She found out she’d been breathing a cancer-causing gas for over a decade. So why won’t Canada’s health-care system let her get her lungs tested?

Leanne Junnila stared at the digital device that measures air quality in her home where she had lived for over a decade, and she was alarmed.

It showed she was breathing odourless, invisible and potentially fatal radon at a level that far exceeded the federal guideline.

Worried about her exposure to the second-leading cause of lung cancer in Canada, she searched the internet for how to get her lungs tested. Her alarm turned to anger.

She learned Canadians with documented levels of elevated radon in their homes are ineligible for lung cancer screening under provincial health-care systems.

There's nothing out there and it seems like the only people who have access to any sort of early screening are heavy smokers," said Junnila, who is a non-smoker. If there's a test, why can't we get that test?"

Radon, which is naturally emitted from soil, is estimated to be responsible for more than 3,000 deaths a year. Long-term radon inhalation is the primary cause of lung cancer among people who have never smoked and dramatically increases the risk for those who do.

As Canadians find themselves spending more time at home than ever before, that threat is becoming increasingly urgent, an ongoing Toronto Star/Investigative Journalism Bureau (IJB) investigation has found.

A gap' in radon knowledge

The guideline established by the Canadian Task Force on Preventive Health Care in 2016 recommends lung screenings for adults aged 55 to 74 who have a significant history of smoking.

For everyone else, the guideline recommends not screening for lung cancer."

Screening programs don't have any methods or formulas to quantify an individual's possible lung cancer risk from radon exposure, said Dr. Alain Tremblay, a professor of medicine at the University of Calgary and medical lead for Alberta's lung cancer screening program.

It's a gap in our knowledge," he said.

And while researchers are working on the problem, Canada is currently missing 100 per cent" of radon-related lung cancers in people who haven't smoked, he said. We're not catching any with screening because it's simply not on the radar."

Dr. Scott Klarenbach, vice-chair of the Canadian Task Force on Preventive Health Care, calls the benefits of screening Canadians with high radon exposure an open question worth inquiry."

If you found there are people at high radon exposures that put them at high risk of lung cancer, would they have the same benefits as these other populations who've been studied for a lung cancer screening?" he asks. I think it's an excellent question."

Health Canada supports the addition of high radon exposure as a qualifier for publicly funded lung cancer screening, an official told the Star.

We would like to see it included over time ... with a new screening program, there's an opportunity to educate about risk," said Kelley Bush, manager of Health Canada's radon outreach and stakeholder engagement program.

The provinces and territories that run the lung screening programs would have to implement the expansion of screenings, Bush said.

It's not Health Canada alone."

University of Calgary radon researcher Aaron Goodarzi calls the ineligibility of Canadians exposed to high levels of radon for lung cancer screening an acknowledged health ... injustice."

Forty per cent of people who will get lung cancer are not, right now, ever going to be eligible for screening."

Work at home? Your radon exposure could increase

Canadians' exposure to deadly radiation has spiked 19 per cent on average since the COVID-19 pandemic as more people work from home where levels are often higher than in workplaces, according to new research from the universities of Calgary and British Columbia, shared exclusively with the Star and IJB.

Canadians living in new houses -- often young, suburban families -- are disproportionately impacted. This is because modern construction methods designed to insulate and maximize energy efficiency can trap radon gas inside.

We will see more cancers unless we are proactive today about solving the exposure crisis," said Goodarzi, one of the co-authors of the study.

While Goodarzi and his colleagues have long known housebound radon is a problem, especially in Western Canada, now is the time to re-evaluate (Canada's) policies."

If you're an employer who's advertising a work-from-home position, that needs to now come with a consideration for how safe that workplace is."

Goodarzi and his fellow researchers at Evict Radon -- an organization of Canadian scientists and scholars working on solutions to understand and fix the country's radon problem -- have been studying radon levels in more than 35,000 houses across Canada since 2015. They surveyed more than 4,000 of those households and found Canadians are spending over 10 per cent more time at home annually -- over a month on average -- leading to drastically higher doses of radiation for those in homes with high levels.

The most substantial increases in residential radon exposure, the study shows, were in homes occupied by those in professional, managerial and administrative positions. That excludes health care, which saw an increased demand for front-line workers.

Urban and suburban areas saw the greatest increases in annual radiation doses compared to rural or isolated communities where work patterns were less impacted by the pandemic.

Bungalows typically have the highest radon levels, research has shown, but detached multi-storey homes like Junnila's aren't far behind.

Junnila, who designs research labs at the University of Calgary and is also a part-time rally car co-driver with national titles, had been living in her southwest Calgary split-level home for around 10 years when she first tested for radon in late 2020. The level was near Health Canada's guideline of 200 becquerels per cubic metre (Bq/m^3). The World Health Organization's guideline is far lower, at 100 Bq/m^3.

Just months later, she tested again and found a reading of 400 Bq/m^3.

I really started freaking out."

She opened the window when it was -25 C outside, hoping it would lower the radon levels inside. They remained high.

Junnila installed a $2,300 radon mitigation system last November, and now her levels are around 20 Bq/m^3.

But she still has no way of knowing whether the radon levels she was breathing for more than a decade have caused long-term damage.

Since lung cancer typically only shows symptoms in the later stages, she is scared of what lies ahead for her and frustrated at the lack of screening options available.

If I came home with a lung cancer diagnosis, then I would be very, very angry that there was nothing in the health-care system to help me when I knew it could potentially be a problem," she said. Right now, it's this frustration that there's just nowhere to turn on the health-care side."

It's just a very clear gap that needs to be looked at."

The Investigative Journalism Bureau is a non-profit newsroom based at the University of Toronto's Dalla Lana School of Public Health.

Robert Cribb is a Toronto-based investigative reporter for the Star. Reach him via email: rcribb@thestar.ca