COMMUNICATIONS TO REDUCE RISK
         UNDERESTIMATION
       AND OVERESTIMATION
     Neil D. Weinstein, Peter M. Sandman
          and William K. Hallman

  Rutgers, The State University of New Jersey
              prepared for

    U.S. Environmental Protection Agency
   Office of Policy, Planning and Evaluation
                  and
        Office of Radiation Programs
              August, 1994

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     COMMUNICATIONS TO REDUCE RISK
               UNDERESTIMATION
             AND OVERESTIMATION
          Neil D. Weinstein, Peter M. Sandman,
               and William K. Hallman
       Rutgers, The State University of New Jersey
                    prepared for

         U.S. Environmental Protection Agency
        Office of Policy, Planning and Evaluation
                        and
             Office of Radiation Programs
                    August, 1994
Note:  This research is Part Two of Phase III of Cooperative
Agreement CR-814506, entitled "Communicating Effectively
about Risk Magnitudes."

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               ACKNOWLEDGEMENTS
Funding from the U.S. Environmental Protection Agency
Office of Policy, Planning and Evaluation and Office of
Radiation Programs is gratefully acknowledged.

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               COMMUNICATIONS TO REDUCE RISK
                       UNDERESTIMATION AND
                           OVERESTIMATION
         Neil D. Weinstein, Peter M. Sandman, and William K. Hallman


                          EXECUTIVE SUMMARY
      There is considerable agreement about the difficulty of conveying informa-
tion to the public about the magnitude of risks.   As many discouraged policy-
makers have noted, citizens often ignore information designed to alert them to
significant risks; yet these same citizens may insist on remedial action for other
risks that are too small to merit the attention they receive.  Even when people
obtain their own tests, as with home measurements for airborne radon or lead in
drinking water, there may be only a weak relationship between their test results .(a
measure of risk magnitude) and their responses.

      A substantial research literature has identified many of the factors other
than risk magnitude that seem to explain why some hazards provoke a far greater
response than others.  But much less research has attempted to determine how
best to explain risk magnitude. Without making any judgment about which factors
"should" influence risk response, it seems unarguably desirable that people
understand risk magnitude information so that, at least when the other factors are
held constant, there  is a strong correlation between the magnitude of the risk and
the magnitude  of the response.

      Research  in the first two budget periods of this cooperative agreement
assigned subjects a hypothetical test result for radon or asbestos, provided a
constant fact sheet about the hazard, and explained their risk magnitude using
various techniques.  Subjects were then asked questions about their threat,
mitigation intentions, and related perceptions. A significant risk magnitude effect
was found; that is, subjects responded with higher risk perception when the risk
magnitude was higher. Three specific components were found to improve the risk
magnitude explanations: (1) A recommended action standard; (2) Explicit advice
on what to do  at various concentration levels; and (3) A risk ladder showing a
range of possible test results and the risk magnitude associated with each (with
ladders designed so that subjects' test results appeared high on the ladder if the
goal  is to increase risk perception, and  low on the ladder if the goal is to decrease

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risk perception). Risk comparisons were found to be helpful in some ways, but
they did not significantly affect threat perceptions or action intentions.1

       The  research reported here expanded this previous research in two
directions: It tested an approach in which comparisons to normal background
levels are provided instead of illness likelihood information, and it examined
communication in two situations in which the risk itself was quite low, one of
them a high-outrage risk controversy.

       Three hypothetical  news stories were used: a low-outrage, high-risk story
("radon"), a high-outrage, low-risk story ("nuclear waste"), and a low-outrage, low-
risk story ("radiation").  For each of ihe first two stories,  there were four treat-
ments: (1) A "base risk" treatment in which  subjects were given their hypothetical
test result and  an estimate of the lifetime cancer risk associated with that result,
in terms of deaths per 1,000 people;  (2) An "alternate risk" treatment in which
subjects were provided the same information, but with a  test  result  and risk
estimate 10 x [i.e. ten "times"] higher (for the low-outrage, high-risk radon story)
or 10 x  lower (for the high-outrage, low-risk nuclear waste story); (3) A "compare
to normal" treatment, in which subjects were given the same test result as in the
"base risk" treatment, but with a comparison to normal background levels provid-
ed instead of the risk magnitude information; and (4) A "base risk + chart"
treatment, in which subjects received the risk information augmented with a risk
ladder,  risk comparisons, and a recommended action level. For the radiation
story, only the  "base risk" and "base risk + chart" treatments were used, yielding a
total of ten conditions in the study. The hope was that some of these treatments
would increase responses to high risk levels  and decrease responses to low risk
levels.

       Subjects were  1,402 homeowners in Inno, South Carolina and Gary, North
Carolina. Each received a four-page, SW-by-ll" pamphlet. The first page of the
pamphlet was a cover letter stating that the  task was to "tell us how you think you
would feel in this situation and what you think you would do."  Page two and the
top of page three contained the particular news story subjects were  asked to read.
The story was followed by various types of information designed to  help subjects
interpret their  radiation test result.  The feedback questionnaire included  four
   'For the complete reports of these findings, see (1) Neil D. Weinstein, Peter M. Sandman, and
Nancy E. Roberts, Communicating Effectively about Risk Magnitudes (Washington, DC: Office of
Policy, Planning, and Evaluation, U.S. Environmental Protection Agency, 1989, Document EPA-230-
08-89-064); and Neil D. Weinstein, Peter M. Sandman, and Paul Miller, Communicating Effectively
about Risk Magnitudes, Phase 2 (Washington, DC: Office of Policy, Planning, and Evaluation, U.S.
Environmental Protection Agency, 1991, Document EPA-230-09-91-003).  Both are also available
from the Center for Environmental Communication, Cook College, Rutgers University, New
Brunswick, NJ 08903.

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questions that were later combined into an index of perceived threat, and four
questions that were later combined into an index of action intentions. Other
questions included checks on the understandability of the  news story and the risk
information, checks on the outrage manipulation (anger, distrust), and demo-
graphic items.

       The Effects of Comparisons to Normal Background.  The most surprising
finding was'the powerful impact of comparisons to normal background on threat
perceptions and action intentions. Compared to the "base risk" condition, infor-
mation that their radiation exposure was 20 x  higher than normal background
increased subjects' perceived threat for the low-outrage, high-risk radon  scenario,
and information that their radiation exposure was 200x lower than normal
background decreased boib perceived threat and action intentions for the high-
outrage, low-risk nuclear waste scenario.

       The Effects of the Risk Chart. Similar effects were achieved by supple-
menting the risk numbers in the "base risk" condition with a chart that included a
risk ladder, risk comparisons, and a recommended action standard.  The chart
increased perceived threat in the high-risk radon situation and decreased per-
ceived threat in both low-risk situations (the high-outrage  nuclear waste  situation
and the low-outrage radiation situation). The effects of the chart were roughly
equal to the effects of comparisons to normal background - they were as great as
a 10 x  increase in actual risk for radon, and were greater than a 10 x decrease in
actual  risk for nuclear waste. Similarly, compared to the "base risk" condition, the
chart decreased action intentions for the nuclear waste and radiation scenarios,
though the effect on action intentions for radon was not quite significant.

       The Effects of Risk Magnitude.  The research in the second budget period
demonstrated an effect of risk magnitude on risk perception. This finding was
replicated in the research reported here. Comparing responses in the low-
outrage, low-risk radiation situation with responses in  the  low-outrage, high-risk
radon situation gives on a measure of risk magnitude effects. For both the  "base
risk" treatment and the "base risk + chart" treatment (the only two used with both
low-outrage stories), subjects experienced higher threat perceptions and  action
intentions when  the risk was high (40 in 1,000) than when the risk was low (1 in "
100,000).  The difference between the two was greater for the "base risk + chart"
treatment than for the  "base risk" treatment, demonstrating that the chart helped
subjects respond appropriately to the level of risk. But even with the bare data
provided in the "base risk" treatment, a 40-in-l,000 risk yielded higher threat
perceptions and  action intentions than a  l-in-100,000 risk.  The "alternate risk"
treatment provided a more sensitive test  of the same question. For the low-
outrage, high-risk radon situation, a 10x  increase in risk from 40-in-l,000 to 400-
in-1,000 yielded a significant increase in threat perceptions and action intentions.
But for the high-outrage, low-risk nuclear waste situation,  a 10 x  decrease in risk

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from l-in-100,000 to 1-in-1,000,000 did not significantly affect threat perceptions
or action intentions.

       Outrage Effects and Outrage Reduction.  Not surprisingly, outrage substan-
tially affected threat perceptions and action intentions. Subjects in the high-
outrage, low-risk nuclear waste situation reported much higher perceived threat
and higher action intentions than subjects in the low-outrage, lo\v-risk radiation
situation, although the actual risk was identical.  More striking, for subjects with
the "base risk" treatment, intentions to take action were just as strong for the
high-outrage, low-risk (1 in 100,000) nuclear waste situation as for the low-
outrage, high-risk (40 in 1,000) radon situation. In addition, anger was highly
correlated with threat perception and action intentions, as was distrust of the
Department of Environmental Protection spokesman for subjects in the  high-
outrage situations.  Most encouraging is the apparent ability of some kinds of risk
information to reduce threat perception and action intentions for very low risk
levels even in the presence of high outrage.  Both comparisons to normal back-
ground and the risk chart had this effect for subjects exposed to the nuclear waste
scenario.  Many practitioners have  suggested that when people are outraged,
explanations of the risk data are unlikely to prove fruitful.  Outrage certainly
increased threat perceptions and action intentions in the study reported  here, but
outrage did not diminish the ability of comparisons to background and risk charts
to reduce threat perceptions and action intentions.

       The risk communication strategies that were helpful in the present research
need to.be tested in real-world situations. When citizens' own lives are  affected,
they may well prove less interested in risk magnitude information and more
sensitive to outrage factors.

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                               INTRODUCTION
       There is considerable agreement about the difficulty of conveying informa-
tion to the public about the magnitude of risks. As many discouraged policy-
makers have noted, citizens often ignore information designed to alert them to
significant risks; yet these same citizens may insist on remedial action for other
risks that are too small to merit the attention they receive.  Even when people
obtain their own tests, as with home measurements for airborne radon or lead in
drinking water, there may be oniy a weak relationship between their test results  (a
measure of risk magnitude) and their responses. Furthermore, the response to
risk numbers for one hazard is often very different from the response to similar
risk numbers for a  different hazard. Some hazards seem to provoke a conser-
vative  response from  the public, while others - even given test results that
indicate a comparable risk — elicit much less concern.

       A substantial research literature has identified many of the factors other
than risk magnitude that seem  to explain  why some  hazards provoke a far greater
response than others.  But much less research has attempted to determine how
best to explain risk magnitude.  Without making any judgment about which factors
"should" influence risk response, it seems  unarguably desirable that people
understand risk magnitude information so that,  at least when the other factors are
held constant, there is a strong correlation between the magnitude of the risk and
the magnitude of the  response.  Aside from the research whose third stage is
reported here, there have been relatively  few empirical studies to support claims
that one approach works better than another.
Research in the First Budget Period2
   2The complete report of these Findings is found in Neil D. Weinslein, Peter M. Sandman, and
Nanc> E. Roberts, 'Communicating Effectively about Risk Magnitudes (Washington, DC: Office of
Polic>, Planning, and Evaluation, U.S. Environmental Protection Agency, 1989, Document EPA-230-
OS-89-064).  It is also available from the Center for Environmental Communication, Cook College,
Rutgers Uni\ersit>. New Brunswick, NJ OS903

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       The research conducted in the first budget period examined a variety of
promising risk presentation formats and tested their success in communicating
about two different hazards, geological radon and asbestos. Seven formats were
evaluated, with varying combinations of the following elements:

       Risk  Probabilities   Information about expected lifetime mortality at vari-
                          ous levels of exposure.

       Risk  Comparisons   Comparisons to smoking risks.

       Histogram          Mortality rates displayed in histogram form.

       Standard           Information about the recommended action level.

       Advice             Detailed action advice and verbal labels for various
                          exposure levels.

       Subjects were New Jersey homeowners who had not tested their homes for
the hazard in question (either radon or asbestos).  Each subject was asked to
assume that he or she had tested and that we were delivering the test result.
Each subject also received a four-page brochure discussing the hazard. The first
three pages  were constant across conditions; the fourth page consisted of the
experimental manipulation.  Subjects then responded to an evaluation question-
naire, giving judgments of "their" risk, "their" level of concern and fear, "their"
likelihood of mitigating, "their" illness probability, the helpfulness of the brochure,
and other issues.  Four readings were used for each hazard, one well below the
recommended action level, one slightly below the level, one slightly above the
level, and one well  above  the level.

       Among the major findings were the following:

1.      The value of the research design. The experimental design created for the
       first budget period  proved to be an efficient, cost-effective, and flexible way
       to investigate format effects on risk perception and risk response.  It
       avoided the ethical problems of testing experimental formats in the context
       of actual risk situations, yet maintained an acceptable degree of realism.

2.      The value of an action standard. The formats with a standard did appreci-
       ably better than those without a standard at helping people distinguish
       between high and low levels of the same hazard.  The addition of risk
       magnitude information  or action advice did not lead to a further differen-
       tiation betv-een high and low levels.

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3.     The value of advice. In this study people were more risk-averse than the
       action recommendations; they often said they would mitigate at levels
       below the guideline. ^Those receiving action advice were most likely to
       accept the recommendations (that is, least likely to "overreact" vis-a-vis the
       standard).

4.     The value qf smoking comparisons. The effects of smoking comparisons
       were inconsistent, varying with the outcome variable. They improved
       subjects' ratings of the brochures and raised the maximum level subjects
       would regard as acceptable, but  they did not influence perceptions of risk
       seriousness or intentions to mitigate.

5.     "Locational" responses. Perhaps the most important finding of the first
       budget period was the great similarity in subjects' responses to radon and
       asbestos, despite the fact that  the lowest radon reading was 25 times as
       risky as the lowest asbestos reading, and the highest radon reading was 25
       times as risky as the highest asbestos reading.  Though several  formats
       proved useful in producing substantial increases in response across the four
       levels for each hazard, no format was efficacious in producing appropriate
       differences in response between the two hazards. It was hypothesized that
       the data might be explained by a "locational" (i.e. placement) effect. For
       both radon and asbestos, high concentrations were located high on the full-
       page "risk ladder," and low levels were low on the  ladder.  If risk percep-
       tions were shaped by location, people would view high levels as riskier than
       low levels (within each hazard),  but would not recognize the difference in
       risk between the two hazards.   In other words, where risk was proportional
       to location (within hazards), several formats worked well; where risk was
       not proportional to location (between hazards), no format worked well.
       What looked like a response to different risk magnitudes  might have been
       chiefly a response to location.
Research in the Second Budget Period3

       Research in the second  budget period consisted of three experiments
designed to address questions raised by the results of the first budget period. The
general research approach was unchanged.  Subjects were asked to assume a
particular hypothetical home test result for either radon or asbestos in their own
   •'The complete report of these findings is found in Neil D. Weinstein, Peter M Sandman, and
Paul Miller, Communicating Effectively about Risk Magnitudes, Phase 2 (Washington, DC: Office of
Policy, Planning, and Evaluation, U.S. Environmental Protection Agency, 1991, Document EPA-230-
09-91-003).  It is also a\ailable from the Center for Environmental Communication, Cook College,
Rutgers Uni\ersit>, New Brunswick, NJ 08903.

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                                      8

home, to read a brochure about the radon or asbestos hazard with that test result
in mind, and then to complete a questionnaire on their assessment of the risk
represented by their assigned test result. Both the assigned test result and the
format of the interpretive brochure were systematically varied, and the results
were  analyzed in terms of the efficacy of different format characteristics in
communicating different levels of risk.

       The first experiment was a direct extension of the first budget period
finding that the standard-only format yielded highly risk-averse  responses.  It
tested the hypothesis that this might be attributable to the absence of the loca-
tional cues of a risk ladder in the standard-only condition.  The experiment
compared the effects of the standard-only format and a new standard+ladder
format for four hypothetical asbestos levels. The hypothesis that the addition of a
risk ladder would significantly reduce the perceived risk was confirmed, though
the effect  was very small.

       The second experiment compared the effects on risk perception of risk
magnitude (actual differences in the probability of harm), location on the risk
ladder, and test numbers (for example, whether responses would differ if asbestos
were  reported as 10 fibers per liter rather than as 1 fiber per deciliter, though  the
difference represents merely a change in unit).  These three factors, confounded
in the first budget period research, were manipulated separately in the second
experiment.  Subjects were randomly assigned to one of four information format
conditions (base, displaced on the risk ladder, high test numbers, and high risk).
The results showed that both risk'magnitude (probability of illness expressed in
cases  of lung cancer per  1000 people exposed plus smoking comparisons) and
location on the risk ladder affected risk perceptions. When risk information was
provided and the risk itself was constant, changing the test  numbers by altering
the units had no effect according to any criterion.

       The third experiment explored two new questions. The first question was
the effect  of simultaneously presenting both asbestos and radon risk information
(as opposed to presenting the identical information on one  hazard alone) in the
hope  that this joint presentation might  help people recognize the difference in  risk
between the two hazards. The second  nev, question was the effect of differences
in the identity of the hazard itself, independent of location, test number, or risk
level.  In addition, the  third experiment sought to replicate  the locational effect
and the risk effect found in the second experiment.  A total of six presentation
formats were used. The  data showed no evidence of any difference between
simultaneous and separate presentations of information about the two hazards.
Nor, surprisingly, was there any evidence of a hazard identity effect, at least
insofar as these two hazards were concerned; when the size of the risk and the
location on the page were held constant, subjects' risk perceptions for radon were
not significantly different from their risk perceptions for asbestos. As in the

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second experiment, significant risk magnitude and locational effects were found; a
half-page locational displacement had about the same impact on risk perception
as a 10-fold difference in the magnitude of the risk.
Three Unanswered Questions

       What did we learn from the first two budget periods to guide us in trying
to explain risk magnitudes?  We learned that the task is not impossible. When
risk magnitude data are presented, high risks do generate higher perceived threat
and greater intentions to take  action than lower risks. We also identified three
factors other than risk magnitude data that significantly affect risk perception:
action standards, explicit advice, and location on-a risk ladder.  Finally, we
learned that all of these effects are relatively small; studying them reliably
requires sizable samples of study participants and sensitive response measures.

      Three unanswered questions were identified for the focus of the third
budget period, as follows:

The Role of Graphic Representations

      An approach not explored in the first two budget periods was the use of
graphic representations of probability or concentration data. The first EPA
Citizen's Guide to Radon  made considerable and controversial use of a matrix of
faces and crosses to show risk  probabilities.  A later EPA report, Hazardous
Substances in our Environment: A Citizen's Guide to Understanding Health Risks
and Reducing Exposure (EPA 230-09-90-081), used a similar matrix.  One pub-
lished report (Kaplan, Hammel, & Schimmel, 1985) suggests that a similar graphic
approach may help to lower anxiety about low-probability risks. These research-
ers used a simple matrix  of dots to convey the denominator of an odds statement
(l-in-1,000 or l-in-10,000 or l-in-100,000).  The college student subjects were less
worried about  the side-effects  of a hypothetical  vaccine if the  odds were accompa-
nied by a matrix of dots than if the numbers were presented by themselves.  This
intriguing result required verification and expansion to more serious risks: Would
the graphic  approach lower concern even when  the risk was substantial, or in this
case would it raise concern instead?

The Relative Impact of Different Treatments

      Based on the work of the first two budget periods, a risk explanation
aiming at maximum impact would include: (1) risk probability information for the
subject's assigned test result; (2) a risk ladder with risk probability information for
different concentration levels,  designed so as to put the subject's test result high
or low on the ladder depending on whether the goal is to raise or diminish risk

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perception; (3) an action guideline, perhaps with explicit advice on what to do at
various levels; and (4) comparisons to more familiar risks.4

       A question for the  third budget period, then, was the relative impact of this
"best shot" risk information package.  Two comparison treatments were obvious
candidates. One  would be a baseline treatment giving subjects no risk informa-
tion whatever, only the basic concentration information that comes from a test
result: so many parts per million, picoCuries per liter, etc. The other would be a
simple presentation of the quantitative risk likelihood at the subject's assigned test
result, without the risk ladder, action guideline,  or comparisons.

Augmenting versus Diminishing Perceived Risk

       Conceptually, (he issue of explaining risk magnitudes probably cannot be
meaningfully investigated without regard to direction, because — as the first
budget period  research suggested — different strategies  may be required for
helping people see that a  small risk is small than for  helping people see that a
large risk is large. (Advice, for example, was much better at the former than the
latter.)

       Moreover,  the policy implications of the two types of risk communication
are quite different.  In recent years the Environmental Protection Agency has
devoted  considerable effort to exploring the discrepancies between expert and
public assessments of risk  and to developing policies that take cognizance of these
different assessments (USEPA, 1987; USEPA, 1990). The need  to become more
skilled at explaining serious risks is grounded in public health and similar con-
cerns; lives are at stake when an agency tries to warn people about serious risks.
When people  persist in worrying disproportionately about minuscule risks, in
contrast, the costs range from unnecessary anxiety to  misused environmental
protection dollars, from public policy gridlock to reduced agency credibility.

      The research of the first two budget periods focused on two hazards, radon
and asbestos in residences. Although radon is the more serious of the two  (at the
levels typically encountered and at the levels used in the research), both pose
serious risks.  Residential  radon and residential  asbestos are not  identical hazards,
of course.  But on the variables that  best predict whether a hazard will provoke
   "The research in the first budget period was inconclusive on the effectiveness of risk compari-
sons, but did find that people believe risk explanations are clearer and more helpful when compari-
sons are given.  A study focusing explicitly on risk comparisons was conducted in Part One of the
third budget period, and has already been reported (Weinstein and Sandman, 1991). It found
virtually no differences among radon risk explanations with \arious sorts of risk comparisons or no
risk comparisons at all .Nonetheless, the earlier decision to include risk comparisons in this study
was not reversed

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underreaction or overreaction from the public — dread, control, familiarity, trust,
fairness, etc. — they are similar, in that both tend toward underreaction.  (As
noted earlier,  significant risk perception differences between the two hazards were
not found when risk level  and location on the risk ladder were held constant.)
The research of the first two budget periods, in other words, shed considerable
light on how to alert people to serious risks but much  less light on how to
reassure people about negligible risks.

      The distinction is especially important for negligible risks that are serious
sources of public concern.  It is often  argued that the public responds less to the
seriousness of a risk (or its knowledge about seriousness as  obtained from agency
communications, the media, or other sources) than to such factors as trust,
control, fairness, and courtesy. Sandman (1987, 1991,  1993), Hance et  al (1988,
1990), and Sandman et al  (1987) have proposed the labels "hazard" and "outrage"
to refer, respectively, to the technical  and the nontechnical aspects of risk.  Using
different vocabulary, many others have also noted and studied the importance of
these nontechnical aspects of risk perception, among them Kasperson (1986),
Krimsky and Plough (1988), Covello et aL (1988), Covello and Allen (1988), and
Slovic (1987).

