Public administrations at all levels must often manage complex situations related to environmental determinants of health, often surrounded by controversy. Many factors contribute to a rapid escalation of those situations: increased sensitivity in the face of uncertain risks, uneven distribution of risks and benefits, and decreasing trust in authorities and entities involved in making decisions influencing public health. There is a need, in such circumstances, to assess the extent of possible health and environment impacts and to manage information, evidence and communication on possible risks, while understanding and taking into consideration the opinions, interests and values of the relevant stakeholders. A workshop, jointly organized by the WHO European Office for Investment for Health and Development in Venice and the WHO European Centre for Environment and Health in Bonn, was held in Trento, italy with the aim of sharing experiences in the management and communication of environmental risks. This report builds on the presentations and discussions from the workshop and presents a series of key messages useful to regional and local authorities, as well as to risk managers in general.