Assessment and Communication of Risk : A Pocket Text for Health and Safety Professionals

This is the long-awaited pocket text on risk assessment for students and professionals in all health and safety fields. Risk assessment and risk-based decision-making are essential skills in today’s health and safety fields, but a convenient pocket or desk reference has been needed with enough theory to begin a preliminary risk assessment, together with clear explanations, applications, and worked examples. This book addresses that need. It provides a practical resource for estimating risks in various applications, as well as assisting with the design of larger project-based assessments. It explains the two main numeric procedures: probabilistic, or “catastrophic”, and quantitative, or “chronic”, risk assessment, along with chapters on qualitative risk assessment and approaches to food-related risks. A final chapter examines how people perceive risk, and provides advice and assistance in the development of essential, effective risk communication with the public and with the media. Numerous case studies are analyzed. Assessment and Communication of Risk: A Pocket Text for Health and Safety Professionals is a one-stop resource for students in all health and safety fields, and provides a valuable guide for existing field practitioners in public health, occupational health and safety, hospitals, environmental assessment offices, and ministries of health, labour, and the environment. Preface Acknowledgment Contents List of Figures About the Authors 1: Risk: Scope, Definitions, and Terminology 1.1 The Scope of Risk Assessment 1.2 Risk Management 1.3 Basic Definition of Risk 1.4 Describing Risks Using the Language of Probability 1.5 Categorizing Risks 1.5.1 “Incremental” Versus “Background” Risks 1.5.2 “Catastrophic” Versus “Chronic” Risk 1.6 Risk and Hazard 1.7 Relative Risk and Odds Ratio 1.7.1 Relative Risk 1.7.2 The Odds Ratio (OR) 1.7.3 Weakness in the Relative Risk and Odds Ratio 1.7.4 Understanding Confidence Intervals (CI) 1.8 Case Study 1: Driving or Flying? Practice Exercises: Chapter 1 References 2: Probabilistic Risk Assessment 2.1 Risk and Uncertainty 2.2 Modeling Probability 2.3 Addition of Probabilities 2.4 Complementary Events 2.5 Multiplication of Probabilities 2.6 Conditional Probabilities 2.7 The Probability Tree 2.8 Using Frequencies or Probabilities 2.9 Order of Entering Variables Into the Tree 2.10 Probabilities Expressed in Disease Screening 2.10.1 Disease Screening Using Bayes’ Theorem 2.10.2 Disease Screening Using Sensitivity and Specificity 2.11 When a Variable’s Independence Is Missing or Uncertain 2.12 Calculation of “At Least One” Outcome (with Multiple Iterations) 2.13 Probabilities: A Summary 2.14 Case Study #2: Challenger Shuttle Disaster Practice Exercises: Chapter 2 References 3: Quantitative Risk Assessment 3.1 Scope of Quantitative Risk Assessment 3.1.1 Long-Term Exposures 3.1.2 The Maximally Exposed Individual (MEI) 3.1.3 The Four-Step Assessment Model 3.2 Hazard Identification (Step 1) 3.2.1 Data from the Site 3.2.2 Assessing Carcinogens Versus Noncarcinogens 3.2.3 The US EPA IRIS Database 3.2.4 Changing Chemicals Over Time 3.2.5 Toxicity Scores 3.3 Dose-Response Assessment (Step Two) 3.3.1 Limited Human Data 3.3.2 Carcinogens and Noncarcinogens 3.3.3 Three-Step Model of Carcinogenesis 3.3.4 Threshold Models 3.3.5 Target Organs and Systems 3.3.6 “Dose” Versus “Dosage” 3.3.7 NOAEL/LOAEL 3.3.8 LD50 3.3.9 The Slope Factor for Carcinogens 3.3.10 Special Note About “Inhalation” and ‘Fugitive Dust” 3.3.11 Sources of Toxicological Data 3.3.12 Safety Factors for Noncarcinogens (ADI, RfD) 3.4 Exposure Assessment (Step 3) 3.4.1 Components of the Pathway 3.4.2 The Migration/Movement of Substances 3.4.3 Identifying Exposed Individuals 3.4.4 Development of Exposure Scenarios 3.4.5 Exposure Point Concentrations 3.4.6 Bioconcentration Factor (BCF) 3.4.7 Incorporating Other Models 3.4.8 Dose Categories 3.4.9 Calculating the Chronic Daily Intake (CDI) 3.4.10 Helpful Hints in Preparing to Calculate Intake 3.4.11 Worked Intake Calculations 3.5 Risk Characterization [Step 4] 3.5.1 Translating Chronic Daily Intake to Risk 3.5.2 Lack of Epidemiological Data 3.5.3 Do We Use the “Mean” or “Maximum” Concentration Data? 3.5.4 Calculation of the Carcinogenic Risk 3.5.5 Use of de minimis to Characterize Carcinogenic Risk 3.5.6 The Delaney Clause 3.5.7 Options for Reducing Carcinogenic Risk 3.5.8 Calculation of a Noncarcinogenic Hazard Index 3.5.9 