Risk management: From needs to knowledge, knowledge to action

Mikko Pohjola, THL

Contents

• Lecture• Round-up of (open) EHRM• Development of shared beliefs to guide action

• Discussion• Agumentation on the use/ban of Pandemrix

Round-up of (open) EHRM

Round-up

• EHRM is “the practice of organizing decision making and taking actions upon known and perceived risks to environment and health”

• i.e. trying to influence what actually happens regarding risks

• Many factors drive RM - systematic science-based decision support (assessments) is one of them• Is or should it be the most important/influential?

Societal setting for RA/RM

Risk assessment is collection, synthesis and interpretation of scientific information and value judgments for use of the society

Risk management is use and implementation of that information

Round-up

• Systematic RM identifies needs for assessments and implements knowledge from assessments (and elsewhere) to practice

• Basically the aim of assessment and management is (or should be!) the same: good societal decisions and actions• -> Decision-oriented assessment (DA)

Risk analysis

Risk assessment Risk management

Hazard identification

Exposure assessment

Dose-response assessment

Options generation

Policy selection & implementation

Policy effect evaluation

Options evaluation

Risk characterization

Lessons from the KTL Centre of excellence in environmental health risk analysis

Does risk analysis pay off?

Risk assessment Risk management

Hazard identification

Exposure assessment

Dose-response assessment

Risk communication

Options generation

Policy selection & implementation

Policy effect evaluation

Options evaluation

Risk characterization

Million euro cycle

Billion euro cycle

General RA/RM framework

• Systematic analysis according to societal needs

Assessment Use

Assessmentprocess

Assessmentproduct

Decision making

Knowledgeneed

Productrequirement

Processrequirement

Why do we do modelling? (2)

Decision options are difficult to compare. Models can summarise important points and help us choose.

Round-up

• EH is complex in many ways• Causes, effects, actors, roles, relations, …• Physical, chemical, biological, social, technological,

economical, political, …• Many approaches exist, most confine themselves to

certain specifics of EH• Useful within their own boundaries, but not sufficient to

address all complexity of EH

NRC: Red book

Extrapolation

Measurements and population characteristics

Hazard identification

Dose-response assessment

Exposure assessment

Risk characterization

Regulatory options

Evaluation of options

Decisions and actions

Risk assessment Risk management

Observations

NRC 1983. Risk Assessment in the Federal Government: Managing the Progress. The National Research Council. National Academy Press, Washington D.C.

REACH – EU Chemical safety

Hazard assessment▪ Hazard identification▪ Classification & labeling▪ Derivation of threshold levels ▪ PBT/vPvB assessment

Exposure assessment▪ Exposure scenarios building▪ Exposure estimation

Risk characterisation

Information: available vs. required/needed▪ Substance intrinsic properties▪ Manufacture, use, tonnage, exposure, risk management

Dangerous or PBT/vPvB

Risk controlled

no yes

noyes

Iteration

Chemical safety report

ECHA 2008. Guidance on Information Requirements and Chemical Safety Assessment. Guidance for the Implementation of REACH.

Round-up

• The traditional model of separating expert, decision maker and stakeholder/public contributions does not serve “knowledge-based societal actions upon issues relevant to environment and health” optimally

• Well-reasoned, sustainable policies & practices?• Influence of assessment on policy/practice?• Meaningfulness/effectiveness of participation?

Purposes for participation

Other factors

Assessment

Participation

OutcomeDecision making

IDEA framework (IEHIA/INTARESE)

Briggs: A framework for integrated environmental health impact assessment of systemic risks. Environmental Health 2008, 7:61.

Round-up• EXAMPLE: climate change is a major (and extremely

complex) environmental health issue• Think of e.g. CC related decision making and actions in the City

of Kuopio• What risks are related?• What causes (for risks) are there?• What effects do they have?• Whose actions relate to the causes?• Who are influenced by the effects?• Who can influence (manage) the risks? How?• Who are relevant actors regarding the risks?• On what basis does/should they act upon the risks?

• Do common/traditional assessment/management approaches serve the needs of CC related DM?

Round-up

• No common solid theory for EHRM exists• Common frameworks are mostly procedural and

oversimplified• Reality of RM is sometimes far from what is

imag(in)ed in EHRM and assessment frameworks

• A proper theory should better• …recognize the nature of actual needs• …serve the plurality of ways to address the needs• …be applicable across the whole range of needs,

from the simplest to the most complex

EHRM framework

The Presidential / Congressional commission on Risk Assessment and Risk Management: Final Report Volume 1, 1997.

NRC: Science and decisions (Silver book)

NRC 2009. Science and Decisions: Advancing Risk Assessment. The National Research Council. National Academy Press, Washington D.C.

Round-up

• Change is needed… …and it is already starting to happen

• Assessment-management-stakeholders intertwined• Practice-driven (needs-driven) search for knowledge• Broad scoping: EH issues inherently within a broader

context• Opinions and values as valid inputs• Success determined according to outcomes

Research question for open risk management

How can scientific information and value judgements be organised for improving societal situations by identifying potential decisions and relevant outcomes in a situation where open participation is allowed?

Emphasis: The decision situation should be clarified.