      In Sandman's terminology, "hazard" is the product of risk magnitude and
probability, while "outrage" is a function of whether people feel the authorities can
be trusted, whether control over  risk management is shared with affected commu-
nities, etc.   Supporters of this distinction argue that hazard and outrage are both
components of risk deserving attention, and that laypeople have had as little
success communicating what they consider significant about  risks to the experts as
the experts have had communicating to the  public.  No matter how serious the
risk is (in  hazard terms), and no  matter how effectively it is explained, this view
maintains that the  degree  of outrage is likely to determine much of the public's re-
sponse to  the risk.

      Three experimental studies of outrage (Sandman et al, 1993), employing
hypothetical news stories, found higher perceived risk when  the  manipulated
outrage was high than when outrage was low. For example, risk perception was
higher when the agency responsible for a spill cleanup was reported to be unre-
sponsive to citizen concerns and  neighbors were reported to be outraged than
when the agency was responsive and neighbors were grateful.  The outrage
manipulation had more  impact on risk perception than a 10,000-fold difference in
risk magnitude; the amount of technical information in the news stories had no
impact on risk perception  at all.

      In the language of "hazard" versus "outrage," then, the research of the first
two budget periods focused on risks that were moderate  to high in hazard and low
in outrage. An important  unanswered question was how effective the approaches

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                                        12

developed in the first two budget period would prove when applied to a risk that
is low in hazard and high in outrage.5

       In this context, it is worth emphasizing that these approaches are all ways
of explaining risk magnitude more effectively.  That is, risk data, risk comparisons,
graphic  displays, advice, standards, and risk ladders are all ways to help people
understand the magnitude of their risk. A more controversial class of risk
communication strategies involves efforts to influence risk response emotionally or
behaviorally rather than through improved comprehension: dramatic fear appeals,
social pressure, rewards for compliance, etc.  Considerable research demonstrates
that these non-cognitive approaches can be very~effective — but many scientists
object to them, believing that risk is a  technical problem that should be explained
in technical  (though understandable and perhaps necessarily simplified) terms.
The question, then, is how much can risk response be shaped simply by presenting
the data effectively.  The research carried out in the first two budget periods
constitutes a sustained effort to answer this question in the context of a serious
risk that people are inclined to underestimate.6 The research carried ,out in the
third  budget period expands that inquiry to inconsequential risks that people are
inclined  to overestimate, in large measure because they are outraged.
The Original Proposed Design

       To answer these three questions, the third budget period proposed an 8-
condition research design.

       Two hypothetical risk situations were proposed: a low-outrage, high-risk
hazard to which the public typically underreacts and a high-outrage, low-risk
hazard to which the public typically overreacts.  We tentatively selected radon
once again for the former, and low-level radioactive waste facilities for the
latter.7 Both are issues with important current policy implications.  In both cases,
        report will use Sandman's term 'outrage' to cover the nontechnical aspects of risk.
However, the technical aspects (in this case, the quantitative likelihood of illness) will be referred to
by the conventional terms 'risk' and 'risk magnitude,* rather than Sandman's 'hazard." "Hazard' will
be used instead in the conventional way, to describe the substance or situation that poses a risk.
Thus, what Sandman would call a 'high-outrage, low-hazard risk,* we will call a 'high-outrage, low-
risk hazard.'

   6Research at Carnegie Mellon University has also focused on this issue.  See for example Ibrekk
& Morgan, 1987.

    The high-outrage, low-risk scenario was later changed from a low-level radioactive waste site in
the neighborhood to the illegal use of mildly radioactive sand from a nuclear power plant in the
manufacture of the cement from which home foundations were constructed.  Thus, both the high-

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                                      13

ongoing risk communication programs at  EPA and other agencies could make
immediate use of our results.  In addition, since both are radiation hazards, we
expected to be able to produce risk explanations that were similar in terms of the
possible disease outcome, the units in which exposure is measured, etc.  At the
same time, there is wide agreement that the task of explaining radon risk magni-
tudes is explaining that they are substantial, while the task of explaining low-level
radioactive waste facility risk magnitudes  is explaining that they are  minimal.
(There are of course other policy issues and other legitimate sources of controver-
sy for both hazards.)

       For each of these two hazards, we  proposed four treatments, as follows: (1)
Baseline.  The baseline treatment would give subjects no risk information at all,
only the basic concentration information that comes from a test result: so many
parts per million, picoCuries per liter, or whatever.  (2) Base risk.  The second
treatment would augment the concentration information with  quantitative risk
information — for example,  "so many parts per million of	is expected to
cause X additional cases of cancer per  1,000 people exposed."  (3) Graphic dis-
play. The third treatment would assess the value of adding a single factor to the
quantitative concentration and risk information already present in the second
treatment.  In this case the  added factor would be the use of a matrix of dots to
make more concrete, more  visible, the size of the risk being presented.  (4) Base
risk + chart.  The previous stages of this research shed light on the impact on
risk perception of location on a risk ladder, action standards with advice, and risk
comparisons.  The "best shot"  treatment would add a chart incorporating these
factors to the quantitative concentration and risk information  in the second
treatment.

       The proposed design entailed only one concentration/risk condition for
each hazard -  a very sizable radon risk and a very tiny nuclear waste risk.  In
most other ways, the proposed design was identical to that of the first two budget
periods. Subjects were to be recruited by telephone. Those who agreed to
participate would be sent a  hypothetical information brochure8 explaining the
radon or nuclear waste problem in their neighborhood, and a hypothetical test
result for their particular home.  All subjects would receive the same information
brochure about either radon or nuclear waste, plus a final page with one of the
treatments discussed above. Finally, subjects would be asked to complete a
response questionnaire. The research in the first two budget periods showed that
the greater sensitivity of a multi-question response scale is needed to demonstrate
outrage scenario and the low-outrage scenario featured an individual-level risk emanating from the
subject's (hypothetical) basement.

   ^his was later changed to a hypothetical news story, making it easier to manipulate trust and
outrage while preserving the credibility of the source of the concentration test result.

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                                      14

statistical significance for the sorts of effects studied.  We therefore proposed that
the four-question threat perception index developed earlier be used once again,
and that a new multi-question index of action intentions be developed to replace
the single-item measure of this variable used previously.

       In summary, there were two series of research  questions to be-investigated
during the third budget period, as follows:

(1)    When subjects are presented with a serious radon risk that they are in-
       clined to underestimate, how effective is each of the following in convinc-
       ing them to see the risk as serious and  intend to take action: (a) concentra-
       tion data alone; (t>) concentration and risk data; (c) concentration and risk
       data accompanied by graphic display; (d) concentration and risk data
       accompanied by standards with advice,  risk comparisons, and locational
       cues in risk ladders, all used in the way that previous research showed was
       most likely to lead people to consider the risk  more serious.

(2)    When subjects are presented with an extremely small risk from nuclear
      •waste that they are inclined to overestimate, how effective is each of the
       following in convincing them, to see  the risk as insignificant and not intend
       to take any action: (a) concentration data alone; (b) concentration and risk
       data; (c) concentration and risk data accompanied by graphic display; (d)
       concentration and risk data accompanied by standards with advice, risk
       comparisons, and locations) cues in  risk ladders, all used in the way that
       previous research  showed was most  likely to lead people to consider the
       risk less serious.
Changes in the Design

      The design as carried out differed from the design originally proposed and
described above in four important ways.

Separation of the Graphic Display Study

      In the absence of prior research (except for the single study by Kaplan et
aL, 1985), it was difficult to determine what particular form the matrix of dots
should take in the graphic display portion of the study. To help answer this
question, two preliminary experiments were conducted, with university students as
subjects. The first experiment used two different hypothetical health risk decision
problems.  It compared responses to three risk probabilities (l-in-50, 200-in-
10,000, and l-in-10,000) and three formats (no graphic display, a matrix of dots to
represent  the denominator of the probability fraction, and a matrix of dots and
X's to represent the denominator and numerator, respectively).  Because the first

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                                      15

experiment failed to find any effects of graphic display, a second experiment was
conducted to more precisely replicate the original Kaplan et al design.

       In neither experiment were threat perceptions or action intentions signifi-
cantly different with any visual display than with the numbers only.  Because of
the large samples used, the failure to detect an effect for graphic display cannot
be attributed to inadequate statistical power in the experimental design. Of
course visual displays other than those examined in these two experiments may
eventually prove to be quite helpful.  And even the visual displays studied may
conceivably have some impact for risk levels greater or smaller than the range
examined (l-in-50 to l-in-10,000), or for audiences other than  university students.

       Nevertheless, these two experiments certainly did not support the idea that
a visual display of dots helps people appreciate the  magnitude of a risk. We
therefore decided not to include a "graphic display" treatment  in the experiment
for the third budget  period.  A report of the two visual display experiments is
incorporated into this report as Appendix A.

Addition of an Alternate Risk Level

       One of the strengths of the research design in the second budget period
was the use of two risk levels to establish a risk magnitude effect on threat
perceptions and action intentions.  The size of this effect could then be directly
compared with the size of the  other experimental effects — establishing, for
example, that the difference between a location one-quarter of the way up the risk
ladder and one three-quarters  of the way up the ladder had roughly the same
effect on perceived threat as a 10-fold difference in actual risk.

       As originally proposed,  the research in the third budget period would lack
this strength, since only one risk level would be studied for each scenario.  We
therefore decided to add an "alternate risk" treatment, identical in form to the
"base risk" treatment (that is, with information provided about  the level of risk at
the subject's assigned concentration but with no risk ladder, risk comparisons, or
standard), but with a 10-fold difference in the risk magnitude itself.

       For the radon scenario, a base risk of 40 additional lung cancer deaths in
1,000 was established.  The alternate risk condition was therefore set at 400 in
1,000 - ten times greater. Thus, the effectiveness of the various treatments in
convincing subjects that a 40-in-1,000 risk is worth taking seriously could be
compared to the increased threat  perceptions and action intentions when the risk
was hiked to 400-in-1,000.

       For the nuclear waste scenario, a base risk of 1 additional lung cancer
death in 100,000 was established.  Since the goal of risk communication in this

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                                      16

case is presumably to convince people that the risk .is a very minor threat and no
action is justified, the alternate risk condition was set ten times smaller than the
base risk, or 1-in-1,000,000.

Addition of a Low-Outrage. Low-Risk Scenario

       Both of the hazards used in the first two budget periods, radon and
asbestos, are moderate to high in risk and low in outrage (at least when found in
one's own home).  One of the main goals of the research in the third budget
period was to find out whether the approaches identified as helpful in explaining
the magnitude of such a risk would work as well when the risk was low and the
outrage high — for example, with nuclear waste.

       However, this contrast of a low-outrage, high-risk hazard with a high-
outrage, low-risk hazard is really two contrasts: whether the risk is high or low,
and whether the outrage is high  or low.  That is, one question is how to convince
people that their risk is indeed low - whether the approaches that help people
understand a high risk magnitude will also help them understand a low risk
magnitude. A second question, conceptually quite different,, is what to do when
outrage is high. An approach  that may work in both a low-outrage, high-risk
situation and a low-outrage, low-risk situation — that is, an approach that  helps
explain both kinds of risk — may nonetheless prove ineffective when high  outrage
clouds the issue.  Similarly, a study that found that a particular approach works
for the low-outrage, high-risk situation but does not  work for the high-outrage,
low-risk situation would leave unanswered the effectiveness of that approach when
outrage and risk were both low.

      To remedy this problem, we decided to add a low-outrage, low-risk
scenario.  (To maintain  high sample sizes in each condition, only "base risk" and
"base risk + chart" treatments  were added for this scenario.)  The fourth logically
possible scenario, high outrage and high risk, probably does not require much
research.  It is not difficult to convince people to take a situation seriously when
both outrage and  risk are  high.

Addition of Comparisons to Background

       As originally conceptualized, the baseline condition in this research was to
have provided no risk information at all.  Subjects would simply be given a
hypothetical test result, expressing their concentration without any explanation of
the associated risk.  This is by  no means an unrealistic condition.  Well water test
results, SARA Title III data, and a wide range of other hazard communications
come in the form  of concentration information without risk information.

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                                      17

       However, even though people often receive concentration information
without risk information, and even though they presumably reach some intuitive
sense of the riskiness of their exposure based on the information available to
them, the hypothetical situation originally proposed for the baseline condition
does lack verisimilitude. How could we ask subjects to answer a series of ques-
tions about the seriousness of the risk (and the clarity of the risk explanation),
when they have simply been told that they have a reading of so many picoCuries
per liter, and nothing more?

       We therefore decided to add ^ojnฃ information to the baseline condition -
not information about risk magnitude, but something to provide at least minimal
context and to make the task seem more realistic.  The information added was
information comparing the subject's test result to normal background exposures to
radiation.  Normal background levels of breathable radiation average roughly 0.4
picoCuries per liter of air. Accordingly, the "baseline" condition for radon includ-
ed the information that the radon test result of 8 picoCuries per liter was 20 x
greater than normal background radiation; and the "baseline" condition for
nuclear waste included the information that the nuclear waste  test result of 0.002
picoCuries per liter was 200 x  less than normal background radiation.9  The "base
risk" condition did not include this information; it included information about the
risk magnitude associated with  the test result instead. The "base risk + chart"
condition included comparisons to background among the other comparisons on
the risk chart, but did not explicitly point out that the subject's assigned test result
was 20 x more or 200 x less than normal background.

      As will be seen in the results section, this information about comparisons
to normal background turned out to be highly impactful, both  in increasing  the
response to a high risk and in decreasing the response to a low one.  As it turned
out, then, the study has no real "baseline" treatment. Instead,  there are four
treatments: "base risk," with information provided about the risk at the subject's
level only; "alternate risk," with the same information provided but a 10-fold
greater or lesser level of risk; "compare to normal," with no risk information but
instead information about the comparison to normal background;  and "base risk
+ chart,"  our attempt to produce the maximum impact communication.
   9In reality it would not be technically possible to attribute a radiation level of 0.002 picoCuries
per liter to nuclear waste, since normal background levels are much greater than this figure and vary
significant!) from house to house and from da) to day.

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                                  METHOD
Experimental Conditions

       Three hypothetical news stories were used: a low-outrage, high-risk story
("radon"), a high-outrage, low-risk story ("nuclear waste"), and a low-outrage, low-
risk story ("radiation").

       For each of the first two stories, four treatments were used: (1) A "base
risk" treatment  in which subjects were given their hypothetical test result and an
estimate of the  lifetime cancer risk associated with that result in terms of deaths
per 1,000 people; (2) An "alternate risk" treatment in which subjects were provid-
ed the same information, but with a test result and risk estimate 10 x  higher (for
the low-outrage, high-risk story) or 10* Jower (for the high-outrage, low-risk
story); (3) A "compare to normal" treatment, in which subjects were given the
same test result as in the "base risk" condition, but with a comparison to normal
background levels provided instead of the risk information; and (4) A "base risk +
chart" treatment, in which subjects received the risk information augmented with a
risk ladder, risk comparisons, and a recommended action level.

       For the third story, only the "base risk" and "base  risk + chart" treatments
were used.

       The radiation levels and explanatory information used in each of the ten
experimental conditions are summarized in Table  1.
Sample

      People who live in communities where radon problems are common may
recognize 4 picoCuries per liter as the level at which action is recommended by
the U.S. Environmental Protection Agency. Such knowledge  could affect their
response to the hypothetical radiation levels used in this experiment. To reduce
this potential complication, the sample was recruited from two communities with
quite low radon levels: Irmo, South Carolina and Gary, North Carolina.  An
additional reason for choosing these communities was their relatively high


                                     18

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                                     19

                                  Table 1
                          Experimental Conditions
Condition
Radiation Interpretive information
level
(PCi/L)
Lung cancer Comparison to
probability normal back-
ground levels

Risk
chart
Low Outrage, High Risk ("Radon")
Base risk
Alternate risk
Compare to nor-
mal
Base risk +
chart
8 40-in- 1,000
80 400-in- 1,000
8 - 20 x greater
than normal
8 40-in-l,000
YES
High Outrage, Low Risk ("Nuclear Waste")
Base risk
Alternate risk
Compare to nor-
mal
Base risk +
chart
.002 l-in-100,000
.0002 l-in-1,000,000
.002 - 200 x less than
normal
.002 l-in-100,000
YES
Low Outrage, Low Risk ("Radiation")
Base risk
Base risk +
chart
.002 l-in-100,000
.002 l-in-100,000
YES
Note: pCi/L = picoCuries of radiation per liter ol air.
education level.  People with more education would be more willing to agree to
read the research materials and would be more likely to complete and return the
feedback questionnaire.
      Because several of the questionnaire items asked what decisions subjects
would make about home remediation in the hypothetical situation presented, only

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                                     20

owners of single-family dwellings - who might find it easier to imagine themselves
in such a situation — were eligible. Within each such residence the male or
female head of household was selected to participate, with the gender requested
alternating from house to house.

      Of those households where a telephone contact was made that met the
selection requirements, 65.5% agreed to take part in the study. A total of 1803
individuals were recruited.  With at least two reminder calls; 1402 (77.8%)
returned completed questionnaires.  This is a net response rate of 51.0%.  The
return rates were equal across conditions, removing any concern that differences
among conditions might be caused by differential subject attrition. However,
conclusions about differences among the treatments are limited to the homeown-
ers who agreed to participate.

      Overall, the sample was 53.3% female.  The education and self-reported
income of subjects are reported in Table 2.  As expected, the sample is better
educated and wealthier than the communities from which it was recruited, in part
because home ownership was a requirement for participation.
Materials

      Each subject received a four-page, 8V$"-by-H" pamphlet.  The first page of
the pamphlet was a cover letter stating that the task was to "tell us how you think
you would feel in this situation and what you think you would do." Page two and
                                  Table 2
                 Education and Income for Study Communities
                           and Study Participants
Community
Irmo, SC
Irmo sample
(N = 668)
Gary, NC
Carv sample
(N = 734)
High school gradu-
ate or higher (%)
94.6
98.5
94.9
98.6
Four-year college
graduate or higher
(*)
35.9
53.3
48.8
60.5
Household income
40,681 (median)
54.1% i $50,000
45,301 (median)
67.5% i $50,000
Note: Education figures based on persons 25 years and over

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                                     21

the top of page three contained the particular news story the subject was asked to
read. The story was followed by various types of information designed to help the
subject interpret his or her radiation level. The ten different pamphlets used
appear in Appendix B.

News Stories

      Three stones were created to describe situations in which radiation within
homes posed a threat of unknown magnitude to residents of the Washburn Circle
section of Middletown. The stories were presented in newspaper columns and
emulated newspaper writing style.  In the low-outrage, high-risk story ("Radon
Risk to Middletown Homes"), the radiation came from radon produced by
naturally occurring uranium. In the high-outrage, low-risk story ("Nuclear Waste
Contaminates Middletown Homes"), the radiation came from sand  that had
absorbed radioactivity when  it covered a storage site for spent nuclear power fuel
rods, sand that had then been used illegally to make concrete for the homes'
foundations.  In the low-outrage, low-risk story ("Radiation in Middletown
Homes"), the source of radiation was sand used to make concrete for the homes'
foundations that was only later learned to contain naturally occurring uranium.

      The key actors in all three stories were Charles Schmidt of the  State
Department of Environmental Protection (DEP); Dr. Susan Baxter, Director of
the Middletown University Health and Safety Program; and Harriet Mossman,
chair of the Washburn Circle Neighborhood Association.  All three stories began
with the sentence, "Homeowners in the Washburn Circle section of Middletown
will find out soon just  how radioactive  their homes are." The radiation was
described as having been discovered accidentally by a sixth grade student who was
conducting a science project on radiation.  The initial assessment of the radiation,
provided by  Schmidt of DEP, was that there is "only a very small health risk."
The stories state that Dr. Baxter was carrying out measurements of home radia-
tion levels independent of the state Department of Environmental Protection.
According to the stories, each homeowner who agreed earlier to have  measure-
ments taken was about to receive a written report. Baxter was quoted as saying
that "the level of radiation, and therefore the level of risk, varied from one home
to the next."  The stories concluded with six nearly identical paragraphs about the
way in which radiation accumulates in  homes, the reason why radiation increases
the risk of lung cancer ("a disease considered virtually incurable and almost
always fatal"), the factors that influence the level of risk, and the possibility of
remediation.

      Low-outrage, high-risk news  story.  In this story (839 words), the source of
the radiation was radon produced by naturally occurring uranium.  Mossman was
described as saying that "we  don't expect to find any serious problems, but we
want to be sure," that the neighborhood association is 'Very grateful to the DEP

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                                     22

and the University for moving so quickly," and that "there are no villains here....
It's just a fact of nature and we know how to deal with it."

       High-outrage, low-risk news storv. In this story (921 words), the "Wellspring
Corporation was paid $2 million by an electric utility to take sand from .a nuclear
fuel storage site and leave the sand at a special disposal facility for radioactive
waste. Instead, Wellspring used it to  make concrete for the foundations  and
porches of the homes it was building in Washburn Circle.  According to the story,
legal recourse probably would not help Washburn Circle residents because the
Wellspring Corporation has gone bankrupt.

       In the story Mossman made several statements indicative of distrust, fear,
and anger.  In response to Schmidt's suggestion that .the risk appears to be very
small,\ she replied, "We're not so sure the risk is small.... The numbers may turn
out much higher than Mi. Schmidt is admitting." Later she said that "whatever
the numbers turn out to be, Washburn Circle residents are  angry, and we will stay
angry until  the contamination is removed and our health is  protected." She added
that "for as much  as  15 years we have let our kids play on radioactive front
porches and have literally built our lives on radioactive foundations.  Who knows
what cancers lurk in  our futures and our children's futures?"

       The story emphasized the impartiality of the soon-to-arrive home  radiation
reports by having  Dr. Baxter say, "We recognize that homeowners need a source
of information they can  trust." Furthermore, Mossman thanked Baxter, saying,
"We didn't  know where to turn for help and are-pleased that the data will come
from someone who has no axe to grind."

       Low-outrage, low-risk news story. This story (839 words) was essentially
the same as the low-outrage, high-risk story, except that the radiation was de-
scribed as coming from uranium  rather than radon. The reason for avoiding the
term "radon" was the possibility that media coverage over the last few years,
during which time radon has been labeled as a serious problem, might have made
it difficult for subjects to believe that the low levels they were being assigned in
these conditions did pose the negligible risk indicated by the information provid-
ed.

Risk Information

       Immediately after the news story, instructions asked subjects to imagine
living in one of the homes in Washburn Circle and to read "their" home radiation
report, which followed.

      The  report, labeled as coming from the Middletown University Health and
Safet) Program, described "the level of extra radiation in your principal living area

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                                     23

from the [experimental source]" as "	picoCuries of radiation per liter of air
(pCi/L)" (where the blank was replaced with the actual level for each condition,
as seen in Table 1).  This information was provided in all conditions.

