Perceptions of environmental health risks among residents in the "Toxic Doughnut": opportunities for risk screening and community mobilization

Oral histories document community mobilisation to participate in decision-making regarding a hazardous waste thermal treatment facility

Colfax, Louisiana hosts a commercial hazardous waste thermal treatment (TT) facility, which treats fireworks, explosives, and military ordnances by open-burn/open-detonation one mile from the edge of the nearest community. Seventy-one percent of Colfax's residents are Black, and forty-six percent live below poverty, indicating the community's structural vulnerability. This community-based study originated at the behest of Colfax community members. We hypothesized that the close relationships among members of this enclave may have enhanced the community's ability to mobilize in opposition to the TT facility. We conducted semi-structured oral history interviews with nineteen community members and examined the social and interorganizational networks used by the Colfax community to claim its role in decision-making regarding the TT facility after years of exclusion from this process. Interview transcripts were analyzed through the lens of community capacity theory to gain insight into how interactions among community members about the environmental hazards led to social mobilization and improved participation in the decision-making process using codes for communication, organization, and outcome. Additionally, we reviewed Louisiana Department of Environmental Quality records for complaints about the facility to gauge public participation. One notable theme across several interviews was exclusion from the initial decision-making process related to the facility. However, interviewees noted a sustained effort was made among community members to educate themselves about the facility, organize a response through neighbor-to-neighbor contact, and take action by submitting formal complaints and participating in public hearings. Through the lens of environmental justice, this study illustrates an evolving condition of procedural justice.

The Environmental Health Literacy of Italian General Population: The SPeRA Cross-Sectional Study

Environmental health literacy (EHL) includes knowledge of health effects due to environmental exposure and skills to protect health from environmental risks. This study investigated some aspects about EHL of the Italian adult population. Data were collected through questionnaires (n = 672) and analysed through multivariable logistic regression models. Results showed that participants with incomplete/insufficient self-perceived knowledge of health effects due to environmental risks verified less information about this topic (adjOR = 0.38 (CI95% 0.25-0.59)/0.09 (0.04-0.21); p < 0.001/<0.001), potentially spreading fake news. The self-perceived exposure to pollution was higher in participants living in towns than in rural areas (small, medium, big towns adjOR = 2.37 (1.41-3.97), 2.10 (1.11-3.96), 3.11 (1.53-6.31); p = 0.001, 0.022, 0.002) and lower in participants with incomplete/insufficient knowledge about pollution effects (adjOR = 0.54 (0.32-0.92)/0.30 (0.13-0.67); p = 0.022/0.004), confirming that knowledge is essential to achieve awareness. Since insufficient self-perceived knowledge of pollution effects was negatively associated with the adoption of pro-environmental behaviours (adjOR = 0.37 (0.15-0.90); p = 0.028), EHL was proven to be a virtuous behaviour promoter. Finally, a lack of institutional support, time and cost were identified as barriers to pro-environmental behaviours. This study provided useful data to design prevention programmes, underlined some barriers to pro-environmental behaviours and highlighted the need to promote attitudes and behaviours aimed at contrasting environmental pollution, thus protecting human health.

Effects of Residential Environmental Screening and Perception Surveys on Superfund Environmental Health Risk Perceptions

Residents at one of the nation’s largest and longest-operating Superfund sites (Butte, Montana) have expressed environmental health risk perceptions that often diverge from those of EPA and other official stakeholders responsible for the investigation and remediation of site contamination aimed at protecting human health and the environment. A random sample of Butte residents participated in a study of how home-based environmental screening influences environmental health perceptions. Participants completed surveys measuring environmental health perceptions before and after a home site screening of soil and drinking water for lead and arsenic conducted by the research team. Local air monitoring for the same contaminants was also completed during the study period. The home-based screening intervention improved the alignment of subjective participant environmental health perceptions with objective environmental screening measures. Key features of the process that helped achieve this effect included (1) co-locating the collection of participant perceptions and individualized screening measurements; (2) sharing environmental screening results in a clear and unbiased manner; and (3) conducting this work independent of agencies and organizations with direct responsibility for Superfund-related cleanup activities. Empowering residents of a Superfund community with knowledge of the specific kinds and levels of environmental contamination in their home environment may help overcome the gap between agency conclusions regarding environmental health risk and the perceptions of community members.

