This paper, an account of the Shetland Islands oil spill (1993), examines the public health controversies surrounding the spill and the clean-up response. It critically examines the risk management policies of both the United Kingdom and the Shetland Islands Public Health Office, and suggests that the withholding of critical information contributed to increased anxiety and suspicion among the disaster victims. In an attempt to reassure the victims, the policies contributed to an increased air of uncertainty. It is further argued that the withholding of information prevents those who are at greatest risk from participating in critical decisions that may affect their health and livelihoods and asserts that a right-to-know policy is a critical first step in risk management practices.