Trust‐Level Risk Evaluation and Risk Control Guidance in the NHS East of England

In recent years, the healthcare sector has adopted the use of operational risk assessment tools to help understand the systems issues that lead to patient safety incidents. But although these problem‐focused tools have improved the ability of healthcare organizations to identify hazards, they have not translated into measurable improvements in patient safety. One possible reason for this is a lack of support for the solution‐focused process of risk control. This article describes a content analysis of the risk management strategies, policies, and procedures at all acute (i.e., hospital), mental health, and ambulance trusts (health service organizations) in the East of England area of the British National Health Service. The primary goal was to determine what organizational‐level guidance exists to support risk control practice. A secondary goal was to examine the risk evaluation guidance provided by these trusts. With regard to risk control, we found an almost complete lack of useful guidance to promote good practice. With regard to risk evaluation, the trusts relied exclusively on risk matrices. A number of weaknesses were found in the use of this tool, especially related to the guidance for scoring an event's likelihood. We make a number of recommendations to address these concerns. The guidance assessed provides insufficient support for risk control and risk evaluation. This may present a significant barrier to the success of risk management approaches in improving patient safety.     

Risk‐Informed Regulation and Safety Management of Nuclear Power Plants—On the Prevention of Severe Accidents

There are four operating nuclear power plant (NPP) units in Finland. The Teollisuuden Voima (TVO) power company has two 840 MWe BWR units supplied by Asea‐Atom at the Olkiluoto site. The Fortum corporation (formerly IVO) has two 500 MWe VVER 440/213 units at the Loviisa site. In addition, a 1600 MWe European Pressurized Water Reactor supplied by AREVA NP (formerly the Framatome ANP—Siemens AG Consortium) is under construction at the Olkiluoto site. Recently, the Finnish Parliament ratified the government Decision in Principle that the utilities' applications to build two new NPP units are in line with the total good of the society. The Finnish utilities, Fenno power company, and TVO company are in progress of qualifying the type of the new nuclear builds. In Finland, risk‐informed applications are formally integrated in the regulatory process of NPPs that are already in the early design phase and these are to run through the construction and operation phases all through the entire plant service time. A plant‐specific full‐scope probabilistic risk assessment (PRA) is required for each NPP. PRAs shall cover internal events, area events (fires, floods), and external events such as harsh weather conditions and seismic events in all operating modes. Special attention is devoted to the use of various risk‐informed PRA applications in the licensing of Olkiluoto 3 NPP.     

Trust in Risk Management: A Model‐Based Review of Empirical Research

This review of studies of trust in risk management was designed, in part, to examine the relations between the reviewed research and the consensus model of trust that has recently emerged in other fields of study. The review begins by briefly elaborating the consensus views on the dimensionality and function of trust. It then describes the various models of trust that have been developed in the field of risk management, comparing them with the consensus approach. The findings of previous reviews are outlined, followed by a delineation of the open questions addressed by the present review, the method used, and the results. Finally, the findings of the review are discussed in relation to the important issue of trust asymmetry, the role of trust in risk management, and directions for future research. The consensus model specifies two conceptualizations of trust, each linked to particular types of antecedents. Relational trust, which is called trust in this review, is based on the relations between the trusting person and the other. Calculative trust, which is called confidence, is based on past behavior of the other and/or on constraints on future behavior. Results of this review showed that most studies of trust in risk management, while exploring matters of particular concern to the risk management community, were at least in part consistent with the consensus model. The review concludes by urging greater integration between the concerns of the former and the insights of the latter.     

Roy’s Safety‐First Portfolio Principle in Financial Risk Management of Disastrous Events

Roy pioneers the concept and practice of risk management of disastrous events via his safety‐first principle for portfolio selection. More specifically, his safety‐first principle advocates an optimal portfolio strategy generated from minimizing the disaster probability, while subject to the budget constraint and the mean constraint that the expected final wealth is not less than a preselected disaster level. This article studies the dynamic safety‐first principle in continuous time and its application in asset and liability management. We reveal that the distortion resulting from dropping the mean constraint, as a common practice to approximate the original Roy’s setting, either leads to a trivial case or changes the problem nature completely to a target‐reaching problem, which produces a highly leveraged trading strategy. Recognizing the ill‐posed nature of the corresponding Lagrangian method when retaining the mean constraint, we invoke a wisdom observed from a limited funding‐level regulation of pension funds and modify the original safety‐first formulation accordingly by imposing an upper bound on the funding level. This model revision enables us to solve completely the safety‐first asset‐liability problem by a martingale approach and to derive an optimal policy that follows faithfully the spirit of the safety‐first principle and demonstrates a prominent nature of fighting for the best and preventing disaster from happening.     

