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5
Risk Communication and
Public Engagement
I
n carrying out this Phase 1 study, the committee quickly came to un-
derstand that the technical issues that it was being asked to address
(see Sidebar 1.1 in Chapter 1) have important social overtones. There
is public concern and a lack of social trust1 on the key question underling
this study: Namely, is it “safe” to live near a nuclear facility? As was noted
in Chapter 1, the U.S. Nuclear Regulatory Commission (USNRC) has been
using the results of the 1990 National Cancer Institute study (Jablon et al.,
1990) as a primary resource for communicating with the public about
cancer risks associated with the nuclear facilities that it regulates. The com-
mittee assumes that the studies recommended in this report, if carried out,
would be used by the USNRC for this same purpose.
Although public engagement was not an explicit part of the task state-
ment for this Phase 1 study (see Sidebar 1.1 in Chapter 1), the committee
recognized that effective public engagement would be essential to the suc-
cess of a Phase 2 study. The Phase 2 study must not only be scientifically
sound to be perceived as credible by the scientific community, it must also
be perceived as credible by the public audiences for which it is intended.
Additional steps beyond those typically followed in a scientific study will
need to be taken to achieve such credibility.
This chapter is intended to provide basic information about risk and
risk communication for the benefit of nonexpert audiences and to identify
some key elements of a stakeholder engagement plan for a Phase 2 study.
1 Social trust is defined as the willingness of the public to rely on experts and institutions in
the management of risks and technologies (Earle and Cvetkovich, 1995).
253
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254 ANALYSIS OF CANCER RISKS
5.1 PUBLIC PERCEPTIONS ABOUT NUCLEAR POWER
The public’s perceptions about nuclear power have been shaped to
some extent by its associations with other nuclear technologies, particularly
nuclear weapons, and also by the occurrence of high-profile accidents at
nuclear plants: Three Mile Island (TMI) in 1979, Chernobyl in 1986, and
Fukushima in 2011.2 Less serious incidents that resulted in unintended
and unmonitored releases of radioactive materials from operating plants
(e.g., releases of tritium from operating nuclear plants; see Chapter 2) have
reinforced these perceptions. Although nuclear accidents are uncommon oc-
currences, they can have very severe consequences. Moreover, they suggest
to some that nuclear technologies are poorly understood and unpredictable
and that the nuclear industry and its regulator cannot be trusted to protect
the public from these technologies.
The question “Is it safe?3” is perhaps of greatest concern to individuals
who have experienced cancer or have family members or neighbors who
have experienced cancer. Reassurances by the nuclear industry and its regu-
lator that facility operations are “low risk” are not always seen as credible.
In fact, the USNRC has sponsored the present study in an effort to address
such concerns. Engaging with members of the public in a Phase 2 study will
be important for understanding their concerns about cancer risks.
5.2 RISK AND COMMUNICATION
The risk assessment community usually defines risk in terms of the fol-
lowing three questions, referred to as the risk triplet (Kaplan and Garrick,
1981):
What can happen (i.e., what can go wrong?)?
How likely is it that that will happen?
If it does happen, what are the consequences?
Scientists and policy makers usually view risk in terms of the likelihood
of harm from a hazard. In other words, the definition of risk is intertwined
with the notion of probability. Technical experts may use probability es-
timates (for example, one-in-a-million chance of harm) to convey the risk
of dying from cancer. However, public perceptions of risks are not shaped
solely on the endpoint of a technical analysis, such as the number of cancer
deaths in a population near a nuclear plant. Some members of the public
2 The Three Mile Island accident resulted in no discernible health effects from radiation
releases, but it nevertheless served to galvanize opposition to the expansion of nuclear power
(Walker, 2004).
3 The term “safe” has different meanings to different people. Some people view safety in
terms of probability and consequences, whereas others view safety in terms of whether an
organization responsible for controlling a hazard is trustworthy.
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RISK COMMUNICATION AND PUBLIC ENGAGEMENT
may personalize the risk—that is, to see a potential harm as affecting
someone they care for such as their spouse or child. Ultimately, each person
decides how much risk is acceptable; the decision will be based on several
factors, some of which are personal.
