presentation krewski.ppt [mode de compatibilité] · 15/10/2008 3 risk communication mclaughlin...

15/10/2008

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Risk Communicationand

Risk ManagementDecision Making

Daniel Krewski, PhD, MHA

Professor and DirectorMcLaughlin Centre for

Populaiton Health Risk Assessment

October 6, 2008

• Evolution of Risk Science

• Risk Communication

• Case Study: Prion Diseases

Ri k P ti

Outline

McLaughlin Centre for Population Health Risk Assessment

• Risk Perception

• Web-based Risk Communication

• Conclusions

• Training

-U.S. National Research Council

-World Health Organization

-Health Protection Branch

-Canadian Standards Association

-Health Protection Branch

19831985

1990

1991

Frameworks for Risk Assessment and Risk Management


-CPHA National Advisory Panel on Risk/Benefit Management of Drugs-Codex Alimentarius

-Canadian Standards Association-U.S. Presidential/Congressional Commission on Risk Assessment and Risk Management

1993

1997

-McLaughlin Centre for Population Health Risk Assessment

2007

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An Integrated Framework forRisk Assessment and


Risk Management

Health Risk Policy AnalysisEvidence Based Policy

Population Health

Multiple Interventions

AdvisoryRegulatory Economic Community Technological

Health Risk ScienceDeterminants and Interactions

Biologyand

Genetics

Socialand

Behavioural

Biology-social interactions

Environmentand

Occupation

Biology-environmentinteractions

Environment-socialinteractions

Problem/Context

RisksEvaluationEngage

S k h ld

U.S. Presidential/Congressional Commission on Risk Assessment and Risk Management (1997)


Options

Decisions

Actions

Stakeholders

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Risk Communication


“…risk communication is the act of conveying or transmitting information between interested parties about (a) levels of health or environmental risks; (b) the significance or meaning of health or environmental risks; or (c) decisions, action, or policies aimed at aging or

t lli h lth i t l i k I t t d

Risk Communication


controlling health or environmental risks. Interested parties include government agencies, corporations and industry groups, unions, the media, scientists, professional organization, public interest groups, and individual citizens.”

Covello et al. (1987)

Risk Communication in Practice

• Determine best ways to present scientific information on important risk issues


• Develop guidelines on expert/public communications

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Domain ofPerceived Risk

Domain ofTechnical Risk

GOVERNMENTS

MassMediaIndustry

Communications Processes Model


GeneralPublic

PublicInterest Groups

PublicSphere

ExpertSphere

IndependentResearchers

Risk Communication Flows

ManagingPrion Disease Risks


Prion Disease Risks

30000

40000

Number

Transmission of Mad Cow Disease to Humans


0

10000

20000of Cases

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• Canada has been challenged both economically and socially by BSE since the first indigenous Canadian case was confirmed in May 2003 in a 6-year old Albertan beef cow.

• 1997: CFIA banned the use of brains, spinal cords and other parts, known as specified risk materials (SRM), in cattle feed. The feed ban also applied to the remains of sheep, goats, bison, elk and deer.

• 2003: Slaughterhouses were to dispose of all SRMs from the bodies of cattle older than 30 months.

BSE Risk Management in Canada


• 2004: New regulations to prevent animal parts linked to BSE from being fed to pets and livestock such as chicken or pigs (not only cows and sheep).

• 2006: Cattle tissues capable of transmitting BSE were banned from all animal feeds, pet foods and fertilizers.

• 2007: CFIA introduces enhanced feed ban.

• People not eligible to donate blood or plasma if they spent a cumulative total of > 3 months in U.K. or France between 1980 and 1996, or a cumulative total of > 5 years in Western Europe (outside U.K. or France) since 1980.

vCJD Risk Management in Canada


• People not eligible to donate blood or plasma if have had a blood transfusion in the U.K., France or Western Europe since 1980.

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Managing BSE/vCJD

Risks


Social Issues Economic Issues

Policy Uptake:Interpreting Science for Decision Makers


InterpretationScientificData

Political IssuesTechnological Issues

SciencePolicy

Toxicity Testing:Science Informing Risk Management

www.nas.edu

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Prion Misfolding as a Toxicity Pathway


Research30%

Provincial9%

Attendee Demographics

Communication with Animal & Health Policy Community


Federal35%

International4%

IndustryAssociations

22%

Attendees = 48

Government (Canada)10%

Other (PAHO, etc.)

