EPA Report: The Science of Environmental Justice  [Printer-friendly version]
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.]

Executive Summary

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."[1]

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.[2]

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

Air Toxics

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.

Asthma

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

Land-based Risks

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.

Water Quality

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.

Recommendations

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.

Next steps

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.

============

[1] 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).

[2] 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