Some individuals and groups question the value of technical risk as-
sessment. A survey of environmental groups in the United States suggested
that “environmentalists resent the technocratic, exclusionary nature of risk
assessments that undermine democratic participation in local environment
decisions” and view risk analysis as a waste of resources, while little is done
to reduce the risk (Tal, 1997). Part of the public frustration often originates
from the fact that current policies in the United States appear to be more
reactionary than precautionary in the way they manage risk (Kriebel et al.,
2001).
There are many subjective dimensions to risks that are unrelated to its
technical definition. These include such things as lack of understanding or
familiarity with the mechanisms underlying a technology; whether a threat
is invisible, manmade, or potentially catastrophic; whether exposure is in-
voluntary, beyond the public’s control, or unfairly distributed; and whether
a risk affects children (Fischhoff et al., 1981). Other societal concerns such
as environmental health and food safety, property values, and decline in
community image (Kasperson et al., 1988) may be hidden within the overall
public perception of risk. Individual differences in risk perception and risk
tolerance can also affect people’s willingness to receive information. There
is also an obvious relationship between perceived risk and unfavorable mass
media coverage. For example, media stories that thoroughly document ac-
cidents and threats may influence how audiences think, feel, and behave
when they receive information (Slovic, 2000).
Public perceptions of risks associated with the nuclear industry are
perhaps unique among advanced technologies. This is demonstrated in a
1978 study (Fischhoff et al., 1978), still relevant today, in which partici-
pants were asked to compare technologies based on nine dimensions of risk.
These included whether the risk was involuntary, familiar, controllable, has
potential for catastrophic consequences, immediacy of those consequences,
and the extent to which scientists and the public understand those con-
sequences. Nuclear power, non-nuclear electric power, and x-rays were
scored (numerical values from 1 to 7) on these risk dimensions. As shown
in Figure 5.1, nuclear power was judged to have a much higher risk than
x-rays. Also, nuclear power was perceived as markedly more catastrophic
and dreaded compared to other technologies that produce energy.
5.2.1 Communicating About Risk
Understanding how nontechnical audiences perceive risk is an impor-
tant first step in successful risk communication. The failure to accept that
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256 ANALYSIS OF CANCER RISKS
FIGURE 5.1 Qualitative characteristics of perceived risk for nuclear power com-
pared to x-rays and other non-nuclear power technologies. SOURCE: Fischhoff
Figure 5.1.eps
et al. (1978).
bitmap
many variables influence risk perceptions in a community, or labeling these
perceptions as irrational, is guaranteed to raise hostility between commu-
nity members and agency representatives (Slovic, 1987).
Historically, technical and policy experts have often performed and
communicated the results of risk assessments to the public in a unidirec-
tional manner. The assessments themselves often involved little or no pub-
lic input. Experts would convey risk information that they deemed to be
important, and risk communicators would clarify or simplify messages by
translating technical jargon. However, the public no longer accepts expert
judgments without question, especially when these judgments affect their
lives. Indeed, Frewer (2004) suggests that there has been a refocusing of
the primary goals of risk communication: initially from an effort to change
public views about risk, later to gaining public acceptance for the sources
of risk and their management, and more recently to building trust.
Successful risk communication now involves sustained, two-way com-
munication and information exchanges between technical and policy ex-
perts and the public. Risk communication combines elements of conflict
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RISK COMMUNICATION AND PUBLIC ENGAGEMENT
resolution with the ultimate goal of solving problems rather than trying to
“educate” the public. Even if problems are not solved, an interactive risk
communication program can help to reduce unwarranted fear and distrust
(Aakko, 2004). A recent paper (Aakhus, 2011) examines ways to improve
interactivity in public communication.
