Risk Communication Strategies in the DiNEH Project Navajo Nation Human Research Review Board Conference November 16, 2011 Window Rock, AZ Chris Shuey, Glenn Stark, Sandy Ramone Diné Network for Environmental Health Project Johnnye Lewis, PI.
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Risk Communication Strategiesin the DiNEH ProjectNavajo Nation Human Research Review Board ConferenceNovember 16, 2011Window Rock, AZChris Shuey, Glenn Stark, Sandy RamoneDiné Network for Environmental Health ProjectJohnnye Lewis, PI
Funding provided by NIEHS, RO1 ES014565; R25 ES013208; P30 ES-012072; DHHS/NIH/NCRR #1UL1RR031977-01; USEPA/ERRG pass-through contract
*Adapted from: Seven Cardinal Rules of Risk Communication. Pamphlet drafted by Vincent T. Covello and Frederick H. Allen. U.S. Environmental Protection Agency, Washington, DC, April 1988, OPA-87-020.
Navajo Nutrition Study (1991-1993) diabetes prevalence = 22% (all ages)
About 1 in 4 participants reported 1 or more environmental exposures
What’s a “surrogate”? We say “substitute” in Navajo
*Environmental legacy exposures are activities that bring people close to or in contact with uranium wastes, over their lifetimes:
(A) Lived near abandoned mines
(B) herded livestock near mines
(C) sheltered livestock in mines
(D) played on or near mines, mills
(E) used mine materials in home
(F) drank or contacted mine water
Red areas represent doubling of risk of high blood pressure, all other risk factors being equal (Odds Ratio = 2.0)
1 exposure 2 exposures
Maps by Glenn Stark
2007 Map by Jamie deLemos, PhD.
This can be prevented!
Know where the abandoned mines are in your community. Visit http://www.epa.gov/region09/superfund/navajo-nation/index.html to learn mine locations on the Navajo Nation.
Locations of Abandoned Uranium Mines in Mariano Lake area increased health risks
Did ore hauling contaminate Old Gulf Mine Road? Assessment needed!
Avoid contact with uranium mine sites!
DiNEH water testing program increased health risks
About 8% of water sources tested had uranium ≥ 30 ug/l, the EPA MCL
Water Sources in Mariano Lake Area increased health risks
Mariano Residence Well
Navajo Nation policy is that livestock-use-only water sources are not to be used for human drinking water.
Rocky Canyon Windmill
Only Mariano Lake unregulated water source tested for bacteria; none present
16K-528 Mariano Lake Chapter Well (inoperative)
Map by Tommy Rock
1940s-60s: Uranium Mining Nation
“Comprehensive” Health Studies?
Miners & Millers Studies
2012: Navajo Birth Cohort Study
2010-11: DiNEH blood & urine study
Church Rock Spill
Health Research on Navajo Uranium Legacy
Navajo land use & health?
2010-12 CUE-JTH: medical monitoring
1980s: Birth Defects Study
Uranium mining, or other exposures?
Uranium worker families
2007: Waxman Hearing
2001: DiNEH Project 1st Integrated Health Study
1990s-2000s: Community Actions for Environmental Health
Mid-80s: Limited Livestock Studies (NM)
Identification of health risks
Community Advisory Board
Ed Carlisle, Jay DeGroat, Herbert Enrico, Thomas Manning,Sr., Lynnea Smith, Jean Whitehorse,
UNM-HSC Community Environmental Health Program & Clinical and Translational Science Center
Johnnye L. Lewis, PhD; Miranda Cajero, BCH; Matthew Campen, PhD; Jeremy DeGroat; Mallery Downs, RN; Eszter Erdei, PhD; Molly Harmon; Gabriel Huerta, PhD; Curtis Miller; Bernadette Pacheco; Glenn Stark; Mary Woodruff; research nursing support
Crownpoint Service Unit, I H S
Navajo Area IHS
Lisa Allee, CNM; John Hubbard; Ryan Johnson, MD; Doug Peter, MD
Donald Molony, MD
Southwest Research Information Center
Chris Shuey, MPH, Sarah Henio-Adeky, Teddy Nez, Sandy Ramone
Jamie deLemos, PhD – Tufts Univ.
Christine George – Stanford Univ.
Tommy Rock, MA, UNM Health Policy Student
Christine Samuel-Nakamura, PhD Candidate, UCLA
Ben Bostick, PhD
University of Arizona Cancer Center & Northern Arizona University, NACRP
Jani Ingram, PhD, Margaret Briehl, PhD
USEPA Region IX
Harry Allen, Rich Bauer, Clancy Tenley
State of New Mexico Diagnostic Laboratory
Navajo Nation EPA Air Quality Division, Public Water Supply Supervision Program, Superfund Program
Navajo Nation Division of Health
Bess Seschillie, Bernice Norton, Jerry Elwood, Harrison Gorman, Harris Arthur (in memoriam), Alta McCabe, Margaret Menache, PhD, Alexis Kaminsky, PhD; Eastern Navajo Health Board
Thanks to the many others who’ve contributedAcknowledgements