Comparative Risk Assessment Methods and Their Applicability to Dredged Material Management Decision-Making

This article reviews the status of comparative risk assessment within the context of environmental decision-making; evaluates its potential application as a decision-making framework for selecting alternative technologies for dredged material management; and makes recommendations for implementing such a framework. One of the most important points from this review for decision-making is that comparative risk assessment, however conducted, is an inherently subjective, value-laden process. There is some objection to this lack of total scientific objectivity (“hard version” of comparative risk assessment). However, the “hard versions” provide little help in suggesting a method that surmounts the psychology of choice in decision-making schemes. The application of comparative risk assessment in the decision-making process at dredged material management facilities will have an element of value and professional judgment in the process. The literature suggests that the best way to incorporate this subjectivity and still maintain a defensible comparative framework is to develop a method that is logically consistent and allows for uncertainty by comparing risks on the basis of more than one set of criteria, more than one set of categories, and more than one set of experts. It should incorporate a probabilistic approach where necessary and possible, based on management goals.     

The Health Risk Assessment Approach,a Tool for Managing Risks on the Scale of a Territory: A French Experience

In France, regulatory analysis of the environment and human health potential consequences is implemented for an isolated industrial activity that requests an authorization to operate using the health risk assessment method. To date, the question is enlarged to the impact of the combination of multiple sources of pollution on the same territory. The main conclusions of the work launched by the French High Council of Public Health focus on four key points: (i) the utility of conducting such an analysis at a territory scale, (ii) the delimitation of the area, (iii) the conditions for the different stakeholders’ involvement, and (iv) the methodological specificities of the “zone health risk assessment.” The work encompassed literature reviews, seminars, and interviews of stakeholders. The utility of a Z-HRA is the central objective for the management of risk. It can no longer be conducted only for itself. The delimitation of the zone entails economic, political, environmental, and population aspects. Stakeholders become key actors in a steering and monitoring committee. Among methodological specificities, cumulative exposure comes first. Interpretation of the results should focus on risk management objectives. Finally, inclusion of Z-HRAs in flexible regulations that can be adapted to the local context is recommended.     

Application of a Multi-Criteria Decision-Making Approach for Ranking Environmental Risks Caused by Petrochemical Industries: A Case Study of a Sodium Carbonate Production Unit

The occurrence of accidents in petrochemical industries that cause environmental catastrophes has persuaded experts to use risk-oriented approaches. The approach is to rank the key elements of risk assessment by which the priority of each risk is specified compared to the other ones. The present study was performed to test the applicability of a multi-criteria decision-making approach for prioritizing environmental risks of a petrochemical complex in southwestern Iran. Accordingly, all risky activities of the Sodium Carbonate Production Unit (SCPU) were identified initially. Afterward, the relevant environmental components affected by the risky activities were specified. According to the specification, the most significant risks were shortlisted using experts’ judgment based on three criteria: “impact intensity,” “occurrence probability,” and the “extent of contamination dispersion in the environment.” The shortlisted environmental risks were then prioritized by the Method “Elimination et Choice Translating Reality (Elimination and Choice Expressing Reality)” abbreviated as ELECTRE. Based on the obtained results, “decreased air quality” and “manpower health threatening” are the top-priority risks while “poor quality of groundwater” was identified as the least priority risk. In a general conclusion, a multi-criteria decision-making approach is quite useful for assessing environmental risks of petrochemical industries.     

Defining risk: Normative considerations

The public thinks about (i.e., defines) environmental human health risks in different terms than the “experts.”; And because the manner in which we conceive of risk goes a long way in determining how risk management is conceived and carried out, any definition of risk has important normative elements. I argue that environmental policy based on the public's conception of risk fails to adequately protect fundamental human rights to health and liberty, by taking undue account of certain psychological factors that enter into the public's perception of risk. A survey of some of these factors is offered in an attempt to determine their policy relevance. The traditional scientific conception of risk, although not adequate to entirely define risk policy, serves as an important anchor for the protection of these rights by focusing on the probability or number of adverse health effects.     