       The "base risk" treatment then translated the radiation level into a risk esti-
mate.  In the 8 pCi/L conditions, for example, a paragraph stated: To interpret
this result,  it may help you to know the health risk caused by being exposed to
this amount of radiation. If 1,000 people lived for 70 years in homes with 8
picoCuries of radiation per liter of air, about 4Q of them would be expected to
contract lung cancer as a result of this exposure. In other words, for every 1,000
people exposed to this level of radiation over a lifetime, 40 more of them, on
average, would get lung cancer than if they were not exposed to the radiation."
Lung cancer probability information was provided in eight of the ten conditions,
all except the two "compare to normal" conditions.

       Comparisons to normal background levels took the following form:  To
interpret this result, it may help you to know that  the average outdoor background
level of breathable radiation in the United States, from all sources, is approxi-
mately 0.4 picoCuries of radiation per liter of air.  The radiation exposure in your
house from [the experimental source] is thus 20 times greater [or 200 times less]
than the average outdoor background level." This information was provided only
in the two "compare to normal" conditions, the two conditions in which lung
cancer probability information was not provided.

       The "base risk +  chart" treatment included a chart containing a variety of
information: (1) A ladder of concentrations that started at 0.0 pCi/L and stopped
at 10 pCi/L, with each pCi/L labeled and a tick mark every 0.1 pCi/L; (2) Infor-
mation about the cancer risk at 11 different levels, in terms of the number  of
excess  lung cancer deaths for 1,000 people exposed to this level over a lifetime;
(3) The'EPA action guideline for radon ("at 4 pCi/L EPA recommends that you
reduce your home  radiation level"); (4) Comparisons to three other causes of
death (stroke, diabetes, and colon/rectal cancer)10; and (5) Comparisons  of three
radiation levels to normal background ("average outdoor radon [or radiation]
level,"  "15 times average outdoor radon [or radiation] level," and "25 times average
outdoor radon [or radiation] level").  A few sentences explained how to use the
chart.  Except for the words "radon" or "radiation" to match the story, the same
chart was used with all stories. A rubber stamp was prepared that contained an
arrow and the phrase "YOUR LEVEL." When subjects received a chart, the
stamp pointed to the spot on the risk ladder that represented their radiation
report, in red ink.  For subjects assigned 8 pCi/L,  the red arrow pointed  four-
   10Research conducted expressly to assist in the revision of the Citizen's Guide to Radon (Wein-
stein and Sandman, 1991) suggested that the choice of comparison hazards was not an important
factor.

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                                     24

fifths of the way up the ladder; for subjects assigned .002 pCi/L, it pointed just
above the 0.0 point at the bottom of the ladder. This chart was provided as a
supplement to the lung cancer probability information in three conditions.

Feedback Questionnaire

      The feedback questionnaire is reproduced in Appendix C.  It appeared on
a separate sheet and was identical in all conditions.

      To check for unintended differences in understandability, the questionnaire
asked how clear the newspaper article was (1  = very confusing; 4 = very clear)
and how clear the information was about the seriousness of the radiation level (1
=  very confusing; 4 = very clear).

      Three questions were written to assess  the effects of the  outrage manipula-
tion: "How angry would you feel to find this level of radiation?" (1 = not at all
angry; 5 = extremely angry); "From what you  have read, do you think you could
trust the risk information provided to you by Dr. Baxter of the University Health
and Safety Program?" (1  = definitely could trust; 5  = definitely could not trust);
and "From what you have read, do you feel that Charles Schmidt, the State DEP
spokesperson quoted in the newspaper article, cares about  the health and safety of
your neighborhood?" (1 = cares a lot; 5 = doesn't care  at all).

      Four questions were employed to measure perceived threat: "How would
you describe the danger from the radiation level found in your Washburn Circle
home?" (1  = no danger; 6 = very serious danger); "If you continued to live in
your Washburn Circle home and did nothing about  the radiation, what is your
impression of the chance  that the radiation would give you lung cancer?" (1 = no
chance; 7  = certain to happen); "How concerned would you feel finding this level
of radiation?" (1 = not at all concerned; 5. = extremely  concerned); and "How
frightened would you feel finding this level of  radiation?" (1 = not at all fright-
ened; 5  = extremely frightened).

      Also, four questions were used to measure action intentions: "Given what
you have learned about the risk, do you think  it would be worth your spending
$300 to reduce  the risk to zero?" (1 = definitely would not spend $300; 5 =
definitely would spend $300); "Given what you have learned about the risk, do
you think  it would be worth your spending $3,000 to reduce the risk to zero?" (1
=  definitely would not spend $3,000; 5  =' definitely would spend $3,000); "If you
learned that it wasn't possible to reduce the radiation in your home, would that
make you want to move away?" (1  = would not feel any interest in moving away;
5 = would insist on moving away); and "Imagine that you were looking for a new
home in a new  neighborhood, and found that  it had this level of radiation (the
level we told you was found in your home). Would this reduce your interest in

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                                     25

buying this new home?" (1 = would not be at all reluctant to buy a home with
this level of radiation; 5 = definitely would not buy a home with this level of
radiation).

      A final section asked  subjects their sex, education, and household income,
and the amount of time they spent reading the booklet and filling out the ques-
tionnaire.
Procedure

      The study was described on the telephone as focusing on how homeowners
make decisions about environmental risks. The caller told the homeowner that
people were being asked "if they would read a brief, one-page news article about
an environmental problem and answer a short questionnaire to tell us what they
would do if they were in that situation."  The sum of $1 was offered as a thank
you for their help.

      The four-page pamphlet (including news story, risk information, and
instructions), two-page questionnaire, and a stamped, self-addressed envelope
were mailed to each subject who agreed to participate.  The questionnaire
contained a printed code that identified which pamphlet had been mailed (i.e., the
subject's condition). Another number served as a subject identification code.
Reminder calls (and additional mailings  if needed) were made to increase
response rates. All data collection took  place in June,  1993.

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                                  RESULTS
Scale Construction

       To measure perceived threat and action intentions, answers to the four
threat questions were added together and answers to the four action questions
were added together. Scale reliabilities were calculated after standardizing the
variables to the same mean and variance within each condition.  The reliability
coefficient (Cronbach's alpha) of the threat perception scale was found to be .90
and  the reliability of the action intentions scale was .86. Although the two scales
were strongly correlated with each other (r - .72 for the pooled, within-condition
correlation coefficient), the items  within each scale correlated more highly with
one  another than with the items in the other scale.  This relationship is indicated
by the fact that a scale  created by combining all eight items had a reliability of
.92, scarcely greater than the figures for the two separate four-item scales. Conse-
quently, the two scales were kept separate.
Analysis Strategy

       Because the low-outrage, low-risk story lacked "alternate risk" and "com-
pare to normal" conditions, the experimental design was not a complete 3 (stories)
x  4 (treatments) factorial. Consequently, analyses could not be based on a
simple, two-factor analysis of variance.  Instead, the analysis strategy was to look
first at the low-outrage, high-risk and high-outrage, low-risk stories in a simple 2
(stories) x 4 (treatments) analysis of variance. If the analysis of variance indicat-
ed that there were significant differences  among treatments, the treatments were
compared, pairwise, with post-hoc tests using Tukey's HSD  criterion, with a signif-
icance criterion of .02 to minimize false positives. These post-hoc tests were
conducted either across both stories when no story x treatment interactions were
found or within each  story when significant interactions were present.  Additional
calculations examined the effect of the  outrage manipulation at a constant low-
risk level by comparing the "base risk" and "base risk plus chart" conditions for the
high-outrage, low-risk story and the low-outrage, low-risk story, in a simple 2
(stories) x 2 (treatments) analysis of variance. These two analyses will be
referred to as the "2x4 analysis of variance" and the "2x2 analysis of variance,"

                                      26

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                                        27

respectively.  The mean values of the main dependent variables are shown in
Table 3 for each condition.

Manipulation Checks

       If the outrage manipulation were successful, distrust of the DEP spokes-
man, Schmidt, and anger at the situation would be much greater in the high-
outrage conditions than in the low-outrage conditions. The mean levels of distrust
of Schmidt are shown in Figure I.11  The 2x4 analysis  of variance confirms that
                                     Table 3
                      Mean Values of Dependent Variables
Condition
Article
clear
Risk
report
clear
Low Outrage
Base risk
(N=131)
Alternate risk
(N=135)
Compare to normal
Base risk * chart
(N=139)

Base risk
(N=149>
Alternate risk
(N=153)
Compare to normal

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                              28
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                        Figure 1
    Effects of Condition on Distrust of DEP's Schmidt

                                     High risk, low outrage
                                     Low risk, high outrage
                                     Low nsk. low outrage
                                                     I
                                                     \

                                                     I
Ecse riSr
                 A.'ierno'ie
Compere to normal Base risk + chart

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                                      29

distrust was much greater in the high-outrage conditions. .The effect of story was
highly significant, f(l, 1074) = 177.7, p < .0001.  There was no treatment effect
nor any interaction between story and treatment (p's > .2).

       Anger revealed a more complicated pattern, as shown in Figure 2.  In the 2
x 4 analysis of variance, there was a  large effect of story, F(l, 1102) = 68.8, p <
.0001, with more anger overall in the  high-outrage conditions. There was no
treatment effect, F(3, 1102) = 1.8, p =  .15, but there was a highly significant story
x treatment interaction, F(3, 1102) = 10.4, p < .0001. Further comparisons
among the treatments associated with each story revealed no differences in anger
among the low-outrage, high-risk conditions, f(3, 533)  = 1.65, p = .18, but a large
difference among the conditions with  the high-outrage, low-risk story, F(3, 562) =
11.6, p < .0001. In particular, subjects who read the high-outrage, low-risk story
experienced significantly less anger with the "compare to normal" treatment and
the "base risk  + chart" treatment than with the treatments with only risk numbers
("base risk" and "alternate risk").  The same finding was observed for the low-
outrage, low-risk story: The anger of subjects in the "base risk + chart" condition
was significantly lower than in the "base risk" condition without the chart, F(l,
289) = 14.4, p < .0002.

      These results indicate effects on anger of both outrage and perceived risk.
The high-outrage stories produced a high level  of anger, but communications that
did a good job of convincing subjects  that the risk was low (as described later) de-
creased this anger substantially.  Both low-outrage stories had low levels of anger
in the "base risk" condition. Communications that improved subjects' under-
standing of the risk diminished anger  still further if the risk was low, but such
communications did not decrease anger if the risk was high.  It might be hypothe-
sized from an examination of the low-outrage, high-risk results that low outrage
helped prevent a high risk level  from  producing anger. Although we did not
include a high-outrage, high-risk story, one might guess that improved under-
standing of the risk in this case would actually increase anger.

       As intended, distrust of the independent expert, Dr. Baxter, was low (see
Figure 3).  The 2x4 analysis of variance showed a very small difference between
the low-outrage, high-risk and the high-outrage, low-risk stories, F(l,1098) = 4.05,
p  < .05, with mean values of 2.21 and 2.31 for these two stories, respectively.
There were no significant treatment effects or story x treatment interactions, p's
> 15. The difference in distrust between the high-outrage, low-risk and the low-
outrage, low-risk stories was not statistically significant,/! > .1.

       Other calculations examined the perceived clarity of the news stories them-
selves and of the risk information provided. The 2x4 analysis of variance
showed that the low-outrage, high-risk story was rated as clearer than the high-
outrage, low-risk story, F(l, 1092)  - 8.80, p = .003.  The difference between the

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                              30
                        Figure 2
              Effects of Condition on Anger




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                                      31
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                                Figure 3
              Effects of Condition on Distrust of Dr. Baxter
                                        High risk, low outroge
                                        Low risk, high outroge
                                        Low risk, low outroge
                                                             I
       Base
                  Alternate risk   Compare to normal  Base risk-I-chart

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                                      32

means, however, was quite small: 3.48 vs. 3.37 for the low-outrage, high-risk and
the high-outrage, low-risk stories, respectively. Apparently, the description of the
illegal activities of Wellspring and its president was slightly confusing. There were
no treatment effects or story x treatment interactions, />'s > .5.

      In contrast to the ratings of the clarity of the news stories, the 2 x 4
analysis of variance showed significant differences among treatments in how
clearly the seriousness of the risk was explained, F(3, 1103) = 9.28, p < .0001.
The "base risk  + chart" treatment (mean = 3.46) was judged to be clearest.
Overall,  it was  rated significantly higher than both the "compare to normal"
treatment (mean = 3.10) and the "base risk" treatment (mean =  3.23),/?'s  < .02.
(The "alternate risk" treatment and the "base risk" treatment were identical except
for the risk levels, and would be expected to receive the same ratings for clarity,
but the former was rated slightly higher for both the low-outrage, high-risk and
the high-outrage, low-risk stories.) There were no differences among the news
stories, p > .2,  and there were no significant story x  treatment interactions.
Effects on Perceived Threat

      The 2x4 analysis of variance of the low-outrage, high-risk and the high-
outrage, low-risk stories revealed a significant story effect, F(l, 1087) = 253.0, p
< .0001, a significant treatment effect, F(3, 1087) = 14.12, p < .0001, and a
significant story x treatment interaction, F(3, 1087) = 3.02, p <  .05.

      Figure 4 shows clearly that, overall, the radon story was correctly recog-
nized as presenting a greater threat than the other two stories. The difference
was not always as great as might be desired, however.  The perceived threat in the
high-outrage, low-risk "base risk" condition was just 1.3 scale points less than the
perceived threat in the low-outrage, high-risk "base risk" condition, despite the fact
that the risk of lung cancer was described as being l-in-100,000 in the former and
40-in-l,000 in the latter, a 4,000x difference. The difference in perceived threat
between these  two base risk conditions was minimal, F(l, 273) = 3.50, .05 < p  <
.1.

      Post-hoc analyses were conducted for the treatments within each story.
These calculations showed that for the low-outrage, high-risk story, the "base risk"
condition was viewed as significantly less threatening than all the other conditions
(which did not  differ from one another for this story).  Comparing the "base risk"
condition (with a lung cancer risk of 40-in-l,000 or 4%) and the "alternate risk"
condition (with a lung cancer risk of 400-in-1,000 or 40%), we see an increase in
the perceived threat scale from 13.9 to 16.2. Thus a 10-fold increase in risk
produced an  increase on the perceived threat scale of  2.3 points. Roughly the
same  increase in perceived threat was accomplished merely by describing the

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                               33
                         Figure 4
         Effects of Condition on Perceived Threat





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Alternate risk   Compare to normal Base risk + chart

-------
                                      34

radon-level as 20 times normal background levels (without providing any risk
statistics) or by adding the chart to the risk statistics in the "base risk" condition.

      For the high-outrage, low-risk story, post-hoc tests showed no significant
difference between the "base risk" condition and the "alternate risk" condition
(with a  risk ten times smaller).  In other words, people reacting to a risk of 1-in-
100,000 did not respond differently than those reacting to a risk of 1-in-1,000,000.
However, the conditions that compared the risk to normal levels or added the
chart to the risk probability information were viewed as presenting significantly
less risk than the "base risk" condition. The mean on  the perceived threat scale
declined from 12.6 in the "base risk" condition to 10.9 for the "compare to normal"
condition and to 10.4 for the "base risk + chart" condition, decreases of 1.7 points
and 2.2 points, respectively.  In a high-outrage, low-risk situation, in other words,
comparisons to background and the risk chart reduced perceived threat more than
a 10-fold  decrease in the actual probability  of lung cancer.

      The 2x2 analysis of variance involving  the high-outrage, low-risk and  the
low-outrage, low-risk stories showed a strong  story effect, F(l, 568)  = 68.4, p <
.0001, a strong treatment effect, F(l, 568) = 38.9, p <  .0001, and no interaction, p
>  .9. There was a 2.9-poim decrease in perceived threat when outrage elements
were absent from the story, an effect far greater than the effect of decreasing the
actual risk by a factor of ten.  The treatment  effect was also substantial.  Adding a
risk chart to the "base risk" condition reduced the perceived  threat scale from  9.8
to 7.6 for the low-outrage, low-risk story, and from 12.6 to 10.4 for the high-
outrage, low-risk story,  reductions of 2.2 points in both cases. The absence of an
interaction effect shows that the chart was just as beneficial in the high-outrage
condition as in the low-outrage condition.  In other words, the outrage effect and
the treatment effect were independent and  additive.  With or without the risk
chart, subjects who read the low-outrage story perceived  less threat than  those
who read the high-outrage story, though the "actual" (stated) risk level was the
same.  And regardless of which story they read,  high-outrage or low, subjects who
received the risk chart perceived less threat than subjects who received just their
own risk probability information.
Effects on Action Intentions

      The findings for action intentions were similar'to those for perceived risk.
The 2x4 analysis of variance of the low-outrage, high-risk story and the high-
outrage, low-risk story revealed a significant story effect, F(l, 1081) = 76.2, p <
.0001, a significant treatment effect, F(3, 1081) = 11.22, p < .0001, and a signifi-
cant story x  treatment interaction, F(3, 1081) =  5.00, p < .002.

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                                      35

       Figure 5 shows that the low-outrage, high-risk story ("radon") produced
greater action intentions overall than the other two.  But in the "base risk"
conditions — that is, with risk numbers only - there was no difference whatsoever
between subjects who read the low-outrage radon story and faced a high risk of
40-in-1,000 and those who read the high-outrage nuclear waste story and faced  a
low risk of 1-in-100,000.

       Post-hoc analyses were conducted within each hazard.  For the low-outrage,
high-risk story, these calculations showed that the "base risk" condition led to
significantly lower action intentions only in comparison with the 10-fold  greater
"alternate risk" condition. The comparisons to normal and the risk chart yielded
slightly lower action intentions than the "alternate risk" treatment.  These were
higher, but not significantly higher (at p  < .02) than the "base risk" condition.  For
subjects who read the low-outrage, high-risk radon story, in other words, no
explanation significantly increased action intentions above the action intentions
produced by the bare-bones risk information — though an increase in the risk from
40-in-l,000 to 400-in-l,000 did increase action intentions.

       For the high-outrage, low-risk story, in contrast, there was no difference  in
action intentions between subjects in the l-in-100,000 "base risk" condition and
those in the l-in-1,000,000 "alternate risk" condition.  However, the comparisons
to normal and the risk chart substantially decreased action plans.  Action plans  in
these two conditions were significantly lower than in both the "base risk" and the
"alternate risk" condition, and not significantly different from one another.

       The 2x2 analysis of variance involving the high-outrage, low-risk and the
low-outrage, low-risk stories again showed a strong story effect, F(l, 562) = 78.5,
p < .0001, a strong treatment effect, F(l, 562)  = 43.3,;? < .0001, and no inter-
action, p > .4. There was a 3.2-pbint decrease in action intentions when outrage
elements were absent from the story, an effect far greater than decreasing the
actual risk by a factor of ten.  And there was a 2.4-point decrease in action
intentions when a risk chart was added to the risk probability information provid-
ed to subjects. The absence of interactions between story and treatment shows
that the chart was just as influential in reducing action intentions for the high-
outrage story as for the low-outrage story.  Once again the two effects were
independent and additive.
Relationships of Anger and Distrust to Perceived Threat and Action Intentions

       Additional calculations revealed the close association between anger and
both threat perceptions and action intentions. The correlations of anger with
perceived threat averaged .70 over the ten experimental treatments, and the
correlations with action intentions averaged .58, both highly significant.

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                               36
                         Figure 5
         Effects of Condition on Action Intentions



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                                     39

       With regard to DEP's Schmidt, the 2  x 4 analysis of variance indicated a
main effect for gender F(l,1054) =  17.32, p  < .0001. Women were more distrust-
ful of Schmidt than men (means of 2.80 and  2.52, respectively).  There was also a
significant gender  x  story interaction,/r(l,1054) =  12.31, p  < .0001. Again,
women were more distrustful of Schmidt  than men in the  high-outrage nuclear
waste story (means of 3.26 and 2.82, respectively).  On the other hand, men were
more distrustful of Schmidt than women in the low-outrage  radon story (means of
2.25 and 2.18, respectively).  The 2x2 analysis of variance revealed no main
effect of gender on trust for Schmidt, but a marginal gender x  story interaction
F( 1,550) = 4.52, p < .04.  Once again; women were more distrustful than men in
the high-outrage nuclear waste story (means  of 3.22 and 3.00, respectively), while
men were more distrustful than women in the low-outrage radiation story (means
of 2.18 and 2.04, respectively).

       Within the various  stories there were  no main effects of education or
income and no interactions of treatment with gender, education, or income.

       The 2x4 analysis of variance showed a main effect of gender on anger
F( 1,1074) = 37.51, p <  .0001.  Again, women were angrier than men (means of
3.05 and 2.57, respectively).  Similarly, the 2  x 2 analysis of variance showed a
main effect of gender on anger F(l,560) = 15.48, p  < .0001, with women angrier
than men (means of 2.61 and 2.24, respectively).

       Subjects with less education were more angry than  those with more
education (p's < .01  in both the 2 x 4 and the 2 x 2 analyses of variance).
These was no significant effect of income. In neither case were there any signifi-
cant interactions of gender, education, or income with story or treatment.
Time Spent Reading the Stories and Answering the Questionnaire

       Most respondents took between 10 (coded as 1) and 15 (coded as 2) min-
utes to complete the task (mean coded value of = 2.45). To examine the effects
of this variable, it was first divided into two categories, using the median answer
as a cutting point.  Analysis of variance calculations were carried out using this
categorical variables, plus gender, story, and treatment, in a factorial design.
These calculations revealed a main effect of time spent on the task.  People who
took longer to comple the experiment perceived a significantly greater threat.

       A one-way analysis of variance, across all ten experimental conditions,
showed no significant differences in the time needed to complete the experiment.
A 2 (gender) x 10 (condition) analysis of variance revealed a main effect of
gender, F(l,1061) =  63.36, p < .001, with females taking more time to complete
the experiment than  men (means of 2.52 and 2.36, respectively).  Across all ten

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                                      40

conditions there was also a significant negative correlation between education and
time, r = -.16, p < .0001.  Partial correlations controlling for the effects of gender
and education showed a significant positive association between the amount of
time spent completing the experiment and both perceived threat, r =  .11, p <
.0001, and inclination to take action, r  =  .08, p < .002.

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                                DISCUSSION
      The research reported here, like the research in the first two budget
periods, used responses to hypothetical situations. Subjects were asked to read a
hypothetical news story, then examine a hypothetical test result for "their" home,
and finally complete a  questionnaire about their response to the hypothetical risk.
It is impossible to say how realistic subjects found these simulations and how
realistically they responded to them.  It seems likely that the effects of outrage
were diminished by the hypothetical nature of the hazards, and that the  effects of
risk magnitude and of various ways of explaining risk magnitude — especially in
the presence of high outrage — were augmented. That is, we would expect
subjects to be  more attentive to risk magnitude information and less liable to
outrage in this study than they would be in a real situation.  But no research
findings back this supposition.

      In addition, real community hazard situations develop over days, months,
or even years; the study compressed these histories into written materials that
take only a few minutes to read. Prolonged exposure to a risk controversy
probably makes people more responsive to outrage factors than they were in this
research.  We  do not know whether it might make them more or less responsive
to explanations of risk  magnitude.  No studies bear on this point either.

