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Jocelyn Barrios, right, holds her son as contractor Arnold Drennen explains a radon gas monitor during his company’s installation of a radon mitigation system in Barrios’ Fort Collins home. Photos by Joe Mahoney / Special to The Colorado Trust


Reducing the Risk of Lung Cancer, Free of Charge

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When Jocelyn Barrios and her husband finally put together enough resources to make a down payment on their Fort Collins home in 2015, an unsettling radon test from the inspection ended up well down on their to-do list.

Barrios was re-establishing her teaching career in the United States after working in Germany, and her husband was looking for full-time work. With the down payment and the move and the list of fixer-uppers, the $1,000-plus cost of radon mitigation seemed out of reach.

Pregnancy has a way of focusing the mind and shoring up the nest. “I wanted to get it solved,” said Barrios, who this spring was nearing a welcome for their first child. “You hear radon can cause cancer, and our nursery has access to the crawl space, so in my mind it was the room that would have higher levels.”

Barrios started searching online for low-interest loans or grants. She turned up LIRMA, Colorado’s Low-income Radon Mitigation Assistance program, which covers the full cost of radon mitigation for up to 100 families a year who meet federal low-income requirements.

Barrios went into the hospital in labor on the deadline day for providing her proof of income to the LIRMA program. But the state sent reminder emails and gave her a grace period, and by early July, a team of private contractors were busy in the Barrios’ home crawl space and up and down the outside walls, installing the airflow barriers and suction fans that dissipate low-level radon emissions to a harmless outside vent. The contractors were in by 9 a.m. and out by 1 p.m.

“If I can prevent our little guy from exposure, I want to do that,” Barrios said.

The LIRMA program is a small but tangible step toward environmental health equity that bridges a gap caused by Colorado’s specific geography and general economic reality.

Colorado’s soils contain a naturally higher level of background radioactive material than many states, and the uranium particles emit unhealthy levels of radon gas in homes from the Western Slope to the Front Range. Though decaying uranium is invisible and odorless, the threat to families can be all too real. The U.S. Environmental Protection Agency (EPA) identifies radon as the second-leading cause of lung cancer, after smoking. The combination of second-hand smoke and radon in a household greatly magnifies the danger. Radon causes about 21,000 deaths each year in the U.S., and about 2,900 of those deaths happen among people who have never smoked, according to the EPA.

“Radon exposure is responsible for more deaths each year than fires, asbestos-related cancer, and carbon monoxide poisoning combined [yet] it lacks the widespread awareness of those home dangers,” Indiana University researchers wrote in a report on radon and economics.

Home radon levels measured above 4 picocuries per liter (pCi/l) of air can, over time, cause higher rates of lung cancer and other disease in residents, according to the EPA. (The World Health Organization sets the bar even lower, saying that levels above 2.7 pCi/l are too high.)

Radon testing and mitigation costs hit busy families with yet another task requiring extensive self-education and a drain on financial resources. (The cost of mitigation, with the goal of getting radon measurements down to the 2.0 pCi/l level or below, ranges from about $495 to $3,500, with typical jobs coming in at about $1,000 to $1,200; the fix usually lasts for decades.) Colorado and national studies show a wide gulf in education and income levels between homeowners who have tested and arranged fixes, and those who have managed neither.

All of Colorado’s counties are considered Zone 1 or high radon-testing counties by the EPA, and Colorado is in the highest handful of states in terms of average radon levels on tests. Nearly 45 percent of household radon tests in Colorado from 2008 to 2012 found levels above EPA action recommendations, from more than 80,000 tests, according to the Colorado Department of Public Health and Environment (CDPHE).

Income and racial differences in Colorado can amplify the risks for different groups, creating equity concerns that CDPHE and others are trying to attack with the free mitigation program and education efforts.

On the income side, for example, household surveys show that while 48 percent of Coloradans with household income of $50,000 or more have tested for radon, only 21 percent have tested in households with less than $15,000 income. (The federal poverty level in 2019 is $25,750 for a family of four.) Households in the lower income brackets are much more likely to experience direct or “drift” secondhand tobacco smoke—the major aggravator for radon gas effects—than households with higher incomes, often due to living in multi-unit housing. “These disparities are contributing to health inequity and environmental injustice, particularly around healthy housing for all Colorado communities,” a CDPHE researcher wrote in a 2014 brief on radon.

Racial disparities in secondhand smoke are even more stark, according to CDPHE. More than 53 percent of African Americans in Colorado experience direct or drifting secondhand smoke in their homes, and 50 percent of Hispanics. About 38 percent of white Coloradans are exposed to secondhand smoke.

