Consumer Responses to Integrated Risk‐Benefit Information Associated with the Consumption of Food

The risk analysis of the health impact of foods is increasingly focused on integrated risk‐benefit assessment, which will also need to be communicated to consumers. It therefore becomes important to understand how consumers respond to integrated risk‐benefit information. Quality‐adjusted‐life‐years (QALYs) is one measure that can be used to assess the balance between risks and benefits associated with a particular food. The effectiveness of QALYs for communicating both positive and negative health effects associated with food consumption to consumers was examined, using a 3 × 2 experiment varying information about health changes in terms of QALYs associated with the consumption of fish (n = 325). The effect of this information on consumer perceptions of the usefulness of QALYs for describing health effects, on risk and benefit perceptions, attitudes, and intentions to consume fish was examined. Results demonstrated that consumers perceived QALYs as useful for communicating health effects associated with food consumption. QALYs communicated as a net effect were preferred for food products associated with negative net effects on health, while separate communication of both risks and benefits may be preferred for food products associated with positive or zero net health effects. Information about health changes in terms of QALYs facilitated informed decision making by consumers, as indicated by the impact on risk and benefit perceptions as intended by the information. The impact of this information on actual food consumption choices merits further investigation.     

Policy Goals for Health and Safety

Health management and safety regulation are separate disciplines but share the aim to extend expectancy of life in good health. The need to improve cost-effectiveness calls for their co-ordinated management according to a unified rationale. Three guiding principles of accountability, demonstrable net benefit and a uniform measure of performance, have been laid out in Canada by the Joint Committee on Health and Safety. They call for open accounting in terms of (health-related quality-adjusted) life expectancy. The principles are utilitarian in format but, it is argued, inequity is naturally diminished in the process of optimizing cost-effectiveness through maximum marginal returns. Comments are made on practical implementation. The need for public consent in practice calls for two additional principles reflecting fair procedure and sovereignty of the citizens. It is concluded that public health and safety measures should be surveyed, documented for cost-effectiveness and prioritized for improvement.     

Establishment of risk acceptance criteria using Life Quality Index: Application to the Indian context

The formulation of risk acceptance criteria may be coupled gainfully with a prediction of the of investment required to comply with it, an exercise which can benefit from the application of socioeconomic indicators. The Life Quality Index (LQI) is one such indicator which amalgamates human mortality and wealth creation and places an implicit economic value on reduction of life risk. While there have been a number of studies to demonstrate the application of LQI pertaining to various technological systems, the present work extends it to estimate the sectoral level investment needed to reduce public risks to within the As Low As Reasonably Predictable region for the chemical industry, with specific illustration of the methodology for India. The potential reduction in public individual risk is computed as a function of percentage increase in safety investment expressed as a fraction of the industry's contribution to the nation's GDP. In addition, using a new, more accurate expression, estimates of a related parameter, the implied cost of averting a fatality (ICAF), are obtained for a number of developed economies and India. The ICAF estimates show reasonable agreement with the value of statistical life (VSL), a parameter which is integral to cost-benefit analysis of safety and environmental regulations.     

Transparency in Europe: A Quantitative Study

In recent years, European pharmaceutical regulators have increasingly committed to heightening access to raw safety‐related data as part of a wave of transparency initiatives (e.g., providing public Internet‐mediated access to clinical trials data). Yet, the regulators—who are under significant pressure—have not yet benefited from a systematic review of this new policy. In seeking to inject much needed evidence, this article explores the effects of new transparency policies designed to promote meaningful communication of risks and benefits to patients. Results of a cross‐national European survey with respondents from Great Britain, the Netherlands, Spain, France, Germany, and Sweden (N = 5,648) shed light on how patients and the public are likely to react to the regulators’ new transparency policies. The findings demonstrate clear national variations in how European citizens are likely to react and emphasize the need to develop evidence‐based, reasoned transparency policies that integrate benefit‐risk communication. The authors conclude by providing six specific recommendations, informed by the study, that seek to improve the European transparency model both within the medical field and across health, safety, and environmental policy domains.     

