Risk Communication and Risk Management Decision Making

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Risk CommunicationandRisk ManagementDecision
Making

• Daniel Krewski, PhD, MHA
• Professor and Director
• McLaughlin Centre for
• Populaiton Health Risk Assessment
• March 12, 2009

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Outline

• Evolution of Risk Science
• Risk Communication
• Case Study Prion Diseases
• Risk Perception
• Web-based Risk Communication
• Conclusions
• Training

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Frameworks for Risk Assessment and Risk Management
-U.S. National Research Council
1983
1985
-World Health Organization
-Health Protection Branch
1990
-Canadian Standards Association
1991
-Health Protection Branch -CPHA National Advisory
Panel on Risk/Benefit Management of
Drugs -Codex Alimentarius
1993
-Canadian Standards Association -U.S.
Presidential/Congressional Commission on Risk
Assessment and Risk Management
1997
-McLaughlin Centre for Population Health Risk
Assessment
2007
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An Integrated Framework for Risk Assessment
and Risk Management
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Population Health
Advisory
Regulatory
Economic
Community
Technological
Multiple Interventions
Health Risk Policy Analysis Evidence Based Policy
Health Risk Science Determinants and Interactions
Biology and Genetics
Social and Behavioural
Environment and Occupation
Biology-social interactions
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U.S. Presidential/Congressional Commission on
Risk Assessment and Risk Management (1997)
Problem/ Context
Risks
Evaluation
Engage Stakeholders
Options
Actions
Decisions
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Risk Communication
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Risk Communication

• risk communication is the act of conveying or
  transmitting information between interested
  parties about (a) levels of health or
  environmental risks (b) the significance or
  meaning of health or environmental risks or (c)
  decisions, action, or policies aimed at aging or
  controlling health or environmental risks.
  Interested parties include government agencies,
  corporations and industry groups, unions, the
  media, scientists, professional organization,
  public interest groups, and individual
  citizens.
• Covello et al. (1987)

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Risk Communication in Practice

• Determine best ways to present scientific
  information on important risk issues
• Develop guidelines on expert/public communications

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Communications Processes Model
Domain of Perceived Risk
Domain of Technical Risk
Mass Media
Industry
GOVERNMENTS
General Public
Public Interest Groups
Independent Researchers
Public Sphere
Expert Sphere
Risk Communication Flows
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Managing Prion Disease Risks
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Transmission of Mad Cow Disease to Humans
Number of Cases
1997
1980
1988
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• Canada has been challenged both economically and
  socially by BSE since the first indigenous
  Canadian case was confirmed in May 2003 in a
  6-year old Albertan beef cow.

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BSE Risk Management in Canada

• 1997 CFIA banned the use of brains, spinal cords
  and other parts, known as specified risk
  materials (SRM), in cattle feed. The feed ban
  also applied to the remains of sheep, goats,
  bison, elk and deer.
• 2003 Slaughterhouses were to dispose of all SRMs
  from the bodies of cattle older than 30 months.
• 2004 New regulations to prevent animal parts
  linked to BSE from being fed to pets and
  livestock such as chicken or pigs (not only cows
  and sheep).
• 2006 Cattle tissues capable of transmitting BSE
  were banned from all animal feeds, pet foods and
  fertilizers.
• 2007 CFIA introduces enhanced feed ban.

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vCJD Risk Management in Canada

• People not eligible to donate blood or plasma if
  they spent a cumulative total of gt 3 months in
  U.K. or France between 1980 and 1996, or a
  cumulative total of gt 5 years in Western Europe
  (outside U.K. or France) since 1980.
• People not eligible to donate blood or plasma if
  have had a blood transfusion in the U.K., France
  or Western Europe since 1980.

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Managing BSE/vCJD Risks
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Policy UptakeInterpreting Science for Decision
Makers
Social Issues
Economic Issues
Science Policy
Political Issues
Technological Issues
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Toxicity TestingScience Informing Risk
Management
www.nas.edu
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Prion Misfolding as a Toxicity Pathway
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Communication with Animal Health Policy
Community
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International Communication
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Risk ManagementPolicy Consultation Workshops
2008 Canada (Ottawa, June 25) North
America (Washington, July 10)
2009 Canada (Regina) North and South
America (Brasilia) Europe (Brussels)
2010 Canada (Edmonton) North and South
America (Washington) Asia (Beijing)
2011 Canada (Ottawa)
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Risk Perception
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Public Perception of Risk
Expert decision making
Risk Assessment
Risk Guidelines
Risk Interventions
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Public Perception of Risk
Cigarette Smoking Ozone Depletion Breast
Implants Street Drugs Stress Chemical
Pollution Crime and Violence Suntanning AIDS Motor
Vehicle Accidents Nuclear Waste Alcohol
Pregnancy PCBs or Dioxin Nuclear Power
Plants Climate Change Non-prescription
Medication Asbestos Waste Incinerators Malnutritio
n High Volt Power Lines Food Irradiation Prescript
ion Drugs Genetically Engineered Bacteria Outdoor
Air Quality Bacteria in Food Moulds in
Food Mercury in Fillings Tap Water Medical
X-rays Indoor Air Quality VDTs Contraceptives Hear
t Pacemakers Bottled Water Contact lenses
Perceived High Risk ()
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Public Perception of Foodborne Risks
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Farm Family Focus Groups
Even the better times are not really better
because you are simply digging yourself out of
the hole, recouping your losses
As a young person who was to take over the
farmI will not go into farming and I want to
tell that to the general public and the
governmentThe message needs to get out that
farming is no longer viable for families
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Sources of Information on Population Health Risks
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Confidence in Sources of Health Risk Information
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Risk Beliefs
Getting cancer mostly depends on the environment.
Getting cancer mostly depends on lifestyle.
Getting cancer mostly depends on genetic makeup.
Genetics
Environment
Social
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Risk Beliefs
I believe that a risk-free environment is an
attainable goal in Canada.
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Why Study Risk Perception?

• Not to correct public misperceptions of risk
• Understanding the factors that shape public
  attitudes and opinions about risk can lead to
  more effective risk communication
• More effective risk communication can lead to
  increased public acceptance of risk management
  interventions
• When the public worries, it is our
  responsibility to worry.
• Dan Beardsley
• US Environmental Protection Agency

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Web-based Risk Communication
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www.emcom.ca
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Endocrine Toxicants

• An exogenous agent that interferes with the
  synthesis, secretion, transport, binding, action
  or elimination of natural hormones in the body
  that are responsible for the maintenance of
  homeostasis, reproduction, development and/or
  behavior" (USEPA 1997).

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Potential Population Health Risks

• breast cancer
• endometrial cancers
• endometriosis
• fecundity and fertility
• increased rates of spontaneous abortion
• sex ratios

• testicular cancer
• ovarian cancer
• prostate cancer
• declining semen quality
• male reproductive tract abnormalities
• precocious puberty

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Website on Population Health Risks
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Conclusions
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Roles of Risk Communication
Media and Stakeholder Involvement
Risk Management
Science - Policy Interface
Policy Debate
Public - Science Interface
Communication
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Training in Risk Science

• Graduate Certificate in Population Health Risk
  Assessment and Management
• MSc in Epidemiology
• PhD in Population Health
• Postdoctoral Fellows
• Visiting Scientists

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