Many federal government agencies recognize the importance of com-
municating with the public about risk. The U.S. Environmental Protection
Agency (USEPA) took the lead in developing a two-way risk communica-
tion strategy in 1987. The Agency for Toxic Substances and Disease Regis-
try (ATSDR), which has a mission to prevent harmful exposures and health
effects related to toxic substances, has increased its capabilities for risk
communication. The U.S. Department of Energy now trains its health of-
ficials in risk communication (Chess and Salomone, 1992). The USNRC has
developed a handbook on effective risk communication (USNRC, 2004a)
as well as other materials related to this topic (e.g., USNRC, 2004b, 2011).
Conveying technical information to nonexpert audiences needs to be
done in a language that these audiences understand, and the content of
the messages that are communicated has to fit the audience’s needs (NRC,
1989). Matching content to needs can be particularly challenging when
communicating about complex scientific and technical concepts, for ex-
ample, radiation cancer epidemiology: Radiation terminology is specialized,
concepts in cancer biology are complicated, and health effects at low radia-
tion levels, if any, are generally small, often delayed, and therefore difficult
to assess in an epidemiologic study.
It can be particularly difficult to communicate with nontechnical audi-
ences about the scientific challenges of establishing a causal relationship be-
tween radiation and cancer. Nontechnical members of the public frequently
associate “correlation” and “association” with “causality.” Because proof
of causality is scientifically demanding, scientists are usually cautious about
making causal inferences. For example, if an association between living
near a nuclear facility and cancer risk is observed, a plausible cause-effect
relationship cannot be established solely by examining the risks in the
communities around the facility. A conclusion about cause and effect will
require additional information, including extrapolations from higher-dose
human exposures and other types of studies.
Although it is important to help the public understand the science be-
hind risk assessment, public audiences are often less interested in technical
and methodological issues and more interested in issues such as trust, cred-
ibility, fairness, and empathy (Covello et al., 1987). Communication can
be considered successful only if those inquiring about the risk are satisfied
that they are being accurately informed and appropriately engaged (NRC,
1989).
Communicating about uncertainties associated with technical risk as-
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258 ANALYSIS OF CANCER RISKS
sessments is an increasingly important and inseparable component of risk
communication. Until recently, there has been little discussion of uncer-
tainty communication by risk communication professionals because they
assumed that the public was unable to conceptualize uncertainty (Wynne,
1992) or that admitting uncertainty could be seen as a sign of incompetence
(Johnson and Slovic, 1995). The historic lack of communication about
uncertainties has increased public distrust in the motives of regulators and
scientists (Frewer, 2004).
All risk assessments are based to a certain extent on unproven assump-
tions and incomplete knowledge that limit the precision of risk estimates.
This is certainly the case for assessments of cancer risks in populations
near nuclear facilities, because data on exposures and disease occurrence
may not be complete (see Chapter 3 and 4). Although uncertainties can be
reduced by obtaining additional data, such acquisition can require great
effort and can result only in marginal gains in precision.
Describing the uncertainties in a risk analysis can enhance the under-
standing of risk estimates. In describing uncertainties, it is important to
separate known and speculative uncertainties and to identify areas of dis-
agreement among experts. This helps others to make informed independent
judgments about the meaning of the risk estimates.
In cases where scientific findings are ambiguous, communication may
take place in an environment marked by disagreements, misunderstanding,
and suspicion. Communicators must diagnose these difficulties, find ways
to create trust and credibility to overcome them, and deepen understanding
(Rowan, 1994). Creating trust, based on the expectations that the commu-
nicator is competent and well meaning, is probably the priority of a risk
communication plan. People are generally uninterested in understanding a
subject or taking any sort of action if they do not trust those who are com-
municating with them.
5.3 PUBLIC ENGAGEMENT IN PHASE 1 STUDY
Although this Phase 1 study did not involve a formal assessment of
cancer risk, the committee understood the importance of engaging with
the public to understand their views and concerns. The project sponsor
(USNRC) also encouraged the committee to engage with the public during
this Phase 1 study and provided funding to make this possible.
The committee judged that public engagement would improve the out-
come of this Phase 1 study, particularly in helping the committee to iden-
tify Phase 2 study designs that could help to address public concerns. The
committee membership includes experts in risk communication and public
health (see Appendix B); these experts helped the committee to engage with
the public during this Phase 1 study.
