RESUMEN
Air pollution is a major global health threat. There is growing evidence for a negative effect of air pollution on health and well-being. Relationships between air pollution and health are mediated by health risk perceptions and play a crucial role in public response to it. Air pollution in the public's mind is often different from air pollution defined by the scientific community. Therefore, in order to develop successful prevention and alleviation strategies, an understanding of public risk perceptions is key. The central question of this paper is: 'How does "the public" (in Brussels) perceive air pollution?' This research is an attempt to enrich the limited body of qualitative research in the field, approaching the topic of perception from 4 different, complementary angles: definition, association, categorisation and problematisation. About 51 interviews were conducted in the Brussels-Capital Region. Consistent with earlier research, this research illustrates that perceptions of air pollution are diverse, subjective, context-dependent and often deviate from conceptualisations and definitions in the scientific community. Respondents underestimate the potential harm and problematisation depends on comparative strategies and perceived avoidability. The novel aspect of this paper is the identification of 5 mental schemes by which specific elements are categorised as being air pollution: (1) the source of the element, (2) its health impact, (3) its climate impact, (4) its functionality and (5) sensory perceptions. The insights gained from this research contribute to the field of environmental epidemiology through a better understanding of how 'the public' perceives air pollution and in what way this may deviate from how it is perceived by experts. We hope to raise the awareness among experts and policy makers that air pollution perceptions are far from universal and consensual but on the contrary individual and contested.
RESUMEN
BACKGROUND: Understanding public health risk perceptions is essential in efficient environmental health management. In the light of the negative impact of air pollution on health and the direct and indirect mediation of this impact through risk perceptions, it is crucial to better understand the lay perceptions of air pollution. Since qualitative research methods are well suited for this aim, the central objective of this study is to present a review of qualitative research articles in the field of environmental epidemiology that investigate health risk perceptions of ambient air pollution since the 2000s. METHODS: We followed the PRISMA-guidelines which resulted in a selection of 20 scientific articles published in peer-reviewed academic journals that used qualitative research methods and reported on health risk perceptions about ambient air pollution. RESULTS: Qualitative research in the field of environmental epidemiology is still scarce. Most of the studies included in the review were based on face-to-face interviews and focus group discussions; a minority used a mixed-method approach. Interesting contributions were made with respect to both the perception of exposure to air pollution and the perception of the health effect associated with air pollution. CONCLUSIONS: The review suggests that data generated through qualitative research might complement the traditionally quantitative field of environmental epidemiology. Mixed method multidisciplinary research is likely to provide a more holistic explanation of environmental health patterns observed through quantitative research. These explanations are key in managing environmental health and in developing successful prevention, mitigation and communication strategies. Implementing qualitative research methods contribute to the field of environmental epidemiology as it i) allows for triangulation of findings; ii) generates nuanced findings and new research questions; iii) triggers in-depth understandings of quantitatively identified patterns; iv) leads to additional surprising and/or multifaceted responses; v) enhances relationships between researcher and respondent; vi) increases the awareness of important context-dependent dynamics or interactions that may generate biases and vii) grasps the local, contextual, situational and cultural elements that interact with health risk perceptions.