Closing the research loop: a risk-based approach for communicating results of air pollution exposure studies - Research

Environmental Health Perspectives, Jan, 2004 by Devon C. Payne-Sturges, Margo Schwab, Timothy J. Buckley

Communities have long been concerned about the environmental health and environmental quality of their neighborhoods. Community-based exposure assessments have the potential to be an effective way to address these concerns. The success of such studies depends critically on the effective translation and communication of study results back to the study participants and the community. In this article we describe the communication approach applied as part of the South Baltimore Community Exposure Study. Specifically, in conjunction with collecting measurements, we asked the community to define questions they wanted answered and the way in which they wanted to receive study results. To meet their needs, we applied the risk assessment framework. The approach we developed helped residents interpret exposure assessment measurements and gave them the raw materials to effect change in their community. The risk-based approach to presenting participant and community results provides the means to move beyond traditional reporting of concentration values in three important ways. First, risk takes into consideration toxicity, thereby enabling a dialogue about community health concerns. Second, risk provides a common denominator so that exposure and risk can be compared and priorities identified. Third, exposure and risk can be summed, thereby meeting the community's need for information regarding cumulative exposure. This approach may be a useful model for other researchers conducting exposure assessments in response to community concerns. Key words: personal exposure monitoring, risk communication, urban communities, volatile organic compounds.

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Exposure assessment has the potential to be an effective way to address community environmental health concerns. Communities can use exposure assessments to a) inform residents about their environmental exposure levels and the sources of those exposures, b) suggest strategies for exposure reduction, and c) enhance the level of substantive dialogue with government policy officials. Although exposure scientists are well trained at reporting human exposure results in peer-reviewed journals (e.g., describing the magnitude, frequency, and duration of exposure; comparing personal exposure monitoring, indoor, and outdoor measurements; evaluating the efficacy of a new measurement technique), this mode of communicating and interpreting results may not address the health-based concerns and information needs of the community. Indeed, community-based studies generate an obligation on the part of the researcher to ensure that participants and the community obtain the information necessary to address their concerns (Israel et al. 1998; Leviton et al. 1998; Metzler et al. 2003; Ng and Hamby 1997; Schulte and Sweeney 1995; Weed and McKeown 2003). Just as in the clinical setting, where the role of communication of results to individual patients "is not to ensure that the 'correct' decision is made, but rather to ensure that the patient has the correct inputs to decision making" (Deck and Kosatsky 1999), in the community setting the role of communication of results is to inform and empower. Human exposure assessment conducted within communities solely for research purposes is likely to leave residents dissatisfied and without the information they need to effect change on a local level. This issue is often raised in an environmental justice context as well (Wakefield 2003).

Effective communication and translation of research facilitate the community's ability to credibly represent the study's implications to policy makers and other stakeholders, thereby closing the loop between science and the community. This builds the foundation for long-term collaborations between communities and research institutions. These collaborations are increasingly required by funding agencies such as the National Institute for Environmental Health Sciences' community-based participatory research grants and the U.S. Environmental Protection Agency's (U.S. EPA) Environmental Monitoring for Public Access and Community Tracking programs (O'Fallon and Dearry 2002). Clearly, exposure scientists need tools to communicate the results of their research so as to build effective community partnerships.

In this article we offer scientists a concrete approach to presenting exposure monitoring results to individuals and communities. Specifically, we demonstrate the use of a risk-based approach to describe the health implications of exposure data. Such an approach both improves understanding of the results and gives communities the resources necessary to communicate the implications of the results to policy makers, if they so choose.

The approach presented here was applied successfully in conjunction with the South Baltimore Community Exposure Study. In this article, we describe the context of the South Baltimore study and the communication approach developed, concluding with a discussion of the lessons learned.

Community Context

The South Baltimore Community Exposure Study was conceived and implemented in response to community concerns about exposures to volatile organic compounds (VOCs) from industrial and mobile sources. The South Baltimore, Maryland, communities of Brooklyn, Brooklyn Park, and Curtis Bay are located primarily in the southeastern quadrant of the City of Baltimore. A significant number of Baltimore's heavy industrial operations are located in South Baltimore, proximate to residences. These industrial facilities emit 360,479,759 pounds of pollutants into the environment annually, placing South Baltimore 12th among U.S. communities, as defined by in the top 100 ZIP codes, for total pollutant releases (Environmental Defense 2001). The communities' industrial air toxic pollutant burden is compounded by intense mobile source emissions from major interstate highways that are also in close proximity to residential areas.