EPA Report: The Science of Environmental Justice, February 11, 2005
PARTICIPATORY RESEARCH AND CUMULATIVE RISK ANALYSIS
[Rachel's introduction: An EPA report on "the science of environmental justice" recommends a precautionary approach to research, including consideration of multiple, cumulative exposures and stresses: "Achieving environmental justice for every community requires a different scientific approach, one that is rooted in communities and that can incorporate people's social stressors, economic stressors, unique needs and vulnerabilities."]
[RPR introduction: This is the Executive Summary of a report titled "Science of Environmental Justice: Participatory Research and Cumulative Risk," published by U.S. Environmental Protection Agency (EPA) February 11, 2005. Get the full report (104 pages) in PDF format here and get EPA's Framework for Cumulative Risk Assessment here.]
On May 24-26, 2004, U.S. Environmental Protection Agency (EPA) New England, EPA's Office of Research and Development (ORD) and Boston University's School of Public Health (BUSPH) co-sponsored the Science of Environmental Justice (SEJ) Working Conference in Boston, Mass.
The title of the conference was: Science to Action: Community-based Participatory Research and Cumulative Risk Analysis as Tools to Advance Environmental Justice in Urban, Suburban and Rural Communities. The conference provided an interactive, educational forum and joined together stakeholders from across the country to discuss current efforts in community-based participatory research (CBPR) and cumulative risk analysis that are helping to assess, address and resolve environmental and public health risks in urban, suburban and rural areas.
The conference presented methods and facilitated discussion regarding needs and opportunities for EPA and other research entities to invest in innovative scientific paradigms in order to better protect human health and the environment in environmental justice communities.
The conference resulted from the awareness that many vulnerable communities and populations (i.e., communities of color, low-income communities, children, the elderly and subsistence fishers) face higher exposures or risks to their overall health and well-being from environmental sources.
Traditional research and risk assessment methods have played an important role in reducing significant environmental health risks to the American public, but must be improved to better protect vulnerable populations and to further reduce residual risks. Achieving environmental justice for every community requires a different scientific approach, one that is rooted in communities and that can incorporate people's social stressors, economic stressors, unique needs and vulnerabilities.
This conference proposed that community-based participatory research and cumulative risk assessment can form the core of this new science of environmental justice and explored, in-depth, the definitions, successes, needs and long-term opportunities for integrating this approach into EPA's research agenda.
The SEJ conference brought together 275 individuals, including scientists, technical experts, community and non-profit group leaders, academia and government representatives from 25 states, the District of Columbia, Puerto Rico and the Virgin Islands. The first day of the conference featured a community tour of Chelsea and East Boston, Mass., which set the stage with a real-life context for discussing ways of better assessing cumulative risks and utilizing participatory approaches to research. The conference sessions included plenary panels on community-based participatory research and cumulative risk. Breakout groups focused on ways to incorporate CBPR or cumulative risk approaches to research on the following topics: Air Toxics, Asthma, Children's Environmental Health, Land-based Risks and Water Quality.
Framing Themes: Community-based Participatory Research and Cumulative Risk Assessment
Community-based Participatory Research
Community-based participatory research (CBPR) holds great potential to improve the accuracy, precision, reliability and relevance of data that are designed to represent real-life and to protect human health and the environment. Traditional challenges in environmental epidemiology, exposure assessment or environmental monitoring studies include accurately capturing data that represents a broad range of human activity patterns and taking precise, unbiased measurements.
CBPR is defined as research in which "scientists work in close collaboration with community partners involved in all phases of the research, from the inception of the research questions and study design to the collection of data, monitoring of ethical concerns and interpretation of the study results."
To this basic definition conference panelists added that CBPR ultimately is about translating research, especially the most relevant and useful science, into better environmental and human health protection and promotion. One panelist stressed three basic principles of the related approach of participatory action research: 1) the participation of the community at every step; 2) equal distribution of power and results among partners; and 3) action-oriented outcomes.
Some specific recommendations for building strong partnerships to conduct CBPR and advance environmental protection included building the scientific capacity of community institutions to engage in research and encouraging long-term collaborations between academic institutions, government agencies and community-based organizations.
