The day began like most others. Jan Poulsen drove to work at Canyon Travel, where, as a travel agent, she helped people plan vacations and adventures to far-flung places across the globe.

The cough, at first, was barely noticeable. It was, she thought, probably just allergies or the beginning stages of a cold virus. But it persisted.

Days became weeks and then a month passed. After a couple months, she decided she needed to consult a doctor.

A chest X-ray led to a Magnetic Resonance Imaging Scan (or MRI), which showed an obvious mass in her lung. And a biopsy confirmed her fears—she had lung cancer. Stage 4. Her options were limited. If she did nothing, she would likely be dead within a few months.

"I was puzzled," she said. "I had never smoked in my life. How could I have gotten lung cancer?"

When she met with an oncologist a short time later, he mentioned the likely culprit: radon.

The odorless, colorless, tasteless gas that is a known carcinogen was first discovered in 1900 by a German chemist named Friedrich Ernst Dorn, who was studying the chain of decay in radium. Several studies conducted on miners in the 1970s and 1980s showed a correlation between increased exposure to radon and increased risk for lung cancer.

But it wasn't until 1984, when an engineer named Stanley Watras tripped the radiation monitors at the nuclear power plant he worked at in Pennsylvania, that the scientific and regulatory communities would begin to consider the threat radon posed to the community at large.

"[Watras' employers] didn't know where the radiation was coming from at first," said Eleanor Divver, who heads the Utah Radon Program at the Utah Department of Environmental Quality (DEQ). "The levels on his clothes were so high, I imagine he must have been kind of like that scene from The Simpsons, where Homer and Bart turn green from radiation exposure."

After testing Watras' home, officials were stunned. It was filled with extremely high levels of radon. They wondered: how many other homes, not only in the area but throughout the country, also had high levels of radon in them?

For Poulsen, radon had not been a concern. She and her husband had tested for it when they bought their home 15 years earlier, and levels were below the threshold that the Environmental Protection Agency (EPA) had deemed "actionable."

They hadn't taken into account that renovations made a few years later—including the creation of a walkout basement—could dramatically change the radon level in their home.

"After my diagnosis, we tested the basement again," she said. "And the readings were 24.9 picocuries per liter (pCi/L)."

A picocurie is a measurement of radioactive decay. At .037 disintegrations per second, it is equal to one-trillionth of a curie, which is to say it is pretty small. No matter where you are in the world, you are likely breathing in radon at a level of at least 1 pCi/L. Because radon is heavier than air, it tends to pool in the lowest levels of homes.

The EPA has determined that a measurement at or above 4 pCi/L is where action should be taken to mitigate. Data from the DEQ shows that 35% of all homes that have been tested for radon in Utah have levels above 4 pCi/L.

The DEQ estimates that the average level in Utah homes is 3.5 pCi/L, but the average radon level of tested homes within the state is 5.3 pCi/L. The highest recorded level found so far in a home in Utah is 664 pCi/L.

The EPA estimates that 25% of people consistently exposed to the levels found in the Poulsen home will develop lung cancer in their lifetime.

But these numbers are not without controversy. Garth Haslem—a certified structural engineer and home inspector for more than 30 years—is an outspoken critic of any legislation requiring mitigation of radon, which he called "a spade."

Haslem claimed that radon mitigators and home inspectors are incentivized to manipulate radon data all the time, because "they're not in the business of measuring data; they're in the business of installing mitigation systems."

"No matter who you talk to," he said, "if they are a stakeholder, they need there to be a problem with radon. For example, if you provide evidence that radon is not a problem to a radon mitigator, that threatens his job."

Haslem also sees a problem with the methodology the EPA has used to arrive at the threshold for when action needs to be taken, and considers the action level to be "too conservative."

Calculated Risks
Because the potential effects associated with radon exposure are chronic, the EPA didn't have any long-term data from household radon exposure to calculate the risks and establish the action level when it released A Citizen's Guide [to radon] in 1986. The action level relies on data from studies on 11 different groups of miners, equaling 68,000 individuals, in a number of areas throughout the world.

All 11 of the miner cohorts demonstrated "a statistically significant elevation in lung cancer mortality with increasing radon exposure."

Extrapolating the data from the miner cohorts to households was complicated and messy. In addition to radon, the miners were often exposed to a number of other toxic materials, such as lead, arsenic, silica and diesel fumes, all of which, according to a 2003 EPA report, "might be a source of positive bias in the risk estimates."

