Academic journal article Environmental Health Perspectives

The Legal Implications of Report Back in Household Exposure Studies

Academic journal article Environmental Health Perspectives

The Legal Implications of Report Back in Household Exposure Studies

Article excerpt

Introduction

Because most people in the United States spend the vast majority of their time indoors, indoor environments are a major source of pollution exposure (Julien et al. 2008). Therefore, while public health research has traditionally focused on the impacts of outdoor pollution, in recent years increasing attention has been paid to exposure in indoor environments, such as homes, schools, and workplaces (Spengler and Adamkiewicz 2009).

This review refers to studies examining chemical exposures in homes, or "household exposure research." These studies have demonstrated that household air and dust contain dozens of potentially harmful chemicals (Brody et al. 2009; Rudel et al. 2003; Mercier et al. 2011; Ashmore and Dimitroupoulou 2009; Weschler and Nazaroff 2008), including some that are heavily regulated or banned, such as lead, asbestos, and polychlorinated biphenyls (PCBs) (Arcury et al. 2014; Lu et al. 2013). Others, such as flame retardants, phthalates, or parabens, are approved for current use or are treated differently in different jurisdictions (Julien et al. 2008; Dodson et al. 2012b; Johnson et al. 2010; Allen et al. 2007; Bornehag et al. 2004; Su et al. 2013; Wilson et al. 2007). Yet as scientific evidence develops, some currently unregulated chemicals may in the future be regulated or even banned. These chemicals come from many sources, including combustion (gas stoves and ovens, furnaces, smoking), consumer products, building materials (including drywall, paint, varnishes, and caulking), the outdoor air, air from other units in a multifamily dwelling, and clothing brought home from a contaminated workplace (Rudel et al. 2003; Spengler and Adamkiewicz 2009).

Scientists engaged in household exposure research face several ethical decisions when deciding how to design their studies, including protocols for interacting with participants during recruiting, informed consent, and results reporting. Most fundamentally, researchers must ensure that the participants, as human subjects, are informed of the risks of participating in the study and voluntarily consent to take part in it. Other considerations include whether the researchers will engage in any follow-up testing to identify the sources of unusual contamination that is identified and/or attempt to remediate the contamination, and whether they can or will keep the participant's results confidential.

Another major consideration is whether to provide participants with their individual results, a process known as "report back." Some researchers and ethicists take the position that only clinically significant results should be reported because the report back of results with uncertain health implications will produce unnecessary fear and stress in study participants without any counterbalancing medical benefits. Others argue that researchers should generally share individual study results with participants in accordance with the ethical principle of respect for personal autonomy and to enable informed activism about community- or society-wide dangers such as local air pollution or harmful chemicals in consumer products. The latter position has gained increasing acceptance in recent years (Brody et al. 2014).

This article reviews laws and regulations that may have a major impact on the reportback decision--whether receiving individual results might trigger legal duties for study participants. For example, study participants who learn that their homes contain dangerous chemicals might have a legal duty to clean up the contamination or to report the presence of the chemicals to a government agency, home buyer, landlord, tenant, or visitor. Although the potential for legal consequences has been identified as a potential risk for study participants (Resnik 2012; NRC/IOM 2005), it has not previously been analyzed in depth.

Given the significant dangers associated with indoor air pollution and other indoor health hazards, it is important that there be no inappropriate or unplanned legal barriers to household exposure research (NRC/ IOM 2005). …

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