Risk perception and access to environmental information in four areas in Italy affected by natural or anthropogenic pollution

Highlights

• Risk perception and access to information was investigated in a sample of 282 subjects in Italy.

• A combined random Forest and logistic regression approach was applied.

• Risk perception is higher in geographical areas characterized by anthropogenic pollution.

• Citizens living in industrial areas are more confident in environmental NGOs than in public authorities.

Abstract

A human biomonitoring (HBM) survey in four areas affected by natural or anthropogenic arsenic pollution was conducted in Italy within the framework of the SEpiAs project. A questionnaire, including the exploration of risk perception (RP) regarding environmental hazards and access to and trust in information, was administered to 282 subjects stratified by area, gender and age.

The survey was designed to investigate how populations living in polluted areas could adopt prevention-oriented habits, fostered by the awareness of existing risks and, in addition, how increased knowledge of RP and information flows could support researchers in identifying recommendations, and presenting and disseminating HBM results.

This study characterizes the four areas in terms of RP and access to and trust in environmental information, and provides insights into the influence of RP and environmental information on food consumption.

For the data analysis, a combined random forest (RF) and logistic regression approach was carried out. RF was applied to the variables derived from the questionnaire in order to identify the most important in terms of the aims defined. Associations were then tested using Fisher's exact test and assessed with logistic regression in order to adjust for confounders.

Results showed that the perception of and personal exposure to atmospheric and water pollution, hazardous industries and waste, hazardous material transportation and waste was higher in geographical areas characterized by anthropogenic pollution. Citizens living in industrial areas appeared to be aware of environmental risks and had more confidence in environmental non-governmental organizations (NGOs) than in public authorities. In addition, they reported an insufficient circulation of information.

Concerning the influence of RP and environmental information on food consumption, a high perception of personal exposure to atmospheric pollution and hazardous industries was associated with a lower consumption of local fish.

In conclusion, different RPs and information flow patterns were observed in areas with arsenic of natural origin or in industrial contexts. These findings may be useful for targeted risk communication plans in support of risk-management strategies.

Introduction

The health risks caused by environmental pressures have attracted increasing public attention. They are of concern at both global and local levels, and are often fostered by the media. Research in the environmental health domain is often required to understand exposure pathways and to suggest preventive measures in high-risk areas (Comba et al., 2007). Over the past few decades the European Union has promoted the growth of “scientific citizenship” (Kok, 2004), as a means to engage communities in local governance, including risk management (Friedman et al., 2015).

The scientific community is aware of the complexity of environmental health issues. Especially in areas where there are environmental hazards, public alarm has been raised, a clear understanding of the risks is lacking, and urgent decisions are needed (Funtowicz and Ravetz, 1992). In these cases, a combination of qualitative and quantitative studies is required to facilitate risk communication and the involvement of the general public. Multidisciplinary groups are convened to carry out complex studies on environmental health determinants (Cirillo, 2014), including expertise in anthropology, sociology and risk communication, and to facilitate the knowledge translation and exchange (Cori, 2016).

The efficacy of strategies aimed at reducing risk in areas characterized by environmental pressure is significantly determined by human behavior, which is strictly connected to risk perception (RP). RP is influenced by a number of personal variables such as education, gender, number of children (Flynn et al., 1994, Kone and Mullet, 1994, Dosman et al., 2001), by the quality of information regarding health and the environment (Wallquist et al., 2010), by the trust in institutions responsible for risk governance. Moreover, the characteristics of the risk and the multiple variables that shape the culture are relevant; cultural prototypes can be considered, and several studies pointed out that in a process of globalization professional values and worldviews are more relevant that national identities in explaining attitudes towards risk (Renn and Rohrmann, 2000).

There are multiple interconnections among perception, behavior, and socioeconomic characteristics, and they become even more complex in the case of human biomonitoring (HBM). The US National Research Council recognized the importance of communication in all the phases of HBM research, where it is recommended that groups of donors be included (Committee on Human Biomonitoring for Environmental Toxicants, 2006). Keune and colleagues reported the experience developed in Flanders (Belgium), where traditional and innovative tools have been used to support communication, supplemented by a multidisciplinary research group (Keune et al., 2008). In Italy, several HMB surveys have included communication activities, using both traditional and innovative instruments (Bianchi et al., 2014a, De Felip et al., 2014, Cori, 2006, Cori et al., 2009a, Cori et al., 2009b). One of these instruments is the SEpiAs study (Epidemiologic Surveillance in areas with natural or anthropogenic Arsenic pollution) based on HBM and preclinical risk surveys.

