Efficacy of a school-based intervention to bring awareness about PCB contamination and exposure avoidance in Guánica, Puerto Rico

  • Daisy Ramirez-Ortiz
  • Glenda L. Almodóvar-Morales
  • Samuel Hopwood
  • Naresh KumarEmail author
Research Article


Production of polychlorinated biphenyls (PCB) was banned in the US in 1970s. However, susceptible populations especially those living at/around the contaminated sites continue to be at a risk of elevated exposure to PCBs because information about the contamination (of the environment) and its associated health risks may not reach these populations. A recent study found the second highest concentration of PCBs ever recorded worldwide in the sediment samples of Guánica Bay, located in the southwestern part of Puerto Rico. PCB levels in fish from the bay were also higher than the tolerance limit of Food and Drug Administration (FDA), which motivated this research to initiate a school-based campaign to bring community awareness about the contamination of the bay and engage students in preventive strategies to reduce their exposure to PCBs. Surveys before and after the campaign were administered in the high school as well as in the communities of Guánica Municipality. The analyses of the survey data suggest that the campaign was effective in bringing awareness among schoolchildren (6.6% before versus 69.7% after the campaign; χ2 ~ 60.4; p < 0.001) and strategies to reduce PCB exposure and its toxicity such as removing adipose tissues from seafood/fish and exercising. In the community, there was a significant decline in the consumption of seafood/fish harvested from the bay after the campaign (54.6% before versus 33% after the campaign; χ2 ~ 10.85; p < 0.001). However, the awareness did not result in significant behavior modifications among schoolchildren, such as avoiding swimming and fishing in the bay. Given hazardous levels of PCBs and some students use the bay for various purposes, including one-third of community members still use seafood/fish harvested from the bay, attention of different stakeholders is warranted for clean-up efforts as well as engaging children and communities in PCB exposure avoidance strategies.


PCB Community exposure School-based awareness Exposure avoidance Impoverished community 



The authors would like to thank the members of Guánica High School for their support and contribution in the development and implementation of the awareness campaign.

Funding information

This research, in parts, was supported by the National Institute of Environmental Health (Grant No. ES029765), and the Springboard Scholarship from the University of Miami Department of Public Health Sciences.

Compliance with ethical standards

The Institutional Review Board of the University of Miami approved this project (IRB approval no. 20150012).

Supplementary material

11356_2019_5587_MOESM1_ESM.docx (36 kb)
ESM 1 (DOCX 36 kb)


