A systematic review of the effectiveness of environmental awareness interventions

The Canadian public is chronically exposed to a wide range of environmental pollutants and hazardous agents.(1-3) Some agents, such as ultraviolet (UV ) radiation(4) and lead,(5) can clearly result in adverse health effects. F or other agents, such as electromagnetic fields (EMFs)(6) and hormonally ac tive environmental contaminants,(7) there appears to be cause for concern, but the evidence for adverse health effects is not as strong. Nonetheless, public concern about the potential effects of the biophysical environment o n human health remains high and generates many inquiries for response by pu blic health units. The Ontario Ministry of Health requires health units to prevent or reduce a dverse health outcomes resulting from exposure to hazardous agents in the e nvironment.(8) This is to be done by: employing effective health hazard man agement strategies; consulting with and providing advice to the community a bout environmental risks; and providing educational materials to raise publ ic awareness.(8) The challenge for health unit staff is to ensure that the general population and those sub-populations at greatest risk are aware of environmental risks to their health; are aware of their capacity to improve environmental conditions or avoid environmental hazards; and are taking ap propriate measures to protect themselves and their families. The purpose of this study was to examine the effectiveness of interventions available to public health staff that could be used to enable the public t o protect itself from environmental risks to health. The interventions exam ined in this study included a variety of health promotion strategies such a s educational sessions, curriculum development, networking and coalition de velopment, counselling, mass campaigns, home assessment, workshops and heal th fairs. The environmental hazards of interest included chemical, physical and biological agents such as air pollutants, water contaminants, land con tamination, trace toxics in foods, UV radiation (due to link with ozone lay er depletion) and pesticides. The systematic review sought to answer the research question: "What is the effectiveness of community-based interventions applicable to public health practice in promoting public awareness of environmental risks to health or adoption of risk reduction measures?" This paper evaluates and summarizes t he evidence on the effectiveness of environmental awareness interventions.