Is the “Ecological Fallacy” a Fallacy?

Ecological studies of health effects due to agent exposure are generally considered to be a blunt instrument of scientific investigation, unfit to determine the “true” exposure-effect relationship for an agent. Based on this widely accepted tenet, ecological studies of the correlation between the local air concentration of radon and the local lung cancer mortality as measured by Cohen have been criticized as being subject to the “Ecological Fallacy” and thus producing invalid risk data. Here we discuss the data that a risk assessment needs as a minimum requirement for making a valid risk estimate. The examination of these data and a “thought experiment” show that it is Cohen's raw ecological data, uncorrected for population characteristic factors, which are the proper data for a risk assessment. Consequently, the “true” exposure-effect relationship is less and less important the more population characteristic factors are identified and the larger they are. This reversal of the usual argument is due to our approach: Here, the prediction of the health effects in an exposed population is of primary importance, not the shape of the “true” exposure-effect relationship. The results derived in this paper hold for ecological studies of any agent causing any health or other effect.     

Rapid prioritization of alien plants for eradication based on climatic suitability and eradication feasibility

Identifying which introduced species have the greatest potential for establishment, spread and impact is critical for prioritizing pre‐ and post‐border control. Using species distribution modelling and existing species locations we assessed the establishment risk based on the climatic suitability areas of 25 plant species listed as eradication targets under South African regulations. To improve confidence, three bioclimatic models were used to predict the potential distribution of each species. This information was combined with the number of localities and the “eradication feasibility syndromes” in a scoring‐categorical system to rank the species. Three management groups were identified. Group “A” includes species with medium‐high establishment risk and higher likelihood to be eradicated, these species should be a priority for eradication. Group “B” includes species with a medium‐low establishment risk but given the low number of known population and the species characteristics, eradication is likely to be feasible. Finally species in group “C” scored a medium‐high establishment risk but the eradication would be difficult due to the high number of known localities. This ranking provides a rapid method to prioritize the management towards the eradication of new potential invasive plant species in the country combining the establishment risk, known number of localities and the inferred eradication success.     

美国、加拿大环境和健康风险管理方法

对目前美国和加拿大多个部门使用的风险评价与风险管理方法进行了全面回顾和综合分析,论述各种不同方法的特征,深入探讨各种管理方法的基础、利弊、使用经验,辨识环境、人类健康和职业健康风险综合方法中应该包含的要素,阐述风险管理目标的确定方法,以期为中国的环境风险管理提供经验。     

Reproduction humaine: le point de vue du philosophe

This article discusses and essential aspect of the link between ethics and life, as expressed in the concept of bioethics. It discusses the various issues related to human reproduction from “the philosopher’s point of view”. This discussion is limited to the principles of this field. The author starts by justifying a philosophical approach to ethical problems in the context of medicine in general and reproduction in particular, a field which specialists, theoreticians or practitioners of medicine and legal medicine in particular, appear to have ignored. This leads to a discussion of the human aspects of reproduction, from questions concerning the nature of living beings (individuals and species) to the relationship between nature and culture (symbol and freedom). Although man “reproduces” and “procreates”, he is also technically able to “produce himself”. This shift from biological reproduction to procreation must take into account problems related to technological science in medicine (technical control of living material and so-called “neutrality” of the technique). The main bioethical issues involving an ethics of decision-making in the field of human reproduction (contraception, abortion, status of the embryo, medically-assisted procreation, desire to master the “form” of the “reproduced” human, or even the “product”, cloning) are then discussed. Finally, the author proposes elements of a “philosophy of point of view”, requiring responsibility for each decision in the context of an “ethics of discussion”.     

