Environmental policies, politics, and community risk perception: case study of community contamination in Casper, Wyoming

Community perspectives on the risk of indoor air pollution arising from contaminated groundwater

The migration of volatile contaminants into overlying buildings, known as vapor intrusion, is a health concern for people living above contaminated groundwater. As public health and environmental agencies develop protocols to evaluate vapor intrusion exposure, little attention has been paid to the experiences and opinions of communities likely to be affected by vapor intrusion. Using a community-driven research approach and qualitative interviews, we explored community perspectives on the vapor intrusion pathway and the perceived impact on community health and well-being among neighbors living atop a large, shallow-chlorinated solvent plume in San Antonio, TX. Most participants associated vapor intrusion with health risks, expressing concern about the unavoidable and uncontrollable nature of their exposure. Few were satisfied with the responsiveness of public officials. Above all, participants wanted more accurate, transparent information and additional independent scientific investigations.

Guidelines for the mapping of cancer registry data: results from a breast cancer expert panel study

CONTEXT

Small area (eg, subcounty) cancer mapping is one of the analytic services most commonly requested of cancer registries and local public health agencies, and difficulties in providing it have been noted to undermine public confidence. Although a great many statistical protocols have been published to enable this practice, none of them are in common use to generate information for the general public.

OBJECTIVES

To evaluate the utility of subcounty breast cancer mapping and articulate guidelines and a possible protocol for its implementation by cancer registries and local public health agencies.

METHODS

We convened an Expert Advisory Group of breast cancer stakeholders from around California to elicit values, priorities, and preferred characteristics of protocols for proactive subcounty breast cancer mapping. Upon formulating a protocol, we applied it to 9 years of data (2000-2008) describing invasive breast cancer in California for evaluation by the Expert Advisory Group.

RESULTS

Maps with subcounty resolution were seen to provide important information with a wide range of applications. Priorities included the avoidance of false-positive findings, scientific credibility, and the provision of information elucidating social and environmental characteristics. A protocol using Kulldorff's Scan Statistic along with postanalytic steps for refining results was elaborated; when applied to the data, 4 discrete regions with elevated rates of invasive breast cancer were identified and described.

CONCLUSIONS

Expert Advisory Group priorities were readily translatable into a scientifically rigorous protocol that protected confidentiality and avoided statistically unstable rate estimates. The resulting maps enabled participants to visualize geographically defined populations falling within and crossing county boundaries. These findings support the enactment of policies for the routine and proactive analysis of breast cancer surveillance data to provide subcounty information.