Using the Community Engagement Framework to Understand and Assess EJ-Related Research Efforts

Within an environmental justice frame, capacity-building has been an important component of efforts to address health disparities at the policy, system, and environment levels. While the literature is replete with studies that discuss the necessity of collective action as a means to generate power to overcome inequities, limited attention has been given to the structure of these efforts to build capacity and challenge environmental injustices. This study applies the community engagement continuum as a framework for understanding the scope of capacity-building strategies and the manner in which research investigators engage with their intended target community. Paired teams of independent analysts screened articles for relevance (n = 8452), identified records for content abstraction (n = 163), and characterized relevant studies (n = 58). Many articles discussed community engagement as being either collaborative or shared leadership (n = 32, 55.2%). While the most commonly used capacity-building strategies were organizing/social action (58.6%) and CBPR (50%), few studies were able to make an environmental impact (n = 23; 39.7%), and fewer had a direct legislative policy-related outcome (n = 13; 22.4%). This review identifies levels of collaborative involvement and strategic approaches used for strengthening community capacity in efforts of making transformative policy, systems, and environmental change.

A Scoping Review of Capacity-Building Efforts to Address Environmental Justice Concerns

Environmental justice (EJ) efforts aimed at capacity building are essential to addressing environmental health disparities; however, limited attention has been given to describing these efforts. This study reports findings from a scoping review of community-academic partnerships and community-led efforts to address environmental inequities related to air, water, and land pollution in the United States. Literature published in peer-reviewed journals from January 1986 through March 2018 were included, and community capacity theory was applied as a framework for understanding the scope of capacity-building and community change strategies to address EJ concerns. Paired teams of independent analysts conducted a search for relevant articles (n = 8452 citations identified), filtered records for content abstraction and possible inclusion (n = 163) and characterized selected studies (n = 58). Most articles implemented activities that were aligned with community capacity dimensions of citizen participation (96.4%, n = 53), community power (78%, n = 45), leadership (78%, n = 45), and networks (81%, n = 47); few articles identified a direct policy change (22%, n = 13), and many articles discussed the policy implications of findings for future work (62%, n = 36). This review synthesizes three decades of efforts to reduce environmental inequities and identifies strategic approaches used for strengthening community capacity.

Environmental health perceptions in a superfund community

A disconnect between community perceptions and officially documented Superfund remedial actions and health outcomes may hinder the essential community engagement at Superfund sites. This study evaluates the extent of one such potential disconnect in Butte, Montana, which is part of the largest U.S. Superfund site in the U.S. Since the 1860s, when mining began in Butte, mine waste disposal practices in Butte and surrounding areas have left behind massive deposits that have contaminated the area's soil, sediment, groundwater and surface water with arsenic and heavy metals. Over the last four decades, a substantial amount of remediation work has been completed along with requisite community engagement and health studies at this Superfund site. The potential disconnect was evaluated using a new survey instrument that covered: (a) general environmental health perceptions, (b) mine-waste specific environmental health perceptions, (c) effectiveness of community engagement, (d) knowledge of health outcomes, and (e) demographics. The survey results demonstrated a disconnect in many instances where objective remedial improvements may not have resulted in improved environmental health perceptions in the community. The disconnect was most pronounced in the case of drinking water protection from mine waste and knowledge of health outcomes (cancer incidence rates and children's blood levels). The use of similar environmental health perception measurements may aid responsible agencies in monitoring for and addressing environmental health perception disconnects through better community engagement for the benefit of the impacted communities.

Risk perception towards healthcare waste among community people in Kathmandu, Nepal

BACKGROUND

Healthcare waste management is a serious issue in context of developing countries. Better assessment of both risks and effects of exposure would permit improvements in the management of healthcare waste. However, there is not yet clear understanding of risks, and as consequences, inadequate management practices are often implemented.

OBJECTIVES

This study primarily aims to assess risk perception towards healthcare waste and secondly to assess knowledge, attitude and identify the factors associated with risk perception.

RESULTS

A cross-sectional community based study was carried out among 270 respondents selected through multistage sampling technique. Face-to-face interview was conducted using semi-structured questionnaires. Risk perception was classified as good and poor based on mean score. Bivariate and multivariate analyses were carried out to determine the associates of risk perception. More than half, 52% of the sampled population had a poor risk perception towards healthcare waste. More than a quarter 26.3% had inadequate knowledge and forty percent (40%) had a negative attitude towards health care waste management. Having knowledge (OR = 3.31; CI = 1.67-6.58) was a strong predictor of risk perception towards healthcare waste. The perception of risk towards healthcare waste among community people was poor. This highlights the need for extensive awareness programs. Promoting knowledge on healthcare waste is a way to change the perception in Nepal. Community engaged research approach is needed to address environmental health concerns among public residents.