Producing ratio measures of effect with quantitative microbial risk assessment

Estimating the risk of infections or other outcomes incident to pathogen exposure is a primary goal of quantitative microbial risk assessment (QMRA). Such estimates are useful to predict population-level risks, to evaluate exposures based on normative or tolerable risk guidelines, and to interpret the likely public health relevance of microbial measurements in environmental media. To evaluate alternative control measures (interventions), ratio estimates of effect (e.g., odds and risk ratios) are needed that are more broadly interpretable in the health sciences and consistent with convention in epidemiology. In this paper, we propose a general method for estimating widely used ratio measures of effect derived from stochastic QMRA approaches, including the generation of appropriate confidence intervals. Such QMRA-derived ratios can be used as a basis for evaluating interventions via hypothesis testing and for inclusion in systematic reviews and meta-analyses in a form consistent with risk estimation approaches commonly used in epidemiology.     

Risk factors for neck and back pain in a working population in Sweden

The relationship between lifestyle, ergonomie and psychosocial workplace factors and musculo-skeletal pain was examined in this cross-sectional study. A total of 22180 employees undergoing screening examinations at their occupational health-care service filled in a series of questionnaires concerning their health, lifestyle and working situation. Of these 31% reported having had neck pain and 18% had seen a health professional for such pain during the previous year. Similarly, 39% reported having had back pain and 16% had seen a professional during the year. Odds ratios were calculated to estimate the relative risk of the various exposure factors. Although not eating regularly and smoking increased the risk for both neck and back pain somewhat, not exercising and consuming alcohol did not increase the risk for these musculoskeletal pains. Lifting, monotonous work tasks, vibration and uncomfortable work postures were the most important ergonomie factors (odds ratios from 1.01 to 2.95). Sitting, however, did not increase the risk for either neck or back pain. A 'poor' psychosocial work environment, as compared to a 'good' one, increased the risk for both neck and back pain (odds ratios from 1.62 to 3.01). Work content and social support were of particular relevance. Finally, a combination of a 'poor' psychosocial work environment and exposure to one of the ergonomic variables produced the highest risk factors (odds ratios from 2.42 to 3.61). Although the conclusions that may be drawn are limited by the cross-sectional nature of this study, the results seem to underscore the complex aetiology of musculoskeletal pain and especially the importance of psychosocial variables. Prevention programmes should therefore be broad-based and include psychosocial as well as ergonomic measures.     

Preventive Health Behavior and Adaptive Accuracy of Risk Perceptions

This study examined the relation between health behavior and risk perceptions in the context of an acute livestock epidemic. Participants in a longitudinal web-based survey ( N = 195) were asked to report their meat consumption and their perceived risk in relation to bovine spongiform encephalopathy (BSE) and other related livestock diseases. Cross-sectional analyses at both measurement points (T1 and T2) showed that participants with low levels of preventive nutrition (high meat consumption) felt more at risk for BSE-related diseases than those reporting comparable higher levels of preventive behavior (low meat consumption), indicating relative accuracy. These results suggest that people recognize when their behavior is risky. More importantly, perceived risk also showed adaptive accuracy from a change perspective: increases in preventive nutrition from T1 to T2 were significantly associated with decreases in perceived risk between T1 and T2. Possible foundations and implications of an adaptive accuracy of risk perceptions are discussed.     

Risk Assessment for Aflatoxin: III. Modeling the Relative Risk of Hepatocellular Carcinoma

Estimates have been made of the cancer potency of aflatoxin exposure among the U.S. population. Risk modeling is used to assess the dose-response relationship between aflatoxin exposure and primary liver cancer, controlling for hepatitis B virus (HBV), based on data provided by the Yeh et al. study in China. A relative risk model is proposed as a more appropriate alternative to the additive ("absolute" risk) model for transportation of risk coefficients between populations with different baseline rates. Several general relative risk models were examined; the exponential model provided the best fit. The Poisson regression method was used to fit the relative risk model to the grouped data. The effects of exposure to aflatoxin (AFB1) and hepatitis B infection were both found to be statistically significant. The risk of death from liver cancer for those exposed to AFB1 relative to the unexposed population, increases by 0.05% per ng/kg/day exposure of AFB1 (p less than 0.001). The results also indicated a 25-fold increase in the risk of death from liver cancer among those infected with hepatitis B virus, relative to noncarriers (p less than 0.0001). With a hepatitis prevalence rate of 1%, the aflatoxin intake level associated with liver cancer lifetime excess risk of 1 x 10(-5) for the U.S. population was estimated as 253 ng/day, based on a liver cancer baseline rate of 3.4/100,000/yr.     