Approximations for Estimating Change in Life Expectancy Attributable to Air Pollution in Relation to Multiple Causes of Death Using a Cause Modified Life Table

There is considerable debate as to the most appropriate metric for characterizing the mortality impacts of air pollution. Life expectancy has been advocated as an informative measure. Although the life‐table calculus is relatively straightforward, it becomes increasingly cumbersome when repeated over large numbers of geographic areas and for multiple causes of death. Two simplifying assumptions were evaluated: linearity of the relation between excess rate ratio and change in life expectancy, and additivity of cause‐specific life‐table calculations. We employed excess rate ratios linking PM_2.5 and mortality from cerebrovascular disease, chronic obstructive pulmonary disease, ischemic heart disease, and lung cancer derived from a meta‐analysis of worldwide cohort studies. As a sensitivity analysis, we employed an integrated exposure response function based on the observed risk of PM_2.5 over a wide range of concentrations from ambient exposure, indoor exposure, second‐hand smoke, and personal smoking. Impacts were estimated in relation to a change in PM_2.5 from 19.5 μg/m³ estimated for Toronto to an estimated natural background concentration of 1.8 μg/m³. Estimated changes in life expectancy varied linearly with excess rate ratios, but at higher values the relationship was more accurately represented as a nonlinear function. Changes in life expectancy attributed to specific causes of death were additive with maximum error of 10%. Results were sensitive to assumptions about the air pollution concentration below which effects on mortality were not quantified. We have demonstrated valid approximations comprising expression of change in life expectancy as a function of excess mortality and summation across multiple causes of death.     

Induced Earthquakes from Long‐Term Gas Extraction in Groningen,the Netherlands: Statistical Analysis and Prognosis for Acceptable‐Risk Regulation

Recently, growing earthquake activity in the northeastern Netherlands has aroused considerable concern among the 600,000 provincial inhabitants. There, at 3 km deep, the rich Groningen gas field extends over 900 km² and still contains about 600 of the original 2,800 billion cubic meters (bcm). Particularly after 2001, earthquakes have increased in number, magnitude (M, on the logarithmic Richter scale), and damage to numerous buildings. The man‐made nature of extraction‐induced earthquakes challenges static notions of risk, complicates formal risk assessment, and questions familiar conceptions of acceptable risk. Here, a 26‐year set of 294 earthquakes with M ≥ 1.5 is statistically analyzed in relation to increasing cumulative gas extraction since 1963. Extrapolations from a fast‐rising trend over 2001–2013 indicate that—under “business as usual”—around 2021 some 35 earthquakes with M ≥ 1.5 might occur annually, including four with M ≥ 2.5 (ten‐fold stronger), and one with M ≥ 3.5 every 2.5 years. Given this uneasy prospect, annual gas extraction has been reduced from 54 bcm in 2013 to 24 bcm in 2017. This has significantly reduced earthquake activity, so far. However, when extraction is stabilized at 24 bcm per year for 2017–2021 (or 21.6 bcm, as judicially established in Nov. 2017), the annual number of earthquakes would gradually increase again, with an expected all‐time maximum M ≈ 4.5. Further safety management may best follow distinct stages of seismic risk generation, with moderation of gas extraction and massive (but late and slow) building reinforcement as outstanding strategies. Officially, “acceptable risk” is mainly approached by quantification of risk (e.g., of fatal building collapse) for testing against national safety standards, but actual (local) risk estimation remains problematic. Additionally important are societal cost–benefit analysis, equity considerations, and precautionary restraint. Socially and psychologically, deliberate attempts are made to improve risk communication, reduce public anxiety, and restore people's confidence in responsible experts and policymakers.     

Altruistic Preferences for Life-Saving Public Programs: Do Baseline Risks Matter?