RfC and IUR Use 3.5.10 Characterizing Groups of Carcinogenic Substances in the Same Medium 3.5.11 Characterizing Groups of Noncarcinogens in the Same Medium 3.5.12 Conversions: ppm to mg/L etc 3.6 Critical Perspectives of the Risk Assessment Process 3.6.1 Excessive Use of “Worst-Case” Compounded 3.6.2 The Toxicological Parameters 3.6.3 “Conservative Estimates” 3.6.4 Missed Transformation and Transport Mechanisms 3.6.5 Inappropriate Statistical Assumptions and Methods 3.6.6 Overuse of Anthropometric Parameter Tables 3.6.7 Questionable “Additive” Model for Noncarcinogens 3.6.8 Omitted Relationship to Background Risk 3.6.9 The Need to Consider Variability and Uncertainty 3.7 Deterministic Versus Stochastic Risk Assessment 3.8 Case Studies in Quantitative Risk Assessment 3.8.1 Case Study #3: US EPA Recall Due to Arsenic 3.8.2 Case Study #4: Hazardous Waste Site, Lackawanna, Pennsylvania 3.8.3 Case Study #5: Poyang Lake (鄱阳湖) 3.8.4 Case Study #6: Acrylamide 3.8.5 Case Study #7 3.8.6 Case Study #8 3.8.7 Case Study #9 3.8.8 Case Study #10: Benzene in Domestic Water Due to Industry 3.8.9 Case Study#11 3.8.10 Solutions for Case Studies #3 to #11 Practice Exercises: Chapter 3 References 4: Qualitative Risk Assessment Methods 4.1 Preliminary/Risk Analysis (PRA) 4.1.1 PRA in Linear/Descriptive Format 4.1.2 PRA in Tabular Format 4.2 Failure Mode Effects Analysis (FMEA) 4.3 Root Cause Analysis (RCA) Using a Fault Tree (FTA) 4.4 Management Oversight and Risk Tree (MORT) Analysis 4.5 Hazard and Operability (HAZOP) Analysis 4.6 Case Study #12: Using FMEA and MORT 4.7 Case Study #13: Using HAZOP Analysis References 5: Risk Assessment in Food Safety and Foodborne Illness 5.1 Scope of Foodborne Illness 5.2 Root Cause Analysis (RCA) in General 5.3 Hazard Analysis, Critical Control Point (HACCP) Methods 5.3.1 HACCP Origins 5.3.2 Identifying the Hazards 5.3.3 A Process Flow Diagram 5.3.4 Validation of the HACCP Plan 5.3.5 Limitations of HACCP 5.3.6 The Difference Between HACCP and ISO 22000 5.4 Microbiological Risk Assessment (MRA) 5.5 Quantitative Food Risk Assessment 5.5.1 Quantitative Risk Assessment-Epidemic Curve Prediction Model (QRA-EC) 5.5.2 A Stochastic (Monte Carlo) Model for Multifactorial Analysis of Norovirus 5.6 Canadian Food Inspection Agency ERA Model References 6: Communicating Risk 6.1 We Have the Numbers, Now What? 6.2 The Decline in Trust and Credibility 6.2.1 Poor Management in High-Profile Health Crises 6.2.2 Loss of Trust in Traditional Sources 6.2.3 A Major Obstacle to Effective Communication 6.2.4 A Proxy for Trust 6.2.5 The Risk Information “Gap” 6.3 Layperson Versus Expert: Two Perceptions of Risk 6.4 Understanding the Dynamics of Outrage 6.5 Identifying Different Needs, Roles, and Approaches to Risk Communication 6.5.1 Four Communication Models 6.5.2 Anticipating Conflict and Disagreement 6.6 Inherent Difficulties to Be Prepared for in All Risk Communication 6.6.1 Asymmetry Produced by Media in Attempting “Balance” 6.6.2 “Dueling PhDs”2 6.6.3 Changes in Estimates or New Information 6.6.4 Assurances That Are Too Assertive 6.6.5 Be Alert to Sensitizing Events 6.6.6 The Untrusted Messenger 6.6.7 Language and Meaning in Risk Assessment: The “Conservative Estimate” 6.6.8 Clarity and Transparency 6.6.9 Very Large or Very Small Numbers 6.6.10 Exponential Misconceptions 6.6.11 Comparing Risks for Better Effect 6.7 The Media Interview 6.7.1 Cultivate Relationships with the Media 6.7.2 Preparing for the Interview 6.7.3 The Media Want an Interview Now 6.7.4 The Interview: Checklist 6.8 The “Town Hall” or Community Meeting 6.8.1 Make Sure All Groups and Stakeholders Are Invited 6.8.2 Organizing and Planning the Meeting 6.8.3 Length of the Presentation 6.8.4 The Presentation at the Meeting 6.8.5 Following Up on Commitments 6.9 The Seven Questions to Prepare for Any Risk Communication 6.10 An In-Depth Look at Communication Delayed 6.11 Case Studies in Risk Communication for Illustration and Discussion 6.11.1 Case Study #14: Helping to Interpret 10−6 6.11.2 Case Study #15: Uncertainty Can Increase Trust 6.11.3 Case Study #16: Getting to “Maybe” 6.11.4 Case Study #17: Off the Record 6.11.5 Case Study #18: Interview with Information 6.11.6 Case Study #19: The BSE Risk Communication Failure 6.11.7 Case Study #20: Dioxin in Animal Feed 6.11.8 Case Study #21: 400,000 Ill in Milwaukee 6.11.9 Case Study #22: Johnson & Johnson: A Crisis Handled Effectively 6.11.10 Case Study #23 6.11.11 Case Study #24 References Glossary, Abbreviations, and Acronyms Index