Communicating to patients about their risk for cancer and other debilitating illnesses can be complex. It can elicit resistance and in some cases have unexpected effects on behavior. The present study addresses health communications directed towards residents living near the Lipari landfill in Mantua, NJ, a site that was once the Environmental Protection Agency's number one clean-up priority. Medical monitoring was ordered by the courts as part of a multimillion dollar class action lawsuit settlement to be made available to affected residents. In a preliminary focus group, the residents expressed extremely high levels of perceived cancer risk and beliefs that most of their health problems were related to toxic chemical exposure.

The present study examined the impact of a routine physical exam and screening tests on perceived risk for cancer and on physical activity. The exam was conducted at a university research facility that specializes in occupational safety and chemical exposure. Community members who were part of the class-action lawsuit (N= 134) were interviewed before receiving a physical exam, directly afterwards, and then again two seeks later. Approximately 80% of those approached agreed to participate and 85% completed the follow-up survey. The majority of participants were women (55%), white (97%), married (75%) and did not have a college degree (54%); the median age was 55.

Participants' perceived risk for cancer was predicted by having physical symptoms that they attributed to chemical exposure (r = .40, p<.001) but not by their other physical symptoms (r = .18, n.s.). Participants' perceived cancer risk—unrealistically high given the nature of their exposure—dropped as a result of the exam, F(2,266) = 20.51, p < .001. Their perceived risk dropped significantly by the post-exam interview. It returned to higher levels during the two weeks between the exam and follow-up but remained lower than when they were first interviewed, ts > 3.70, ps < .001. At the same time, more participants reported at follow-up that they had avoided pleasurable activities over the previous month because they were concerned about exposure to chemicals, t(133) = -2.83, p = .005.

The study demonstrates a health communication intervention that effectively lowered risk perceptions but may have negatively affected participants' engaging in pleasurable activities.