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Environmental and Public Health Interventions around NOA: A Community Case Study Marci R. Culley, Ph.D. Georgia State University.

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Presentation on theme: "Environmental and Public Health Interventions around NOA: A Community Case Study Marci R. Culley, Ph.D. Georgia State University."— Presentation transcript:

1 Environmental and Public Health Interventions around NOA: A Community Case Study Marci R. Culley, Ph.D. Georgia State University

2 GSU/CDC Seed Grant Awards in the Social and Behavioral Sciences Purpose – enhance research relationships How this study came about 2 years Research Team - Who are we? - Agency for Toxic Substances and Disease Registry - Georgia State University Community Psychology - skill sets

3 Why Collaborate on this Issue? Previous ATSDR & GSU collaborations Environmental health science and behavioral sciences - some conceptual integration - limited application Federal environmental and public health agencies - environmental hazards intervention, public involv. - series of successes and failures Enhance understanding of env. health intervention Potential widespread impact of NOA

4 Overview of Study

5 The Setting for Research El Dorado Hills, California

6 Why We Chose El Dorado Hills Significant regulatory and public health attention Complexity of dealing w/ NOA in residential setting Unique challenges associated w/ NOA - regulatory hot potato - not your typical dirt job Potential widespread nature of NOA - broader public health implications - recent attention from USGS, others

7 Notable Environmental and Public Health Actions in El Dorado Hills Oak Ridge High School - EPAs cleanup under CERCLA / Superfund authority - ATSDRs Public Health Consultation EPAs October 2004 activity-based sampling - Rolling Hills Middle School - Jackson Elementary, garden - Silva Valley Elementary - NY Creek Nature Trail - CSD park


9 Media Continuum of Coverage…

10 Series of articles 1998 – present Sacramento Bee Mountain Democrat

11 Science News January 13, 2007 U.S. EPA to revisit asbestos toxicity

12 Mother Jones: May/June 2007

13 Specific Aims of the Study

14 1)Use social and behavioral sciences methods to conduct a qualitative community case study: - describe the environmental and public health interventions / actions used to mitigate NOA effects - document how these were perceived by key stakeholder groups - determine feasibility of framework / tool for assessing these

15 2) Provide guidance to communities potentially effected Panel convened to provide feedback in 2 areas: - case study findings and recommendations - accuracy and utility of analytic framework / tool Panel Participants experience - Program evaluation / logic models - environmental public health intervention - NOA science - community members

16 3) Disseminate results in various ways - academic journals - academic conferences - environmental and public health officials - media - El Dorado Hills community

17 My focus tonight: Qualitative Case Study Findings

18 Research Questions: 1.What is the nature of environmental and public health interventions / actions in this community? 2.How do key stakeholders experience these? 3.How might this case study inform future interventions?

19 Qualitative Community Case Study Method Laying groundwork for recruitment, interviews - talked with ATSDR staff - met with LAWG, CAG - recruitment s to key stakeholder groups - compiled and read background info Sought Interviews with 4 key stakeholder groups: - County level officials (N=11) - State agency officials (N=9) - Federal agency officials (N=8) - Community activists (N=10) Targeted sample to meet objectives of case study

20 Interview Participants Federal and state govt. employees (11) - 7 federal (87.5%), EPA and ATSDR - 4 state (44.4%), CARB, OEHHA, DHS Community activists (7) – 70% of those recruited County employees some initial interest expressed - from EDC Superintendent of Schools - those who initially expressed interest then declined DTSC employees – 0 - cited lack of time, scheduling conflicts - informally told otherwise, not confirmed

21 Interview Method In person by GSU researcher and grad assistant - August and September 2006 Location chosen by participants Average length about 1 hour Informed Consent, Confidentiality Audio recorded, transcribed verbatim for analysis Open-ended question asked of all participants

22 Tell me what you think is important for me to know about how NOA had been addressed in El Dorado Hills…

23 Possible Interview Prompts What actions / interventions occurred? What worked well / was successful? Challenges? Lessons learned or recommendations? Open-ended technique allows for rich description of participants experiences vs. researchers preconceived notions of such

