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5 Communicating with the Public about Exposure to I-131
Pages 125-151

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From page 125...
... This chapter provides a broader framework for DHHS to consider as it develops its information strategy. Communicating effectively with the general public about the health risks posed by exposure to I-13 1 fallout from aboveground nuclear tests some 40 years ago presents a difficult challenge to DHHS for several reasons: .
From page 126...
... CHARACTERISTICS OF RISK COMMUNICATION As is the case with most risks, communicating effectively possible health hazards stemming from exposure to I-131 fallout from the Nevada nuclearweapons tests will be complicated. Most risk communication efforts fail because communicators believe the process is relatively simple: "educate the public" (Liu
From page 127...
... For example, Stevenson and Greene (1980) studied individuals' judgments about possible bias in news stories about presidential candidates and found that "people see as biased news information which is discrepant with the cognitions they already hold about the situation described in the news story" (p.
From page 128...
... It might be appropriate in some instances, therefore, to use less resource-intensive risk communication strategies. Whatever strategy is pursued, it must be remembered that people who encounter DHHS information about exposure to I-131 will predictably incorporate the messages in ways that are consistent with their personal understanding of the Nevada tests and their fallout.
From page 129...
... The Centers for Disease Control and Prevention's Cancer Information Service offers another example. It experiences an upsurge in the number of telephone calls soon after news about a particular cancer is disseminated in the mass media (Freimuth 1998~.
From page 130...
... As noted in Chapter 4, even basic literacy and numeracy must be recognized as challenges. Application Creating appropriate risk messages requires recognition of the heterogeneous nature of the audience and of the importance of risk salience, information resources, and other factors that inform people's responses to information.
From page 131...
... Application Traditional informational messages about the health effects of aboveground testing will serve to reinforce existing beliefs, whatever they are, among individuals who already have complex and enduring beliefs about those risks. Effective communication with these groups may require more intensive work such as community meetings, establishment of advisory groups, and working with other information sources that may be more credible to those with strong existing beliefs.
From page 132...
... The aboveground nuclear-weapons tests will provoke cultural reactions as well as disparate individual responses. DHHS may need to focus on more than I-131 exposure and probabilities of developing thyroid cancer and to acknowledge that radiation is not like most risks because it is not observable and exposure is not voluntary or often even known by those exposed.
From page 133...
... If DHHS is trying to communicate information about the general risk stemming from the Nevada tests, mediated channels are fine. There is some evidence that individuals who attend to those messages will learn from them.
From page 134...
... One way to invest less effort is to employ judgmental shortcuts that focus on the credibility and trustworthiness of information channels, not information sources. That is, rather than enter into the laborintensive task of picking apart a message to judge the credibility of a particular source, an individual will make a broader judgment about the credibility of the channel.
From page 135...
... And in such long-running and volatile issues as the aboveground Nevada tests, credibility is important in public acceptance of information. In lieu of changing perceptions of credibility a decades-long task at best it might be useful to separate types of information such that a specific type of information is matched with an information provider who will be seen as credible in that instance (see Jungermann and others 1996~.
From page 136...
... An added benefit was an enhanced sense of political efficacy; these persons now believed their opinions mattered (Fishkin 1996~. As judged by the degree of community involvement, perhaps one of the better current risk communication templates is the Hanford Health Information Net
From page 137...
... The remainder of this section briefly discusses elements of the interpretive context, offering a list of domains that DHHS should consider as it decides on the content of its messages. The use of specific communication strategies is discussed, including risk comparisons, the question of whether the World Wide Web can contribute, and a means for people to estimate personal risk from exposure to I131 during the Nevada tests.
From page 138...
... It will be important to account for contingent conditions when trying to evaluate an individual's future lifetime risk of being diagnosed with thyroid cancer. Such evaluations should emphasize that increased probability of developing thyroid cancer caused by I-13 1 exposure is restricted to a relatively narrow birth cohort and that, even for members of that cohort, future risk of developing thyroid cancer is most likely less than a few percent.
From page 139...
