Project: Personalized Cancer Primary Prevention through Citizen Participation and Digital Social Innovation (4P-CAN)
Period covered: October 2023 – September 2024
Lead partner: Plovdiv University, Bulgaria
Overview
This interim report presents progress on establishing an environmental-focused Living Lab aimed at improving primary prevention of lung cancer through research on indoor radon exposure. The work focuses on the Central South Region of Bulgaria (Plovdiv Province) and compares findings with a partner region in Romania.
Radon — a naturally occurring radioactive gas released from soil and rocks — is recognized as the second leading cause of lung cancer after smoking. The project investigates how environmental conditions, building characteristics, and human behavior influence real exposure levels and health risks.
Objectives
The main goals of the reported activities were to:
- Review scientific evidence on radon exposure and lung cancer risk in Central and Eastern Europe.
- Identify regions with different geological radon potential in Bulgaria and Romania.
- Analyse regional medical data on lung cancer occurrence.
- Prepare real-life monitoring through Living Labs using modern digital sensors.
- Develop methods for citizen participation and community-based prevention research.
Key findings
Radon exposure and health
- Radon enters buildings mainly through floors, walls, pipes, and poorly ventilated ground-level spaces.
- Indoor concentrations vary depending on geology, construction materials, ventilation, and daily living habits.
- Modern continuous monitoring technologies now allow real-time assessment of individual exposure.
Regional environmental differences
- Geological analysis shows significant variation in ground radon levels between study regions.
- The Plovdiv region is located near major uranium deposits, suggesting higher radon potential.
- The Romanian study area shows comparatively lower expected ground radon levels.
Lung cancer data analysis
- Researchers analysed more than 5,300 confirmed lung cancer cases in Plovdiv Province (2010–2022).
- Incidence rates differ between municipalities.
- The highest lung cancer incidence was observed in areas located near uranium deposits, supporting the need for further investigation of environmental factors.
Living Lab preparation
To enable real-life research:
- Criteria were developed for selecting households and workplaces.
- Settlements with predominantly ground-floor living conditions were prioritised.
- Fifteen smart monitoring devices were produced and deployed.
- Sensors measure radon levels alongside air quality indicators such as particles, VOCs, humidity, and temperature.
- Community surveys were designed to assess lifestyle, housing characteristics, and health risks.
Innovation and impact
The project introduces a new approach by combining:
- environmental monitoring,
- medical data analysis,
- digital technologies,
- and citizen participation.
Instead of measuring only average radon exposure, the research focuses on actual received dose, considering everyday behaviour, housing conditions, and environmental factors.
Next steps
The next phase will include:
- Installation of sensors in selected households in Bulgaria and Romania.
- Continuous monitoring of indoor environments.
- Medical and behavioural data collection through community participation.
- Development of evidence-based recommendations for cancer prevention policies.
Conclusion
The interim results confirm the importance of environmental factors — particularly radon exposure — in lung cancer prevention. The Living Lab model developed within the 4P-CAN project provides a practical framework for integrating science, technology, and citizen engagement to support healthier living environments and improved public health strategies.