20%

Industry

Attendee Demographics

International Communication

‘Prion Disease Risk Management’


Government (U.S.)42%Research

19%

Industry Association

8%

Government (Mexico & Costa Rica)

1%Attendees = 50

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2009 Canada (Regina)North and South America (Brasilia)

2008 Canada (Ottawa, June 25)North America (Washington, July 10)

Risk ManagementPolicy Consultation Workshops


Europe (Brussels)

2010 Canada (Edmonton)North and South America (Washington)Asia (Beijing)

2011 Canada (Ottawa)

Risk Perception


p

Public Perception of Risk

RiskAssessment

RiskGuidelines

RiskInterventions

Expert decision making


Public decision making

RiskPerception

RiskAcceptability

RiskBehaviours

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Cigarette SmokingOzone Depletion

Breast ImplantsStreet Drugs

StressChemical Pollution

Crime and ViolenceSuntanning

AIDSMotor Vehicle Accidents

Nuclear WasteAlcohol & Pregnancy

PCBs or DioxinNuclear Power Plants

Climate ChangeNon-prescription Medication

AsbestosW t I i t

Public Perception of Risk

0 20 40 60 80

Waste IncineratorsMalnutrition

High Volt Power LinesFood Irradiation

Prescription DrugsGenetically Engineered Bacteria

Outdoor Air QualityBacteria in FoodMoulds in Food

Mercury in FillingsTap Water

Medical X-raysIndoor Air Quality

VDTsContraceptives

Heart PacemakersBottled Water

Contact lenses

Perceived High Risk (%)

Bacteria M=2 2 SD=1 1Art ificial sweetners M=2,3, SD=1,3

Genetically modified foods M=2,3, SD=1,3Imported food M=2,5, SD=1,0

Improper food labelling M=2,5, SD=1,2Antibiot ics in livestock M=2,5, SD=1,2

Food additives M=2,5, SD=1,1Pesticides M=2,5, SD=1,1

Mercury in fish M=2,6, SD=1,1Growth hormones M=2,7, SD=1,1

Public Perception of Foodborne Risks


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Bottled water M=1,4, SD=1,2Foot and mouth disease M=1,7, SD=1,3

Tap water M=1,7, SD=1,2WILD GAME DISEASE M=1,8, SD=1,2

Food packaging M=1,8, SD=1,2Food irradiation M=2,0, SD=1,2

MAD COW DISEASE M=1,9, SD=1,4Agroterrorism M=2,0, SD=1,4

Bacteria M 2,2, SD 1,1

“Even the ‘better times’ are not really better because you are simply digging yourself out of the hole, recouping your losses”

“A [ h t t k th f ] I ill

Farm Family Focus Groups


“As a young person [who was to take over the farm]…I will not go into farming and I want to tell that to the general public and the government…The message needs to get out that farming is no longer viable for families”

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U i S i ti t / S i J l

Friends and Relatives

Health Brochures / Pamphlets

Internet

Medical Doctors

News Media

Sources of Information on Population Health Risks


0% 20% 40% 60% 80% 100%

Industry

Government

Pub. Interest or Env. Groups

Univ. Scientists / Sci. Journals

A lot Fair Little None Don't Know / No Opinion

News Media

Friends and Relatives

Health Brochures / Pamphlets

Univ. Scientists / Sci . Journals

Medical Doctors

Confidence in Sources of Health Risk Information


0% 20% 40% 60% 80% 100%

Industry

Pub. Interest or Env. Groups

Government

Internet

A lot Fair Little None Don't Know / No Opinion

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Getting cancer mostly depends on the environment.

Getting cancer mostly depends on lifestyle.

Getting cancer mostly depends on genetic

makeup.

Risk Beliefs


020406080

100

Disagree Agree Don’tKnow / NoO pinion

020406080

100


020406080

100


Environment Social Genetics

I believe that a risk-free environment is an

attainable goal in 6080

100

Risk Beliefs


attainable goal in Canada.

02040


• Not to correct public misperceptions of risk• Understanding the factors that shape public attitudes and

opinions about risk can lead to more effective risk communicationM ff ti i k i ti l d t i d

Why Study Risk Perception?


• More effective risk communication can lead to increased public acceptance of risk management interventions

• “When the public worries, it is our responsibility to worry.”» Dan Beardsley

US Environmental Protection Agency

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Web-basedRisk Communication


Risk Communication

The preferred source of information and commentary on endocrine modulation

EM

www.emcom.ca


EM comwelcome to emcom

bienvenue chez emcomENTER HERE ENTREZ ICI

An exogenous agent that interferes with the synthesis, secretion, transport, binding, action or elimination of natural hormones in the body that

ibl f h i f

Endocrine Toxicants


are responsible for the maintenance of homeostasis, reproduction, development and/or behavior" (USEPA 1997).

Session 6 – 22/29

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• breast cancer• endometrial cancers • endometriosis• fecundity and fertility

• testicular cancer• ovarian cancer • prostate cancer• declining semen quality

Potential Population Health Risks


• fecundity and fertility • increased rates of

spontaneous abortion• sex ratios

• declining semen quality• male reproductive tract

abnormalities • precocious puberty

Website on Population Health Risks


Conclusions


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Risk ManagementMedia andStakeholderInvolvement

Science -PolicyPolicy Debate

Roles of Risk Communication


Public -Science Interface

yInterface

Policy Debate

Communication

• Graduate Certificate in Population Health Risk Assessment and Management

• MSc in Epidemiology

Training in Risk Science


• PhD in Population Health

• Postdoctoral Fellows

• Visiting Scientists

presentation krewski.ppt [mode de compatibilité] · 15/10/2008 3 risk communication mclaughlin...

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