      The present simulation research strategy has obvious advantages in terms
of feasibility, efficiency, and the avoidance of ethical problems. Nonetheless, the
time is approaching when these findings need to be confirmed in situations where
citizens are making decisions about real hazards.
The Effects of Comparisons to Normal Background

      The most surprising finding of this research was the powerful impact of
comparisons to normal background levels on threat perceptions and action inten-
tions. The "compare to normal" treatment was originally intended as a baseline
control condition, since no information about the size of the risk was provided.
The comparison to normal background was added to make the treatment more
realistic for subjects.


                                     41

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                                     42

       Despite having no information at all about the likelihood of harmful conse-
quences, subjects responded strongly to the information that their radiation expo-
sure in the low-outrage, high-risk story ("radon") was 20 x higher than normal
background radiation, or that their radiation exposure in the high-outrage,  low-
risk story ("nuclear waste") was 200 x lower than normal background. Compared
to the  "base risk" condition, comparisons to normal increased perceived threat for
the radon story and decreased both perceived threat and action intentions for the
nuclear waste story.  In other words, when subjects were given a comparison of
the risk from the situation in the news story to the risk from their normal back-
ground exposure, this comparison did a better job than risk information itself in
helping them respond in proportion to the actual risk. Phrased another way,
comparisons to normal background helped subjects respond more to the high-risk
radon situation even though the outrage was small, and respond less to the low-
risk nuclear waste situation even though the outrage was great. The effect of the
comparison to normal was equal to the effect of a 10-fold increase in risk for
radon; it was greater than the effect of a 10-fold decrease in risk for nuclear
waste.

       The impact of comparisons to normal background on anger is also worth
noting, since this appears to be an effect on outrage. Subjects in the high-outrage
"nuclear waste" conditions were understandably angry. Their anger was reduced
far more by the knowledge that the situation posed a risk 200 x less than normal
background than by the knowledge that the risk posed was a mere l-in-100,000 or
even a mere 1-in-l,000,000.  In other words, the illegal and intentional use  of
radioactive sand in construction of their homes' foundations generated far less
anger among subjects when it was described as a risk 200 x less than normal
background radiation than when  it was described as a 1-in-1,000,000 risk.

       The potency of the comparison to normal background and its symmetry
(that is, its effectiveness in both low-outrage, high-risk situations and high-outrage,
low-risk situations) suggest that it may be a valuable piece of information to
include in any risk communication - at least when the information is available.  In
the research reported here, background levels were known and could be expressed
in the same units as the levels from the hypothetical situation: picoCuries of
radiation per liter of breathable air.  In many situations such a direct comparison
to normal background is not possible.

       In effect,  people may view the normal background exposure as the maxi-
mum safe exposure, regardless of the level of risk it presents.  This exposure can
then serve as an anchor or comparison standard (Slovic, Fischhoff, & Lichtenstein,
1982) for their risk judgments, with higher levels seen as "unsafe" and lower levels
as "safe." It is important to note that comparisons to normal can be very mislead-
ing.  If a hazardous substance is extremely rare in nature, one can  have  an

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                                     43

exposure that is many times background but still so low that the risk it presents is
vanishly small.

      The study also leaves unclear the impact of comparisons to normal
background for risks that are less serious than 20 x  greater than background but
more serious than 200 x smaller than background.  Suppose a neighborhood's
exposure to effluent from a nearby factory is equal  to normal background for a
particular chemical; the factory thus doubles the neighborhood's total exposure to
that chemical.  Deciding that 20 x  background is serious or that 200 x  less than
background is trivial is a comparatively easy decision; how would citizens interpret
an exposure that was roughly the same as background?  Would such information
increase or decrease threat perceptions and action intentions?  Or would the
direction of its impact depend  on other factors?  Or would it have no impact at
all?  The answers to these questions are not known.

      In the research reported here, the low-outrage, low-risk story did  not
include a "compare to normal" condition, so it is not possible to say how this
treatment would fare when both outrage and risk are low.  Given its success
under low-outrage, high-risk and high-outrage, low-risk conditions, however, it
seems reasonable to surmise that it would probably work well in low-outrage, low-
risk situations as well.

      It should not be forgotten that a comparison to background does not
constitute risk information. For some hazards, normal background levels are
sufficient to constitute a meaningful health risk, and even a small increment would
be unwise if it were preventable. For other hazards, the risk due to normal back-
ground exposure is negligible, and an exposure many times background would still
be negligible. It is not easy to find two agents known to be harmful such that an
exposure of 200 x less than background to one is more serious than an exposure
of 20 x greater than background to the other.  But with lower multiples,  it would
not be hard to find examples where comparisons to background give impressions
contrary to the actual risk  magnitudes, and are thus misleading.

      Nonetheless, the finding is clear.  When a risk adds only a very small
percentage to normal background, people readily conclude that it is not too
serious; when it adds a large multiple of normal background, they readily con-
clude that it is quite serious. At least with the large multiples and small fractions
of "normal" studied here, information about how a target risk compares to normal
background levels has more impact on perceived threat and action intentions than
numbers describing the odds of experiencing harmful effects.

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                                      44

The Effects of the Risk Chart

       Similar effects were achieved by supplementing the "base risk" condition
with a chart that included a risk ladder (with the target risk high on  the ladder for
the "radon" story, low on the ladder for the "nuclear waste" and "radiation"
stories), risk comparisons, and a recommended action standard.  The chart
decreased perceived threat in both low-risk situations (the high-outrage "nuclear
waste" situation and the low-outrage "radiation" situation), while it increased
perceived threat in the  high-risk "radon" situation.  The effects of the chart were
roughly equal to the effects of comparisons to normal background - equally
effective as a 10 x increase in actual risk for radon, and more effective than a
10 x decrease in actual  risk for nuclear waste. Similarly, the chart decreased
action intentions for "nuclear waste" and "radiation," though the effect on action
intentions for "radon" was not significant.

       The "base risk + chart" treatment was initially conceptualized as a  "maxi-
mum impact" treatment, incorporating all the approaches found  effective in the
previous research.12 Note, however, that it  did include some of the comparison
information that proved so effective in the "compare  to normal"  treatment.
Comparisons to normal background were included on the chart,  along with
comparisons to the risk from stroke, colon/rectal cancer, and diabetes. At the top
of the risk ladder, the chart showed "25 times average radon [or radiation] level";
a little over halfway up the ladder, the chart showed  "15 times average radon [or
radiation] level"; near the bottom of the ladder, it showed "average outdoor radon
[or radiation] level."13  Thus, a subject who  studied the chart carefully could
deduce that his or her risk was far above normal background for the radon situa-
tion, and far below normal background for  the other two. This information was
far less emphasized, however, than it was in the "compare to normal" treatment.

       No experimental treatment combined the "compare to normal" and the
"base risk + chart" treatments. We know that either comparisons  to normal
background or  risk information supplemented with a risk ladder, risk comparisons,
and an action standard  works better than risk  information alone — whether the
goal is to increase attention to a  big risk or decrease concern about a small one.
We do not know if the  combination of an explicit comparison to normal back-
ground plus the risk chart would  work better than either alone, nor can we be
   12Except for the recommended action standard at 4 picoCuries per liter, the "base risk + chart"
treatment did not include action advice at other risk levels, though the research in the first budget
period showed such advice at various levels to be helpful.  Advice was kept off the chart partly to
avoid excessive clutter and partly because action advice for radon is largely a function of mitigation
feasibility, a variable that we did not wish to add to the study.

   13For the radon story, the term used was "radon." For the other two stories, it was "radiation."

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                                      45

certain that the risk chart would be effective without the comparisons to normal
background embedded in it.

      This study had no true baseline "control" condition.  The treatment that
was supposed to have constituted the control - comparisons to background
without risk information — turned out to be just as effective as the most effective
collection of risk information identified in previous research.  The "base risk"
treatment — in which subjects were told simply that their risk was either 40-in-
1,000 (radon) or 1 -in-100,000 (nuclear waste and radiation) —  was thus the only
baseline available. The "base risk +  chart" condition constituted a significant
improvement over this baseline.  For all three hypothetical situations, the chart
significantly influenced threat perceptions — decreases when the actual risk was
low,  increases when it was high.  It similarly decreased action  intentions when the
actual risk was low, though the effect on action intentions for  the high-risk "radon"
story was not significant.
The Effects of Risk Magnitude

      The research in the second budget period demonstrated an effect of risk
magnitude on risk perception.  This finding was replicated in the research report-
ed here.

      Although the study had no true baseline control, we can compare responses
to the low-outrage, low-risk situation and the low-outrage, high-risk situation to
get a measure of risk effects independent of how the risk was explained. For both
the "base risk" treatment and the "base risk + chart" treatment (the only two used
for the low-outrage, low-risk story), subjects experienced higher threat perceptions
and action intentions  when the risk was high  than when the  risk was low. The
difference between the two was greater in the "base risk + chart" condition than
in the "base risk" condition, demonstrating that the chart helped subjects respond
appropriately to the level of risk. But even with the bare  data provided  in the
"base risk" condition,  a 40-in-1,000 risk yielded higher threat perceptions and
action intentions than a 1-in-100,000 risk.

      The "alternate risk"  treatment provided a more sensitive test of the same
question.  For the low-outrage, high-risk situation, a 10 x increase in risk (from
40-in-1,000 to 400-in-1,000) yielded a significant increase in threat perceptions and
action intentions.  But for the high-outrage, low-risk situation, a 10 x decrease in
risk (from 1-in-100,000 to 1-in-1,000,000) did  not significantly affect threat
perceptions or action intentions. It is not unreasonable that people would
respond more to the first difference than to the second. Though both differences
are one order of magnitude, in absolute terms the first is by far the greater
difference. Once a risk gets as low as 1-in-100,000,  moreover, further declines

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                                      46

may well be psychologically irrelevant or difficult to comprehend.  Very little is
known about the relationship between the level of risk and the impact of a change
of constant proportion, but it seems logical that halving or doubling a large risk
would yield more change in response than halving or doubling a tiny one.
(However, results from the "compare to normal" treatment suggest that expressing
differences in terms of risk ratios may lead people to respond as much to a
change from  1-in-1,000,000 to l-in-100,000 as to a change from l-in-1,000 to 1-in-
100.)

      Another possible explanation for these findings might be that high outrage
reduces people's response to changes in risk magnitude.  The "alternate risk"
treatment was not used for the low-outrage, low-risk situation, so it is impossible
to assess this possibility.
Outrage Effects and Outrage Reduction

       Subjects in the high-outrage situation ("nuclear waste") were of course
much angrier than in the two low-outrage situations, and they were much more
distrustful of the DEP  spokesperson, Schmidt.  It is noteworthy that they were not
more distrustful of the neutral information source, Dr. Baxter.  This suggests that
the distrust that typically characterizes high-outrage risk controversies need not
contaminate all actors; an independent expert who is not affiliated with the
distrusted authorities can sometimes be trusted.

       Not surprisingly, outrage affected threat perceptions and action intentions.
That is, subjects in the high-outrage, low-risk situation reported much higher per-
ceived threat and higher action intentions than subjects in the low-outrage, low-
risk situation, although the actual risk was identical.  In addition, anger was highly
correlated with threat perceptions and action intentions, as was distrust of the
DEP spokesman for subjects in the high-outrage conditions.

       When subjects received only risk numbers, the outrage effect was just as
large as the 4,000-fold  difference in risk between the high-risk and low-risk
conditions.  In other words, there were no significant differences in threat percep-
tions or action intentions between the  "base risk" treatments for the radon story
(at a risk of 40-in-1,000) and the nuclear waste story (at a risk of l-in-100,000).
When  communication was improved by comparisons to normal  background levels
or by the risk chart,  however, the outrage effect, though still substantial, was
smaller than the 4,000-fold difference in risk.

       Most encouraging is the apparent ability of some kinds of risk information
to reduce threat perceptions and action intentions even in the presence of high
outrage. Both comparisons to normal  background and the risk  chart had this

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                                      47

effect for subjects exposed to the "nuclear waste" scenario.  Many practitioners
have suggested that when people are outraged, explanations of the risk data are
unlikely to prove fruitful.  In the study reported here, outrage certainly increased
threat perceptions and action intentions — but outrage did not diminish the ability
of comparisons to background and risk charts to reduce threat perceptions and
action intentions.

      And if anger is a measure of outrage itself, then both comparisons to back-
ground and risk charts actually influence outrage. Both treatments reduced anger
for subjects who read the high-outrage, low-risk "nuclear waste" story.

      Much  more work needs to be done on the relationship between outrage
and risk perception, but two conclusions are apparent from this study.  First,
outrage significantly affects risk perception.  Second, well-handled explanations of
risk magnitude from a trusted source significantly affect risk perception even when
outrage is high, and may significantly affect outrage itself. When people are  angry
and upset about a high-outrage, low-risk situation, it may be that explanations
coming from  the distrusted source of the trouble do not help much.  Merely
providing risk probability  data also does not appear to help much, even if the
source is trusted. But considerable reductions in threat perceptions and action
intentions are possible when a trusted, neutral source offers a comparison to  back-
ground or a chart with a risk ladder, risk comparisons, and an action standard.

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                              REFERENCES
Covello, V.T., P.M. Sandman, and P. Slovic, Risk Communication, Risk Statistics,
      and Risk Comparisons (Washington, DC: Chemical Manufacturers Associa-
      tion, 1988).

Covello, V.T., and F.W. Allen, "Seven Cardinal Rules of Risk Communication"
      (pamphlet), U.S. Environmental Protection Agency, Washington DC, April
      1988.

Hance, B.J., C. Chess, and P.M. Sandman, Improving Dialogue with Communities:
      A Risk Communication Manual for Government (Trenton, NJ: Division of
      Science and Research, New Jersey Department of Environmental Protec-
      tion, 1988).

Hance, B.J., C. Chess, and P.M. Sandman, Industry Risk Communication Manual
      (Boca Raton, FL: CRC Press/Lewis Publishers, 1990).

Ibrekk, H., and M.G. Morgan, "Graphical Communication of Uncertain Quantities
      to Nontechnical People," Risk Analysis, 1987, pp. 519-529.

Kaplan, R.M., B. Hammel, and L.E. Schimmel, "Patient Information Processing
      and the Decision to Accept Treatment," Journal of Social Behavior and
      Personality, 1, 113-120, 1985.

Kasperson, R.E., "Six Propositions on Public Participation and Their Relevance
      for Risk Communication," Risk Analysis, 1986, pp. 275-281.

Krimsky,  S., and A. Plough, Environmental Hazards: Communicating Risks as a
      Social Process (Dover, MA: Auburn House, 1988).

Sandman, P.M., "Risk Communication: Facing Public Outrage," EPA Journal,
      November 1987, pp. 21-22.
                                    48

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                                    49

Sandman, P.M., "Risk = Hazard + Outrage: A Formula for Effective Risk
      Communication" (videotape) (Fairfax, VA: American Industrial Hygiene
      Association, 1991).

Sandman, P.M., Responding to Community Outrage: Strategies, for Effective Risk
      Communication (Fairfax, VA: American Industrial Hygiene Association,
      1993).

Sandman, P.M., P.M. Miller, B.B. Johnson, and N.D. Weinstein, "Agency Commu-
      nication, Community Outrage, and Perception of Risk: Three Simulation
      Experiments," Risk Analysis, 13 (6), 1993, pp. 589-602.

Sandman, P.M., N.D. Weinstein, and M.L. Klotz, "Public Response to the Risk
      from Geological Radon," Journal of Communication, Summer 1987, pp. 93-
      108.

Slovic, P., "Perception of Risk," Science, April 17, 1987, pp. 280-285.

Slovic, P., B Fischhoff, and S. Lichtenstein, "Facts Versus Fears: Understanding
      Perceived Risk," in D. Kahneman, P. Slovic, and A. Tversky (eds.), Judg-
      ment Under Uncertainty: Heuristics and Biases (Cambridge: Cambridge
      University Press, 1982), pp. 463-489.

U.S. Environmental  Protection Agency,  Unfinished Business: A  Comparative
      Assessment of Environmental Problems (Washington, DC: U.S. Environmen-
      tal Protection Agency, February 1987).

U.S. Environmental  Protection Agency, Reducing Risk (Washington, DC: U.S.
      Environmental Protection Agency, 1990).

Weinstein, N.D., and P.M. Sandman, Evaluating Risk Comparisons for Use in the
      Citizen's Guide to Radon (Washington, DC: Office of  Policy, Planning and
      Evaluation and Office of Radiation Programs, U.S. Environmental Pro-
      tection Agency, November 1991).

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                                                   Visual Display
                   Testing  a  Visual  Display  for
                  Explaining  Small Probabilities
Neil D. Weinstein, Peter M. Sandman, and William K. Hallman

Cook College
Rutgers, The State University of New Jersey,
Running head:  "Visual Display"
                                Al

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                  Appendix A

Paper Describing Pilot Work on Graphic Displays:

    Testing a Visual Display for Explaining
              Small Probabilities

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                                                   Visual Display
                   Testing a Visual Display to
                   Explain Small Probabilities
  Neil D. Weinstein,1'2 Peter M. Sandman3 and William K.  Hallman1

                             Abstract
     Two experiments investigated the report of Kaplan et al.'1'
that a grid of dots representing the denominator of a small
probability helped subjects understand  that the risk was small.
Study One compared perceptions of several probabilities  (1/50,
200/10,000 and 1/10,000) and several formats (no dots, dots for
probabilitiy denominator, and dots and  X's representing the
denominator and numerator, respectively) in the context of two
hypothetical health risk decision problems.  Study Two more
precisely replicated the original Kaplan et al. experiment.
Neither study found any significant effect of  the visual displays
on action intentions, and only small effect's on perceived threat
were observed.
Key Words:     Risk communication; risk perception; visual dis-
               play; graphics; risk probability
                                A2

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                                                   Visual Display
1. INTRODUCTION
     Statements made by government officials and industry
representatives often imply that the fundamental cause of
disagreements over risk issues is the public's failure to
understand the sizes of the risks in question.  Overestimation of
low-probability risks is viewed as the reason for excessive
concern; failure to appreciate high-probability risks, is seen as
an important reason why people fail to take recommended
precautions.  Although responses to risks are certainly much more
complicated than is suggested by such an analysis — and agreement
that a risk is small is not the same as saying the risk is
acceptable — there is nonetheless a need for ways of communi-
cating better with the public about the sizes of risks.
     Among the avenues that have been examined for helping people
appreciate risk magnitudes are comparisons with more familiar
risks'2"4' and choosing verbal labels to designate probabilities of
different sizes.(5<6>  Weinstein, Sandman, and Roberts(7> and
Weinstein, Sandman, and Miller<8> have studied a variety of format
variables, including .comparisons to smoking, action standards,
evaluative labels for different exposure levels, and advice.
     The efficacy of conveying risk magnitudes through visual
displays has received very little empirical attention.  Wein-
stein, Sandman, and Roberts(7) found no differences in effect
between a histogram and a textual presentation of the same risk
information.  Weinstein, Sandman, and Millerc8<9> found that the
location of an assigned level on a exposure "ladder" helped
orient subjects to their risk; with the risk itself held con-
stant, subjects perceived it to be higher when it appeared near
the top of the ladder than when it appeared near the bottom.
                                A3

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                                                   Visual  Display
     One visual display  sometimes used  is  a matrix of dots or
other symbols to represent the  likelihood  of the risky event
under discussion.  For example, the U.S. Environmental Protection
Agency's Citizen's Guide to Radon<10) used a grid containing
outlines of heads, with  some outlines replaced  by a black  square,
to indicate the probability of  cancer from exposure to different
radon levels.  The effectiveness of this particular display has
not been evaluated.
     The results of a study by  Kaplan,  Hammel,  & Schimmel<1>
suggest that such visual displays can help people understand
small probabilities and  can encourage them to take actions that
,are appropriate for the  size of the risk.  In their
investigation, college students were asked to decide whether they
would choose to be vaccinated against a life-threatening influ-
enza epidemic.  The vaccination was highly effective, but  carried
a small probability of undesirable, but non-fatal, side effects.
In one condition the likelihood of side effects was the same as
the likelihood of getting influenza and dying;  in the other two
conditions the likelihood of side effects  was much smaller than
the likelihood of dying.  Subjects were more likely to choose
vaccination if the probability  of these side effects was
accompanied by a display of dots (for a risk of 1 in 10,000, for
example, subjects compared a page containing 1 dot with another
page containing 10,000 dots).   In other words, the display
appeared to help subjects see that the  likelihood of suffering
side effects was sufficiently small to  justify receiving the
vaccine.  Thus, the present studies were design to explore this
promising risk communication technique.
2. STUDY ONE
                                A4

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                                                   Visual Display
     Study One compared reactions to a numerical presentation of
the odds with reactions to a grid of dots reflecting the
demoniator of the odds ratio.  Two risk levels were used, 1 in 50
and 1 in 10,000.
     Another issue examined was the potential difference between
a format displaying only the denominator of the odds ratio and
one displaying both numerator and denominator.  Lippman-Hand and
Eraser, (11)  in discussing responses to genetic  counseling,  have
suggested that some clients focus on the denominator of the odds
ratio.  When the risk is 1 in 100, for example, clients are reas-
sured by attending to the large number who do not suffer prob-
lems.  But other clients focus on the numerator, and are fright-
ened by the vivid image of that one person in a 100 who does
suffer harm.
     Study One addressed this issue by compainrg two types of
visual displays:  a) a grid of dots reflecting only the denomi-
nator of the odds; and b)  X's added to indicate on this grid
which specific individual(s) experienced harmful effects  (as in
the EPA radon brochures).   To exaggerate this factor we added a
third risk condition of 200 in 10,000 (equivalent to 1 in 50).
We expected that a display showing 200 "victims" in a field of
10,000 dots would make the situation appear much more dangerous
than a display that showed 10,000 dots and only mentioned the
odds being 200 in 10,000,  or a display that showed 50 dots and
mentioned the odds being 1 in 50, or a display that showed one X
out of 50 dots.
2.1 Design
     The two different decision dilemmas, three odds ratios, and
three formats were crossed in a 2 x 3 x 3 factorial design.
                                A5

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                                                   Visual Display
2.2 Subjects and Procedure
     Subjects were college students at Rutgers University en-
rolled in one of four different large classes.  The sample  (N =
896) was 34.9% male.  An experimenter visited each class and
asked for assistance in a study of how people make decisions
about environmental and health risks.  Each student received a
experimental booklet and responded to it in this group setting.
Assignment to condition was random.  Although participation was
voluntary, it appeared that at least 90% of those present took
part in the study.
2.3 Materials
     Page one of the experimental booklet presented a decision
dilemma,  page two contained the visual representation of the risk
(when used) and pages three and four constituted the assessment
questionnaire.
     Hazard dilemmas.  Two different decision problems were used,
with each student responding to one only.  The Insecticide
Contamination dilemma concerned a misapplication of a pesticide
in a dormitory that posed a risk of minor but permanent nerve
damage.   "The damage, if it occurs, is mild, such as tingling or
numbness on fingers or toes."  The choice offered was: stay in
the dormitory and accept the risk, or endure the inconvenience of
moving out and eliminate the risk.  Experts' estimates of the
probability of nerve damage to students who remained in the
dormitory were provided, either "1 in 10,000," "200 in 10,000,"
or "1 in 50."
     The Influenza Vaccine dilemma concerned a severe strain of
influenza that would soon spread to the area.   If they contracted
the disease,  young adults were likely to experience two to. three
                               A6