24 Data Analysis – Interviews Participants given opportunity to review transcripts - about ½ offered edits / clarifications - typically minor About 400 single-spaced pages of transcripts - textually analyzed - to identify emerging themes and subthemes Goal to characterize data – range of responses - NVIVO 7 qualitative data software

25 Document Data Sources Hundreds of pages of background info reviewed - specific to NOA actions in EDH / EDC - env & public health agencies at local, state, fed levels - scholarly publications - information produced by stakeholder groups - media - several key docs 2005 Joint Senate Committee Hearing transcript agency websites, fact sheets & reports Chronology of Events / Timeline Development - triangulation of data sources

26 Interview Findings (Table pp ) Actions Challenges Successes Recommendations / Lessons Learned Most and least salient…

27 Actions (100%) Communication Asbestos ID / Sampling / Monitoring Enhanced Regulation and Enforcement Building Agency Collaboration Remediation / Mitigation Risk Assessment Work

28 Communication Subtheme Series of public meetings most frequent (100%) - May 2005 joint EPA / ATSDR meetings - GV, ORHS, BOS, EPA science seminar , telephone btwn agencies and citizens (55%; 57%) Inter-agency communications (73%; 14%) General agency communication w/ public (55%; 29%) - public release of reports, press, policymakers - fact sheets, websites, info repository Attendance of ACAG, LAWG meetings (18%; 14%)

29 Asbestos ID / Monitoring / Sampling Subtheme (91%; 100%) Historic sampling / ID in mid 1980s (27%; 57%) - GV, Cothrin Ranch Road, DMG mapping ORHS and surrounding areas - CARB (45%; 57%) - EPA (64%; 29%) - County (18%; 57%) - School district (18%; 43%) - CSD (9%; 43%) EPAs Oct 2004 activity-based sampling (73%; 43%) - most frequently noted by participants

30 Enhanced Regulation and Enforcement Subtheme (82%; 100%) Countys BEACON dust program (45%; 100%) States updated ATCM and related rules (64%; 29%) - paving materials, quarries, construction / dust DTSCs Interim Guidance for CA Schools (55%; 43%) - new construction rules - O & M Guidance - hazardous materials removal / oversight for lot County regulation of buffer zones (0%; 43%)

31 Building Agency Collaboration Subtheme (91%; 43%) EPA state and county (45%; 0%) ATSDR state and county (55%; 0%) EPA & ATSDR EPA Tech Working Group (36%; 0) Method 435 Group (36%; 0%) County Task Force / Steering Committee (18%; 29%) BOS collaborations with State DMG (0%; 29%) OEHHAs technical support work (18%; 0%) EPAs USGS (18%; 0%)

32 Remediation / Mitigation Subtheme (64%; 80%) EPAs removal action at ORHS (55%; 43%) County level remediation efforts (27%; 57%) - ORHS, CSD Road paving in Garden Valley (36%; 29%) DTSC hazardous materials removal (0%; 29%) - tremolite on Woedee Drive residential lot

33 Risk Assessment Work Subtheme (82%; 52%) ATSDRs Public Health Consult for ORHS (36%; 57%) ATSDRs 2 nd Health Consult (45%; 0%) EPA expert panel (9%; 29%) ATSDRs biomarkers expert panel (18%; 0%) OEHHAs risk assessment work (18%; 0%) ATSDRs white paper / NTP proposal (18%; 0%) - EPAs response to RJ Lee report (27%; 14%)

34 Challenges (100%) Regulatory Issues - The hot potato effect (100%; 86%) - Regulatory loopholes (91%; 100%) - The nature of bureaucracy (36%; 29%) NOA Science - Risk assessment and communication (100%) - Sampling methods and analyses (91%; 71%) - Identification of asbestos (73%; 71%) - The nature of asbestos and remediation (45%; 86%)

35 Challenges Cont… Local and State Issues - Resistance to NOA issues (91%; 100%) - Community conflict (100%; 86%) - Resource issues (82%; 57%) - Distrust of government (64%; 0%) Political Context (73%; 100%) - Political nature of local, state and federal agencies - Conflict of interest - Conflicting political values or ideology

