Risk assessment is policy

1. Risk assessment is policy Wim Passchier Health Risk Analysis and Toxicology, Maastricht University

2. Mid-air aircraft crash An accident that cannot happen

3. The aircraft Public Policy - Risk & Uncertainty

4. An accident that cannot happen • July 1, 2002 • 23:35 • Überlingen • Germany • Tupolev 154 collides in mid-air with Boeing 757 • 71 fatalities Public Policy - Risk & Uncertainty

5. More pictures Public Policy - Risk & Uncertainty

6. It cannot happen General Before flight In flight Training Construction Maintenance Flight plan Weather Checklist Traffic control Detection systems Public Policy - Risk & Uncertainty

7. Alertness Instrument failures Time of the year Weather Topography Reduced visibility Pilot error Population density Death Procedure flaws Proximity to airport Reduced visibility Unstable air Ice Population density Training Skill Target character-istic Impact zone Injuries Instrument failures Procedure flaws ATC errors Crash angle Aircraft failure Fuel loading Maintenance quality Foreign object injection Training Skill Fuel loading Fire/ explosion Property damage Age Flight density Alertness Aircraft ownership Type Aircraft size Network model aircraft crashes Environment Exposure Factors Effects Type/stage of crash Human error Public Policy - Risk & Uncertainty Aircraft Failure

8. Look behind the obvious • Hardware • Poor state or unavailability of equipment and tools • Design • Poor design of a whole plant as well as individual equipment • Housekeeping • Poor housekeeping • Defences • Poor quality of the protection against hazardous situations • Maintenance management • Poor quality of the maintenance procedures regarding quality, utility, availability and comprehensiveness • Error enforcing conditions • Poor quality of the working environment, regarding circumstances that increase the probability of mistakes Public Policy - Risk & Uncertainty

9. Look behind the obvious (cont’d) • Employee training • Inadequate training or insufficient experience • Procedures • Poor quality of the operating procedures regarding utility, availability and comprehensiveness • Incompatible goals • Poor way safety and internal welfare are defended against a variety of other goals like time pressure and a limited budget • Communication • Poor quality or absence of lines of communication between the various regions, department or employees • Organisation • The way the project is managed and the company is operated Public Policy - Risk & Uncertainty

10. Alertness Instrument failures Time of the year Weather Topography Reduced visibility Pilot error Population density Death Procedure flaws Proximity to airport Reduced visibility Unstable air Ice Population density Training Skill Target character-istic Impact zone Injuries Instrument failures Procedure flaws ATC errors Crash angle Aircraft failure Fuel loading Maintenance quality Foreign object injection Training Skill Fuel loading Fire/ explosion Property damage Age Flight density Alertness Aircraft ownership Type Aircraft size Assessing the Überlingen crash Environment Exposure Factors Effects Type/stage of crash Human error Public Policy - Risk & Uncertainty Aircraft Failure

11. Behind the obvious: Überlingen • Hardware (ATC) • Design • Housekeeping • Defences • Maintenance management • Error enforcing conditions (ATC, Tupolev) • Employee training (Tupolev) • Procedures (ATC, Tupolev) • Incompatible goals (ATC) • Communication (ATC, Tupolev) • Organisation (ATC) Public Policy - Risk & Uncertainty

12. The accident’s risk tail One and a half year after the aircraft catastrophe at Lake Constance Swissair traffic controller stabbed Public Policy - Risk & Uncertainty

13. Risk - case Motorized transport: Accidents, noise and air pollution

14. context Cause-effect sequence cause-effect sequence human action, natural processes changes in material and energy fluxes stressors exposure harm drivers accidents feedback Public Policy - Risk & Uncertainty

15. Normal operation Human needs Human wants Choice of technology or production process Emissions of materials or energy Diffusion in the environ-ment - ‘exposure’ Effects Damage to health of man and the environ-ment Loss of control Disturbed operation Extended cause-effect sequence (drivers and accidents included) Uncertainties Test measures? Indirect effects Options Public Policy - Risk & Uncertainty

16. Mobility Products Heating Individual transport Cars with combus-tion engines Emission of combu-tion products Noise generation Spread of polluted air, inhalation by people Noise exposure Lung disease, cardio-vascular disease, Mortality Annoyance Loss of quality of life Disease Health care costs Loss of life Road accidents Disturbed operation Risk assessment of exposure to emissions from motorized vehicles Normal operation Human needs Human wants Choice of technology or production process Emissions of materials or energy Diffusion in the environ-ment - ‘exposure’ Effects Damage to health of man and the environ-ment Loss of control Disturbed operation Normal operation Public Policy - Risk & Uncertainty

17. PM10 risk assessment Public Policy - Risk & Uncertainty

18. Characterizing risk Measures are value laden

19. Measures for characterizing harmful health effects • Selecting measure to characterize risk is value laden • Example: Deaths - • Per million people in the population • Per million people within x km of exposure source • Per unit of concentration • Per facility • Per ton of air toxic released • Per ton of air toxic absorbed by people • Per ton of chemical produced • Per million dollars of product produced • In terms of loss of life expectancy Public Policy - Risk & Uncertainty

20. Measures for characterizing harmful health effects (cont’d) • Selecting measure to characterize risk is value laden • Requires interaction between decision maker and analyst An example taken from Wilson and Crouch demonstrates how the choice of one measure or another can make a technology look either more or less risky. For example, between 1950 and 1970, coal mines became much less risky in terms of deaths from accidents per ton of coal, but they became marginally riskier in terms of deaths from accidents per employee. Which measure one thinks more appropriate for decision making depends on one's point of view. From a national point of view, given that a certain amount of coal has to be obtained to provide fuel, deaths per million tons of coal is the more appropriate measure of risk, whereas from a labor leader's point of view, deaths per thousand persons employed may be more relevant. Public Policy - Risk & Uncertainty