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                                                   Visual Display
weeks in bed and night be unable to finish the semester.  A
vaccine was available that offered almost total protection, but
it posed a risk of minor but permanent nerve damage.  The nerve
damage effects and the probability of nerve damage were described
exactly as for the pesticide.  Unlike the Kaplan et al.n) study,
no numerical value was given for the likelihood of contracting
influenza.
     Visual depiction of probability.  Three formats were used.
(1) Subjects receiving the Numbers formats received no visual
aid.  (2) Subjects receiving the Denominator formats saw a
regular grid of dots, with the number of dots equal to the
denominator of the risk probability they were considering (i.e.,
either 50 dots or 10,000 dots).  The density of the dots was held
constant, so the 50 dots occupied an area approximately 1/2 inch
by 5/8 inches and the 10,000 dots.occupied an area approximately
7 1/2 inches by 9 inches.  Above the grid was an explanatory
statement, such as the following: "To help you get a sense of
what that number [e.g., 1 in 10,000] means, this page shows what
10,000 dots look like."  (3) Subjects receiving the Numerator
Plus Denominator formats saw a similar grid, except that some
dots were replaced by X's to represent the numerator of the risk
probability, i.e., the number of victims out of the full group.
     Assessment instrument.  Four questions were employed to
assess perceived risk.  These referred to: the perceived danger
of deleterious effects from the vaccine/pesticide (1 = no danger,
6 - very serious danger); the likelihood of experiencing negative
side effects from the vaccine/pesticide (1 = no chance, 7 =
certain to happen); how concerned about side effects respondents
would be if they chose to get,the vaccine/stay in the dormitory
                               A7

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                                                   Visual Display
(1 = not at all concerned, 5 = extremely concerned); and how
worried about side effects respondents would be if they chose to
get the vaccine/stay in the dormitory  (1 = not at all worried, 5
= extremely worried).
     Four questions elicited action intentions.  These referred
to the subject's own decision about obtaining the vaccine/staying
in the dormitory, the advice the subject would give to a friend,
the advice to a friend if contracting the flu/moving from the
dormitory would ruin the friend's semester, and the advice to a
friend who planned a sports career that would be ruined by nerve
damage (for all, 1 = definitely move out of the dormitory/not get
the vaccine, 5 = definitely stay in the dormitory/get the vac-
cine) .  Note that subjects who wanted to escape the risk of nerve
damage from pesticide exposure would tend to take action, i.e.,
move out of the dormitory.  In contrast, sujbeets who wanted to
escape the risk of nerve damage from the vaccine would be led
toward inaction, i.e., not get vaccinated.
     The questionnaire also' asked subjects to describe how we'll
the risk from the vaccine/pesticide had been explained (1=1
have a very good understanding of the risk, 4=1 feel very
uncertain about the risk).
2.4 Results
     Answers to the four questions relating to perceptions of
risk were added together to form a single scale of perceived
threat (alpha = .76), and answers to the four questions relating
to the action decision were added together to form a single
measure of action intentions (alpha = .81).  Group means are pre-
sented in Table 1.
     These data were examined by a 2 (Dilemma) x 3 (Odds Ratio) x
                                A8

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                                                   Visual Display
3 (Format) analysis of variance.  The tests of greatest interest
are the Format main effects and the interactions of Format with
Odds Ratio and Dilemma.
     The Format main effect approached significance for the
perceived threat of the pesticide/vaccine side effects, F(2,862)
= 2.91, p_ = .055, but not for action intentions, F(2,862) < 1.
Post-hoc tests on the threat variables indicated that no formats
differed reliably (E < .05) from any others.  Looking at the
separate components of perceived threat revealed significant
Format effects on perceived likelihood, p_ < .01, and concern, p_ <
.05, but not on danger or worry, p_'s > .3.
     There were no significant interactions with Format:  Format
x Odds Ratio,  F(4,862) = 1.56, p_ > .15 for threat and F(4,862) <
1 for action;  Format x Dilemma, F(2,862)  = 2.17, p_ = .11 for
threat and F(2,862)  < 1 for action; and Format x Odds Ratio x
Dilemma, threat and action F's < 1.
     Not surprisingly, the analysis did reveal significant
effects of Odds Ratio on perceived threat, F(2,862) = 65.8, p. <
.001 and action intentions, F(2,862)  = 35.5, p_ < .001.  Appropri-
ately, subjects reacted more to odds of 1 in 50 or 200 in 10,000
than, to odds of 1 in 10,000.
     There were also significant Dilemma effects.  The perceived
threat from the pesticide exposure was greater than the perceived
threat from the side effects of vaccination, F(l,862)  = 25.1, p. <
.001.  The difference in action intentions, however, was in the
opposite direction.   Subjects given the pesticide scenario were
more inclined to stay in the dormitory and risk nerve damage
(when the alternative was moving out) than those given the
influenza scenario were inclined to get vaccinated and risk nerve
                                A9

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                                                   Visual Display
damage (when the alternative was possibly getting influenza),
1(1,862)  = 228, E <  .001.  Neither of the Hazard x Odds Ratio
effects was significant, F(2,862) = 2.02, E = .13 for threat and
ฃ(2,862)  = 1.2, E >  .3 for action.
     Additional tests showed that subjects in the Denominator and
Numerator Plus Denominator conditions felt they understood the.'
size of the risk better than subjects in the Numbers condition,
F(2,891)  = 5.4, ฃ <  .005, but the differences were very small
(means of 2.19, 2.02 and 1.98, for the Numbers, Denominator, and
Numerator Plus Denominator conditions,- respectively).
3. STUDY TWO
     Several factors might explain our failure in Study One to
find effects of the visual display of probabilities on behavioral
intentions.  First, we used a series of verbal categories to
assess behavioral intentions, whereas Kaplan et al. asked for a
                                        t
single numerical response (the percentage likelihood of vaccina-
tion) .  Second, our decision dilemmas — even the one pitting
influenza against the side effects of vaccination — were not
identical to those used by Kaplan et al.  In particular, we did
not provide a numerical value for the likelihood of contracting
influenza if' no vaccination was obtained.  Third, Kaplan et al.
used a version of the dot matrix differing slightly from the one
we tested:  they gave subjects the risk numerator (a single dot)
on one page to compare with the numerator in dots on another
page.  Fourth, it is possible that .our subjects reviewed the
experimental booklets less carefully than had subjects in the
Kaplan et al. study.
     Study Two was designed to eliminate these differences.   Only
one decision dilemma (vaccination) was used, with wording taken
                               A10

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                                                   visual Display
directly from that used by Kaplan et al.   A new risk perception
question was added to the assessment instrument, a replicate of
the Kaplan et al. question asking for a numerical estimate of the
likelihood of vaccination.  A new format was added with the risk
denominator on one page and the numerator on another.  Finally,
rather than administering the experiment to a large college
class, subjects were approached one at a time, and a condition
was added in which the research materials were administered one
step at a time, to make certain that subjects spent enough time
looking at the visual display of the odds.
3.1 Design
     Only one decision dilemma and-one level of risk were used.
There were four format conditions.
3.2 Subjects
     Subjects were college students at Rutgers University.  The
sample (N = 287) was 47.7% male.
3.3 Materials
     Decision problem.  All subjects received the same decision
problem.  They were asked to imagine that their doctor had told
them about a serious flu epidemic that was approaching.  Without
vaccination they would have "one chance in twenty (1/20)V of
contracting the disease.  Furthermore, if they did contract the
disease they would have "one chance in fifty (1/50)" of dying
from it.  "This means that without receiving the vaccine you now
have one chance in a thousand (1/1,000) of dying as a result of
this flu."  If they decided to receive the vaccine there would be
no chance of getting the flu.  However, the vaccination carried
the risk of a rare side effect,  the Guillain-Barre Syndrome,
producing partial paralysis of the head, face, neck, and upper
                               All

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                                                   Visual Display
body.  The risk of experiencing the Guillain-Barre Syndrome was
"one chance in ten thousand (1/10,000)."
     Visual depiction of probability.  Four formats were used.
(1) Subjects receiving the Numbers format received nothing
additional to help them comprehend the risk.  (2) Subjects
receiving the Denominator format were told that a representation
was provided "to help you visualize the probability of being
adversely affected by the vaccine:  On the next sheet of paper
there are 10,000 dots.  When you think about 1 dot out of those
10,000 you will be able to see the chance you have of contracting
Guillain-Barre Syndrome as a result of the vaccine."  The dots
were spread over a 7" x 9" area in a regular grid.  (3) Subjects
receiving the Denominator Plus One format (duplicating the format
of Kaplan et al. received the page of dots plus a subsequent page
with only one dot.  Their instructions said, "When you compare
those [10,000] dots to the single dot on the following page, you
will be able to see the chance you have" of experiencing the side
effects of the vaccine.  (4) Subjects in the Controlled Presenta-
tion group received the same materials as those receiving the
Denominator format, although the manner of presentation was
different.
     Assessment instrument.  The first evaluation question
duplicated that of Kaplan et al.  Subjects were asked to estimate
the probability that they would choose to obtain the vaccine on a
scale of "0 to 100, with 0 meaning, 'I absolutely would not take
the vaccine,' and with 100 meaning 'I am certain that I would
take the vaccine.'"  The four questions used to assess perceived
risk, the four questions used to assess action intentions,  and
the question used to assess perceived understanding of the risk
                               A12

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                                                   Visual Display
were the same as those used in Study One.  One additional/ open-
ended question asked subjects to explain how they had made their
decision about getting vaccinated.
3.4 Procedure
     Individual subjects were approached in public places, such
as cafeterias and lounges, and were asked to participate in a
study of decision-making about risky situations.  The cooperation
rate was 94%.
     Subjects were assigned randomly to format.  Those in the
Numbers, Denominator, and Denominator Plus One groups received
the decision problem, visual representation of the risk probabil-
ity (except in the Numbers group), and assessment questionnaire
at the same time.  In the Controlled Presentation group these
three items were handed to subjects one at a time, as subjects
indicated their readiness to proceed to the next step, in order
to ensure that subjects spent time examining the grid before they
began to answer the questionnaire.
3.5 Results  ,
     Experimental effects.  As in Study One,, the answers to the
four questions relating to perceptions of the risk from receiving
the vaccine were added together to form a single scale of
perceived threat (alpha = .80) and the answers to the four
questions relating to the decision to receive the vaccine were
added together to form a measure of vaccination intentions (alpha
= .86).  The association between these two variables was only
moderate, with higher perceived threat associated with less
intention to be vaccinated, ฃ = -.39, E < .001.  Table 2 presents
the group means for these variables, for the probability of
action, and for the perceived understanding of the risk from the
                               A13

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                                                   Visual Display
vaccine.
     Analysis of variance calculations found no effect of format
on the self-reported probability of vaccination, ฃ(3,267) = .28,
ฃ > .5, on the vaccination intentions scale, ฃ(3,283) =  .24, g >
.5, or on self-reported understanding of the risk, ฃ(3,279) =
1.37, E > .25.  (The number of cases in these analyses varies
slightly depending on missing data.)
     There was a significant format effect on perceived threat,
ฃ(3,280) = 2.90, p < .04.  Post-hoc tests using Tukey's procedure
showed significant differences only between the two extreme
means, with perceived threat being higher in the Denominator Plus
One group than in the Controlled Presentation group.  Additional
tests showed that the Controlled Presentation group had the
lowest perceived risk on all four items from the threat scale.
These between-format effects were appreciable for concern, p. -
.07, and worry, j> < .05, but not for the perceived danger and
likelihood of vaccination side effects, j>'s > .15.  Note, that
none of the three formats using dots was significantly different
from the format using only numbers.
     Reasons for decisions.  In contrast to the discrepancies
between the present findings and those reported by Kaplan et al..
one interesting result appeared in both investigations:  Subjects
were surprisingly reluctant to choose vaccination.  In Study Two,
partial paralysis from vaccination certainly seems preferable to
death from influenza, and the likelihood of paralysis was de-
scribed as ten times smaller than the likelihood of dying from
influenza.  Consequently, vaccination seems to be the obvious
choice.  Nevertheless, the mean reported probability of
vaccination was only 66%-70% across conditions.
                               A14

-------
                                                   Visual Display
     To explore this outcome further, the explanations subjects
had given for their decisions in the Study Two open-ended
question were examined.  Approximately equal numbers of ques-
tionnaires at each level of the 5-point, personal decision ques-
tion (where choices ranged from "definitely would not get vacci-
nated" to "definitely would get vaccinated") were coded by two.
assistants (N = 206).  Four coding categories used were: conse-
quences of vaccination, consequences of influenza, likelihood of
vacci.nation side effects, and likelihood of influenza.  Each code
also indicated whether the answer referred to low threat (e.g.,
likelihood is small, consequences are minor) or to high threat
(likelihood is great, consequences are severe).  Multiple codes
for each answer were permitted.
     About one-quarter ofthe subjects mentioned consequences (of
influenza or side effects)  only, about one-quarter mentioned
likelihood (of influenza or side effects) only, about one-quarter
mentioned both consequences and likelihood, and about one-quarter
mentiond neither.  The subjects alluding to likelihood clearly
favored vaccination:  38.1% referred to the likelihood of
influenza as large or the likelihood of vaccination side effects
as small, whereas only 12.9% referred to the likelihood of
influenza as small or the likelihood of vaccination side effects
as large.  In contrast, subjects mentioning consequences were
nearly equally divided between those favoring vaccination (23.3%
mentioning consequence of influenza as serious or consequences of
vaccination side effects as minor)  and those contrary to
vaccination (21.4% mentioning consequences of influenza as minor
or consequences of vaccination side effects as serious).
     In other words, although the probabilities presented in the
                               A15

-------
                                                   Visual Display
decision problem were seen by most subjects as favoring
vaccination, the consequences were not seen as consistently
favoring any particular decision (and, as mentioned earlier, only
about half the subjects did mention probability issues).
     We suspect that labeling the health threat as "flu"  and
mentioning symptoms associated with typical cases of influenza
•("inflamation of the respiratory tract, fever, muscular pain, and
irritation in the intestinal tract") made it difficult for
subjects to see this as a potentially fatal illness, even though
the decision problem explicitly stated that "your doctor" says
that "if you do contract the flu, you have one chance in fifty of
dying from it."  Had the health threat been either unfamiliar or
a disease entity considered life-threatening, we believe that
subjects would have chosen vaccination with greater certainty.
     It is also worth noting that the vaccination dilemma con-
trasted purposeful exposure to a risk (vaccination) with passive
waiting and contrasted an unfamiliar threat (Guillain-Barre
Syndrome) with a familiar alternative.
4. DISCUSSION
     These investigations failed to replicate the results of
Kaplan et al.. even when we reproduced their study virtually
intact.  In neither of our two studies was any visual display
significantly different from the numbers only group in either
threat perception or action intentions.  Because of the large
samples used, the failure to detect format effects can not be
attributed to inadequate statistical power in the experimental
design.  No plausible reason appears to explain the discrepancy
between our results and theirs.
     Visual displays can vary along many dimensions, and versions
                               A16

-------
                                                   Visual Display
different from those examined here or employed in different ways
than those utilized here may eventually prove to be quite help-
ful.  Furthermore, it should be recognized that the effects of
visual displays when probabilities are large may be quite
different from effects when probabilties are small.
Nevertheless, although aids to help people appreciate the magni-
tudes of risks are much needed, the present experiments do not
support the idea that using a visual display of dots to represent
a small probability helps people appreciate that the risk is
small.
                               A17

-------
                                                 Visu'al Display
                           Table 1

        Study One: Format Effects on Perceived Threat

                    and Action Intentions
Odds Ratio
Format
Numbers
Threat
Action
Denominator
Threat
Action
Denominator
Plus Numerator
Threat
Action
                      Influenza Vaccination Dilemma
1 in 50
2,00 in 10,000
1 in 10,000
14.
15.
13.
9
6
3
14.3
14.4
13.0
14
14
12
Pesticide
1 in 50
200 in 10,000
1 in 10,000
15.
16.
13.
7
3
4
17.7
17.4
15.6
15
16
13
.0
.8
.3
14
14
12
.4
.1
.6
Contamination
.2
.1
.1
17
17
15
.2
.8
.3
14
14
11
.8
.1
.6
14
14
12
.1
.0
.3
Dilemma
15
17
12
.9
.1
.5
17
17
15
.1
.9
.3
Note:  Entries are group means.  The number of subjects in each
Dilemma x Format x Odds Ratio group ranged from 46 to 53.
                             A18

-------
                                                              Visual Display
                                     Table 2



                Study Two:  Format Effects an Dependent Variables
Response variable

Numbers
(N = 73)
Format
Denominator
(N - 70)
Denominator
Plus One
(N = 76)
Controlled
Presentation
(N = 68)
Probability of being
vaccinated
Perceived threat from
side effects
Vaccination intentions

Understanding of risk
from side effects
65.7
(29.4)
12.3
(3.68)
14.2
(4.00)
1.92
(.66)
68.6
(27.6)
12.2
(3.33)
14.3
(3.76)
1.90
(.70)
68.5
(28.1)
12.8
(3.49)
13.8
(4.15)
1.88
(.58)
70.2
(30.0)
11.1
(3.53)
14.35
(4.27)
1.72
(.60)
Note:  Entries are group means, with standard deviations in parentheses.
                                       A19

-------
                                                         Visual Display


1.     Department of Human Ecology, Cook College, Rutgers University, P.O. Box 231, New
      Brunswick, NJ 08903.

2.    To whom  all correspondence should be addressed.

3.     54 Gray Cliff Road, Newton Centre, MA 02159.
                                   A20

-------
                                                     Visual Display
REFERENCES

1.   R.M. Kaplan, B. Hammel, and L.E. Schimmel, "Patient Information
     Processing and the Decision to Accept Treatment,11 Journal of
     Social Behavior and Personality. 1, 113-120  (1985).
2.   National Research Council, Improving Risk Communication.
     Washington, D.C., National Academy Press, 1989.
3.   E. Roth, E.G. Morgan, B. Fischhoff, L. Lave, A. Bostrom, "What
     Do We Know About Making Risk Comparisons?" Risk Analysis. 10,
     375-387, 1990.
4.   P. Slovic, N. Kraus, and V. Covello, "What Should We Know About
     Making Risk Comparisons?" Risk Analysis. 10, 389-392.
5.   D.V. Budescu and T.S. Walisten, "Consistency in Interpretation
     of Probabilistic Phrases," Organizational Behavior and Human
     Decision Processes. 36, 391-405, 1985.
6.   H.J. Sutherland, G.A. Lockwood, D.L. Tritchler, F. Sem, L.
     Brooks, and J.E. Till, "Communicating Probabilistic Information
     to Cancer Patients: Is There 'Noise' on the Line," Social
     Science and Medicine. 32, 725-731, 1991.
7.   N.D. Weinstein, P.M. Sandman, and N.E. Roberts, Communicating
     Effectively About Risk Magnitudes (EPA/230/08/89/064),
     Washington, D.C., U.S. Environmental Protection Agency, 1989.
8.   N.D. Weinstein, P.M. Sandman, and P. Miller, Communicating
     Effectively About Risk Magnitudes. Phase Two
     (EPA/230/09/91/003), Washington, D.C., U.S. Environmental
     Protection Agency, 1991.
                                 A21

-------
                                                     Visual Display
9.   P.M. Sandman, N.D. Weinstein, and P. Miller, "High risk or low:
     How Location on a 'Risk Ladder' Affects Perceived Risk," Risk
     Analysis, (in press).
10.  United States Environmental Protection Agency, A citizen's Guide
     to Radon. Washington, D.C., Author, 1986.
11.  A. Lippman-Hand and F.C. Fraser, "Genetic Counseling: Provision
     and Reception of Information," Americal Journal of Medical
     Genetics. 3, 113-117 (1979).
                                 A22

-------
             Appendix B

Cover Letter, Stories, and Treatments
         for All Conditions

-------
                      THE STATE UNIVERSITY OF NEW JERSEY
                      RUTGERS
Cover Letter
(all conditions)
                 Cook College  - Department of Human Ecology
             P.O. Box 231  - New Brunswick  - New Jersey 08903-0231
                   Voice: 908/932-9153  - FAX: 908/932-8887

                             July. 1993
Dear Homeowner:

     Thank you for talking with us  on  the phone and for agreeing
to take part in our project.

     At Rutgers we are studying how to explain environmental
risks to people so that they can make  their own decisions about
what to do.  The next two pages are a  newspaper article that
tells about a possible radiation problem in some homes in the
Washburn Circle section of Middletown.  Try to imagine that the
home you live in now is located in  Washburn Circle and that the
last page of this booklet—the radiation report from the
Middletown University Health and Safety Program--tells how much
radiation has been found in vour home.

     Please take what you learn from the newspaper article and
the Health and Safety Program radiation report and tell us how
you think you would feel in this situation and what you think you
would do.  There are no right or wrong answers; we want to learn
about your opinions and your reactions.

     All answers are confidential.   The code number on the
questionnaire is used only to show  us  which questionnnaires have
been returned, so we don't call and remind people who have
already mailed theirs back.

     THANK YOU VERY MUCH FOR AGREEING  TO HELP.

                         Sincerely,
                         Neil Weinstein, Professor
                         Peter Sandman, Professor
                         William Hallman, Assistant Professor
                               Bl

-------
                                                High-risk,  low-outrage,  base  risk condition
                    Radon  Risk to  Middletown  Homes
        MIDDLETOWN - Homeowners in .the
Washbum Circle section of Middletown will find
out soon whether their homes are radioactive.
        The source of the radioactivity is radon, a
decay product of uranium that occurs naturally in
rocks and  soil.
        According to the U.S. Environmental
Protection Agency, radiation from radon is a serious
problem in some parts of the country.
        EPA recommends that every home in the
U.S., except apartments above the second floor,
should be  tested for radon.
        According to geologist Charles Schmidt of
the State Department of Environmental Protection
(DEP), Washburn Circle is built  on a granite ledge.
Granite sometimes contains uranium, the radioactive
mineral that decays into radon.
        But Schmidt said there was no reason to
predict that high radon levels would be common in
the Washburn Circle area.
        "Granite is common all  through the state,"
he said. "Some homes  turn out to have a radon
problem, and lots of homes don't, even if they're
right next  door. The only way to find out is to
test."