  1. Allison DG, Higginson P, Martin S (2017) Antibiotic resistance awareness: a public engagement approach for all pharmacists. Int J Pharm Pract 25:93–96CrossRefGoogle Scholar
  2. Arsenescu V, Arsenescu RI, King V, Swanson H, Cassis LA (2008) Polychlorinated biphenyl-77 induces adipocyte differentiation and proinflammatory adipokines and promotes obesity and atherosclerosis. Environ Health Perspect 116:761–768CrossRefGoogle Scholar
  3. ATSDR (2014) Polychlorinated Biphenyls - ToxFAQs™. In: Division of Toxicology and Health Human SciencesGoogle Scholar
  4. Ayuso R, Idania R, Santiago MM (2010) Nuevas Estadísticas de MortalidadGoogle Scholar
  5. Baker JE, Bohlen WF, Bopp RF, Brownawell B, Collier TK, Farley KJ, Geyer WR, Nairn R, Rosman L (eds) (2006) PCBs in the upper and tidal freshwater Hudson River Estuary: the science behind the dredging controversy. Cambridge University Press, CambridgeGoogle Scholar
  6. Burger J, Staine K, Gochfeld M (1993) Fishing in contaminated waters: knowledge and risk perception of hazards by fishermen in New York City. J Toxicol Environ Health 39:95–105CrossRefGoogle Scholar
  7. Burger J, Gaines KF, Peles JD, Stephens WL Jr, Boring CS, Brisbin IL Jr, Snodgrass J, Bryan AL Jr, Smith MH, Gochfeld M (2001) Radiocesium in fish from the Savannah River and Steel Creek: potential food chain exposure to the public. Risk Anal 21:545–559CrossRefGoogle Scholar
  8. Choi JJ, Eum SY, Rampersaud E, Daunert S, Abreu MT, Toborek M (2013) Exercise attenuates PCB-induced changes in the mouse gut microbiome. Environ Health Perspect 121:725–730CrossRefGoogle Scholar
  9. Eum SY, Andras I, Hennig B, Toborek M (2009) NADPH oxidase and lipid raft-associated redox signaling are required for PCB153-induced upregulation of cell adhesion molecules in human brain endothelial cells. Toxicol Appl Pharmacol 240:299–305CrossRefGoogle Scholar
  10. Everett CJ, Frithsen I, Player M (2011) Relationship of polychlorinated biphenyls with type 2 diabetes and hypertension. J Environ Monit: JEM 13:241–251CrossRefGoogle Scholar
  11. Food and Drug Administration (FDA) (2009) 2009 NSSP Guide for the Control of Molluscan Shellfish Action levels for poisonous or deleterious substances in human food and animal feed. In: National Shellfish Sanitation ProgramGoogle Scholar
  12. George CM, Factor-Litvak P, Khan K, Islam T, Singha A, Moon-Howard J, Van Geen A, Graziano JH (2013) Approaches to increase arsenic awareness in bangladesh: an evaluation of an arsenic education program. Health Educ Behav 40:331–338CrossRefGoogle Scholar
  13. Glanz K, Rimer BK, Lewis FM (2002) Health behavior and health education: Theory, research, and practice. Jossey-Bass, San FranciscoGoogle Scholar
  14. Goncharov A, Haase RF, Santiago-Rivera A, Morse G, McCaffrey RJ, Rej R, Carpenter DO (2008) High serum PCBs are associated with elevation of serum lipids and cardiovascular disease in a native american population. Environ Res 106:226–239CrossRefGoogle Scholar
  15. Goncharov A, Bloom M, Pavuk M, Birman I, Carpenter DO (2010) Blood pressure and hypertension in relation to levels of serum polychlorinated biphenyls in residents of Anniston, Alabama. J Hypertens 28:2053–2060CrossRefGoogle Scholar
  16. Goodwin MJ, Greasley S, John P, Richardson L (2010) Can we make environmental citizens? A randomised control trial of the effects of a school-based intervention on the attitudes and knowledge of young people. Environ Polit 19:392–412CrossRefGoogle Scholar
  17. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap) - a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381CrossRefGoogle Scholar
  18. Helferty A, Clarke A (2009) Student-led campus climate change initiatives in Canada. Int J Sustain High Educ 10:287–300CrossRefGoogle Scholar
  19. Hertwig R, Barron G, Weber EU, Erev I (2004) Decisions from experience and the effect of rare events in risky choice. Psychol Sci 15:534–539CrossRefGoogle Scholar
  20. Jaycox LH, McCaffrey DF, Weidmer Ocampo B, Shelley GA, Blake SM, Peterson DJ, Richmond LS, Kub JE (2006) Challenges in the evaluation and implementation of school-based prevention and intervention programs on sensitive topics. Am J Eval 27:320–336CrossRefGoogle Scholar
  21. Jones C, Hine DW, Marks AD (2017) The future is now: reducing psychological distance to increase public engagement with climate change. Risk Anal 37:331–341CrossRefGoogle Scholar
  22. Khan K, Ahmed E, Factor-Litvak P, Liu X, Siddique AB, Wasserman GA, Slavkovich V, Levy D, Mey JL, van Geen A, Graziano JH (2015) Evaluation of an elementary school-based educational intervention for reducing arsenic exposure in Bangladesh. Environ Health Perspect 123:1331–1336CrossRefGoogle Scholar
