Human Biomonitoring for Environmental Chemicals (2006) / Chapter Skim
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6 Communicating Results, Interpretations, and Uses of Biomonitoring Data to Nonscientists
6 Communicating Results, Interpretations, and Uses of Biomonitoring Data to Nonscientists
Pages 201-237
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From page 201... ...
Two allegedly competing implications were trumpeted by outside groups: "The nation is awash in toxics." "Look at the progress made in reducing exposures." Anxiety among laypeople can be heightened by frequent reporting of biomonitoring data that are not fully explainable with current scientific knowledge. Communication is essential for proper interpretation and use of biomonitoring data.
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From page 202... ...
The remainder of Chapter 6 assumes that appropriate evaluation planning and implementation, partnership consideration and implementation, and constituency assessment have been done, and therefore this chapter focuses on reporting of results, interpretation, and use. Without effective communication in particular between biomonitoring researchers and nonscientists and among nonscientists, proper interpretation and use of biomonitoring data will occur only with difficulty, conflict, anxiety, and waste of time and money.
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From page 203... ...
As noted in Chapter 4, potential discussants of environmental biomonitoring are more diverse than just "laypeople" and "experts," and there is great diversity within each constituency cited in Chapter 4 in the nature and degree of beliefs relevant to biomonitoring. Communication is best described as at least a two-way, if not a multiple-voice alltalking-at-once, conversation in which scientists are not the sole generators of biomonitoring data (see Chapter 2)
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From page 204... ...
Fourth, although good communication is critical for interpretation and use of biomonitoring data, this dictum should not blind anyone to the limits of what communication about biomonitoring can accomplish, given the volatile social and political context cited in the introduction to Chapter 4. Communication will not eliminate all value conflicts, will not obscure or reduce all imbalances of power between parties contending about what constitutes good science or appropriate risk management, and will not even get everyone to agree on interpretation of "facts" even if they agree on the facts themselves.
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From page 205... ...
COMMUNICATING RESULTS, INTERPRETATIONS, AND USES 205 remarks, we do not wish to encourage the view that communication about biomonitoring would be ineffective or inefficient. On the contrary, communication and systematic evaluation of communication techniques has been given inadequate attention in environmental management (Chapter 4)
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From page 206... ...
Those and other contextual factors affect whether and how mutual understanding, agreement, and action on biomonitoring data occur; and people charged with such communication must learn the answers to these and related questions. The tension between "principles" and effective communication practices is illustrated in discussion of uncertainty (and variability)
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From page 207... ...
COMMUNICATING RESULTS, INTERPRETATIONS, AND USES 207 uncertainty about bad outcomes from activities that have small or uncertain benefit; control over outcomes is preferred to the lack of control that uncertainty implies (Edwards and Weary 1998)
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208 HUMAN BIOMONITORING FOR ENVIRONMENTAL CHEMICALS Sketchy but provocative suggestions are beginning to emerge from empirical studies of uncertainty in risk communication. Frewer et al.
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From page 209... ...
However, experience and correlational studies suggest that trust in institutions is a critical factor in judgments of how risky something is, and it is likely, in the contentious atmosphere surrounding biomonitoring, that trust will also affect whether nonscientists see having biomarker concentrations in one's body tissues as risky. For example, later in this chapter we point to evidence of skepticism about the protectiveness of benchmarks based on external-exposure monitoring and suggest that it might apply to biomonitoring benchmarks, too.
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Those studies differ in the conditions that make valuesharing helpful. For example, some scholars argue that effective demonstration that one shares the constituency's salient values is most important when people are unfamiliar with a hazard (often the case with environmental chemicals)
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From page 211... ...
the effects are not certain. Similarly, messages should not imply without evidence that a specific activity is the source of observed body burdens or that particular actions will reduce exposures to environmental chemicals.
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inferred, from biomonitoring data would be prudent (Hance et al. 1988; NRC 1989; Pflugh et al.
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Nondetection could be ideal for everyone except (perhaps) biomonitoring researchers: all else being equal, no one wishes evidence of human exposure to environmental chemicals.
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From page 214... ...
. CDC's Third National Report on Human Exposure to Environmental Chemicals (2005)
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(2004) note that they yield "unequivocal evidence that both exposure and uptake have taken place." As a result, state officials said "that human exposure [biomarker]
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From page 216... ...
It would entail intensive interviews that begin with nondirective questions (for example, "Tell me about environmental chemicals in human blood, urine, or breast milk") followed by questions informed by scientific views of the causal process.7 Later largescale surveys reveal the relative prevalence of particular biomonitoring views in the population.
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From page 217... ...
COMMUNICATING RESULTS, INTERPRETATIONS, AND USES 217 For example, many people seem to hold a one-hit "mental model" of carcinogenesis; 58% of Canadians in a national survey disagreed that "the body usually repairs the damage caused by exposure to radiation so that cancer does not occur," whereas only 31% agreed (Krewski et al.
