
Environmental Encyclopedia 3
Risk assessment (public health)
Risk assessment process
The risk assessment/management procedure consists
of five steps: (1) Hazard assessment seeks to identify causative
agent(s). Simply put, is the substance toxic and are people
exposed to it? The hazard assessment demonstrates the link
between human actions and adverse effects. Often, hazard
assessment involves a chain of events. For example, the re-
lease of
pesticide
may cause
soil
and ground
water pollu-
tion
. Drinking contaminated
groundwater
from the site
or skin contact with contaminated soils may therefore result
in adverse health effects. (2) Dose-response relationships de-
scribe the toxicity of a chemical using models based on
human studies (including clinical and epidemiologic ap-
proaches) and animal studies. Many studies have indicated
a threshold or “no-effect” level, that is, an exposure level
where no adverse effects are observed in test populations.
Some health impacts may be reversible once the chemical
is removed. In the case of potential carcinogens, linear mod-
els are used almost exclusively. Risk or potency factors are
usually set using animal data, such as experiments with mice
exposed to varying levels of the chemical. With a linear
dose-response model, a doubling of exposure would double
the predicted risk. (3) Exposure assessment identifies the ex-
posed population, detailing the level, duration, and frequency
of exposure. Exposure pathways of the chemical include in-
gestion, inhalation, and dermal contact. Human and techno-
logical defenses against exposure must be considered. For
example, respirators and other protective equipment reduce
workplace exposures. In the case of prospective risk assess-
ments for facilities that are not yet constructed—for example,
a proposed hazardous waste incinerator—the exposure as-
sessment uses mathematical models to predict emissions and
distribution of contaminants around the site. Probably the
largest effort in the risk assessment process is in estimating
exposures. (4) Risk characterization determines the overall
risk, preferably including quantification of uncertainty. In
essence, the factors listed in the equation are multiplied for
each chemical and for each affected population. To arrive
at the total risk, risks from different exposure pathways and
for different chemicals are added. Populations with the maxi-
mum risk are identified. To gauge their significance, results
are compared to other environmental and societal risks.
These four steps constitute the scientific component of risk
assessment. (5) Risk management is the final decision-making
step. It encompasses the administrative, political, and eco-
nomic actions taken to decide if and how a particular societal
risk is to be reduced to a certain level and at what cost. Risk
management in the United States is often an adversarial
process involving complicated and often conflicting testi-
mony by expert witnesses. In recent years, a number of
disputes have been resolved by mediation.
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Risk management and risk reduction
Options that result from the risk management step
include performing no action, product labeling, and placing
regulations and bans. Examples of product labeling include
warning labels for consumer products, such as those on
tobacco products and cigarette advertising, and
Material
Safety Data Sheets
(MSDS) for chemicals in the work-
place. Regulations might be used to set maximum permissi-
ble levels of chemicals in the air and water (e.g., air and
water quality
criteria is set by the U.S.
Environmental
Protection Agency
). In the workplace, maximum exposures
known as Threshold Limit Values (TLVs) have been set by
the U.S.
Occupational Safety and Health Administra-
tion
. Such regulations have been established for hundreds
of chemicals. Governments have banned the production of
only a few materials, including DDT and PCBs, and product
liability concerns have largely eliminated sales of some pesti-
cides such as Paraquat and most uses of
asbestos
.
A variety of social and political factors influence the
outcome of the risk assessment/management process. Op-
tions to reduce risk, like banning a particular pesticide that
is a suspected
carcinogen
, may decrease productivity, prof-
its, and jobs. Furthermore, agricultural losses due to insects
or other pests if pesticide is banned might increase malnutri-
tion and death in subsistence economies. In general, risk
assessments are most useful when used in a relative or com-
parative fashion, weighing the benefits of alternative chemi-
cals or agricultural practices to another. Risk management
decisions must consider what degree of risk is acceptable,
whether it is a voluntary or involuntary risk, and the public’s
perception of the risk. A risk level of one in a million is
generally considered an acceptable lifetime risk by many
federal and state regulatory agencies. This risk level is mathe-
matically equivalent to a decreased life expectancy of 40
minutes for an individual with an average expected lifetime
of 74 years. By comparison, the 40,000 traffic fatalities annu-
ally in the United States represent over a 1% lifetime chance
of dying in a wreck—10,000 times higher than acceptable
for a chemical hazard. The discrepancy between what an
individual accepts for a chemical hazard in comparison to
risks associated with personal choices like driving or smoking
might indicate a need for more effective communication
about risk management.
Risk assessments are often controversial. Scientific
studies and conclusions about risk factors have been ques-
tioned. For example, animals are often used to determine
dose-response and exposure relationships. Results from these
studies are then applied to humans, sometimes without ac-
counting for physiological differences. The scientific ability
to accurately predict absolute risks is also poor. The
accu-
racy
of predictions might be no better than a factor of 10,
thus 10 to 1,000 cancers or other health hazard might be