Expert and Public Perception of Risk from Biotechnology

Risk perceptions of a series of biotechnology applications were examined in a public (nonexpert) sample and an expert sample. Compared with the experts, the public perceived all biotechnology applications as more risky. Both groups perceived food-related applications to be riskier than medical applications. Compared with the public, experts perceived both food and medical applications as less harmful and more useful. Experts also judged the risks posed from medical biotechnology applications as more familiar and acknowledged by people and science. Lay estimates of the risk of food applications were predicted by potential harm, potential benefits, science knowledge, and familiarity; experts' estimates were predicted only by harm and benefits. Lay estimates of the risk of medical applications were predicted by potential harm; experts' estimates were predicted by potential benefits, number and type of people exposed, and science knowledge. We discuss the implications of the results for risk communication about and management of different types of biotechnologies.     

Perceived risk and behavioural feedback: Strategies for reducing accidents and increasing efficiency

There is overwhelming evidence that people will adapt to an increase in perceived risk by taking more care, and to a reduction in perceived risk by taking less care (behavioural feedback). This can reduce the effects of some safety measures and even, in some cases, produce the opposite effect to that which was intended or expected. Any safety programme should take account of this by seeking to minimize any change in perceived risk while maximizing the change in objective risk. It is, for example, probably counterproductive to 'oversell' the potential benefits of any safety measure.     

Perceived risk and behavioural feedback: Strategies for reducing accidents and increasing efficiency

Abstract

There is overwhelming evidence that people will adapt to an increase in perceived risk by taking more care, and to a reduction in perceived risk by taking less care (behavioural feedback). This can reduce the effects of some safety measures and even, in some cases, produce the opposite effect to that which was intended or expected. Any safety programme should take account of this by seeking to minimize any change in perceived risk while maximizing the change in objective risk. It is, for example, probably counterproductive to ‘oversell’ the potential benefits of any safety measure.     

行为金融:认知风险与认知期望收益

在行为金融的框架下,本文建立了含有过度自信心理的认知风险度量模型和含有过度自信心理的认知期望收益模型,研究了认知风险与认知期望收益的相互关系,研究结果表明:认知风险与认知期望收益的相互关系与标准金融理论中风险与收益的正相关关系相反,认知风险与认知期望收益呈现负相关关系。本文的研究结果对Shefrin(2001)通过金融实验得出的认知风险与认知期望收益为负相关关系的结论,给出了一种有效的理论解释。     

Taxonomic Analysis of Perceived Risk: Modeling Individual and Group Perceptions Within Homogeneous Hazard Domains

Previous studies of risk perception have typically focused on the mean judgments of a group of people regarding the riskiness (or safety) of a diverse set of hazardous activities, substances, and technologies. This paper reports the results of two studies that take a different path. Study 1 investigated whether models within a single technological domain were similar to previous models based on group means and diverse hazards. Study 2 created a group taxonomy of perceived risk for only one technological domain, railroads, and examined whether the structure of that taxonomy corresponded with taxonomies derived from prior studies of diverse hazards. Results from Study 1 indicated that the importance of various risk characteristics in determining perceived risk differed across individuals and across hazards, but not so much as to invalidate the results of earlier studies based on group means and diverse hazards. In Study 2, the detailed analysis of railroad hazards produced a structure that had both important similarities to, and dissimilarities from, the structure obtained in prior research with diverse hazard domains. The data also indicated that railroad hazards are really quite diverse, with some approaching nuclear reactors in their perceived seriousness. These results suggest that information about the diversity of perceptions within a single domain of hazards could provide valuable input to risk-management decisions.     

