When one soars above the Flyover State, a colorful patchwork of cornfields expands below. A closer look at the bucolic landscape reveals flourishing gardens filled with flowers and fresh produce.

Crisp, fresh streams can be heard trickling through the pastures. But these serene observations of Iowa miss one integral element — something that can’t be seen, smelled, or heard.

The state’s invisible and odorless presence is the radioactive gas radon — which experts estimate is responsible for causing 400 lung-cancer-related deaths across the state each year.

On a bigger scale, radon is a leading environmental carcinogen and second most common cause of lung cancer in the nation, behind tobacco use.

These numbers have caught the attention of environmental and public-health advocates throughout the state who are determined to educate, inform, and push for legislation related to radon safety.

These advocates — including members of the University of Iowa College of Public Health and Johnson County Department of Public Health — helped form a Radon Coalition group in 2010. Since then, they have attempted to introduce a bill in the Iowa Legislature, as well as educate the public regarding the risks of radon exposure.

Attempts at drafting a bill have so far failed, and so the coalition will meet in Grinnell one week from today to draft a new strategy.

Sara Comstock, the executive director of the Iowa Cancer Consortium and one of the coalition’s leaders, said the meeting’s main focus will be mapping out a plan for the legislative interim aimed at advancing the radon bill — which did not make it to the floor this February — next session.

"It is important to keep the dialogue going so that partners stay engaged and energized to reduce radon exposure in Iowa," she said.

Radon Coalition member and Iowa native Gail Orcutt is a poster child for why radon matters.

Orcutt, 59, leads an active and healthy lifestyle. And though she never smoked a day in her life, a persistent, wheezing cough made her decide to visit the doctor in 2010.

"Never in my wildest dreams did I ever imagine someone would tell me I was diagnosed with lung cancer," Orcutt said, who survived the cancer. "It was devastating."

After her diagnosis, Orcutt decided to test her home for radon and found the levels at 6.9 picoCuries per liter — 2.9 picoCuries above the Environmental Protection Agency’s safe home guideline.

She’s now dedicated her life to helping other Iowans understand the danger.

Ultimately, Comstock said, she hopes this meeting will begin the process that can finally lead to a bill passing through the Legislature.

"Hopefully, we will come out of the meeting with a plan, action steps, and a timeline for the next six to eight months," she said. "We hope to play off of everyone’s strengths to maximize the effectiveness of our coalition’s work."

How it got to Iowa

Radon is formed naturally by the decaying process of uranium and radium — both of which can be found in many rocks. During the Ice Ages — spanning from roughly 3 million to around 10,000 years ago — glaciers moved over, ground up, and carried rocks from what is now Minnesota, Wisconsin, and Ontario to Iowa.

All rocks that house uranium and radium naturally release radon, but the glacier’s movement pulverized the rocks into smaller chunks, increasing the surface area of the once whole rocks. This increased surface area allows radon to escape the rocks more readily. Over time, rain, freeze-thaw, plant roots, and exposure to oxygen weathered the pulverized rock fragments, which increases their porosity, allowing more opportunity for radon to escape into the soil, air, and water.

Source: Bob Libra, Iowa state geologist.

Levels in Iowa

The U.S. Environmental Protection Agency capped the allowable radon level for safe buildings at 4.0 picoCuries per liter of air — which is the unit of measurement used to measure the amount of radon in the air.

Iowa has the highest average levels of radon in the nation, according to the EPA. The state falls into the EPA radon red zone, which means every county has a predicted average indoor radon screening level greater than the suggested 4.0 picoCuries per liter. Johnson County’s levels are estimated to be 4.4 picoCuries per liter, which is lower than most surrounding counties but more than three times greater the national average radon concentration.

SOURCE: Bill Field, UI Occupational and Environmental Health professor and national radon expert

How it enters a building

Once a house or building is constructed, it acts as a vacuum that sucks the radon out of the soil and traps it in the structure. Radon enters a building through cracks in the foundation, sump pumps, or spaces around pipes.

