Written health risk communication during the tragedy of Lac-Mégantic: Lessons learned

Background: On July 6^th 2013, a train derailment incinerated Lac-Mégantic’s (Québec, Canada) downtown area and killed 47 people. In such a crisis, the public health’s mandate is to assess and manage health risks. Risk communication is very important in this process, but can be very complex.  Our objective is to review the risk communication principles in an emergency situation and examine their application when tragedy strikes.

Methods: A normative design was used to evaluate written communication during the first month following the tragedy. Using an explicit grid of eight criteria based on current literature, analyses were performed separately by examiners and then compared to ensure a good inter-judge reliability. 

Results: Eight written health risk communication activities were made to inform victims about the current situation. These documents contained relevant information and recommendations, but were not always explicit about existing risk versus uncertainty. Also, lisibility was not adapted to the targeted audience.  As well, other criteria, such as absence of contradiction, were not met because of lack of coordination between the different collaborating instances. Over time, messages were however coherent and allowed bidirectional communication. Finally, of the eight documents evaluated, two had been developed beforehand and seemed more respectful of the best practices in risk communication.

Conclusion: Globally, written risk communication during the Lac-Mégantic tragedy was adequate although many documents did not meet all the grid criteria.  Planning and preparing communications for disasters, particularly with public safety partners, before a crisis occurs would be helpful in the future.