A panelist from the EPA's Office of Research and Development (ORD) noted that community involvement in ORD research projects was valuable in the design, implementation and actual conduct of studies, and in the analysis and communication of the resulting data. Other panelists noted that community involvement in environmental research becomes crucial for ensuring that public policy makes sense in real life, rather than getting lost in the minutiae of data details, and serves as a public interest counterweight to the increasing private funding of research.
Cumulative Risk Assessment
Traditional risk assessment methods that have been used by the EPA and other regulatory bodies are intended to identify and reduce the greatest risks to human health and the environment, and in many instances these methods have been effective. However, as the environmental justice movement has helped identify, many of these risk assessment approaches have focused on one chemical, media or exposure pathway at a time, or have relied on assumptions that are not validated on a regular basis. The consequence can be approaches to risk assessment that are not effectively protecting all groups.
Cumulative risk assessment (CRA) was defined in this conference as the "analysis, characterization and possible quantification of the combined risks to health and the environment from multiple agents or stressors." Cumulative risk assessment is characterized by its focus on place or populations and investigates the question, "What types of stressors are affecting this population?" It differs from traditional risk assessment methods that focus on specific, individual chemicals or stressors and asks, "What type of threat does this agent pose to human health?"
Cumulative risk assessment is notable for its focus on multiple exposures or stressors, its inclusion of non-chemical and nonphysical stressors and its integration of vulnerability or susceptibility factors. An additional development on traditional risk assessment methods is the attempt in CRA to conduct various elements of the assessment process simultaneously, or iteratively, rather than sequentially.
The Framework for Cumulative Risk Assessment identifies the basic elements of the cumulative risk assessment process and provides basic guidelines for conducting cumulative risk assessment, although it does not provide specific protocol or methodologies.
The Mississippi River Industrial Corridor has multiple point and area sources of air and water pollution and diverse populations, many of which are characterized by severe health burdens and characteristics that many increase their exposures or susceptibility to environmental health hazards, and was presented as an illustration of why cumulative risk assessment approaches are crucial for protecting the health of all Americans. Three case studies, of the Merrimack Valley in Mass., the industrial community of Chester, Pa., and the local communities of Chelsea and East Boston, Mass., were presented to illustrate some key lessons learned regarding cumulative risk assessment. These lessons included: 1) the need to prioritize prevention and action and recognize that aggregate and multiple risks may never be accurately assessed; 2) that a better integration of quantitative and qualitative data is needed to assess actual risks; and 3) that community involvement and collaborative approaches provide tremendous advantages for the accuracy and applicability of risk assessment and management.
Specific Topics: Air Toxics, Asthma, Children's Environmental Health, Land-based Risks and Water Quality
Exposure to hazardous air pollutants (HAPs) presents significant environmental justice and public health concerns. Hazardous air pollutants, also known as air toxics, have been associated with many adverse human health effects, including cancers, asthma and other respiratory ailments and neurological problems such as learning disabilities and hyperactivity.
Sources of air toxics include industrial emissions from chemical manufacturing, refineries, waste incinerators and smaller stationary facilities (e.g., dry cleaners), emissions from mobile sources (e.g., cars, buses and trucks) and consumer products.
This panel presented the results from the EPA's National Air Toxics Assessment, which modeled ambient levels of major hazardous air pollutants for every county in the United States, and the related National Scale Assessment, which calculated resulting risks to human health from these air toxics and characterized the contributions of various emission sources to human exposure and risk.
This assessment identified benzene, chromium and formaldehyde as national drivers of cancer risk, and arsenic, 1,3-butadiene, polycyclic organic matter and coke oven emissions as regional drivers of cancer risk in 1996. The National Scale Assessment will be used to address residual risk, or the risk remaining to human populations after the technology-based standards for emissions of hazardous air pollutants have been put into place.
Diesel exhaust was presented as an air toxic of great concern to many environmental justice communities, and the successful community-based participatory research efforts of a community group in West Oakland, Calif., was described in a case study illustrating best practices in CBPR.
One panelist presented study findings linking residential segregation to racial disparities in exposure to air toxics in Southern California. This led to a discussion on the importance of including socioeconomic and political factors, including zoning, land use and transportation investments, in attempts to reduce residual risks. In other words, without understanding how and why greater segregation is linked to higher exposures to air toxics, purely regulatory and technological approaches to reducing air toxics will never be effective in protecting the most highly exposed communities.