However, the age of a building is not determinant of the risk of radon.

SOURCE: Bill Field, UI Occupational and Environmental Health professor and national radon expert

Testing for radon

It doesn’t take a professional to test for radon.

Home testing kits are available ranging in cost from $10 to $30; it can take from two to more than 90 days to complete testing, depending on whether a short- or long-term test is used.

Typically, kits are placed in high-occupancy rooms for a specified amount of time; to obtain the results, the detectors have to be sent to a lab for analysis.

Fans, fireplaces, furnaces, air-conditioning use, open windows, rain, and barometric pressure are just some of the factors that play a role in causing radon levels to fluctuate.

Therefore, it is advised houses be under "closed conditions" when performing a short-term test.

This means all windows and doors are shut during the testing.

However, most people do not live in this type of environment, which poses a question on the accuracy of radon tests. Closed house conditions are intended to maximize radon concentrations so that if the short-term test result indicates radon concentrations below 4.0 picoCuries per liter, there is little chance the yearlong average will be more than 4.0.

But for those who are concerned about the accuracy of a home test, state-licensed radon professionals can perform checks for about $100 to $150.

SOURCE: Bill Field, UI Occupational and Environmental Health professor and national radon expert

Mitigation

If radon test results come back higher than 4.0 picoCuries per liter, the EPA advises action be taken to mitigate the radon problem. Mitigation is a method used to reduce the amount of radon in a building by sucking the radon out of the soil underneath the house and releasing it above the rooftop before it has a chance to enter the home.

Field said a popular method is called active soil depressurization. The radon-reduction method involves drilling a 4-inch diameter through the foundation flooring. A PVC pipe is placed through the hole, into the ground and extends through the house into the attic. A fan is installed in the attic to draw air from under the house and vent it through the rooftop. A radon-mitigation specialist must be trained and have credentials to install radon-reduction systems in Iowa.

SOURCE: Bill Field, UI Occupational and Environmental Health professor and national radon expert

Legislation

There is only one piece of legislation that has passed regarding the regulation of radon testing: that licensed daycares are required to be tested every two years.

However, a radon-disclosure law requires homeowners who have tested for radon to disclose the results of their tests when they sell their homes.

"This is a very counterproductive law, in my opinion," Field said. "Most people do not remember accurately what their radon test indicated. It also tends to reduce radon testing, because people do not want to have to disclose that they tested."

The Radon Coalition proposed a bill in the Legislature this February that would have required "the state building code commissioner to adopt statewide radon-control standards in residential construction, requiring that radon testing, mitigation, or abatement be conducted in schoolhouses and certain residential buildings, requiring certain notifications, and providing an income tax credit, and including retroactive applicability provisions."

However, the bill never reached the floor.

Peggy Huppert, Iowa director of governmental relations for the American Cancer Society, was one of the bill’s authors. She said the bill failed because the group could not come to an agreement over what the bill should encompass in a timely fashion.

"We had a hard time agreeing on what we wanted to ask for," Huppert said. "There is no state that has what we would call an ideal radon law. There’s just not a lot of great resources about writing laws about radon."

Money was also an issue.

Galen Howsare, the chief financial officer for the Iowa Association of School Boards was a registered lobbyist against the bill. He said requiring schools to be tested would be too expensive.

"They keep adding to the list of what we have to do, and we don’t have any money left to do it," Howsare said. "The way we felt the legislation was written, the testing wouldn’t be funded by insurance, and the districts wouldn’t have any money to withstand the costs."

The EPA’s proposed 2013 budget would eliminate all money radon related grans distributed to states — which in the 2012 fiscal year was $8 million — to help promote radon awareness, oversee professional testing, and reduce the risks of exposure.

Sen. Joe Bolkcom, D-Iowa City, said it’s a mistake for Congress to cut that funding.

"States rely on that funding, and for some states, that’s the only funding they have," he said. "Radon is deadly in places such as Iowa."

Though radon is a concern, Sen. David Johnson, R-Ocheyedan, said the nation is financially struggling.