Cost-benefit analyses of life-saving public programs typically focus on the number of expected deaths avoided (statistical lives saved) as the metric for evaluating benefits. Although this measure of population risk is clearly important, it ignores the distribution of underlying individual risks. A similar number of lives can be saved by protecting relatively large populations with relatively low baseline risk as can be saved by protecting smaller populations faced with higher baseline risks. Should the value of saving a statistical life be sensitive to the baseline levels of risk to exposed individuals? This paper addresses this issue by focusing specifically on individuals’ altruistic values with regard to life-saving programs. Using results from a survey, this study finds that when individuals are asked to state their preference for equally costly life-saving programs that will only affect others’ level of risk, they prefer those that save more lives. More importantly, however, controlling for the number of lives saved, they also prefer programs that affect smaller populations facing higher levels of baseline risk. Furthermore, the results suggest that each order-of-magnitude increase in the level of baseline risk to others approximately doubles the altruistic value component of a statistical life saved.     

Use of Quality-Adjusted Life Year Weights with Dose-Response Models for Public Health Decisions: A Case Study of the Risks and Benefits of Fish Consumption

Risks associated with toxicants in food are often controlled by exposure reduction. When exposure recommendations are developed for foods with both harmful and beneficial qualities, however, they must balance the associated risks and benefits to maximize public health. Although quantitative methods are commonly used to evaluate health risks, such methods have not been generally applied to evaluating the health benefits associated with environmental exposures. A quantitative method for risk-benefit analysis is presented that allows for consideration of diverse health endpoints that differ in their impact (i.e., duration and severity) using dose-response modeling weighted by quality-adjusted life years saved. To demonstrate the usefulness of this method, the risks and benefits of fish consumption are evaluated using a single health risk and health benefit endpoint. Benefits are defined as the decrease in myocardial infarction mortality resulting from fish consumption, and risks are defined as the increase in neurodevelopmental delay (i.e., talking) resulting from prenatal methylmercury exposure. Fish consumption rates are based on information from Washington State. Using the proposed framework, the net health impact of eating fish is estimated in either a whole population or a population consisting of women of childbearing age and their children. It is demonstrated that across a range of fish methylmercury concentrations (0-1 ppm) and intake levels (0-25 g/day), individuals would have to weight the neurodevelopmental effects 6 times more (in the whole population) or 250 times less (among women of child-bearing age and their children) than the myocardial infarction benefits in order to be ambivalent about whether or not to consume fish. These methods can be generalized to evaluate the merits of other public health and risk management programs that involve trade-offs between risks and benefits.     

Parkinson,Peter and probability: Implications for productivity

Improving productivity and effectiveness in society and organizations is a need which is not being met satisfactorily in most countries. Goals of society and organizations are defined in circular and spiral terms, one leading to the other, as encouraging the development of individual capabilities, achieving greater effectiveness, attaining a better quality of life, and enhancing human dignity. Parkinson's Law, Peter's Principle and Robinson's Law (“in a bureaucracy, work alters upon advancement”) illustrate in satirical form many truths about why organizations and society are not increasing their levels of goal attainment. Clues for overcoming this adversity are the treatment of such laws as probability concepts to demonstrate that future performance of a specific organization cannot be predicted, and the recognition that unstated assumptions—we know how to apply accumulated knowledge and the research approach should be followed—need to be converted to much different explicit ones. Evidence demonstrating why this is so and what ought to be done is reviewed. A planning and design approach based on an orientation of purposes-target-results is presented, and some different change principles that result from the approach are described.     

Considering the Risk of Infection by Cryptosporidium via Consumption of Municipally Treated Drinking Water from a Surface Water Source in a Southwestern Ontario Community