According to the Centers for Disease Control and Prevention (CDC), 20 million people, including 6.3 million children, have asthma. Asthma has increased sharply across the nation in the past two and a half decades, particularly in large cities. Asthma is particularly a public health crisis for some communities of color and for children, making it a classic environmental justice health challenge.
The CDC reports that African-Americans continue to have higher rates of asthma emergency room visits, hospitalizations and deaths than Caucasians. Americans with lower income levels report higher asthma prevalence than those at higher income levels.
Examples from schools in Connecticut, public housing in Boston, Mass. and a community-based participatory research project on asthma and air pollution in the South Bronx, New York City, were all presented to illustrate the various cumulative risks that might be contributing to the increased prevalence and the opportunities presented by community- based participatory research to reduce the harsh burden of asthma on the health of communities of color and children. Major research needs identified were:
1) Surveillance on asthma incidence and prevalence at the community- level;
2) Evaluation of the impact of primary prevention of asthma on the overall incidence;
3) Evaluation of the impact of building intervention on the severity and persistence of asthma in homes, daycare facilities and schools;
4) Detailed, multi-factorial exposure assessments of air pollution and social stressors such as violence and a better understanding of how each stressor may magnify the other; and
5) Evaluation of the efficacy of individual and bundled interventions, including interventions on environmental factors, in reducing asthma morbidity.
The value of community knowledge in asthma research was stressed. Evidence was provided to show that engaging communities in challenging inaccurate, and generally unstated, assumptions adds valuable practical knowledge and helps frame research questions in a manner that ensures the greatest chance of environmental health success.
Children's Environmental Health
Children have unique susceptibilities to environmental hazards and often face higher exposure to environmental pollutants. Their rapidly developing bodies, biological systems, differences in physiology and behavior make them vulnerable to environmental insults in ways that adults are not. At the same time, children do not have a defined role in decision-making to protect their health.
Risk assessment methods to date have essentially cast children as "tiny adults or big rats," without accurately assessing how environmental agents may be affecting their growth, development and health risks.
Children of color are especially at risk for increased exposure to pollutants such as lead and mercury. One panelist noted the importance of looking at the intersection circles of exposure, family and community in order to most accurately assess environmental risks to children's health.
An overview of the National Children's Study was presented describing the Congressionally-mandated, multi-million dollar environmental epidemiology study that will track 100,000 children for 21 years to assess the impacts of environmental exposures on their health. Research results from the Columbia Center for Children's Environmental Health demonstrate that prenatal exposure to some air pollutants and pesticides is associated with decreased birth weight and size, and that "chronic material hardship" significantly exacerbated the effects of environmental tobacco smoke on children's development.
This last result illustrates the ways in which nonphysical stressors and exposures can aggravate the adverse impacts of environmental exposures. A panelist from the Lead Action Collaborative in Boston described a community-driven effort to eliminate childhood lead poisoning in Boston. This best practices approach utilized community participation and collaboration efforts to generate data on environmental conditions at an extremely high resolution -- lot-by-lot - with sophisticated technological tools or Geographic Information Systems (GIS) to identify and prioritize the highest risk housing in Boston for lead poisoning prevention efforts
Low-income and minority communities are often faced with a multiplicity of land-based risks ranging from lead contaminated of soils from lead paint use to pesticide contamination due to agriculture. The cumulative risks associated with the buildup of various chemicals have yet to be fully determined.
This panel looked at pesticide contamination in Georgia, lead contamination in Connecticut and the health and environmental impacts associated with industrial-scale animal agriculture in North Carolina. The case of the Woolfolk Chemical Works Superfund site in Fort Valley, Ga., was used to present the concept of "brown houses," which are homes in or near a Superfund site where there is known or perceived contamination -- in this case, by arsenic-containing dusts generated at the chemical works site.
The Connecticut case study focused on the potential of phytoremediation to reduce accumulated lead in dust in urban soil. Another case study from North Carolina illustrated environmental and human health impacts of industrial animal operations and the local political challenges that can frustrate efforts to prevent and remediate the enormous pollution generated by these operations. A panelist from the EPA Office of Environmental Justice presented a GIS- based assessment and compliance tool that allowed the EPA to incorporate environmental justice considerations into its identification of priority sites requiring environmental enforcement or other actions.
