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PEDIATRICS Vol. 112 No. 1 July 2003, pp. 211-217

Environmental Risk Communication for the Clinician

Mark Miller, MD, MPH* and Gina Solomon, MD, MPH*,{ddagger}

* Pediatric Environmental Health Specialty Unit, University of California, San Francisco, California
{ddagger} Natural Resources Defense Council, San Francisco, California

Although they are accustomed to discussing risks in the medical arena through the process of informed consent, primary care clinicians may have difficulty communicating with their patients and communities about environmental health risks. Clinicians are generally trusted and can play important roles as educators, alert practitioners, or even advocates talking about environmental health risks with individuals and groups. Communication of risk requires an understanding of how scientists and clinicians assess risk—the process of quantitative or qualitative risk assessment. Risk is never a purely scientific issue; risk is perceived differently depending on some well-understood characteristics of the hazard, the individual perceiving the risk, and the social context. Many low-income communities of color have faced and continue to face disproportionate environmental exposures and disease burdens. The issue of environmental justice can significantly affect the context of a discussion about a specific environmental risk. The essence of risk communication has been well described and requires careful evaluation of the science and the social context, honesty, listening to and partnering with the community, and a clear, compassionate team approach.

Key Words: environmental justice • environmental pollutants • environmental health • risk assessment • child • risk communication • risk perception

Abbreviations: NAS, National Academy of Sciences

Received for publication Jul 26, 2002; Accepted Jan 17, 2003.


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