36 Regulatory Issues…

37 The Hot Potato Effect It was kind of like, well whos in charge here? I mean, thats really…a huge problem and will continue to be a problem for issues like that everywhere. Govt. Employee You envision a bunch of people standing in a big circle and everybody pointing to the right claiming its this guys responsibility. Citizen

38 Regulatory Loopholes Lack of regulation specific to NOA Enforcement of O & M procedures Dust rules Land use planning

39 Part of the huge issue is that this kind of situation falls through the regulatory cracks. Govt. Employee What has happened is incomplete and…is focused on new construction, not addressing historic issues. Citizen

40 NOA Science Risk assessment and communication - ill-fitting, underdeveloped risk models - related debates on toxicity of different fibers - disproportionate focus on chrysotile / occupational - lack of understanding latency periods, disease mechanisms dosage, duration, synergistic / cummulative - modeling risk from soil / traditional air sampling - challenges of risk communication given these

41 You cant answer the specific questions of well my kid plays soccer five times a week, is he gonna get sick?...the problem is we dont know…we dont know if one serious hit off that big cloud is gonna be enough to trigger disease. Govt. Employee Sometimes the public may not realize that [it is] very frustrating for us to not be able to provide a clear answer to them…weve got answers based on a lot of inexact science. Govt. Employee

42 They dont have all the answers, and as far as risk is concerned, theyre never gonna have black and white answers, and I dont think people understand that here…thats not the nature of risk. Citizen

43 NOA Science Cont… Sampling methods and analyses - Ambient / Background air monitoring - flow rates, testing limits - location of monitors - whether done under realistic situations - capturing personal activity-based exposures - Soil sampling - variability - capturing personal activity-based exposures

44 NOA Science Cont… ID of asbestos - cleavage fragment vs. fiber debate - ID beyond serpentine / ultramafic - fiber types (chrysotile v. amphiboles) - visual inspection v. electron microscopes Nature of asbestos and remediation - once uncovered and spread around - not a typical dirt job - invisible nature of fibers

45 You cant undergo some kind of normal remediation process where youd clean it up and bury it or seal it. Whats our solution? So thats a real challenge. Govt. Employee No matter how much you spray water on it…this is not a controllable situation…it dries…the wind blows and people run over it with bicycles or walk on it, or animal tracks or whatever, so…its never a controllable situation, which humans feel they can control everything. Citizen

46 Local and State Issues Resistance to acknowledging or addressing NOA - particularly county officials - state agencies - residents, parents, school staff

47 A lot of what US EPA and ATSDR [did] was motivated by the perception that there had been a lack of willingness on the part of some state agencies and perhaps local agencies…to even acknowledge there was a problem. Govt. Employee People dont want to know. Citizen

48 Local and State Issues Cont… Community conflict - polarization evident via media, public meetings - fallout feared if petitioners named - difficulty working together - impacted federal agencies work

49 I heard it more than once that oh this is just something these anti-development people are making up so that we retain our green space and we dont put up any more houses up here… So, they literally thought that [it was] totally fabricated. Govt. Employee [The former School] Superintendent said this was a left wing conspiracy brought out by environmentalists…it polarized the population. Citizen

50 Local and State Issues Cont… Resources - financial constraints - lack of staff and training / expertise Distrust of government - especially federal govt. - across continuum

51 [The] Air Pollution Control District…theyre a tiny office of three people. How can they run around making sure its enforced? Govt. Employee The schools have certainly had to spend a lot of money in mitigation for asbestos. Citizen The executive offices of different [state] departments are kinda like well, wait a minute, were not getting any funding to do this…we dont want this becoming an enormous resource sink. Govt. Employee

52 Successes / What Worked Well (100%; 57%) Science Public Communication Collaboration CSD Work Political Savvy

53 Science Subtheme (64%; 43%) EPAs activity-based sampling (45%; 29%) State geologists work (0%; 29%) Method 435 work (9%; 0%) CARB air monitoring efforts (9%; 0%) EPAs Technical Working Group (9%; 0%)

