Introduction: Public interest and media coverage on environmental health matters have increased in parallel with mistrust of official bodies and their handling of such issues. Key to the management of environmental health issues are both the content of information and the process by which communication is carried out. In the social science, and more latterly the medical literature, the methods of risk communication have changed from a 'deficit' model which assumes the public as 'unknowing' recipients of information to more participatory approaches. Trust, credibility, and local applicability have been highlighted as factors that influence the effectiveness of risk communication: This study explores the understandings of the roles and responsibilities of stakeholders following the discovery of incinerator ash on allotments footpaths across the city of Newcastle upon Tyne, UK. During the investigations into the extent and consequences of ash disposal on allotments, the views about the roles of the different organisation, especially the role of the health authority appeared to differ amongst stakeholders. The aims of the present study were to examine those relationships in depth, to understand the factors influencing them, their implications for effective risk communication and to make recommendations for future incidents.
Methods: Two complimentary qualitative methods were used: (i) items of correspondence and meeting minutes were examined, (ii) semi-structured, in-depth interviews were carried out with ten stakeholders; representatives from environment and health related bodies and members of a campaign group. Interviews were tape recorded, transcribed, and analysed using a grounded theory-type approach.
Results: Five inter-related themes were identified: [S] Trust Initially the campaign groups had different levels of trust in statutory agencies and academics with the health authority being relatively highly regarded. Later their trust in health authority diminished creating a them-us split of trust between campaign groups and all professionals. [S] Communication 'The public' included diverse audiences with differing information needs. Statutory agencies felt they had been as open as possible in their communication, but campaign groups felt that information had been withheld. [S] Knowledge and expertise Local and national sources of expertise were scarce, requiring all local stakeholders to climb a steep learning curve. Lay campaigners were equally able to access information and expert advice as professionals. Experts disagreed about the significance and interpretation of results. [S] Roles and relationships Uncertainty about the roles and responsibilities of the different organisations influenced early working relationships and trust. Relationships were also affected by perceived conflicts of interest. Professionals were uncertain who should represent the views of 'the public. [S] Confidentiality and secrecy Differing understandings of the meaning of confidentiality -as opposed to secrecy-led to mistrust and suspicion.
Conclusions: This investigation posed new challenges for all statutory agencies involved-dealing with a new area of knowledge and a controversial local situation. Even though a wealth of literature on risk communication exists, difficulties were encountered by risk communicators. We suggest that evidence from risk communication research had not filtered down to those working in the front line. There is an urgent need for support, training and robust and accessible structures to deal with environmental health incidents at local level.
(C) 2003 Lippincott Williams & Wilkins, Inc.