Research question for open assessment

How can scientific information and value judgements be organised for improving societal decision-making in a situation where open participation is allowed?

Emphasis: The decision situation is clear, focus on evaluating and choosing good options.

Open risk management: overview

QRA

Round-up

• Methods, tools and practices to enable ORM/OA are being developed

• Collaborative learning• Technical support for:

• Collective knowledge creation (=learning)• Implementation of knowledge

• …in a social context, for practical needs• E.g. Opasnet

Three metaphors of learning

Round-up• (increased) openness becoming easier to reason for and

easer to be accepted, but many hindrances exist in practice• A cultural change is needed• Plenty of examples come up everyday

Purpose

Method

System

OutcomeUse

Round-up

• From• Process-centeredness• Separation and disengagement• Narrow scopes• Individual learning (monologue)• Producing and sharing information (dialogue)• Curiosity-driven question setting• …

Round-up

• Towards• Focusing on content• Openness (in all its aspects)• Rich contextuality and situatedness• Collaboration, co-creation of knowledge (trialogue)• Practice/needs-driven questions• Outcome-orientation• …

Open risk management

A collaborative game ofquestions and answers

Experts

PublicStakeholders

Decision makers

Other influence

Outcome

Outcome Outcome

Opasnet

Assessment

Participant’s knowledge

Participant’s knowledge

Participant’s knowledge

Participant’s updated knowledge

Updated assessment

Participant’s updated knowledge

Decision

Decision m

aking

Perce

ption

Perception

Contributio

n

Con

trib

utio

n

Pohjola et al. State of the art in benefit-risk analysis: Environmental health. Manuscript.

Outcome-oriented modelling approach

Matthews et al.: Raising the bar? – The challenges of evaluating the outcomes of environmental modelling and software. Environmental Modelling & Software, March 2011, Pages 247-257.

Properties of good assessment

Round-up summary/conclusions

• In the end it is all about developing well-founded shared belief systems to guide actions upon issues with great societal relevance

• Intentionally created collective knowledge is a means towards (collectively) desired ends

Example: what makes a good hammer?

Development of shared belief systems

Science and shared belief systems

• Falsification and “scientific method”

• Justified true belief and its problems

• Inference rules

• Shared belief systems

• Shared belief systems as artifacts (intentionally produced objects)• Hypothesis development and testing

• Abductive reasoning and argumentation• Game of questions and answers

• Evaluation of page content in Opasnet

Different ways of sharing knowledge in a group

• Live discussion

• Written discussion

• Formal argumentation

• Quantitative model

• There is a need for tools that bring these different ways closer and make it easier to cross the barriers.

Objective: improve action as much as possible

• Does not require that everybody understand the knowledge, as long as the knowledge guides them.

• It is enough that people accept and act based on the outcome of a discussion by the group, even if they don’t know the details, understand them, or even agree with them.• Example: Pandemrix use?

Scientific method: steps

Mathematical method

Scientific method

1 UnderstandingCharacterization from experience and observation

2 Analysis Hypothesis: a proposed explanation

3 SynthesisDeduction: prediction from the hypothesis

4 Review/Extend Test and experiment

George Polya in http://en.wikipedia.org/wiki/Scientific_method

Inference rules: axioms and concepts.

• Axioms of open assessment define the things that cannot be verified by observation, so there is no other way to know but just to believe.

• Statement is a presentation of opinion or position about something that is (ie., a scientific statement) or something that should be (ie., a moral statement).

• A group in open assessment means one or more individuals who participate in some activity, e.g. performing or reading an assessment.

• A belief system is a collection of statements that are considered valid by a person or group.

• A belief system that is considered valid by a group is called a shared belief system.

Discussion rules in practice

• An argument is valid if it is promoted and not attacked by a valid argument.

• The order of arguments:1. Valid attacking arguments2. Invalid attacking arguments3. Valid defending arguments4. Invalid defending arguments5. Comments and branches

Successful attacks

• Successful attacks are based on arguments showing that the attacked statement – is not true or– is not relevant in its context and– the attacking argument itself is not attacked.

• Note: if a statement is weak– it is easier to defend– it has smaller impact on the resolution.

• Try to optimise the strength of your statements.

Inference rules (1/2)

• Anyone can promote a statement about anything. • A promoted statement is considered valid unless it is invalidated

(i.e., convincingly shown not to be true, or successfully attacked). • A priori beliefs are updated into a posteriori beliefs based on and

only on– observations (in case of scientific statements) or – opinions (in case of moral statements) and – open criticism that is based on shared rules. In practice, this means

the use of scientific method. • There may be uncertainty about whether a statement is true. This

can be quantitatively measured with subjective probabilities. • There can be other rules than these inference rules for deciding

what a group should believe. Rules are treated as statements. • The validity of a statement is always conditional to a particular

group.

Inference rules (2/2)

• If two people within a group promote conflicting statements, the a priori belief is that each statement is equally likely to be true.

• A statement always has a field in which it can be applied. By default, a scientific statement applies in the whole universe and a moral statement applies within a group that considers it valid.

• Two moral statements by a single group may be conflicting only if the fields of application do not overlap.

• Opinions of each person are given equal weight.

Evaluation of page content in Opasnet

Discussion

Argumentation on use/ban of Pandemrix