  23. Kramer S, Hikel SM, Adams K, Hinds D, Moon K (2012) Current status of the epidemiologic evidence linking polychlorinated biphenyls and non-hodgkin lymphoma, and the role of immune dysregulation. Environ Health Perspect 120:1067–1075CrossRefGoogle Scholar
  24. Kumar N, Ramirez-Ortiz D, Solo-Gabriele HM, Treaster JB, Carrasquillo O, Toborek M, Deo S, Klaus J, Bachas LG, Whitall D, Daunert S, Szapocznik J (2016) Environmental PCBs in Guánica Bay, Puerto Rico: implications for community health. Environ Sci Pollut Res Int 23:2003–2013CrossRefGoogle Scholar
  25. Levinton JS, Waldman JR (2006) The Hudson River Estuary. Cambridge University Press, CambridgeCrossRefGoogle Scholar
  26. May H, Burger J (1996) Fishing in a polluted estuary: fishing behavior, fish consumption, and potential risk. Risk Anal 16:459–471CrossRefGoogle Scholar
  27. NOAA (2012) Guánica Bay Watershed update. EPA studies distribution of terrestrial sediment in coastal zone, vol 3, p 2Google Scholar
  28. Park S, Johnson MA (2006) Awareness of fish advisories and mercury exposure in women of childbearing age. Nutr Rev 64:250–256CrossRefGoogle Scholar
  29. Satterthwait D (2010) Why are 'hands-on' science activities so effective for student learning? Teach Sci 56:7–10Google Scholar
  30. Schantz SL, Widholm JJ, Rice DC (2003) Effects of PCB exposure on neuropsychological function in children. Environ Health Perspect 111:357–576CrossRefGoogle Scholar
  31. Ser PH, Watanabe C (2012) Fish advisories in the USA and Japan: risk communication and public awareness of a common idea with different backgrounds. Asia Pac J Clin Nutr 21:487–494Google Scholar
  32. Sheu LC, Toy BC, Kwahk E, Yu A, Adler J, Lai CJ (2010) A model for interprofessional health disparities education: student-led curriculum on chronic hepatitis B infection. J Gen Intern Med 25(Suppl 2):S140–S145CrossRefGoogle Scholar
  33. Spence A, Poortinga W, Pidgeon N (2012) The psychological distance of climate change. Risk Anal 32:957–972CrossRefGoogle Scholar
  34. STATA (2017) STATA/MP 14.2 - Data Analysis and Statistical Software. Stata Corp LP, College StationGoogle Scholar
  35. The Agency for Toxic Substances and Disease Registry (ATSDR) (2000) Public Health Statement Polychlorinated Biphenyls (PCBs). In: Department of Health and Human ServicesGoogle Scholar
  36. The Agency for Toxic Substances and Disease Registry (ATSDR) (2014a) ATSDR Case Studies in Environmental Medicine Polychlorinated Biphenyls (PCBs) Toxicity. In: U.S. Department of Health and Human ServicesGoogle Scholar
  37. The Agency for Toxic Substances and Disease Registry (ATSDR) 2014b Polychlorinated Biphenyls - ToxFAQs™. In: Division of Toxicology and Health Human SciencesGoogle Scholar
  38. U.S. Environmental Protection Agency (EPA) (1995) Guidance for assesing chemical contaminant data for use in fish advisories risk communicationGoogle Scholar
  39. U.S. Environmental Protection Agency (EPA) (2013) Health Effects of PCBs. Environmental Protection Agency. Accessed November 14.
  40. U.S. Public Health Service (PHS), The Agency for Toxic Substances and Disease Registry (ATSDR), U.S. Department of Health and Human Services (HHS), and U.S. Environmental Protection Agency (EPA) (2012) Public Health Implications of Exposure to Polychlorinated Biphenyls (PCBs)Google Scholar
  41. US Census Bureau (2013) Guánica Municipio, Puerto RicoGoogle Scholar
  42. US Office of the Surgeon General (2002) Report of the Surgeon General's Workshop on Osteoporosis and Bone Health: December 12 – 13, 2002, Washington, DC. Rockville (MD): Office of the Surgeon General (US). In: Surgeon General's Workshop on Osteoporosis and Bone Health. Washington, DCGoogle Scholar
  43. Velicer CM, Knuth BA (1994) Communicating contaminant risks from sport-caught fish: the importance of target audience assessment. Risk Anal 14:833–841CrossRefGoogle Scholar
  44. Vreugdenhil HJI, Lanting CI, Mulder PGH, Boersma ER, Weisglas-Kuperus N (2002) Effects of prenatal PCB and dioxin background exposure on cognitive and motor abilities in dutch children at school age. J Pediatr 140:48–56CrossRefGoogle Scholar
  45. Weber EU (2006) Experience-based and description-based perceptions of long-term risk: why global warming does not scare us (yet). Clim Chang 77:103–120CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of EpidemiologyFlorida International UniversityMiamiUSA
  2. 2.Áurea E. Quiles Claudio High SchoolGuánicaUSA
  3. 3.Department of Public Health SciencesUniversity of MiamiMiamiUSA

Personalised recommendations