ADVANCEMENT OF THE SCIENCE
Even though respondents found results easy to understand, most could not correctly recall all exceedances in their results, with only two respondents accurately recalling all exceedances. Notably, respondents had a more accurate recall of exceedances of federal standards for well water or soil when com- pared with exceedances of state standards (73% versus 45%, respectively; Figure 4). Among respondents who answered the question about follow-up action ( n = 13), three took appropriate actions based on exceedances in their results (e.g., replaced pipes, shared results with doctor, installed filters). The well and soil results of these three respondents showed exceedances of at least one federal standard. Several respon- dents reported that they were still consider- ing water filter installation. One respondent, who was drinking bottled water, indicated cost as a barrier to taking permanent action to reduce exposure to contamination. Discussion In the Well Empowered study, results pre- sented pictorially, together with tables and information about health eects, were designed to support well users in taking or considering appropriate actions. Yet in fol- low-up surveys, many could not recall all the contaminants that were present in their water. An inability to recall specific contami- nants in well water or soil could limit the ability of residents to follow up appropri- ately, including implementing proper filtra- tion methods or sharing information with a healthcare professional. Existence of federal standards (such as MCLs) might have played a role in recall, as respondents typically could recall results for contaminants that exceeded a federal standard. The federal standards were repre- sented as a bright red line in pictorial for- mat, signifying danger, which also could have influenced respondents’ attention to those contaminants. In contrast, multiple state standards were used as benchmarks for other contaminants in the Well Empow- ered pilot study, including established and interim groundwater quality standards and health screening goals. In report-back mate- rials, the state standards were represented pictorially with different colors of lines (orange or purple) depending on the type of standard (groundwater standard versus
FIGURE 5
Adapted Version of Well Empowered Test Results
Your Well Results – Metals and Your Health All results below are presented in parts per billion ( ppb ), which is equal to micrograms per liter ( μg/l ). Any results with an orange background are considered to be above the relevant standard. Contaminants are grouped under the relevant federal or state standard that regulates their presence in drinking water. Potential health effects are noted for any contaminants that exceed standards and for lead, which has no known safe level of exposure. Potential Health Effects Federal Drinking Water Quality Standard (U.S. EPA Maximum Contaminant Level or Treatment Technique (TT) Action Level) Antimony 6 0.36 Arsenic 10 10.89 Skin damage, circulatory system problems, and risk of cancer. Cadmium 5 0.04 Copper 1300 (TT) 12,748 Liver or kidney damage; gastrointestinal distress. Contaminant Standard Your Water
There is no safe level of lead in water 1 . Infants and children: delays in physical or mental development. Adults: Kidney problems, high blood pressure, and increased risk of cancer.
Lead
15 (TT)
2.45
Selenium
50
0.05
Uranium
30
0.32
1 US Environmental Protection Agency set a Maximum Contaminant Level Goal (MCLG) for lead at zero based on the best available science which shows there is no safe level of exposure to lead.
Note: All sample analysis was completed at the UNC Superfund Research Program Chemistry and Analytical Core Laboratory.
Note. UNC = University of North Carolina; U.S. EPA = U.S. Environmental Protection Agency.
health screening goal, respectively). These variations in color also could have influ- enced participants’ perceptions of associated danger and recall. Further, emerging con- taminants, such as vanadium and hexavalent chromium, might not have been as familiar to participants, which could have influenced their ability to recall them. These results highlight challenges associ- ated with communicating information on emerging contaminants, specifically the lack of relevant standards and limited or lack- ing information on potential health eects. Without an established reference point, resi- dents might be less able to identify and take appropriate health-protective action. This finding is supported by questions raised in the community meeting about what actions, if any, residents should take based on test results when exceedances were not based on a federal standard. Ultimately, such decisions are up to the individual and grounded in the
resources available to them and the amount of risk they are willing to accept. When discussing potential actions, the research team communicated risks in a con- text of uncertainty related to potential health eects of contaminants that were not well studied. Given that expert views of risk often dier from lay public views (Frewer, 2004; Johnson & Slovic, 1998), researchers who share environmental exposure data with com- munities could benefit from training in princi- ples of risk and science communication. Such training could prepare researchers to engage in dialogue with residents who are seeking to understand potential health implications and then implement health-protective actions. Since completing this evaluation in Stokes County, North Carolina, the study team has collected evaluation surveys from over 250 participants in the Well Empowered study and we are currently analyzing these data for similar trends. Individual report-back
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Volume 85 • Number 8
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