Mediating and Moderating Roles of Trust in Government in Effective Risk Rumor Management: A Test Case of Radiation‐Contaminated Seafood in South Korea

This study has two aims: to identify effective strategies for managing false rumors about risks and to investigate the roles that basic and situational trust in government play in that process. Online experiment data were collected nationwide from 915 adults in South Korea. They were exposed to a false rumor about radiation‐contaminated seafood and were randomly assigned to one of three rumor response conditions (refutation, denial, attack the attacker). One‐way ANOVA indicated that the refutation response yielded the highest level of situational trust in government response (TGR). Results of moderated mediation models using the PROCESS Macro indicated the following. (1) The refutation response had a positive effect on TGR, and the attack response had a negative effect. (2) There were significant interaction effects between the attack response and preexisting basic trust in government (BTG) in that the attack response had a negative effect on TGR only when BTG was low. (3) TGR significantly mediated the relationship between each of the three rumor responses and two dependent variables (intentions for rumor dissemination and for unwarranted actions), but in dramatically different ways across the responses. This study provides evidence for the superior effectiveness of the refutation rumor response and identifies specific roles of trust in government in the risk rumor management process.     

Significant Factors of Aviation Insurance and Risk Management Strategy: An Empirical Study of Taiwanese Airline Carriers

Aviation insurance premiums have become a heavy burden for the airline industry since September 11, 2001. Although the industry must constantly balance its operations between profitability and safety, the reality is that airlines are in the business of making money. Therefore, their ability to reduce cost and manage risk is a key factor for success. Unlike past research, which used subjective judgment methods, this study applied quantitative historical data (1999–2000) and gray relation analysis to identify the primary factors influencing ratemaking for aviation insurance premiums. An empirical study of six airlines in Taiwan was conducted to determine these factors and to analyze the management strategies used to deal with them. Results showed that the loss experience and performance of individual airlines were the key elements associated with aviation insurance premiums paid by each airline. By identifying and understanding the primary factors influencing ratemaking for aviation insurance, airlines will better understand their relative operational strengths and weaknesses, and further help top management identify areas for further improvement. Knowledge of these factors combined with effective risk management strategies, may result in lower premiums and operating costs for airline companies.     

Sensitivity Analysis of a Two‐Dimensional Quantitative Microbiological Risk Assessment: Keeping Variability and Uncertainty Separated

The aim of quantitative microbiological risk assessment is to estimate the risk of illness caused by the presence of a pathogen in a food type, and to study the impact of interventions. Because of inherent variability and uncertainty, risk assessments are generally conducted stochastically, and if possible it is advised to characterize variability separately from uncertainty. Sensitivity analysis allows to indicate to which of the input variables the outcome of a quantitative microbiological risk assessment is most sensitive. Although a number of methods exist to apply sensitivity analysis to a risk assessment with probabilistic input variables (such as contamination, storage temperature, storage duration, etc.), it is challenging to perform sensitivity analysis in the case where a risk assessment includes a separate characterization of variability and uncertainty of input variables. A procedure is proposed that focuses on the relation between risk estimates obtained by Monte Carlo simulation and the location of pseudo‐randomly sampled input variables within the uncertainty and variability distributions. Within this procedure, two methods are used—that is, an ANOVA‐like model and Sobol sensitivity indices—to obtain and compare the impact of variability and of uncertainty of all input variables, and of model uncertainty and scenario uncertainty. As a case study, this methodology is applied to a risk assessment to estimate the risk of contracting listeriosis due to consumption of deli meats.     

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.     

Long‐Term Contracting: The Role of Private Information in Dynamic Supply Risk Management

We examine the critical role of evolving private information in managing supply risk. The problem features a dyadic channel where a dominant buyer operates a multiperiod inventory system with lost sales and fixed cost. He replenishes from a supplier, whose private state of production is vulnerable to random shocks and evolves dynamically over time. We characterize the optimal inventory policy with a simple semi‐stationary structure; it distorts order quantity for limiting information rent only in the initial period; the optimal payment compensates for production cost in every period but concedes real information rent only in the initial period. These properties allow us to derive an easy‐to‐implement revenue‐sharing contract that facilitates ex ante strategic planning and ex post dynamic execution. This work advances our understanding on when and how to use private information in dynamic risk management.     

