Risk Assessment at Crossroads

The changing landscape of assessment & risk governance

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Risk Assessment at Crossroads

1. Background

2. The faces of ‘risk’

3. .

4. .

Europe? What Europe?

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Science – Policy Interface

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Research perspectiveAmbient PM has an independent effect on health

Sources

ConsequencesExposures

Electricity

TrafficIndustry

Households

Diesel

Bio-aerosol

PM2.5

PM10

BS

PAH

Carbonaceous

pH

Ultrafines

Transient

metals

Symptoms

Pulmonary

function

Mortality

Cough

Wheeze

FVC

FEV1

PEF

CVD

Resp. dis.

Policy perspective

A strong ,effective, efficient and coherent policy reduces the public health impact of ambient PM

Physical planning

Prevention & care

Regulation & permits

Traffic Industry

Households

PM2.5 PM10BS

Symptoms Mortality

PAH

Ultrafines

Pulmonary function

CoughWheezeElectricityDiesel

Carbonaceous

pHTransient metals FVC

FEV1PEF CVD

Resp. dis.

Bio-aerosol

We always need translational efforts to translate research into policy

Something about risk: Risk constructs Objectivism

– Countable, measurable – Independent

● Risk

– Risk determination › Chance › Severity › Scale

– Value free

● Analytical – ‘Risk = danger’

● Scientific definition

– Risk determination

Constructivism

– Social construct

– Collectively composed (subjective)

● Risk

– Nature of the hazard

– Risk determination

– Management of the risk

– Social context

– Personal traits and characteristics

● Sensing and feeling

– ‘Risk = danger + response to danger’

● Societal definition

– Risk acceptability

Risk governance

● Governance refers to the actions, processes, traditions and institutions by which authority is exercised and decisions are taken and implemented. Risk governance applies the principles of good governance to the identification, assessment, management and communication of risks

● Governance is a term refering to a shift from central hiërarchical government to a “….cooperation based style of government, where state, market and civil society actors participate in a diversity of networks (Hajer et al 2004)

● The literature describes different forms: network governance, multi-level governance and deliberative governance.

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What science do we need for risk assessment? Cefic | European Chemical Industry Council

› Good science

Classic risk assesment paradigm; NRC Redbook

8

Integrated assessment of health risk from environmental stressors | 18 November 2010

9

NRC Understanding risk 1996 ● Getting the science right

● Getting the right science

● Getting the right participation

● Getting the participation right

● Developing accurate, balanced, and informative synthesis

IRGC Risk Governance Framework

Risk escalator

Risk typologies: ● Risk ladder based on degree costs, controversy & uncertainty

– Step 4: Potentialy serious risks with high uncertainty and/or ambiguïty (process, discours)

– Step 3: Complex problems with divers risk dimensions (MCA)

– Step 2: Average complexity, and uncertainty, but high costs & high stakes (CEA, CBA)

– Step 1: Simple problems, little complexity and uncertainty

(after Ortwin Renn)

● Or classification suggested by Gobble (Clark University)

› hidden risks – unstudied or insufficient thought

› surprises (SARS, Mexican flue, Q-fever)

› fresh controversies (fuel additives, genomics)

› persistent controversies (noise, fine particles)

What are our public health problems?

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Main Burden of Disease determinants anno 2014

13

Bron: RIVM, 2014

Smoking Environ-ment Obesity

Occup environ-ment

Low physical activity

High alcohol consumption

High salt intake

Low fruit intake

High cholesterol

Low fish & greens

High saturated fat

Ex post revealed valuation of gained YOLL € - log scale

● Air quality

● Screening breast cancer

● Obesity campaigns

● Smoking cessation campaigns

● Healthy diet campaigns

● Childhood vaccination

● Zoning LPG stations

● Reduce Campylobacter cont.

● Roundabouts

● Smoke detectors

● Blind spot mirrors on trucks

● Indoor radon

● Mandatory car check-up

● Cancer medication

● Deltaworks / dikes

● Chlorine transport

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Indicative crude estimates

Why is risk communication difficult?

● Public, policy makers and scientists use different definitions and concept to describe risk

● Different sciences use different definitions and terms for risk

● Differ in:

– attribution

– appreciation

– acceptance

Science Public

Policy

Attrib

utio

n

Acce

pta

nce

Appre

ciatio

n

Policy

Citizens

Science XXX X

XX

X

X

X

Concepts do not match or are conflicting

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Disease burden

Monetary cost

Risk perception & acceptability

Policy performance

17

Risicoperceptie en acceptatie “Als u begrijpt wat ik bedoel….”

Onacceptabel Acceptabel

gering groot

manmade natuurlijk

groot gering

ongelijk gelijk

gering groot

groot gering

gering groot

groot klein

zeer weinig

18

The impartance of context

MUPS are a substantial problem

● Burden on care; absenteeism, low quality of life

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Trolley problems (after Philippa Foot, 1967)

Pictures from falkenblog.blogspot.com, blog.mvonederland.nl and creative commons

Elderly

Should you push the fat guy?

Should you pull the lever?

In conclusion ● There is a big disconnect between

main public health problems and topics in risk research

● There is a big disconnect between disciplines in risk assessment and governance

● In addition to splitter scientists, we need scientific lumpers

● Translational science needed, which means funding, training, better incentives and reduction of barriers

● We need to get out of our disciplinary ghettos and comfort zones