Science and Decisions National Research Council; Division on Earth and Life Studies; Board on Environmental Studies and Toxicology
09/2009
eBook
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Risk assessment has become a dominant public policy tool for making choices, based on limited resources, to protect public health and the environment. It has been instrumental to the mission of the ...U.S. Environmental Protection Agency (EPA) as well as other federal agencies in evaluating public health concerns, informing regulatory and technological decisions, prioritizing research needs and funding, and in developing approaches for cost-benefit analysis.
However, risk assessment is at a crossroads. Despite advances in the field, risk assessment faces a number of significant challenges including lengthy delays in making complex decisions; lack of data leading to significant uncertainty in risk assessments; and many chemicals in the marketplace that have not been evaluated and emerging agents requiring assessment.
Science and Decisions makes practical scientific and technical recommendations to address these challenges. This book is a complement to the widely used 1983 National Academies book, Risk Assessment in the Federal Government (also known as the Red Book). The earlier book established a framework for the concepts and conduct of risk assessment that has been adopted by numerous expert committees, regulatory agencies, and public health institutions. The new book embeds these concepts within a broader framework for risk-based decision-making. Together, these are essential references for those working in the regulatory and public health fields.
Earthquakes, floods, drought, and other natural hazards cause tens of thousands of deaths, hundreds of thousands of injuries, and billions of dollars in economic losses each year around the world. ...Many billions of dollars in humanitarian assistance, emergency loans, and development aid are expended annually. Yet efforts to reduce the risks of natural hazards remain largely uncoordinated across different hazard types and do not necessarily focus on areas at highest risk of disaster. Natural Disaster Hotspots presents a global view of major natural disaster risk hotspots – areas at relatively high risk of loss from one or more natural hazards. It summarizes the results of an interdisciplinary analysis of the location and characteristics of hotspots for six natural hazards – earthquakes, volcanoes, landslides, floods, drought, and cyclones. Data on these hazards are combined with state-of-the-art data on the subnational distribution of population and economic output and past disaster losses to identify areas at relatively high risk from one or more hazards.
Before Fukushima, the most notorious large-scale nuclear accident the world had seen was Chernobyl in 1986. The fallout from Chernobyl covered vast areas in the Northern Hemisphere, especially in ...Europe. Belarus, at the time a Soviet republic, suffered heavily: nearly a quarter of its territory was covered with long-lasting radionuclides. Yet the damage from the massive fallout was largely imperceptible; contaminated communities looked exactly like noncontaminated ones. It could be known only through constructed representations of it. InThe Politics of Invisibility, Olga Kuchinskaya explores how we know what we know about Chernobyl, describing how the consequences of a nuclear accident were made invisible. Her analysis sheds valuable light on how we deal with other modern hazards -- toxins or global warming -- that are largely imperceptible to the human senses.Kuchinskaya describes the production of invisibility of Chernobyl's consequences in Belarus -- practices that limit public attention to radiation and make its health effects impossible to observe. Just as mitigating radiological contamination requires infrastructural solutions, she argues, the production and propagation of invisibility also involves infrastructural efforts, from redefining the scope and nature of the accident's consequences to reshaping research and protection practices. Kuchinskaya finds vast fluctuations in recognition, tracing varyingly successful efforts to conceal or reveal Chernobyl's consequences at different levels -- among affected populations, scientists, government, media, and international organizations. The production of invisibility, she argues, is a function of power relations.
Genetic engineering has a wide range of cultural, economic, and ethical implications, yet it has become almost an article of faith that regulatory decisions about biotechnology be based only on ...evidence of specific quantifiable risks; to consider anything else is said to "politicize" regulation. In this study of social protest against genetically engineered food, Abby Kinchy turns the conventional argument on its head. Rather than consider politicization of the regulatory system, she takes a close look at the scientization of public debate about the "contamination" of crops resulting from pollen drift and seed mixing. Advocates of alternative agriculture confront the scientization of this debate by calling on international experts, carrying out their own research, questioning regulatory science in court, building alternative markets, and demanding that their governments consider the social and economic impacts of the new technologies. Kinchy focuses on social conflicts over canola in Canada and maize in Mexico, drawing out their linkages to the global food system and international environmental governance. The book ultimately demonstrates the shortcomings of dominant models of scientific risk governance, which marginalize alternative visions of rural livelihoods and sustainable food production.The hardcover edition does not include a dust jacket.
Summary Background Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease ...analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. Methods We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability YLD and years of life lost YLL) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. Findings In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% 95% uncertainty interval 6·2–7·7 of global DALYs), tobacco smoking including second-hand smoke (6·3% 5·5–7·0), and household air pollution from solid fuels (4·3% 3·4–5·3). In 1990, the leading risks were childhood underweight (7·9% 6·8–9·4), household air pollution from solid fuels (HAP; 6·8% 5·5–8·0), and tobacco smoking including second-hand smoke (6·1% 5·4–6·8). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2–10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0·9% (0·4–1·6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, Andean Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, most of Latin America, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania. Interpretation Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children. Funding Bill & Melinda Gates Foundation.
Fungicides are indispensable to global food security and their use is forecasted to intensify. Fungicides can reach aquatic ecosystems and occur in surface water bodies in agricultural catchments ...throughout the entire growing season due to their frequent, prophylactic application. However, in comparison to herbicides and insecticides, the exposure to and effects of fungicides have received less attention. We provide an overview of the risk of fungicides to aquatic ecosystems covering fungicide exposure (i.e., environmental fate, exposure modeling, and mitigation measures) as well as direct and indirect effects of fungicides on microorganisms, macrophytes, invertebrates, and vertebrates. We show that fungicides occur widely in aquatic systems, that the accuracy of predicted environmental concentrations is debatable, and that fungicide exposure can be effectively mitigated. We additionally demonstrate that fungicides can be highly toxic to a broad range of organisms and can pose a risk to aquatic biota. Finally, we outline central research gaps that currently challenge our ability to predict fungicide exposure and effects, promising research avenues, and shortcomings of the current environmental risk assessment for fungicides.
Summary
Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis.
Introduction
The International Osteoporosis ...Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2013. This manuscript updates these in a European setting.
Methods
Systematic reviews were updated.
Results
The following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture risk; general and pharmacological management of osteoporosis; monitoring of treatment; assessment of fracture risk; case-finding strategies; investigation of patients; health economics of treatment. The update includes new information on the evaluation of bone microstructure evaluation in facture risk assessment, the role of FRAX® and Fracture Liaison Services in secondary fracture prevention, long-term effects on fracture risk of dietary intakes, and increased fracture risk on stopping drug treatment.
Conclusions
A platform is provided on which specific guidelines can be developed for national use.
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