Measuring Risk Perception in Pregnant Women in Heavily Polluted Areas: A New Methodological Approach from the NEHO Birth Cohort

Abstract

Risk perception (RP) evaluation during pregnancy and its relationship with lifestyles are considered useful tools for understanding communities living in high-risk areas and preventing dangerous exposure. It is well known that exposure to pollutants and less-healthy lifestyles may result in increased disease occurrence during life. Our work investigated environmental RP through ad hoc questionnaires administered to 611 mothers within the NEHO birth cohort, recruited in three heavily contaminated areas of Southern Italy. Four different RP indices, an exploratory factorial analysis (EFA), and a latent class analysis were evaluated from questionnaires. The highest values of risk perception index were observed in the Milazzo site (0.64 ± 0.16) and the lowest in the Crotone site (0.5 ± 0.18). EFA revealed four latent factors, including different items describing environmental pollution, and subjects were classified into four latent classes with different RP indices. Significant RP profiles were different among the sites (p < 0.001). Our results did not demonstrate any association between RP and lifestyles during pregnancy. Improving healthy lifestyle behaviours, particularly in polluted areas, would generate co-benefits by preventing further risk factors. As remediation interventions can take a long time, it needs to improve healthy lifestyles in residents until remediation is completed.

The Influence of Sociodemographic Factors, Lifestyle, and Risk Perception on Dietary Patterns in Pregnant Women Living in Highly Contaminated Areas: Data from the NEHO Birth Cohort

“…Usually, studies on mothers’ RP refer to risks directly related to motherhood and childbirth, and in most of these works, “perception” is used as a synonym for awareness, recognition, discernment, and understanding. Instead, in a previous study on the mothers of the NEHO birth cohort, we investigated RP related to environmental and health issues, examining the influences of various factors such as measured exposure to hazards, educational level, and perception of personal conditions during pregnancy [ 18 ]. In our sample, among the 589 women who answered the questions about RP, we found that the pregnant women adhering to the “prudent” profile presented the highest average values for all of the four RP indices.…”

“…To determine whether pregnant women with higher perceived risks adhered to healthier dietary patterns than those with lower RP, we used risk perception indices computed in a previous study [ 18 ]. Risk perception was evaluated by means of four indices: the Hazard Perception Index (HPI), which reflects the mothers’ perceptions regarding the presence or absence of hazards in their residence area; the Exposure Hazard Perception Index (EHPI), representing the perception of being exposed to a danger in the area where the mothers live; the Health Risk Perception Index (HRPI), which reflects the perception of the health risk (that is, the perception that various diseases could occur in their area of residence [allergies, infertility, chronic respiratory diseases, different types of cancer]); and the Risk Perception Index (RPI), representing the perception of both environmental and health risks.…”

“…The above indices were computed from a total of 22 items related to a subset of questions reported in Section J of the questionnaire. The questions used in the indices’ construction and the detailed procedure for the computation of the RP indices were reported in a previous work [ 18 ]. For each participant, the HPI, EHPI, HRPI, and RPI were calculated with a value from 0 to 1, a higher value corresponding to higher RP.…”

“…Contaminants such as heavy metals (HMs) and persistent organic pollutants (POPs) may transfer from one environmental matrix to another one and, depending on their chemical-physical properties, are able to infiltrate the human body through different exposure pathways and routes [ 17 ]. In a previous study, to better describe pregnant women living in high-risk areas, we evaluated risk perception (RP) during pregnancy, a useful tool for understanding communities living in high-risk areas and preventing dangerous exposures [ 18 ]. We found that environmental and health risk perception in pregnant women residing in industrialized areas was higher when compared to risk perception reported from women living in areas with less industrial impact [ 18 ].…”

“…In a previous study, to better describe pregnant women living in high-risk areas, we evaluated risk perception (RP) during pregnancy, a useful tool for understanding communities living in high-risk areas and preventing dangerous exposures [ 18 ]. We found that environmental and health risk perception in pregnant women residing in industrialized areas was higher when compared to risk perception reported from women living in areas with less industrial impact [ 18 ].…”