Genetics, lifestyles and a wide host of other variables also had to be considered. Not all of them could be measured. In the end, the EPA concluded that "about one-fourth of the [estimated 21,000 annual] radon-related lung cancers [in the United States] could be averted by reducing radon concentrations in homes that exceed EPA's recommended 4 [pCi/L] action level."

And while the methods used to arrive at that number may carry some controversy, the conclusions seem to have been validated by several additional studies, including one that analyzed data from 13 peer-reviewed, European case-control studies with more than 21,000 participants within home environments. The results: prolonged exposure to radon, even at relatively low levels, increases one's risk of developing lung cancer.

Based on that report, the World Health Organization recommended mitigation occurs at or above 2.7 pCi/L. The EPA's recommendations didn't change, but the agency admitted its gas action level might be flawed, just not in the way most skeptics seem to think it is. A report by the EPA from the 1990s states the current radon action level leaves "millions of Americans at risk from radon gas."

James VanDerslice, PhD, is the Chief of the Division of Public Health at the University of Utah. In an email to City Weekly, he said the EPA generally sets health guidelines to protect the most vulnerable sub-groups in society, such as children. But the EPA action level has remained where it is mostly as a matter of practicality.

"The EPA chose 4 pCi/L as the action level," he wrote, "because it is a level that can usually be achieved with standard mitigation measures (such as sub-slab depressurization) at a cost that is comparable with other home improvement projects."

Penny Wise, Pound Foolish
No legislation focused on the dangers of radon was attempted in Utah until 2013. The summer prior to that, a number of homeowners in Utah County had become upset after discovering high levels of radon in their newly constructed homes.

They contacted KSL, who contacted then-state Sen. John Valentine (R-Orem). He contacted Michael Siler, who was then the director of government relations for the American Cancer Society in Utah.

"It was at that point," Siler recalled, "I discovered that radon was really flying under the radar. The only people who were really providing any information about the dangers of radon were the radon mitigation companies, which, in my opinion, was kind of like the fox guarding the henhouse."

Siler formed the Utah Radon Coalition and the Utah Radon Policy Coalition—both of which are non-profit organizations—and, with Valentine's help, submitted a bill that echoed legislation in several other states, including requirements for radon-resistant new construction.

But the bill was killed before even being drafted. "We were beaten to death by the building industry," Siler said. "Their rationale was that every additional requirement adds to the cost of the home, which exacerbates the problem of making homes affordable."

The cost to mitigate a single-family home can range from between $1,500 to $4,000. Most homes can have an active mitigation system, with a fan, installed for under $2,000.

Because ductwork and flues are easily accessible during the course of construction, installing a mitigation system in a new home is cheaper than in an existing home. Adding a mitigation system that costs $2,000 to a 30-year mortgage on a new home would increase the monthly payment by $5.56.

"There are three things we need to do with radon," Siler observed. "Radon awareness is the big thing. Radon testing is the second thing and, of course, radon mitigation—when needed—is the third thing."

To Siler, it became obvious that the state was not going to do much about the issue, so the Utah Radon Coalition took it upon itself to raise awareness. So far, they've provided more than 2,000 free tests.

"This may not seem like a lot," he said, "but frankly speaking, our efforts have been the most concentrated efforts that have taken place in Utah."

Divver, who happens to be the only employee with the DEQ's Radon Program, said that the state started collecting radon data in the late 1980s. "Utah is considered a gold standard in data collection," she asserted. "The DEQ has over 100,000 data points, so it has a pretty good picture of where radon is."

Even with those numbers, the DEQ has data for only 11% of homes in Salt Lake County, 6% of homes in Davis County and 8% of homes in Utah County.

She explained that the DEQ only reports data that have been reported to its Radon Program from the laboratories that conduct the tests, and that the data include both tests done before and after mitigation. The DEQ doesn't accept data from mitigators or other entities, including the Utah Radon Coalition.

"It would be awesome if data was shared more openly between organizations," she admitted. "But in the eyes of data experts, data from mitigators or other parties could be tainted."

Getting a charcoal test through the state is relatively cheap through the DEQ's website. "Right now the cost of a charcoal-based test is only $11," Divver said, "but that price might be increasing soon, as our contract with the laboratory is set to expire and needs to be renegotiated."

"You want to make sure [the test] is an area where you spend a good amount of time," she continued. "A lot of people will place it in their crawl space, because that is the lowest level of their home. But no one spends much time in a crawl space. They would want to place it in the lowest level that is lived in."

Full Disclosure
In 2021, the State Legislature passed HB45, which, among other things, requested the Utah Geological Survey write a report on ways to "increase public awareness about the risks of radon gas and ways to mitigate Utah residents' exposure to radon."

