Missing the “big picture consequences”

Missing the “big picture consequences”

Oct 4th, 2012

The Italian Ministry of Health received a study from the National Institute of Health.  The study is entitled “Sentieri”. It shows that in the city of Taranto, Italy, there was a 10% mortality increase in the period 2003-2008 with respect to the general Italian average rate. Taranto is heavily contaminated, in particular by a large foundry.

Classic forward looking” risk assessments missing the “big picture consequences”

Classic forward looking” risk assessments missing the “big picture consequences”

The trend reportedly confirms previous analyses, covering the period of 1995-2002. Those revealed mortality profile of the resident populations in sites belonging to the national list of highly contaminated sites. The list contains about 60 sites in Italy, the Italian equivalent of the US EPA Superfund list. The sites await environmental remediation.

These sites also reportedly have a higher death rate, incidence of lung cancer in both men and women. They also feature higher than normal death rate for acute respiratory diseases (ARD).

From a toxicological point of view we are seeing and measuring here the adverse effects of long-term contamination on public health. As we learn immensely from failures, it would be useful to our Human society to see an unbiased toxicological risk assessments of Taranto developed a posteriori.

Toxicological risk assessments are specialists approaches geared toward ascertaining adverse health effects from exposure to agents, in this case man-made contamination of the air. Such a “back-analysis” would offer a platform to recalibrate how to perform this type of assessment.  Thus large projects such as power plants, chemical plants, new chemicals to be released in the environment, etc. would receive better evaluation. If we do so, all the pain and the suffering endured by the exposed populations will deserve a positive purpose.

Performing a toxicological risk assessment on a generic contaminated site typically includes an estimate of the probability of harm. The probability of harm can be the probability of liver toxicity or the effect on wildlife, human health. This includes a clear description of the various assumptions and many uncertainties that go into the risk assessment. Like any other human endeavor, toxicological risk assessment may be biased. Or they may look only at “rosy scenarios”, or “average scenarios”, etc. The proposed Taranto back-analysis will help “clean-up” optimistic biases.

Let’s now talk about “classic forward looking” risk assessments.
Their goal is to provide decision makers with a basis for decisions making. Decision makers may be, for example, government regulatory officials, industry health and safety directors, public health officials, . Decisions may be related to the use or the production of physical agents/contamination in order to protect people’s health and the environment. The decision-making process often involves factors in addition to the risk assessment results These may include social values, technical feasibility and economic factors.

As described by the National Research Council of the National Academy of Sciences, toxicological risk assessments have four components:

1) Hazard identification. What the agent/contamination “can do” to the exposed population, i.e, for example, the capacity to cause liver or nervous system damage, cancer.
2) Dose response assessment. How much of an agent/contamination is necessary to cause a toxic effect, and a prediction of exposure levels with negligible effects.
3) Exposure assessment. How much of an agent/contaminant impacts people under various conditions.
4) Risk characterization. What is the likelihood that there will be an increase in cancer in a population exposed to the agent/contaminant.

A toxicological risk assessment will also discuss, as mentioned above, in detailed manner assumptions and uncertainties, in order to enable decision makers to understand how “safe” the conclusions are.

Can you see the piece missing in here? It is so big, right in front of us….

We are missing the “big picture consequences”…

For one person that might get sick, we are talking about an entire family suffering, psychological pressure, depression, psychosomatic ailments, etc.
It is too simplistic to characterize the risk by the increase of cancer rates. What about the lost agricultural production from contaminated farmland, lost tourism revenue? What about swimming restrictions in the lake or sea water next to home, and not being able to eat the fish, drink the milk, etc.?

The common reply to this statement is: “well, it’s too difficult to evaluate”.
A very good excuse, isn’t it? But it remains only an excuse.
Methods to get that difficult job done do exist and we use them. As an example in the formulation of the consequences of Cyber-attacks, large scale environmental damages. They are certainly not deterministic, and they are certainly not 100% accurate. However,  rather than wallowing in self-inflicted blindness, we much rather prefer to be generally right than precisely wrong (or ignorant).

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Category: Consequences, Hazard, Mitigations, Risk analysis, Risk management, Tolerance/Acceptability

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