CDPHE’s Chrystine Kelley has spent the last 15 years overseeing a state-run radon testing program that predated her, sending out free consumer test kits (funded by EPA grants) in the mail to anyone who asks. It served a purpose, but was never enough, Kelley said.

“We’d get lower-income people to test and then we had no way to help them mitigate,” Kelley said. “It was a constant frustration of mine that we didn’t have any way of helping them fix their houses.”

CDPHE was part of a coalition in 2016 that went to the state legislature to seek radon mitigation funding. The state charges fees at hazardous waste facilities and for handling emergency hazardous responses, and Colorado House Bill 16-1141 asked to use the interest earned on those fees to pay for as many radon mitigation projects each year as possible. The bill also broadened the state’s education and awareness program for radon.

“We didn’t have to ask for new money,” Kelley said, always a boost in a legislative system that requires fiscal notes detailing any potential new spending arising from each bill.

After months of writing rules for screening contractors and applicants, the new program started accepting applications in February 2018. To participate, homeowners must be Colorado residents and occupying the property, qualify as a low-income household per federal standards, and have radon test results of 4.0 pCi/l or higher. The fee interest generates about $100,000 to $150,000 a year, meaning CDPHE can fund mitigation at about 100 to 150 homes.

“People are so grateful,” Kelley said. “Imagine talking to an 80-year-old lung cancer patient who just made it through surgery, and she barely has food on the table, and we can mitigate her house.”

CDPHE’s ongoing outreach and education program uses health fairs, public service announcements and grants to 20 local health departments to offer test kits to Coloradans. State staff try to study patterns in how people ask for kits and who returns them, in order to improve their outreach to underserved areas. Quilting bees, PrideFest, Telemundo and Univision, VFW halls and Juneteenth are just some of the avenues by which they’ve handed out forms or encouraged people to request a kit online.

The state Low-income Energy Assistance Program (LEAP), which provides grants to helps residents pay heating bills, also markets the radon program. Weatherizing a house to lower energy bills can also increase radon risk by further sealing in radon gas, so mitigation information can go hand-in-hand with LEAP marketing.

Online requests are convenient for the consumer, but there is some evidence that test kits requested through a written form or coupon have higher return rates because residents have made even a slightly bigger commitment to seeking a test.

“If [a radon test kit] never gets returned, it’s a waste of our tax dollars, so we’re now trying to boost return rates of those who requested online,” Kelley said.

Once a test kit has registered a high result, a homeowner seeking help covering the cost of mitigation fills out a page-and-a-half application and provides proof of income. Translators can help foreign-language speakers walk through the process, and the state is working on making all documentation available in Spanish as well as English. (One of the application reviews checks whether the house is for sale—many new homeowners seek a radon test as part of an inspection, but CDPHE doesn’t want to pay for mitigation just to save the home’s seller those costs.)

Officials say they will go out of their way to make residents comfortable, like the elderly Garfield County woman who didn’t have a computer for applying and also was hesitant about meeting the contractor. A state health department employee came to her house during the mitigation work to keep her company.

The state wants more contractors, especially in far-flung corners of Colorado. The qualification process is daunting for some, as they need to be nationally certified and bonded, and declare which of the multiple acceptable standards of mitigation they will follow.

“We just got a contractor in Durango, and that was a thrill. We get lots of testing from there,” Kelley said. Without local contractors, the state sees increased costs by having to pay per diem rates for Front Range contractors to travel; staff will try to schedule multiple mitigations in one weekend for distant locations.

CDPHE staff are also searching hard for certified Spanish-speaking contractors, an ongoing challenge.

Once a home project is complete, the state asks for another test of radon levels. The contractor can do more extensive mitigation efforts—still paid for by the radon program—if results remain too high. Radon levels in the Barrios home had a long way to come down—her initial tests were between 13 and 14 pCi/l, not unheard of but certainly well above the bar set at 4.

On the day she was interviewed, Jocelyn Barrios had her non-air conditioned house shut up on a sweltering day so that the post-mitigation test would be accurate. But she was happy to sweat a little with her healthy new baby in her arms. She couldn’t even hear the new pipe-and-fan system running up the side of the house that drew any tainted air out of the basement.

She was even happier when the test results came back in mid-July and the family home scored a 2 pCi/l.

“I found it to be a really easy process,” Barrios said. “We’re extremely thankful.”

Michael Booth

Denver, Colo.

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