Perception of Mobile Phone and Base Station Risks

Perceptions of risks associated with mobile phones, base stations, and other sources of electromagnetic fields (EMF) were examined. Data from a telephone survey conducted in the German- and French-speaking parts of Switzerland are presented (N = 1,015). Participants assessed both risks and benefits associated with nine different sources of EMF. Trust in the authorities regulating these hazards was assessed as well. In addition, participants answered a set of questions related to attitudes toward EMF and toward mobile phone base stations. According to respondents' assessments, high-voltage transmission lines are the most risky source of EMF. Mobile phones and mobile phone base stations received lower risk ratings. Results showed that trust in authorities was positively associated with perceived benefits and negatively associated with perceived risks. People who use their mobile phones frequently perceived lower risks and higher benefits than people who use their mobile phones infrequently. People who believed they lived close to a base station did not significantly differ in their level of risks associated with mobile phone base stations from people who did not believe they lived close to a base station. Regarding risk regulation, a majority of participants were in favor of fixing limiting values based on the worst-case scenario. Correlations suggest that belief in paranormal phenomena is related to level of perceived risks associated with EMF. Furthermore, people who believed that most chemical substances cause cancer also worried more about EMF than people who did not believe that chemical substances are that harmful. Practical implications of the results are discussed.     

Does Medical Risk Perception and Risk Taking Change with Age?

Across adulthood, people face increasingly more risky medical problems and decisions. However, little is known about changes in medical risk taking across adulthood. Therefore, the current cross‐sectional study investigated age‐related differences in medical risk taking with N = 317 adults aged 20–77 years using newly developed scenarios to assess medical risk taking, and additional measures designed to evaluate risk‐taking behavior in the medical domain. Greater expected benefits on the Domain‐Specific Risk‐Taking Scale—Medical (DOSPERT‐M) predicted more active risk taking, whereas higher perceived risk predicted less active risk taking. Next, we examined differences in active and passive risk taking, where passive risk taking refers to risk taking that is associated with inaction. Age was associated with less passive risk taking, but not with active risk taking, risk perception, or expected benefits on the DOSPERT‐M. Participants were overall more likely to opt for taking medical action than not, even more so for a scenario about a vaccine for a deadly flu than for a scenario about a chemotherapy treatment for cancer. Overall, participants were more likely to accept medication (vaccine or chemotherapy) for their child than for themselves. Increasing age was associated with a lower likelihood of accepting the treatment or vaccine for oneself. Taken together, our study provides important insights about changes in medical risk taking across adulthood when people face an increasing number of complex and risky medical decisions.     

Cognitive Components of Risk Ratings

This study examined what lay people mean when they judge the "risk" of activities that involve the potential for accidental fatalities (e.g., hang gliding, living near a nuclear reactor). A sample of German and American students rated the "overall risk" of 14 such activities and provided 3 fatality estimates: the number of fatalities in an "average year," the individual yearly fatality probability (or odds), and the number of fatalities in a "disastrous accident." Subjects' fatality estimates were reasonably accurate and only moderately influenced by attitudes towards nuclear energy. Individual fatality probability correlated most highly with intuitive risk ratings. Disaster estimates correlated positively with risk ratings for those activities that had a low fatality probability and a relatively high disaster potential. Annual average fatality rates did not correlate with risk ratings at all. These findings were interpreted in terms of a two-dimensional cognitive structure. Subjective notions of risk were determined primarily by the personal chance of death; for some activities, "disaster potential" played a secondary role in shaping risk perception.     

Characterising the Perceived Risks and Benefits of Some Health Issues

Previous work on perceived risk, particularly a study by Fischhoff et al. (1978), is critically examined with reference to its applicability to specific health related issues. Judgments were obtained from 159 subjects of 15 health-related items in terms of perceived risk, benefit, and a number of risk characteristics based on the Fischhoff et al. research. In addition, demographic details concerning sex of respondent, seat belt usage, smoking status, and birth order were collected. Using regression analyses it was found that the direction of the risk-benefit relationship was dependent on the issue being judged. Risk was found to be better explained by ratings of likelihood of mishap and likelihood of death as a consequence of mishap. Benefit was poorly explained by the risk characteristics and demographic data. However, subject group characteristics were shown to be important influences on risk and benefit perception in certain situations. The implications of these results for understanding behavioral decisions involving risk in relation to specific activities are discussed.     