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From page 218... ...
218 HUMAN BIOMONITORING FOR ENVIRONMENTAL CHEMICALS Health Effects Cannot Be Ruled Out The message that biomarker data alone do not indicate health problems is incomplete, if necessary, and should not stand on its own. Without reasonably definitive data demonstrating the absence or likely absence of health effects due to observed magnitudes of exposure (such as well-done epidemiologic studies of the same or a similar population or reliable benchmarks)
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From page 219... ...
to have stable, consensual mental models of their own on this topic. CDC does not report personal body burdens of environmental chemicals -- partly, it seems, because of concern about precisely this potential perception, partly because the hundreds of chemicals that it now tests for are not tested in every subject.
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. Data are also needed on how laypeople understand or respond to notions of detection limits or the scope of surveillance efforts and on their views on the effects of exposures to chemical mixtures on health.
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From page 221... ...
COMMUNICATING RESULTS, INTERPRETATIONS, AND USES 221 have" or "you have values three times those of the general population but [more or less than] this occupationally exposed group" (J.
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From page 222... ...
For example, CDC has mentioned Biological Exposure Indices (BEIs) for substances for which they are available, warning that these occupational values are "not appropriate" for the general population and are provided "for comparison, not to imply that the BEI is a safety level for general population exposure" (CDC 2005)
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From page 223... ...
For example, for external doses it is a legal violation when a utility's water exceeds a drinking-water standard, as determined by mandated measurement protocols. Being ambivalent or ambiguous about what constitutes proper and improper conditions here defeats the purpose of efficient and equitable enforcement of the rule.
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224 HUMAN BIOMONITORING FOR ENVIRONMENTAL CHEMICALS sages (as appropriate) that expert uncertainty about health effects diminishes as exposure gets further above the benchmark and that a carcinogen proved in animals may not be proved in humans may help to forestall undue expression of the bright-line syndrome among biomonitoring constituents.
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From page 225... ...
as a means to make biomarker benchmarks more credible, in addition to such communication alternatives as educating people about natural and other nonindustrial sources of environmental chemicals. Recent papers on European attitudes toward real or hypothetical precautionary measures regarding health risks posed by mobile telecommunication handsets and towers or base stations (Timotijevic and Barnett 2006; Wiedemann and Schütz 2005)
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From page 226... ...
Interpreting Biomarker Findings in the Context of Clinical Data The best opportunities for communicating health implications of biomonitoring data arise when an unequivocal internal dose-response relationship has been established for humans (by methods discussed in Chapter 5) or when a clinician has data on a person's health that can be used for context-setting.
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From page 227... ...
COMMUNICATING RESULTS, INTERPRETATIONS, AND USES 227 who order biomarker tests themselves or through their doctors) may have been subject to lower-quality tests or less-informed consent, which may have presented their physicians with challenges that the doctors had trouble recognizing.
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From page 228... ...
Without strong institutional support for communication planning and evaluation in individual studies and without development of communication infrastructure generally, biomonitoring communication will become at best unhelpful and at worst a barrier to effective interpretation and use of biomonitoring data. Occasional creative solutions will die for lack of support and dissemination.
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From page 229... ...
CDC's biannual reports on human exposure to environmental chemicals now include information on each chemical's uses and sources but too generically to be much more than a start for deciding whether and how to act. Exposure-source and -reduction information is unlikely to come from biomonitoring projects themselves in most cases, so other researchers and institutions must provide information on exposure reduction that will be useful for biomonitoring-study design, communica
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From page 230... ...
Identify Mental Models of Exposure and Health Effects. The direct and indirect links between external dose, biomarker concentrations, and biologic effects (Figure 3-1)
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From page 231... ...
Research to identify the current nature and scope of biomonitoring-related communications by various organizations, including retrospective analyses of generic and project-specific informational materials, will be a vital complement to the prospective evaluation of new project communications recommended in Chapter 4. For example, the apparently growing phenomenon in which individuals contract with a testing laboratory to measure biomarkers in their urine or blood independently of any formal study (Chapter 2)
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What are the best means to convey that low or typical biomarker concentrations do not rule out health effects? · Can values affirmation and other techniques to reduce resistance to messages of personal relevance (such as exposure and exposure reduction)
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U.S. Department of Health and Human Services, Agency for Toxic Substances and Disease Registry [online]
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From page 234... ...
2005. Third National Report on Human Exposure to Environmental Chemicals.
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COMMUNICATING RESULTS, INTERPRETATIONS, AND USES 235 Johnson, B.B.
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2005. National Health and Nutrition Examination Survey (NHANES)
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From page 237... ...
Environ. Health Perspect.
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