1.1 Introduction
The outdoor and indoor living environment, occupational exposure and lifestyle may have diverse effects on human health depending on age and gender. Segments of living conditions may be modified on an indivdual basis, such as diet, smoking or drinking habits, while the major contaminants in air, food or water can only be improved through political will, economic conditions and public awareness which is largely based on the educational level of the parties involved. Development of sustainable buildings is a significant step forward, from both economic and ecological viewpoints, though the microenvironment created in such living surroundings may present a complex radiochemical setting that could pose a potential threat to the health of its occupants. As the modern lifestyle involves spending the majority of time indoors (70–80%) (Farrow et al., 1997), indoor air quality significantly contributes to overall public health.
The construction sector is rapidly developing and over the past two decades many new materials and technologies that improve the economy and energy efficiency of buildings have been introduced. Although reliable data on the health effects of volatile organic compounds, formaldehyde, asbestos and flame retardants have been collected, legislation and control of their application and emissions remain unsatisfactory. Small children and pregnant women deserve special concern, as foetuses and small children have specific metabolism, bioaccumulation and elimination of xenobiotics. Knowledge of the health effects of dangerous gases, particles and fibres that may be emitted at room temperature from certain building furnishing materials and construction products containing radionuclides that increase indoor exposure to ionizing radiation, has to be applied by all parties involved in construction of buildings and available to their occupants. Xenobiotics in indoor air may be irritants, immunodisturbing agents, endocrine disruptors and/or carcinogens. Their mechanisms interact and overlap, provoking various diseases based on genomic and non-genomic mechanisms which are both age-and gender-specific.
1.2 Radiation
Exposure to ionizing radiation is one of the basic mechanisms of evolution. However, the nuclear weapons industry and testing, nuclear war and nuclear accidents have increased ionizing radiation in the living environment to levels to which life on Earth has not adapted during evolution.
For decades, exposure to radiation was associated with genome damage and cancer development. Recent research on the mechanisms by which ionizing radiation may increase health risk has also been focused on cardiovascular diseases and immunological disturbances. There are special cases of very complex mechanisms involved in the biological effects of radioactive isotopes which may not only be a source of radiation but, as heavy metals, such as uranium, can express also hormonal, oestrogen-like activity.
In addition to naturally occurring radon, which may be present in high concentrations in some areas depending on geological characteristics and the soil, radioisotopes from fly ash, certain granites and zirconium minerals are major sources of exposure to ionizing radiation in the indoor environment.
Indoor exposure to radon is correlated with an increased risk of lung cancer, with an excess relative risk of 10% per 100 Bq m− 3 (Fucic et al., 2010). Causality between radon exposure and lung cancer is known for uranium miners (Vacquier et al., 2011). Genome damage caused by densely ionizing radiation of radon represents a complex interaction of DNA damage and repair capacity that can be exhausted during tissue regeneration of lung cells. Such new mechanisms explain disturbance of cell division control beyond the threshold dose rate (Madas and Balásházy, 2011). Other biological mechanisms may also appear after exposure to radon (alpha particles), such as the bystander effect (in which unirradiated cells exhibit irradiated effects as a result of signals received from nearby irradiated cells) and adaptive response (when exposure to low doses of ionizing radiation can make cells more resistant to later radiation exposure). These mechanisms result in different lung cancer aetiology between uranium miners and residential, low-dose exposures (Balásházy et al., 2009). At the individual level, the risk of radon-induced lung cancer is much higher among current cigarette smokers than among lifelong non-smokers. This was illustrated in a pooled analysis of European residential radon studies (Darby et al., 2005). For lifelong non-smokers, it was estimated that living in a home with an indoor radon concentration of 0, 100 or 800 Bq m− 3 was associated with a risk of lung cancer death (at the age of 75) of 4, 5 or 10 per 1000 persons, respectively. However, for cigarette smokers, each of these risks is substantially greater, namely 100, 120 and 220 per 1000 persons. For former smokers, the radon-related risks are substantially lower than for those who continue to smoke, though they remain considerably higher than the risks for lifelong non-smokers. This confirms the cost-effectiveness of indoor radon control of future policies, especially if complemented with policies for smoking reduction (Groves-Kirkby et al., 2011). It should be pointed out that cigarettes are not only a major source of numerous chemical agents, the majority of which are carcinogens, but also of radioactivity, as cigarettes also contain polonium and radioactive lead (Desideri et al., 2007). Additionally, the risk of combined exposure to smoking and indoor radon is gender-specific (Truta-Popa et al., 2010). There are also inter-individual differences in radiosensitivity to radon, since for carriers of certain types of the detoxification enzyme gluthatione-S-transferase, the risk of lung cancer is three times higher (Bonner et al., 2006).
Regulation and control of radon levels in occupational and living environments has been ongoing for several decades and reflects the knowledge to date. The current opinion given by international bodies such as ICRP, WHO and IAEA agrees on an upper limit for residential indoor radon of 200–300 Bq m− 3, which will be incorporated in their new documents in a short time (Bochicchio, 2011). However, the control of indoor radon levels and recommended remediation pertain to naturally occurring indoor radon, while there is no regulation that would control the incorporation of fly ash in concrete which may also significantly increase indoor radon levels.
Children are of special concern (Fucic et al., 2008; Holland et al., 2011) as they are more radiosensitive due to the higher cell division rate and underdeveloped xenobiotic elimination system. For this reason, radon-caused genome damage is especially dangerous in children (Bilban and Vaupotič, 2001). As radon is nine times heavier than air, small children who breathe air closer to the floor and at a higher frequency per body mass than adults (Gratas-Delamarche et al., 1993) are more exposed than adults. It could be thus suggested that recommendations for radon level in kindergartens and schools should be lower than in other buildings and the general population should be educated in how to protect children at home.
Fly ash as a by-product of thermal plants concentrates radionuclides such as uranium (235U, 238U), radium (226Ra), thorium (232Th), lead (210Pb), polonium (210Po) and potassium (40 K) by a factor of 20 to 25 compared to levels in the original peat (European Commission, RP-112, 1999). Globally, about 280 million tonnes of coal ash is produced annually, of which 40 million tonnes is used in the production of bricks, cement, road stabilizers, road fill, and asphalt mix (UNSCEAR, 2006). From such sources, individual doses of radiation exposure to the general public can be about 100 μSv per year (Menon et al., 2003). Cement is successfully replaced with fly ash in concrete in the range from 10% to 80%. As fly ash is a hazardous waste containing toxic metals and radionuclides, its use as a construction material is encouraged as a form of waste management. Thus, fly ash has become a zero-cost raw building material that would otherwise require special waste management (Nisnevich ...