Health Education and Risk Communication Strategies

Preventing New Exposures

Development of strategies for this population should also be based on the nine questions above.

We recommend piloting potential prevention strategies at the local level that can be implemented as models for action at the national level. These approaches are based on models that have worked with other health risks, and these models may be available for modification and application to the current situation on MP. (For example, research on community-based approaches to reducing lead contamination may be of use.) Because we realized that the agencies will be planning major strategies, and we did not have time to develop a step-by-step planning outline, we focused on innovative approaches that might be overlooked.

1. Manufacturer's recall program of MP that does not have "stenching" agent. Local farmers may exchange unused MP at their local providers and distribution centers. There should be incentives provided for them to do so.

   It may be possible for the manufacturer to backtrack from distribution lists to target individuals such as farmers. This approach does not necessarily represent an immense additional burden for the agencies involved. On the contrary, we believe that this may help curtail the spread of the problem in a cost-effective manner by targeting information to those who may be distributing the pesticide illegally to consumers. It is also possible to utilize existing channels of contact to farmers that already exist through the Department of Agriculture. Other agencies might issue a short, half-page brochure that includes information about the availability of new and safer batches of MP (with the stenching additive) that they must use as soon as possible. The pamphlet would also include information on the outbreak and effects of indoor use and the consequences of not following these , such as prosecution. This approach to the sources of MP can be complemented with the amnesty and recall strategies.

2. Amnesty program for illegal applicators for returning the MP they have in exchange for immunity from prosecution. This amnesty program would be implemented at local levels during a finite period of time. Consider requiring applicators to bring client list without fear of prosecution for a limited time during the amnesty. This would serve two purposes: (a) to reduce the amount of MP that is now stockpiled and does not meet the new requirements for making it impossible for use indoors; and (b) to help identify other potentially exposed populations.

   Potential incentives to encourage the recall may be the understanding that people who do not come forward during the allotted time of the amnesty WILL be prosecuted. This can be conveyed by using the examples of people who have already been prosecuted, jailed, and fined. The recall could also serve to reduce the risk of illegal dumping of the MP materials. Although the agency contacts we spoke with implied that such an amnesty program is impossible, gun recall efforts and tax amnesties should be explored as potential options.

3. Certified applicators have a vested interest in informing the public about the possible consequences of using illegal applicators for their pest control needs. Agencies may want to consider exploring the following ideas with commercial applicators through trade associations: (a) commercial applicators developing advertisements that build on the theme that not only do they get rid of bugs, they do so safely; (b) development of a joint media campaign between agencies and commercial applicators that recommends the use of certified exterminators because they can be safer than illegal applicators; (c) discussion of possibility of commercial applicators employing those who come forward in amnesty program and training them for certification and employment (in some areas there are shortages of applicators and this may be feasible); (d) encouragement of applicators to consider public housing contracts; (e) discussion of ways to encourage the trust in commercial applicators that people have invested in illegal applicators who are friends, ministers, tradespeople who have been relied on for years.

4. Agencies such as the Better Business Bureau can be used to inform consumers about legitimate commercial applicators who have proper certification.

5. Resident managers at public housing areas and landlords can be provided with lists of recommended applicators whom they may contact for their pest control needs. The incentive for landlords to get involved is to reduce the likelihood of use of illegal applicators who may cause contamination.

6. Real estate agencies may inform home buyers that utilizing MP will reduce the value of their homes. This approach may use the radon model of enlisting Realtors to disseminate agency information. Informal practices of Realtors have been useful in the past (e.g., encouraging buyers to put in clauses regarding radon on prepurchase agreements caused homeowners to take radon seriously).

7. Affected community residents can address existing community-based organizations to inform others about the potential risks of using MP indoors. By using a train-the-trainer approach, agencies have the potential to reach a large number of people who may not be aware of the risks involved in using MP. For this approach to work, the expertise gained by the community members who have gone through this process must be validated. They may share their experiences in the format of a testimonial at the local churches, parent-teacher association meetings, and other venues where community members meet.

8. Outreach to local schools can be used to encourage integrated pest management in the homes. This outreach can build on the successes of recycling programs and the Open Airways for Schools asthma management curriculum from the American Lung Association, where integrated pest management becomes part of the science curriculum as a homework project that students take to their homes.

9. Creative approaches to national media. Agencies should recognize that one letter in Dear Abby or an appearance on Oprah or 20/20 can reach more people than any pamphlet or news broadcast. Although agencies may not be able to use such strategies, affected individuals can do so in effective ways--not merely to talk about victimization but to discuss the need for people to take responsibility on this issue.

10. Use of punishment of applicators as news peg. In some areas applicators are let off with a slap on the wrist, but in one region an applicator received 25 years in prison and a substantial fine. This type of example highlights the salience of problems with illegal pesticide use.

11. Chicago story. As unfortunate as this incident is, it will also be able to generate media coverage in ways that small southern towns cannot.