54 Public Communication Subtheme EPA and ATSDR efforts (73%; 14%) - May 2005 large public meeting / availability session - EPA website, work w/ press, science seminar - ATSDR biomarkers meeting

55 I had never seen such a huge community meeting…a thousand people [were] there and I thought that was really important because…I think there were a lot of different community members, not just the people whod been interested in it for a long time or who were activists but…the soccer moms, kids, the dad…it was an opportunity to get some information across…I thought the folks who were sitting up there from EPA and ATSDR did a great job. Govt. Employee

56 Collaboration Subtheme (64%; 14%) EPA and ATSDR EPA Technical Work Group Method 435 Group County and DMG

57 CSD Work Subtheme (0%; 57%) Particularly CSD Director

58 [The CSD Director] spent money…he hasnt bitched or complained or whined. Hes just done it. Hes finding ways to get it done. Citizen

59 Political Savvy Subtheme (18%; 14%) Community activists – building awareness; catalyst for actions EPA and ATSDR management – laying the groundwork

60 Lessons Learned / Recommendations (100%) Proactive / Preventive Approaches (55%; 100%) Resource Dedication (55%; 71%) NOA Science Development (55%; 71%) Policy Change (64%; 43) Collaboration (36%; 43%) Communication (55%; 14%) Political Understanding (27%; 14%) Tailored Interventions (18%; 14%)

61 I hope El Dorado is a lesson to fast growing communities, to look at their environment, their geology, and really take a hard look at how they should build, where they should build [so that they are] actually preventing additional public health problems…This is a prime example to show other communities that it is up to them to…prevent themselves the heartache…down the line. Govt. Employee

62 Interpreting Findings and Recommendations

63 Actions Interview and document data sources revealed a fairly comprehensive picture of NOA actions - Chronology / Timeline, triangulation of sources - confirmed participant accounts - filled gaps due to lack of participation by some

64 Challenges Documents helped to confirm interview findings - county officials perceived challenges that parallel - evidence of county / state resistance - only stakeholder group to suggest overestimation Data reveal differences in opinion about what challenges mean - who has authority, responsibility? - who will devote resources?

65 Successes Very little here… - more from govt. employees - typically qualified - ambivalent about science, communication

66 Lessons Learned / Recommendations Many offered Multi-layered understanding of complicated issue

67 Social Sciences Literature EDH community response similar to other communities facing toxic exposure disputes - natural and chronic technological disasters / disputes - psychosocial impact of toxic materials - individual and community response patterns - community conflict / corrosive community - combination of natural and human-made elements here - Lack of cohesive institutional response only exacerbates

68 Recommendations Findings specific to this case Social sciences literature Researchers experiences with similar case studies Necessarily Interrelated…

69 Recommendation #1 Proactive and preventive approaches are consistent with prudent public health practice and the precautionary principle; therefore, whenever possible, such approaches should be utilized.

70 These approaches are reasonable given U.S. environmental and public health agencies consider all forms of asbestos to be hazardous to human health - evidence that amphiboles may be more toxic At the local level, these approaches could: - mitigate adverse p.h. outcomes associated with NOA - avoid expensive and impractical after the fact remediation - ease community conflict related to NOA exposure disputes Best of all scenarios - ID before exposed - develop strategies to avoid exposures - e.g., informed land use planning

71 If NOA has already been disturbed… Some version of these approaches may still be applied - avoid further release of material - contain the material already uncovered - track over time material identified on parcels - provide land owners with accurate info about exposure av. - relocate people to uncontaminated areas Decision-making about implementation or whether necessary - involvement of local, state, federal agencies and public - meaningful engagement of all stakeholders - open process These processes informed by evaluation of existing policies…

72 Recommendation #2 Evaluation of how existing policies specific to NOA (at local, state and federal levels) could facilitate a cohesive, comprehensive approach to the problem should occur.