"The federal government is handing out money to states, and they can’t sustain that very long," Johnson said. "There is either federal stimulus money or the states have to increase taxes to keep programs running. I don’t think we ought to have a roller-coaster ride like that financially. There have to be cuts somewhere."

Radon death

The first symptom of radon-induced illness is serious — lung cancer.

As radon decays, it produces solid radioactive products that people can inhale. The decayed products attach to the lining of a person’s lungs and can lead to the formation of cancer, but there are no prior symptoms, not even a cough, Field said.

And while lung cancer can be caused by many different factors — such as smoking, genetics, or pollutants — Thomas Gross, an associate professor of internal medicine at the UIHC Pulmonary and Critical Care Division, said radon has a clear association with lung cancer.

However, the magnitude of the risk is hard to determine.

"There are radon zealots who think all lung cancer can be traced back to radon and others who think it is a very minor player – [the] truth [is] probably somewhere in between," Gross said.

But according to unofficial estimates from the EPA, radon is the No. 1 environmental carcinogen that causes death and is responsible for 21,000 deaths per year in the United States.

Residential

UI graduate student Katie Jones has lived in her cozy cabin-like apartment in Iowa City for the past 10 months.

Upon starting a job with the Iowa Cancer Consortium, she learned what radon was and how to test for it, which led her to place a testing kit in her bedroom on April 10.

And while Jones’ radon levels were low, this is a step she wished more students would take.

"A lot of young people just don’t think about it a lot or are aware of it," she said. "Students only live [in a specific apartment] for a year or two and might not want to start an issue with the landlord. It’s just an awkward position to be in as a tenant."

But Iowa City residents can breathe a little easier knowing there are local laws in place that require more protection against radon in comparison with towns across the state.

In Iowa City, builders are required to put in a passive mitigation system — a vent pipe — that would allow for a fan to be installed if the homeowner decides to mitigate in the future, said Tim Hennes, Iowa City senior building inspector.

In addition, said Stan Laverman, another city senior housing inspector, radon testing must be completed upon selling a house, which is stricter than the state law, which simply requires homeowners who have tested their homes to reveal the test results before the sale.

John Marshall, the president of the Iowa City Area Association of Realtors, said part of the purchase agreement concerns radon testing.

"Buyers can then choose whether or not if they want to have the testing done," Marshall said. "But it is at their expense that it is done usually."

Marshall said if the results come back and lead to mitigation, then the buyer and seller need to negotiate the expense.

Greg Bal, the supervising attorney of UI Student Legal Services for five years, said he has never been approached by a student with legal questions about radon.

"Essentially, the landlord has to provide a residence that is safe and habitable," Bal said. "Radon is very dangerous and unacceptable and would be the basis for termination of lease if the apartment or house is no longer safe."

Bal said the landlord should be required to pay for the testing and mitigation. If the landlord refuses to mitigate, the tenants should have the right to terminate the lease, ending all obligations they hold to the landlord.

Field said several students have contacted him about radon concerns, and residential radon is worrisome because of how much time people spend in their homes.

"I am aware that several leases were successfully broken when the landlord refused to lower the radon concentrations in the apartment," Field said. "Students have the right to live in a safe dwelling. I personally would love to see all off-campus housing tested for radon."

University

With 1,700 acres of land, 129 major buildings, and thousands of rooms, the University of Iowa has a massive footprint in Johnson County.

However, only four buildings and 11 rooms have been tested for radon since 2008. Each of the tests performed registered a level of radon below the EPA requirement of 4.0 picoCuries per liter.

UI spokesman Tom Moore said the UI has an effective preventative system in place to eliminate the need for routine testing.

"The testing that we have done has only found levels of radon that are not considered harmful by the Environmental Protection Agency, which seems to indicate that the university already has appropriate safeguards in place," Moore said. "In summary, the university appears to have an effective prevention strategy in place and testing seems to confirm that approach works."

Moore said the buildings maintain low levels of radon from the heating, ventilating, and cooling systems that mixes in outside air. He said this system is different than the ones used in residential homes.