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RISK COMMUNICATION AND PUBLIC ENGAGEMENT
5.3.1 Outreach to Public Audiences
The committee used several processes to engage interested members of
the public in this Phase 1 study. Two of these processes are legally required,
as noted below, but most were implemented by the committee to enhance
its efforts to inform and engage the public.
• Committee meetings were announced in advance through the Na-
tional Academies website4; additionally these announcements were
shared with news outlets.
• A study-specific website (www.national-academies.org/nrsb/Can-
cerRisk) was developed to supply information about the study, for
example, background materials on the project and meeting infor-
mation, including copies of meeting presentations.
• An interested-parties listserv was created and maintained to com-
municate about upcoming committee meetings and other project-
related activities.
• A project email address was established that could be used by any-
one with access to email to submit information and comments to
the committee. The committee also encouraged the submission of
written comments at its meetings. Materials received from outside
the National Academies are maintained in a Public Access File for
the project.5 Anyone can examine this file and request copies of
materials.
• The committee met in different geographic regions of the United
States, primarily near USNRC-licensed facilities, to afford oppor-
tunities for interested members of the public to attend and interact
with the committee (see Appendix C). Public comment sessions
were scheduled at all of the committee’s public meetings.
• The information-gathering meetings of the full committee were
webcasted, and the webcasts were archived on the project website
(referenced above) to allow for later viewing.
The committee received a large number of comments from outside
groups and individuals during this Phase 1 study. The committee found
these comments to be useful for:
• Understanding public concerns about the study.
• Uncovering data sources and documents unknown to the committee.
• Identifying study issues that require clarification.
4 This
notification is required by Section 15 of the Federal Advisory Committee Act.
5 Maintenance of a Public Access File is required by Section 15 of the Federal Advisory
Committee Act.
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260 ANALYSIS OF CANCER RISKS
• Receiving recommendations on study design.
• Receiving preliminary data on suspected cancer clusters near nu-
clear facilities.
The comments received from the public during this Phase 1 study covered
many subjects. However, some common concerns emerged, including the
following:
• The USNRC is sponsoring the Phase 1 study.
• The USNRC relies on the nuclear industry to self-report radioactive
effluent releases; measurements and summaries of these data should
be provided by independent sources and be made available to the
public.
• Allowable radioactive effluent release limits are too high.
• There are multiple historic instances of leaks of radioactive ma-
terials at nuclear facilities, not always reported at the time of the
release.
• Releases (routine or accidental) may be higher than those reported;
therefore, associated risks may be higher than those conveyed.
• The high number of cancer cases in the communities around the
nuclear facilities should be evidence of the risk.
Many of these comments appear to reflect public distrust of the nuclear
industry and its regulator.
The committee also received some recommendations for study design,
including the following:
• Widen the study scope; include non-USNRC-regulated facilities,
and examine noncancer effects such as birth defects, cardiovascular
disease, and infertility.
• Include multiple cancers and age groups in the analysis, with a
special focus on susceptible populations such as young children and
those exposed in utero.
• Consider current and past routine releases, accidental releases, and
releases from spent fuel stored in the facilities.
• Find alternate ways to investigate risks in states where cancer reg-
istration is not adequate.
• Independently investigate the type and amount of radioactive re-
leases from nuclear facilities.
• Do not rely solely on distance from a facility as a measure of ex-
posure, but incorporate wind direction and water sources in the
models.
• Include other plants that produce energy, such as coal-fired plants,
as a comparison group.
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RISK COMMUNICATION AND PUBLIC ENGAGEMENT
• Use biomarkers to measure damage due to radiation to increase
sensitivity of the study.
• Communicate with the public with clarity about the progress of the
study.
5.3.2 Outreach to State Public Health Departments
To understand the concerns of individuals who live near nuclear fa-
cilities and collect information on past risk assessments, the committee
contacted the Departments of Public Health in states that are now hosting
or have previously hosted a USNRC-licensed nuclear facility to request
information on the following issues:
Reports from members of the public about health concerns6 or sus-
•
pected health effects related to nuclear plants or nuclear fuel-cycle
facilities in their communities.
