Is environmental radon gas associated with the incidence of neurodegenerative conditions? A retrospective study of multiple sclerosis in radon affected areas in England and Wales

• Multiple Sclerosis has been postulated to be triggered by elevated radon gas levels.
• MS incidence analysed from 20 million person-years monitoring in radon affected areas.
• Linear regression slope of ERR against radon level is 0.22 per 100 Bq·m−3 (R2 = 0.25).
• Linear fit 95% CI encompasses the Null Hypothesis and is therefore not significant.
• Potential confounding processes are shown to have minimal impact on the results.

To test whether an association exists between radon gas concentration in the home and increased multiple sclerosis (MS) incidence, a retrospective study was undertaken of MS incidence in known areas of raised domestic radon concentration in England and Wales, using The Health Improvement Network (THIN) clinical research database.The study population comprised 20,140,498 person-years of clinical monitoring (males: 10,056,628: 49.93%; females: 10,083,870: 50.07%), representing a mean annual population of 2.5 million individuals. To allow for the possible latency of MS initiation following exposure, data extraction was limited to patients with at least five years registration history with the same GP practice before first diagnosis. Patient records were allocated to one of nine radon concentration bands depending on the average radon level in their postcode sector.MS incidence was analysed by searching for patients with first MS diagnosis over the eight calendar years 2005–2012 inclusive. 1512 new MS cases were diagnosed, 1070 females, 442 males, equivalent to raw incidence rates of 7.51, 10.61 and 4.40 per 105 person-years respectively, comparable to previously reported results. Of these new cases, 115 could be allocated to one of the radon bands representing high radon areas.Standardising to the UK 2010 population, excess relative risk (ERR) figures for MS were calculated for each radon band. Linear regression of ERR against mean band radon concentration shows a positive gradient of 0.22 per 100 Bq·m−3 (R2 = 0.25, p = 0.0961) when forced through the origin to represent a linear-no-threshold response. The null hypothesis falls inside the 95% confidence interval for the linear fit and therefore this fit is not statistically significant. We conclude that, despite THIN sampling around 5% of the population, insufficient data was available to confirm or refute the hypothesised association between MS incidence and radon concentration.