A detailed description of the guidelines in EPA's Cumulative Risk Assessment Framework for conducting human health risk assessments at specific contaminated sites was also presented, emphasizing the need for community collaboration at those sites to generate the highest quality data.
One recommendation that emerged from this panel was the need for collaboration between agencies, stakeholders and the community to determine the appropriate structure of response and identify and fill the regulatory gaps. Panelists also emphasized the importance of sustainable solutions that take into consideration both economic and health problems associated with contamination. Finally, they expressed the desire to strengthen partnerships and increase educational awareness within effected communities.
In recent years, water quality problems have become serious environmental issues -- particularly for low-income communities and communities of color. In urban, suburban and rural settings across the United States, these communities have had particularly low access to adequate drinking, surface and sewer water resources.
Many people in these communities rely on fish and other seafood as a significant part of their diets and are therefore threatened by a disproportionately high risk of exposure to contamination from substances such as mercury, polychlorinated biphenyls and dioxin, which have entered the aquatic habitat and have bioaccumulated in the fish.
Panelists described the EPA's efforts to develop improved surface water sampling methods, more rapid analysis and further health studies to create improved surface water quality indicators.
A panelist from the Virgin Islands presented on the challenges of maintaining high drinking water quality and how community-based participatory research had improved drinking water quality. A panelist from EPA's Office of Water described the revisions and improvements to EPA's human health criteria methodology, including more accurate fish consumption estimates and a greater reliance on site-specific conditions rather than default values for assessing risk.
The environmental cycling and bioaccumulation of mercury in fish was discussed, and the human health threat created by the consumption of mercury-contaminated fish was noted as a concern for all Americans.
Lessons from Puerto Rico in community capacity-building and the development of better communication between regulators and the public were presented.
Specific recommendations included: 1) the development of a surveillance system to identify the factors that make various communities vulnerable to environmental contaminants; and 2) the creation of data banks at the community-level to provide practical experience and information to build community capacity to engage in water quality protection efforts.
1) Adopt a precautionary approach to research.
2) Adopt collaborative approaches to research.
3) Incorporate community involvement in all stages of research.
4) Build capacity and empower communities, academic institutions and government agencies to assess and address environmental health risks.
5) Develop place-based, flexible approaches to research and risk assessment.
6) Incorporate socioeconomic factors into risk assessment.
7) Develop a better understanding of vulnerability that includes both physical and nonphysical factors.
8) Create interdisciplinary, holistic approaches to risk assessment, combining quantitative and qualitative data.
9) Promote innovative technologies and research methodologies.
10) Emphasize action to protect communities in the application of research.
This working conference represents the beginning of an essential dialogue between critical stakeholders. Three days of discussion cannot integrate all that is needed to develop a new scientific approach to EPA's research agenda. It was evidenced by conference participants that the need for a paradigm shift is necessary and that the will for action is strong.
The current challenge is in finding a way to build an infrastructure that can allow the dialogue that was begun at the conference to continue on a national and regional level throughout the country. EPA has done much to address the issues and concerns facing environmental justice communities, but there is still more that the agency can and must do to protect these vulnerable communities. The agency must maintain a leadership role in keeping this dialogue alive and, furthermore, must demonstrate a way to implement the recommendations contained in this report.
One way to translate our collective will into action is to find and support a forum where the same stakeholders that met on a national level can meet on a regional level to focus on specific issues, needs and opportunities for investing in appropriate science and research that meets community needs.
As we implement these conference recommendations, community-based participatory research and cumulative risk assessment will become a standard practice within EPA's approach to research and will be integrated into the research agenda and projects across the country.
 Shepard PM, Northridge ME, Prakash S, Stover G. "Advancing Environmental Justice through Community-based Participatory Research." Environ Health Perspect 1 10(suppl 2): 139-140 (2002).
 Framework for Cumulative Risk Assessment. U.S. Environmental Protection Agency, Office of Research and Development, National Center for Environmental Assessment, Washington Office, Washington, DC, EPA/600/P-02/001F, 2003