Toward an Epidemiology of Safety and Security Risks: An Organizational Vulnerability Assessment in International Airports

International airports are complex sociotechnical systems that have an intrinsic potential to develop safety and security disruptions. In the absence of appropriate defenses, and when the potential for disruption is neglected, organizational crises can occur and jeopardize aviation services. This investigation examines the ways in which modern international airports can be “authors of their own misfortune” by adopting practices, attitudes, and behaviors that could increase their overall level of vulnerability. A sociotechnical perspective, the macroergonomic approach, is applied in this research to detect the potential organizational determinants of vulnerability in airport operations. Qualitative data nurture the case study on international airports produced by the present research. Findings from this study highlight that systemic weaknesses frequently reside in areas at the intersection of physical, organizational, and social spaces. Specific pathways of vulnerability can be drawn across these areas, involving the following systemic layers: individual, task, tools and technology, environment, and organization. This investigation expands the existing literature on the dynamics that characterize crisis incubation in multiorganization, multistakeholder systems such as international airports and provides practical recommendations for airport managers to improve their capabilities to early detect symptoms of organizational vulnerability.     

Risk Perception and Movies: A Study of Availability as a Factor in Risk Perception

Media effects on risk perception have often been explained by Tversky and Kahneman's availability principle, but research has not consistently supported it. What seem like media effects based on availability may be effects of new information. In an experimental study, entertainment movies depicting dramatic risk events were shown. They were found to produce no average effects on perceived risks in spite of large mood effects and being perceived as credible. We found, however, evidence of idiosyncratic effects of the movies, that is, people reacted immediately after the movies with enhanced  or  diminished risk beliefs. These reactions had faded after 10 days. Implications for the availability heuristic and risk perception are discussed.     

Cyber Security Risk Management: Public Policy Implications of Correlated Risk,Imperfect Ability to Prove Loss,and Observability of Self‐Protection

The correlated nature of security breach risks, the imperfect ability to prove loss from a breach to an insurer, and the inability of insurers and external agents to observe firms’ self‐protection efforts have posed significant challenges to cyber security risk management. Our analysis finds that a firm invests less than the social optimal levels in self‐protection and in insurance when risks are correlated and the ability to prove loss is imperfect. We find that the appropriate social intervention policy to induce a firm to invest at socially optimal levels depends on whether insurers can verify a firm's self‐protection levels. If self‐protection of a firm is observable to an insurer so that it can design a contract that is contingent on the self‐protection level, then self‐protection and insurance behave as complements. In this case, a social planner can induce a firm to choose the socially optimal self‐protection and insurance levels by offering a subsidy on self‐protection. We also find that providing a subsidy on insurance does not provide a similar inducement to a firm. If self‐protection of a firm is not observable to an insurer, then self‐protection and insurance behave as substitutes. In this case, a social planner should tax the insurance premium to achieve socially optimal results. The results of our analysis hold regardless of whether the insurance market is perfectly competitive or not, implying that solely reforming the currently imperfect insurance market is insufficient to achieve the efficient outcome in cyber security risk management.     

Shareholders' Wealth‐Maximizing Operating Decisions and Risk Management Practices in a Mixed Contracts Economy

This paper establishes a critically important positive role for operations management practices and financial hedging. We show that operations management decisions and financial hedging are intertwined, and we advance a framework that can identify their combined effects on investors' wealth. We show that: (a) firms (publicly traded corporations) will optimally hold adequate riskless working capital (e.g., cash) to minimize the cost of obtaining non‐financial inputs, and the magnitude of this cash holding depends on operating details, and (b) operations management and financial hedging can lower firms' cash requirements, and boost productivity, defined as the wealth created in the firm per dollar of invested capital. Productivity‐enhancing practices—by “freeing up” some of the firm's cash—can maximize the investors' wealth. We show that these results obtain because firms' contracts with many of the providers of non‐financial inputs are not traded, and because investors can invest not just in public corporations but also in businesses “outside the markets” (e.g., proprietorships, partnerships, and private equity).     

Assessment and Management of Risk in the Transport of Dangerous Materials: The Case of Chlorine Transport in France

The purpose of this paper is to provide the main results of a study concerning the risk of chlorine transport by train in France. The specific problem of chlorine transport is presented in the framework of a general model for assessing the risk in the transport of dangerous materials. The probability of accidents followed with a chlorine release involving fatalities are put in perspective with other risks having potential health effects on the public. Two types of application of the model are envisaged in relation to the management of risk: the selection of protective measures through a cost-effectiveness approach and the use of the model for a better planning of decisions in an accident situation.     