Probability Size Matters: The Effect of Foreground-Only versus Foreground+Background Graphs on Risk Aversion Diminishes with Larger Probabilities

Graphs are increasingly recommended for improving decision-making and promoting risk-avoidant behaviors. Graphs that depict only the number of people affected by a risk (“foreground-only” displays) tend to increase perceived risk and risk aversion (e.g., willingness to get vaccinated), as compared to graphs that also depict the number of people at risk for harm (“foreground+background” displays). However, previous research examining these “foreground-only effects” has focused on relatively low-probability risks (<10%), limiting generalizability to communications about larger risks. In two experiments, we systematically investigated the moderating role of probability size on foreground-only effects, using a wide range of probability sizes (from 0.1% to 40%). Additionally, we examined the moderating role of the size of the risk reduction, that is, the extent to which a protective behavior reduces the risk. Across both experiments, foreground-only effects on perceived risk and risk aversion were weaker for larger probabilities. Experiment 2 also revealed that foreground-only effects were weaker for smaller risk reductions, while foreground-only displays decreased understanding of absolute risk magnitudes independently of probability size. These findings suggest that the greater effectiveness of foreground-only versus foreground+background displays for increasing perceived risk and risk aversion diminishes with larger probability sizes and smaller risk reductions. Moreover, if the goal is to promote understanding of absolute risk magnitudes, foreground+background displays should be used rather than foreground-only displays regardless of probability size. Our findings also help to refine and extend existing theoretical accounts of foreground-only effects to situations involving a wide range of probability sizes.     

Risk Perception,Experience, and Objective Risk: A Cross‐National Study with European Emergency Survivors

Understanding public risk perceptions and their underlying processes is important in order to learn more about the way people interpret and respond to hazardous emergency events. Direct experience with an involuntary hazard has been found to heighten the perceived risk of experiencing the same hazard and its consequences in the future, but it remains unclear if cross‐over effects are possible (i.e., experience with one hazard influencing perceived risk for other hazards also). Furthermore, the impact of objective risk and country of residence on perceived risk is not well understood. As part of the BeSeCu (Behavior, Security, and Culture) Project, a sample of 1,045 survivors of emergencies from seven European countries (i.e., Germany, the Czech Republic, Poland, Sweden, Spain, Turkey, and Italy) was drawn. Results revealed heightened perceived risk for emergency events (i.e., domestic and public fires, earthquakes, floods, and terrorist attacks) when the event had been experienced previously plus some evidence of cross‐over effects, although these effects were not so strong. The largest country differences in perceived risk were observed for earthquakes, but this effect was significantly reduced by taking into account the objective earthquake risk. For fires, floods, terrorist attacks, and traffic accidents, only small country differences in perceived risk were found. Further studies including a larger number of countries are welcomed.     

CWD Prevalence,Perceived Human Health Risks,and State Influences on Deer Hunting Participation

This study examined factors predicted by previous research to influence hunters’ decisions to stop hunting deer in a state. Data were obtained from mail surveys of resident and nonresident deer hunters in Arizona, North Dakota, South Dakota, and Wisconsin (n = 3,518). Hunters were presented with six scenarios depicting hypothetical CWD prevalence levels and human health risks from the disease (e.g., death), and asked if they would continue or stop hunting deer in the state. Bivariate analyses examined the influence of five predictor variables: (a) CWD prevalence, (b) hypothetical human death from CWD, (c) perceived human health risks from CWD, (d) state, and (e) residency. In the bivariate analyses, prevalence was the strongest predictor of quitting hunting in the state followed by hypothetical human death and perceived risk. The presence of CWD in a state and residency were weak, but statistically significant, predictors. Interactions among these predictors increased the potential for stopping hunting in the state. Multivariate analyses suggested that 64% of our respondents would quit hunting in the worst‐case scenario.     

Risk Management for Hazardous Materials Transportation: A Local Study in Lyons

A probabilistic risk assessment study has been undertaken in the French city of Lyons. The issue was to know whether it was justified to forbid hazardous material lorries in the city center and to divert them through the suburbs. Therefore, two routes, the City Center route and the Suburban route were compared. This paper describes the analysis and shows how the results were used in the decision-making process. It also lists the difficulties that are encountered when trying to incorporate formal risk analysis into actual decision-making processes. The risk analysis showed that rerouting is an effective option with respect to all criteria. The mathematical expectation of the number of deaths is divided by three, the reduction on the annual frequency of catastrophic accidents is even more important (about one order of magnitude for accidents involving more than 50 deaths). The spatial analysis proved that the risk was more evenly distributed along the Suburban route. However, the annual expected number of death is low: 0.5 in the worst case. So traditional decision-making approaches do not indicate the necessity of rerouting. Such a situation is believed to be typical for risk management of major hazards. In Lyons, the use of a very small risk aversion factor is sufficient to justify the rerouting option on a formal decision-aiding basis. This is rather unusual, but it is thought that the recognition of the importance of risk aversion by the decision-makers themselves is a very positive outcome from this study.     

