A general guideline for management of risk from carcinogens

A simple relationship is formulated that helps to discriminate between acceptable and unacceptable individual lifetime risks (RL) to populations that are exposed to chemical carcinogens. The relationship is an empirical one and is developed using objective risk data as well as subjective risk levels that have found substantial acceptance among those concerned with carcinogenic risk assessment issues. The expression sets acceptable levels of lifetime carcinogenic risk and is a function of the total population exposed to the carcinogen. Its use in risk assessment and risk management provides guidance in distinguishing those carcinogens that should be regulated because of the health hazard they pose from those whose regulation may not be needed.     

Does a Reactor Need a Safety Backfit? Case Study on Communicating Decision and Risk Analysis Information to Managers

An approach to communicating decision and risk analysis findings to managers is illustrated in a real case context. This article consists essentially of a report prepared for senior managers of the Nuclear Regulatory Commission to help them make a reactor safety decision. It illustrates the communication of decision analysis findings relating to technical risks, costs, and benefits in support of a major risk management decision: whether or not to require a safety backfit. Its focus is on the needs of decision makers, and it introduces some novel communication devices.     

Sensitivity Analysis for Importance Assessment

We review briefly some examples that would support an extended role for quantitative sensitivity analysis in the context of model-based analysis (Section 1). We then review what features a quantitative sensitivity analysis needs to have to play such a role (Section 2). The methods that meet these requirements are described in Section 3; an example is provided in Section 4. Some pointers to further research are set out in Section 5.     

Bayesian incorporation of repeated measurements in logistic discrimination

A common problem in medical statistics is the discrimination between two groups on the basis of diagnostic information. Information on patient characteristics is used to classify individuals into one of two groups: diseased or disease-free. This classification is often with respect to a particular disease. This discrimination has two probabilistic components: (1) the discrimination is not without error, and (2) in many cases the a priori chance of disease can be estimated. Logistic models (Cox 1970; Anderson 1972) provide methods for incorporating both of these components. The a posteriori probability of disease may be estimated for a patient on the basis of both current measurement of patient characteristics and prior information. The parameters of the logistic model may be estimated on the basis of a calibration trial. In practice, not one but several sets of measurements of one characteristic of the patient may be made on a questionable case. These measurements typically are correlated; they are far from independent. How should these correlated measurements be used? This paper presents a method for incorporating several sets of measurements in the classification of a case.     

Errors in Estimates of Smoking-Related Deaths Derived from Nonsmoker Mortality

A number of recent analyses have computed present and future costs associated with a risk by estimating what would happen if the risk were absent. Two sources of bias are associated with this approach: (1) differences in confounding factors between present risk avoiders and risk takers, and (2) the difficulty of selecting an unbiased sample of risk avoiders. A staff memo from the Office of Technology Assessment used this approach to estimate mortality due to smoking. Numbers of deaths and age at death distributions of U.S. smokers and nonsmokers for all causes, all cancers, lung cancers, heart disease, and cerebrovascular lesions are used to assess the accuracy of these estimates. Large errors in the OTA estimates are found. Conditions are discussed that might help reduce errors from this approach.     

Hazardous Waste Incineration at Sea: EPA Decision Making on Risk

This paper critiques the Environmental Protection Agency's assessment of risk for hazardous waste incineration at sea. It reviews operational and transportation risks and considers alternative approaches for managing chlorinated organic hazardous wastes. It concludes that depending on the scale of the program, ocean incineration will either contribute little to the overall management of this waste stream or else it will engender significant risks, especially in the coastal environment. Furthermore, past assessments on the part of EPA have tended to understate the risks of incineration at sea while simultaneously holding out the promise of the technology as a commercial-scale management option. Finally, this paper observes that the Western European countries that pioneered incineration in the North Sea are now finding practical alternatives. It is recommended that waste reuse, on-site treatment, and techniques of waste reduction provide viable alternatives and obviate the need for incineration at sea.     

The Risks of Using Nuclear Energy Sources in Space: Some Lay Activists'Perceptions

A combination of directive and nondirective techniques was used to study the mental models of 30 lay activists regarding the risks of nuclear energy sources in space. Respondents'perceptions were compared with an "expert model" of the processes generating and controlling these risks, in terms of both the substance of their beliefs and several statistical measures of their performance. These analyses revealed a complex pattern of strengths and weaknesses. Their details are used to derive recommendations for formulating messages about these risks.     

Consideration of Background Exposures in the Management of Hazardous Waste Sites: A New Approach to Risk Assessment

The current approach to health risk assessment of toxic waste sites in the U.S. may lead to considerable expenditure of resources without any meaningful reduction in population exposure. Risk assessment methods used generally ignore background exposures and consider only incremental risk estimates for maximally exposed individuals. Such risk estimates do not address true public health risks to which background exposures also contribute. The purpose of this paper is to recommend a new approach to risk assessment and risk management concerning toxic waste sites. Under this new approach, which we have called public health risk assessment, chemical substances would be classified into a level of concern based on the potential health risks associated with typical national and regional background exposures. Site assessment would then be based on the level of concern for the particular pollutants involved and the potential contribution of site contaminants to typical background human exposures. While various problems can be foreseen with this approach, the key advantage is that resources would be allocated to reduce the most important sources of human exposure, and site remediation decisions could be simplified by focussing on exposure assessment rather than questionable risk extrapolations.     

Do you think that your health or safety are at risk because of your work? A large European study on psychological and physical work demands

Throughout Europe there are relatively few statistics, gathered a national level, which deal specifically with the problem of violence at work. In the UK, the revised Reporting of Injuries. Diseases and Dangerous Occurrences Regulations (RIDDOR) 1995 now require that certain violent incidents are reported on a national basis. The criteria for reporting, which are entirely dependent on the physical outcome of incidents, are discussed. It is recommended that employing organizations should establish their own internal systems for reportmg and recording a wider range of violent, and potentially violent, incidents. These should then be used to inform risk assessment and risk management.     

A Review of the High-Level Nuclear Waste Repository Siting Analysis

We critique two 1986 Department of Energy reports concerning the selection of sites for characterization as the nation's first high-level nuclear waste repository. We find that the multiattribute utility analysis of the five nominated sites was well done, although we express concern about the assessed probabilities, question the construction of two important attribute scales, and disagree with some of the value tradeoffs that were used. In contrast, we find the logic of the recommendations report to be weak and unconvincing.