• Reports from physicians or other healthcare providers concern-
ing suspected disease clusters that could be related to radioactive
releases from these facilities.
• Assessments of cancer risks in association with nuclear facilities
that were carried out by the department.
• Other individual or organized activities that have been undertaken
by the department in response to environmental monitoring or
health surveillance programs.
• Interactions between departments and communities around nuclear
facilities to solicit feedback on potential health concerns.
The letter template is provided in Appendix M, and responses are tabu-
lated in Table 5.1. Of the 38 state Public Health Departments contacted,
31 (81 percent) responded to the committee’s request for information. Of
these, 15 stated that no relevant concerns7 had been reported. States to
which health concerns were reported followed up with some investigation
or analysis of cancer rates in counties at issue. Inconclusive results that
required further investigation were reported from a few states, including
Michigan, New York, and Virginia.
Departments heard concerns about or received requests for examina-
tion of potential cancer clusters from various sources including the public,
news media, oncology practices, and elected officials. A typical examination
6 The committee provided no guidance to health departments on what constituted a “health
concern,” leaving that determination instead to the professionals who responded to the com-
mittee’s inquiry.
7 In the absence of a clear definition of what constitutes a “health concern,” the reader
should be cautious when making judgments about the significance of the responses.
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262 ANALYSIS OF CANCER RISKS
TABLE 5.1 Reported Health Concerns Associated with USNRC Licensed
Nuclear Facilities
Reported Health Concerns
State Reported inquiries Year Facility Implicated
Arizona 0 — —
Arkansas 0 — —
California 1 2008 Diablo Canyon
San Onofre
Humboldt Bay
Rancho Seco
Connecticut 6 1987 Haddam Neck, Millstone
2000 Haddam Neck
2004 Millstone
2007 Millstone
2011 Indian point
Millstone
Florida not routinely 1996 St. Lucie
Georgia 0 — —
Illinois Multiple 2000-today Dresden
Braidwood
Iowa 0 — —
Kentucky 2 2002 Paducah
2007 Paducah
Louisiana 0 — —
Maine 1 1989 Maine Yankee
Maryland 0 — —
Massachusetts Multiple 1980-today Vermont Yankee
Pilgrim
Michigan 4 1994 Fermi
1999 Fermi
2005 Fermi
2009 Fermi
Minnesota Multiple 1994 Monticello
Prairie Island
2000 Prairie Island
Mississippi 0 — —
Nebraska 0 — —
New Hampshire 1 2009 Vermont Yankee
New Mexico 0 — —
New York multiple Major
1980s Indian Point
1990s Indian Point
Ginna
Nine Mile Point FitzPatrick
1995 Ginna
Nine Mile Point
FitzPatrick
2002 Nine Mile Point
2007 Ginna
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RISK COMMUNICATION AND PUBLIC ENGAGEMENT
TABLE 5.1 Continued
Reported Health Concerns
State Reported inquiries Year Facility Implicated
2003 Indian Point
2008 Indian Point
North Carolina 0 — —
Ohio 2 2011 Davis-Besse
2009 Perry
Oregon 0 — —
Pennsylvania 1 1979 Three Mile Island
South Carolina 0 — —
Tennessee 2 2009 NFS
2010
Texas 0 — —
Vermont Routinely Vermont Yankee
Virginia 2 2001 North Anna
Surry Power
2009 North Anna
Surry Power
Washington 0 — —
Wisconsin 0 — —
NOTE: NFS, Nuclear Fuel Services.
SOURCE: Based on responses to the letter shown in Appendix M.
by a health department involved calculating incidence rates and case counts
for areas at issue for a specific period by county, city, census tract, or ZIP
code. The assessments were often performed by agencies or universities
other than the health departments.
For example, in 2002 a public health assessment was conducted by the
ATSDR in Kentucky. The assessment encompassed both radiological and
nonradiological hazards related to the Paducah Gaseous Diffusion Plant.
In 2007, the University of Kentucky’s Kentucky Water Resources Research
Institute produced an assessment on behalf of the Kentucky Radiation
Health Branch addressing radiation dose and risk assessment attributable
to surface waters near the plant.