Exploring Factors Influencing the Risky Cycling Behaviors of Young Cyclists Aged 15–24 Years: A Questionnaire-Based Study in China

Road traffic crashes are the leading cause of death for young people, among whom cyclists account for a higher percentage of injuries and deaths than any other road users. This study aimed to examine the factor structure of the Young Cyclist Behavior Questionnaire (YCBQ) and investigate the relationships among demographic characteristics, cycling use-related variables, perceived risk, perceived cycling skills, and risky cycling behaviors among young people. A sample of 448 cyclists (mean age of 20.37 years) completed the questionnaire. Exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were utilized. The YCBQ had a clear factorial structure, items with high factor loadings, and good internal consistency. The five-factor structure included traffic violations, impulsive behaviors, ordinary violations, distractions, and errors. Risky cycling behaviors could be explained by gender, age, perceived risk, and perceived cycling skills, with the model explaining 37% of the variance. Gender had the greatest impact on risky cycling behaviors; male individuals were more likely to engage in risky behaviors. Young cyclists with higher levels of perceived risk had lower probabilities of engaging in risky cycling behaviors. Cyclists with lower scores on perceived cycling skills were more likely to report engaging in risky cycling behaviors. Age significantly explained risky behaviors; the younger the cyclist was, the higher his or her risky behaviors score. This research provides a theoretical foundation for the prevention of risky behaviors among young cyclists. Regarding intervention design, attention to the identified gender differences, the need to strengthen the ability to perceive risk, and the importance of road safety education for young cyclists may promote safer cycling.     

Communication About Micropollutants in Drinking Water: Effects of the Presentation and Psychological Processes

This study investigates how people change their risk perception, trust, and behavior as a consequence of being informed about the occurrence of micropollutants in drinking water. Micropollutants are substances present in extremely low concentrations that might be dangerous in higher concentrations. Data were gathered in the city of Zurich, Switzerland in 2013 using a questionnaire in which the information on micropollutants was presented differently to 12 experimental groups. Data of the key constructs were gathered before and after this information, so that causal effects could be quantified by regression analyses. Affective reactions to the information turned out to be the critical mediator of changes in risk perception (operationalized as the perceived change of quality due to pollution), which is an important determinant of changes in behavior and trust. Also, direct effects of affective reactions on behavior and trust were observed. Trust before appraising risks reduces negative affective reactions; however, it also reduces perceived quality (i.e., increases risk perception) and trust after risks are appraised. The different forms of information mainly influenced the participants’ affective reactions, but they also influenced perceived quality. The presentation with the least negative effects was a comparison of the intake of the substance by water with intake by food. The experimental design with repeated measurement that considers trust as a determinant and consequence of risk perception uncovered positive and negative effects of trust before appraising risks on changes of risk perception and trust due to appraising risks.     

Assessing the Effects of Information About Global Population Growth on Risk Perceptions and Support for Mitigation and Prevention Strategies

The human population is forecast to increase by 3–4 billion people during this century and many scientists have expressed concerns that this could increase the likelihood of certain adverse events (e.g., climate change and resource shortages). Recent research shows that these concerns are mirrored in public risk perceptions and that these perceptions correlate with a willingness to adopt mitigation behaviors (e.g., reduce resource consumption) and preventative actions (e.g., support actions to limit growth). However, little research has assessed the factors that influence risk perceptions of global population growth (GPG). To contribute to this important goal, this article presents three studies that examined how risk perceptions of GPG might be influenced by textual‐visual representations (like those in media and Internet articles) of the potential effects of GPG. Study 1 found that a textual narrative that highlighted the potential negative (cf. positive) consequences of GPG led to higher perceived risk and greater willingness to adopt mitigation behaviors, but not to support preventative actions. Notably, the influence of the narratives on perceived risk was largely moderated by the participant's prior knowledge and perceptions of GPG. Contrary to expectations, studies 2 and 3 revealed, respectively, that photographs depicting GPG‐related imagery and graphs depicting GPG rates had no significant effect on the perceived risk of GPG or the willingness to embrace mitigation or preventative actions. However, study 3 found that individuals with higher “graph literacy” perceived GPG as a higher risk and were more willing to adopt mitigation behaviors and support preventative actions.