municating that level of understanding about exposure is crucial to moving forward. However, Lioy cautioned that numerical information posted on the Internet is often not very meaningful to the general public. For example, he pointed to posted occupational and environmental toxin levels being in parts per million versus parts per billion, respectively, and how that difference is meaningless to many people. For many people, he said, “a number is a number.” The problem is not just with numeracy. Rosenstock pointed to confusion around the use of terms such as “barrels” and “gallons.” While the public understands the massive scope of what is happening, variable use of terms can be very confusing.

Who is going to help communicate and navigate the information that already exists, and how will organizations be held responsible for presenting clear and concise risk-mitigating information in a health-literate way? Many other disasters have point persons assigned to deliver information (e.g., the 2001 anthrax episode). Does the ongoing and complex nature of the Deepwater Horizon oil disaster necessitate a point person, or are there other ways to coordinate and communicate useful information?

Lioy replied that a coordinated approach does not necessarily imply one voice. Rather, it means selecting people with the most knowledge about individual components of what needs to be communicated and using those people to determine if what is being communicated is going to be effective. He stated that the information that needs to be communicated is not just health information. It also includes engineering and mitigation information, such as information about how to prevent oil from reaching shore. Therefore, a variety of expertise is needed to help with the communications strategy. While health officers are very important, this is a very complex problem with multiple components. He opined that a coordinated group of people with expertise in a variety of areas would be a more effective tool for providing good information to the people than a single voice. Moreover, because there will likely be discontinuities in the information, a group may be able to express uncertainties more clearly and may be able to say “I don’t know” more effectively.

Lichtveld agreed that having a single point person is not the best approach to take at this time. She observed that there are existing statelevel health systems already responsible for communication and emphasized early collaboration with the health officers of the affected states

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