Community responses to naturally occurring asbestos: implications for public health practice

We used a qualitative community case study design to examine stakeholder responses to naturally occurring asbestos (NOA), a newly emerging environmental threat. The community of interest represents the first residential setting in the United States to receive substantial federal, state and local regulatory attention where NOA exposures largely resulted from local development. Because NOA is an emerging problem that will require evidence-based public health responses in the United States and elsewhere, we explored stakeholder responses to NOA and examined how these responses fit with what is known about individual, community and institutional responses to environmental hazards. The convergence of findings from multiple data sources, including interviews with stakeholder groups and documents, revealed a myriad of challenges associated with environmental and public health interventions in this community. What unfolded was consistent with the social sciences literature about communities facing similar hazards. 'Natural' and 'human-made' elements, the toxic nature of the threat and inadequate institutional responses to the threat combined to spark community conflict and other significant challenges. Implications for improved public health practice are discussed.