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COMPARATIVE RISK ASSESSMENT: SETTING PRIORITIES FOR URBAN ENVIRONMENTAL MANAGEMENT IN DEVELOPING COUNTRIES

COMPARATIVE RISK ASSESSMENT: SETTING PRIORITIES FOR URBAN ENVIRONMENTAL MANAGEMENT IN DEVELOPING COUNTRIES. Presentation by Barbara Britton January 18, 2000. OUTLINE OF PRESENTATION. Part I Introduction and Background . Part II International Experience with CRA . Part III Methodology.

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COMPARATIVE RISK ASSESSMENT: SETTING PRIORITIES FOR URBAN ENVIRONMENTAL MANAGEMENT IN DEVELOPING COUNTRIES

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  1. COMPARATIVE RISK ASSESSMENT:SETTING PRIORITIES FOR URBAN ENVIRONMENTAL MANAGEMENT IN DEVELOPING COUNTRIES Presentation by Barbara Britton January 18, 2000

  2. OUTLINE OF PRESENTATION Part I Introduction and Background Part II International Experience with CRA Part III Methodology

  3. PART I: INTRODUCTION AND BACKGROUND

  4. HISTORY OF COMPARATIVE RISK ASSESSMENT • First used in the U.S. in 1987 • “Unfinished Business” evaluated 31 problems and changed USEPA priorities • Many projects completed for regions, states, and cities • Used outside the U.S. by USAID and USEPA • First assessment was in Bangkok, 1990 • Assessments completed for about 10 cities and regions

  5. What DID EPA Learn From Comparative Risk Efforts? • Chemical-Specific, Media-Specific, Technology-Based Approaches have Limitations • Policies Based on Comparative Risk Assessments Could Lead to More Efficient Use of Resources and Greater Protection of Public Health and the Environment

  6. ENVIRONMENTAL MANAGEMENT Comparative Health Risk Assessment is used to set priorities for environmental management. Identify and evaluate risks, set priorities among problems. Risk Assessment Develop and implement solutions for high priority problems Risk Management

  7. ENVIRONMENTAL RISKS Environmental damage may have three types of negative effects.  Public Health--illness, injuries, deaths Ecological--loss of species and habitat Quality of Life--economic and social costs

  8. TYPES OF “RISK ASSESSMENT” Health Risk Assessment: evaluates the potential public health impacts of an environmental condition Comparative Health Risk Assessment: evaluates and compares the potential health impacts of severalenvironmental conditions Comparative Risk Assessment: evaluates and compares the potential health, ecological, and quality-of-life impacts of several environmental conditions

  9. PART II: INTERNATIONAL EXPERIENCE WITH COMPARATIVE RISK ASSESSMENT

  10. International Experience WithComparative Risk Assessment Bangkok: Accelerated plans for banning lead in gasoline Cairo: USAID projects to reduce air pollution and lead contamination Ahmedabad: Municipal program to reduce air pollution from transport Lima: USAID environmental health project under design Silesia: USAID technical assistance to high risk industrial facilities

  11. “HIGH RISK” PROBLEMS FROM FIVE CRAs Environmental Problem Categories Quito Cairo Lima Bangkok Ahmedabad Water, Sanitation, or Microbial Diseases     Ambient PM     Indoor Air  Lead   Air Pollution from Transport  Solid Waste 

  12. Bangkok, Thailand (1990) Airborne Particulate Matter Lead Contamination High Microbiological Diseases Carbon Monoxide (CO) Moderate Other Metals Toxic Air Pollutants Other Gaseous Air Pollutants (SO2, NO2, O3) Surface Water Contamination Low Ground Water Contamination Pesticides & Metals in Food Solid & Hazardous Wastes CRA RESULTS: BANGKOK

  13. Cairo, Egypt (1994) Airborne Particulate Matter Lead (all media) High Microbiological Diseases Microbiological Contamination of Food Moderate Ozone Other Gaseous Air Pollutants (SO2, CO) Moderate/Low Indoor Air Pollution Drinking Water (microbes, chemicals) Solid and Hazardous Wastes Toxic Air Pollutants Low Other Water Pathways (e.g. fish, irrigation) CRA RESULTS: CAIRO

  14. Ahmedabad, India (1995) Air Pollution from Mobile Sources Ambient Air Pollution (all sources) High Indoor Air Pollution Drinking Water Moderate Wastewater Occupational Hazards Low Traffic Hazards Food Contamination CRA RESULTS: AHMEDABAD

  15. Lima, Peru (1997) Inadequate Water Supply Inadequate Sanitation High Solid Waste Surface and Groundwater Contamination Food Contamination Moderate Air Pollution Water Pollution (marine) Hazardous Waste Low Toxic Substances Indoor Air Pollution Loss of Landscaped Areas & Farm Land CRA RESULTS: LIMA