Commonly, the concerns reported to the state health departments
would be for noncancer health concerns related to nuclear facilities, such
as Down’s syndrome prevalence (Massachusetts Health Department), infant
death (Illinois and New York health departments), and low birth weight
(New York Health Department). Nonhealth issues were also reported,
such as a claim regarding elevated radiation levels in goat milk samples in
Connecticut and decreased productivity of livestock and crops in Kentucky.
Some states reported that they received phone calls from concerned citizens
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264 ANALYSIS OF CANCER RISKS
related to radiation risks from the recent disaster in Japan (North Caro-
lina, Massachusetts). Health concerns resulting from 1979 TMI incident
were reported by the Pennsylvania Department of Health. Following that
incident, the Department received state funding to conduct multidecadal
health-related studies.
The number of concerns received by the public health departments may
not be an accurate estimate of overall community concerns. For example,
although the Tennessee Department of Public Health reported that it has
been contacted by only two members of the public in 2009 and 2010 with
concerns about the Nuclear Fuel Services facility located in Erwin, Tennes-
see, the study committee is aware that a group of citizens in Erwin have
filed a class-action lawsuit against Nuclear Fuel Services, claiming that
releases from the facility are to blame for high rates of cancer. The Health
Department of Georgia reported that it has not received any relevant health
reports; however, members of the public voiced health-related concerns
during the committee meeting in Atlanta, Georgia. It is possible that some
members of the public are unaware of state health department reporting
systems, or they lack confidence to report concerns or that their concerns
will be investigated.
Some states, such as Kentucky and Oregon, noted that they do not
have a formal database for tracking complaints. Instead, public complaints
are addressed individually and followed up as deemed appropriate by the
specific departments devoted to radiation health. It is possible (as stated
by the New York Department of Health) that the records and recollections
from staff are incomplete.
Finally, one state department of public health may receive public re-
quests about facilities in neighboring states if the facility is close to the state
border. For example, health departments in Massachusetts and Connecticut
have received concerns about facilities in Vermont (Vermont Yankee) and
New York (Indian Point), respectively.
5.4 PUBLIC ENGAGEMENT IN PHASE 2 STUDY
The committee judges that public engagement will be an import ele-
ment of any Phase 2 study. Engagement needs to be designed to address
the needs of the broad public population, which may not be coincident
with the population that is targeted by the epidemiologic study. Although
there is no checklist for sucessful engagement, previous National Research
Council (NRC) reports can be used to identify important plan elements.
Such reports include Improving Risk Communication (NRC, 1989), Sci-
ence and Judgment in Risk Assessment (NRC, 1994), Understanding Risk
(NRC, 1996), and the more recent Science and Decisions (NRC, 2009). The
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RISK COMMUNICATION AND PUBLIC ENGAGEMENT
objective of public engagement is to improve the Phase 2 study, particularly
with respect to addressing public concerns, and to build trust and credibility
in the study results.
5.4.1 Goal Setting
Public engagement requires the exchange of information among inter-
ested parties. Engagement efforts that have (and demonstrate commitment
to) defined goals are more likely to be successful than those that do not.
Goal setting is important to encourage realistic expectations and to clarify
motives and objectives. For example, although public participation in any
Phase 2 epidemiologic study is essential for its success, the scientific aspects
of the study remain the responsibility of the experts who are carrying out
the study. To avoid misunderstanding and false expectations, the limits of
participation need to be made clear from the beginning. Moreover, goals
may need to be adjusted based on new information, feedback from stake-
holders, or a goal evaluation process. Having a schedule for goal accom-
plishment and a set of measures for evaluating effectiveness in achieving
those goals can help to ensure communication program effectiveness.
5.4.2 Stakeholder8 Identification
This Phase 1 project has already identified some key stakeholders.
These include participants at the Phase 1 public meetings and users of the
project listserv. A Phase 2 study could include other interested members of
the public who live near the nuclear facilities to be studied as well as state
and local officials and other community leaders. Although not formally
stakeholders, the media and related intermediaries can help ensure that
messages reach intended stakeholder audiences and are accurate.