21. serious annoyance acute respiratory infection progressive degenerative disease child cancer disability weight 0 population 1 10 20 30 40 50 60 70 80 age potential healthy life years 'health' loss DALY-concept Public Policy - Risk & Uncertainty

22. DALY’s from motorized transport Public Policy - Risk & Uncertainty

23. Risk Attribute of human activities

24. Economic subsystem Social subsystem Ecological subsystem Risk:(serious) harm might occur Economic subsystem Economic subsystem Socialsubsystem Socialsubsystem Ecological subsystem Ecological subsystem Risk Public Policy - Risk & Uncertainty

25. Definitions of risk • Probability of harm • Seriousness of (maximum) harm • Multi-attribute weighted sum of components of harm • Probability x seriousness of harm ('expected loss') • Probability-weighted sum of all components of harm ('average • expected loss') • Graph of points relating probability to extent of harm • Variance of harm about mean expected consequence • … Risk:a situation or event in which something of human value (including humans themselves) has been put at stake and where the outcome is uncertain. Public Policy - Risk & Uncertainty

26. Governance of risk Including stakeholders

27. New issues or policy results Define policy Evaluation Policyimplementation Appraisal Policy cycle Agenda setting Public Policy - Risk & Uncertainty

28. Consensus oriented Accountable Good governance Participatory Transparent Follows therule of law Responsive Effective and Efficient Equitable and inclusive Good governance Public Policy - Risk & Uncertainty

29. Management Sphere: Decision on & Implementation of Actions Assessment Sphere: Generation of Knowledge Pre-assessment • Problem Framing • Early Warning • Screening • Determination of Scientific Conventions Risk appraisal Risk management • Implementation • Option Realisation • Monitoring & Control • Feedback from Risk Mgmt. Practice • Decision Making • Option Identification & Generation • Option Assessment • Option Evaluation & Selection • Risk Assessment • Hazard Identification & Estimation • Exposure & Vulnerability Assessment • Risk Estimation • Concern Assessment • Risk Perceptions • Social Concerns • Socio-Economic Impacts Communication Tolerability and acceptability judgement • Risk Evaluation • Judging the Tolerability & Acceptability • Need for Risk Reduction Measures Risk Characterisation •Risk Profile •Judgement of the Seriousness of Risk •Conclusions & Risk Reduction Options Risk assessment framework Public Policy - Risk & Uncertainty

30. Framing motorized transport issues • Climate change issue • Fuel efficiency, Reduction of mobility • Mobility issue • Train, Plane, Car • Individual local transport issue • Public transport, Cycling, Car • Issue of car technology • Fuel efficiency, Exhaust cleaning • Physical planning issue • Offices near stations, Shops in towns, Bicycle paths Public Policy - Risk & Uncertainty

31. Perceptions of transport risks:own car Public Policy - Risk & Uncertainty

32. individualist egalitarian nature stable nature instable fatalist hierarchist nature capricious nature limited Attitudes and values Better cars. Technology solves problems. Bicycles and free public transport Exposure limits for PM10 and noise. Nothing helps. Public Policy - Risk & Uncertainty

33. Vulnerable groups • Risk are unequally distributed • People living near express ways are more exposed to PM10 and noise from traffic than people living rural areas • People are not equally sensitive • Older people may suffer more from PM10 and noise that young adults • These differences are also influenced by socio-economic differences • Higher income groups can afford better food and housing • Education may help to effectively influence risk mitigation measures Public Policy - Risk & Uncertainty

34. Environmental health The top of the iceberg

35. Processing by the organism Genetic and acquired characteristics Environment and health Dynamic demographic, social, cultural, economical and technological environment Determinants: Physical environment Social environment Life style Effects on health and quality of life Health care and prevention Public Policy - Risk & Uncertainty

36. Environment and Health Mortality Manifest phenomena Morbidity (Aggravation of) disease,medical consumption absenteeism Adverse health effects (impairments) Retarded development of organ systems (e.g. brain), (progressive) loss of organ function (e.g. lung, kidney, cardiovascular system, liver), chronic disturbance of sleep, concentration and performance, prolonged inflammation, allergy, immuno-suppression Functional or structural changes Reversible loss of organ function, chronic stress, alteration of macromolecules (protein, DNA), enzyme induction, inflammation, immune suppression, physical, biochemical, psychological changes (e.g. in diastolic/systolic blood pressure, in serum lipoproteins, anxiety) Phenomena observable in specific surveys or investigations Body burden Exposure Persistent organic chemicals, cadmium, lead, infection, DNA-adducts, stress-hormones Chemical, physical, biological, psychological factors Public Policy - Risk & Uncertainty

37. Summary • Risk is an attribute of societal processes • Risk assessment is part of policy processes • Risk governance is integral and inclusive • The framing of risk issues determines the nature and degree of risk mitigation • But many still like driving a car! Public Policy - Risk & Uncertainty

38. Contact data • Severij 1, NL 3155 BR MAASLAND • tel +31 10 599 0247, mobile +31 6 1297 4165 • e-mail wfpas@wxs.nl • Universiteit Maastricht • Dept. of Health Risk Analysis and Toxicology • PO Box 616, NL 6200 MD MAASTRICHT • tel +31 43 388 1097 (secretariat) • e-mail wf.passchier@grat.unimaas.nl Public Policy - Risk & Uncertainty