  16. PART III: COMPARATIVE RISK ASSESSMENT METHODOLOGY

  17. STEPS IN RISK ASSESSMENT Health risk assessment is quantitative, based on experimental and observational data. Hazard Identification-- identify health risks associated with exposure Dose-Response Assessment-- model the relationship between dose and effects Exposure Assessment-- estimate a group’s exposure (amount, duration) Risk Characterization-- estimate the probability and severity of effects

  18. Source Transport and Fate in the Body Discharge Transport and Fate in the Environment Dose Target Organs Exposure Damage, Disease, or Death Intake CONCEPTUAL MODEL LINKING ENVIRONMENTAL CONDITIONS AND HEALTH

  19. EXAMPLE:HEALTH RISK ASSESSMENT Health Risk Assessment in Bangkok: • Population: 5.9 million • Airborne particulates: 90 - 200 g/m3 • Health effects (per year): • 9 - 51 million restricted activity days • 300 - 1400 deaths

  20. EXAMPLE:HEALTH RISK ASSESSMENT Health Risk Assessment in Quito, Ecuador: Population: 1.1 million Pesticides in food: 44.3 g/day intake of heptachlor 11.0 g/day intake of aldrin Health Effects: 0.3 to 9.1 x 10-3 lifetime cancer risk Up to 150 excess cancer cases/year

  21. EXAMPLE: COMPARATIVEHEALTH RISK ASSESSMENT Quito, Ecuador (1993) Risk Metropolitan Area Asentamientos Populares Microbiological Diseases (Food) Microbiological Diseases (Food) High Airborne Particulate Matter Airborne Particulate Matter Indoor Air Quality Occupational Disease and Injuries Drinking Water and Wastewater Traffic Injuries Traffic Injuries Drinking Water and Wastewater Solid & Hazardous Waste Disposal Moderate Indoor Air Quality Occupational Disease and Injuries Solid & Hazardous Waste Disposal Pesticides in Food Low Pesticides in Food

  22. CRA METHODOLOGY Four Phases of Comparative Risk Assessment • Planning • Determine scope of the study • Select and organize the team • Identify data types and sources • Data Collection and Analysis • Identify and gather data • Analyze data to estimate risks • Priority Setting • Interpret and compare risks • Debate and agree on priorities • Reporting • Prepare report as input to risk management planning

  23. FUNCTIONS AND RESPONSIBILITIES The organization of a CRA must address five necessary functions: Function Typical Unit Project Management and oversight Project Manager Policy direction and project mandate Steering Committee Public participation Public Advisory Committee Final risk ranking Steering Committee or Public Advisory Committee Technical Committees Technical analysis--data collection, risk assessment, preliminary ranking

  24. PARTICIPATORY ASPECTS OF CRAs • Broad participation is critical because: • Analysis is multi-disciplinary and highly complex • Setting priorities are ultimately based on values • of the community • Broad participation is linked to acceptance of • CRA results and implementation of actions to • reduce risks

  25. TECHNICAL ANALYSIS • Identify and evaluate health impacts of manyenvironmental conditions • water and food • sanitation, drainage, and wastewater • ambient and indoor air, gases and particles • solid and hazardous wastes • occupational injuries and exposures • infectious, vector-borne, and pollutant-related diseases

  26. ISSUE RESPONSE ADAPTING TECHNICAL ANALYSIS FOR CRA IN DEVELOPING COUNTRIES Scope includes infectious diseases, outside traditional risk assessment methods Use health data from clinics and local survey to estimate disease rates. Use environmental, health, and qualitative data Limited information and many data gaps. Data are not computerized and are aggregated at inappropriate geographic levels. Reorganize information; use assumptions and extrapolation where necessary. Some standard exposure assumptions are inappropriate due to culture or conditions. Adjust assumptions; conduct special studies if possible.

  27. PRIORITY SETTING • Categorize each health impact by magnitude and severity • magnitude -- number of people affected • severity -- of effect, and importance of group affected • Combine magnitude and severity scores • Compare and categorize environmental problems • high, medium, and low risk

  28. CRA Risk Ranking Risk ranking requires judgments based on values Comparing health effects: acute vs. chronic disease vs accidents Comparing effects among groups: children vs. working adults vs. elderly poor vs. middle income voluntarily exposed vs. involuntary exposed women vs. men

  29. Conclusion • CRA’s can form an effective basis for urban environmental management planning • Allow cities to address worst environmental problems first • Broad-based participation is crucial to ensure risk ranking reflects views of entire community • Stakeholder involvement is pivotal to ensuring risk assessment results translate into management action

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