        The Discovery and the Reaction

        Washburn  Circle's tests are pan of an
ongoing efort by the Middletown University Health
and Safety Program to examine all areas of the'
county for possible trouble spots.
        When the Washburn Circle Neighborhood
Association heard about the testing program, it
volunteered to recruit homeowners to take pan.
        It is not known whether any Washburn
Circle homeowners tested on their own before the
current survey was started. If any did test, the
results they obtained are also unknown.  Testing in
the neighborhood is believed to have been
infrequent.
        The kickoff for the survey was a public
meeting at which DEP experts briefed neighborhood
residents about radon.
        After that. Dr.  Susan Baxter, the Director
of the University Health and Safety Program, in-
stalled radon monitoring devices in the principal
living areas of all homeowners in Washburn Circle
who wanted to participate in the program. About
170 families took part.
        The cost of the testing,  about $8,000, was
paid by the DEP.
        Baxter announced yesterday that the
University's work is finished.  Each homeowner
will receive a written report next week, she
explained. After that, a public meeting will be
scheduled to answer questions from homeowners
and the media.
        She declined to comment in detail until
after the individual reports are received by the
homeowners.
        But she did say yesterday that the level of
radon,  and therefore the level of risk, varied
substantially from one home to the next.
        That wasn't especially surprising to Harriet
Mossman, chair of the Washburn Circle
Neighborhood Association.
        "We understand that radon has to be
looked at one house at a time," Mossman said.
"We don't expect  to find any serious problems, but
we want to be sure."
        Mossman added that the neighborhood
association is "very grateful to the DEP and the
University for moving so quickly" to explain about
radon and carry out the tests.
        "We are confident that we can do what
needs to be done if anyone in the neighborhood
finds a radon problem.  We are proud of our
neighborhood," she said.
        "There are no villains here," Mossman
said, "just a possible natural  problem and a neigh-
borhood that knows how to solve it."

             The Nature of the Risk

        According to radiation experts, granite
often contains traces of uranium and other radio-
active minerals. The uranium in the granite under
Washburn Circle's 200 homes slowly decays into
radon.
        Because radon is  a gas, it rises through  the
rock and soil  toward the surface. If it happens to
rise under someone's home, it can enter the house.
       The radon tends to accumulate inside the
basement or crawl space, and can rise into other
parts of the house as well. It can also pass through
openings and cracks in concrete slabs, and enter
houses without basements or crawl spaces.
Especially if a house is well-insulated, the radiation
can build up.
        Radon is  a colorless, odorless, and tasteless
gas.  It can be detected only with special equi-
pment.
       Just as uranium decays into radon, the
radon gas continues to decay into particles of other
radioactive substances, sometimes called "radon
daughters."
        When these radioactive particles are
breathed by people in the house, the particles may
lodge in the lungs, where they continue to give off
radioactivity.  This is especially likely to happen to
smokers.  The result, experts say, is an  increased
                                                 B2

-------
risk of lung cancer, a disease considered virtually                  If the risk is high enough to worry about.
incurable and almost always fatal. According to the        experts say, it can be greatly reduced by making
EPA. radon is the second biggest cause of lung            sure the radiation has an easier path around the
cancer, after smoking                                  house than into the house — a combination of
        The amount of lung cancer risk depends          sealing and ventilation.
mostly on three factors: how much radon comes
into the home from the radioactive rock underneath.
how  long people  are exposed; and whether the
radiation accumulates inside the house or escapes to
the outside, where it is quickly diluted to safe
levels.
                                          INSTRUCTIONS

     Please imagine that the house you are actually living in now is located in Washbum Circle,
     and that the University Health and Safety Program radiation report that appears on the next
     page of this booklet is the radiation reading for your  house.

     Read the radiation report and then answer the questions on the blue sheet. Feel free to refer
     back to the newspaper article and to the Health and  Safety Program report as much as you
     like when answering the questions.
                                                B3

-------
                                   High-nsK, low-outrage,  case riSK. conaicion
  ?-: .MIDDLETOWN UNIVERSITY
     • a
    .-  •  At the request of the Washbum Circle Neighborhood[Association"
 'and with your permission, the University Health and Safety Program has
  measured the level of breathable radioactivity in your home due tp.>*'[
 'naturally occurring radon. The level of extra radiation'in.your.principal.;':""
  living area from radon was found to be:     " / *'•"• ""' ;A:\;rj^: ' * *.. \ -,
                          o   .     .   '^"^-^^b**^
                         _8__picocunes of radiation^ j^^^.'f^;-
                              per liter of airl, * -•**'ป ****'**-  *   • "
-^ซ*?-
             ..-*->
 '.-ปป•

        To interpret this result, it may help you to know.the.health risk -^r
  caused by being exposed to this amount of radiation.  If. 1,000 people  \
 Jived for 70 years in homes with 8 picocuries of radiation per liter ^pf^ir,,^
^ about 40 of them would be expected to contract lung cancer. as~a result' ฃT
ฃ of this exposure. In other words, for every 1,000 people exposed to-this ;,v,
  level of radiation over a lifetime, 40 more of them, on average,.vypuld get.4
ฃ lung cancer than if they were not exposed to-the radiatjon^J^A ^" JC'i/.'..'
1 RADON

-------
                                                    High-risk, low-outrage,  alternate  risk  condition
                    Radon  Risk  to  Middletown  Homes
        MIDDLETOWN — Homeowners in the
Washburn Circle section of Middletown will find
out soon whether their homes are radioactive
        The source of the radioactivity is radon, a
decay product of uranium that occurs naturally in
rocks and soil.
        According to the U.S. Environmental
Protection Agency, radiation from radon is a serious
problem in some parts of the country.
        EPA recommends that every home in the
U.S., except apartments above the second floor.
should be tested for radon.
        According to geologist Charles Schmidt of
the State Department of Environmental Protection
(DEP), Washburn Circle is built on a granite ledge.
Granite sometimes contains uranium, the radioactive
mineral that decays into radon
        But Schmidt said there was no reason to
predict that high radon levels would be common in
the Washburn Circle area.
        "Granite is common all through the state,"
he said. "Some homes turn out to have a radon
problem, and lots of homes don't, even if they're
right next door. The only way to find out is to
test"

        The Discovery and the Reaction

        Washburn Circle's tests are pan of an
ongoing efort by the Middletown University Health
and Safety Program to examine all areas of the
county for possible trouble spots.
        When the Washburn Circle Neighborhood
Association heard about the testing program, it
volunteered to recruit homeowners to take part.
        It is not known whether any Washburn
Circle homeowners tested on their own before the
current survey was started.  If any did test, the
results they obtained are also unknown.  Testing in
the neighborhood is believed to have been
infrequent.
        The kickoff for the  survey was a public
meeting at which DEP experts briefed neighborhood
residents about radon.
        After that, Dr. Susan Baxter, the Director
of the University Health and Safety Program, in-
stalled radon monitoring devices in the principal
living areas of all homeowners in Washburn Circle
who wanted to participate in the program. About
170 families took pan.
        The cost of the testing, about $8,000, was
paid by the DEP.
        Baxter announced yesterday that the
University's work is finished  Each homeowner
will receive  a written report next week, she
explained.  After that, a public meeting will be
scheduled to answer questions from homeowners
and the media.
        She declined to comment in detail until
after the individual reports are received by the
homeowners.
        But she did say yesterday  that the level of
radon, and therefore the level of risk, varied
substantially from one home to the next.
        That wasn't especially surprising to Harriet
Mossman, chair of the Washburn Circle
Neighborhood Association.
        "We understand that radon has to be
looked at one house at a time," Mossman said.
"We don't expect to find any serious problems, but
we want to  be sure."
        Mossman added that the neighborhood
association  is "very grateful to the DEP and the
University for moving so quickly" to explain about
radon and carry out the tests.
        "We are confident that we can do what
needs to be  done if anyone in the neighborhood
finds a radon problem. We are proud  of our
neighborhood," she said.
        "There are no villains here," Mossman
said, "just a possible natural  problem and  a neigh-
borhood that knows how to solve it."

            The Nature of the Risk

        According to radiation experts, granite
often contains traces of uranium and other radio-
active minerals. The uranium  in the granite under
Washburn Circle's 200 homes slowly decays into
radon.
        Because radon is a gas, it rises through  the
rock and soil toward the surface. If it happens to
rise under someone's home,  it can enter the house.
        The radon tends to accumulate inside the
basement or crawl space, and can rise  into other
parts of the  house as well. It can also pass through
openings and cracks in concrete slabs, and enter
houses without basements or crawl  spaces.
Especially if a house is well-insulated, the radiation
can build up.
        Radon is a colorless, odorless, and tasteless
gas.  It can  be detected only with special equi-
pment.
        Just as uranium decays into radon, the
radon gas continues to decay into particles of other
radioactive  substances, sometimes called "radon
daughters."
        When these radioactive particles are
breathed by people in the house, the particles may
lodge in the lungs, where they continue to give off
radioactivity. This is especially likely to happen to
smokers.  The result, experts say, is an increased
                                                 B5

-------
                                               High-risk,  low-outrage,  alternate risk condition
risk of lung cancer, a disease considered virtually                  If the nsk is high enough to worry about,
incurable and almost always fatal. According to the         experts say, it can be greatly reduced by making
EPA, radon is the second biggest cause of lung            sure the radiation has an easier path around the
cancer, after smoking.                                   house than into the house — a combination of
        The amount of lung cancer risk depends           sealing and ventilation.
mostly on three factors: how much radon comes
into the home from the radioactive rock underneath;
how long people are exposed; and whether the
radiation accumulates inside the house or escapes to
the outside, where  it is quickly diluted to safe
levels.
                                         INSTRUCTIONS

    Please imagine that the house you are actually living in now is located in Washbum Circle,
    and that the University  Health and Safety Program radiation report that appears on the next
    page of this booklet is the radiation reading for your house.

    Read the radiation report and then answer the questions on the blue sheet. Feel free to refer
    back to the newspaper article and to the Health and Safety Program report as much as you
    like when answering the questions.
                                               B6

-------
                             High-risk,  low-outrage, alternate risk condition
      MIDDLETOWN UNIVERSITY.H^ALTHf
              AND SAFETY PROGRAM^
            HOME RADIATION
I*'
       At the request of the Washbum Circle Neighborhood Association,1
  and with your permission, the University Health and Safety Program has
  measured the level of breathable radioactivity in your home due to
  naturally occurring radon.  The level of extra radiation in your principal;.V
  living area from radon was found to be: " "•'" '.*" ;'• t?"';***^   ' *
     ^                                 '    . **• ^ •-* M*  ป fc .  . -' - -
                                                  i_
                        80  Dicocuries of radiation       -.^ . r.  .
                             per liter of air.   - .
                                                  '*•
       To interpret this result, it may help you to know .the health.
  caused by being exposed to this amount of radiation. : If 1 ,000 people
  lived for 70 years in homes with 80 picocuries of radiation per liter of air,
  about 400 of them would be expected to contract lung cancer as a result
  of this exposure.  In other words, for every 1,000 people exposed to. this .
  leyel of radiation over a lifetime, 400 more of them, on average,^ wpuJdH;
  get lung cancer than if they were not exposed to the radjation^'^&| :t'*
2 RADON
                              B7

-------
                                              High-risk, low-outrage,  compare to normal condition
                    Radon  Risk to  Middletown  Homes
        MIDDLETOWN - Homeowners in the
Washburn Circle section of Middletown will find
out soon whether their homes are radioactive.
        The source of the radioactivity is radon, a
decay product of uranium that occurs naturally in
rocks and soil.
        According to the U.S. Environmental
Protection Agency, radiation from radon is a serious
problem in some parts of the country.
        EPA recommends that every home in the
U.S., except apartments above the second floor,
should be tested for radon.
        According to geologist Charles Schmidt of
the Slate Department of Environmental Protection
(DEP), Washburn Circle is built on a granite ledge.
Granite sometimes contains uranium, the radioactive
mineral that decays into radon.
        But Schmidt  said there was no reason to
predict that high radon levels would be common in
the Washburn Circle area.
        "Granite is common all through the state,"
he said.  "Some homes turn out to have a radon
problem, and lots of homes don't, even if they're
right next door. The only way to find out is to
test."

        The Discovery and the Reaction

        Washburn Circle's tests are pan of an
ongoing efort by the Middletown University Health
and Safety Program to examine all areas of the
county for possible trouble spots.
        When the Washburn Circle Neighborhood
Association heard about the testing program, it
volunteered to recruit homeowners to take pan.
        It is not known whether any Washburn
Circle homeowners tested on their own before the
current survey was staned. If any did lest, the
results they obtained are also unknown.  Testing in
the neighborhood is believed to have been
infrequent.
        The kickoff for the survey was a public
meeting at which DEP experts briefed neighborhood
residents about radon.
        After that, Dr. Susan Baxter, the Director
of the University Health and Safety Program, in-
stalled radon monitoring devices in the principal
living areas of all homeowners in Washburn Circle
who wanted to participate in the program.  About
170 families took pan.
        The cost of the testing, about $8,000, was
paid by the DEP.
        Baxter announced yesterday that the
University's work is finished.  Each homeowner
will receive a written report next week, she,
explained. After that, a public meeting will be
scheduled to answer questions from homeowners
and the media.
        She declined to comment in detail until
after the individual reports are received by the
homeowners.
        But she did say yesterday that the level of
radon, and therefore the level of risk, varied
substantially from one home to the next.
        That wasn't especially surprising to Harriet
Mossman, chair of the Washburn Circle
Neighborhood Association.
        "We understand that radon has to be
looked at one house at a time," Mossman said.
"We don't expect to find any serious problems, but
we want to be sure."
        Mossman added that the neighborhood
association is "very grateful to the DEP and the
University for moving so quickly" to explain about
radon and carry out the tests.
        "We are confident that we can do what
needs to be done if anyone in the neighborhood
finds a radon problem.  We are proud of our
neighborhood," she said.
        "There are no villains here," Mossman
said, "just a possible natural problem and a neigh-
borhood that knows how to solve it."

             The Nature of the Risk

        According to radiation experts, granite
often contains traces of uranium and other radio-
active minerals. The uranium in the granite under
Washburn Circle's 200 homes slowly decays into
radon.
        Because radon is a gas, it rises through  the
rock and soil  toward the surface.  If it happens to
rise under someone's home, it can enter the house.
        The radon tends to accumulate inside the
basement or crawl space, and can rise into other
parts of the house as well.  It can also pass through
openings and  cracks in concrete slabs, and enter
houses without basements or crawl spaces.
Especially if a house is well-insulated, the radiation
can build up.
        Radon is a colorless, odorless, and tasteless
gas.  It can be detected only with special equi-
pment.
        Just as uranium decays into radon, the
radon gas continues to decay into particles of other
radioactive substances, sometimes called  "radon
daughters."
        When these radioactive particles are
breathed by people in the house, the panicles may
lodge in the lungs, where they continue to give off
radioactivity.  This is especially likely to happen to
smokers. The result, experts say, is  an increased
                                                 B8

-------
                                                        .  iuซ-uui.ia^e ,  conspaic  c^  mjiiiiaj.  ซ.onaj.cion
risk of lung cancer, a disease considered virtually                 If the nsk is high enough to worry about,
incurable and almost always fatal. According to the        experts say,  it can be greatly reduced by making
EPA, radon is the second biggest cause of lung            sure the radiation has an easier path around the
cancer, after smoking                                   house than into the house — a  combination of
        The amount of lung cancer risk depends           sealing and ventilation.
mostly on three factors, how much radon comes
into the  home from the radioactive rock underneath,
how long people are exposed,  and whether the
radiation accumulates inside the house or escapes to
the outside, where it is quickly diluted to safe
levels.
                                         INSTRUCTIONS

     Please imagine that the house you are actually living in now is located in Washbum Circle,
     and that the University Health and Safety Program radiation report that appears on the next
     page of this booklet is the radiation reading for your house.

     Read the radiation report and then answer the questions on the blue sheet.  Feel free to refer
     back to the newspaper article and to the Health and Safety Program report as much as you
     like when answering the questions.
                                                B9

-------
                            High-risk, low-outrage, compare to normal condition
     MIDDLETOWN UNTVERSITY^HEALTH
              AND SAFETY PROP!
            HOME RADIATION REP0Rr
                        ..v*' . V, ^:ปli"^.Iw2^5"iซ'/:
                    -^-'...-   .--.---   •-•  r*r:,*r%3
                                                         . '•*• • ;
                                                         ซซ• •
                                                    *-?;••:'*"?ฃ•ซ.
       At the request of the Washbum Circle Neighborhood Association,^;
  and with your permission, the University Health.and Safety.Program has •
 • measured the level of breathable radioactivity in your home due to
  naturally occurring radon. The level of extra radiation in your principal   ••
 •r living area from radon was found to be:    „,. .  :   "*        *"^  "
 jKi-  •-.  •                . - -   •-  -•= '-V.74. .-.r*j

                        8  picocuries of radiation
                        -   per liter of air. '-•"'; ;

       To interpret this result, ft may help you to know that the .average ;"
.j outdoor background level of breathable radiation in the United States,'
  from all sources, is approximately 0.4 picocuries of radiation per liter of;.'
  air. The radiation exposure  in your house from radon is thus 20 times  , 1
  greater than the average outdoor background level/  Xf; ff t"T';;7  r ' '
                                                      ...,>
                                                .^>^:.^ ;V V-:
3 RADON
                              BIO

-------
                                              High-risk,  low outrage,  base  risk &  chart condition
                    Radon Risk  to  Middletown  Homes
        MIDDLETOWN - Homeowners in the
Washburn Circle section of Middletown will find
out soon whether their homes are radioactive.
        The source of the radioactivity is radon, a
decay product of uranium that occurs naturally in
rocks and soil.
        According to the U.S Environmental
Protection Agency, radiation from radon is a serious
problem in some parts of the country.
        EPA recommends that every home in the
U.S.. except apartments above the second  floor,
should be tested for radon.
        According to geologist Charles Schmidt of
the State Department of Environmental Protection
(DEP), Washbum Circle is built on a granite ledge.
Granite sometimes contains uranium, the radioactive
mineral that decays into radon.
        But Schmidt  said there was no reason to
predict that high radon levels would be common in
the Washbum Circle area.
        "Granite is common all through the state,
he said. "Some homes turn out to have a  radon
problem, and lots of homes don't, even if they're
right next door. The only way to find out is to
test."

        The Discovery and the Reaction

        Washburn Circle's tests  are pan of an
ongoing efort by the Middletown University Health
and Safety Program to examine all areas of the
county for possible trouble spots.
        When the Washburn Circle Neighborhood
Association heard about the  testing program, it
volunteered to recruit homeowners to take pan.
        It is not known whether any Washburn
Circle homeowners tested on their own before the
current survey was started.  If any did test, the
results they obtained are also unknown. Testing in
the neighborhood is believed to have been
infrequent.
        The kickoff for the survey was a public
meeting at which DEP experts briefed neighborhood
residents about radon.
        After that. Dr. Susan Baxter, the  Director
of the University Health and Safety  Program, in-
stalled radon monitoring devices in the principal
living areas of all homeowners in Washburn Circle
who wanted to participate in the  program. About
170 families took pan.
        The cost of the testing, about $8,000, was
paid by the DEP.
        Baxter announced yesterday that  the
University's work is finished.  Each homeowner
will receive a written report next week, she
explained.  After that, a public meeting will be
scheduled to answer questions from homeowners
and the media.
        She declined to comment in detail until
after the individual reports are received by the
homeowners.
        But she did say yesterday that the level of
radon, and therefore the level of risk, varied
substantially from one home to the next.
        That wasn't especially surprising to Harriet
Mossman, chair of the Washburn Circle
Neighborhood Association.
        "We understand that radon has to be
looked at one house at a time," Mossman said.
"We don't expect to find any serious problems, but
we want to be sure."
        Mossman added that the neighborhood
association is "very grateful to the DEP and the
University for moving so quickly" to explain about
radon and carry out the tests.
        "We are confident that we can do what
needs to be done if anyone in the neighborhood
finds a radon problem. We are proud  of our
neighborhood," she  said.
        There are  no villains here," Mossman
said, "just a possible natural  problem and a neigh-
borhood that knows how to solve it."

