A follow-up community survey (n=83) of residents living near a planned hazardous waste facility revealed that the majority of residents maintained considerable concerns over a four year period. They were worried about their health and safety, distrustful of the facility operator, and anticipated limited community benefits. Demoralization, a measure of nonspecific psychological distress, remained disturbingly high, with 41% of those interviewed scoring above the mean of community mental health center clients. One of the two communities studied had lower perceptions of risk than the other, suggesting that expectations of compensation may influence risk perception. Improved communication is needed between local residents and government agency and private industry personnel to address perceptions of danger and distrust. Primary prevention strategies are discussed to improve communication and monitor the health status of residents most at risk of developing physical and psychological problems.