Managing environmental risks: the benefits of a place-based approach.

CONTEXT: Effective management of environmental risks such as food and water contamination requires both high quality scientific information and effective, informed social policy. Not only must health practitioners and policy-makers recognize the complexities of human health as a social phenomenon, they must also negotiate the vagaries of uncertainty, precaution, and ethics in their implementation of public health guidelines and advisories. For example, some health practitioners in Alaska have argued against implementation of US Environmental Protection Agency and World Health Organization's standardized consumption advisories for methylmercury (MeHg) in fish, in favor of place-based approaches to evaluating and communicating risk. They stress the importance of traditional subsistence foods and lifestyles, along with other local environmental, economic, and cultural drivers and determinants of environmental health. Such place-based approaches have been successful in improving health outcomes in Alaska and elsewhere. ISSUE: Nevertheless, debate continues regarding the validity and ethics of place-based approaches to developing and communicating standards and advice for managing environmental risks. Recent critiques suggest that place-based approaches to environmental health represent an undesirable kind of regional 'exceptionalism': the implication of which is that precaution, in respect to acting on the best available objective science, is undermined by attention to subjective local values. In this article we comment on this debate, a debate rooted in concerns regarding the delineation between science-based and policy-based decision-making. LESSONS LEARNED: Our experience with the social and ecological dimensions of MeHg contamination of fish and game in Alaska and elsewhere offers three considerations regarding the potential benefits available through place-based approaches: (1) they can contribute to the accuracy and systematic characterization of risks and their relationship to multiple direct and indirect health outcomes; (2) they are more likely to inform actual changes in behavior; and (3) they afford greater transparency to the risk management process and therefore facilitate environmental justice. We stress that standardized risk assessments and advisories remain important for providing a precautionary baseline that can inform the management and enforcement of industrial and other polluting activities at the state level. However, the management of environmental health at the regional and local level requires an approach that is cognizant of local circumstances and needs, and addresses health in a systemic and integrative fashion capable of incorporating qualitative social, cultural, and economic drivers and determinants. Thus, we recommend a two-tiered approach that blends state-based and place-based environmental risk management.

Scientific research, stakeholders, and policy: continuing dialogue during research on radionuclides on Amchitka Island, Alaska.

It is increasingly clear that a wide range of stakeholders should be included in the problem formulation phase of research aimed at solving environmental problems; indeed the inclusion of stakeholders at this stage has been formalized as an integral part of ecological risk assessment. In this paper, we advocate the additional inclusion of stakeholders in the refinement of research methods and protocols and in the execution of the research, rather than just at the final communication and reporting phase. We use a large study of potential radionuclide levels in marine biota around Amchitka Island as a case study. Amchitka Island, in the Aleutian Island Chain of Alaska, was the site of three underground nuclear tests (1965-1971). The overall objective of the biological component of the study was to collect a range of marine biota for radionuclide analysis that could provide data for assessing current food safety and provide a baseline for developing a plan to monitor human and ecosystem health in perpetuity. Stakeholders, including regulators (State of Alaska), resource trustees (US Fish and Wildlife Service, State of Alaska), representatives of the Aleut and Pribilof Island communities, the Department of Energy (DOE), and others, were essential for plan development. While these stakeholders were included in the initial problem formulation and approved science plan, we also included them in the refinement of protocols, selection of bioindicators, selection of a reference site, choice of methods of collection, and in the execution of the study itself. Meetings with stakeholders resulted in adding (or deleting) bioindicator species and tissues, prioritizing target species, refining sampling methods, and recruiting collection personnel. Some species were added because they were important subsistence foods for the Aleuts, and others were added because they were ecological equivalents to replace species deleted because of low population numbers. Two major refinements that changed the research thrust were (1) the inclusion of Aleut hunters and fishers on the biological expedition itself to ensure that subsistence foods and methods were represented, and (2) the addition of a fisheries biologist on a NOAA research trawler to allow sampling of commercial fishes. Although the original research design called for the collection of biota by Aleut subsistence fishermen, and by a commercial fishing boat, the research was modified with continued stakeholder input to actually include Aleuts and a fisheries biologist on the expeditions to ensure their representation. The inclusion of stakeholders during the development of protocols and the research itself improved the overall quality of the investigation, while making it more relevant to the interested and affected parties. Final responsibility for the design and execution of the research and radionuclide analysis rested with the researchers, but the process of stakeholder inclusion made the research more valuable as a source of credible information and for public policy decisions.

Science, policy, and stakeholders: developing a consensus science plan for Amchitka Island, Aleutians, Alaska.

With the ending of the Cold War, the US Department of Energy is responsible for the remediation of radioactive waste and disposal of land no longer needed for nuclear material production or related national security missions. The task of characterizing the hazards and risks from radionuclides is necessary for assuring the protection of health of humans and the environment. This is a particularly daunting task for those sites that had underground testing of nuclear weapons, where the radioactive contamination is currently inaccessible. Herein we report on the development of a Science Plan to characterize the physical and biological marine environment around Amchitka Island in the Aleutian chain of Alaska, where three underground nuclear tests were conducted (1965-1971). Information on the ecology, geology, and current radionuclide levels in biota, water, and sediment is necessary for evaluating possible current contamination and to serve as a baseline for developing a plan to ensure human and ecosystem health in perpetuity. Other information required includes identifying the location of the salt water/fresh water interface where migration to the ocean might occur in the future and determining groundwater recharge balances, as well as assessing other physical/geological features of Amchitka near the test sites. The Science Plan is needed to address the confusing and conflicting information available to the public about radionuclide risks from underground nuclear blasts in the late 1960s and early 1970s, as well as the potential for volcanic or seismic activity to disrupt shot cavities or accelerate migration of radionuclides into the sea. Developing a Science Plan involved agreement among regulators and other stakeholders, assignment of the task to the Consortium for Risk Evaluation with Stakeholder Participation, and development of a consensus Science Plan that dealt with contentious scientific issues. Involvement of the regulators (State of Alaska), resource trustees (U S Fish and Wildlife Service), representatives of the Aleut and Pribilof Island communities, and other stakeholders was essential for plan development and approval, although this created tensions because of the different objectives of each group. The complicated process of developing a Science Plan involved iterations and interactions with multiple agencies and organizations, scientists in several disciplines, regulators, and the participation of Aleut people in their home communities, as well as the general public. The importance of including all parties in all phases of the development of the Science Plan was critical to its acceptance by a broad range of regulators, agencies, resource trustees, Aleutian/Pribilof communities, and other stakeholders.