            The Nature of the Risk

        According  to radiation experts, granite
often contains traces of uranium and other radio-
active minerals. The uranium in the granite under
Washbum Circle's 200 homes slowly decays into
radon.
        Because radon is a gas, it rises through the
rock and soil toward the surface. If it happens to
rise under someone's home, it can enter the house.
        The radon tends to accumulate inside the
basement or crawl space, and can rise  into other
pans of  the house as well. It can also pass through
openings and cracks in concrete slabs, and enter
houses without basements or crawl spaces.
Especially if a house is well-insulated, the radiation
can build up.
        Radon is a colorless, odorless, arid tasteless
gas.  It can be detected only with special equi-
pment.
        Just as uranium decays into radon, the
radon gas continues to decay into particles of other
radioactive substances, sometimes called "radon
daughters."
        When these radioactive particles are
breathed by people  in the house, the panicles may
lodge in the lungs, where they continue to give off
radioactivity. This  is especially likely to happen to
smokers. The result, experts say, is an increased
                                                  Bll

-------
risk of lung cancer, a disease considered virtually
incurable and almost always fatal. According to the
EPA. radon is the second biggest cause of lung
cancer, after smoking.
      The amount of lung cancer risk depends
mostly on three factors: how much radon comes
into the home from the radioactive rock underneath;
how long people are exposed; and whether the
radiation accumulates inside the house or escapes to
the outside, where it is quickly diluted to safe
levels.
                                      nign-risK, low  outrage,  base risk &  chart condition
      If the risk is high enough to worry about,
experts say, it can be greatly reduced by making
sure the radiation has an easier path around the
house than into the house — a combination of
sealing and ventilation.
                                   INSTRUCTIONS

    Please imagine that the house you are actually living in now is located in Washbum Circle,
    and that the University Health and Safety Program radiation report that appears in the box
    below is the radiation reading for your house. Your level is shown in terms of the number of
    picoCuries of radiation  in each liter of air (abbreviated as pCi/L).  After you read the report,
    look at the chart on the next page to see how much risk is associated with different radiation
    levels, the U.S. EPA action recommendation, and how your risk compares to other hazards.
    A red arrow shows where your level would fall on this chart. Then answer the questions on
    the blue sheet. Feel free to refer back to the newspaper article, Health and  Safety Program
    report, and chart as much as you like when answering the questions.
   *MEDDLETOWN UNIVERSITY? HEAE
      •  .SAFETY  PROGRAM HOME
     iV: At the request of the Washbum Circle Neighborhood AssocL
 * your permission, the University Health and Safety^Programtias.measur
 ^ level'of breathable radioactivity in your home. due4o-natur^|y(<^^rring4rac
 /.The level of extra radiation in your principal living area from^radon7was;f"
          ^•t'tfv V^ i\^% • "•  6 - picocuries of radiation.'
 ji^;;**^^.!....•.   />. ,\,perliter^ofair(DG
 IS57y:.:V-  -r-   ^.--     •-:  . ••y-v-- .--,-   --$
         It may help you to know the health risk caused by being expjosed
  jampunt-of .radiation^ If 1,000 people Jived. for:70  :— - •- *-*-- --*--^ซซ
 ^ffradiatibn per liter of air, about 4Q. of themwou
 *; cancer as a result of this exposure. In other words, for every 1,000
 MY exposed to this level of radiation over a lifetime, 40.more bf^them^on averaj
  1 would get lung cancer than.if they were not exposed to	
  The chart on the next page will help you interpret your
 •-.. wjj, > . .--•-•':-;•          .    f,      .  ~   • - . • -  rf ..>• -'"-*-v
-------
                                          tiign-nsK, low outrage,  oase  TISK t, cnart conditior
RADON
LEVEL
 (pCi/L)
         CANCER RISK
If 1000 people were exposed to this level
    over a lifetime, it would cause...
ACTION ADVICE AND COMPARISONS
        TO OTHER HAZARDS
 10.0
   9.0
   8.0
   7.0
   6.0
   5.0
   4.0
   3.0
   2.0
   1.0
   0.0
                  About 50 lung cancer deaths
                  About 45 lung cancer deaths
                  About 40 lung cancer deaths
                  About 35 lung cancer deaths
                  About 30 lung cancer deaths
                  About 25 lung cancer deaths
                  About 20 lung cancer deaths
                  About 15 luno cancer Deaths
                  About 10 lung cancer deaths
                   About 5 lung cancer deaths
     About 0 lung cancer deaths
                                        25 times average outdoor radon level
                                           The risk of dying from a stroke
                                        15 times average outdoor radon level
                                    At 4 pCl/L EPA recommends that you
                                        reduce your home radon level
                                                    The risk of dying from colon/rectal cancer
                                          The risk of dying from diabetes
                                                         Average outdoor radon level
                                         B13

-------
                                                Low-risk,  high-outrage,  base risk condition
       Nuclear  Waste  Contaminates  Middletown  Homes
        MIDDLETOWN - Homeowners in the
Washbum Circle section of Middletown will find
out soon just how radioactive their homes are.
        The radiation measurements were carried
out after the State Department of Environmental
Protection (DEP) revealed last year that the
concrete foundations and crawl space walls of
homes in Washbum Circle contained nuclear waste.
        The sand used in making the concrete had
been taken improperly from a radioactive fuel
storage site at a nuclear power plant more than a
hundred miles away.
        The DEP claims the level of radioactivity
is "only a very small health risk," in the words of
Charles  Schmidt of the DEP's Bureau of Radiation
Protection.
        But DEP representatives and local residents
clashed  bitterly at a public meeting last December.
        "We're not so sure the risk is small," said
Harriet Mossman, chair of the Washbum Circle
Neighborhood Association,  which was organized in
response to the contamination controversy.
        The numbers may turn out much higher
than Mr. Schmidt is admitting," she said.  "Of
course he says there is nothing to worry about., Mr.
Schmidt doesn't live in Washbum Circle."
        The neighborhood association asked the
Middletown University Health and Safety Program
to carry out independent measurements.  "We
recognize that homeowners need  a source of
information they can trust," said Dr. Susan Baxter,
Program Director. "That's why we agreed to help
out."
        Mossman thanked Baxter, commenting,
"We didn't know where to turn for help and are
pleased  that the data will come from someone who
has no axe to grind."
        Baxter announced yesterday that the
University's house-by-house radiation measurements
are finished. Each homeowner will receive a
written report within the week. After that, a public
meeting will be scheduled to answer questions from
homeowners and the media.
        She declined to comment in detail on her
findings until after the  individual reports are recei-
ved by the homeowners.
        But she did say yesterday that the level of
radiation, and therefore the level  of risk, varied
from one home  to the next.
        That wasn't especially reassuring to Harriet
Mossman and the rest of the Washbum Circle
Neighborhood Association.
        "Whatever the numbers turn out to be,"
Mossman said, "Washbum Circle residents are
angry, and we will stay angry until this
contamination is removed and our health is
protected."
        She added that "for as much as IS years
we have let our kids play on radioactive front
porches and have literally built our lives on
radioactive foundations. Who knows what cancers
lurk in our futures and our children's futures?"
        The radioactive contamination was dis-
covered last year by  pure coincidence when a sixth
grader was doing a science project on radiation.
His borrowed geiger counter showed higher
readings from his home's foundation walls than
from the test samples provided by his teacher.
        His parents  persuaded the DEP to check
out their son's findings, and the investigation was
launched.

    How A Neighborhood Was Contaminated

        The story  begins in 1977, when the
Wellspring Corporation, builder of the Washbum
Circle Development, was hired by Downstate
Electric Company to clear away contaminated sand
from its Lincoln nuclear power plant, more than a
hundred miles from Middletown.
        The sand had been used to cover a storage
site for spent nuclear fuel rods, and had absorbed
some radioactivity.
        Under state  law, WellSpring should have
disposed of the sand  in a special radioactive waste
site.  WellSpring's payment from the utility
company, just over $2 million, included money to
cover the high fees charged for radioactive waste
disposal.
        But instead of disposing of the radioactive
sand properly, WellSpring used it to make concrete
for the foundations and porches of the homes it was
building in Washbum Circle.  WellSpring declared
bankruptcy in 1984.
        According to legal records obtained by this
newspaper, the president of WellSpring was
Alexander Saunders.
        Saunders has declined to comment on the
Washbum Circle problem, except for a one-sentence
statement that "the radioactive contamination, if it
happened, was entirely an accident."
        Legal investigations are continuing, but
they probably won't  do Washbum Circle  home-
owners much good.  "Since the corporation
responsible is bankrupt," explained Middletown City
Attorney James Cavello, "there is no way to make it
or Saunders pay unless criminal intention is
proved."
                                                B14

-------
             The Nature of the Risk
        According to experts, the radioactive
contaminants in Washbum Circle foundations
slowly decay into other radioactive substances.
        These substances tend to accumulate inside
the basement or crawl space, but can rise into other
parts of the house as well. They can also pass
through openings and cracks in concrete slabs, and
enter houses without basements or crawl spaces.
Especially if a house is well-insulated, the radiation
can build up.
        The radioactive gases and particles in the
house are colorless, odorless, and tasteless.  They
can be detected only with special equipment.
      , nign-oucrage,  case  riar. conaicion
        When radioactive particles arc breathed by
people in the house, the particles may lodge in the
lungs, where they continue to give off radioactivity
This is especially likely to happen to smokers. The
result, experts say. is an increased risk of lung
cancer, a disease considered virtually incurable and
almost always fatal.
        The amount of lung cancer risk depends
mostly on three factors: how much radiation is in
the contaminated foundations and walls; how long
people are exposed;  and whether the radiation
concentrates inside the house or escapes to the
outside, where it is quickly diluted to safe levels.
        If the risk is high enough to worry about,
experts say, it can usually be greatly reduced by
making sure the radiation has an easier path to the
outside — a combination of sealing and ventilation.
                                           INSTRUCTIONS

     Please imagine that the house you are actually living in now is located in Washbum Circle,
     and that the University Health and Safety Program radiation report that appears on the next
     page of this booklet is the radiation reading for your house.

     Read the radiation report and then answer the questions on the  blue sheet.  Feel free to refer
     back to the newspaper article and to the Health and Safety Program report as much as you
     like when answenng the questions.
                                                  B15

-------
                                 Low-risk, high-outrage, base risk condition
fr •.:•:•
      MIDDLETOWN
     3r-       AND SAFETY PROQ
      '   "
                                    '   ' • v••".'*5^4^^i&E/
        At the request of the Washbum Circle Neighborhood Association,
 tand with your permission, the University Health and Safety Program has
 r measured the level .of breathable radioactivity ih^your-home due1c4-:^iVv'
 ^radioactive sand in your foundation.-crawl .space Avallsr"--4 *-~u;
p'radioactive sand in your foundation.-crawl .spacewalls|Jnd^jrchW.^tp
|. level of extra radiation in your principal living area from the radioactive '
I'Sand was found to be:      '            --     ;-vX:5c/Svi;;^/:,.t;
                         0.002 Dicocuriesof
                                   liter of air
                                   "t'ol
     .   To interpret this result, it may help you to know the health ri
f- caused by being exposed to this amount of radiation... If 100,000,people^
  lived for 70 years in homes with 0.002 picocuries of radiation per liter of:.;4
  air, one of them would be expected to contract lung cancer as a result of;,-,
  IhFs exposure. In other words, for every 100,000 people jexppsed.to tWigt:?
  level of radiation over a lifetime, one more of them, 'on average? would" •;-
 ^ get lung cancer than if they were not exposed to the extra radiation. ,-^V^-
1 SAND
                                 B16

-------
                                                 Low-risk,  high-outrage,  alternate risk  condition
       Nuclear  Waste  Contaminates  Middletown  Homes
        MIDDLETOWN — Homeowners in the
Washburn Circle section of Middletown will find
out soon just how radioactive their homes are.
        The radiation measurements were carried
out after the State Department of Environmental
Protection (PEP) revealed last year that the
concrete foundations and crawl space walls of
homes in Washburn Circle contained nuclear waste.
        The sand used in making the concrete had
been taken improperly from a radioactive fuel
storage site at a nuclear power plant more than a
hundred miles away.
        The DEP claims the level of radioactivity
is "only a very small health risk," in the words of
Charles Schmidt of the DEP's Bureau of Radiation
Protection.
        But DEP representatives and local residents
clashed bitterly at a public meeting last December.
        "We're not so sure the risk is small," said
Harriet Mossman, chair of the Washburn Circle
Neighborhood Association,  which was organized in
response to the contamination controversy.
        The numbers may turn out much higher
than Mr. Schmidt is admitting." she said.  "Of
course he says there is nothing to worry about. Mr.
Schmidt doesn't live in Washburn Circle."
        The neighborhood association asked the
Middletown University Health and Safety Program
to carry out independent measurements.  "We
recognize that homeowners need  a source of
information they can trust." said Dr. Susan Baxter,
Program Director. "That's why we agreed to help
out."
        Mossman thanked Baxter, commenting,
"We didn't know where to turn for help and are
pleased that the data will come from someone who
has no axe to grind."
        Baxter announced yesterday that the
University's house-by-house radiation measurements
are finished. Each homeowner will receive a
written report within the week. After that, a public
meeting will be scheduled to answer questions from
homeowners and the media.
        She declined to comment in detail on her
findings until after the individual reports are recei-
ved by the homeowners.
        But she did say yesterday that the level of
radiation, and therefore the level  of risk, varied
from one home  to the next.
        That wasn't especially reassuring to Harriet
Mossman and the rest of the Washburn Circle
Neighborhood Association.
        "Whatever the numbers turn out to be,"
Mossman said, "Washburn Circle residents are
angry, and we will stay angry until this
contamination is removed and our health is
protected."
        She added that "for as much as 15 years
we have let our kids play on radioactive front
porches and have literally built our lives on
radioactive foundations. Who knows what cancers
lurk in our futures and our children's futures?"
        The radioactive contamination was dis-
covered last year by pure coincidence when a sixth
grader was doing a science project on radiation.
His borrowed.geiger counter showed higher
readings from his home's foundation walls than
from the test samples provided by his teacher.
        His parents persuaded the DEP to check
out their son's findings, and the investigation was
launched.

    How A Neighborhood Was Contaminated

        The story begins in 1977, when the
Wellspririg Corporation, builder of the Washbum
Circle Development, was hired by Downstate
Electric Company to clear away contaminated sand
from its Lincoln nuclear power plant, more than a
hundred miles from Middletown.
        The sand had been used to cover a storage
site for spent nuclear fuel rods, and had absorbed
some radioactivity.
        Under state law, WellSpring should have
disposed of the sand in a special radioactive waste
site.  WellSpring's payment from the utility
company, just over $2 million, included money to
cover the high fees charged for radioactive waste
disposal.
        But instead of disposing of the radioactive
sand properly, WellSpring used  it to make concrete
for the foundations and porches of the homes it was
building in Washburn Circle.  WellSpring declared
bankruptcy in 1984.
        According to legal records obtained by this
newspaper, the president of WellSpring was
Alexander Saunders.
        Saunders has declined to comment on the
Washburn Circle problem, except for a one-sentence
statement that "the radioactive contamination, if it
happened, was entirely an accident."
        Legal investigations are continuing, but
they probably won't do Washburn Circle home-
owners much good.  "Since the corporation
responsible is bankrupt." explained Middletown City
Attorney James Cavello, "there is no way to make it
or Saunders pay unless criminal intention is
proved."
                                                 B17

-------
            The Nature of the Risk
        According to experts, the.radioactive
contaminants in Washburn Circle foundations
slowly decay into other radioactive substances.
        These substances tend to accumulate inside
the basement or crawl space, but can rise into other
parts of the house as well. They can also pass
through openings and cracks in concrete slabs, and
enter houses without basements or crawl spaces.
Especially if a house is well-insulated, the radiation
can build up.
        The radioactive gases and particles in the
house are colorless, odorless, and tasteless.  They
can be detected only with special equipment.
Low-risk,  high-outrage,  alternate  risk condition
              When radioactive panicles are breathed by
      people in the house, the particles may lodge in the
      lungs, where they continue to give off radioactivity
      This is especially likely to happen to smokers.  The
      result, experts say, is an increased risk of lung
      cancer, a disease considered virtually incurable and
      almost always fatal.
              The amount of lung cancer risk depends
      mostly on three factors: how much radiation is in
      the contaminated foundations and walls; how long
      people are exposed;  and whether the radiation.
      concentrates inside the house or escapes to the
      outside, where it is quickly diluted to safe levels.
              If the risk is high enough to worry about.
      experts say, it can usually be greatly reduced by
      making sure the radiation has an easier path to the
      outside — a combination of sealing and ventilation.
                                           INSTRUCTIONS

     Please imagine that the house you are actually living in now is located in Washbum Circle,.
     and that the University Health and Safety Program radiation report that appears on the next
     page of this booklet is the radiation reading for your house.

     Read the radiation report and then answer the questions on the blue sheet.  Feel free to refer
     back to the newspaper article and to the Health and Safety Program report as much as you
     like when answering the questions.
                                                  B18

-------
                                       nign-outrage, axcernace
     MIDDLETOWN UNIVERSITY -HEALTH
            * AND SAFETY PROGRAMi*5p|
            HOME RADIATION
   '•ป->
>'* •*•
  :     At the request of the Washbum Circle Neighborhood Association,
  and with your permission, the University Health and Safety" Program."
 'measured the level of breathable radioactivity in.your home due to
  radioactive sand in your foundation, crawl space walls, and porches. The
  level of extra radiation in your principal living area from the radioactive
c-sand,was found to be:  .' .. -            .  1< >         '""' '"^~*""
                        0.0002 picocuries of radiation
                              per liter of air,    -;..:v;.
                                                "'*?.%*
                                                **'*••""'  •" 5. ^
',     .  To interpret this result, it may help you to know.the health risk'.
:  caused by being exposed to this amount of radiation. If 1,000,000 people*
jr lived for 70 years in homes with 0.0002 picocuries of radiation per liter of
L air, one of them would be expected to contract lung cancer as a result-of ,-
fc this exposure.  In other words, for every 1,000,000 people exposed to. •• "-
-  this level of radiation over a lifetime, one more of them, on average, ~
  would get lung cancer than if they were not exposed to the extra "7.1  ,'/  :
-.radiation.                                  .. .-,    "•'.". •,   '.   .
2 SAND
                              B19

-------
                                             Low-risk,  high-outrage, compare to normal  condition

       Nuclear  Waste  Contaminates Middletown Homes
        MIDDLETOWN — Homeowners in the
Washbum Circle section of Middletown will find
out soon just how radioactive their homes are.
        The radiation measurements were carried
out after the State Department of Environmental
Protection (DEP) revealed last year that the
concrete foundations and crawl space walls  of
homes in Washburn Circle contained nuclear waste.
        The sand used in making the concrete had
been taken improperly from a radioactive fuel
storage site at a nuclear power plant  more than a
hundred miles away.
        The DEP claims the level of radioactivity
is "only a  very small health risk," in  the words of
Charles  Schmidt of the DEP's Bureau of Radiation
Protection.
        But DEP representatives and local residents
clashed bitterly at a public meeting last December.
        "We're not so sure the risk is small." said
Harriet Mossman, chair of the Washburn Circle
Neighborhood Association, which was organized in
response to the contamination controversy.
        "The numbers may turn out  much higher
than Mr. Schmidt is admitting," she said. "Of
course he says there is nothing to worry about.  Mr.
Schmidt doesn't live in Washbum Circle."'
        The neighborhood association asked the
Middletown University Health and Safety Program
to carry out independent measurements.  "We
recognize that homeowners need a source of
information they can trust," said Dr. Susan Baxter,
Program Director. "That's why we agreed to help
out."
        Mossman thanked Baxter, commenting,
"We didn't know where to turn for help and are
pleased that the data will come from  someone who
has no axe to grind."
        Baxter announced yesterday that the
University's house-by-house radiation measurements
are finished. Each homeowner will receive  a
written report within the week.  After that, a public
meeting will be scheduled to answer  questions from
homeowners and the media.
        She declined to comment in detail on her
findings until after the individual reports are recei-
ved by the homeowners.
        But she did say yesterday that  the level  of
radiation, and therefore the level of risk, varied
from one home to the next.
        That wasn't especially reassuring to Harriet
Mossman  and the rest of the Washburn Circle
Neighborhood Association.
        "Whatever the numbers turn out to be,"
Mossman  said, "Washbum Circle residents are
angry, and we will stay angry until this
contamination is removed and our health is
protected."
        She added that "for as much as IS years
we have let our kids play on radioactive front
porches and have literally built our lives_pn
radioactive foundations.  Who knows what cancers
lurk in our futures and our children's futures?"
        The radioactive contamination was dis-
covered last year by pure coincidence when a sixth
grader was doing a science project on radiation.
His borrowed geiger counter showed higher
readings from his home's foundation walls than
from the test samples provided by his teacher.
        His parents persuaded the DEP to check
out their son's findings, and the investigation was
launched.

    How A Neighborhood Was Contaminated

        The story begins in 1977, when the
Wellspring Corporation,  builder of the Washbum
Circle Development, was hired by Downstate
Electric .Company to clear away contaminated sand
from its Lincoln nuclear power plant, more than a
hundred miles from Middletown.
        The sand had been used to cover a storage
site for spent nuclear fuel rods, and had absorbed
some radioactivity.
        Under state law, WellSpring should have
disposed of the sand in a special radioactive waste
site.  WellSpring's payment from the utility
company, just over $2 million, included money to
cover the high fees charged for radioactive waste
disposal.
        But instead of disposing of the radioactive
sand properly. WellSpring used it to make concrete
for the  foundations and porches of the homes it was
building in Washburn Circle.  WellSpring declared
bankruptcy in 1984.
        According to  legal records obtained by this
newspaper, the president of WellSpring was
Alexander Saunders.
        Saunders has  declined to comment on the
Washburn Circle problem, except for a one-sentence
statement that "the radioactive contamination', if it
happened, was entirely an accident."
        Legal investigations are continuing, but
they probably won't do Washbum Circle home-
owners much good.  "Since the corporation
responsible is bankrupt," explained Middletown City
Attorney James Cavello, "there is no way to make it
or Saunders pay unless criminal intention is
proved."
                                                B20

-------
             The Nature of the Risk
        According to experts, the radioactive
contaminants in Washbum Circle foundations
slowly decay into other radioactive substances.
        These substances tend to accumulate inside
the basement or crawl space, but can rise into other
parts of the house as well. They can also pass
through openings and cracks in concrete slabs, and
enter houses without basements or crawl spaces.
Especially if a house is well-insulated, the radiation
can build up.
        The radioactive gases and particles in the
house are colorless, odorless, and tasteless.  They
can be detected only with special equipment.
        .When radioactive particles are breathed by
people in the house, the particles may lodge in the
lungs, where they continue to give off radioactivity
This is especially likely to happen to smokers. The
result, experts say, is an increased  risk of lung
cancer, a disease considered virtually incurable and
almost always fatal.
        The amount of lung cancer risk depends
mostly on three factors: how much radiation is in
the contaminated foundations and walls; how long
people are exposed; and whether the radiation
concentrates inside the house or escapes to the
outside, where it is quickly diluted to safe levels.
        If ihe risk is high enough  to worry about,
experts say, it can usually be greatly reduced by
making sure the radiation has an easier path to the
outside — a combination of sealing and ventilation.
                                           INSTRUCTIONS

     Please imagine that the house you are actually living in now is located in Washbum Circle,
     and that the University Health and Safety Program radiation report that appears on the next
     page of this booklet is the radiation reading for your  house.

     Read the radiation report and then answer the questions on the blue sheet. Feel free to refer
     back to the newspaper article and to the Health and  Safety Program report as much as you
     like when answering the questions.
                                                  B21

-------
                             Low-risk,  high-outrage, compare to  normal condition
           .                                  .
      MIDDLETOWN UNIVERSITY
            JHOME RADIATION REPOR
       At the request of the Washbum Circle Neighborhood Association,. C
7 and with your permission, the University Health and Safety Program.has: >
'I, measured the level of breathable, radioactivity in your home due to*^*^*
I' radioactive sand in your foundation, crawl space:walls,:and.porches.!'
  level of extra radiation in your;principal living area from the radioactive:
                         0.002  picocuries of radiation^
                               per liter.of-air.  / *$$*-.'-•ซ
                                  "•  •   ''  '   * :'-r- -.- .-'
 ^4'Vr ^;To interpret this result, it may help you'to knowjhat the.i
| outdoor background level of breathable radiation in the'United,i
  from all sources, is approximately 0.4 picocuries.of radiatiorfper liter of '*f
•{:air.  The extra radiation exposure in your house from the-radioactive*
{ is thus two hundred times less than the average outdoorbackgrouhd
3 SAND
                               B22

-------
                                             Low-risk, high outrage,  base risk &  chart  condition

        Nuclear Waste Contaminates  Middletown Homes
        MIDDLETOWN — Homeowners in the
 Washburn Circle section of Middletown will find
 out soon just how radioactive their'homes are.
        The radiation measurements were carried
 out after the State Department of Environmental
 Protection (DEP) revealed last year that the
 concrete foundations and crawl space walls of
 homes in Washburn Circle contained nuclear waste.
        The sand used in making the concrete had
 been taken improperly from a radioactive fuel
 storage site at a nuclear power plant more than a
 hundred miles away.
        The DEP claims  the level of radioactivity
 is "only a very small health risk," in the words of
 Charles Schmidt of the DEP's Bureau of Radiation
 Protection.
        But DEP representatives and local residents
' clashed bitterly at a public meeting last December.
        "We're not so sure the risk is small," said
 Harriet Mossman, chair of the Washburn Circle
 Neighborhood Association, which was organized in
 response to the contamination controversy.
        "The numbers may turn out much  higher
 than Mr. Schmidt is admitting." she said.  "Of
 course he  says there is nothing to worry about.  Mr.
 Schmidt doesn't live in Washburn Circle."
        The neighborhood association asked the
 Middletown University Health and Safety Program
 to carry out independent measurements. "We
 recognize  that homeowners need a source of
 information they can trust," said Dr. Susan Baxter,
 Program Director. "That's why we agreed to help
 out."
        Mossman thanked Baxter, commenting,
 "We didn't know where to turn for help and are
 pleased that the data will come from someone who
 has  no axe to grind."
        Baxter announced yesterday that the
 University's house-by-house radiation measurements
 are finished.  Each homeowner will receive a
 written report within the week. After that, a public
 meeting will be scheduled to answer questions from
 homeowners and the media.
        She declined  to comment in detail on her
 findings until after the individual reports are recei-
 ved by the homeowners.
        But she did say yesterday that the level of
 radiation,  and therefore the level of risk, varied
 from one  home to the next.
        That wasn't especially reassuring to Harriet
 Mossman and the rest of the Washburn Circle
 Neighborhood Association.
        "Whatever the numbers turn out to be,"
 Mossman said, "Washburn Circle residents are
angry, and we will stay angry until this
contamination is removed and our health is
protected."
        She added that "for as much as IS years
we have let our kids play on radioactive front
porches and have literally built our lives on
radioactive foundations.  Who knows what cancers
lurk in our futures and our children's futures?"
        The radioactive contamination was dis-
covered  last year by pure coincidence when a sixth
grader was doing a science project on radiation.
His borrowed geiger counter showed higher
readings from his home's foundation walls than
from the test samples provided by his teacher.
        His parents persuaded the DEP to check
out their son's findings, and the investigation was
launched.