Variation in primate decision-making under uncertainty and the roots of human economic behaviour

Uncertainty is a ubiquitous component of human economic behaviour, yet people can vary in their preferences for risk across populations, individuals and different points in time. As uncertainty also characterizes many aspects of animal decision-making, comparative research can help evaluate different potential mechanisms that generate this variation, including the role of biological differences or maturational change versus cultural learning, as well as identify human-unique components of economic decision-making. Here, we examine decision-making under risk across non-human primates, our closest relatives. We first review theoretical approaches and current methods for understanding decision-making in animals. We then assess the current evidence for variation in animal preferences between species and populations, between individuals based on personality, sex and age, and finally, between different contexts and individual states. We then use these primate data to evaluate the processes that can shape human decision-making strategies and identify the primate foundations of human economic behaviour.This article is part of the theme issue ‘Existence and prevalence of economic behaviours among non-human primates’.     

An Evaluation of Risk Drivers from a Sample of Risk Assessments Conducted for the U.S. Army

We evaluate risk drivers at selected U.S. Army installations by developing a database containing contaminant-pathway-receptor combinations that exceed regulatory thresholds for ecological (toxicity quotient greater than one), human health cancer risk (predicted incremental lifetime cancer risk greater than one in ten thousand), and noncancer human health (hazard index greater than one). We compare the risk drivers from the database to reported corrective action objectives from available decision documents. For noncancer hazards, explosives (particularly in ground water) dominate the reported exceedances of regulatory thresholds in the database. PAHs in home-grown produce show the highest number of exceedances of regulatory thresholds for cancer risk. For ecological risks, PAHs in both terrestrial and aquatic environments dominate the exceedances of regulatory thresholds. All available cleanup levels were derived based on human health exposures rather than ecological exposures, except for one site. In general, ecological risks were considered to be “more uncertain,” and that was used as a basis for not relying on backcalculated target levels on the basis of ecological risk. The reverse was true for human health risks: the “conservative” assumptions incorporated into the modeling provided the justification for backcalculating health-protective target levels.     

Comprehensive Realism's Weight-of-Evidence Based Distributional Dose-Response Characterization

Challenges to low-dose linearity and other default assumptions in cancer risk assessment and the limitations associated with NOAELs, LOAELs, and constant uncertainty factor values in the evaluation of noncancer health effects have stimulated the continued evolution of risk assessment methodologies. The increasing need for more realistic estimates of the dose-response relationship, better uncertainty characterization, and greater utilization of cost-benefit analyses have also contributed to this evolution. “Comprehensive Realism” is an emerging quantitative weight-of-evidence based risk assessment methodology for both cancer and noncancer health effects which utilizes probability distributions and decision analysis techniques to reflect more of the relevant human exposure data, more of the available and pertinent human and animal dose-response data, and the current state of knowledge about the relative plausibility of alternative dose-response analyses. A tree (like a decision tree and a probability tree) is used to decompose the dose-response assessment into component factors, to provide a structure for explicitly considering multiple alternatives for each factor, and to explicitly incorporate the current state of knowledge about the relative plausibility of these alternatives. Groundbreaking work has demonstrated the feasibility of weight-of-evidence based distributional characterizations, and provided initial examples. Computer software implementations are also available.     

Quantification Methodology of “Health Human Resources” Related to “Health Technologies” Based on Indicators “RhSan”, “TechSan” and “RhTech”: Application to Senegal