"Most homes are negatively pressurized due to exhausting combustion air from the furnace and a natural stack effect of hot air rising to the highest point in the home, thus creating a negative pressure which naturally draws soil gases such as radon into the home," Moore said.

Bob Libra, who is Iowa’s state geologist and works in Trowbridge Hall, said he has never thought about radon in his workplace.

"I never have been concerned," he said. "You’re only here so much, but it’s not that much."

Moore said the university responds to requests from faculty and staff to have their offices or buildings tested for radon and that the safety of their employees is of utmost importance.

School District

The average Iowa grade-school student is required to spend half the year in class, while a preschooler spends much less time hitting the books.

But in the Iowa City School District, testing for radon is only mandatory for preschool rooms and not all elementary schools, based on the licensing standards of the Iowa Department of Human Services.

In 1990, 535 radon tests were performed on all Iowa City School District buildings following a notice from the Iowa Department of Public Health recommending all schools in the state test — no such subsequent mass testing of all buildings has been performed since then.

Paul Schultz, the School District’s director of the physical plant, said most of the tests came back with results below 4.0 picoCuries per liter, but 37 fell in the range of 4.0 to 20.

There was one outlier, a room at Lemme Elementary, that tested at 23.9 — if a test is above 100, it is strongly recommended that students relocate.

Schultz said "construction efforts" took place at Lemme in 1991, but he has no records indicating whether those efforts were strictly due to the high radon test results.

"This facility had a heating and air-conditioning project that would have allowed for more fresh-air exchange in 1991," he said.

Additional testing was performed in this location in 1991 and found to be 3.2 picoCuries per liter.

However, David Dude, the district’s executive director of operational resources, said a new heating system was installed in 2004 in Lemme Elementary — 14 years after the radon results.

"The district installed a [heating, ventilation, and air conditioning] system with ground source heat pumps that includes piping fresh air ventilation throughout Lemme," Dude said.

The district has not tested Wickham Elementary or North Central Junior High because they were built after the 1990 testing was performed, he said.

Few parents have expressed concern about radon, he said.

"About others inquiring [regarding radon concerns], I only know of one inquiry from a parent who also runs a home-safety-products business," Dude said.

Kelli Kucera, a Longfellow Elementary parent, said radon has never worried her.

"I haven’t been concerned, but honestly, I haven’t really looked into it," she said. "I don’t remember the school sending anything home with students [about radon], so there’s nothing that I’m aware of, but I could be wrong."

The district’s preschools were tested in 2010 and will be tested again this year. The last test was at Hills Elementary and cost the district $125.

Sen. David Johnson, R-Ocheyedan, said there is reluctance in the Legislature to further mandate any program on local governments such as school districts.

"Education efforts should continue, but it should be up to school districts and school boards to decide what to do rather than the state requiring what to do," he said.

However, Peggy Huppert, Iowa director of governmental relations for the American Cancer Society, said the states aren’t doing enough to regulate schools, and she noted that children can attend the same school for many years.

"That’s seven years in a [possibly] bad environment," she said. "But there is more concern for the staff. Some staffers are there for many more years, and they are exposed."

However, Schultz said he does not feel at risk for radon injuries in his work environment.

"I work in these buildings as well as our support services staff," Schultz said. "If I felt it was an unsafe working environment, I would notify the district administration."

Radon healers

A distinct tie to lung cancer would be enough for most people to shy away from radon, but not Briana Harris.

She thinks low level exposure is just fine.

Harris is the office manager for Merry Widow Health Mine in Montana — a group that takes people into a mountain tunnel for radon therapy — allowing them to sit and drink mine water.

She said she believes radon helps sick patients recover from arthritis and allergies, and it even cures bad cases of acne.

"I have to admit that when I first started working here, I was a true skeptic," she said. "I couldn’t believe that something I had heard bad things about could possibly be good for you, but after a couple of months, I was convinced. I have seen people that could barely walk or move when they first arrived here literally be able to walk miles while doing their treatments."