Risk situations related to brownfield sites, contaminated lands and groups exposed to toxic substances are common in South America. In some of these situations, there is a lack of institutional response to the risks and consequences coupled with a failure to communicate the risks to those affected. Drawing on empirical research in 4 South American communities exposed to lead contamination, we investigated which strategies of risk communication (RC) have been used by researchers to communicate the risks of contamination, and the possible impacts of these strategies. Considering that risk situations of contaminated lands are characterized by uncertainty/strain/controversy, and that their residents are in a collective stress situation because of the physical conditions in their neighborhood and possible impacts on their health, in our study we argue for the need of participative RC in medical geology studies. The participative RC is based on cultural/social elements, trust, open dialogue and collective learning process to implement policies for mitigating risks and for a sustainable future. However, the analysis of these cases suggests that the efforts of RC have focused only on information transmission and public persuasion. We noticed that RC did not promote an open dialogue, or any discussion about the life styles of locals, which gave the impression that research results have not been properly released, and therefore, the general understanding (by assorted actors) is that environmental/health research is not being undertaken for the public good. 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