SEpiAs was designed to build new knowledge regarding the early effects and intake of arsenic, to understand the exposure pathways and to provide recommendations for prevention. The knowledge of information sources and the comprehension of risk perception in relation to different environmental pressures is critical. The information acquired in this domain can play a key role in defining suitable communication strategies and in supporting effective prevention policies (Rosa et al., 2014). An important aim in this field is to clarify the relationship between exposure and risk perception, knowing that it is specific for each type of environmental exposure. Thus, RP could be considered as one of the key elements in making recommendations for public health protection based on environmental epidemiology research results. The use of knowledge gained by questionnaires and by the qualitative insights included in the background information is illustrated in the SEpiAs case, along with considerations regarding further developments. The change in RP and exposure and in their relationship will in fact be analyzed after the completion of the SEpiAs follow up phase, which is ongoing. In this view, consideration of RP in surveillance programs represents advancement in the evaluation of the effectiveness of primary prevention interventions.

The present study analyzes the section of the HBM questionnaire used by SEpiAs dedicated to risk perception, information and trust.

The aim of this study, which was developed within SEpiAs, is to characterize the four areas in terms of RP and access to information on the environment and health, and on trust in different sources of information. Insights into the influence of RP and environmental information on food consumption are also provided.

The SEpiAs study was carried out in Amiata and Viterbese, two mountainous/hilly areas located in central Italy, characterized by arsenic of natural origin, and in two cities in southern Italy, Taranto and Gela, where arsenic originates from anthropogenic sources (Bustaffa et al., 2014).

The four areas included in the SEpiAs study were: Viterbese: the Municipalities of Civita Castellana and Ronciglione, (Latium, central Italy); Amiata: the Municipality of Abbadia San Salvatore (Tuscany Central Italy); the Municipality of Gela (Sicily, southern Italy); the Municipality of Taranto (Apulia, Southern Italy). In Viterbese, arsenic is recognized as the main pollutant in water. It has been constantly monitored by public health authorities, which asked from 2004 to the end of 2012 three derogations to the EU Directive establishing the limit of 10 μg/l (instead of 50 µg/l) (Directive 98/83/CE). Since the beginning of 2013, in most of the 60 Municipalities in the Viterbo Province the water distributed by the public aqueduct is non-drinkable (D'Ippoliti et al., 2015, Cubadda et al., 2015).

In Amiata, the mining of cinnabar for mercury extraction was intense from 1846 until 1976, thus spreading pollution in the area. Since long time, the area has been exploited for geothermal energy (Gray et al., 2014, Tamasi and Cini, 2004).

The environmental characterization of Taranto and Gela is profoundly different. These areas are highly polluted and have been included in the list of reclamation sites of national interest since 2000. They are characterized by large industrial sites, which were built during the 1960s, with various sources of arsenic emissions, located very close to both cities (Pirastu et al., 2013).

The exposure of the general public to information to environmental pollution and health risks was explored via in-depth interviews and meetings with stakeholders in the initial phase of the SEpiAs study. In the Viterbese area, the local communities are concerned and the local media tend raise the alarm whenever health-related news emerges or epidemiological data and environmental monitoring data are disseminated. During the SEpiAs implementation, specific articles and TV broadcasts on the presence of arsenic in the tap water were constant.

In Amiata, the local community is aware of the presence of mercury and arsenic in the environment and has raised concerns regarding geothermal energy. Residents usually mention mercury, and are worried about metals in general. There was no single information flow while SEpiAs was operative in the area.

In Taranto, the information flow regarding environmental pollution and health consequences has been intense and dramatic, especially when the investigations of the prosecutor's office were made public, or environmental studies were released. The community is polarized between those with negationist attitudes and those showing great concern, represented by different components of society including non-governmental organizations (NGOs), and the debate is open regarding the fate of the local steel factory. Local authorities, and in particular the Regional Environmental Agency have been publicizing information and scientific data.

Also in Gela the information flow regarding the environment and health issues has been intense, especially linked to epidemiological studies, both on the presence of congenital anomalies (Bianchi et al., 2006, Bianchi et al., 2014b) and arsenic as revealed by a previous HBM survey (Bianchi et al., 2014a). Here the polarization is mainly between workers supported by unions, with a conservative approach to defending jobs, and NGOs committed to the environment and health protection, with local authorities in the middle but not playing much of an active role in the public arena.

In Taranto and Gela areas the main attention by the media was devoted to the pollutants usually emitted by the steel industry and the petrochemical factories, while the arsenic issues have been always left in the shadow. Otherwise, in the Viterbese and Amiata areas, the arsenic pollution has been constantly on top of the environmental health priorities.