Through the use of case‐control analyses and quantitative microbial risk assessment (QMRA), relative risks of transmission of cryptosporidiosis have been evaluated (recreational water exposure vs. drinking water consumption) for a Canadian community with higher than national rates of cryptosporidiosis. A QMRA was developed to assess the risk of Cryptosporidium infection through the consumption of municipally treated drinking water. Simulations were based on site‐specific surface water contamination levels and drinking water treatment log₁₀ reduction capacity for Cryptosporidium. Results suggested that the risk of Cryptosporidium infection via drinking water in the study community, assuming routine operation of the water treatment plant, was negligible (6 infections per 10¹³ persons per day—5th percentile: 2 infections per 10¹⁵ persons per day; 95th percentile: 3 infections per 10¹² persons per day). The risk is essentially nonexistent during optimized, routine treatment operations. The study community achieves between 7 and 9 log₁₀Cryptosporidium oocyst reduction through routine water treatment processes. Although these results do not preclude the need for constant vigilance by both water treatment and public health professionals in this community, they suggest that the cause of higher rates of cryptosporidiosis are more likely due to recreational water contact, or perhaps direct animal contact. QMRA can be successfully applied at the community level to identify data gaps, rank relative public health risks, and forecast future risk scenarios. It is most useful when performed in a collaborative way with local stakeholders, from beginning to end of the risk analysis paradigm.     

Emergency risk communication and sensemaking during smoke events: A survey of practitioners

Emergency risk communication (ERC) for smoke emitted from major fires continues to challenge governments. During these events, practitioners (including scientific, communication, and emergency response government staff) are tasked with quickly making sense of the public health risks and the communication options available. Practitioners’ sensemaking—the process of creating meaning from information about an unfolding emergency—is key to effective ERC. This article identifies the factors that ERC practitioners consider the most important to their sensemaking for smoke events. A survey of practitioners (n = 86) was conducted to elicit their views on the level of importance of 22 different factors (individual, organizational, and contextual) on their sensemaking. The results indicate that the majority of the factors tested are very important to practitioners. This finding likely reflects the multidimensional nature of emergency smoke events and provides evidence as to why practitioners are challenged when trying to make sense of emergency situations. Despite multiple factors being considered very important to practitioners, the time-limited nature of emergencies means that practitioners will inevitability be forced to prioritize in their sensemaking efforts. Our results also provide insight into practitioners’ prioritization of different information sources. Specifically, practitioners prioritize their own knowledge and the knowledge of other practitioners. The two most important factors were information from other incident management stakeholders and the practitioners’ past experience. Other information, including community-based and academic knowledge, appear to be of lower priority for practitioners. Based on the study results, recommendations for practice and future research are discussed.     

A Definition and Categorization System for Advanced Materials: The Foundation for Risk‐Informed Environmental Health and Safety Testing

Novel materials with unique or enhanced properties relative to conventional materials are being developed at an increasing rate. These materials are often referred to as advanced materials (AdMs) and they enable technological innovations that can benefit society. Despite their benefits, however, the unique characteristics of many AdMs, including many nanomaterials, are poorly understood and may pose environmental safety and occupational health (ESOH) risks that are not readily determined by traditional risk assessment methods. To assess these risks while keeping up with the pace of development, technology developers and risk assessors frequently employ risk‐screening methods that depend on a clear definition for the materials that are to be assessed (e.g., engineered nanomaterial) as well as a method for binning materials into categories for ESOH risk prioritization. The term advanced material lacks a consensus definition and associated categorization or grouping system for risk screening. In this study, we aim to establish a practitioner‐driven definition for AdMs and a practitioner‐validated framework for categorizing AdMs into conceptual groupings based on material characteristics. Results from multiple workshops and interviews with practitioners provide consistent differentiation between AdMs and conventional materials, offer functional nomenclature for application science, and provide utility for future ESOH risk assessment prioritization. The definition and categorization framework established here serve as a first step in determining if and when there is a need for specific ESOH and regulatory screening for an AdM as well as the type and extent of risk‐related information that should be collected or generated for AdMs and AdM‐enabled technologies.     