73 Some changes in local (EDC) and state (CA) policies - aim to further protect public - gaps exist that yield less than prudent p.h. practices Majority of interview participants cited loopholes / gaps - pose significant problems for sufficiently addressing NOA - pose problems for protecting public Working at cross-purposes w/ fed & state officials - contributed to inability of stakeholders to come together - resistance to implementing O & M procedures - authority to enforce O & M - all forms of soil disturbance not addressed - retro-fitting, day-to-day residential v. commercial Suggests that not all avenues have been covered to protect public

74 Not difficult to imagine similar scenarios elsewhere Suggest consideration of the following points: Differences in opinion about authority, responsibility - only exacerbated by gaps in policy - combined, can interfere w/ prudent public health practices - publics health would be better protected if gaps addressed Conflict of interest / resistance at local level - may interfere with enforcement and regulation p. h.

75 State and/or federal agencies may be better suited to lead - eval. (state-wide task force w/ local and national players) - develop & enforce existing regulations (land use w/ toxics) Inadequate institutional response to toxic exposure disputes - associated with increased psychological / social stress - may pose additional, although unintended health risks

76 Recommendation #3 Evaluation of strategies to enhance resource dedication and usage at local, regional, state and federal levels should occur.

77 Resources should be dedicated to the following: Continued development of NOA-related science Adequate regulation and enforcement efforts Ensuring best practice public health ed / communication - in communities already dealing with NOA - others with existing but unexposed NOA - effective and accurate communication - about what is known, not known, will never be known - could ease some community conflict The development of local and state capacity to deal with NOA - economically; staff training / expertise Further research to enhance community response to NOA issues

78 Community Tool Kit - may facilitate proactive / preventive approaches to NOA - for areas suspected to contain NOA - mapping, historical info, experiences of NOA communities Might include: - strategies to determine roles / responsibilities of agencies - strategies to determine regs / planning processes in place - model regs, policies, monitoring related to NOA - model regs for id of new areas and existing conditions Would be good reference to avoid reinventing the wheel - should include explicit statements about gaps

79 Recommendation #4 Prudent public health practice requires responsible leadership by those who have the resources, the power and the authority to protect the public, and such leadership, particularly from federal agencies should occur.

80 This kind of leadership could - emphasize importance of proactive / preventive approaches - facilitate consistent and comprehensive approaches - inform NOA resource dedication and usage - engage local, state and natl players to guide policy change When considering how responsible leadership might occur, we suggest consideration of the following points: The politics of asbestos appear to impact policies at all levels - may interfere with enforcement and regulation - yield less than prudent public health practices

81 Federal agencies should take proactive approach - provide guidance to state and local agencies to protect p.h. - neutral position may actually represent a position In the case of El Dorado Hills - downplaying resistance / conflict at local level - may have helped to facilitate polarization in community - what is known, not known…

82 No Easy Fix… Complex, Multi-layered Issue You gotta get all of the stakeholders together in a room and you gotta have that knock down, drag out fight to make progress. Its always uncomfortable but its inevitable under our present system. Citizen

83 Conclusions EDH community experiences not uncommon Data suggest multi-layered approach to intervene - also indicate gaps in intervention / actions Interventions to mitigate and prevent NOA exposure - will require multi-strategy, multi-level response NOA science is still being developed - prudent p.h. practice dictates protecting the public Stakeholders often have conflicting views - economic interests and health / well-being - will have to work together

84 Limitations of Study Sample size, representativeness - may be viewed as limitation - lack of participation of key stakeholder group - portraying an accurate picture of various positions - document data sources, chronology Did not conduct interviews with the general public - info about public participation, perceptions of actions - purposeful focus on key informants Focus on agency actions versus community activist actions - catalyst for agency actions

85 Generalizability - reflected pattern of experiences similar to other cases - can only speculate about extent - may reflect a story unique to this group - alternative explanations (e.g., privileged community) - access to resources may have shaped events here Emphasis of depth versus breadth was purposeful - allowed for rich and descriptive data - based on multiple sources - accommodates exploration of patterns across data sets - inter-rater reliability - texts came full circle - suggests fairly representative story being told here Helps to illuminate a pattern of experiences related to dispute

86 Acknowledgements Janet Heitgerd, Ph.D., ATSDR Terrie D. Sterling, Ph.D., CDC Jennifer Zorland, GSU graduate research assistant Panel Participants Study Participants

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