Who Lives Near Coke Plants and Oil Refineries? An Exploration of the Environmental Inequity Hypothesis

Facility-specific information on pollution was obtained for 36 coke plants and 46 oil refineries in the United States and matched with information on populations surrounding these 82 facilities. These data were analyzed to determine whether environmental inequities were present, whether they were more economic or racial in nature, and whether the racial composition of nearby communities has changed significantly since plants began operations.The Census tracts near coke plants have a disproportionate share of poor and nonwhite residents. Multivariate analyses suggest that existing inequities are primarily economic in nature. The findings for oil refineries are not strongly supportive of the environmental inequity hypothesis. Rank ordering of facilities by race, poverty, and pollution produces limited (although not consistent) evidence that the more risky facilities tend to be operating in communities with above-median proportions of nonwhite residents (near coke plants) and Hispanic residents (near oil refineries). Over time, the racial makeup of many communities near facilities has changed significantly, particularly in the case of coke plants sited in the early 1900s. Further risk-oriented studies of multiple manufacturing facilities in various industrial sectors of the economy are recommended.The authors are all affiliated with the Harvard Center for Risk Analysis     

Distribution of Exposure Concentrations and Doses for Constituents of Environmental Tobacco Smoke

The ultimate goal of the research reported in this series of three articles is to derive distributions of doses of selected environmental tobacco smoke (ETS)-related chemicals for nonsmoking workers. This analysis uses data from the 16-City Study collected with personal monitors over the course of one workday in workplaces where smoking occurred. In this article, we describe distributions of ETS chemical concentrations and the characteristics of those distributions (e.g., whether the distribution was log normal for a given constituent) for the workplace exposure. Next, we present population parameters relevant for estimating dose distributions and the methods used for estimating those dose distributions. Finally, we derive distributions of doses of selected ETS-related constituents obtained in the workplace for people in smoking work environments. Estimating dose distributions provided information beyond the usual point estimate of dose and showed that the preponderance of individuals exposed to ETS in the workplace were exposed at the low end of the dose distribution curve. The results of this analysis include estimations of hourly maxima and time-weighted average (TWA) doses of nicotine from workplace exposures to ETS (extrapolated from 1 day to 1 week) and doses derived from modeled lung burdens of ultraviolet-absorbing particulate matter (UVPM) and solanesol resulting from workplace exposures to ETS (extrapolated from 1 day to 1 year).     

Residential Building Codes,Affordability, and Health Protection: A Risk-Tradeoff Approach

Residential building codes intended to promote health and safety may produce unintended countervailing risks by adding to the cost of construction. Higher construction costs increase the price of new homes and may increase health and safety risks through income and stock effects. The income effect arises because households that purchase a new home have less income remaining for spending on other goods that contribute to health and safety. The stock effect arises because suppression of new-home construction leads to slower replacement of less safe housing units. These countervailing risks are not presently considered in code debates. We demonstrate the feasibility of estimating the approximate magnitude of countervailing risks by combining the income effect with three relatively well understood and significant home-health risks. We estimate that a code change that increases the nationwide cost of constructing and maintaining homes by $150 (0.1% of the average cost to build a single-family home) would induce offsetting risks yielding between 2 and 60 premature fatalities or, including morbidity effects, between 20 and 800 lost quality-adjusted life years (both discounted at 3%) each year the code provision remains in effect. To provide a net health benefit, the code change would need to reduce risk by at least this amount. Future research should refine these estimates, incorporate quantitative uncertainty analysis, and apply a full risk-tradeoff approach to real-world case studies of proposed code changes.     

A Risk Assessment Method for Biological Introductions

This article describes an application of a method for assessing risks associated with the introduction of an organism into a new environment. The test organism was a binucleate Rhizoctonia fungal isolate that has potential for commercial development as a biological control agent for damping-off diseases in bedding plants. A test sample of host plant species was selected using the centrifugal phylogenetic host range principles, but with an emphasis on economic species. The effect of the fungus on the plant was measured for each species and expressed on a logarithmic scale. The effects on weights of shoots and roots per container were not normally distributed, nor were the effects on the number of plants standing (those which survived). Statements about the effect on the number standing and the shoot weight per container involved using the observed (empirical) distribution. This is illustrated with an example. Problems were encountered in defining the population of species at risk, and in deciding how this population should be formally sampled. The limitations of the method are discussed.     

Reliability Analysis for Hazardous Waste Treatment Processes

The reliability of a treatment process is addressed in terms of achieving a regulatory effluent concentration standard and the design safety factors associated with the treatment process. This methodology was then applied to two aqueous hazardous waste treatment processes: packed tower aeration and activated sludge (aerobic) biological treatment. The designs achieving 95 percent reliability were compared with those designs based on conventional practice to determine their patterns of conservatism. Scoping-level treatment costs were also related to reliability levels for these treatment processes. The results indicate that the reliability levels for the physical/chemical treatment process (packed tower aeration) based on the deterministic safety factors range from 80 percent to over 99 percent, whereas those for the biological treatment process range from near 0 percent to over 99 percent, depending on the compound evaluated. Increases in reliability per unit increase in treatment costs are most pronounced at lower reliability levels (less than about 80 percent) than at the higher reliability levels (greater than 90 percent, indicating a point of diminishing returns. Additional research focused on process parameters that presently contain large uncertainties may reduce those uncertainties, with attending increases in the reliability levels of the treatment processes.     

Chinese and Americans Agree on What Is Fair,but Disagree on What Is Best in Societal Decisions Affecting Health and Safety Risks

Through surveys of students and junior professionals and interviews with business and government executives, we studied Chinese choices and fairness perceptions in risky health and safety decisions. The survey responses were compared with American responses from an earlier study by Keller and Sarin.The survey results show that the American and Chinese respondents had similar fairness perceptions, but the Chinese did not make decisions that were consistent with their fairness perceptions, whereas the Americans did. We found that the middle-age Chinese professionals tended to make choices that were more different from the Americans than were the choices of the young Chinese management students. It is likely that these discrepancies were caused by cultural differences, with the younger Chinese tending to face a stronger Western influence.The insights from the survey results were enriched by interviews that revealed fairness perceptions of Chinese business and government executives. A framework to interpret cultural influences on decision making was also proposed.     

Improving performance in a contracted physician network

Health care organizations face significant performance challenges. Achieving desired results requires the highest level of partnership with independent physicians. Tufts Health Plan invited medical directors of its affiliated groups to participate in a leadership development process to improve clinical, service, and business performance. The design included performance review, gap analysis, priority setting, improvement work plans, and defining the optimum practice culture. Medical directors practiced core leadership capabilities, including building a shared context, getting physician buy-in, and managing outliers. The peer learning environment has been sustained in redesigned medical directors' meetings. There has been significant performance improvement in several practices and enhanced relations between the health plan and medical directors.