Identifying Exposed Populations
Similar questions to the nine posed above should shape the strategy for identifying exposed populations.
The agency representatives who provided information to this panel have expressed a concern that the cases identified are merely the "tip of the iceberg." This possibility should not deter the agencies involved from continuing or expanding efforts to identify other populations that have been exposed. We believe that before these identification efforts, agencies need to devise a standard protocol to deal with newly exposed individuals and new areas of contamination. This protocol should then be communicated effectively to the newly identified populations so that follow-up expectations from the community can be met.
Impact of media campaigns
It is not known whether the media campaign used thus far has reached the populations at risk or what message they have received and understood. Therefore, there is a need to assess what the people who have been reached from the campaign already implemented have understood from the information, what they expect will be done in their cases, and what other general expectations they have regarding the agency's responsibilities. To address these questions within the exposed population that have already been identified, it is recommended that the agencies take an individualized approach to case management. (See section on communicating with exposed populations.)
Impact on rural populations
There is a concern that rural populations are not being reached by the bulletins being issued for the identification of possibly exposed individuals. There is a need to assess whether the populations at risk are being reached effectively. This can be done by direct sampling (such as telephone interviews) of the target populations to assess awareness of the campaign.