By identifying key stakeholders, one can better select the appropriate
communication channels and develop effective engagement strategies and
tools. These strategies and tools may need to be tailored for different audi-
ences, and it is important that this tailoring be easily seen and understood.
Attention is often paid to the characteristics of the stakeholders when
tailoring such strategies. Such characteristics include culture, language,
knowledge and resources, and attitudes toward the nuclear industry and
regulators. Stakeholders will have differing levels of participation and in-
terest, but engagement needs to be consistent and ongoing, even if no new
information is available.
Learning about the concerns of the stakeholders is important for effec-
8 Stakeholders are defined as “interested and affected parties” (NRC, 1996).
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266 ANALYSIS OF CANCER RISKS
tive engagement. Effective tools for gathering information about such con-
cerns include interviews, surveys, informal discussions with small groups or
community opinion leaders, and focus groups. Focus groups, if represen-
tative of the community, are particularly helpful for identifying obstacles
to effective communication because they allow for social interaction and
can surface issues that a structured questionnaire or interview would miss.
Moreover, focus groups establish a basis for dialogue and generate active
involvement, so participants view themselves as providers of useful infor-
mation rather than as passive receivers (Johnson, 1993). Stakeholder views
can change over time; focus groups can also be a way to monitor these
changes.
5.4.3 Competence and Expertise
Credible and trusted sources can improve the perceived accuracy of
communications with public audiences. Trust and credibility can usually
be improved by engaging subject-matter experts (for a Phase 2 study, such
experts would include epidemiologists and statisticians, for example) in the
communication effort. Experts need to be able to demonstrate that they do
not promote any particular interests and that they produce accurate and
independent assessments. A distrusted information source that is perceived
to promote a particular view may be perceived as deliberately biased or
inaccurate. In some instances, partnering with a person or organization that
stakeholders find credible, for example an organization that has strong ties
to the community, can improve public trust. Moreover, periodic indepen-
dent reviews of the study by scientists who are not involved in its conduct
and are in part selected by stakeholders may increase credibility.
5.4.4 Transparency
Transparency is characterized by open and honest communication with
stakeholders. It requires that information be accessible to the public when
legal considerations permit, and also that information be presented with
clarity. For example, background documents, conceptual information about
the study design, sources of information used in the study, study results and
uncertainties, and study progress reports can be shared.
Transparency also gives the communicator an opportunity to receive
information from stakeholders. Affected parties have important perspec-
tives that can help inform the Phase 2 study; it is important to demonstrate
openness to receiving information and being clear about how such informa-
tion is being used in the project.
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RISK COMMUNICATION AND PUBLIC ENGAGEMENT
5.5 RECOMMENDATION
The Phase 2 study should include processes for involving and communi-
cating with stakeholders. A plan for stakeholder engagement should be de-
veloped prior to the initiation of data gathering and analysis for this study.
Stakeholder engagement is an essential element of any risk assessment
process that addresses important public interests. Several approaches were
used in this Phase 1 study to engage with stakeholders. The Phase 2 study
can build on these Phase 1 efforts to achieve effective collaboration with
local people and officials and increase social trust and confidence. To this
end, the Phase 2 study should develop and execute an engagement plan that
includes processes to:
• Identify key stakeholders and stakeholder groups with whom en-
gagement is essential.
• Assess stakeholder concerns, perceptions, and knowledge.
• Communicate the questions that the Phase 2 study can address
and its strengths and limitations; communicate the results from
the Phase 2 study in forms that are useful to different stakeholder
groups.
• Make the information used in the Phase 2 study publicly accessible
to the extent possible.
It is important that the engagement plan be developed prior to the
initiation of data gathering and analysis to ensure early engagement with
stakeholders in the Phase 2 study. It will also be important to monitor
how stakeholder views and concerns change during the study in response
to external events. Adapting the plan to changing events can improve the
success of engagement efforts.
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Chess, C., and K. Salomone. (1992). Rhetoric and reality: Risk communication in government
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