Competition and Coordination in Two‐Tier Public Service Systems under Government Fiscal Policy

As a result of government budgetary limits and rapid market growth, many public service systems—such as health care—are characterized by extensive customer wait times that have become a serious problem. This problem might be solved by allowing private firms to enter these markets, which would provide customers with a choice between a free (governmental) public service provider (SP) and a fee‐charging (or “toll”) private SP. In such a two‐tier service system, the two SPs are differentiated by service quality and cost efficiency. This study focuses on the competition and coordination issues for two‐tier service systems with customers who are sensitive to both service quality and delay. The free system attempts to maximize its expected total customer utility with limited capacity, whereas the toll system attempts to maximize its profit. Neither goal is aligned with the social welfare goal of the public service. To achieve the social welfare goal, the government plays a crucial role in coordinating the two‐tier service system via the budget, the tradeoff of social members' goals, and tax‐subsidy policies. Using a mixed duopoly game, we establish Nash equilibrium strategies and identify the conditions for the existence of the two‐tier service system. We employ several interesting and counter‐intuitive managerial insights generated by the model to show that the public service can be delivered more efficiently via customer choice and SP competition. In addition, we show that a relatively low tax‐subsidy rate can almost perfectly coordinate the two SPs to achieve most of the maximum possible benefit of the two‐tier service system.     

Work Conditions,Social Incorporations,and Foodborne Diseases Risk: Reflections About the (Non)Compliance of Food Safety Practices

The number of foodborne diseases has increased in all continents, and efforts must be made to control this urgent and expressive public health problem. This article aims to present and discuss situations related to the compliance and noncompliance of food safety practices (FSPs) in light of Bourdieu's social theory. This qualitative study was conducted in commercial restaurants in two cities in São Paulo, Brazil. Participant observation was used in the restaurants, and notes referring to the kitchen workers and their bosses’ work processes were registered in field journals. Thematic type content analysis was used to determine the meaning cores of field journals. It was found that aspects inherent to convenience and haste at work, deficient infrastructure, lack of employees, negative boss examples, exposure to noise, and body pain experienced by workers can contribute to noncompliance of FSPs and consolidate in the habitus and practical sense some dispositions that can increase the risk of foodborne diseases. This study highlights the necessity of creating environments that address food safety, which means being able to perform a service properly.     

Perception and control of occupational injury risks in fishery--a pilot study

The frequency of occupational accidents in fishery is high in most fishery nations. Implementation of safety measures has, however, been limited. The purpose of the present cross-sectional study was to explore Swedish fishermen's attitudes towards occupational risks and accident control. Information was acquired through a questionnaire distributed to a convenience sample of 92 fishermen. Indices were built, containing variables relevant to perceived risk levels in connection with work, perceived manageability of risks, activity in safety work, technical knowledge and individual attitudes towards risks. The results did not support earlier findings of low risk awareness and risk acceptance among fishermen. Perceived manageability of risks but not perceived risk level, accident experience or risk acceptance, were significantly associated with activity in safety work. The results suggest that safety work might benefit from efforts to develop fishermen's understanding of how the development of hazardous situations can be prevented or managed. The results do not support strategies for accident control in fishery based solely on increasing risk awareness.     

Tenacity: The American Pursuit of Corporate Responsibility

This article attempts to answer the question, “What are the most important ideas from serving as Executive Editor of the five‐year history project that culminated in the book, Corporate Responsibility: The American Experience?” The ideas focus on (1) clarifying the phenomenon of tenacity; (2) looking at three foundations of our tenacity; and (3) asking “How fragile is our tenacity?” This article also presents three foundational principles that underlie the American experience of corporate responsibility. First, the Checks & Balances Principle tells us that there are checks and balances in democratic capitalism which give us confidence that the pursuit of economic goals will be moderated for the common good. Second, the Moral Projection Principle shows that there is good reason to consider the corporation not only as a legal person under corporate law but also as a moral person. And, last, the Moral Common Ground Principle reflects that there are shared moral values ascertainable by well‐developed consciences in individuals and in corporations. The article concludes with this argument: The tenacity regarding corporate responsibility that has been so characteristic of American capitalism is fragile—calling for serious vigilance if it is to endure.     