    How A Neighborhood Was Contaminated

        The story begins in 1977, when the
Wellspring Corporation,  builder of the Washbum
Circle Development, was hired by Downstate
Electric Company to clear away contaminated sand
from its Lincoln nuclear power plant, more than a
hundred  miles from Middletown.
        The sand had been used to cover a storage
site for spent nuclear fuel rods, and had  absorbed
some radioactivity.
       -Under state law, WellSpring should have
disposed of the sand in a special radioactive waste
site.  WellSpring's payment from the utility
company, just over $2 million, included  money to
cover the high fees charged for radioactive waste
disposal.
        But instead of disposing of the radioactive
sand properly, WellSpring used it to make concrete
for the foundations and porches of the homes it was
building in Washburn Circle.  WellSpring declared
bankruptcy in  1984.
        According to legal records obtained by this
newspaper, the president of WellSpring was
Alexander Saunders.
        Saunders has declined to comment on  the
Washburn Circle  problem, except for a one-sentence
statement that "the radioactive contamination, if it
happened, was entirely an accident."
        Legal investigations are continuing, but
they probably won't do Washburn Circle home-
owners much good. "Since the corporation
responsible is bankrupt," explained Middletown City
Attorney James Cavello, "there is no way to make it
or Saunders pay unless criminal intention is
proved."
                                                B23

-------
           The Nature of the Risk
       According to experts, the radioactive
contaminants in Washbum Circle foundations
slowly decay into other radioactive substances.
       These substances tend to accumulate inside
the basement or crawl space, but can rise into other
parts of the house as well. They can also pass
through openings and cracks in concrete slabs, and
enter houses without basements or crawl spaces.
Especially if a house is well-insulated, the radiation
can build up.
       The radioactive gases and particles in the
house are colorless, odorless, and tasteless. They
can be detected only with special equipment.
Low-risk, high outrage, base risk & chart condition
               When radioactive particles are breathed by
        people in the house, the particles may lodge in the
        lungs, where they continue to give off radioactivity.
        This is especially likely to happen to smokers. The
        result, experts say, is an increased risk of lung
        cancer, a disease considered virtually incurable and
        almost always fatal.
               The amount of lung cancer risk depends
        mostly on three factors: how much radiation is in
        the contaminated foundations and walls; how long
        people are exposed;  and whether the radiation
        concentrates inside the house or escapes to the
        outside, where it is quickly diluted to safe levels.
               If the risk is high enough to worry about,
        experts say, it can usually be greatly reduced by
        making sure the radiation has an easier path to the
        outside — a combination of sealing and ventilation.
                                      INSTRUCTIONS

Please imagine that the house you are actually living in now is located in Washbum Circle, and that the
University Health and Safety Program radiation report that appears in the box below is the radiation
reading for your house. Your level is shown in terms of the number of picoCuries of radiation in each
liter of air (abbreviated as pCi/L).  After you read the report, look at the chart on the next page to see
how much risk is associated with different radiation levels, the U.S. EPA action recommendation, and
how your risk compares to other hazards. A red arrow shows where your level would fall on this chart.
Then answer the questions on the blue sheet. Feel free to refer back to the newspaper article. Health
and Safety Program report, and chart as much as you like when answering the questions.
            fe.
      MIDDLETOWN
             '
              "'"   '
                  *HOME
      '';: At the request of the Washbum Circle Neighborhood Associaton,; ^^jv
 r'your permission, the University Health and Safety^Program'JTas*"  ""*'--""
   level of breathable radioactivity in your home due to radioactive
  I foundation, crawl space-walls,'and .porches. The-leyel of-extrajBdjat^^1
   pc|pai;?ving i™ fromTthe^
   ftspate?*** A* **-A. •:;$-**#**  **f ^^*Vrป*ปff^b8Kifii
   •Bifeafci4S&*.  • X-. i(ฃQQ2  picocuries of radiatforS^^^
     H,. To, interpret this result, it may help you to know the healthy
  ^beirig exposed to this amount^ iadiationy-lf^pO,arw----•"•" '
  "homes with.0.002 picocuries of radiation perjjter of
 ^/expected to contract lung cancer as a result of this
  .every 100,000 people exposed to this level
                                       ;•*ซ
        chart on the next page will help
                                                                               Ito^
                                                                               rfet
                                                                                      te.--.
4 tod
                                            B2A

-------
                                          Low-nan,  nign oucrage, oase  riSK o cnarc conaicion
RADIATION
  LEVEL
   (pCi/L)
         CANCER RISK
If 1000 people were exposed to this lovel
    over a lifetime, it would cause...
ACTION ADVICE AND COMPARISONS
        TO OTHER HAZARDS
   10.0
    9.0
    8.0
    7.0
    6.0
    5.0
    4.0
    3.0
    2.0
    1.0
    0.0
                    About 50 lung cancer deaths
                    About 45 lung cancer deaths
                    About 40 lung cancer deaths
                    About 35 lung cancer deaths
                    About 30 lung cancer deaths
                    About 25 lung cancer deaths
                    About 20 lung cancer deaths
                    About 15 lung cancer 
-------
                                                  Low-risk,  low outrage,  base risk  condition
                      Radiation in Middletown  Homes
        MIDDLETOWN - Homeowners in the
Washburn Circle section of Middletown will find
out soon just how radioactive their homes are.
        The source of the radioactivity is uranium,
an element that occurs naturally in rocks and soil.
         In this case, the uranium appears to be
present in the concrete foundations and crawl space
walls of homes in the Washburn Circle
neighborhood.
        According to geologist Charles Schmidt of
the State Department of Environmental Protection
(DEP), sand often contains small amounts of
uranium. The  sand  used to make the concrete for
Washburn Circle homes seems to be of that type.
        There is seldom enough uranium in the
sand to cause any health problems, whether it's on
the beach or used to make concrete," Schmidt said.
"But it isn't rare to find uranium in sand."
        The uranium was discovered last year by
pure coincidence when a sixth grader was doing a
science project on radiation. His borrowed geiger
counter showed higher readings from his home's
foundation  walls than from the  test samples
provided by his teacher.
        His parents persuaded the DEP to check
out their son's finding, and the  investigation  was
launched.  The DEP later asked the Middletown
University Health and Safety Program to conduct
radiation tests throughout the neighborhood.
        "Even though the chances are that it's only
a very small health risk." Schmidt said, "the only
way to know for sure is to test every home."
        When the Washburn Circle Neighborhood
Association heard about the testing program, it
volunteered to  recruit homeowners to take pan.

             The Testing Program

        The kickoff for the survey was a public
meeting at which DEP experts briefed neighborhood
residents about radiation and uranium.
        After  that, Dr. Susan Baxter, the Director
of the University Health and Safety Program.
installed radiation monitoring devices in the
principal living areas of all homeowners in
Washburn Circle who wanted to participate in the
program.  About 170 families look part.
        The total cost of the testing, about $8,000,
was paid by the DEP.
        Baxter announced yesterday that the
University's work is finished.  Each homeowner
will receive a written report next week, she
explained. After that, a public meeting will be
scheduled to answer questions from homeowners
and the media.
        She declined to comment in detail until
after the individual reports are received by  the
homeowners.
        But she did say yesterday that the  level of
radiation, and therefore the level of risk, varied
from one home to the next.
        That  wasn't especially surprising to Harriet
Mossman. chair of the Washburn Circle
Neighborhood Association.
        "We  understand that the measurements
have to be looked at one house at a time,"
Mossman said. "We don't expect to find any
serious problems, but we want to be sure."
        Mossman added that the neighborhood
association is  "very grateful  to the DEP and the
University for moving so quickly" to explain the
situation and carry out the tests.
        "We  are confident that we can do  what
needs to be done if anyone in the neighborhood
finds a radiation problem.  We are proud of our
neighborhood," she said.
        "There are no villains here," Mossman
said, "It's just a fact of nature and we  know how to
deal with it."

             The Nature of the Risk

        According to experts, the uranium  in the
sand in Washburn Circle foundations slowly decays
into other radioactive substances.
        These substances  tend to accumulate inside
the basement  or crawl space, but can rise into other
parts of the house as well.  They can also pass
through openings and cracks in concrete slabs, and
enter houses without basements or crawl spaces.
Especially if a house is well-insulated, the radiation
can build up.
        The radioactive gases and particles in the
house are colorless, odorless, and tasteless.  They
can be detected only with  special equipment.
        When radioactive particles are breathed by
people in the  house, the particles may  lodge in the
lungs, where they continue to give off radioactivity.
                                                 B26

-------
                                                 Low-risk,  low  outrage,  base  risk condition

 This is especially likely to happen (o smokers.  The                If the nsk is high enough to worry about,
 result, expens say, is an increased risk of lung             experts say, it can usually  be greatly reduced by
 cancer, a disease considered virtually incurable and        making sure the radiation has an easier path to the
 almost always fatal.                                    outside — a combination of sealing and ventilation.
         The amount of lung cancer risk depends
 mostly on three factors: how much radiation is  in
 the contaminated foundations and walls; how long
 people are exposed, and whether the radiation
 concentrates inside the house or escapes to the
 outside, where it is quickly diluted to safe levels.


                                           INSTRUCTIONS

Please imagine that the house you are actually living in now is located in Washbum Circle, and that the
University Health and Safety Program radiation report that appears on the next page of this booklet is the
radiation reading for your house.

Read the radiation report and  then answer the questions on the blue sheet.  Feel free to refer back to the
newspaper article and to the Health and Safety Program report as much as you like when answering the
questions.
                                                 B27

-------
                                      Low-risk, low outrage, base risk condition
                   AND;SAFETY PRQG
                                                                           y
                                                                          -:'*•-? .
             request of the Washbum Circle Neighborhood Association, andJwrth
?,your permission, the University Health and Safety Program has measured the level
>!pf.:breathable radioactivity in your home due to radioactive sand irjyQur.foundation^ v
 ' rawT space .walls, and porches. The level of extra .radiation '  '   7 •  •   • -• •  •-
  ^L—'1*-^	"*il^-	^JS_—_AS..-. ___-i ...__ <..._^ ซ. w-n^''*.***-.!^^1.*^^!
                                                                        V - " -• ~i
                                                                            A
                                                                            -V. 1
      7 To interpret this result, it may help you to knowlthe
      exposed to this amount of radiation.  If 100,000 pec
 iorn.es with, 0.002 picocuries of radiation per Irter of ^air.^
^expected to'contract lung cancer as a result of this
 every 100,000 people exposed to this level of radiatlqrvover
   "im," on average, would get lung cancer than if they were not exposed to the extra;
^radiation,!.            .         • •-.."     r..  _  '.  ^..*\,. ~ . *.v •...?.-•- -•  ^ป-  -  ' •
                                      B28

-------
                                             Low-risk,  low-outrage, base  risk &  chart  condition
                      Radiation in Middletown Homes
         MIDDLETOWN - Homeowners in the
 Washburn Circle section of Middletown will find
 out soon just how radioactive their homes are.
         The source of the radioactivity is uranium.
 an element that occurs naturally in rocks and soil.
         In this case, the uranium appears to be
 present in the concrete foundations and crawl space
 walls of homes in the Washburn Circle
 neighborhood.
         According to geologist Charles  Schmidt of
 the State Department of Environmental Protection
 (DEP), sand often contains small amounts of
 uranium. The sand  used to make the concrete for
 Washburn Circle homes seems  to be of that type.
         There is seldom enough uranium in the
 sand to cause any health problems, whether it's on
 the beach or used to make concrete," Schmidt said.
 "But it isn't rare to find uranium in sand."
         The uranium was discovered last year by
 pure coincidence when a sixth grader was doing a
 science project on radiation  His borrowed geiger
 counter showed higher readings from his home's
 foundation walls than from the  test samples
 provided by his teacher.
         His parents persuaded  the DEP to check
 out their son's finding, and the  investigation was
 launched. The DEP later asked the Middletown
 University Health and Safety Program to conduct
' radiation tests throughout the neighborhood.
         "Even though the chances are that it's only
 a very small  health risk," Schmidt said, "the only
 way to know for sure is to test  every home."
         When the Washburn Circle Neighborhood
 Association heard about the testing program, it
 volunteered to recruit homeowners to take pan.

             The Testing Program

         The kickoff for the survey  was  a public
 meeting at which DEP experts  briefed neighborhood
 residents about radiation and uranium.
         After that. Dr. Susan Baxter, the Director
 of the University Health and Safety Program,
 installed radiation monitoring devices in the
 principal living areas of all homeowners in
 Washburn Circle who wanted to participate in the
 program. About  170 families took part.
         The total cost of the testing, about $8.000.
 was paid by the DEP.
        Baxter announced yesterday that the
University's work is finished. Each homeowner
will receive a written report next week, she
explained. After that, a public meeting will  be
scheduled to answer questions from homeowners
and the media.
        She declined to comment in detail until
after the individual reports are received by the
homeowners.
        But she did say yesterday that the level of
radiation, and therefore the level of risk, varied
from one home to the next.
        That wasn't especially surprising to Harriet
Mossman, chair of the Washburn Circle
Neighborhood Association.
        "We understand that the measurements
have to be looked at one house at a time,"
Mossman said. "We don't expect to find any
serious problems, but we want to be sure."
        Mossman added that the neighborhood
association is "very grateful to the DEP and  the
University for moving so quickly" to explain the
situation and carry out the tests.
        "We are confident that we can do what
needs to be done if anyone in the neighborhood
finds a radiation problem.  We are proud of  our
neighborhood," she said.
        There are no villains here." Mossman
said, "It's just a fact of nature and we know  how to
deal with it."

            The Nature of the Risk

        According to experts, the uranium in the
sand in Washburn Circle foundations slowly  decays
into other radioactive substances. •
        These substances tend to accumulate inside
the basement or crawl space, but can rise into other
parts of the house as well.  They can also pass
through openings and cracks in concrete slabs, and
enter houses without basements or crawl spaces.
Especially if a house is well-insulated, the radiation
can build up.
        The radioactive gases and particles in the
house are colorless, odorless, and tasteless.  They
can be detected only with special equipment.
        When radioactive particles are breathed by
people in the house, the particles may lodge  in the
lungs, where they continue to give off radioactivity.
                                                 B29

-------
                                       Low-risk,  low-outrage, base  risk & chart condition
 This is especially likely to happen to smokers.  The
 result, experts say, is an increased risk of lung
 cancer, a disease considered virtually incurable and
 almost always fatal.
        The amount of lung cancer risk depends
 mostly on three factors: how much radiation is  in
 the contaminated foundations and walls; how long
 people are exposed; and whether the radiation
 concentrates inside the house or escapes to the
 outside, where  it is quickly diluted  to safe levels.
                                        If the risk is high enough to worry about,
                                 experts say, it can usually be greatly reduced by
                                 making sure the radiation has an easier path to the
                                 outside — a combination of sealing and ventilation.
                                    INSTRUCTIONS

Please imagine that the house you are actually living in now is located in Washbum Circle, and that the
University Health and Safety Program radiation report that appears In the box below is the radiation
reading for your house. Your level is shown in terms of the number of ptaoCuries of radiation In each liter
of air (abbreviated as pCi/L). After you read the report, look at the chart on the next page to see how
much risk is associated with different radiation levels, the U.S. EPA action recommendation, and how your
risk compares to other hazards.  A red arrow shows where your level would fall on this chart.  Then
answer the questions on the blue sheet. Feel  free to refer back to the newspaper article, Health and
Safety Program report, and chart as much as you like when answering the questions.
    l-'j*'
MMJBTOWJtf UNTVERS
   ;''  "'  r'.SAFETY  PROQ
       HOME RADIATION
          'At the request of the Washbum Circle Neighbomcxjd AssociatiphV and.with:"'
   ""your permission, the University Health and Safety Program has, measure.;	"''
   : level:of breathable radioactivity in your home due to
   .foundation, crawl space walls, and porches. -TheJeveLof,
   ^principal living area from the. radioactive,sand was found
   Ktf-^t^-t ^j^j^/.^^/.f^S &ฃ%"& f v'-tp^fii^BR
   b^j^^^^^- .r.-:* >••• •'•- ~^picocuries:of rofefc^
                                   per liter of air i
                                   •  .         ^  *
    "ff" " To interpret this result/ft may help you to know the hearth
   Lbeirjg exposed to this amount of radiation.  If
   Themes wi^, 0.002 picocuries of :radiatjon per,
   ^expected to contract lung cancer as a result of Uiisj
   *    >-100,000 people exposed to this level of radiation bve
    JThe.chart on.the next page can help yqu;mtejpretyo"^!g^llr
                                          B30

-------
                                         Low-risK, .Low-outrage, base  TISK. 6 cnarc condition
RADIATION
  LEVEL
   (pCi/L)
         CANCER RISK
If 1000 people were exposed to this level
    over a lifetime, it would cause...
ACTION ADVICE AND COMPARISONS
        TO OTHER HAZARDS
    10.0
     9.0
     8.0
     7.0
     6.0
      5.0
      4.0
      3.0
      2.0
      1.0
                    About 50 lung cancer deaths
                    About 45 lung cancer deaths
                    About 40 lung cancer deaths
                    About 35 lung cancer deaths
                    About 30 lung cancer deaths
                    About 25 lung cancer deaths
                    About 20 lung cancer deaths
                    About 15 lung cancer deaths
                    About 10 lung cancer deaths
                     About 5 lung cancer deaths
                                       25 times average outdoor radiation level
                                           The risk of dying from a stroke
                                        15 times average outdoor radiation level
                                    At 4 pCI/L EPA recommends that you
                                      ' reduce your home radiation level
                                                      The risk of dying from colon/rectal cancer
                                           The risk of dying from diabetes
                                                          Average outdoor radiation level
      0.0 L         About 0 lung cancer deaths
                                            B31

-------
      Appendix C



Feedback Questionnaire

-------
                   FEEDBACK  QUESTIONNAIRE  (ail conditions)



How do you think you would react if you  lived in Washburn  Circle and
found that you had this  amount of radiation in your home?   Feel free
to refer back to the article and the University radiation  report as
you'answer the following questions.


1. How clear was the newspaper article  (Please circle the  choice
   that  best reflects  your opinion):

     very clear       fairly clear        somewhat confusing   very confusing

2. How clear was the information about the seriousness of  your
   radiation level provided by Middletown  University Health and
   Safety Program:

     very clear       fairly clear        somewhat confusing   very confusing

3. How would you describe the danger from  the radiation  level  found
   in your Washburn Circle home? (Please check the box that best
   reflects your opinion.)
           no danger
           very slight danger
           small danger
           moderate danger
           serious danger
           very serious danger

4. If you continued to live in your Washburn  Circle home and did
   nothing about the radiation, what is  your  impression  of the
   chance that the radiation would give  you lung cancer?
           no chance
           very unlikely
           unlikely
           moderate chance
           likely
           very likely
           certain to happen

5. How angry would you feel to find this level of radiation?

   not at all         slightly      moderately      very       extremely
   angry              angry        angry          angry      angry

6. How concerned would you feel finding  this  level of radiation?

   not at all    slightly      moderately      very       extremely
   concerned     concerned    concerned       concerned   concerned

7. How frightened would  you feel finding this level of radiation?

   not at all    slightly      moderately      very       extremely
   frightened    frightened    frightened      frightened  frightened

8. Given what you have learned about the risk, do you think it would
   be worth your spending $300 to reduce the  risk to zero?
           definitely would spend $300
           probably would  spend $3,00
           unsure what I would decide
           probably would  not spend $300
           definitely would not spend $300

                            PLEASE TORN OVER
                                    Cl

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                         feeaoack Questionnaire lail conditions;

9. Given what  you have  learned about the risk,  do you think  it would
   be worth your spending $3.000  to reduce  the risk  to zero?
           definitely would spend $3.000
           probably would spend $3,000
           unsure what I would decide
           probably would not spend $3.000
           definitely would not spend $3,000


10.   If you learned  that  it wasn't possible  to reduce the radiation
      in your home,  would  that  make you want  to move  away?
           would insist on moving away
           would feel a very strong desire to move away
           would feel a moderate desire to move away
           would feel only a little interest in moving away
           would not feel any interest in moving away

11.   Imagine that you were looking for a new home in a new neighbor-
      hood, and found  that it had  this level  of radiation (the  level
      we told you was  found in  your home).   Would this reduce your
      interest  in buying this new  home?
      [  ]  definitely would not buy a home with this level of radiation
      (  ]  would be very reluctant to buy a home with this level of radiation
      {  ]  would be somewhat reluctant to buy a home with this level of radiation
      [  ]  would be only a little reluctant to buy a home with this level  of
           radiation
      [  ]  would not be at all reluctant to buy a home with this level of  radiation

12.   From what you have read,  do  you think you could trust the risk
      information provided to you  by Dr. Baxter of the University
      Health and  Safety Program!

      definitely  probably could     uncertain   probably could     definitely
      could not   not trust                    trust            could trust
      trust

13.   From what you have read,  do  you feel  that Charles Schmidt,  the
      State PEP spokesperson quoted in the newspaper  article,  cares
      about the health and safety  of your neighborhood:

      doesn't     cares very         cares a     cares a moderate   cares a lot
      care at     little            little           amount
      all
For classification purposes please  tell us:

a. Your sex:      [  ]   male  [   ]    female

b. How much school have you completed?
   [  )  some elementary school       [  ) some college/finished 2-year college
   [  1  finished elementary school    [  ] finished 4-year college
   (  J  some high school            [  ] some graduate study
   I  ]  finished high school         [  ] graduate degree

c. Yearly household income:
   [  ] $0-25,000   [  ] $25.001-50,000   (  ) $50.001-75.000   (  ) ever $75.000

d. About how  long did it  take to  read the booklet and  fill out the
   questionnaire?
   [  ) S min.   [  ) 10 rain.    (  } 15 Bin.   [  ) 20 min.  (  ]  25 min. or more



THANK YOU.  PLEASE RETURN THE QUESTIONNAIRE ZN THE ENVELOPE PROVIDED.
                                     C2

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