  S N Rai,et al.  Uncertainty and variability analysis in multiplicative risk models. , 1998, Risk analysis : an official publication of the Society for Risk Analysis.

[37]  J. Schoenberg,et al.  Relationship among short- and long-term radon measurements within dwellings: influence of radon concentrations. , 1993, Health physics.

[38]  Naomi H. Harley,et al.  Comparative Dosimetry of Radon in Mines and Homes , 1992 .

[39]  S B Thacker,et al.  Radon and lung cancer: a cost-effectiveness analysis. , 1999, American journal of public health.

[40]  D K Stangl,et al.  Prediction and decision making using Bayesian hierarchical models. , 1995, Statistics in medicine.

[41]  K. A. Wilbert,et al.  Element of risk: The politics of radon , 1994 .

[42]  D Ozonoff,et al.  Compliance with EPA guidelines for follow-up testing and mitigation after radon screening measurements. , 1992, Health physics.

[43]  Rajeev Dehejia,et al.  Program Evaluation as a Decision Problem , 1999 .

[44]  L B McCullough.  Prioritizing or Rationing Health Care , 1995, Annals of Internal Medicine.

[45]  M J Small,et al.  Risk-based environmental remediation: Bayesian Monte Carlo analysis and the expected value of sample information. , 1995, Risk analysis : an official publication of the Society for Risk Analysis.

[46]  J D Graham,et al.  The value of monitoring for radon in the home: a decision analysis. , 1988, JAPCA.

[47]  W. Nazaroff,et al.  Distribution of airborne radon-222 concentrations in U.S. homes. , 1986, Science.

[48]  J Siemiatycki,et al.  Design issues in studies of radon and lung cancer: implications of the joint effect of smoking and radon. , 1995, Environmental health perspectives.

[49]  Kenneth T. Bogen,et al.  Do U.S. county data disprove linear no‐threshold predictions of lung cancer risk for residential radon?‐A preliminary assessment of biological plausibility , 1997 .

[50]  A E Gelfand,et al.  Approaches for optimal sequential decision analysis in clinical trials. , 1998, Biometrics.

[51]  P N Price,et al.  Bayesian prediction of mean indoor radon concentrations for Minnesota counties. , 1996, Health physics.

[52]  K E Warner,et al.  Toward a more realistic appraisal of the lung cancer risk from radon: the effects of residential mobility. , 1996, American journal of public health.

[53]  Bradley P. Carlin,et al.  BAYES AND EMPIRICAL BAYES METHODS FOR DATA ANALYSIS , 1996, Stat. Comput..

[54]  S. R. Watson,et al.  Decision Synthesis: The Principles and Practice of Decision Analysis@@@Strategic and Tactical Decisions , 1989 .

[55]  M. Degroot.  Optimal Statistical Decisions , 1970 .