Health Implications of Radon Exposure Among Children: A Systematic Review

Background: Radon exposure has been recognised as a risk factor for developing lung cancer and other health issues. The mutagenic changes associated with long-term radon exposure take 10-30 years to manifest, which may lead to a lower observed incidence of lung cancer in children. Children are more vulnerable to radon exposure and its effects due to their smaller lung capacity and faster breathing rates, resulting in greater radon inhalation. Objective: The aim of the study is to present current evidence on the association between radon exposure and health effects among children. Methodology: We conducted a systematic review of the available literature on radon exposure and its health impacts, focusing on children. A preliminary literature scoping was conducted in CINAHL, PubMed, Google Scholar, and ScienceDirect. Some of the search terms included: "children" OR "health" OR "implications" OR "radon" OR "exposure". Subsequently, a comprehensive search was conducted, covering quantitative studies in EBSCOhost across all selected databases. The review adhered to the 27-item PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. The quality of the evidence gathered was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The study was registered with PROSPERO under the ID: CRD420251269394. The review analysed 26 studies, all published between 1994 and 2025. Results: The incidence of lung cancer was projected to increase with childhood radon exposure, with statistical significance (OR per radon 100 Bq/m³ = 1.16; 1.05-1.31). Certain biological markers were associated with childhood long-term radon exposure: IL-5 (13.4%; 95% CI: 0.4-2.8; p = 0.044). Conclusions: Childhood radon exposure, although rarely enough to cause overt malignancy, contributes cumulatively to lifetime lung cancer risk and causes detectable biological markers.