Reanalysis of the DEMS Nested Case‐Control Study of Lung Cancer and Diesel Exhaust: Suitability for Quantitative Risk Assessment

The International Agency for Research on Cancer (IARC) in 2012 upgraded its hazard characterization of diesel engine exhaust (DEE) to “carcinogenic to humans.” The Diesel Exhaust in Miners Study (DEMS) cohort and nested case‐control studies of lung cancer mortality in eight U.S. nonmetal mines were influential in IARC's determination. We conducted a reanalysis of the DEMS case‐control data to evaluate its suitability for quantitative risk assessment (QRA). Our reanalysis used conditional logistic regression and adjusted for cigarette smoking in a manner similar to the original DEMS analysis. However, we included additional estimates of DEE exposure and adjustment for radon exposure. In addition to applying three DEE exposure estimates developed by DEMS, we applied six alternative estimates. Without adjusting for radon, our results were similar to those in the original DEMS analysis: all but one of the nine DEE exposure estimates showed evidence of an association between DEE exposure and lung cancer mortality, with trend slopes differing only by about a factor of two. When exposure to radon was adjusted, the evidence for a DEE effect was greatly diminished, but was still present in some analyses that utilized the three original DEMS DEE exposure estimates. A DEE effect was not observed when the six alternative DEE exposure estimates were utilized and radon was adjusted. No consistent evidence of a DEE effect was found among miners who worked only underground. This article highlights some issues that should be addressed in any use of the DEMS data in developing a QRA for DEE.     

Stakeholders’ Perspective on Ecological Modeling in Environmental Risk Assessment of Pesticides: Challenges and Opportunities

The article closely examines the role of mechanistic effect models (e.g., population models) in the European environmental risk assessment (ERA) of pesticides. We studied perspectives of three stakeholder groups on population modeling in ERA of pesticides. Forty‐three in‐depth, semi‐structured interviews were conducted with stakeholders from regulatory authorities, industry, and academia all over Europe. The key informant approach was employed in recruiting our participants. They were first identified as key stakeholders in the field and then sampled by means of a purposive sampling, where each stakeholder identified as important by others was interviewed and asked to suggest another potential participant for our study. Our results show that participants, although having different institutional backgrounds often presented similar perspectives and concerns about modeling. Analysis of repeating ideas and keywords revealed that all stakeholders had very high and often contradicting expectations from models. Still, all three groups expected effect models to become integrated in future ERA of pesticides. Main hopes associated with effect models were to reduce the amount of expensive and complex testing and field monitoring, both at the product development stage, and as an aid to develop mitigation measures. Our analysis suggests that, although the needs of stakeholders often overlapped, subtle differences and lack of trust hinder the process of introducing mechanistic effect models into ERA.     

Interpreting MSHA Citations Through the Lens of Occupational Health and Safety Management Systems: Investigating Their Impact on Mine Injuries and Illnesses 2003–2010

Since the late 1980s, the U.S. Department of Labor has considered regulating a systems approach to occupational health and safety management. Recently, a health and safety management systems (HSMS) standard has returned to the regulatory agenda of both the Occupational Safety and Health Administration (OSHA) and the Mine Safety and Health Administration (MSHA). Because a mandated standard has implications for both industry and regulating bodies alike, it is imperative to gain a greater understanding of the potential effects that an HSMS regulatory approach can have on establishment‐level injuries and illnesses. Through the lens of MSHA's regulatory framework, we first explore how current enforcement activities align with HSMS elements. Using MSHA data for the years 2003–2010, we then analyze the relationship between various types of enforcement activities (e.g., total number of citations, total penalty amount, and HSMS‐aligned citations) and mine reportable injuries. Our findings show that the reduction in mine reportable injuries predicted by increases in MSHA enforcement ranges from negligible to 18%. The results suggest that the type and focus of the enforcement activity may be more important for accident reduction than the total number of citations issued and the associated penalty amount.     

An Integrated Risk Assessment Model of Township‐Scaled Land Subsidence Based on an Evidential Reasoning Algorithm and Fuzzy Set Theory

Land subsidence risk assessment (LSRA) is a multi‐attribute decision analysis (MADA) problem and is often characterized by both quantitative and qualitative attributes with various types of uncertainty. Therefore, the problem needs to be modeled and analyzed using methods that can handle uncertainty. In this article, we propose an integrated assessment model based on the evidential reasoning (ER) algorithm and fuzzy set theory. The assessment model is structured as a hierarchical framework that regards land subsidence risk as a composite of two key factors: hazard and vulnerability. These factors can be described by a set of basic indicators defined by assessment grades with attributes for transforming both numerical data and subjective judgments into a belief structure. The factor‐level attributes of hazard and vulnerability are combined using the ER algorithm, which is based on the information from a belief structure calculated by the Dempster‐Shafer (D‐S) theory, and a distributed fuzzy belief structure calculated by fuzzy set theory. The results from the combined algorithms yield distributed assessment grade matrices. The application of the model to the Xixi‐Chengnan area, China, illustrates its usefulness and validity for LSRA. The model utilizes a combination of all types of evidence, including all assessment information—quantitative or qualitative, complete or incomplete, and precise or imprecise—to provide assessment grades that define risk assessment on the basis of hazard and vulnerability. The results will enable risk managers to apply different risk prevention measures and mitigation planning based on the calculated risk states.