Indoor Radon Exposure and Risk of Childhood Leukemia:  A Systematic Review and Meta-analysis

Amirhosein Nazari; Setareh Sabeti; Parniyan Sadeghi; Ali Darvishinia; Mahdi Daraei; Sepehr Ghahramani; Neda Hajizadehanari; Rozhina Yasini; Mohammad Nayebi; Mahna Soleimani; Tara Kashefi; Yaser Soleimani; Alireza Mosavi Jarrahi

doi:10.31557/apjec.2042.20250816

Authors

Amirhosein Nazari Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Setareh Sabeti Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Parniyan Sadeghi Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ali Darvishinia Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mahdi Daraei Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sepehr Ghahramani Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Neda Hajizadehanari Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Rozhina Yasini Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mohammad Nayebi Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mahna Soleimani Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tara Kashefi Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Yaser Soleimani Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Alireza Mosavi Jarrahi Cancer Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI:

https://doi.org/10.31557/apjec.2042.20250816

Abstract

Background: Radon, a naturally occurring radioactive gas, is a known carcinogen for lung cancer, but its role in leukemia remains less understood. This systematic review and meta-analysis aimed to evaluate the association between radon exposure and the risk of leukemia.

Methods: We conducted a systematic review of case-control and cross-sectional studies to investigate the link between radon exposure and leukemia risk. Studies were selected based on specific criteria, including validated radon exposure assessments and quantitative risk estimates. A comprehensive search across PubMed, Scopus, and Web of Science identified 743 articles, with 11 studies meeting the inclusion criteria. Data were extracted using a standardized form, and the Joanna Briggs Institute (JBI) critical appraisal tool assessed study quality. Meta-analysis was performed using a random-effects model to account for study heterogeneity.

Results: The meta-analysis of 11 studies yielded a pooled odds ratio (OR) of 1.57 (95% CI: 0.77–2.38), suggesting a potential positive association between radon exposure and leukemia risk. However, this association was not statistically significant, as the confidence interval included the null value of 1. Substantial heterogeneity was observed across studies (I² = 99.54%, p < 0.001). Sensitivity analyses indicated that no single study disproportionately influenced the pooled estimate. Funnel plot inspection and statistical tests (Egger’s and Begg’s) revealed no evidence of publication bias.

Conclusion: This meta-analysis suggests a potential association between radon exposure and leukemia risk, though the evidence is not statistically significant. The observed heterogeneity underscores the need for further research with standardized methods and larger sample sizes to clarify the relationship between radon exposure and leukemia. Future studies should focus on improving exposure assessment and exploring underlying biological mechanisms.