ObjectivesAfter a century of spectacular advances, healthcare systems are facing unprecedented crisis, linked to shortage of health human resources and health technologies. In fact, availability of care depends on both technological and human resources of health. The objective of this study is to develop indicators that can measure qualitatively human resources and technologies of health in healthcare facilities, in order to assess availability of care in sub-Saharan African countries.Materials and MethodsRegarding “health technology” related to “medical devices”, an indicator called “TechSan” for “Technologies de Santé” was previously developed and published (Ndione FB et al. (2019) [6]). To address the deficiencies in usual indicators related to health human resources, a second indicator called “RhSan” for “Ressources humaines de santé” in French is proposed. This indicator assigns a weight to each health worker taking into account his specific “level of medical knowledge” and “experience”. In order to correlate “RhSan” with “TechSan”, a third indicator called “RhTech” is also developed to assess matches between “health technologies” and “health human resources” and establish realistic availability of care. These indicators have the advantage to be consolidated by specialty such as laboratory, imaging, surgery, and “mother and child care”.ResultsThe application of TechSan, RhSan and RhTech to data collected in Senegal in 2016, enabled to assess the distribution of “health technology” and “health human resources” in this country. They also permit the mapping of care availability per specialty in Senegal. The results show a strong oversupply of Dakar in terms of both human resources and technologies of health compared to other Senegalese regions. Oppositely, Sedhiou, Kaffrine, Matam and Kédougou are poorly endowed showing limits of the Senegalese health pyramid system.ConclusionTechSan, RhSan and RhTech can provide reliable decision-making tools in order to elaborate health policies in sub-Saharan African countries on more rigorous basis.     

An Integrated Framework for Risk Management and Population Health

The traditional medical model of health and health policy development has focused on individuals and the role of medical care in preventing and treating disease and injury. Recent attention to health inequities and social determinants of health has raised the profile of population heath and evidence-based strategies for improving the health of whole populations. At the same time, risk science has emerged as an important new discipline for the assessment and management of risks to health. This article reviews historical developments in the fields of risk management and population health and proposes a joint population health risk management framework that integrates the key elements of both fields. Applying this integrated approach to managing population health risks will facilitate the development of evidence-based health policy. It will encourage a more systematic and comprehensive evaluation of population health issues and promote the use of a broader suite of interventions to reduce health risks and enhance population health status.     

Risk Assessment of Human Activities on Protected Areas: A Case Study

No study has been done on the impact of anthropogenic risks on protected areas. This may be due to complexity and diversity of risk assessment indices. In this research, using multicriteria decision-making methods, qualitative and complex indices were converted to simple and quantitative indices by which anthropogenic risks affecting the Helleh Protected Area in Iran were analyzed. To this end, a questionnaire was prepared and delivered to Delphi panelists consisting of environmental expertise. In order to prioritize the identified risks, Technique for Order Preference by Similarity to Ideal Solution (TOPSIS), Analytical Hierarchy Process (AHP), and Simple Additive Weighting Technique (SAW) were used as a subset of Multiple Attribute Decision-making methods (MADM). In this study, risk factors were evaluated using three criteria of severity, probability of occurrence, and sensitivity of the recipient environment. In order to reach enough transcendence (consensus on priority of risks), an integrated approach comprising average, Borda, and Copeland methods was used. The obtained results suggested that “dam inundation upstream of the study area” is a top-priority risky factor threatening the wetland. “Stopping water pumps from the wetland” and “use of modern irrigation systems” were recommended as the most effective managerial strategies to control the identified risk.     

Prioritization of Veterinary Medicines in China's Environment

Large amounts of veterinary medicines are widely used as therapeutic drugs and feed additives (growth promoters) in China, the environmental presence of which possibly poses challenges to the environment and human health. Therefore, it is important to list the veterinary medicines that are considered to be of relatively high priority in China for environmental management. In this study, a three-stage prioritization scheme was applied to veterinary medicines in China. In Stage I, exposure assessment was conducted based on usage amounts and the possibility of entering the environment. In Stage II, the ecotoxicity and human health effects of compounds having a high potential to enter the environment were assessed. In Stage III, considering both the results of Stages I and II, veterinary medicines were assigned into four priority classifications. Using the approach, 38 compounds were assigned to “H,” 7 compounds to “M,” 2 compounds to “L,” and 22 compounds to “VL.” Among the top-ranked compounds, antibiotics, endoparasiticides, and aquacultural medicines accounted for 57.9%, 28.9%, and 10.5%, respectively. Insecticides used widely in China's aquaculture need to be taken into account due to their high priority rank. This is the first study on the prioritization of veterinary pharmaceuticals in China.     