The report, which was provided to legislators in August 2022, lists six recommendations on both of those points. The Legislature enacted none of them.

One of those recommendations was to require radon testing in public schools, daycares and prison facilities. Enter associate professor of Political Science, Tabitha Benney, PhD. As a trained economist, Benney has spent most of her career working on climate-based economic issues, such as carbon markets, pricing and tax.

She realized that the risks associated with radon exposure were as much a political issue as a science and research issue.

"Because I have an understanding of the behavioral and political side of radon," she explained, "I began to lean into that side of the story."

Benney mentioned the parallels that Utah has to Colorado. "We have similar geological features," she said, "similar extractions and similar elements in the ground."

But of course, Utah is not Colorado. In 2023, Colorado's Legislature passed SB23-206, which requires landlords and sellers to provide state-approved written disclosures to tenants or prospective buyers.

They must also provide any knowledge of radon levels in the dwelling. Failure to do so could result in the seller/landlord being held liable and paying for testing and mitigation.

In Utah, some of the largest gaps in the data come from dwellings occupied by tenants. Landlords are not required to test, nor mitigate, nor even disclose known radon levels to tenants.

Discovering high levels of radon in one's apartment is not enough to get out of a lease agreement. On a seller disclosure form in Utah, radon is mentioned in the same sentence as asbestos and lead-based paint, but there is no legal recourse if a seller fails to disclose known levels of radon in a home.

Some of Benney's main objectives with starting the Utah Radon Lab at the University of Utah were to fill some of the gaps in the data and get the appropriate information to the right people.

"We've really tried to tailor the information we share with people, so that it resonates with their circumstances," she reported. "When we say one in three homes in Utah has [elevated levels of radon], people tend to say, 'but that's not my home.' When we show them information to their zip code, people tend to be affected more by the numbers."

With the help of several undergraduate students and the direction of the DEQ, the Radon Lab began a grassroots campaign to test public schools.

Fewer than 10% of the schools in the state had ever been tested for radon. Only four districts regularly test for radon.

With a small amount of funding from the DEQ, University students during the lab's debut semester tested all 43 schools in the Salt Lake City School District, as well the Headstart programs and community centers attached to those schools.

"We were finding areas in some schools within a 60 to 80 [pCi/L] range," Benney said. "As a researcher, it was quite shocking. We've also been able to come up with low-cost interventions for several of the schools that have areas with high levels of radon, things like putting a $5 cover over the drains in janitorial spaces when not in use."

This coming semester, the lab will be conducting tests in the Price and Morgan school districts, as well as in several tribal nations.

The lab has also gotten permission from the largest radon lab in the U.S. to create a space where data can be stored.

"We just need an interface for it, and that requires funding," Benney stressed, "so securing funding is also something [the lab] will be working on."

Shoulda, Woulda, Coulda
The Utah Radon Program at the DEQ is also trying to secure additional funding from outside the state. A bunch of red tape currently holds up a large grant from the EPA.

"We're waiting on a federal grant, in partnership with the DEQ," Siler said. "If it is approved, it will be the first time the EPA has actually provided funding for mitigation. We hope that it will triple the number of [free mitigation systems] we can provide in under-served and low-income areas."

It is unlikely Utah's legislature will pass anything significant, anytime soon, to help prevent radon-induced lung cancers in the state.

Emails requesting interviews sent to several legislators with known ties to the real estate industry all received no response.

"Having worked in a number of developing nations," Benney observed, "it is common to see a large region lacking the knowledge or infrastructure to deal with these types of issues, but to have that in the United States is quite shocking. And that fact became very motivating for me, not only as researcher, but also as a mom with a young child in school in the region and as a member of the community."

Divver said she frequently hears from people who have been diagnosed with lung cancer, or whose loved ones have developed lung cancer, even though they have never smoked.

"It's heartbreaking," Divver said, "when people call me and say 'if I had known I needed to test, I would have tested.'"

For travel agent Poulsen—and approximately 200 other Utahns annually who are diagnosed with radon-induced lung cancer—testing for radon is key and the cost of mitigation is far better than the cost of cancer treatments.

After she had recovered from having her right lung completely removed, Poulsen underwent chemotherapy for the next five years. A short while after she was told she was cancer free, it re-emerged in the form of brain tumors. She is cancer free today, but has recently begun to show signs of dementia—likely a side effect of cancer.

"Testing your home should be considered a part of general maintenance," Poulson emphasized. "Do it every two to five years, because levels can change. Even if your neighbors remodel or new construction occurs down the street, levels can change within your own home."