... The authors note, "Essentially, all risk comparisons even those that are widely seen as acceptable risk comparisonsinvolve the provision of information by proponents and officials. If those proponents and officials are not trusted, then even 'legitimate' risk comparisons can do more to arouse suspicions than to assuage them" (p.
From page 140...
... If numeracy skills are low or if individuals have accepted competing naive theories the risk communicator must tailor the message accordingly, and consider the possibility and consequences of communication failure. World Wide Web Communication The World Wide Web's popularity has led many to predict an explosion in public reliance that will eventually exceed that for today' s traditional information channels, with the possible exception of television (CommerceNet 1997; WorthlinWorldwide 1996~.
From page 141...
... How do users make reasonable judgments about the trustworthiness of the information presented? Although research on how people use the Web as an information channel is just beginning, one possibility, admittedly optimistic, is that, for risk communication purposes, the Web combines the best attributes of mediated and interpersonal channels.
From page 142...
... The democratic approach now can be used only to guarantee that all affected parties can participate and affect future decisionmaking. The issue of health effects caused by I-131 fallout from the Nevada tests is one for which technical and democratic perspectives are both present and, at times, seem to collide.
From page 143...
... The addendum to this chapter includes for DHHS consideration an example of a method people could use to assess their exposure to iodine-131 and their risk of developing thyroid cancer and to help them decide whether they wanted to seek further information and advice. The specific county classifications, risk categories, and multipliers provided for in the assessment method would need to be chosen carefully and validated appropriately.
From page 144...
... In developing a method that could be used to distribute information, one approach it might consider is funding the assignment of public-health personnel educated on the topic of Nevada Test Site radiation health effects in some or all public-health-service regions. These personnel would provide information to interested members of the public, as well as to state health agencies, and would respond to questions and concerns.
From page 145...
... ADDENDUM 5: EXAMPLE OF A METHOD TO ASSIST INDIVIDUALS IN ESTIMATING THEIR PERSONAL THYROID CANCER RISK The IOM/NRC committee believes that some Americans will want to learn more about the thyroid cancer risk they individually face. In this context, risk refers to the chance that a specific person will develop thyroid cancer as a result of exposure to I-131 from the Nevada tests.
From page 146...
... In addition, supplementary material would also be necessary to provide information to the reader about the nuclear testing program, the years of birth that would result in the highest risk, thyroid cancer risks specific to each sex, radioactive fallout and I-131, natural occurrence of thyroid cancer, the benefits and possible harms of thyroid disease screening, the prognosis of thyroid cancer once it is diagnosed, and information about seeking counseling and guidance from a family physician or other medical specialist. Again, the intent of the committee is to provide an example of a relatively simple procedure to assist in assessing and communicating an individual person's risk of developing thyroid cancer following exposure to the Nevada tests.
From page 147...
... . Those who consumed mostly cows' milk from a commercial source during the testing refer to Table 1A, which is derived from the NCI data using as a reference group, males aged 5-14 who drank average quantities of milk during the 6 major test series between 1951 and 1957.
From page 148...
... Thus, to determine relative risk according to location, use is made of Table 1B, in which the counties are divided into 3 categories low, medium, and high deposition. The allocation of counties was determined for males, drinking average quantities of milk from a backyard cow summed over the 6 major test series between 1951 and 1957.
From page 149...
... Procedure: Multiply the 4 factors obtained from Steps 2 and 3 to determine your relative risk value. Explanation: The product of the 4 factors is a number that indicates the risk of developing thyroid abnormalities (cancer in particular)
From page 150...
... Male, born in 1941, living in county "a" (medium-deposition county) who drank commercial milk at twice or more the average rate in the 1950s: From Table 1A, column 2 From Table 2, age section From Table 2, milk consumption section From Table 2, gender section Risk (relative to reference group)
From page 151...
... Your lifetime risk of developing thyroid cancer is the same as for people not exposed to radiation, about 1 in 400 for males, and 1 in 150 for females.b You have been exposed to a risk of very small Nothing. magnitude; when compared with many other risks, it is of little consequence.


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