Risk Analysis,Uncertainty Factors,and the Susceptibilities of Children

This article examines the use of uncertainty factors (UFs) by the Agency for Toxic Substances and Disease Registry (ATSDR) when developing health guidance values known as minimal risk levels (MRLs) in environmental risk analysis as it applies to children. Improvements in the chemical-specific databases often reveal new information and thereby reduce uncertainty or alternatively raise new concerns. As a result, MRLs can and will change. Children, in particular, are not “small adults” and in some instances demonstrate greater risks of exposure to environmental toxicants and greater susceptibility for adverse health effects once exposed. Recent experience with risk analysis for three toxicants (organic mercury, dioxin, and manganese) is recounted to demonstrate how ATSDR has revised MRLs as the emerging science generates greater knowledge and awareness of children's special vulnerabilities to toxic substances in the environment.     

An Ecological Basis for Integrated Environmental Management

Historically, approaches to environmental management activities have been reactive rather than proactive. Environmental laws and regulations have been generated primarily in response to particular issues (e.g., chemical contamination), creating a piecemeal approach for managing the environment. Responsibilities for managing different resources (e.g., water, air, forests, wildlife) have been assigned to different agencies or groups within government, further fragmenting environmental management. Proactive approaches that recognize the interconnectedness of environmental components are necessary to address complex and long-term environmental management issues. This Perspective proposes an environmental management approach that is comprehensive and systematic, while still being comprehensible to decision-makers and other stakeholders. The proposed approach is based on ecology and environmental values related to decision-making. It considers interrelationships among and between living organisms (including humans) and their physical environment. The proposed approach builds on the ecological risk assessment (ERA) paradigm, including goal (or problem) identification, values identification (ecological and human) for the environment being managed, and data collection and analysis focused on management decision-making. Stakeholder involvement and active participation are essential elements. As demonstrated herein, application of the proposed framework has enabled environmental managers to achieve workable solutions and to avoid or resolve environmental conflicts at both local and regional scales. The proposed framework is demonstrably transportable across political boundaries, applicable to all environments involving natural resources, independent of any particular ideology, and applicable to environmental management activities at all scales.     

A one health framework for estimating the economic costs of zoonotic diseases on society

This article presents an integrated epidemiological and economic framework for assessing zoonoses using a "one health" concept. The framework allows for an understanding of the cross-sector economic impact of zoonoses using modified risk analysis and detailing a range of analytical tools. The goal of the framework is to link the analysis outputs of animal and human disease transmission models, economic impact models and evaluation of risk management options to gain improved understanding of factors affecting the adoption of risk management strategies so that investment planning includes the most promising interventions (or sets of interventions) in an integrated fashion. A more complete understanding of the costs of the disease and the costs and benefits of control measures would promote broader implementation of the most efficient and effective control measures, contributing to improved animal and human health, better livelihood outcomes for the poor and macroeconomic growth.     

“Solution-Focused Risk Assessment”: A Proposal for the Fusion of Environmental Analysis and Action

For 30 years, more attention and resources have been expended on dissecting problems (risk assessment) than on evaluating actual solutions that reduce risks. The basic dogma holds that risk assessment must precede risk management. But there is an opposite and perhaps better way: the opening question should not be “How bad is the problem?” but “How good are the solutions we might apply to the problem?” Rethinking risk assessment in this context offers three classes of benefits over the status quo. First, it can help break the endless cycle of analysis: when the goal is to know enough to decide, rather than to know everything, natural stopping points emerge. Second, it can lead to more decisions that actually achieve risk reduction, rather than pronouncements about how much risk reduction would be optimal. Third, it can highlight ways to resolve multiple risks simultaneously, avoid needless and tragic risk-risk tradeoffs, and involve affected stakeholders in debating what should be done. Arguably, the longer the disembodied analysis of risk information is allowed to proceed, the more likely it is that the “problem” will be defined in a way that blunts the free-wheeling discussion of solutions, to the detriment of human health, the environment, and the economy.