As many of us may know, it is World Cancer Day tomorrow, February 4, and the link between cancer and housing is not a well-kept secret anymore.

The ARCHIVE Institute works squarely at the intersection of housing and health, and aims to tackle and reduce rates of diseases such as cancer, by increasing awareness of the ways in which poor housing adversely affects health. Research has demonstrated an inextricable link between cancer and standards of housing.
The following article discusses radon, a natural radioactive gas found in homes identified to be the number one cause of lung cancer in non-smokers, and also the association between stomach cancer and poor living conditions. Poor housing environments contribute to ill health in many ways, through poor amenities, shared facilities and overcrowding, inadequate heating or energy inefficiency.

Full article from ARCHIVE after the jump.
As many of us may know, it is World Cancer Day tomorrow, February 4, and the link between cancer and housing is not a well-kept secret anymore.

The ARCHIVE Institute works squarely at the intersection of housing and health, and aims to tackle and reduce rates of diseases such as cancer, by increasing awareness of the ways in which poor housing adversely affects health. Research has demonstrated an inextricable link between cancer and standards of housing.
The following article discusses radon, a natural radioactive gas found in homes identified to be the number one cause of lung cancer in non-smokers, and also the association between stomach cancer and poor living conditions. Poor housing environments contribute to ill health in many ways, through poor amenities, shared facilities and overcrowding, inadequate heating or energy inefficiency.

Full article from ARCHIVE after the jump.
CANCER AND HOUSING

The ARCHIVE Inst works squarely at the intersection of housing and health: our work, therefore, seeks to use one fundamental right (housing) to deliver another (health). Housing is perhaps the ultimate nexus between the built environment and health disparities: it has been the focus of much recent research and intervention activity looking at new approaches to old problems¹. Poor housing environments contribute to ill health most obviously through poor amenities, shared facilities and overcrowding, inadequate heating or energy inefficiency.

The relationship between cancer and standards of housing may initially seem vague; even non-existent. In fact, research has demonstrated an inextricable link between the two. Barker et al.’s 1990 study demonstrated the aetiological processes linking stomach cancer with poverty in England and Wales. They were able to relate mortality from stomach cancer in local authority areas of England and Wales to indices of poor living standards derived from 1971, 1951, and 1931 censuses. They also found that geographical differences in stomach cancer were closely related to measures of domestic overcrowding from the 1931 census, and 1936 surveys: historic levels of domestic overcrowding in northwest Wales were consistent with its previously unexplained high death rates from stomach cancer. It was concluded that overcrowding may be a major determinant of stomach cancer, and might act by promoting the transmission of causative organisms².

Helicobacter Pylori is a bacterium that colonizes the stomach, and high prevalence of H Pylori infection has been linked with high gastric cancer rates. Prevalence of this micro-organism is closely linked to socio-economic factors, such as low income and poor living conditions during childhood - particularly inadequate sanitation and overcrowding³.

These factors aside, there remains one further, more direct link between cancer and the built environment. Radon is an odourless, colourless, natural radioactive gas formed by the breakdown of uranium found in soil, rocks beneath and around building foundations, ground water wells, and some building materials⁴. The most common source of radon poisoning in the home is from the soil used in potting plants and flowerbeds. Radon can also find its way into drinking water, though the risks in this case are much lower. The largest risk from radon-contaminated water comes from the gas being released into the air when water is used for showering and other household purposes⁵. Radon may be present in any home or building, regardless of age. Because it is a gas, it can leak into homes through the cellar, through cracks in concrete floors and walls, through floor drains and sump holes, or through well water. Ultimately, any home can be susceptible to radon poisoning⁶.

Though it does not elicit immediate symptoms, exposure to radon in homes can dramatically increase the risk of lung cancer⁷. Indeed, radon is responsible for up to 21,000 lung cancer deaths each year, and has been estimated to be responsible for 2,500 deaths per year in the UK⁸. The U.S. Environmental Protection Agency (EPA) lists indoor radon as one of the most serious environmental health problems in the United States, and the number one cause of lung cancer in non-smokers. About 2,900 non-smokers die from lung cancer caused by radon exposure each year in the U.S⁹ .

Because radon is invisible, odourless, and tasteless, regular testing is the only way to know if a home has a high concentration of radon¹⁰. In flats, it is most important to test units on the basement level where radon from the ground is likely to be highest, though tests should also be conducted on the first and second floors of any apartment complex¹¹.