Who Would Be Willing to Accept Disaster Debris in Their Backyard? Investigating the Determinants of Public Attitudes in Post‐Fukushima Japan

In the wake of the 2011 Great East Japan Earthquake and tsunami, the Ministry of Environment in Japan asked municipalities nationwide to accept and treat disaster waste. This call for cross‐jurisdictional waste treatment provoked considerable public controversy. To explore how the national and municipal governments can seek more public acceptance in the wake of future disasters, this study implemented a nationwide survey and addressed the question of what factors influence the public's willingness to support their municipalities’ plans to host disaster waste. Three strands of the literature—on risk perception, public dissent, and prosocial behavior—offer valuable insights into hypothesis building, although none has addressed the above question. Estimates from an ordered logistic regression (N = 1,063) reveal that the conditions of a nuclear accident and living with a small child in the household would lower the level of support for accepting disaster waste, although this does not mean that people would give their support in the absence of a nuclear accident. The results also suggest that the national and municipal governments should communicate more with the public about the risks, benefits, and costs associated with hosting disaster debris, and make efforts to improve public trust in the national government.     

Conflict of Interest Mitigation Procedures May Have Little Influence on the Perceived Procedural Fairness of Risk‐Related Research

Two between‐subject experiments explored perceived conflict of interest (COI)—operationalized as perceived procedural unfairness—in a hypothetical public–private research partnership to study the health risks of trans fats. Perceived fairness was measured as subjects’ perceptions that health researchers would be willing to listen to a range of voices and minimize bias (i.e., COI) in the context of a research project. Experiment 1 (n = 1,263) randomly assigned research subjects to a partnership that included (1) a combination of an industry partner, a university partner, and a nongovernmental organization (NGO) partner; and (2) one of three processes aimed at mitigating the potential for COI to harm the quality of the research. The procedures included an arm's‐length process meant to keep the university‐based research team from being influenced by the other partners, an independent advisory board to oversee the project, and a commitment to making all data and analyses openly available. The results suggest that having an industry partner has substantial negative effects on perceived fairness and that the benefit of employing a single COI‐mitigation process may be relatively small. Experiment 2 (n = 1,076) assessed a partnership of (1) a university and either an NGO or industry partner and (b) zero, one, two, or three of the three COI‐mitigation procedures. Results suggest there is little value in combining COI‐mitigation procedures. The study has implications for those who aim to foster confidence in scientific findings for which the underlying research may benefit from industry funding.     

The Health Impact of Mandatory Bicycle Helmet Laws

This article seeks to answer the question whether mandatory bicycle helmet laws deliver a net societal health benefit. The question is addressed using a simple model. The model recognizes a single health benefit—reduced head injuries—and a single health cost—increased morbidity due to foregone exercise from reduced cycling. Using estimates suggested in the literature on the effectiveness of helmets, the health benefits of cycling, head injury rates, and reductions in cycling leads to the following conclusions. In jurisdictions where cycling is safe, a helmet law is likely to have a large unintended negative health impact. In jurisdictions where cycling is relatively unsafe, helmets will do little to make it safer and a helmet law, under relatively extreme assumptions, may make a small positive contribution to net societal health. The model serves to focus the mandatory bicycle helmet law debate on overall health.     

Risk Perception and Social Acceptability of Technologies: The French Case

The authors present results of a February 1987 survey on judged frequency of mortality causes and risk perception of technologies in a representative sample of the French population. Although the French context is very different, and the impact of public controversies have been very limited on technological choices such as the nuclear energy program, strong similarities in risk perception of technologies are observed with results from U.S. surveys. Results, which could be worthwhile for other countries, suggest that risk perception is influenced by two different types of components. The first influence is the global feeling of "security" that society procures to its members. Such feeling depends on the individual's socioeconomic status, subjective state of health, and personal discomfort in daily life, and explains individual aversion to risk independently of the mortality causes or technologies involved. The second influence is the degree of perceived social legitimization of the activities involving risks. Risks of medical and transportation activities are strongly opposed to illegitimate risky behaviors (smoking, drugs, alcohol); technologies which have been an object of public debate (nuclear plants, the chemical industry, lead in gasoline) have an intermediate position reflecting the remaining uncertainties of public opinion about their risk–benefit balancing. Tentative conclusions for risk communication are proposed.