The Health Protection Agency (HPA) in the UK works with social landlords to carry out radon measurement and remediation (reduction) programmes. This helps landlords to comply with their duty of care and meet the requirements of the Housing Health and Safety Rating System (HHSRS)¹². If high levels of radon are found, the social landlord determines the most appropriate remediation for the property. This could be in the following ways:

Sump system
This is the most effective remediation over a wide range of radon levels. It must be installed under a solid floor or membrane over the soil.

Positive ventilation system
This is generally cheaper, but only effective over a limited range of radon levels. This method needs access to the loft space; householders cannot leave their windows open.

Underfloor ventilation
This is used with suspended or block and beam flooring. There must be a through flow of air from one side of the property to the other. It is the cheapest method and at its most effective when the radon concentration is just above the Action Level.

For home-owners, actions to mitigate the spread of radon in the home can be taken within two broad categories:

1. Prevent the radon from entering the home.
The most common and usually most effective way to prevent radon from entering the home is through sub-slab depressurization, which involves venting air from beneath the foundation. Another preventative measure involves placing a heavy plastic over the soil in earth-floored spaces beneath the floor of a building, and using a fan and pipes or duct work to vent the radon to the outside (from underneath the plastic)13. This technique needs to be performed by qualified contractors who have completed training in a radon proficiency program.

2. Reduce the level of radon after it has entered.
Ventilation is the simplest, most effective way of reducing levels of radon in the home. Specific methods include: opening windows; installing vents in basements or crawl spaces; using ceiling fans to increase air movement; and venting air outside the house from sump holes or floor drains14. Other control methods used to reduce radon include sealing cracks in the foundation or walls and using air cleaners15. Because the balance of air exchange is so critical to the removal of radon from the home, it is important that such measures are carried out in consultation with a contractor trained in radon reduction.

These examples aside, the link between poor housing/living conditions and different strains of cancer is an area that has been drastically overlooked. More research is needed to make conclusive recommendations. The ARCHIVE Institute’s foremost goal is to improve health outcomes by delivering better housing conditions. We use a community-driven and site-specific approach to housing, which targets the health challenges faced by individual households and provides them with the skills to sustain these changes in the future.

ARCHIVE aims to tackle and reduce rates of diseases such as cancer, by increasing awareness of the ways in which poor housing adversely affects health, and by developing architectural projects based on these principles. We also conduct research projects and run open-innovation competitions to improve medical outcomes through architectural inputs.

Please visit our website at www.archiveinstitute.org for more information; or why not check us out on facebook.


¹ Hood, E. Dwelling Disparities: How Poor Housing Leads to Poor Health, Environmental Health Perspectives, May 2, 2005 (available online, accessed 15/01/2010).
² Barker, D.J.P et al, Poor housing in childhood and high rates of stomach cancer in England and Wales, Br. J. Cancer, (1990), 61,575-578.
³ Krew, D.C, Neugut, A.I, Epidemiology of Gastric Cancer, World J Gastroenterol 2006 January 21;12(3):354-362
⁴ Alliance for Healthy Homes, available at http://www.afhh.org/hps/hps_radon.htm#ResourceDocuments (accessed 15/01/2010)
⁵ Ibid
⁶ Ibid
⁷ Ibid
⁸ Wilkinson, D. Poor Housing and Ill Health: A Summary of research evidence, The Scottish Office, Central research unit available at http://www.scotland.gov.uk/Resource/Doc/156479/0042008.pdf, 1999
⁹ U.S. Environmental Protection Agency. Radon. Available at: http://www.epa.gov/radon/index.html (accessed 15/01/2010)
¹⁰ South face. Radon Resources and FAQ. 2006. Available at http://southface.org/web/resources&services/radon/sf_radonmenu.htm.(Accessed 15/01/2010).
¹¹ Alliance for Healthy Homes.
¹² Miller C. Et al, Reducing Radon levels and lung cancer risk to tenants in social housing, Environmental Radon Newsletter, spring 2009, Issue 58.
¹³ U.S. Environmental Protection Agency (2006). Consumer's Guide to Radon Reduction. Available online: http://www.epa.gov/radon/pdfs/consguid.pdf
¹⁴ ibid
¹⁵ ibid